Teaching Safe Delivery Practices
Eastern Division faculty members train physicians, midwives, and nurses in Rwanda
The most common causes of maternal and fetal death in developing nations, such as Rwanda, include maternal hemorrhage, shoulder dystocia, a condition where the baby’s shoulders get stuck inside the mother’s body and cannot pass into the birth canal, and infant breathing problems. Several WVU Health Sciences Center Eastern Division faculty members and Department of Family Medicine residents returned from a 17-day medical mission to Rwanda, where they taught 85 Rwandan nurses, midwives, and physicians about safe childbirth practices.
Participants included Rosemarie Cannarella Lorenzetti, MD, MPH, co-founder of the WVU Rural Family Medicine Residency Program; David Baltierra, MD, WVU Rural Family Medicine Residency Director; Angela Oglesby, MD, WVU Rural Family Medicine Residency Associate Director; Amy Lohman, MD, a third-year resident, and Chief Resident, Lola Burke, MD, who is staying on as Family Medicine faculty after graduation in June.
Dr. Lorenzetti noted that family medicine is a relatively new specialty in Rwanda. She and her team taught healthcare providers at Rwinkwavu and Musange district hospitals and a health center in the capital city of Kigali. They used the “Helping Babies Breathe” and “Helping Mothers Survive” programs, both of which rely on patient simulators. Patient simulators are training manikins, life-sized anatomical human models used to help train people on medical procedures – much like the manikins used for CPR classes.
“Helping Babies Breathe” is an initiative of the World Health Organization that helps to train birth attendants in developing countries the essential skills of newborn resuscitation, to have a health worker attend each birth, and to ensure infants are breathing well within a minute of birth or be ventilated. “Helping Mothers Survive” teaches health workers skills in prevention, detection, and management of postpartum bleeding.
The Eastern Division team took two MamaNatalie birth simulators and seven NeoNatalie baby simulators with them as well as extra reusable suction bulbs, infant masks, and resuscitation equipment. MamaNatalie is the name of a manikin used to simulate childbirth, delivery, baby positioning, and fetal heartbeat. NeoNatalie is a newborn manikin that can simulate birth cries, umbilical pulse, spontaneous breathing, and heart sounds, making the teaching of resuscitation techniques more life-like.
“'Helping Babies Breathe,' utilizing NeoNatalie, and 'Helping Mothers Survive,' using MamaNatalie, teach safe delivery practices, with a focus on reducing most common causes of maternal and fetal death in developing nations – maternal hemorrhage, shoulder dystocia, and recognition of post-delivery fetal distress and apnea,” Lorenzetti said. “This equipment was new to most of the class attendees and the use of the equipment was reviewed and taught to attendees, with emphasis placed on the team approach, recognition of distress in mother and baby, and continued efforts to train others.”
Another great need in Rwanda, Lorenzetti said, is for respiratory support equipment such as nebulizers and inhaled bronchodilators. The Eastern Division team also shared some of those resources.
“Most of the equipment was left in Rwanda for the teams to continue to practice techniques and train others,” Lorenzetti added. “We also assessed additional equipment needs.”
“It was a valuable first trip to evaluate the possibilities of instituting an educational exchange with the family physician group in Rwanda and those here in WVU Eastern Division. The WVU doctors certainly learned more than they taught and look forward to future educational exchanges.”
The Eastern Division group received donations from Jefferson Medical Center physician staff and Berkeley Medical Center physician staff to support the cost of the trip for the resident physicians. Funds raised by WVU School of Medicine’s Alpha Omega Alpha (AOA)Honor Medical Society and a donation by the Eastern Panhandle Medical Society supported the purchase of the simulation equipment used for the educational classes.