I can’t for the life of me remember learning how to put on gloves. I’m sure that I was very small when I learned, given that I grew up in Ohio when it still snowed in the winter. Maybe it was my mom and maybe it was one of my older sisters, but I’m sure that it took more than one time of them explaining how to locate the thumb and turn the glove so that they matched up. This week I had the joy of watching my big sister teach this same lesson to forty some Traditional Birth Attendants.
My sister Angie has been a labor and delivery nurse for close to ten years. When I first told her about the TBA trainings that Diantha Hodges was planning for South Sudan she was immediately on board for coming to help. She worked hard to raise support for her trip, but also for the cost of the trainings and supplies for the TBAs. By selling Mothers Day cards and accepting donations, we were able to come to South Sudan with bulb syringes, latex gloves, pen lights, four neonatal practice dolls and 250 birth kits for these hard working women! What a blessing it was to be sent off with so much love and support.
Diantha has been working with TBAs associated with each of the 18 United Methodist Churches in the Yei area. Alongside doctors Lynn and Sharon Fogleman, a missionary couple who joined the force in February, she has taught the TBAs to identify signs of complications, worked to get pregnant women prenatal care, and emphasized the importance of having at least two women present at each birth. The focus of last week’s training was what to do it a baby is not breathing- training that has helped to reduce infant mortality in Zambia by as much as 45 percent!
The training started with each TBA receiving a bag of supplies: a clean sheet of plastic to lay their tools on, five pair of latex gloves, a bulb syringe (and instructions for sterilizing it), and a penlight. The first training began with a demonstration of the use of each of the new tools. Soon enough the women were broken into groups to practice for themselves; we were shocked to see their struggles. The first few women had a terrible time getting the gloves on- they would end up with two fingers sharing the same space or a pinky finger bent into the place for the thumb. When the task of properly gloving their hands was finally successful, they moved on to trying the bulb syringe. It was quickly apparent that they had no concept of how this simple machine worked. They would move the bulb to and from the doll’s mouth without squeezing or letting go of it. Although they were mimicking the demonstration as best they could, the purpose of the syringe was lost on them.
As TBA after TBA met the same challenges, the teacher in me began to realize that the problem was not with the students, rather the poor teaching we had done. I have often seen the same thing happen in my first period class when I don’t know what the students don’t know. How could we have assumed prior knowledge of donning gloves in an area where the temperature rarely dips below 70 degrees? How can we expect these women to understand a tool for suction when the only tools they have been exposed to are sticks for stirring and hoes for digging? We quickly put on the brakes and began practicing flexivity- a term my dear friend Stacy coined meaning to use creativity while being flexible.
It was amazing to watch the women’s faces light up as we showed them to turn the glove so that the thumbs matched up- a lesson all of us have learned at some point. We then went step by step showing them how the bulb syringe worked: we showed them that squeezing the bulb forced the air out and releasing it sucked air in. I wish we would have recorded the sounds of excitement when they saw me suck all of the water out of a clear cup using the syringe! The action did not need any translation; as soon as they saw this, looks of understanding and joy flashed across their faces. It was apparent that they knew why it was going to be so helpful for babies.
After completing three of the five scheduled trainings for TBAs, Angie said a tearful goodbye to those she had worked beside. I’m convinced that the lessons she taught will stay with her always, tucked away in her heart along with the knowledge that her seemingly small lessons will have a tremendous impact on hundreds of mothers and babies!