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Three Weeks until Nurses and Volunteers Training in Salavan

IMG_7526On December 20th, CleanBirth.org and our partner OVA will meet with the 16 nurses we have trained to date. We will check data, give a 6 month supply of birth kits and conduct a mini-training on educating Village Volunteers.

On December 21st, our 2nd Village Volunteers training will take place at Buengkharm Clinic: 3 nurses will train 11 Volunteers.

Not only will these Village Volunteers return home with knowledge about how to make birth safer, they will bring AYZH Clean Birth Kits to pregnant women in their village.

With the generous help of Carol Perks of Save the Children in northern Laos, we have developed a picture tool to track the use of the kits.  No reading required!

TBARecordOnce we see that the Volunteers can distribute and track the kits, we will be able to scale up the Village Volunteer program.  Our goal: to get kits and education into every village in Salavan Province to make birth safer.

 

 

 

 

First CleanBirth Village Volunteers Trained!

IMG_7526We just received the most exciting email. What was an idea in July has become a reality in October.  Our partner in Laos, Our Village Association, with a local clinic in Ta-oiy Province have executed the first CleanBirth Volunteers Training!

IMG_7538The training “Making Birth Safe” was led by a local nurse, Ms. Chanpheng at Pachoudone Clinic, Ta-oiy District, SaravanProvince.  The workshop was under the chairmanship of Mr. Boundala, the head of Pachoudone Clinic.

There were 8 participants from 4 villages, unfortunately 7 others from three additional villages were kept away by heavy rains.  The participants were:

  1. Ms. Tha, woman’s union volunteer from SanaengVillage
  2. Ms. Vae, traditional midwife from SanaengVillage
  3. Ms. Koab, woman’s union volunteer from PhorbeiyVillage
  4. Ms. Koun, traditional midwife from PhorbeiyVillage
  5. Ms. Loiy, woman’s union volunteer from PachouchernVillage
  6. Ms Ms. Orn, midwife from Pachouchern Village
  7.  Ms. Lang, woman’s union volunteer from ChotaiVillage. Orn, traditional midwife from PachouchernVillage
  8. Ms. Kamouan, traditional midwife from ChotaiVillage

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The contents in the workshop included:

1. How to use the AYZH Clean Birth Kits

2. How to encourage breastfeeding

3. Warning signs in pregnancy and labor

Noi, the OVA employee tasked with coordinating CleanBirth.org’s activities on the ground, gave these details about the training:

The training room was cramped and we could not hold the training outside due to the heavy rain but the participants were interested in the topics.

The trainer used dialect language (Ta-oiy language) on the training made them clearly understand the lessons.

IMG_7554We could not be more thrilled that this training went so well, that it was led exclusively by local staff and monitored by Noi.  Locals helping each other make birth safe!

This is a great start to our CleanBirth.org Village Volunteer Training!

Giving Birth Lao Style: Reasons for Homebirth

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1. Distances to clinics are great, costly
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2. Poor treatment by staff, iInadequate clinic resources
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3. Moms can’t leave older children for long periods
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4. They want to observe traditional practices

Wonderful that Vanphanom Sychareun et al have brought attention to the issues surrounding Laos’ high rate of maternal and infant deaths.   Their August 2012 study “Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study” reveals the reasons for women’s preferences and gives basic recommendations.

The method was focus group discussions (FGD) and in-depth interviews with 71 mothers, husbands and grandmothers.

Reasons for homebirth:

1. Distance and cost of transport

2. Poor treatment/practices like horizontal birth position, episiotomies, no privacy, male staff

3. Desire for family/other children near

4. Desire for traditional birth practices: squatting position and “hot bed” (fire underbed) post-partum

What to do?  Clinics should respect traditions/wishes of mothers.  Further, mothers/family should be educated about high risk pregnancies so that they go to the clinic regardless of preference.

Giving Birth Lao Style

Looking at the many pictures I have from clinics in Laos, I wanted to learn more specifics about why birthing practices such as the “hot bed” are so important to postpartum recovery in Laos.

bedI found this blog post which excerpted a “Vientiane Times” July 2006 article that sheds some light:
“A grey-haired woman chews betel nut as she puts a pot of glowing charcoal under the bed of her daughter, who lies there weakly after giving birth a few days ago.
The young mother’s body is covered in sweat due to the heat of the fire, which is as hots as the coals on which she normally grills fish.

insideclinicI asked Mrs. Yad, who is taking care of her daugther Van, why it was necessary for her to lie over a bed of coals.

Mrs. Yad smiled and said that there were two accepted methods of post-natal recovery, referred to as cool or hot.

The “cool” method involves only taking traditional medicine and does not require the mother to lie over a fire. The “hot” method requires the mother to lie in bed over burning charcoal for at least 15 days.

While both these methods are traditional and have been in existence for as long as anyone can remember, almost every young mother without exception follows the “hot” method as requested by her family. This method is the more effective, according to Mrs. Yad.

IMG_0093The fire must stay alight all the time until the mother has completed her recovery, at a date determined by her own mother. This is done because it is believed that the heat of the fire will heal the uterus and birth canal more quickly. ‘If a new mother doesn’t do this, she may develop backache and an aching waist,’ she explained.

Mrs. Yad believes that if mothers can withstand the heat for this length of time, they will be healthier in the long run. The longer they lie over the fire, the sooner they will recover.

newmomDuring this time, Van will drink several litres of hot water every day, boiled in a cooking pot and containing herbs to ensure that she will produce enough milk to breastfeed her baby. She also has to shower three of four times a day, again using warm water with traditional herbs. This is the Lao way, and it is rigorously adhered to.

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The new mother is not allowed to eat normally after giving birth, and her diet is limited to prevent her becoming ill. In the first three days after delivery, she will only eat fried galangal with salt. AFter this she can eat friend meat of a black feathered chicken and of a black buffalo.”

 

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