Primer Dia de AEIPI en Chicaman/Uspantan - First day of the Infant and Maternal Course in Qiuche Guaemala

Primer Dia de AEIPI en Chicaman/Uspantan - First day of the Infant and Maternal Course in Qiuche Guatemala

Chicaman Sunrise

Monday was a day that our team had been studying and preparing for several months. Providence and its partner Medical Team’s International had been asked by the medical community to resume teaching a World Health Organization Course that had been previously been provided in Guatemala until about 8 years ago to due lack of government funding. This had been preceded by over 2 years of study since Providence Health International made its commitment to provide expertise and resources to Guatemala and specifically this region or department Quiche and the communities of Chicaman and Uspåntan. 

Workshop emphasizing AIEPI Strategy

The mortality statistics for Guatemala are that 15/1000 newborns die in the first year of life. The maternal mortality rate, although much improved over the past decade, is still quite high among rural indigenous women. The AEIPI (Spanish acronym for Atencion Integradas en la Enfermadades de Prevalentes in la Infancia - translated in English as IMCI –Infant and Maternal Care Integration) is a course for medical and nursing professionals that is taught in a series of 3-4 day modules. Each module has a specific focus and more facilitated than taught in keeping with principles of adult based and popular education. The first few days are the workshops and the next 1-2 are direct observation. Emphasis is placed on providing preventative care and acute care within frameworks designed to help health workers recognize the risk level after conducting a patient evaluation and then strategizing the risk as Red (high), Yellow (Intemediate) and Green (Low). Treatment and follow-up plans are then outlined for the provider in the format of colorful charts and templated registration forms.

At the Papelogråfelo

Glady Ramirez participating

If this sounds a bit complicated don’t feel troubled, it was a bit overwhelming to us initially, especially trying to do this in Spanish and coordinating the information in 3 different manuals in each language. Furthermore, the facilitator must to their best to draw out the participants in an active and participatory way, avoid Powerpoint and make the experience positive and fun. I can say that I could not have a better team to do this with. Lisa Arnold, Laurie Davis, Dana Gersten, Carrie Schonwald, our interpreter Bianca Fernandez and I were up to the task! Much of the course introduction is about the AIEPI strategy which is based on principle of social justice, addressing social determinants of health and placing high value on health care as a human right. It is very beautifully written yet can be a bit difficult to communicate effectively. 

However, in order to enliven and personalize the content and experience, we used several popular education techniques we have learned from our own community health workers in Hood River. The Hot Cabbage (Repollo Caliente), the Hot Basket (Canasta Caliente), Sociodramas (involved a returning very odd looking pregnant character) were blended into the day and a few more were added of our own creations Doctor’s Hot Seat (Asiento de Medico) and Salsa Dancing. Pre-test, Reading the syllabus and completing assignments in worksheets, group discussion, Flipcharts, reading and role play remained the mainstays of the course.

When our team arrived at the salon upstairs in a restaurant in Uspantan, we were greeted by Gladys Ramirez RN and Walter Lopez M.D. who are the key individuals from Medical Teams International and have taught this course many times before in Guatemala before 2010. After introductions to the course of the 8 participants of physicians and nurses, who will become trainers after completing the modules for other clinicians in Guatemala.

We had an amazing day. The participants were engaged, patient with our process, pronunciation and seemed to really get into the dînamicas (role plays, games and dancing). Many were quite experienced physicians and nursing with over 20 years of caring for the people of this area and gave their time to be with us, many had office hours later in the evening as well. Pictured are scenes for the day. Our team took some time at the end of our day for a brief reflection on gratitude for the day, and later that evening we were provided almost immediate feedback by Gladys on our teaching, facilitating and organization.

Dana painting the "Oscar"

We were told “Thumbs Up” even though we knew they were being super kind to us as well. A short stroll up to a church on hill near our hotel provided a nice back-drop for a group photo. The primary Providence Team completed their community service project in the community building latrines for individual families. We shared dinner with these hardworking nurses and employees of Providence/St. Joseph and then went back to work reviewing our curriculum for the next day which will be covering Labor risk assessment and essential newborn care.

Dana took on the job of painting a “donated” stethoscope gold to be awarded to the best play acting by a participant at the end of the week. We consider it our “Oscar”. Too tired to write more now but “hasta mañana”

Bob “El Loro Verde” Gobbo