Pacific Partnership Trainers Teach Midwives Safe Birthing Techniques

According to U.S. Air Force Col. Daniel Bruzzini, a neonatologist assigned to the hospital at Wright Patterson Air Force Base in Dayton, Ohio, many babies in foreign countries die in the neonatal, or newborn period because midwives and birth attendants do not know how to help that baby take their first breath. He also says they don't need to have ventilators, electricity and [bottled] oxygen to make it happen, as he found out when he attempted this training in other foreign countries.

"My Maternal Infant Training Team and I were sent from Landstuhl Regional Medical Center Germany to local Afghan hospitals to improve the obstetrical, gynecological, pediatric, and newly born care delivered," Bruzzini explained. "The challenge of adopting the resource intensive and complex protocols of current U.S. newborn resuscitation training to an austere medical environment demonstrated a need for this kind of humanitarian capacity building."

Helping Babies Breathe (HBB) is a program designed to assist midwives in austere medical environments. The program teaches groups critical techniques with few tools that allows them to properly deliver or assist in delivering a child not born in a hospital or harsh environment.

"'Helping Babies Breathe' puts a strong emphasis on the 'train the trainer' method of instruction," said Bruzzini. "It is not just about how much the students can do, but how effectively they can go forward and teach others to do it as well."

With a small, reusable kit that costs about $20, students of HBB can assist in delivering babies and then use those same tools, which can be sterilized and used continuously, to teach future midwives and birth assistants to do the same.

Dr. Eriyati Indrasanto, a neonatologist from the Indonesian Society of Perinatology, worked very closely with the class and PP14 leaders to organize this training. With her help, midwives from eight local hospitals attended the first training session and even had the course reading material translated from English to Bahasa, all to ease flow of knowledge for everyday use.

"This program is very good, especially for the midwives and it's very simple," said Indrasanto. "The training is designed for use as primary health care or in a primary health center where there are no doctors or specialists to deliver babies and the midwife is the only 'fighter' to help the mother."

The organization and knowledge from helping babies inspired the first class that they decided before the week was over to teach the second generation of midwives in Kupang - with no help from PP14 participants.

"We started with a group of eight very motivated midwives from the Kupang, each from different hospitals, including the Kupang Naval Medical Center," said Bruzzini. "We gave them the training first, and they took off with it, training the next class of 16 midwives all by themselves. They are very motivated and very bright and want to make things better in Kupang."

Bruzzini said that was the best thing he could hope for.

"They will all go back to their home institutions and not only continue to practice these techniques, but train others which will continually expand them so that throughout Kupang and in other areas of Indonesia they have an effective resuscitation method for newborns in a limited medical resource environment," said Bruzzini. "It's been incredible to see them go from not understanding HBB to owning it and being able to teach it to others, and that has been the most amazing thing to me."

Pacific Partnership is in its ninth iteration and is the largest annual multilateral humanitarian assistance and disaster relief preparedness mission conducted in the Asia-Pacific region.