Saving Babies in Central Vietnam 2016: April 28, 2016 HBB for 36 participants in Vinh Linh

Our 36 new HBB Providers and our 6 facilitators and our interpreters. Woo Hoo!

Today we taught 36 new HBB Providers. Five physicians, 4 Physician Assistants, 22 Midwives, and 5 Traditional Birth Attendants. It was an amazing class and our new instructors did so well. Betsy and I (Harriet) spent the day mentoring the new instructors. Giving direction, helping with the skills practice, encouraging, consulting - but not teaching. We are so excited! The participants were really engaged and seemed to love the class.

The Neonatalie manikin is a wonderful teaching tool. Today we used 18 of them as we had 36 students. The students work in pairs. Each Neonatalie costs about $100, even at the developing country cost, so we have to take very good care of them. Here you see them relaxing at the end of a very hard day, with Betsy and I along side for encouragement!

Yesterday started with another amazing breakfast, served in the hotel. Although overcast, it was still hot all day.

We arrived at Vinh Linh in our van and our new facilitators/instructors immediately began rearranging the room and setting up the tables. We had 6 tables of 6 students each, with an instructor at each table. The room was not really big enough - worked fine but crowded. There is not any air conditioning so it was hot. Our participants and our instructors do not complain. Perhaps one of the most refreshing things about teaching in a developing country is the flexibility and gratitude of the students. And the instructors. Everyone works so hard and is appreciative of what they have and of what we have to offer. No complaining. No asking what time we will be through. Our 5 Traditional Birth Attendants got up at 4 AM for an AM class as they had to travel by motor bike from the mountains. They went home tonight and will be back tomorrow. The Vietnamese are lovely, friendly, engaging people. Smiles all around, as you will see in the pictures.

A huge thank you to Evann Bragg (Betsy's mother) for the knitted hats! Evann and her friends knitted infant hats so that each participant in our classes can receive a a hat to use for the first baby that they deliver. Each participant also receives a bag with a resuscitation bag and mask and a penguin suction.

The participants really paid attention during the didactic portions of the class and instructors were great at keeping them engaged throughout the class. Of course, the most fun is the practice and everyone loves to practice. Learning should be fun and we have a lot of laughs when teaching this class, even though it is very serious material. We start each class with introductions of the instructors and then we find out about the participants, It is really helpful for us to know the breakdown of physicians to traditional birth attendants. This class includes one of the physician directors of the clinic.

The clinic is surrounded by rice fields. As far as you can see. Water buffalo waddle in the rice paddies behind the clinic. The scenery is quite beautiful.

There are no gender bathroom issues at the clinic - or at least they are different. There is a WC and when you go inside there are stalls for Men and Women.

HBB is an active course with much practice of skills. We start with preparation for delivery, closing windows, turning on lights, getting equipment ready. Then we deliver the baby and dry, stimulate and warm. If the baby cries right away we give the baby to the mom, skin to skin, to feed. If the baby does not cry, we have to cut the cord, place on a flat surface, suction the mouth, stimulate to breathe, and, if the baby does not breathe, start breathing for the baby in 60 seconds. We use timers (on our phones) to mark the 60 seconds.

Break time is very important. Nguyet brings the food each day - yoghurt, cookies, and coffee - and everyone is quite excited for the food and spends the break time together talking and laughing. The participants are very careful to make sure that we, the instructors, have something to eat.

After break, we continue with practice on delivery, routine care, and the Golden Minute.

We all go out for lunch. The food is amazing and I, for one, am eating way too much. I want to try everything. Chopsticks are the norm, although cutlery is available on request and spoons are used for soup, served at almost every meal. We ended lunch with tea and passion fruit juice - so good!

After lunch, there is more practice with the Neonatalie manikins, and then discussion of the 'Danger Signs' - signs that a newborn may be having trouble with breathing or infection.

If you are a medical person looking at these pictures, you will notice that the resuscitation bag is different. It is an 'upright bag' and is not available for use the the United States. Laerdal developed the bag when HBB Master Trainers noted some of the difficulties using the traditional bag. This bag is much easier to use, particularly for those seeing the bag for the first time in this course. The bag position allows the user to have an easier time getting a seal between the face and the mask.

Each participant receives a certificate of completion. This is very important and everyone waits until all have received their certificates. There is applause and congratulations for all. Nguyet has lovely handwriting and is the one who puts the names on the pre-printed certificates. Thank you Nguyet!

Here you see her hard at work.

The final step in the actual class is learning how to take the resuscitation bags apart for cleaning and sterilization (they can be boiled). Warren does this part for us.

And, at the end of the day, the certificates! Everyone is so proud, as are we. Thirty-six newly trained women who now have more skills to safe the life of a newborn. Each going home with equipment to do so - equipment that can be cleaned and sterilized for repeated use. We also have six proud instructors - instructors who are skilled and are now gaining confidence at teaching this course.