Sunday, 28 September 2014

A, B, C,...

Thursday mornings, 8am sees the nurses, midwives, laboratory technicians and pharmacy staff of Guinebor 2 hospital gather in a hot, cramped shipping container for a weekly teaching. Subjects covered range from care and treatment of malaria, diabetes, malnutrition, dehydration, seizures, hand washing, to reviews on how we as a hospital are performing and how we can improve the services we provide.

Formal lectures are the usual mode of educating in Chad but my level of teaching tends to be of a more basic kind using whatever resources I can find to make it interactive, prompting discussion. Thus clouds of flour, over the top dramatic enactments of procedures and pictures feature highly, much to the bemusement of the staff.

I also find that resources, such as food and drinks, can also act
as 'encouragements' for participation!
I could give an eloquent explanation for how this teaching method encourages participation and learning, but to be honest, it is basically a method in which I can avoid having to speak French in front of a crowd! I continue to find myself stumbling over expressions and grappling for words, which in English would roll off my tongue without a second thought. One of my more notorious blunders was by putting a stress in an inappropriate place when saying a word, I found myself, instead of saying “the patient will feel hunger”, I said “the patient will feel ‘woman’”! Cue a collective sharp intake of breathe and stifled giggles from the staff, while I quickly took on a more puce complexion, as, having been gently corrected, I realised what I’d said!  Thankfully these errors are not too common and the staff are extremely forgiving and generous of my French. But while I can admit and laugh about it now, it has taken me over a year to confess this incident!

Given the language challenge, and perhaps more significantly, teaching in a culture where it is shameful to admit ignorance, I am more and more appreciating the importance and the effectiveness of small group, or one to one teaching. Myself and Sue, my colleague have put this into practices and merged it with our desire to invest in the nurses and help them improve their own practise. For the past couple of years a pack of competencies for each nurse and midwife to complete has been developed and during August and September we have been concentrating on resuscitation, focussing on new born babies.

For many reasons, new born babies are the group of patients we resuscitate the most here and is an extremely stressful scenario.  And so, this module has included a weekly formal teaching on each stage of resuscitation, summarised in English with A, B, C, D, E. Again, another linguistically challenge awaited me as I wrote the teachings- how to translate a straightforward model in English, A= Airway, B= Breathing etc, into a French equivalent. With a bit of creativity and discussion with the staff we came up with an answer and even now continue to review and develop it to make sure it is as easy as possible to follow.

Having completed the formal teaching, Sue and I walked around the hospital each day over a course of a few weeks spotting staff with a moment to spare. Clutching a doll and a resuscitation mask, we got to work, putting the theory we had learnt in the classroom (AKA shipping container AKA sardine tin!) into practise as the nurses and midwives ‘resuscitated’ the doll. Despite the serious nature of the subject, it was a joy to get alongside the staff and spend time with them and fun was had along the way. It wasn’t just the staff that enjoyed and expressed appreciation at the course, just the sight of me walking around the hospital with a doll caused a great deal of interest and laughter from the patients and their carer’s, as cries of “bébé nasara” (white baby) followed me around!

Midwife Sara and nurse Gondje practising their neonatal
resuscitation technique

Although teaching here is not always as easy as ABC, it is essential and can even be fun!

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