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Project title: ISUOG Outreach training in ultrasound in obstetrics and gynecology, Part 2.
Dates: 9-13 January 2012
Location: St Damien Hospital, Port-au-Prince, Haiti. Originally a pediatric hospital, St Damien’s began offering maternity care after the devastating earthquake of Jan 12, 2010 as many other maternity hospitals in the area suffered severe damage. Current volume of deliveries is approximately 500/month with a 24-30% C Section rate as they are considered a “high risk referral center” offering operative delivery. Prenatal care is provided in community clinics in the surrounding area.
Project partners: ISUOG is extremely fortunate to be working with very dedicated partners for this project. Project partners Fondazione Francesca Rava - NPH Italia have contributed significant funds, time and effort in making this project a success. The St Damien Hospital, funded by NPH Italia, and its staff have also made this project a success with their hospitality and invaluable assistance in organising the daily activities of the training team and trainees. Physicians for Peace are our logistical partners and have assisted with travel logistics for this project. Médecins Sans Frontières, ISUOG program partners, sent 5 trainees to the course. One Voluson system was provided on loan to the project from GE Healthcare.
Industry partner: GE Healthcare
ISUOG volunteers:
Dr. Lisbet Hanson, USA (Team Leader)
Prof. Enrico Ferrazzi, Italy
Prof. Jean-Claude Fouron, Canada/Haiti
Prof. Andrea Paganelli, Italy
Dr. Maria Small, USA
Dr. Samir Khalife, Canada
Dr. Frank Sanderson, Canada
From top to bottom and left to right: Enrico Ferrazzi, Lisbet Hanson (team leader), Jean-Claude Fouron, Samir Khalife, Frank Sanderson, Maria Small and Andrea Paganelli.
Course participants:
Total: 25 trainees
Obstetricians: 14 (including 10 from St Damien’s and 4 from 2 local MSF hospitals)
Nurse Midwives: 4
Generalists: 4
Senior OBGYN Residents: 3
Ultrasound machines: 3 GE Volusons, one of which was provided on loan for the course by GE from Italy and 1 SonoSite NanoMaxx (brought in by MSF trainees for the course). One vaginal probe was available. The Aloka machine that had been used during the previous training in May 2011 was not used, as it was needed in triage.
Course format: Lectures were given from 8 AM to 12 noon followed by hands on scanning at 4 stations from 1PM until last patient scanned, about 5 to 6:30 PM.
Pre and Post Test for First Trimester, Second and Third Trimester and Gynecology were obtained.
Team Leader Dr Lisbet Hanson with Prof Enrico Ferrazzi and Dr Jean-Edgard Aupont
Training week summary:
Previous issues with language were overcome with much of the training provided in French by francophone trainers.
Dr Samir Khalife delivering a lecture
Facilities for both the theoretical and hands-on training were comfortable and adequte. All the machines being used for scanning had surge protectors, which greatly helped in protecting the systems from unstable currents which can have very damaging effects! Fortunately, the team did not experience any problems with the machines.
Prof Jean-Claude Fouron, Dr Andrea Paganelli and Dr Maria Small supervise a scan
There was a regular and manageable number of patients for scanning, which allowed for more time with each patient. As the trainees were significantly better at obtaining basic fetal measurements, it was possible for them to spend some time learning more in depth fetal CNS and cardiac anatomy.
Trainees listen to Prof Jean-Claude Fouron
The schedule's flexibility allowed for unplanned changes to the day's activities. For example, on Day 4, which was the second anniversary of the 2010 Earthquake, despite advance scheduling there were no patients who came to the hospital for scans. Instead, patients were brought in from the in-patient ward. This probably saved one woman’s life as she was delivered that same day due to findings on exam at the time of the ultrasound.
Prof Jean-Claude Fouron and Dr Samir Khalife scan a newborn
This was the largest ISUOG Team to date and the extra hands were extremely helpful. This allowed for breaks and a little time to visit some f the other projects run by NPH. Although 4 members of the team were new to ISUOG Outreach, they each had unique strengths and personalities to contribute. The ISUOG Team worked very well together.
Dr Enrico Ferrazzi presents a certificate of completion to a trainee
The larger training team allowed for breaks and time to sightsee in the morning for some of the Trainers, which was greatly welcomed as this always contributes to a greater understanding of the local context and culture.
Dr Maria Small guides an OB-GYN resident through her first scan
Social activities included a morning tour of the Rava-sponsored Cité Soleil clinic, a site visit to HUEH (the General University Hospital), dinners at 2 nearby restaurants including one restaurant sponsored by Rava and another at an old sugar plantation, a Celebration one evening at the hospital with visiting dignitaries including representatives for the Minister of Health and the Pope, and several HUEH OB-GYN Department staff. There was a dance party at the local restaurant one evening and a visit to a Rava-sponsored children’s home and school on the last day. ISUOG was also fortunate to be present at the opening of the newly-renovated Maternity, also funded by the Rava Foundation.
Dr Frank Sanderson and Dr Lisbet Hanson enjoy a visit at a children's home
Lessons learned:
As Trainees progress at different speeds, some Trainers recommended even more time with one on one training, the use of simulation or splitting of the groups so that hands on training was available throughout the day. The Trainers also recommended bedside training be considered to help formulate treatment plans for inpatients as clinical management of cases was identified as an area that help is needed in.
Course evaluations were overwhelmingly positive. Comments included appreciation for the overall course, the opportunity for personal interactions with Trainers, the coordination of lectures and hands-on. Suggestions for improvement in the future included a request for more time to practice hands-on training, and the use of medical translators for lectures being given in a language other than French. More lectures on fetal malformation, Doppler and fetal echo were also requested.
Follow-up activities:
Trainees were each given ISUOG Ultrasound Reporting logbooks to use in their practice. Each trainee will submit three full ultrasound reports with images per quarter to ISUOG for review.
Trainees help each other scan
ISUOG and the Outreach team would like to thank all the partners and trainees in helping to make this project a success. We would especially like to thank Dr Lisbet Hanson, Dr Maria Small, Prof Enrico Ferrazzi, Prof Jean-Claude Fouron, Prof Andrea Paganelli, Dr Samir Khalife and Dr Frank Sanderson for taking the time out of their busy schedules to participate in this project. Thank You!
The training team with commemorative gifts
The trainees
Read the training team's daily updates on our
Outreach blog
.
Previous trips to Haiti:
May 2011
January 2010 (at the time of the earthquake)
July 2009
May 2009
December 2008