Laying the Foundations to Save Newborn Lives: Nakaseke Scale-Up

By Dr. Anna Bruett Hedstrom, Brandie Giles and Sue Prueitt

As clinicians with Adara Development’s international medical volunteer (IMED) team, we were super excited to finally be at Nakaseke Hospital to be a part of the initial phases of Adara’s scale-up project in Uganda. We usually do our work with Adara’s partner, Kiwoko Hospital, but on this trip we were tasked with implementing the first steps of scale-up in Nakaseke, Central Uganda.

As part of this work, we are taking the knowledge and skills that have been developed at Kiwoko Hospital and scaling the programme to reach more women and children in need. This trip to Nakaseke Hospital is just step one of many more to come (so stay tuned!).

On our first trip to Nakaseke Hospital we were led by Adara’s country director, Daniel Kabugo, and Global Health Manager, Sister Christine. When we arrived we were greeted warmly by Eva, an amazing midwife of whom we had heard so many good things, and David, the Hospital Administrator. David has a personal connection with Kiwoko, as his daughter’s life was saved there 5 years ago. He named her Debbie, after our very own CEO, to honor her as a leader in the development of the NICU at Kiwoko Hospital. As we began discussing Adara’s plan to grow their programs in the greater communities of Uganda, it was heartwarming to see that they were as enthusiastic as we were to get started.

Eva and David toured us through the hospital’s Maternity Unit, Labor & Delivery Unit, and last but not least, the room that would be the new home to the Newborn Care Unit where our scale-up work would begin. It was a small but bright room with a wall of windows, a low counter with a sink, and a lamp and an incubator in need of repair. As a group we reviewed the ‘toolkit’ we had developed in Adara’s US office over the last year. This toolkit is a list of essential items required to set up a newborn care unit in a low-resource setting. Eva and David agreed that all were necessary and, fortunately, had many items within the hospital. The two planned to procure the remaining items in the near future.

Dr. Bernard, the hospital’s Senior Medical Officer, joined us and expressed his anticipation and support for the project. We were thrilled with their eagerness as they brainstormed about additional ideas that could benefit the unit. Eva even suggested taking down a wall to expand into the adjacent room. Unexpectedly, David thought this was a good idea and agreed! She further suggested getting a clothesline so they could air dry the laundry and linens outside. David also observed the room was not well lit and proposed installing additional lighting. It was a successful initial collaboration and we left feeling confident for the newborn care unit.

When we returned later that week we were delighted to see all the work that the staff had done to prepare the room. It was like a TV home makeover – Flip That Room!

Our following visits to Nakaseke Hospital were devoted to teaching the midwives the Helping Babies Breathe (HBB) and Helping Babies Survive (HBS) training programs that were developed by a number of global partners to reduce neonatal mortality in low resource settings. We spent three days training approximately 10-14 midwives. Our own amazing Sister Christine was an integral part of the training, and she also guided us through the cultural differences when chairing Ugandan meetings. We soon learned we would need a pseudo-committee to guide the small group – including a priest and a time keeper!

The HBB and HBS program included many simulated scenarios that required the midwives to perform at skills stations. These stations allowed them to refine the proper technique of resuscitation and newborn care practices. The training was an immense success that reflected in their pre- and post- test scores.

Our years of volunteer work with Adara have always been rewarding, but on this trip to Nakaseke we found it overwhelmingly fulfilling due to our expanding reach to reduce neonatal mortality and morbidity rates in these communities. We look forward to future trips to continue this important work of saving the lives of babies in low resource settings.

Note to travelers… it’s a bumpy drive from Kiwoko to Nakaseke! If you suffer from motion sickness, we advise a Scopalamine patch.  If not, just sit back, relax and enjoy the “Ugandan massage”!

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