In an innovative move to counteract the health worker brain drain, urbanisation and loss of doctors through recent armed conflict (in Liberia), the Ministries of Health in two sub-Saharan African countries, Liberia and The Gambia, have given the go-ahead to three UK based international medical charities to train midwives in how to safely perform emergency obstetric surgery, such as Caesarean sections and to train nurses in how to give anaesthesia and provide high dependency care. Once trained, these health workers will work together in rural areas to improve emergency obstetric and newborn healthcare and thereby help to save mothers’ and babies’ lives.
Maternal and Childhealth Advocacy International (MCAI), The Advanced Life Support Group (ALSG), and Mothers of Africa (MOA), have been working in The Gambia and Liberia for five or six years, helping the countries’ governments to improve emergency healthcare for pregnant women and girls (almost half of all pregnancies occur in children under 18 years), newborn babies and children attending national (public) health facilities. In both of these countries, doctors and surgeons are extremely scarce, and grossly over-worked, making it difficult to provide life-saving surgery, anaesthesia, and newborn infant care, especially in the poorest rural areas. As a result, many women and newborn babies are dying or experiencing preventable severe complications, which affect the quality of their lives.
In recognition of the need to train available health workers to provide this essential care, in a joint project with all three charities and ministries of health, with the support of WHO, experienced midwives working in the national health services of these countries will be carefully selected to receive training from UK experts in obstetric surgery, such as performing Caesarean sections on women in obstructed labour. Once fully trained, these midwives will be able to perform surgery on pregnant women in emergency situations without delay.
As it is essential for any surgery to be performed under anaesthesia, experienced nurses will be trained by UK experts in how safely to administer anaesthesia, working alongside the midwife surgeons. These nurse anaesthetists will also be trained to manage critically ill newborn infants.
Although this innovative project has been given the go ahead, it still needs to be fully funded.
On behalf of MOA, Dr Tei Sheraton says: “As a consultant anaesthetist in Aneurin Bevan Health Board in South Wales and chair of trustees MOA, I am convinced that this partnership and project will impact on MDG 5 and improve quality of life for families in these countries in a sustainable way. We are actively seeking volunteers and funding.”
Dr Barbara Phillips of ALSG says: “Our skills based training programme, Emergency Maternal and Newborn Health, has been successful in driving up standards in The Gambia, where it is now sustainably taught by the Gambians themselves. It is a vital component of our Strengthening Emergency Care programme which will now be enhanced by this new project to train midwives in emergency obstetric surgery and nurse anaesthetists in High Dependency care for mothers and babies, bringing the whole range of self-sufficient emergency care for the most vulnerable to these West African countries”.
Professor David Southall of MCAI says: “Lack of suitably trained Healthworkers in health facilities in poorly resourced rural areas of Africa is, in our experience, the main obstacle to improving maternal and neonatal healthcare. This project will be the first time that midwives have been trained to undertake emergency surgery and nurse anaesthetists trained to provide emergency care for newborn infants who have life threatening illnesses.”
This programme is supported by the Global Initiative for Emergency and Essential Surgical Care of the World Health Organisation Geneva, as well as by the WHO in both countries.
