Friday, 5 March 2010

Training on emergency care in Bo

I have spent the last five days in Bo, I have barely spent much more than a week in one place since I arrived in Sierra Leone two months ago. My first two months here have flown by and I am enjoying my work immensely, I do feel a bit like a tortiose carrying it's house around as I am permanently living out of my rucksack!

I got back to Freetown last night having spent the week in Bo, at the Government Hospital, as one of the facilitators of a four day training course. The course is designed specifically for health workers providing maternal and newborn care in low resource countries by the Liverpool School of Tropical Medicine [LSTM]. It is an extremely comprehensive course aimed to equip health workers with the skills to recognise complications and effectively manage maternal and newborn emergencies in order and reduce the high number of deaths of mothers and babies.

The participants were made up of four midwives and 27 MCHAs - who although are not as highly trained as midwives are the frontline workers in Sierra Leone; they deliver a huge amount of the care of women and babies and are the ones who are working (often as the only health worker) in remote, rural areas. It is essential for them to have the skills being taught on this course both to enable them to be able to identify when a case is outside their scope of practice and needs referral but equally importantly how to manage these emergencies whilst transfer to a hospital is arranged. Transferring a woman or baby to hospital can take many hours because of the poor infrastructure and limited transport options here. Women and babies lives will be saved if these health workers can implement life saving measures.

We were 8 facilitators in all, half from in country and the others who facilitate the courses for LSTM from UK and Nigeria. I really enjoyed working with the other facilitators and there was a great team spirit throughout the week. Jen, Jo and I enjoyed walking around Bo, some fabric shopping and cold drinks together in the evenings. We were all lucky to have Alpha with us who now lives in the UK but is from Bo, he made sure we got to and from the hospital everyday and brought us delicious home cooked food from his family.

The enthusiasm and committment from the participants (many of whom are only just completing their training and were being taught many of the skills for the first time), was inspiring and enabled us to get through an intense four days of training in 30+ degree heat, trying to be heard over the noise of two generators with smiles on our faces and a real sense of achievement. Especially as the pre and post course assessments of the participants knowledge and skills showed a marked improvement.

I think Gladys who ensured we were all well fed had a large part to play in the smooth running of the four days too. She served us such huge platefuls of lunch that we were nearly able to feed half the hospital, as we all needed to share our portions. She managed to serve something different everyday and each dish was delicious, especially Jollof rice with fried chicken and pepper sauce. I'll be writing from Makeni next as I leave on sunday for work at the Midwifery School on monday. Pictures to follow, internet not fast enough right now!


  1. I'm really enjoying your blog and am finding it very inspiring. The video was great - really bought it all to life and wasn't too wobbly at all!
    Anne ( newly qualified mw, did my options placement in Uganda and hope to do VSO one day)

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  3. Hi Zoe - it's your cousin here, Karen Palmer. Your mum forwarded your web page to me. You are doing a fantastic job - well done you. Have also posted your web page to my brother in LA so that he can see how well you are doing. Keep up the good work and hope to see you when you get back. Karen xxx

  4. Hey there! Thank you for posting this information about emergency care. You have such an very interesting and informative page. I am looking forward to visit your page again and for your other posts as well. Keep it up! I'm so glad to pass by your page and to have additional knowledge about emergency care.
    Well, I'd like to add that I have read in one article that emergency medicine encompasses a large amount of general medicine and surgery including the surgical sub-specialties. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them after treatment as necessary. The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. Emergency physicians must have the skills of many specialists—the ability to resuscitate a patient (critical care medicine), manage a difficult airway (anesthesia), suture a complex laceration (plastic surgery), reduce (set) a fractured bone or dislocated joint (orthopedic surgery), treat a heart attack (cardiology), work-up a pregnant patient with vaginal bleeding (Obstetrics and Gynecology), stop a bad nosebleed (ENT), place a chest tube (cardiothoracic surgery), and to conduct and interpret x-rays and ultrasounds (radiology).
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  5. Hi there! Keep it up! This is a good read. You have such an interesting and informative page. I will be looking forward to visit your page again and for your other posts as well. Thank you for sharing your thoughts about Emergency Care. I am glad to stop by your site and know more about Emergncy Care.
    Emergency medicine (EM) as a medical specialty is relatively young. Prior to the 1960s and 70s, hospital emergency departments were generally staffed by physicians on staff at the hospital on a rotating basis, among them general surgeons, internists, psychiatrists, and dermatologists. Physicians in training (interns and residents), foreign medical graduates and sometimes nurses also staffed the Emergency Department (ED). EM was born as a specialty in order to fill the time commitment required by physicians on staff to work in the increasingly chaotic emergency departments (EDs) of the time. During this period, groups of physicians began to emerge who had left their respective practices in order to devote their work completely to the ED. The first of such groups was headed by Dr. James DeWitt Mills who, along with four associate physicians; Dr. Chalmers A. Loughridge, Dr. William Weaver, Dr. John McDade, and Dr. Steven Bednar at Alexandria Hospital, VA established 24/7 year round emergency care which became known as the "Alexandria Plan". It was not until the establishment of American College of Emergency Physicians (ACEP), the recognition of emergency medicine training programs by the AMA and the AOA, and in 1979 a historical vote by the American Board of Medical Specialties that EM became a recognized medical specialty. The first emergency medicine residency program in the world was begun in 1970 at the University of Cincinnati and the first Department of Emergency Medicine at a U.S. medical school was founded in 1971 at the University of Southern California.
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