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Dec 31, 2019

Volunteer's trip report

Local trainers receiving materials for outreach
Local trainers receiving materials for outreach

At the beginning of November, two volunter midwives made the four-day journey from the UK to Laillenpi in Chin state, Myanmar. This is the 8th visit to the township, where training and practical support has been provided to Traditional Birth Attendants (TBAs) and other community healthcare workers with the aim of improving maternal and child health outcomes in the rural communities. 

Since the start of this project over 180 TBAs have been trained.  In 2017 the project was expanded to provide Training of Trainers to local women, who then provide training to TBAs in more remote villages. An additional development of this trip, was the opportunity to provide support to three nurses who have recently graduated through the support of Health & Hope's Freedom to Education Project (FEP) as well as provide training and support to local government midwives. 

Due to ongoing conflict in the region, it wasn't possible for the volunteers to travel to more remote villages as planned. Instead, two days of clinics were arranged in the town, where almost 150 mothers & babies were seen and treated!  Following this, the UK midwives conducted a week-long workshop with 36 TBAs, 5 government midwives and 2 trained nutritionalists, who were keen to receive training so that they can deliver health advice for pregnant women and new mothers. 

As always, it was wonderful to receive feedback from the TBAs who have been able to put the training they've had over the years into practice. One TBA revealed how she had delivered a breeched baby 12 years ago and the baby had died because she did not know what to do. Since coming to the training, she has been able to get over her fears and recently deliver a breech baby successfully. She said:"I knew what to do because of the training I had received, and the mother and baby are well. It was the best day of my life!"

As part of the project, the team distributed birth bags, which contain essential equipment and clean birth kits, as well as training and distribution of basic medicines. The result of this continued work has been a clear improvement in conditions, skills and expertise provided by the TBAs. The assessment at the end of the training week showed that the TBAs have grasped a good understanding in critical practices such as handwashing & hygiene, initial assessment of the mother, manoeuvres of breeched births, and immediate post-natal care of the newborn, including skin-to-skin contact and first breastfeed. As well as these basic concepts, the TBAs also now have a good understanding of how to deal with complications and emergencies in delivery such as  bleeding. 

This visit also created an opportunity for the three graduate nurses to gain further training and experience in maternal and neonatal health. The nurses, who are now part of the Health & Hope Myanmar team in Lailenpi, were translating during the clinics and training sessions, giving them the chance to deepen their knowledge and grow in confidence. As a result, Hope Clinic, based in Lailenpi, and our other health projects, will now benefit from the enhanced skills and experience of these trained staff. 

All of this is thanks to your generosity and continued support. We are so grateful for your partnership and look forward to updating you on the progress of this project again soon. 

Breastfeeding training for Health & Hope nurses
Breastfeeding training for Health & Hope nurses
TBA Training Group Photo
TBA Training Group Photo
Training of local trainers
Training of local trainers
Suturing training
Suturing training
Dec 30, 2019

Graduate nurses from local villages join Health & Hope team!

FEP student nurses graduating
FEP student nurses graduating

It all started seven years ago. A dream to see young women from rural Chin State have the opportunity to train as nurses and then come back to serve their community.  Thanks to the financial commitment of long-term supporters, this dream has become a reality. 

In the summer of 2019, three young women who have been supported by the Freedom to Education project graduated from university after completing their nursing degrees. Their training included:
- a one year internship with Health & Hope
- completing their year 11-12 secondary education in India
- an undergraduate degree in India
- a year internship in hospitals in Yangon

Following their graduation ceremony the nurses received a week's training from our partner Birthlink, took part in supervised outreach work in rural villages and received two months of training in maternal health and emergency neonatal care.

The nurses will now support the delivery of the Maternal and Neonatal programme, in addition to working in Hope Clinic and responding to emergencies through a newly established mobile medical service for remote villages.

Last month, two volunteer midwives travelled from the UK to run training workshops and mother & baby clinics in Lailenpi. The midwives wrote this summary about the nurses in their trip report: 

"One extremely valuable outcome of working with the Nurse Team throughout the week was their own development in midwifery knowledge. By working continuously alongside us in the clinics and during training, their knowledge increased substantially. On several occasions the nurses reported how their knowledge of antenatal, intrapartum and post-natal care had increased by hearing it from us in English, translating it into Mara, facilitating the questions and explanations and practising enthusiastically alongside all the trainees. Confidence and language skills increased and they thoroughly enjoyed taking part in the training.  They became competent in all the skills and fostered a positive, interactive learning environment. They grew in confidence in their organisational and teamworking skills throughout the time. When a problem arose, they were quick to admit it and efficient in finding solutions. They were very committed to the smooth running of the course and worked long hours to achieve this. We felt that positive and lasting relationships were built between us all and that very good teamworking was achieved."

It's wonderful to see the real impact that has resulted from the Freedom to Education project in just a few months after graduation, with the nurses full of hope, passion and knowledge returning home to serve in their communities. 

Your support is not only changing the lives of the individual students, but also having a wider-reaching impact on local communities through providing the skills and expertise needed to reach out and sustain our work amongst the most vulnerable in western Myanmar. 

Internship at a hospital in Yangon
Internship at a hospital in Yangon
Participating in mother & baby clinic
Participating in mother & baby clinic
Receiving neonatal training from UK midwives
Receiving neonatal training from UK midwives
Practical breastfeeding training
Practical breastfeeding training
Care of the newborn training
Care of the newborn training
Oct 3, 2019

Reaching out to remote communities in Myanmar (Burma)

Childhood screening
Childhood screening

Thank you so much for your continued support of our Maternal & Child Health project.

In our last update, we shared with you about the workshops conducted with Area Coordinators earlier in the year. We also mentioned that due to the escalation of conflict in the region, we were unable to conduct the planned training for Traditional Birth Attendants (TBAs) that was due to take place in February.

We can't understate the seriousness of how the conflict has left some of our health workers isolated and vulnerable.  One of them reported to us:

"Around the village there is active fighting.  We're not allowed to travel and there are curfews in place.  We've been unable to harvest the remaining crops due to the fear of landmines.  I tried to visit other health workers near my home, but I was stopped three times and questioned by rebel groups, the army and the police.  They asked me; 'are you a spy?', 'why are you carrying medicines?', 'are you treating the rebels?'.

After being questioned for six hours I had to return home.  I was able to visit only four villages in June and July, since then I was sent back by the army. The internet connection was shutdown, so this is the first time that I am able to share what has happened."

Despite the ongoing challenging situation, our staff team have been able to conduct a number of outreach visits to remote villages, as well as running some mobile clinics in IDP camps where communities have had to flee their homes. Below is an extract from a trip report written by Dr Pahu, one of the project leaders:

It took us 24 days to travel through four areas and 13 villages. In some areas, the travel was so difficult and in some areas we were unable to travel because of the curfews.

We saw more than 700 patients, met with village administrators and Village Health Committees.  We were able to check on the activities of the Community Health Workers (CHWs) and TBAs. We were also able to undertake childhood screening for over 270 children in schools in some villages. The main medical conditions were gastritis, gynaecological problems for women, acute respiratory disorders, suspected anaemia and eye health. 

We were also able to carry out the baseline survey of the communities we are supporting. Together we carried out 96 interviews and also distributed many health education leaflets, helping to explain to the villagers how they can better take care of their own health needs.”

As a result of these outreach visits and surveys, we have also been able to assess the impact of previous years' work. For example, we found that almost 70% of the population assessed now know how to treat a child under 5 who is suffering with diarrhoea, which sadly is still a common cause of death for young children in the region. Simple post-natal practices such as breastfeeding within 1 hour of birth and exclusively breastfeeding up to 5 months, are also being adopted in order to improve the early chances of survival for newborns. 

The quote below is from one CHW, who has seen the direct results from their training:

"My name is Khai and I am from Tlopi village in Chin State.  I was chosen by my village to be trained as a health worker under Health and Hope and at the time I went to the India border to join six months training. Since I have returned home, many things have improved thanks to the health knowledge that was shared.  We have reduced the mortality rate of children under 10, and not one has died from diarrhoea thanks to the way we have been instructed to care for them.  Also, there have been a lot of snake bites in my village, and many people used to die.  However, I learnt some knowledge about managing snake bites from the health training and I shared this with my village.  I am so happy that I have been able to save two people’s lives thanks to the knowledge I learnt from training at Health and Hope.

Sometimes it is very difficult for us in the villages.  It is so remote we have not been able to participate in further training.  So it was an unexpected joy when the doctors from Health and Hope came to visit my village and offer clinics for patients and training. I know that resources are so limited and there are so many villages, but I was amazed and so thankful to them that they came. I really appreciate Health and Hope's love for us and all that they have sacrificed to help us. I pray that they will be able to return regularly to help us."

Although there is still plenty of work to be done, it is encouraging to see the positive impact of our work to date through the training and support of TBAs and CHWs in the region.

As the monsoon rains clear, the team in Lailenpi are starting to plan the next phase of training workshops for local TBAs and Area Co-ordinators who will be involved in bringing maternal and child health care to remote communities across the region. 

We are so grateful for your ongoing support. We currently have a real need to top-up funding for this project to enable two workshops to run over the course of the next six months.  If you are able to support our work financially, please do click below to give via Global Giving.

Thank you again for you interest in our work. Our next update will follow the journey of two midwives from the UK visiting the jungles of Myanmar, conducting training for the local women and also government midwives in the region. 

Mobile clinics
Mobile clinics
Childhood screening
Childhood screening
Inside the IDP camps
Inside the IDP camps
Transporting medicines to remote communities
Transporting medicines to remote communities
 
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