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INTERNATIONAL TRIP REPORT – Thailand January 2024

ABOUT THIS MISSION TRIP

I was traveling on behalf of what organization or humanitarian group:

Thai Physician Association of America (TPAA)

Thai Physician Association of America Foundation

All Thai physicians in the US belong to these two organizations. Medical missions are being done through TPAA by medical education and donation of medical equipment. TPAAF is a nonprofit organization and people can donate to their school education fund through TPAAF. TPAAF provides operation funds to TPAA and Red Cross.

The goal of this trip was to provide medical education for nurses and doctors in Thailand by teaching S.T.A.B.L.E. classes including the new cardiac S.T.A.B.L.E. as well as donations of much needed medical equipment to the hospital and enable many TPAA members to share their experience with the medical staff of various departments in the hospital.

Medical equipment donations received by Maharat Nakhon Ratchasima Hospital – 

Transport incubator TR200, Masimo pulse oximeter, Syringe pumps, NST, and Infusion pumps.

TPAA Goals

• Provide medical education for nurses and doctors in Thailand.
• Donation of medical equipment to the hospitals in Thailand.
• Donation for scholarship fund for master’s degree at Harvard school of Public Health for Thai students.
• Donation for education scholarship fund for poor students in Thailand. 
• Disaster relief fund for earthquake, flood victims in US, and anywhere in the world.

People are often interested in knowing more about the region you visited. Please describe the community where S.T.A.B.L.E. was taught. 

Maharat Nakhon Ratchasima Hospital is located in the southeast of Thailand 261 km from Bangkok population 2.7 million. It is the largest regional hospital in Thailand providing medical education for medical students, interns, and residents as well as patient care in all specialties. 5000 births annually, three neonatologists covering the 40 bed NICU with the ability to perform therapeutic hypothermia for HIE. It has a total of 1387 hospital beds. 

How many students attended your course and what were their credentials?  

There were 205 attendees – 51 RNs, 154 physicians.

Describe some of the nursing and medical challenges being faced by the S.T.A.B.L.E. course attendees with regard to provision of day-to-day neonatal care: 

Nurses may have some difficulty in English language, so the class was taught as much as possible in the Thai language. The transport incubator received with this trip was just in time as the one on site had just gone out of commission even after repeated repair. 

How do you envision The S.T.A.B.L.E. Program will help the health care providers you taught?

The S.T.A.B.L.E. Program provides an excellent review for common neonatal problems with reminders so the provider does not miss the diagnoses that could lead to serious consequence by providing consistent ways to use the mnemonic enhancing memory and recall. This provides confidence in stabilizing the sick babies before transport. The cardiac module was very useful for all staff including physicians as a learning tool for understanding the anatomy of CHD as well as diagnosing and managing CHD correctly and safely. 

How others can help with your humanitarian efforts

We welcome any donation to TPAAF, our non-profit organization. https://tpaaf.us/

Kris Karlsen (STABLE Program Author) is very kind, very generous and very supportive. She gave us a good discount for the manuals to help our medical mission in Thailand, we are very thankful and very appreciative.

In summary, I and our team cherished the whole experience and found that all the students were very excited, attentive, and very happy. 

Thank you very much very much Kris, Beth, Mason, and S.T.A.B.L.E program for the creation of this wonderful neonatal education program.

Materials donated from The S.T.A.B.L.E. Program for your course: 

6^th Edition Learner Manuals

2^nd Edition Cardiac books. 

6^th Edition Learner Course slides on USB. 

2^nd Edition Cardiac slide program subscription

Before the class

STABLE Maharat

Class completed

Equipment Donation

 Dr Pichaya Thanomsingh – Course Organizer (2^nd from the left) 

Dr. Boonyapredee and his wife 

Gifts of Appreciation given to Dr. Boonyapredee

THE S.T.A.B.L.E. PROGRAM

INTERNATIONAL TRIP REPORT – May 2023

1. Location where S.T.A.B.L.E. Learner Course was taught

              Tamale, Ghana

2. Report Submitted by:

              Geralyn Sue Prullage DNP, APN, NNP-BC

              Tamale Teaching Hospital

3. COURSE INFORMATION

               S.T.A.B.L.E. Learner Course: May 30 and 31^st, 2023

               Tamale Teaching Hospital

               S.T.A.B.L.E. Instructor:  Geralyn Sue Prullage, DNP, APN, NNP-BC

                                                        Board Member of Council of International Neonatal Nurses

                                                        Clinical Educator of Community of Neonatal Nursing Practice

               Who attended the Learner Course?

              4 BSc Neonatal Nurse Specialists and 9 General Nurses

               Materials donated from S.T.A.B.L.E. for your course:

              S.T.A.B.L.E. Learner Course Slides 

              Physical Exam and Gestational Age Assessment Slide Program

4. ABOUT THIS TRIP

I was traveling on behalf of the Council of International Neonatal Nursing [COINN] (coinnurses.org). This is an organization that has brought together over 5000 neonatal nurses across the world. The purpose of the trip was to train nurses to be experts in the field and to be preceptors.

People are often interested in knowing more about the region you visited. Please describe the community where S.T.A.B.L.E. was taught.

Tamale is in Northern Ghana. It is the largest city in the Northern region of Ghana. Tamale Teaching Hospital (TTH) has a busy neonatal unit that has doctors, pediatricians, advanced practice nurses, medical officers, and house officers. The unit has a well-run kangaroo mother care unit. TTH is the referral center for the northern region.

Describe some of the nursing and medical challenges being faced by the S.T.A.B.L.E. course attendees with regard to the provision of day-to-day neonatal care.

The unit had several actual CPAP machines, but they did not function well due to poor oxygen outlets and no oxygen tanks available. So, most of the babies that needed CPAP were placed on the “traditional” homemade CPAP. There were not enough incubators or overhead warmers for each admission to have their own incubator or overhead warmer. There is no actual transport system. Parents must pay for any transport needed and finances are difficult. So, often babies arrive on the back of motorcycles or the tricycle (a motorized golf cart adapted with seating). Every piece of equipment needed must be paid for by the family.

How do you envision The S.T.A.B.L.E. Program will help the healthcare providers you taught?

The participants are to be the preceptors for new employees and students. The understanding of hypoglycemia and thermoregulation is paramount. I envision that they have a better understanding of the identification and treatment of the things we talked about in the STABLE course. We actually admitted a baby with a subgaleal hemorrhage, and the participants were able to understand what was going on and were eager to provide appropriate care.

S.T.A.B.L.E. International Activity in Zambia

Wakako Eklund DNP, APRN, NNP-BC, FAANP, FAAN

April and May 2023

During the month of April and early May 2023, the Advance Practice Neonatal Nursing students at the University of Zambia received a series of respiratory pathophysiology and assessment lectures given by Wakako Eklund who has been a S.T.A.B.L.E. instructor for many years.

The school year began in March 2023, and we have students from Zambia but also from Rwanda and Botswana this year. The students from Botswana are supported by their Health Ministry to improve the newborn outcomes.

Given that not everyone in the class is well-familiar with the level 3 NICU and common procedural practices related to management of respiratory care, I utilized the procedure slide decks (Chest Tube insertion, Positive Pressure Ventilation, Needle aspiration, and Intubation) and zoom-recorded the lecture to demonstrate how these procedures are completed.

The images and the contents that these slide sets cannot be easily replicated, and I appreciate the quality of the slide decks that are highly valued by the students and also by us, the volunteer faculty team. We appreciate the immense generosity that is extended by S.T.A.B.L.E. to make this possible for these students who are often without textbooks and other resources that we in high resource countries take for granted. The students are looking forward to taking the full S.T.A.B.L.E. course later this summer.

THE S.T.A.B.L.E. PROGRAM

INTERNATIONAL TRIP REPORT

Location where S.T.A.B.L.E. Learner Course was taught

      Dar es Salaam,  Tanzania

Report Submitted by 

      Louise Sabbagh, MSN, RN

      S.T.A.B.L.E. Lead Instructor

      Walter Reed National Military Medical Centre

      Bethesda, MD

COURSE INFORMATION

      S.T.A.B.L.E. Class date(s): May 8, 2023 & May 9, 2023

      Course Instructor: Louise Sabbagh RN, MSN

      Shree Hindu Mandal Hospital

      Pediatric and Child Health Department

      Dar es Salam, Tanzania

ABOUT THIS MISSION TRIP

This mission trip was a planned and personal contribution to enhance care given to babies requiring Intensive Neonatal Care. I would like to thank the STABLE program for the generous donations of STABLE products.  I would also like to express my gratitude to family and friends who supported me in this journey – from stationery products to hospitality, I have been surrounded with kindness for which I am eternally grateful.

The purpose of this trip:

Having lived in Tanzania for many years, I feel the need to return to my place of birth.  I wanted to share knowledge that is systematic, and evidence based.  Bringing S.T.A.B.L.E to Tanzania, I want to improve outcomes for babies needing specialized treatment. In presenting this program, I believe that I enhance the care that nurses and doctors provide and will positively influence statistics like Retinopathy of Prematurity and negative effects of cold stress.

People are often interested in knowing more about the region you visited. Please describe the community where S.T.A.B.L.E. was taught.

I taught S.T.A.B.L.E in Dar es Salaam, Tanzania.  Tanzania is in East Africa and is the thirteenth largest country in Africa. Situated just south of the equator, Tanzania is home to Mount Kilimanjaro which is the highest mountain in Africa.  Taking a Safari to Ngorongoro Crater or Serengeti National Park is an unforgettable experience especially when you catch sight of elephants, lions, leopards, buffalo and rhinos.

I taught S.T.A.B.L.E in a level 1-2 Hospital situated in the center of Dar es Salaam.  Shree Hindu Mandal Hospital has 50-60 deliveries per month.  I conducted 8-hour full day classes on two separate days.  The classes were attended by nurses, physicians, and midwives. A total of 19 staff attended the classes.

The nearest tertiary hospital is Muhimbili hospital, which is not far away, but traffic makes navigating the one-lane roads extremely challenging.

The biggest difference was that the transport of a sick baby was done by the hospital that requested the transport not the tertiary center.  The staff of the referring hospital had to prepare and transport the sick baby to the tertiary center.

Describe some of the nursing and medical challenges being faced by the S.T.A.B.L.E. course attendees with regard to provision of day-to-day neonatal care

In speaking with the staff, I learned that staffing was a challenge.  Hiring and retaining staff was an ongoing effort. Another challenge was obtaining equipment like blended oxygen.  This was available only in certain bed spaces which made oxygen administration somewhat challenging.

How do you envision The S.T.A.B.L.E. Program will help the health care providers you taught?

The S.T.A.B.L.E. Program was well received, and I had many interesting discussions especially about future Quality Improvement projects. The Head of the Nursing Department was very interested in future classes and ways that the Nurse Practice Council could start implementing various projects using principles from the S.T.A.B.L.E course.

How many students attended your course and what were their credentials?

RNs: 12

Midwives: 2

Physicians: 4

If you collected information regarding student’s impressions of the S.T.A.B.L.E. course, please provide that information here:

They found the program very informative with a lot on information. They thought that there was a lot covered in a short amount of time.

The videos were a great review and presented in a easy to understand way.

HOW OTHERS CAN HELP WITH YOUR EFFORTS

I plan to visit again and would really like to provide more educational materials to promote safe care for all babies.  I would also like to assist the hospital in obtaining equipment like breast pumps, incubators, and cardiorespiratory/O2 saturation monitors.

MATERIALS DONATED FROM THE S.T.A.B.L.E. PROGRAM FOR YOUR COURSE:

• Blood Gas Nomograms
• S.T.A.B.L.E. Learner Course Slides (USB)

THE S.T.A.B.L.E. PROGRAM

INTERNATIONAL TRIP REPORT

Locations where the S.T.A.B.L.E. Learner Courses were taught

Tha Muang , Tha Muang  district,  Kanchanaburi  Province, Thailand

Mueang Sakon Nakhon Ditrict, Sakon Nakhon Province, Thailand

Report submitted by:

    Wichest  Boonyapredee, MD, FAAP

    Neonatologist, Community hospital

    Department of Pediatrics (honorary member)

    901 Mac Arthur Blvd.

    Munster, IN 46321

COURSE INFORMATION

S.T.A.B.L.E. Learner Course, January 10 to 11, 2023

Course location 

    Sakon Nakhon hospital

    1041 Charoen Mueang Road, That Choeng Chum

    Mueang Sakon Nakhon District,

    Sakon Nakhon 47000, Thailand

Teaching Team: Wichest  Boonyapredee, MD, FAAP

S.T.A.B.L.E. Learner Course, January 19 – 20, 2023

Course location

    Somdet Phra Sangkarat  19th hospital

    978/1  Moo  3   Sangchuto  Road, Tha Muang,

    Tha Muang district, Kanchanaburi Province , Thailand

Teaching Team:

    Wichest  Boonyapredee, MD, FAAP

    Chutima Kannasoot MD, Neonatologist

     Department of Pediatrics

    Paholphonpayuhasena Hospital, Meung District

    Kanchanaburi

ABOUT THIS MISSION TRIP

I was traveling on behalf of the TPAA medical mission (Thai Physician Association of America)

TPAA received funding from donations to TPAAF (Thai Physician Association of America Foundation), a nonprofit organization .

The goal of TPAA:

• Provide medical education for nurses and doctors in Thailand.
• Donation of medical equipment to the hospitals in Thailand
• Donation for scholarship fund for master’s degree at Harvard school of Public
• health for Thai students
• Donation for education scholarship fund for poor students in Thailand
• Disaster relief fund for earthquake, flood victims in US and anywhere in the
• world.

People are often interested in knowing more about the region you visited. Please describe the community where S.T.A.B.L.E. was taught.

A. Kanchanaburi province is in the central region of Thailand, many interesting site seeing, River Kwai bridge WWII, Cemetery for Unknown soldiers, beautiful Arawan waterfall, Oottamanusorn bridge the longest wooden bridge in Thailand. 

Somdet Phra Sungkarat 19th is one of the largest community hospitals with 120 beds and 1000 deliveries per year, second highest in Kanchanaburi province and in the process of setting up 4 beds NICU where TPAA members donated 4 sets of high flow nasal cannula with a few sets of bubble CPAP and one set of Masimo pulse oximeter radical 97.

The class was very successful!

There were 6 members on the team, one Ob-Gyn, one Family practice, one internist and two nurses. The hospital Administrator and staff were very happy, took care us very well, sponsored hotel for three nights and three dinners as well as karaoke Farewell party.

Sakon Nakhon province

This province is located in the northeast of Thailand. There are many beautiful temples where the very well respected monk used to stay, Wat Tham Pha Daen, Wat Phra That Choeng Chum Worawihan Temple. We also visited Ban Tharae Catholic Community, Phra Archan Man Phurithatto Museum, and beautiful Nong Han Chaloem  Phra Kiat Park. We visited the famous Kram Sakon Indigo dyeing shop for clothes, cotton .        

Sakon Nakhon hospital is the largest hospital in Sakon Nakhon province with 800 patient beds and 3500 deliveries per year with 12 beds NICU and one neonatologist.

Sixteen TPAA members met at Don Mueang and flew to Sakon Nakhon airport where we received a very warm welcome from the members of red cross and enjoyed a delicious reception dinner. All together 19 TPAA members participated in this medical mission.

The class was very successful! Here TPAA members donated one set of transport incubator with Neopuff resuscitator, four syringe pumps, three infusion pumps, and  two Masimo pulse oximeter radical 97 to the Department of Pediatrics, Sakon Nakhon hospital.

How many students attended your course and what were their credentials? 

1. Class 1: There were 47 students with 40 nurses and 7 physicians.
2. Class 2: 147 students from 37 hospitals attended the class (139 nurses and 8 MDs)

Describe some of the nursing and medical challenges being faced by the S.T.A.B.L.E. course attendees with regard to provision of day to day neonatal care:

The  Nursing and medical challenges in Thailand are:

• Medical equipment shortage
• The patients overload especially nurses and doctors who have to work very hard
• Some patients live so far from the hospital
• Some language barriers. For example, I spoke Thai during the class because most of the books are in the Thai Language.

How do you envision The S.T.A.B.L.E. Program will help the health care providers you taught?

I always think that S.T.A.B.L.E classes are a very valuable, in addition to NRP, providing excellent information for the care of sick neonates and should be a must for all neonatal providers.

If you collected information regarding student’s impressions of the S.T.A.B.L.E. course, please provide that information here:

HOW OTHERS CAN HELP WITH YOUR HUMANITARIAN EFFORTS:

We plan to do this medical mission every year, and you all are truly welcome to help support this medical mission by donating to TPAAF Save Babies Life project.

Kris Karlsen (STABLE Program Author) is very kind, very generous and very supportive. She had donated a large amount of S.T.A.B.L.E manuals previously and gave us a good discount for the manuals to help our medical mission in Thailand, we are very thankful and very appreciative.

In summary, I and our team cherished the whole experience and found that all the students were very excited, attentive, and very happy.

Thank you very much very much Kris, Beth, Mason, and S.T.A.B.L.E program for the creation of this wonderful neonatal education program.

MATERIALS DONATED FROM THE S.T.A.B.L.E. PROGRAM FOR YOUR COURSE:

6th Edition Learner/Provider Manuals

6^th Edition Instructor Manuals

2^nd Edition Cardiac Module books

THE S.T.A.B.L.E. PROGRAM

INTERNATIONAL TRIP REPORT

S.T.A.B.L.E. Learner Course: November 15 and November 21, 2022
University of Zambia, Lusaka, Zambia, Africa

Course Instructor: Geralyn Sue Prullage, DNP, APN, NNP-BC, University of Zambia and University Teaching Hospital

ABOUT THIS EDUCATIONAL OFFERING:
I am the director of neonatal education for the Council of International Neonatal Nurses (COINN; https://www.coinnurses.org/) and I always travel within their name. But I was asked by Dr. Kunda and the University of Zambia to come and mentor NNP students.

The purpose of this trip:

Provide mentorship to the 1st and 2nd year NNP students. This is a brand-new program, and they have no developed mentorship program. I was to help develop the mentorship program and felt that STABLE should be part of what they needed to know. Several of the students had heard of STABLE and they were excited to have the content available to them.

STABLE: Our Instructors are often interested in knowing more about the region you visited. Please describe the community where S.T.A.B.L.E. was taught.

Lusaka Zambia is the capital of the country. Millions of people live in Zambia. The country has a neonatal mortality rate that has risen over the last few years to 27 deaths per 1000 live births. The University of Zambia trains doctors and nurses. They created a NNP program in 2020 which started with 7 nurses. It is the only program on the African continent that is training at the Advanced Practice Nurse (APN) levels. I worked with those nurses and six 1st years (now 2nd years). They currently have six new 1st years from Botswana, Malawi and Zambia. We are helping the University teach these students. S.T.A.B.L.E. Lead Instructor Wakako M. Eklund DNP, APRN, NNP-BC, FAANP, FAAN and I will offer STABLE via live Zoom to those students so that they too can be certified in the S.T.A.B.L.E. Learner course.

STABLE: Describe some of the nursing and medical challenges being faced by the S.T.A.B.L.E. course attendees with regard to provision of day-to-day neonatal care

The University Teaching Hospital (UTC) has several struggles.

• No working CPAP machines they are using “homemade” CPAP.
• Four ventilators and at any given time only one or two were working.
• Ability to do lab but dependent on parents paying before the labs were drawn.
• No transport mechanism. Each district hospital transferred with a staff from that hospital in a general ambulance. From the L&D unit the neonate was generally transported by a midwife or student

STABLE: How do you envision The S.T.A.B.L.E. Program will help the health care providers you taught?

The students were very excited to learn about labs especially gases. From the first day I got there it was something they asked for repeatedly. The course helped solidify their learning.

STABLE: How many students attended your course and what were their credentials?

We started with 14 students and 9 finished. They had trouble with work schedules and attending both days.

MATERIALS DONATED FROM THE S.T.A.B.L.E. PROGRAM FOR YOUR COURSE:
S.T.A.B.L.E. Learner Course Slides
Physical Exam and Gestational Age Assessment Slide Program

S.T.A.B.L.E. Program – Ethiopia

August 26, 2018

Dear Kris Karlsen and Everyone at The S.T.A.B.L.E. Program:

The team at Wax and Gold would like to take this opportunity to thank Kris karlsen and everyone at the S.T.A.B.L.E. Program for your support and donations as we introduced the S.T.A.B.L.E program at the St. Paul Hospital Millennium Medical College in Addis Ababa, Ethiopia.

We have just certified the third group of nurses and St. Paul Hospital now has a total of 32 S.T.A.B.L.E. providers.  We initially incorporated S.T.A.B.L.E. in the Neonatal Advanced Life Support training program, specifically for providers in the delivery room and now have started giving the course to the NICU nurses. The third group of students just certified were 11 of the forty NICU nurses.

This training has made a significant impact for neonates at St. Paul hospital. Neonatal hypothermia is one of the major causes of morbidity and mortality and because of the introduction of this training, and because of the awareness of the detrimental effect of hypothermia, the practice has changed. The rate of admission to the NICU with the diagnosis of hypothermia has decreased by over 90%.

We hope to continue training more individuals and introduce the course to other facilities in the country.

Materials donated by The S.T.A.B.L.E. Program:

• 10 Learner Manuals
• 5 Cardiac Manuals
• 1 USB Learner Course
• 1 USB Physical Exam/Gestational Age
• 1 Cardiac Intranet CD-ROM
• 10 Bedside Reference Cards

Sincerely,

Misrak Tadesse, MD
Co-Founder
Wax and Gold, Inc.
www.waxandgold.org

S.T.A.B.L.E. Program – Rwanda
April 25, 2010

Dear Kris Karlsen and Everyone at The S.T.A.B.L.E. Program:

In March 2008, I was a member of a medical education delegation to Rwanda. Once I returned home, I kept feeling as if there were more I could do there. The country and its people continued to haunt me, and I eventually felt led to start a 501c3 organization to continue working with some of the people and projects that I had visited. In March 2009, I became a Lead S.T.A.B.L.E. instructor so that I could bring this program to the medical community in Rwanda. My first class was in October 2009 and I had 22 students made up of residents, nurse midwives, ER nurses, ICU nurses, L&D nurses, and NICU nurses.

Being the typical naive American abroad, I went with the expectation that this S.T.A.B.L.E. class would be similar to those I had taught in the U.S.-after all, they had a neonatal intensive care unit and took care of ventilated babies! What a surprise and treat I was in for during that class. These students were totally engaged in the class and I soon realized that much of the information was new to them. I discovered that many nurses in Rwanda have only a high school equivalent education and their training is literally “on the job.” During the temperature module, the nurse midwives asked how they might keep babies warm out in the rural areas where there are no radiant warmers or isolettes. Recognizing these limitations, we discussed how to do Kangaroo mother care and thus added this important information to the Temperature module. The rest of the class was spent with me coming up with “alternate” ideas for those rural situations – I was teaching at a regional hospital, very different from the situations most Rwandan mothers found themselves in!

The “treat” for me was in realizing that, as Americans from a very developed country, we have to volunteer not only our services, but also our acceptance of what is. Making change is not easy in places where things we in America have come to take for granted. Maternal and infant mortality is not just a statistic, but an unfortunate reality of life. Water that someone has walked three miles one way to haul back is most often used for drinking, not for hand washing. What a challenge, but also one of the most rewarding experiences I have had in 29 years as a nurse. I am returning to Rwanda in July 2010 to teach S.T.A.B.L.E. again as well as to do some teaching at a hospital on the border of the Democratic Republic of the Congo. My goal is to return twice a year, each time a little more knowledgeable and better prepared to adapt my teaching. My hope is that other colleagues will choose to make the trip with me!

Sincerely,

Sherri Brown
President
One Good Deed, Inc.
www.onegooddeedkc.org

Seeking assistance with an explanation from Alice Cannon, Team Leader (Educator) in the NICU at King Faisal Hospital, Kigali.

Neonatal emergencies such as volvulus were of particular interest to these students.

Rwandan nurses, midwives, and residents learning S.T.A.B.L.E. for the first time at King Faisal Hospital in Kigali, Rwanda.

Calling upon my critical thinking skills to adapt S.T.A.B.L.E. principles to Rwandan capabilities.

S.T.A.B.L.E. Program – American Samoa
By Bev Jorgensen
Lead Instructor, American Samoa

Map of American Samoa, submitted by Bev Jorgensen, Lead Instructor

In October 2006 the S.T.A.B.L.E. Program was taught to forty RNs and LPNs in American Samoa. This class had never been offered before in American Samoa and was made possible through the American Samoa Emergency Services for Children program (EMSC). The materials were generously donated by The S.T.A.B.L.E. Program. This trip was a group of physicians, nurses and paramedics organized by the South Dakota EMSC. The S.T.A.B.L.E. Learner Course was taught by Bev Jorgenson, Rhonda Karl and Dr. Stephen Karl of Sioux Falls, South Dakota. The team also did clinics for the children of the two distant small islands of Ofu and Ta’u.

American Samoa is located in the South Pacific Ocean. The largest island, Tutuila is where the capital city of Pago Pago is located. Travel to and from the island can be challenging, since commercial flights are available only twice a week. The LBJ Tropical Medical Center is the only hospital on the islands. In the adjoining emergency services building, a classroom was built specially for these courses. Resources are limited for critically ill infants.

The beautiful Samoan coastline

The Samoan people come from a strong Polynesian culture that embraces tradition. English is their second language. Teaching of the STABLE class required that the cultural aspects of the nursing staff be taken into account, including the length of the classes and emphasizing hands on learning of the material presented.

Rhonda Karl RN, teaching the Blood Pressure Module in American Samoa

Edna Hala RN from American Samoa

Specially built teaching facilities at EMSC Building

NICU care is delivered at the LBJ Medical Center. The committed staff and administration of the island typically care for four to five NICU infants at a time. Specialty services are limited and infants needing tertiary services are air transported out when necessary, and depending on resources available. The closest tertiary NICU care is typically located on the Hawaiian Islands or New Zealand.
Teaching in a different culture is very challenging yet very rewarding. The S.T.A.B.L.E. program provided a resource that was very much appreciated and utilized.

S.T.A.B.L.E. Program – Doha, Qatar
By Ann Schwoebel, MSN, RNC, Clinical Nurse Specialist, Lead Instructor
Pennsylvania Hospital
Philadelphia, Pennsylvania

S.T.A.B.L.E. Class Date: March, 2008

  Google Map of Qatar

 

In March 2008, Patti Clifford MSN, RNC Clinical Nurse Specialist and Jackie Evans, MD Medical Director of Children�s Hospital of Philadelphia Intensive Care Nursery and myself had the great opportunity to introduce the S.T.A.B.L.E Program and the Cardiac Module to physicians and nurses in Doha Qatar. The S.T.A.B.L.E. program was held as a pre-conference day at the International Neonatal Cardio-Respiratory Symposium presented by the Hamad Medical Corporation

The program was well received with sixty-nine (69) participants in the S.T.A.B.L.E. Learner Course and two (2) participants in the S.T.A.B.L.E. Instructor Course. There were 2 physicians, 6 respiratory therapist, 59 nurses and 4 nursing students in attendance.

S.T.A.B.L.E. Attendees

Qatar (pronounced KAH-ter) occupies a small peninsula that extends into the Persian Gulf from the east side of the Arabian Peninsula. Saudi Arabia is to the west and the United Arab Emirates to the south.

Qatar is largely barren, flat desert. Water is scarce, and agriculture is minimal. Once a nomadic society, Qatar now has little rural population. Doha, the main urban
center, is on the eastern coast of the peninsula.

Patti Teaching the Cardiac Module

About 40% of the inhabitants are Sunni Arabs of the Wahhabi sect of Islam. There are Christian and other minorities. Other ethnicities include South Asians, Iranians, and Palestinians. Less than one fifth of the population is native Qataris; most of the nursing staff working in the intensive care nursery is from the Philippines and India. Arabic is the official language, although English is widely used.

Patti and myself with several of our colleagues from Hamad Medical Hospital

Materials donated by The S.T.A.B.L.E. Program:

• 20 Learner Manuals
• 1 Instructor Manual
• 1 CD-ROM Slide Program
• 1 Physical Exam and Gestational Age Assessment CD-ROM
• 1 Cardiac Module CD-ROM Slide Program
• 10 Cardiac Module Handbooks