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Bahr el Gazel Health

Training in resuscitation and obstetrical emergency

January 18 – 19, 2023 at the Provincial Hospital in Moussoro

Introduction

Service au Sahel (SAS) organized training in Moussoro in coordination with the Representative of the Ministry of Health, Dr. Amboulmato Hormo. The training was led by two volunteer doctors who came to Moussoro from N’Djamena.

SAS previously organized postpartum hemorrhage training at the hospital in Moussoro in June 2022, neonatal resuscitation training in November 2021 and dental extraction in October 2019.The training was officially opened by Dr. Hormo along with the Director of the Provincial Hospital, Brahim Mahamat Mahadi. Dr. Hormo underlined the importance of this training at the hospital, because often such trainings are only given at the largest hospitals in the largest cities in Chad.

Day 1 Cardio-Pulmonary Arrest

Day 1 focused on cardio-pulmonary arrest and was taught by Dr. Michael Schüle.

Adult resuscitation typically has a low rate of success due to various complicating factors. Therefore, it is advantageous to prevent cardo-pulmonary arrest before it starts.

Dr. Schüle’s training covered all steps necessary for basic adult resuscitation as well as the steps needed for advanced resuscitation.

He finished by reviewing the material on neonatal resuscitation that had been covered in the previous training in November 2021.Practical exercises were woven throughout the material to help reinforce the information that was being shared.

Day 2 Obstetrical emergencies

Day 2 focused on obstetrical emergencies and was taught by Dr. Claudia Wahl. She discussed how emergencies are rare but are nonetheless potentially mortal for either the mother or the child, or both.

First, she focused on bleeding as a sign of urgency. She covered the various diagnostic actions that need to be done to diagnose the patient.

After the break, she taught about convulsions as a sign of urgency. Eclampsia is always a risk for women with a pregnancy that is more than 22 weeks along.

Finally, the training finished with a review of post-partum hemorrhaging that had been covered in June 2022.Similar to the training from Day 1, practical activities were included in the training so that participants could gain experience responding to different scenarios in the training room.

Conclusion

A total of 16 people were trained, including two doctors, five midwives, four nurses, and three nursing technicians. The 16 healthcare providers who completed the training at the hospital received certificates at the end of the training. In addition, the two doctors who gave the training each received a certificate from the Health Representative recognizing their contribution.

The participants with their certificates

The Representative of the Ministry of Health emphasized in his speech, the need for the hospital staff to put the training into practice. He said that the training will help to save someone’s life. Similarly, Service au Sahel desires to see improved healthcare at the Provincial Hospital and throughout the Province. 

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Bahr el Gazel Kurutini Center

Library opening in Moussoro

The new library has been opened at the “Centre Kurutini” in Moussoro. The library has books that especially correspond with students studying at the local collège and lycée: French, literature, geography, biology, and math.

The cost to sign up is 3’000 FCFA for the school year: from the beginning of October to the end of July of the following year.

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Bahr el Gazel Board of Directors Development Kurutini Center

Opening of the “Centre Kurutini” in Moussoro

The opening ceremony for the new center took place on Wednesday October 5, 2022 in the presence of the local authorities as well as the Coordinator of the association.

The history of the association in general and the work in the Bahr el Gazel in particular was shared during the ceremony:

The video is in French only.

The new center is called “Centre Kurutini”. The name is a combination of French and Goran words. A Center is an establishment for courses and learning. The center is a place for the library, reading and for meetings. ‘Kurutini’ means development in the Goran language and means to put things forward. We want the “Centre Kurutini” to fulfill the aspirations of our association but also those of the community to advance the development of the city and the province.

There is a proverb in Goran that says

Tefaruma kijai, giju-ma tussu. 

The proverb says that saying something is easy, but doing it is hard. It is easy to share the ambitions of the association through this new center. The achievement will depend on the work that happens afterwards: the courses given, the relationships forged and the actions carried out. The realization will also depend on the authorities of the province and the city which can facilitate our work; the implementation will depend on our partners, the NGOs on site in Moussoro; the realization will depend on the civil society as well as the youth of the city. And without forgetting, the realization will depend on the help of God who will be able to do “infinitely more than all that we ask or imagine”.

The ceremony finished with a family photo:

Our thanks in particular go to the local authorities who officially declared the center to be open.

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Bahr el Gazel Kurutini Center

Certificate ceremony in Moussoro

Twelve people finished a level one computer class in Moussoro.

Over a period of 20 hours of instruction, students learned the basics of computing:

  • The physical components of the computer
  • The difference between the Operating System and software
  • How to use the keyboard, particularly the accents
  • How to open Microsoft Word and type up a document
  • Formatting a document with tab stops

The training finished with a ceremony at our training center.

Categories
Bahr el Gazel Health

Training in neonatal resuscitation and prevention and treatment of postpartum hemorrhage

Introduction

Service au Sahel (SAS) organized training in Moussoro in coordination with the Representative of the Ministry of Health, Dr. Amboulmato Hormo. The training was led by two volunteer doctors who came to Moussoro from N’Djamena.

SAS previously organized neonatal resuscitation training at the hospital in Moussoro in November 2021 and dental extraction in October 2019.

Neonatal resuscitation at the Urban Health Center

According to the World Health Organization, “Sub-Saharan Africa had the highest neonatal mortality rate in 2020 at 27 (25–­­32) deaths per 1000 live births.” Chad’s neonatal mortality rate is 32.81 deaths per 1000 live births, which is the 10th highest in the world according to the World Health Organization’s Global Health Observatory.

The first part of the training was done on 15 June 2022 at the Urban Health Center in Moussoro. 

The morning began with a visit of the Health Center, including the admitting room, the labor room, the delivery room, as well as the laboratory. Then training on neonatal resuscitation was given to six nurses and midwives.

The goal of this part of the training was to prepare the nurses and midwives to better respond to a newborn who was having trouble breathing.

Instruction was given and then the participants were able to practice resuscitation using an inflatable simulator called NeoNatalie that resembles a newborn baby. 

Training at the Moussoro Provincial Hospital

Two days of training, 16-17 June 2022, were given at the Provincial Hospital in Moussoro. Sixteen participants, a combination of doctors, nurses, midwives, and health aides were trained on three subjects: prevention and treatment of postpartum hemorrhage, neonatal resuscitation, and improved charting using the partograph.

Module 1: Prevention and treatment of postpartum hemorrhage

The WHO says that “Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known.” The leading cause of maternal death is “Severe bleeding after birth also called postpartum haemorrhage”, which “can kill a healthy woman within hours if she is unattended.” 

Chad has a maternal mortality rate of 1140 deaths per 100,000 live births, which is the 2nd highest in the world. The World Health Organization has a Sustainable Development Goal to reduce the global maternal mortality rate to less than 70 deaths per 100,000 live births. 

The “Bleeding After Birth Complete 2.0” program from Helping Mothers Survive, a program of Jhpiego, was used for the training. 

The training showed healthcare providers how to identify the causes of heavy bleeding and manage each one correctly. Charts were used which helped identify the steps to take for routine care and advanced care. Focus was given to rapid response in emergencies, requiring the assistance of other staff members.

Module 2: Refresher course on neonatal resuscitation

A refresher module was given on neonatal resuscitation. Like the training at the Urban Health Center, the training helped the healthcare providers know how to respond to a newborn who was having trouble breathing.

Module 3: Improved charting using the partograph

Médecins sans Frontières defines the partograph as “a tool for monitoring maternal and foetal wellbeing during the active phase of labour, and a decision-making aid when abnormalities are detected. It is designed to be used at any level of care.”

The provincial hospital wanted to improve their use of the partograph in the maternity. Trainees were shown how to chart labor and delivery. They were taught how to recognize the signs for alert and the signs for action. Using a hypothetical scenario, they practiced using the partograph for charting.

Conclusion

With an estimated population of 349,000 people in the Bahr el Gazel, the Provincial Hospital and Urban Health Center are two of the most used healthcare structures in the province.

The 16 healthcare providers who completed the training at the hospital received certificates at the end of the training. In addition, the two doctors who gave the training each received a certificate from the Health Representative recognizing their contribution.

The association Service au Sahel is proud to have helped organize this training to reduce neonatal and maternal mortality in Moussoro and the Bahr el Gazel. Additional training in Moussoro in 2022 will be discussed in collaboration with our local partners.

Categories
Bahr el Gazel Development

Pump repair in Lugudinga

On May 12, 2022, the association Service au Sahel received a visit from a delegation from the village of Lugudinga, situated 20km southeast of Moussoro.

The delegation explained that their hand pump wasn’t working any more. The village had been able to repair the pump several times, particularly closing the holes caused by rust in the pipes. They asked the association de help them repair the pump.

On May 17 the association, along with a team of repairmen based in Moussoro, were able to go visit the village. The removal of the pipes by the repair team showed clearly that all eight pipes were too rusted to be able to be used again. The association was able to offer eight new galvanized pipes.

Once the installation was done, the pump was quickly put into service by the children who live in the village. The residents of the village expressed their thanks for the repair.

The village has around 100 households according to its residents.

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Bahr el Gazel Board of Directors Development Hadjer Hadid Health Kurutini Center Markas al Nour N'Djamena Ouaddai

2021 Year-End Report

Introduction

This year-end report is a combination of updates from each of our projects. Together, they show the diversity of our activities as well as our desire to achieve our common vision:

“Reaching and transforming communities using education and development.”

The slogan of our association

We would like to thank all those who contributed during the past year to our common objectives.

Map of the primary locations where we work

Map showing the primary locations of the year-end report
The places where we worked in 2021

Report sections

The different sections of the year-end report can be downloaded below.




Conclusion

“There is a time for everything and a season for every activity under the heavens.” Ecclesiastes 3:1

2021 saw a new start for Markas al Nour in N’Djamena with the appointment of a new director in August. Classes and other activities were less in the Bahr el Gazel in 2021 compared to 2020. Water and community-led total sanitation continued in the Ouaddai with the same rhythm as before.

The transformation we would like to see in coming, but has not yet been achieved, so we will continue to work hard in the coming years. In the meantime, we hope that you appreciate reading the report about what we’ve accomplished in 2021.


N’Djamena, the 27th of March 2022

The Secretary General of SAS

Categories
Bahr el Gazel Health

Training in neonatal resuscitation

Service au Sahel held a two-day training in neonatal resuscitation at the Provincial Hospital in Moussoro. The course was held on November 12 and 13 and 16 medical staff from the hospital were trained.

The program teaches skills in caring for neonates with a focus on those babies who have difficulties in breathing after birth. The participants improved their practical skills in basic life support, working on clinical scenarios in small groups. Implementation of a set of simple measures like bag and mask ventilation has been shown to reduce early neonatal mortality up to 50% in the low resource setting.

The entrance to the hospital in Moussoro

Of the 16 medical staff trained, five were from the Maternity department of the hospital.

The training on neonatal resuscitation is the second collaboration Service au Sahel has had at the hospital in Moussoro. The first was a dental training in November 2019.

Categories
Markas al Nour

English Club at Markas al Nour

The English Club at Markas al Nour education center has been re-started!

English Club
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Board of Directors Markas al Nour N'Djamena

The History of Markas al Nour

Beginnings (2002-2006)

This is the history of Markas al Nour, an education center in N’Djamena whose name means the “Center of Light.”

The entry to Markas al Nour, circa 2005
The entry to Markas al Nour, circa 2005

The association Service au Sahel was started in 2002 by a group of volunteers. The association is non-profit and non-political, working primarily in education and development. The association received its Autorisation de Fonctionner from the Chadian government in 2003. The board of directors is composed of three to seven people and is led by a Coordinator.

The association’s first venture was the education center named “Markas al Nour” on the 30m road in N’Djamena. Markas al Nour opened its doors in January 2003.

Initially the center was equipped with donated books and computers and had two classrooms. Two Chadians were hired full-time: a secretary and a librarian.

The Markas al Nour library

In 2005 the French embassy gave a grant to help equip the center with more than 600 books, a third classroom, a new generator, and updated computers. The updates were finished in 2006, and a ceremony was held with representatives from the French embassy and from the neighborhood. A 50% increase in students was seen in 2006 because of these upgrades.

Graduates of one of the first computer classes

Growth and Challenges (2007-2011)

Upgrading the building to include a new computer classroom

Significant upgrades were made to the center starting in 2007. Computer teachers gained such good instruction at Markas al Nour that they went on to find good positions working in IT. It became necessary to recruit more teachers for computer classes.

A volunteer teaches a networking class

In 2010, the center had major problems with the electrical generator resulting in costly repairs. In 2011 a new 22 kVA electrical generator was donated to the center.

Autonomy and financial pressure (2012-2019)

Students at the end of class

During this period, French classes grew from on average 130 students per year to almost 500 students per year. Night classes (7-9pm) were added in 2015 and that brought in more students who didn’t have time to study in the afternoons. Morning classes also became more regular at the center with a peak of 25 morning classes during 2017.

However, the increase in French language classes was offset by the decrease in computer classes: computer classes dropped below 100 students per year in 2016 for the first time and have remained low, although MaN received a gift of updated computers in 2016.

In 2018, the center opened a Maternelle, but failed to attract enough children to pay for the teacher. The nursery school was not continued in 2019.

Financial pressure increased as Chad’s economy contracted in 2017 and 2018 due to plunging oil prices. Increased competition from other education centers put pressure on MaN to reduce the price of French classes.

Reorganisation (2020-2021)

Markas al Nour officially closed in July 2020 due to this financial pressure along with the added strain of covid restrictions. However, by November 2020 the center reopened, and classes restarted.

The history of Markas al Nour has been full of growth and change. The years to come will bring more change with one constant: high quality education classes for the northern neighborhoods of N’Djamena.

Markas al Nour Statistics (2004-2020)

statistics from the history of Markas al Nour (2004 to 2020)

English was the most popular class from 2005 to 2008 powered in part by an active English club.

Computer classes were the most popular from 2009 to 2012, including classes on maintenance, networking, and website creation.

French classes have been the most popular from 2013 until today.

2016 was the biggest year when more than 1000 students attended classes. 2020 was the smallest year due to the center closing and reorganizing.