Helping Babies Breathe
A comparison of trainings in Guatemala and Washington
By: Anna Pollock, Medical Project Coordinator – Guatemala
Earlier in the year, I wrote a post called “Conversations with Midwives in Quetzaltenango” which detailed two focus groups conducted in January with traditional midwives working in Guatemala. In this post, I describe the context in which many traditional midwives practice in the Guatemalan Highlands, the types of trainings they have received (or not received) in the past, and their frustration with the constant lack of supplies. Since the focus groups, multiple conversations have ensued about the value of training on neonatal resuscitation, and ultimately we made a decision to hold a training using the Helping Babies Breathe (HBB) curriculum endorsed by the American Academy of Pediatrics. Teaching this simple yet highly effective strategy will be a good first step in impacting neonatal mortality in Guatemala’s Western Highlands – one of the main goals of our Capacity Building Grant. After this decision was made, karma must have been on my side because I was invited to attend two Helping Babies Breathe trainings during the month of March!
In early March, myself, along with the entire Pop Wuj Clinic staff (3 Guatemalan doctors and a nurse) and 4 local midwives, went to Panajachel at Lake Atitlan to receive the HBB training from the Babies Breath Project, a group of nurses who work at the Minneapolis Children’s Hospital. The training was extremely beneficial – the small class size ensured a lot of individual attention that focused on proper resuscitation techniques, including water-filled mannequins that simulate breathing and an umbilical pulse to practice resuscitating. Trainers walked us through different response scenarios with increasingly serious situations. The mood of the training was light, and even though it was done in English and translated into Spanish, everyone who participated found it to be a beneficial and informative experience.
Dr. Hurtado, an OBGYN with years of experience, told me that he really enjoyed the training and now feels much more comfortable dealing with asphyxiating babies. He said that in Guatemalan hospitals usually the nurses deliver the babies, but sometimes he is there with just one nurse (or alone), and it can be very scary when something goes wrong. Doña Ana, a midwife who also works closely with Timmy clinics, shared her thoughts on the training and told the following story: “I have had an Ambu bag in my clinic for a long time but I never really knew how to use it. I could never understand why the air would always leak out the sides. The training was really great because we got to practice enough times to perfect the technique. When I came home on Saturday night I had 2 births – one around 11PM and another in the morning. The second baby came out a little asphyxiated, so I got my Ambu and he came right back to life and started breathing. Learning the C technique was invaluable for me – if only I had known earlier what I know now!”
Near the end of March, I went to Olympia, Washington to participate in another HBB training with a small group of pediatricians and family doctors who are planning on coming to Guatemala in August to support our training. Though I had completed the training already, and felt pretty comfortable with the material and logistics of setting up the training, I picked up a few more tips from Tom DiDonna, the facilitator who has led HBB trainings around the world. It was also great to have the opportunity to sit down in person and chat about our larger goals for the August training, which include gathering pre-training data, doing home visits to each of the midwife’s clinics, and holding tri-annual follow-up trainings that will give us a chance to evaluate the program’s impact as well as provide continuing education.
The Helping Babies Breathe curriculum is very effective because it is simple, and mostly based on hands-on practice – making these concepts accessible to local midwives regardless of their ability to read or write. The HBB kits come with everything you need to run the training – Ambu bag, bulb suction, the mannequin, all of the training materials and learner materials, cords to tie the umbilical cord, a hat and blanket to warm the baby, a timer to time yourself through the “golden minute” and more. The entire curriculum is very simple so that once you have received the training, you know it well enough to facilitate it for others. When we finished the training, both Tom DiDonna and the Babies Breath Project gave us lots of support and insider tips about ordering materials, collecting data, etc. Attending both of these trainings was integral to the success of the program in August.
It is incredible to imagine that this one training improved the experience for someone like Doña Ana, a midwife with years and years of experience. We know as this project continues local midwives will be instilled with greater confidence and advanced skills, which will further our united objective to decrease infant mortality rates for their communities.