Dr. Bulane, a staff physician at the Makoanyane Military Hospital in Maseru, Lesotho, deals daily with a shortage of trained medical personnel and supplies. His landlocked country Lesotho, in the southern part of Africa, suffers from near 30 percent HIV/AIDS infection, a 34.4-year life expectancy, recurring drought, poverty and high infant mortality.
Because of his concern for high infant mortality, Dr. Bulane registered for a training program in neonatal resuscitation conducted in his community by the Humanitarian Services Division of The Church of Jesus Christ of Latter-day Saints.
Such programs, an attempt to reduce the occurrence of birth asphyxia (a newborn’s lack of oxygen at birth), are conducted in many parts of the world as an ongoing humanitarian initiative of the Church and as a response to the World Health Organization concern for infant deaths.
Soon after participation in the June 2006 training session, Dr. Bulane implemented his new techniques by saving a newborn baby boy. “The mother had excess water, and a Caesarean section was performed,” he explained. “Her baby was born blue. Through neonatal resuscitation techniques, the baby was saved. He is doing great now. I used the timeline I had been taught. Without it there might have been complications. It was very exciting; the training puts everything else in perspective. As far as I am concerned, it instills confidence. I now know exactly what to do. There is no panic.”
Gaining confidence to respond in the critical seconds after birth is the stated goal of neonatal resuscitation, according to Deb Whipple, a nurse in the Newborn Intensive Care Unit at LDS Hospital in Salt Lake City and also a frequent participant in the worldwide training initiative. “I know the procedures work,” Whipple acknowledged. “I’ve seen it save lives within those first valuable 30 to 60 seconds.”
Whipple uses her skills daily in the hospital delivery room but also shares her expertise internationally with other medical professionals. “The neonatal resuscitation course is taught to 50 students who, in turn, return to their clinics, hospitals and neighborhoods to teach other birthing attendants,” she said.
Participating countries are selected based on infant mortality rates, according to Dean Walker of Church Humanitarian Services. Teaching clinics are scheduled through local ministries of health in the participating countries, and training kits, including practice mannequins, training manuals and resuscitation equipment are donated by the Church.
In 2006, training courses were offered in 23 countries.
Physicians, nurses, respiratory therapists and other medical professionals volunteer their time to staff the resuscitation trainings.
For Dr. Ted Kimball, an emergency room physician at the University of Utah Hospital in Salt Lake City and chair of the Humanitarian Services advisory committee, the role as a facilitator in addressing health issues in developing countries brings multiple rewards.
“These people live simple lives,” Kimball noted. “They don’t need flat-screen TVs or computers. They have only three basic needs: a chance for education, a chance for health and an opportunity for peace or freedom from political strife. Neonatal resuscitation plays a critical role in two of these needs: education and health. Our training makes a contribution.”
The minister of health in Uganda, a recent participant in neonatal resuscitation training, stated to Dr. Kimball that each birth loss in his country creates an estimated $100,000 deficit on his country’s economy. “In these areas where grinding poverty exists,” Kimball said, “they need a healthy, educated workforce to carry the people out of poverty. A healthy, self-reliant community is the key. Without birth loss of life, there’s another back to carry the economic load of the country, another person leading the way out of poverty.”
The neonatal resuscitation training concerns in Ghana mirror those of their African neighbors, Lesotho and Uganda. Dr. David Gourley, a Salt Lake City physician and member of the Humanitarian Services advisory committee, reported that “a simplified course designed for rural midwives and community nurses will provide basic resuscitation skills and equipment necessary to lower Ghana’s infant mortality rate.”
Dr. Gourley related the following account from a recently trained midwife: “Dora delivered a breech delivery. She thought the baby was dead because he was floppy and not breathing. Dora went through the initial steps of resuscitation. She only needed to correctly position the baby’s airway and suction with a bulb syringe before the baby began breathing and tone improved. Today the baby is thriving.”
Based on local evaluations, Dr. Gourley noted that in the six months following the May 2006 Ghana training, 646 infants were successfully resuscitated using the basic equipment donated by the Church.
The equipment and the training contribute to the neonatal resuscitation program’s long-term goal that a qualified birth attendant be present at every delivery.
For Whipple, a mother herself, the goal is broader. “I want all those babies to have a healthy body to experience life,” the nurse concluded. “Mothers have the same emotions worldwide — they all have the hope their child will be healthy and have the opportunity to be happy, to be a part of a family.”