- Improving Mother and Baby Health with Nurse Vered -
June 20, 2014
On behalf of Tag, I have just returned from my second visit to Indonesia is a beautiful land, full of surprises with wonderful people, and endless rice fields. As a nurse I was asked by Tag to initiate teaching methods that would increase the healthcare knowledge of community workers to help mothers and children. These activities contribute towards achieving the Millennium Development Goal 5: “reducing maternal mortality and achieving universal access to reproductive health”.
“Knowledge is power” has been my proverb for many years, so I closely identify with Tag’s motto of ‘sharing knowledge, changing lives’. Together with a local NGO, YAKKUM, we created a community health education project whereby I would teach in villages and health centers around Java.
Twice I had the honor to spend 3 weeks with local midwives, social workers, nurses, cadre (health care volunteers) and posyandus (lay people that help the midwives).
Let me share a few stories from the field that will show the importance of teaching local health care providers.
Newborn babies can have difficulty taking their first breath. If the midwife does not act quickly and correctly there is a fair chance that that baby, if he survives, will have some brain damage. When I asked what they do in such instances, some of the answers were worrying. One group told me proudly that they have a machine that will help the baby breath. That wonderful apparatus is kept in another room 3 minutes running from the delivery suite. Another group demonstrated that massaging the neck of the baby was their preferred treatment. I was happy that nobody wanted to turn the newborn upside down and shake him or her. We practiced CPR according to the international guidelines. When I returned after two months the people that I had taught were still practicing the correct procedure.
Transferring a pregnant women sitting straight in the front seat of the pick-up car after her amniotic fluid washed part of the umbilical cord to the outside was a common occurrence. Sadly, this can lead to the death of the baby. After explaining the importance of keeping the umbilical cord free from any pressure we practiced with a lot of laughter how to position the women in the back of the pick-up.
Hand washing was one of the subjects the alumni of the training during my first visit loved to teach. They all understood the importance of this simple act and that more then 50% of diseases can be prevented by proper hygiene. Learners had not realized that the water tap or the plastic cup used for rinsing their hands also needs to be cleaned.
Safe needle and syringe disposal In one hospital I saw a nurse vaccinating babies, and after the injection she covered the dirty needle again, which is regrettably an excellent way to spread Hepatitis and HIV. A small overflowing basin was full with used cotton wool balls, applicators, dirty syringes and covered needles. Upon my enquiry, it was explained that a nurse with gloved hands separates everything in order to send them to a place where the government will burn the needles. I looked and found an empty plastic bottle and taught the how dispose the used needles inside without ever touching them. This cheap and safe method was accepted with a lot of smiles, together we tied the bottle to the worktable encouraging all the staff to use it.
Hygiene In one hospital emergency room I noticed that all staff used a single stethoscope without cleaning it before or after use, which risked spreading infections throughout the staff. Upon understanding the dangers of this practice, we decided together to use hand sanitizer to clean the earpieces and drum after each use. When I returned 3 months later the physician proudly showed me his own stethoscope; everyone in the emergency room had received one from the hospital. New knowledge empowered them to act. Some midwifes used an unclean piece of string to close the umbilical cord after home deliveries, so we found a feasible solution to boil the string in the pot with their instruments.
Posters the size of a regular page, with best practice methods were used during and handed out after each teaching session. These laminated papers were copied and given to the participants who used them to continue the teaching. This empowered the learners and helped them to teach with correct material.
Learning from the learners is not less important then teaching. I received from one of the learners a recipe for persistent coughing. One cup of lemon grass tea in the morning, in the afternoon eat sawo fruit and at night drink sweet soya sauce with lime.
I only added that when a child has a respiratory infection it is important to put a pillow under his mattress to ease his breathing. I saw many small infants with a pillow under their head, bending their neck and making breathing even harder.
Curing diabetes by eating insects called oender oender, tiny crablike creatures, was another medical revelation for me. Insulin is not always available and I praised the cadre that taught me this. I only added information related to the importance of a balanced diet especially during pregnancy.
Thanks to the dedication of the amazing people at YAKKUM, this project enabled the training of hundreds of community and hospital healthcare workers, improving healthcare for many thousands of people.