In accordance with Kendall, the flight journey from Kathmandu to Dhangadhi was very scenic and lovely. As the plane passed through the mountains, we could feel the eternal beauty of Himalayas. After landing in Dhangadhi, we traveled to the hotel in electric auto rickshaws, which are referred as 'Tuk Tuk' by the locals.
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Tuk Tuk!!! |
In the evening, we started our exploration of the city in search of a forest (found out on Google Maps) and ended up finding a temple which has a gigantic Shiva lingam (The hindu god Shiva's idol). We reached top of the unfinished idol and enjoyed the panoramic view of Dhangadhi.
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Yayy!!! |
During dinner, Sandhya informed us about details and schedule of the next day's training program. Next morning, we woke up excited about our first global clinical immersion and have reached our site the Seti zonal hospital, which was 2 km away from the hotel. The training facility in the hospital was on the second floor of the Reproductive Maternal Newborn, Child Health (RMNCH) program building, which is opposite to the main block of the hospital. A vaccination drive was going on the first floor of the building, We remembered our childhood days, looking at the kids being reluctant to get vaccine shots.
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Training facility of Seti hospital |
We were warmly welcomed by master trainers and trainees, who were already aware of our arrival. We were impressed to see that the participants were very comfortable in interacting with us despite the language barriers. Sandhya informed us that all the trainees had gone through Skilled Birth Attendant (SBA) training and have lot of clinical experience. She added that these trainees have been going out to other districts to train healthcare providers at various peripheral health facilities.
The master trainers presented the agenda of the workshop, to standardize some of the important training skills among the participants and update them on new skills that will be added in the SBA curriculum.
Objectives of the training
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Ground Rules and Incentives!! |
The workshop was officially started by Dr. Ganesh Singh, an obstetric and gynecology physician who is the medical director of Seti zonal hospital. He addressed the gathering about the importance of this workshop and acknowledged the support and inputs of Jhpiego in organizing this 'first of its kind' workshop. He emphasized on the importance of having standardized teaching approaches by trainers and the difficulties associated with independent/modified approaches.
The master trainers asked the trainees to take a pre-training test, which is used to assess their current skills level. While the participants were deeply engaged in the examination, we had a very informative discussion with Dr. Singh, who explained us about a wide range of topics including hospital structure in the country and training of healthcare providers at different level.
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Pre-training test and discussion with Dr. Ganesh |
In afternoon, each of three master trainers organized a skill station, where trainees demonstrated their current practices of normal delivery, cervical tear, manual removal of placenta, bi-manual compression and aortic compression. Mama Natalie was used to demonstrate normal delivery, manual removal of placenta, bi-manual compression and aortic compression. A locally developed foam model was used to demonstrate cervical tear. The master trainers assessed the trainee's procedure and scored according to the standard SBA facilitator's manual.
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Normal delivery
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Manual removal of Placenta
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Cervical tear repair |
We observed all the three stations in turns and have obtained valuable insights about the skills and their implementation using training models. After each trainee rotated their demonstration at all the stations, master trainers demonstrated the Uterine balloon tamponade using Mama-U.
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Uterine Balloon Tamponade |
We called it a day after discussing with master trainers about our observations and insights pertaining to the training.
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