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| Christina having an eclamptic seizure |
ALSO is a course, akin to CPR training that family physicians who practice obstetrics are advised to take every 2-3 years. The goal of the course is to learn a systematic approach when emergency situations happen, such as a mom having a hemorrhage after the baby is delivered, or a baby’s shoulder getting stuck. In these situations, every second counts and needs to be spent in resolving the emergency.
Friday we held our fourth annual mini-ALSO course at a hotel in Huehue (way-way). The people who attended the class were nurses, internos (6th year medical students), quintos (5th year medical students), and OB/GYN residents, along with their chief resident and two of their residency faculty, Dr. Cano and Figueroa.
We assured them in the beginning that we were indeed intelligent people despite speaking Spanish like kindergartners and launched into the course. Chris led off with 3rd trimester bleeding while Josh dressed in drag as the bleeding mom. Rosalicia then spoke about preeclampsia while Chris played the preeclamptic then eclamptic mother who had a large seizure, much to the entertainment of everyone.
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| Suzy demonstrating the breast pump |
What came next was three very short lectures with hands-on workshops using the pelvic models we brought with us. Melissa started with shoulder dystocia (shoulder getting stuck in the birth canal), then Josh who spoke about delivering a baby who is unexpectedly breech, then Mariah, who focused on postpartum hemorrhage. Probably the most entertaining part was when Josh (speaking in Spanish) asked the group, “What do you do when a woman comes along with her butt hanging out?”. The intended question was to ask them about how they manage a baby who is coming out breech.
After the ALSO course, we managed to jump unawares into a political quagmire. In 2016, 72 women died in the Department of Huehuetenango in pregnancy. Likely there will be more this year. The largest reason was hemorrhage, followed by preeclampsia, followed by infection. 90% of babies are delivered outside the hospital by midwives in communities that are hours from the National Hospital in Huehuetenango. Lay midwives are prohibited by law in Guatemala from dispensing medication despite the World Health Organization advising that Misoprostol can be given by non-medical providers. Our idea prior to coming was to make Misoprostol (the only oral medication that can help stop acute bleeding after delivery) more available to rural health stations and we brought a couple hundred tablets. Turns out that that option is also has some serious bureaucratic barriers as well. After meeting with the head of maternal child health in Huehuetenango, we made an agreement with the doctor to leave the Misoprostol tablets with her and she would try to advance the proposal.
At the end of the day, we found the perfect way to spend night with Manuel Saenz, a friend of Suzy who is an artist and has a flat in downtown Huehue. Mariah bought a painting, and we all had the chance to share with someone who has a deep love for his country and a broader awareness of the world.
Friday we held our fourth annual mini-ALSO course at a hotel in Huehue (way-way). The people who attended the class were nurses, internos (6th year medical students), quintos (5th year medical students), and OB/GYN residents, along with their chief resident and two of their residency faculty, Dr. Cano and Figueroa.
We assured them in the beginning that we were indeed intelligent people despite speaking Spanish like kindergartners and launched into the course. Chris led off with 3rd trimester bleeding while Josh dressed in drag as the bleeding mom. Rosalicia then spoke about preeclampsia while Chris played the preeclamptic then eclamptic mother who had a large seizure, much to the entertainment of everyone.
After the ALSO course, we managed to jump unawares into a political quagmire. In 2016, 72 women died in the Department of Huehuetenango in pregnancy. Likely there will be more this year. The largest reason was hemorrhage, followed by preeclampsia, followed by infection. 90% of babies are delivered outside the hospital by midwives in communities that are hours from the National Hospital in Huehuetenango. Lay midwives are prohibited by law in Guatemala from dispensing medication despite the World Health Organization advising that Misoprostol can be given by non-medical providers. Our idea prior to coming was to make Misoprostol (the only oral medication that can help stop acute bleeding after delivery) more available to rural health stations and we brought a couple hundred tablets. Turns out that that option is also has some serious bureaucratic barriers as well. After meeting with the head of maternal child health in Huehuetenango, we made an agreement with the doctor to leave the Misoprostol tablets with her and she would try to advance the proposal.
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