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Utah Section Fellow reflects on decade of international service

Dr. W. Lawrence WarnerW. Lawrence Warner, MD, Utah Section chair

Perhaps one of the most fulfilling aspects of being a physician, particularly an ob-gyn, for the past 35 years has been the opportunity to serve others and be a part of their life experiences. I don’t have to go outside my private practice to have more than enough great memories to reflect on for the remainder of my life. I have discovered, however, that a whole new set of experiences await us when we venture outside our familiar sphere and become involved in service opportunities in other parts of this world.

Ten years ago, I was invited to be part of a small team of physicians, under the direction of the Church of Jesus Christ of Latter-day Saints (LDS), who would travel to Moldova to teach a group of doctors the standardized Neonatal Resuscitation Program (NRP). Since that initial experience, I have also been to Brazil, Egypt, India, Uganda, and most recently Tajikistan in 2012 and 2013. 

Tajikistan Midwives

Group of Tajikistan midwives trained by Dr. Warner and his colleagues

 

Central Asia consists of a collection of now independent countries that were part of the old Soviet Union. Similar to other third world countries, they have limited financial resources, which is most evident in their health care systems. Physicians are poorly paid and many are relocating. This places more of the responsibility for obstetric and newborn care on midwives, who have limited training and resources.

When we made our first trip to Tajikistan last year, we visited a busy hospital that does thousands of deliveries. They had only one Ambu bag in the entire facility for resuscitating apneic newborns, and many of the care providers did not know how to do basic resuscitation. We taught three groups of physicians in two cities. LDS Charities provided newborn simulators, intubation mannequins, NRP textbooks and wall charts (in Russian), and enough clinical kits (with a bag and mask, stethoscope, and reusable bulb syringe) to equip every delivery room in the hospitals where the physicians practiced. At the end of the two-day courses, the physicians received certificates and were charged with the responsibility to go back and teach their colleagues the skills they had learned.

Tajikistan Pediatricians

Dr. Warner teaches Tajikistan pediatricians proper intubation technique.

 

This past September, I returned with the same group (a neonatologist, an anesthesiologist, and me) to Tajikistan. This time, however, in addition to teaching the full NRP course to a group of 46 doctors in the northern part of the country, we taught the abbreviated Helping Babies Breathe Program to two groups of 50 midwives in two cities. 

We partnered with the United Nations Children’s Fund and the German International Cooperation Agency, and they made all of the travel, hotel, and meal arrangements for the doctors and midwives. LDS Charities again provided the training materials and equipment for participants to take back to their medical facilities. This time, we used doctors we trained the previous year as the instructors and table facilitators, which reduced the need for interpreters and reinforced their skills as they taught others. 

The Ministry of Health officials in Tajikistan have become our good friends. They are so pleased with the impact our training has had on the country’s maternal mortality rate that they have asked us to return again next summer to teach in the remote eastern mountainous region of the country where only midwives deliver care. We are developing an expanded training program to combine a new segment called Helping Mothers Survive with the Helping Babies Breathe Program.

It is so exciting and gratifying to see the positive effect we have had in this country in the two trips we have made. We estimate that several hundred physicians and midwives have now been trained, either by us directly or by those who we have trained. Approximately 600 clinical kits have been placed in their delivery units.

There are many opportunities to use our experience and skills to improve the lives of others. I treasure the experiences I have had, the friendships I have formed, and the lives I have been able to touch.

 

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