HOPE works in more than 35 countries worldwide. Please enjoy our blog as we document the successes and challenges of our work to provide Health Opportunities for People Everywhere.
In the Philippines, women die during childbirth at an alarming rate. The Philippines has not been able to reduce the number of deaths from childbirth as much as other developing countries have over the past few decades. A 2013 study of maternal deaths in the Philippines concluded that, despite the fact that women in labor were reaching a hospital in time, many health facilities are not able to manage serious obstetric complications. The medical staff of these facilities indicated they felt inadequately trained to deal with these emergencies.
Project HOPE is aiming to reduce the number of maternal and infant deaths from childbirth in the Philippines by improving the quality of care for moms in hospitals. Funded by Ferring, the three-year PROMPT (PRactical Obstetric Multi-Professional Training) program is designed for teams of all maternity staff. The program has published evidence of improvement of maternal outcomes in both developed and developing countries. This Project HOPE program is working with eight hospitals in the Philippines and the Philippines Obstetrical and Gynecological Society to achieve its goals.
In September we had an amazingly well attended Day 1 of the PROMPT training program with 100% attendance from our target list of eight hospitals with five team members each. It seems no one wanted to miss this international-caliber training program that Project HOPE is offering to obstetricians, anesthetists, OB residents and supervisory nurses. There were six rotating training drills for the participants in the following topics and scenarios: post-partum hemorrhage, pre-eclampsia, shoulder dystocia, labor room board, sepsis and vaginal breech.
The participants greatly appreciated the teaching methodologies. They gave the PROMPT trainers almost perfect scores in the training assessment. Tomorrow, we will work on how PROMPT will actually be implemented in the hospitals. We will provide critiquing and coaching sessions and a planning session for integrating this team approach to dealing with obstetric emergencies in the hospitals.
As the weather gets colder, the number of migrants and refugees transiting through Macedonia continues to rise. Only a couple of months ago, the number averaged 2,000 a day. Today, the average is 4,000-5,000 refugees transiting on a daily basis, through Macedonia, to more permanent resettlement in the European Union countries.
The number of people asking for medical assistance each day at Macedonia’s two transit centers has also risen, to about 800 total requests per day.
Yesterday, the Project HOPE team again visited the General Hospital in Gevgelija, and the nearby transit center on the southern border of Macedonia with Greece. Last week, Project HOPE distributed its first shipment of donated medical supplies to support these medical facilities.
The hospital is receiving, on average, 15-20 patients a day. General fractures top the list of medical needs for the refugees. Consequently, HOPE’s donation including splints and bandage rolls has been put to immediate use. Donated examination gloves, syringes, masks, catheters and other supplies have also been put to use. The hospital staff told us they assisted a traveling mother in the birth of a healthy baby boy on September 29, which is the second birth that has taken place since the refugee crisis escalated in this hospital.
At the medical facility at the refugee transit center, the small medical team, including the doctor on site also emphasized that the Project HOPE-donated supplies are helping the small team provide better care. “The donated Tympanic thermometer makes our work much easier, especially with the pediatric patients,” the doctor said. “No such product was available to us prior to HOPE’s donation.”
At the time of our visit to the transit center, there were around 2,000 refugees waiting for the train to Kumanovo on the border with Serbia. It was clear that the women with babies, young children and men were not prepared for colder weather.
One young Syrian mother was waiting at the transit center for her husband to cross the border with another group of refugees. She told us she did not have any winter clothes. “It was summer when we started our journey,” she said. “My baby is only seven months old.” Thanks to the donations of clothes from the Macedonian people, the mother managed to find a jacket for her baby.
Since June 2015, the number of people that have been officially issued licenses to transit Macedonia is 102,753. No one expects that the crisis will come to an end any time soon.
In the meantime, the transit center is being adjusted for the upcoming colder weather. HOPE’s next shipment of donated medicines and supplies is scheduled to arrive within the month.
Jovin Panthapattu is a final year Doctor of Pharmacy (Pharm.D.) candidate from the University at Buffalo, School of Pharmacy and Pharmaceutical Sciences. As a Project HOPE volunteer, he is completing his advanced pharmacy practice experience rotation at the Alluri Seetharama Raju Academy of Medical Sciences (ASRAM) Hospital in Vijayawada, India.
I have spent the last couple of weeks at the ASRAM Hospital observing pharmacy practice and pharmaceutical care. I have been fortunate to work in the intensive care unit, where I have found the staff eager to learn about the similarities and differences in the practice of medicine between India and the United States.
Being a student pharmacist trained to practice in the United States, I have often found myself jumping to initial conclusions about the delivery of pharmaceutical care. After conversing with Indian physicians, I learned that they provide more than just medical care; they also perform the duties of a case manager, often considering patient affordability during and after the hospital visit. I found the doctors and nurses to be very knowledgeable in their respective areas, but the lack of access to resources often required them to adapt the care provided.
I started my rotation at ASRAM as a passive observer of ICU care, but over time I have become more involved in patient care. I often find myself conversing with physicians about pharmaceutical care and treatment guidelines, teaching nurses about proper medication administration and surveying patient charts for any potential medication errors or adverse drug interactions.
I have been fortunate enough to observe clinical cases which are only mentioned in US textbooks. Being in a teaching and learning institution, I am able to network with students and faculty from the department of community medicine and learn about prevention education measures. I also assist in community outreach. I am only halfway through my journey at ASRAM, and I am hoping the next half will be as equally exciting as the first!
As Project HOPE sends additional medicines and medical supplies to help the thousands of Syrian refugees traveling through Macedonia on a daily basis, staff on the ground continues to assess the conditions and needs of the camps set up along the Greek and Serbian borders. While visiting the Gevgelija transit center earlier this week, HOPE staff met with some of the men, women and children fleeing Syria for a better life. Here are their stories.
Mother Seeks Better Life for Children
First we met a young Syrian mother, traveling with her two kids. One of her children is only three months old. She carries him in a baby sling. The other young child, about five or six years old walks along beside her. She told us that she is traveling to Germany, where she hopes to find a better life for her sons.
Man Paves Way for Family
We also met a Syrian refugee from Damascus. He told us he is the first person in his family to escape his country. He was a clothing designer in his country but had to escape. His goal is to reach Germany and find a way to have a better life, where he can bring his family with him.
Brothers Flee War
At the hospital in Gevgelija, we met young Bahir. Just nine years old, Bahir left Syria with his older brother. While escaping, he broke his arm on the ship and had to go to the hospital in Macedonia. His brother told us that here in Macedonia they are finally being treated as human beings and given the medical assistance they need. The brothers are hoping to reach Norway in search of a brighter future after leaving their parents behind in Syria.
Amy Montes is a registered nurse currently working toward her Master’s degree at the University of Colorado, Anschutz Medical Campus to become a primary pediatric nurse practitioner. She spent one month volunteering with Project HOPE at the NRI General Hospital in Vijayawada, India, where she mentored and taught the pediatric nurses.
For the past month, I’ve had the privilege of working alongside nurses at the NRI General Hospital in southeast India. Upon my arrival here, I was welcomed warmly and oriented to the campus and my living quarters for the next month. I quickly became engrossed in my daily routine. Mornings were spent working with nurses and patients in the pediatric ward, PICU or NICU, and afternoons were dedicated to developing adapted Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP) curricula and teaching the respective courses.
I recall finding myself jumping to initial conclusions about nursing and medical practices that could be improved or were done incorrectly. After reframing my focus to observing and learning rather than judging, I found the nurses’ knowledge base to be very sound. Their care was quite similar to what we provide in the United States, but adapted for the limited resources available. With a deeper understanding of the rationale behind the care provided, I was able to better educate the nurses and influence the delivery of quality care.
A particular memory that comes to mind occurred in my third week on the pediatric unit. There was an abundance of nursing students taking on patient care activities, and I found myself with little to do and wondering if I was making any kind of difference. Looking around the ward, I couldn’t help but feel saddened by the disengaged faces of the patients. There was utterly nothing for the children to do except lie in bed and wait days to weeks to be discharged. Fortunately, I had a moment of creativity and dedicated that evening to vigorously cutting up an old book and educating myself in the art of origami. For the next several days the unit was filled with paper frogs, butterflies and smiling faces.
As I continue to process and reflect upon this experience, I find myself pondering whether I had a larger impact on NRI, or NRI upon me. Maybe the answer to that question is not so important, but rather the importance lies in the way I live my life following these experiences. Emulating the goodness I saw each day, particularly the powers of patience, warmth, kindness and an open heart.
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