Uganda Day 6 - Teaching time

 Today was the first day of our proper teaching. It meant an early start but I had slept well and my headache had gonr which was just as well! It was going to be a very busy day! 

We were not in the nursing school today as we were teaching the hospital staff. This didn't just mean nurses and doctors but included cleaners and lab technicians, the ambulance drivers and janitors. We collected the equipment.. dolls, stethoscopes, bag and masks, sheets and suction penguins and headed back over to the hospital. We only were given one area to teach in and we needed 2 separate areas, so myself and Claire set up tables and benches outside under some trees for shade and waited for our group of students to arrive. At some point today a local lady was coming to talk to both groups about menstrual hygeine but we weren't sure when she was going to arrive. So we started.! 

Teaching resuscitation here is slightly different as they do not have equipment for advanced resus so it was basic resuscitation... bag and mask ventilation and CPR if required. Firstly I ran through a resus situation whilst explaining every step, then I ran through it again with Claire as my help in real time.  We then split up the group into 2 and Claire took one half and I took the other so that every student would get a chance to try bag and mask resus and CPR. This is where the fun began. Initially they were hesitant to join in and I found that a good way to encourage participation was to take the baby away from the resus area and place it further away as if baby had been born in a different place. The person doing thebresus then __had to run and retrieve the baby and take it back to the resus area. This caused a lot of laughter and broke the ice in the group. Whilst I was running through reaus scenarios, I was keeping an eye out for people who showed particular aptitude so that we could earmark them as future trainers of resus. 

Whilst I was training them I didn't ask what their job was in the hospital... technically it didn't matter. Out here any one of them could be easily in a position where they needed to resuscitate a baby, even if it was their sister's child or just walking down the road to the hospital. 

We had a lot of fun and also I found that this group of professionals had some very good questions. I had the doctor in my group. and he asked what I would do if the heart rate was still low and the baby wasn't breathing at 20 minutes. I said that in the UK, we would consider stopping resuscitation at this point. Here they do not have provision to look after children with cerebal palsy well and it is much harder for the family to support disabled children.... 

The lady who came to talk about menstruation came, only she had been told she had the whole day, whilst we had only given her an hour, as we had to test all the staff on what they had learnt about neonatal resus.

She started her talk about hygeine in general and we were sitting in the shade as much as possible. The otehrs were being good and listening intently to her talk, at the beginning, whilst I was making more friends with the local. kids. I handed out some pencils and paper that I had brought and did some. writing with them. One of them in particular stuck to me like glue and wrote me a note 'I want to be your friend'. Done! Friends for life. One of the children came back and gave me an orange as a thank you flr the pencil! One boy, a patient at the hospital had a cannula in his hand. He said that he had not eaten for three days. We asked about where his family were, as usually here the family would stay in the hospital with the patient and cook and clean for them. He said he had no family.   I dug out the orange that the girl had given me and gave it to him.

It can be hard out here... you want to help all the kids but it is very difficult to help them all so we give them toys and books and pencils.

The menstruation lady (Margaret) finally got to the important bit of her personal hygeine talk... we were joking that she had taken lessons from the bishop yesterday for long windedness! She started talking about menstrual hygeine. Some of the girls in other villages use soil or banana leaves instead of sanitary towels. Some girls go and sit on a rock or over a hole for 7 days, missing school, until their period has finished.

Here most of them. said they had access to either diaposable sanitary towels or reusable cloths which they washed. It was very interesting. The few men in the group listened attentively but the older man in the group didnt want to touch the sanitary pad  It was all very interesting.

When Margaret had finished, we went back to our groups and carried on with the resus training until lunchtime.

We had had no electricity this morning, which isnt unusual around here and it still hadn't come back on by lunchtime. So we fired up the gas cyclinder and Gillian and Claire made lunch... fruit and rice cakes with peanut butter. Bread was out as the ants had got into the bread... it was covered with ants and when I took out a slice... lots of ants fell onto my plate. The dates were in a similar state but they could be washed off! Most of the problems came from the fact that with no electricity, the fridge was off and the ants were then happy to invade. There were ants in lines up walls and along the sink but they hadn't been such a big problem until now. Neither were the other residents of our accomodation. Cin the cockroach and Gary the gecko, along with gary junior, generally kept out of our way, scuttling along the floor when we switched on our torches or the main light (when we had electric).

After lunch we switched the groups over and went through the whole process again. Whilst me and Claire were teaching the resus, Sam and Gillian were teaching birth emergencies such as PPH (hemorrhage) and breech delivery. Whilst we were teaching resus or perhaps if I finished before time was up, I tried to teach a bit about neonatal infection and resognising a baby who is becoming sick. Its hard when you dont know whether they have the equipment to do the monitoring that we do, so I asked questions of the staff too.  It was 2 way learning in action!

Claire, at one point had to stop teaching, because one of the turkeys babies was nibbling on her toes under the table.... We were definately not in the UK! 

Once the teaching had finished, we set up a third table and one by one they came over and ran through a test resus situation. Some of them were excellent and clearly had taken on board everything we said, others were less sure and struggled... but we had to remember that some of them were not nursing or midwifery staff and may work in the lab.  I had also collected round my table during thebday an assortment of children and mothers, some patients, some of them. mothers of patients. They were very good and listened intently to what I was teaching. 

Once we had deemed the staff passed, they went back to Gillian to receive a certificate and their payment for coming to the training.

Near the end of the testing session, I had one student who was struggling a little and one of the mothers, carrying her 4 month old, chimed in to help her. She knew exactly what to do. When my student had finished, I asked the mother who had helped the student if she worked here. No she said, my son is a patient!  She said she wanted to have a go at doing the resus.... so I got Claire to hold her child (which she was very happy to do) and took this mother through a resus scenario. She was spot on. I ran over to Gillian and got her a certificate and ran back with it. Myself and Claire both told her that she should try and start training as  a nurse. Even if she ended up unable to do this, she would now be able to help women in her family if a child was born needing help.

Gillian kindly gave her some money, even though she wasn't staff because she had clearly listened to the training and taken it on board. It was a wonderful moment that stood out in a week full of wonderful moments so far!

We headed back to our accomodation later than expected, exhausted but very pleased with how the day went.  Less pleasing was the fact that we still had no electricity! We were also running out of bottled water so myself and Sam volunteered to walk into the village to pick up some more bottles. No one else wanted to come so we strolled down the street with a list of things to pick up... Water, avocados, and if possible some ginger beer called Stoneys. We wandered round some of the  street stalls looking for avocadoe. When we found them they only cost 500 shillings each... barely anything so we brought 2. Further on we found the people we had bought the jackfruit off before and bought another 2 bags.. again for pence.  Everywhere we went we told them to keep the change!

We walked past a stall selling chapattis and I couldnt resist..  they were hot and tasted really good. We found a place selling bottles of water so picked up a few and then my master plan came into action. Gillian wasn't with us and we were laden down with stuff... well not that laden but it was a good excuse.... We negotiated a price for 2 boda boda and hopped on the back of the motorbikes and away we went... me saying faster faster, sam saying slower slower... it was great fun and cost next to nothing. What happens in Ngora, stays in Ngora.

When we got back to the hospital we noticed that the bats were starting to come in to roost and we went for a quick wander to find the trees they went in for the night...

We found a tree and spent 10 minutes, our necks craned upwards, wathcing the bats come in, hang upside down and get comfy for the night. It was a really cool thing to see.

We got back to find dinner nearly ready and still no electric. All the other houses seemed to have light, it was just us without! So we cooked, ate and cleaned up by torchlight, which was kinda fun. I think the others were getting a bit bored of it... but I had a battery pack with lots of charge and no internet anyway. My internet had run out and for some reason wouldn't recharge.

I can hot spot off one of the others Ugandan sims to post to the blog site but Ugamda has a tax to use social media, which means Facebook doesnt work so well making it very difficult to post photos and updates to my facebook page, so I will have to catch up when I get wifi in Kampala or when I get home... its not the end of the world!

Given the lack of light, after a quick after dinner chat, we headed off to bed in the hope electric would be restored the following day. Myself and Sam had a very quick night walk, where we saw a little mouse scurrying away from us and a few toads, but that was it. 

I fell asleep almost immediately, despite how warm it was in my room. Tomorrow.. another day of training. Hopefully we are making some kind of impact.