Honduras

                                      Norma Brown teaching in Honduras

Two S.T.A.B.L.E. Lead instructors, Norma Brown (Nevada) and Ramona Wilder (Utah) traveled to Honduras in March 2004 to implement the S.T.A.B.L.E. Program (Learner and Instructor courses) in two locations (Tegucigalpa & San Pedro Sula). Norma Brown submitted the following trip report upon her return. We are very grateful for the expansion of the S.T.A.B.L.E. Program to so many healthcare providers in the many countries who feel they benefit from this increased knowledge and systematic approach to caring for sick infants.

In March, Ramona Wilder and I had the great opportunity to bring the S.T.A.B.L.E. Program to physicians and nurses in Honduras. The program was very well received and both physicians and nurses were very excited about the possibilities of implementing this program in Honduras. This was such a rewarding and wonderful experience for us.

The trip to Tegucigalpa & San Pedro Sula, Honduras, was sponsored by the LDS Church Humanitarian Services, to bring both the Neonatal Resuscitation Program (NRP) and S.T.A.B.L.E. Learner Program instruction and training to physicians and nurses.

• In Tegucigalpa, there were 57 participants in the S.T.A.B.L.E. Learner Course and nine participants in the S.T.A.B.L.E. Instructor Course. There were 17 physicians and 40 nurses and other healthcare providers in attendance. We held both courses at the LDS Conference Center in Tegucigalpa. Two physicians registered as Lead instructors and seven physicians registered as Support instructors.
• In San Pedro Sula, there were 33 S.T.A.B.L.E. Learner Course Participants and seven S.T.A.B.L.E. Instructor Course participants. There were 23 physicians and 9 nurses in attendance. Both Learner and Instructor courses were held at the Hospital Mario Catarino Rivas Conference Center, in San Pedro Sula. Four physicians registered as Lead instructors and three physicians registered as Support instructors.

The NICU Unit in San Pedro Sula, Honduras

The biggest challenge we faced on this trip was trying to teach the S.T.A.B.L.E. Learner and Instructor course without manuals! Unfortunately, the books had arrived in Honduras, but customs would not release them in time for the course. We did have the Spanish version slide presentation to guide the course; however, it was still difficult to present the material and explain the charts and graphs without the books. Nevertheless, the enthusiasm and interest expressed by the participants, particularly in Tegucigalpa, was great.

In discussion with the groups, participants identified several issues concerning their situation in Honduras.

First, Emergency Medical System and Ambulance Services essentially provide transportation from one place to another, but no one is available to monitor or provide care to the patient during transport. There are no trained personnel who are available for transport of patients. This, of course, poses a great problem for transport of an infant. Second, small hospitals in rural areas do not have trained personnel or equipment necessary to stabilize ill newborns.

The group of new S.T.A.B.L.E. Instructors were already planning a proposal to submit to the city government for funding to provide S.T.A.B.L.E. Program instruction and training to Ambulance personnel in the city and in rural areas. This would raise awareness of the importance of monitoring the infant during transport and at the very least, keeping the infant warm. In addition, there was much interest in taking the S.T.A.B.L.E. Program to physicians in rural areas to instruct them on neonatal stabilization and transport.

The NICU Unit in San Pedro Sula, Honduras

All in all, I must give tremendous credit to these groups of physicians and nurses, who despite the lack of resources and personnel take wonderful care of sick neonates. Their dedication and commitment are unsurpassed. I wish them great success in their endeavors to implement the S.T.A.B.L.E. Program in Honduras.