Train the Trainer & Kodak Moments

Saturday 6 October—Bonga, Ethiopia--lush, green, and beautiful landscape, warm and gentle people...

I reflect on today and yesterday with wonderment.    And now as I type, I hear the gentle but steady split-splat upon the corrugated tin rooftop that provides shelter to this guesthouse.  Now the rain is coming down faster and faster—tap tap tap tap tap.

And almost as quickly as it started, it has now come to an end…with simply the thud thud thud of what sounds like a single stream of rain repeatedly hitting the same target on my roof above.  Perhaps I’ll open the window before I sleep (good thing for mosquito nets!) to allow the fresh night air to flow freely in my modest but comfortable room.

Back to the past two days—yesterday, we conducted an ALSO Instructor course for a dozen of the most motivated students who completed the ALSO Provider course.  These were primarily medical interns (see 4 Oct entry for further details).  They did a phenomenal job preparing their brief lectures ahead of time.  One or two really grasped the concept of providing feedback in relationship to how well the student taught or conveyed information, rather than focusing on the lecture content itself.  I think they got stretched beyond their comfort zone as they learned to give feedback to one another, and in the process, further develop their skills as teachers.  At the end of the day, we “graduated” a dozen of Jimma University’s first ALSO Instructor Candidates.  And 5 of them volunteered to use their vacation time to join us in Bonga to teach an ALSO Provider Course to midwives and health officers next week.  Win-win situation, but in the immediate short-term, a windfall for us.  They bring with them not only energy and zest, but also language skills that will help bridge the gap between the learners and us.  God is so very good and faithful.

Speaking of which, before we left Jimma on Saturday, I was able to connect with the BLSO Course coordinators in Addis.  Dr. Lou will be the course director – he and Jenny split from our team to head north to Addis for this purpose – but the course itself is being coordinated through Addis Ababa University/Black Lion Hospital.  I’d previously suggested to Project Mercy that they send 2 nurses to this training but hadn’t heard an update…then touched base with Deme on Friday, who confirmed that two midwives had been identified by Dr. Fekadu…but how to get them registered at this late hour?  As the Lord wills, that’s how!  I spoke with Dr. Sofia, the appointed Ethiopian ALSO Champion, who connected me with Dr. Aklilu and Haimonot in Addis.  After a few persuasive conversations, they agreed to accept two new students, our Project Mercy midwives.  A call to Dr. Fekadu in Yetebon and  a few more text and email exchanges, and it seems that these two midwives will indeed travel to Addis on Monday for the three-day training.  They will return to Yetebon as BLSO Instructor Candidates, ready to teach their first course with the Zubers and me 18-19 Oct.  How the Lord provides!!

Our drive to Jimma was beautiful and rather uneventful, save the stops to capture “Kodak moments” and interact with the baboons traipsing along the road, eager to steal a snack from a willing driver.  The team split in two—one half staying in town at “Coffeeland Hotel” with the rest of us staying at the guest house at the edge of town—a lovely, quiet dwelling nestled upon a hill with visions of colorful flowers, fragrant trees, and the sounds of dozens of songbirds filling our senses.  We enjoyed a quiet evening of much-needed rest.

Sunday 7 Oct—we awakened with a plan: hiking to the waterfall.

We parked at the Catholic Mission and were blessed to hear the sound of hundreds of voices singing songs of praise.  Two school-aged boys voluntarily led the way up the muddy, uneven path flanked by tall eucalyptus trees.  On the way back, I was flanked by two young boys, each holding my hand…one a little more eagerly and longer than the other.  On my iPod I listened to “On Christ the solid rock I stand, all other ground is sinking sand…” with such joy in my heart.  Any time I freed my hands to snap a picture (or two or a thousand), the boy on my left would immediately place his so I could easily grab it again.  Such warmth.  I thought to myself, these two precious boys beside me are like Ashley and Harrison roaming freely through the forest, befriending a stranger and leading him or her along the way.  Hmmm.

Moved

(Late posting due to lack of internet access--in the interim, we've completed training in Jimma and Bonga, visited Chiri, and now am back in Addis for a few days before heading south to Yetebon)

4 October 2012--Jimma University School of Medicine:  Today marks the end of our first ALSO Provider Course, which we taught over 3 days.  Let’s just say our team is exhausted but thrilled!  25 of the 27 students who tested passed the course!! (>30 people attended the course each morning, but several of the OB residents did not complete the course because they spent the afternoons studying for their advancement exam on Monday.)  And we are revving up for a one-day Instructor Course tomorrow, for which 12-13 students are enrolled.  Then, up to 5 of tomorrow’s students, “Instructor Candidates” will join us in Bonga to teach a series of courses to midwives and health officers (Mon-Wed) and health extension workers (Fri-Sat).  This fulfills one of our team’s primary missions—to not only provide training, but to “train the trainer” so that the information can be meaningfully propagated in a way that is put into effect to improve outcomes for moms and babies.

Two instances particularly moved me today.

The first was this morning, when a senior OB resident requested a CD I’d prepared with various references for teaching future courses.  We navigated through each folder, and he shared with me his desire to incorporate the ALSO Course into OB intern orientation!!  YES!  I highly applaud this idea and will make myself available through email or whatever means to help, as needed.  I then encouraged him to consider taking groups of senior OB residents to rural communities and teaching the BLSO Course to the front line workers of the community health posts.  To build bridges via community outreach.  To gain at least a glimpse/first-hand understanding of the circumstances in which rural providers must operate.  And to provide guidelines for prenatal and intrapartum care which result in improved outcomes.

The second instance was this afternoon.  During the course, it became obvious that the language skills among the learners were quite variable.  To maximize our ability to communicate clearly, we invited several of the interns (actually 5^th year medical students who, upon graduation, will spend 2-4 years “paying back” the government in return for their medical education; the number of years correlates with the location where they serve—the more rural/removed, the less time required) who had completed both the written and practical aspects of the test to assist us with the “megadeliveries” via serving as translators.  They agreed—we only needed 3 students, and that’s what we got.  They were truly a Godsend.  I am so proud of them, their work ethic and willingness to go above and beyond!

Calling it a night—

Sarah

Birds, Butterflies, and Baboons

0600 3 Oct, looking out my balcony window I see colorfully-clad women walking the packed red clay street.  3-wheeled taxis vie for passengers amidst the bright blue buses.  There is a constant rumble of motors running, and the air has a somewhat burnt smell and haziness about it. Beep! Goes the taxi driver, followed by the deeper honk! of a bus.  It is the start of a new day, and I pause to reflect on what’s passed since our arrival.

Mon, 1 Oct: The windy road to Jimma brought with it vibrant views of post-rainy season (well, nearly post-rainy season--it poured again last night!!) hills lush with green grass, acacia and eucalyptus trees, and tall green forests.  Traditional tukuls and plentiful mosques dot the neighborhoods.  The sounds of warbling weaver birds punctuated the curvy drive now and again, and we were even blessed to witness a small flock of these bright yellow birds flit treetop to treetop, chirping merrily (and loudly) in their course toward their upside-down beehive-shaped nests.  Imagine my surprise when I spotted the grey-brown tail of a baboon, who then simply stared at me...what a treat!  And moreso, to see two maribou storks standing regally in a field of tall yellow grass.  Scarlet red poinsettia bushes and fields of meskel abeba (yellow "cross flowers") brightened the colorful landscape, along with the purple and green uniforms adorned by the schoolchildren walking along the roadside. Rainbows of patterned cloth swathed gracefully over women, many of whom carried the day's burden of water jugs atop their heads or bound wood upon their backs.  Such a life.  

The ride from Addis to Jimma took nearly 8 hours.  We filled our time with a mix of conversation, comfortable silence, and short catnaps.  I don’t know how Dawit managed to stay so focused and good-spirited for the entire drive, but I do know that I am thankful that he is with us for these two weeks!  Such a mild-mannered, gentleman with an easy warm smile, able to negotiate the crazy rush hour traffic of Addis Ababa without a blink of an eye and the windy mountainous roads without making us carsick-prone individuals lose our lunch.

Tuesday, 2 Oct was the first day of our initial ALSO Provider course.  We planned an 8am start time…but didn’t begin until close to 0930.  We planned for 32 students…and 38 showed up.  We planned to have 3 workstation rooms…and had to work really hard to find (and clean) 2.  God perpetually calls us to depend on Him to meet our daily needs, and today was no exception.  We learned to be flexible, to communicate effectively with our Ethiopian colleagues, and to “go with the flow.”  The students – ranging from health officers to nurses & midwives to medical residents – were attentive and, though initially shy, were easily engaged and shared beautiful smiles as we worked through the afternoon’s hands-on workstations (Maternal resuscitation/postpartum hemorrhage, Neonatal resuscitation, and Emergency breech delivery).  The last student of the day that I worked with smiled at me, said, “thank you, we love you so much.”  Unexpected but genuine warmth, so freely expressed in this beautiful culture, makes my heart swell, especially when I am missing the warmth of my family every day.  The Lord provides.

As I stand back a bit and consider all the hands that have made this one day alone possible, I am humbled and awed—but isn’t that just like God, to give us what we can handle in the increments we can handle?  It is so natural to get caught up in the “to dos” of each day—and indeed we are called not to worry, to focus on today, “for today has enough cares of its own…” and we are not promised tomorrow.  Yet I would be remiss not to consider the many arms and hands and eyes and ears—many members, one Body—that worked together to put this series of courses in motion.  The coordination between PeaceCare and the Peace Corps volunteers—I haven’t even talked about John and Mike, who are both completing their two years of service in Bonga, and who are young, capable, compassionate servants (with a good sense of humor and amazing command of Amharic, to boot!), and who’ve been instrumental in handling the on-the-ground logistics.  Meeting with the Jimma University OB faculty.  Securing a location for the course.  Inviting participants from places near and far.  Ensuring the twice-daily “shy/buna” (tea/coffee) breaks are woven into the schedule—non-negotiable!  Making last minute copies.  Getting SIM cards, flip charts, markers, and the like.  And not to mention our team of 7 professionals (6 physicians, 1 nurse) – we are gelling and working together in a way that makes it seem that we’ve known one another for much longer than the 3 months (or less!) it’s actually been…

So birds, butterflies, baboons…and BONDING.

A new day begins, and with it, much hope and inspiration to serve others and thankfulness for the opportunity to do so.

Sarah