This past week we have been hosting Dr. Michael and Sister
Liz Visick. They are short-term specialists (STS) for our church as part of it's Neonatal Resuscitation Training (NRT) projects.
Over the past 11 months that we have been in Indonesia we
have been trying to expand our relationship with a group called Perinasia on behalf of our church. Perinasia is a
group of highly qualified doctors that have committed themselves to saving
babies lives through the teaching of NRT.
They have done this for a number of years. The relationship with our church started
approximately 17 years ago when our mission president Dr. George Groberg came
to Indonesia to teach NRT as a STS and teamed together with Perinasia. Since that time over 10,000 medical personnel in
Indonesia have been trained.
Our goal since we have been here has been to develop a
project with Perinasia that would be able to continue on throughout the years. We would also like to be able to use our church's humanitarian funds in a way that we felt would be
useful. I (Eileen), with my background in
neonatal nursing and labor & delivery nursing, have a keen interest
in the area of NRT.
After several months of planning we were able to have a
project wherein we took Dr. Visick to an area in West Java called Bandung. West Java has a higher than normal (Indonesian average) newborn infant mortality rate, currently over 3/100. Statistically, world-wide, one in 10 babies born need some assistance breathing after birth and only 1/100 babies born need
extensive resuscitation.
Perinasia arranged for us to visit three healthcare facilities in the area. First we visited a referral hospital called
Rumah Sakit Hasan Hadikan. This is a
hospital that gets referred all the babies with complications from other smaller hospitals
and puskesmas’ (clinics) in the area. We
were especially impressed with two of the neonatologists Dr. Dadang and Dr. Tetty who took us on a tour there.
They obviously had a passion for their work despite their limited resources. They only had 5 respirators where they needed
10. There was a set of conjoined twins in their NICU that would eventually be separated. Their ER was full. One baby in the ER was admitted with severe
asphyxia and was being manually bagged by a nurse until he/she could be transferred
to another hospital due to the lack of an available respirator. The care that was being given looked
excellent, and the neonatologists were very knowledgeable.
The next place we went to was called Rumah Sakit Cicalengka,
a smaller hospital outside of Bandung. It admits babies which have complications following home births, at the puskesmas and expectant mothers with complications. Again I was impressed with the care that was
being given. The E.R. physician, Dr Lukeman, told us
about the need for more resuscitation equipment. In the NICU there were no respirators. Two babies were there that had been
asphyxiated at birth and then referred to this hospital. Unfortunately, at this
point although there is no way to know for sure, there is a high likelihood that these babies will be handicapped due to the
asphyxiation. The pediatricians here had the knowledge of how to care for the
babies and did their best, but were also without adequate equipment.
The third place we went was a puskesmas. Women who don’t deliver at hospitals either
deliver at home or a local clinic called a puskesmas. Officially there are 8 puskesmas that feed into Rumah
Sakit Ciralengka. However, about twice that number refer clients there. We visited the nicest puskesmas. It was extremely hot in the
delivery room. There were about 15 midwife
students that I enjoyed visiting with.
All of them had seen about 10 deliveries in the year they had been in
school. This particular puskesmas was
the only one that had any kind of resuscitation equipment - a suction bulb and one bag & mask (cost about $20). There was still no oxygen in the delivery
area.
On Saturday and Sunday we attended Perinasia’s teaching of
NRT to doctors and nurses. They were teaching very advanced skills
promoted by the American Academy of Pediatrics.
The challenge that we could see is that many of the people in this area
do not have the equipment to offer the “advanced” skills that NRT
requires.
Sunday morning we attended church in Bandung. Afterwards we
attended a meeting we had requested with Perinasia doctors. As we visited with
them we offered a plan. We proposed that
our church, in association with Perinasia, would bring in equipment and teachers
to teach trainers, who would then teach additional students a program called
helping babies breathe. (HBB) This
program only requires a stethoscope, suction, and a bag & mask for delivering
breaths to the baby. We would present
this program to the midwives, pediatric doctors and nurses of the area that do not have
access to the training or equipment that the more advanced hospitals might have. Each trained midwife would have with her the donated equipment so that even with a home birth she could have the ability to
resuscitate a baby during the first critical minute after a
baby is born.
The Perinasia physicians supported the idea and seemed
excited about its implimentation. Instead of building more wings onto the hospital, or adding more
equipment, perhaps we could reduce their need by addressing the cause of the problem…birth asphyxia.
The project
is currently being written up to bring to our supervisors for approval. Unfortunantly for us, the first training session will be after our return home. Oh, how I wish we could be a part of it. I love patient care and miss nursing. We are
glad however that it is happening and hope that by having this program infant
mortality will go down in Indonesia.
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DR TRI OPENING ONE OF 4 RESUSCITATION BABIES GIFTED TO PERINASIA
PRESIDENT GROBERG AND DR. VISICK LOOKING ON |
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| PREEMIE UNDER THE LIGHTS |
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| EILEEN AND HER WANNA BE GRANDBABY |
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| BABY BEING MANUALLY VENTILATED IN EMERGENCY ROOM |
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| DR. RETNO AND DR. REBY FROM RUMAH SAKIT CICALENGKA WITH EILEEN |
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| RUSSELL AT RUMAH SAKIT CICALENGKA IN NURSERY |
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| RUSSELL LOVES THOSE BABIES |
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| SARI, EILEEN AND DR. RETNO IN NURSERY |
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| LOCAL PUSKESMAS WITH SUCTION AND BAG AND MASK |
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| EILEEN WITH MIDWIFE STUDENTS |
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| DRS DISCUSSING RESUSCITATION TECHNIQUES |
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| DR TETTY TEACHING BASIC RESUSCITATION TECHNIQUES |
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| RUSSELL EXPLAINING HIS THOUGHTS TO SARI AND DR. VISICK |
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| MEETING WITH PERINASIA TO DISCUSS PROJECT |
