12 Steps to Saving Mothers Lives (How to organize a training course in Ethiopia)

LunchDiscussing maternal mortalitySurgical Staff

One of the midwives demonstrating CPR in obstetrics
One of the midwives demonstrating CPR in obstetrics

So this blog post might give you a bit of an idea of what kind of work I’m up to here in Ethiopia. Training is probably my favourite part as the staff are really keen to learn and you feel like you might actually be doing something. As this post shows however there’s not a lot of glamour or life-affirming work, but I’m getting really good at admin and negotiation, skills I hope to promote in my next job interview…

  1. Identify topic for training – Note this may not necessarily be anything you have specialized knowledge in, but ultimately is determined by where the funding comes from (maternal and neonatal health being particularly donation-laden causes). Once you start researching however, you realize that the main themes for improvement are essentially the same in any area of healthcare: patient education, communication and good basic nursing and medical care.
  2. Prepare lectures – the main consideration here is how best to adapt the language for non-english speakers, some of the staff here despite completing their degrees in English, cannot speak English. Thankfully there is always someone on hand to translate; but I am always concerned when they ‘translate’ and there is laughter, particularly when I never made any jokes.
  3. Identify staff you wish to train – this is a trade off between whom you want to train (who you think will benefit most from the training due to their role), and whom the hospital management thinks should be trained (depends on who they will pay for and who is not too busy with clinical duties). There is also influence to train more women than men as traditionally they are under-represented. When you complete your reports you must count how many of each sex you have trained.
  4. Apply for funding – not actually a significant amount, just to cover manual printing and lunch/refreshments for the staff. Although you have to consider per diems (a lump sum staff expect for attending training – this is endemic in a lot of African countries as a result of NGO influence to encourage people to attend training).
  5. Funding part 2 – Haggle for a cheap lunch. As advised by the NGO; in order to secure funding for lunch I must first get 3 quotes from separate places to ensure I get the cheapest lunch. Have managed to secure lunch for 35 Birr (£1.10) per head, accepting increased costs to include meat.
  6. Print manuals – nothing like spending an afternoon in a print shop (supervision is required due to language difficulties). The afternoon is spent looking out the door, occasionally being shouted at by kids or asked for money.
  7. Putting manuals together – this covers an evening, the time shortened greatly by a helper (thanks Vicki), of placing all the handouts in order before heading back to the print shop for another afternoon of supervised binding.
  8. Confirm venue and confirm lunch provider – best to do at last minute (see point 10)
  9. Confirm names of staff to be trained – To date I have had 5 meetings with management to explain the staff I wished trained and request the list so I can prepare. I still don’t have it. Correction- I got it the day before.
  10. Double check 2 days before course on the list of names; only to find out that the weekend you booked 6 weeks ago has at the last minute been taken by another training session and so yours must be postponed. Worry that the meat you requested has already been prepared (a goat killed) and desperately try to contact the lunch provider to advise of postponement.
  11. Finally deliver the course 1 week late; and in spite of it all have a great time and successfully train 40 people how to safely manage obstetric emergencies (sadly the goat didn’t make it).
  12. Get on with the financial report, if it’s not finished within the week (before I leave) I won’t be allowed my exit visa…



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