News and updates from Paul and Cathy Middleton, serving in southern Africa.

21 February 2017

Breath of Life in the Switzerland of Africa


In February, Mercy Air had the privilege of partnering with The Ohio State University when they travelled to Swaziland to provide training in Neonatal Survival. Our friends Roger and Katy Pacholka (In His Name Ministries and partners of Mercy Air) have had many years of involvement with one of the major hospitals in Swaziland and offered assistance in helping to reduce the infant mortality rate by providing training.

The Swazi Department of Health embraced the idea and a group of neonatal nurse practitioners, a neo-natologist and nurse midwives from The Ohio State University ran a course for three weeks on ‘Helping Babies Breath’ and Neonatal survival. Cathy was privileged to be part of the team as a nurse/midwife.
The course had 21 participants and included nurses, midwives, doctors and pediatricians from six hospitals in Swaziland.
It included theoretical class room sessions and practical training on manikins, learning the skill of using the bag valve mask.

Students were taught how to give babies ventilation and assess the heart rate working together as a team.

A lot of concentration and co-ordination was required!

Some interesting fun role play simulating a delivery (even the guys had a go at giving birth) and care of the baby immediately after birth.
Women come from villages far away up to a month before their due date and wait in this expectant mother's house. It's very basic but beats having your baby along the road or in a taxi.
Women in early labour wait outside the labour ward and are left to cope with their pain alone.
In the labour and delivery room there is very little privacy and the mothers labour without support from their relatives.
After all the hard work this lady was very tired but grateful to have a beautiful, healthy baby boy.
After the delivery the babies are brought to another room where they are given further resuscitation if needed. Our students assessed them and used their new skills.
There is a high HIV positive rate amongst the population of Swaziland but prevention of mother to child transmission (PMCT) is helping to reduce this. Babies born to HIV positive mothers are started on ARV's immediately after birth.
Babies were given a full examination by our students to detect any abnormalities.

Our students did a Ballard Test to determine the gestational age of the babies, a useful tool as many of the women are unsure of their due date.

Rubbing a baby to stimulate it.
 
Some babies required oxygen after delivery to help their transition into life outside the womb.
Examination of the babies after delivery is part of the training, here the student is listening to the heart to detect any murmurs.
Dr. Louis, a neo-natologist worked in the special care baby unit giving support and advice.

This tiny baby girl weighed in at only 900 grams, after being assessed we found that she was 31 weeks old.
Here she is after a couple of days, doing well and enjoying some skin to skin contact with mummy. Kangaroo care is frequently used for these premature babies.
An interesting case was of a mother, Futhi, who was in labour for most of the day and failed to progress so was transferred to theater for cesarean section. She was very afraid that her baby might die.
Skilled doctors delivered this strapping boy by cesarean section.

Our students together with instructors were present at the birth and provided resuscitation of a  baby boy.
He weighed in at 4.7 kg (10.34 lbs)!
Our students did a great job of keeping him warm, stimulating him and clearing his airways. He thanked them with a vigorous cry.
Cathy with the baby a day after his birth.
A very relieved, happy mummy and baby!
A baby abandoned whilst the team was at the hospital also gets care.
These lovely ladies (some of our students) are getting ready for graduation.
Thank you.

Cathy.