This activity report brings together reports from the three provinces where we work: N’Djamena, Bahr el Gazel and Ouaddaï.
Each province has specific needs, so our activities are different depending on the context. But education and development remain our two pillars, according to the vision of the association:
“Reaching and transforming communities using education and development.”
We thank all those who have contributed through their efforts to the advancement of our common goals.
Table of Contents
“Markas al Nour” Culture and Training Centre – N’Djamena
“Kurutini Centre” Education and Development Centre – Bahr el Gazel
2022 has been a stable year for the association. Activities in each of the three provinces have advanced and been refined to better serve the local populations.
In N’Djamena, as in the Bahr el Gazel, several hundred people were able to take advantage of educational courses. In the Ouaddai as in the Bahr el Gazel, several communities have benefited from better access to drinking water. In both the Bahr el Gazel and in N’Djamena, dozens of people have been equipped with training to improve health care.
Through our various activities, the association remains faithful to its vision:
“Reaching and transforming communities using education and development.”
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.
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.
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.
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 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.
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.
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
The places where we worked in 2021
Report sections
The different sections of the year-end report can be downloaded below.
“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.
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.
