Essential Obstetric and Newborn Care Course

So I'm currently at an obstetrics/newborn training session for midwives/nurses/physicians.  It's pretty cool, cuz it's put together by the Liverpool school of tropical medicine and the royal college of obs/gyn and WHO.  I think it's a really good program because it's actually improving the skills of people who are dealing with these ob/newborn emergencies.  It's pretty amazing how little people know, and it's also amazing how much people are learning.  I'm supposed to be a participant, but because I was invited last minute, my role is almost kind of in between an observer and a participant.  I'm learning stuff too as well.  Anyhow, I really think these classes could play a huge part in decreasing the maternity death rate (which at one point was 20%).  

Anyhow, another good thing about this course is I got to talk to some people from other hospitals to get an idea of what other hospitals are like.  And I'm surprised to hear that Nixon hospital is actually not that much worse than the other hospitals.  Sure, they may have more staff (3 vs. the 1 at NIxon), but in terms of equipment, most of them don't have oxygen, many don't have the drugs that one might find to be every-day-use drugs in the states, etc.  From the participant's surprise in hearing about doing basic resuscitation with the ABC's (airway, breathing circulation), it sounds like they don't really have much in terms of emergency care/resuscitation either.  Some of the participants also work in peripheral health units, which means they don't even do blood transfusions, c/sections, etc...and they mostly just do basic stabilization (with IV fluid), and then refer to another medical center. I would really like to visit a few of the other centers and see how their organization is.  I hear the Women's Health/Pediatrics Center in Alberdeen (Freetown) is super well-run/organized, so maybe I can arrange a short rotation there.