By Dr Ioanna Beiataua (supplements by Dr Sharron Bolitho)
“We started the PEMNeT training as soon as we returned home from the training in Auckland last July. Our target group were the interns and midwives. We trained 10 midwives, two registrars and two interns. There were three sessions altogethet and the roll out of training was done with the assistance of Dr Sharron Bolitho from Christchurch.
We plan to train medical assistants and the lecturers of midwives and nurses. There will be at least five sessions per year and the content will include all the emergency obstetric skills and early neonatal care.”
Dr Sharron Bolitho followed through and issue this report:
“I am very pleased to report that PEMNET has gone well in Kiribati. We did one day of Train the Trainers then ran 2 back to back 2 day courses. On reflection it would have been wiser to run 3 days TOT followed by one 2 day course. There was pressure to get all 28 interns through the course. On the other hand there is no training like actually doing it and they have managed 2 courses!!!.
The Kiribati team did exceptionally well and each day we improved the delivery of the course. I am very impressed with a couple of interns who have really picked up and run with it. Also I would like to say that midwife Toonga was very organised and had done a lot of ground work with organising equipment venue and catering, identifying potential facilitaors and allocating midwifery staff to come on the courses prior to my arrival. As well as being in charge in the background , an efficient timekeeper, MC and provider of icebreakers which I have enjoyed very much.
I have learnt a vast amount about presenting style and how to engage adult Pacific learners this week. I have consulted with the facilitator team and changed the program style (and also the speed and clarity of my speech as I realise some were finding me hard to understand). I have of course not changed the the content just added in local Kiribati protocols where available and tried to make it as appropriate as possible to their setting ie not suggesting treatments and systems which they do not have and adapting scenarios to the Kiribati setting eg cord prolapse at Betio with the number of staff who would actually be on duty…
The topics we have covered were: maternal and perinatal mortality, teamwork in an emergency, eclampsia, cord prolapse, post-pantun haemorrhage, maternal collapse, sepsis, shoulder dystocia and breech. (I did teamwork and maternal collapse, other topics done by local team with my support)
Bronwyn [Robinson] will chuckle because on Day 2 of the course I basically threw all the power points out and went for interactive activities, before each practical drill, just having a discussion and using local cases and group work . I still think powerpoint would be a useful resource for facilitators to prompt them where to go next and display key points and diagrams for visual learners. Bronwyn would love to talk directly . I apologise if I haven’t got it previously, and freely admit that although I have run PROMPT for nearly 10 years I am not a trained educator.
I am humbled by the fabulous people I have met this week who work in with difficult cases in low resource settings. Although I acknowledge I have limited knowledge of the Pacific context, I do genuinely believe the majority of participants were engaged with PEMNET due to the discussions , body language and feedback. On discussion with Prof Rajat Gyaneshwar today, he has advised that the key to PEMNETs success is the quality and effectiveness of the TOT. I am in complete agreement with this and feel that particularly when each country is doing their first TOT that support needs to be given. Also for a sustainable program ongoing training needs to be available as new facilitator members come on board and to keep current members up to date.
Ioanna is suggesting that next I assist them to train a team to go to train the hospitals in the outerislands and their associated health assistants. I think the PEMNET course is a brilliant concept to train local clinicians to run their own program and is the way forward. Well done PSRH and RANZCOG! I am thrilled to be a part of it. Exciting times”