Sunday, May 30, 2010

Deseret International Charities Update

The effects of the Dzud continue. Many herders have lost all of their herds. It is expected that thousands of herder families will be forced to move to the city to survive and will come looking for work, but because most of them have no other skills and because there are not many jobs, it will bring some terrible challenges to Ulaanbaatar and the other cities. In Mongolia, about 37 percent of the population is below the poverty level. Some companies are starting to do a lot of mining here for coal, copper, silver, gold, etc., which over the long run, will bring a lot of money into the Mongolian economy and create a lot of jobs, but that will all take time.

Deseret International Charities requested and received another $150,000 in emergency relief aid from the Church/Emergency Relief Fund to help support the herder families. DIC signed agreements with the governors of seven provinces (like our states) and transferred the money to them to purchase and distribute basic food supplies, medicines, fuel, sanitation items and fodder for their animals. Many of the herders are destitute and near starvation because of the loss of their animals and thus their livelihood. Also, late winter-spring is the season for the young animals to be born, but their mothers aren't able to produce milk so part of the funds will be to provide a milk substitute for the mother's milk. This brings the total emergency relief donation to $200,000, which is a lot of money here in Mongolia.

DIC is just completing 4 water wells in Zuun Kharaa, a town about 3 hours north of Ulaanbaatar where the local governor held sanitation training last Saturday. We will be holding a ceremony there in a couple of weeks to donate the wells to the people of Zuun Kharaa.

We are also working to have DIC build 5 dump stations here in Ulaanbaatar. Dump stations are located in neighborhoods which do not have water. They are like a well house, but instead of a well they have a big storage tank. The water department is responsible to haul water from wells to these dump stations. The water trucks fill the tank every week or more often as needed. People then bring their own containers to be filled at the dump stations and carry the water to their homes. Many of the children are assigned this task and it is really a difficult chore. Currently, some of the people have to walk as far as 1.5 kilometers to get water. We hope this project will work so the distance they have to go for water will be much shorter. We took this photo last week of some children hauling water up a steep hill in the area we are looking to put a dump station in. The second photo shows part of the area that would be serviced.

We also implemented a garden project for all 22 units of the Church here (wards and branches) under the direction of the priesthood. DIC provided seeds, tools, some fabric for small back-yard greenhouses and a nice gardening book in Mongolian which teaches how to plan a garden, prepare the ground, plant the seeds, and store the produce. The members are really excited about this. The Church humanitarian program has recently adopted food production as their 5th major initiative, along with: clean water, wheelchairs, neonatal resuscitation training and equipment, and vision care.

DIC has major projects going on in all five of these areas, plus some smaller area initiative projects.

Thursday, May 6, 2010

Neonatal Resuscitation Training in Mongolia sponsored by Deseret International Charities

Throughout the world over 1,000,000 babies die at birth from asphyxia and another 4,000,000 are born with brain damage because of breathing difficulties experienced at birth. One of Deseret International Charities' major initiatives is to provide neonatal resuscitation training in developing countries to help birth attendants learn how to save the lives of these infants and help them overcome their breathing difficulties. DIC also donates equipment for doctors and midwives to use in this process.

April 24 to April 30, 2010, Deseret International Charities (DIC) implemented a Neonatal Resuscitation Training project in Ulaanbaatar, Mongolia. DIC partnered with Dr. Soyolgerel of the Ministry of Health and Dr. Bayasaa from the MCHRC Hospital. DIC donated 40 training kits, 600 manuals, 500 infant resuscitators, and 1000 bulb syringes. DIC also coordinated arrangements for Dr. Michael Preece and Dr. Devn Cornish from America to travel to Ulaanbaatar to provide neonatal resuscitation training. During Dr. Preece's development visit, the DIC team devised a plan to gather all of the neonatologists from Mongolia together and train them to return to their provinces and hospitals to train other doctors in neonatal resuscitation techniques. Part of this DIC project was to donate the equipment needed to accomplish the training and in order to provide neonatal resuscitation when needed.

DIC ordered and shipped the equipment to be donated, coordinated arrival of the team of doctors from the USA, made plans to host the training at the Bayanzurkh building, transported the equipment, ordered lunches and refreshments, and made other hosting arrangements for the training. Dr. Soyolgerel and Dr. Bayasaa confirmed attendance by all of the neonatologists from all twenty-one of the provinces in Mongolia. They also arranged for ten English speaking neonatologists to attend the special pre-training the Saturday before, who were trained to assist Dr. Preece and Dr. Cornish in the actual training. Dr. Soyolgerel prepared the final perpetuation training and reporting plan and prepared a Ministerial Order for distribution of the that were donated by Deseret International Charities to the people of Mongolia. She is also prepared a draft for certificates to be given to participants who completed the course. DIC's office finished the layout, put the names on, ran them off, and had them laminated. The certificates were then signed and stamped by the Minister of Health and DIC Country Director.

Friday afternoon Dr. Cornish arrived at the airport and Dr. Preece and his wife arrived at 11:35 that evening. They were supposed to arrive with Dr. Cornish, but the first leg of their flight from SLC to LA was canceled so they missed their connection and had to start over with a whole new itinerary. It cost a lot more, but since it was necessary for them to be here. The total cost for the NRT project was well over $50,000.

The training of the ten trainer neonatologists on Saturday went very well. Only one doctor was unable to attend the pre-training meeting because of a scheduling conflict, but she came during the actual training. Dr. Preece and Dr. Cornish are master teachers! It was an intimate setting for the training and there was a warm spirit there. The doctors were grateful for the training and excited to be part of the team of instructors. To further build the team DIC took group pictures, presented each a backpack (made by Sukhbaatar) as a token of appreciation for their help, and took them to lunch at the Ukrainian Restaurant. Dr. and Sister Eliason, Battsetseg and Assaya attended as well. It helped everyone to feel part of the team.

The actual Neonatal Resuscitation Training training went very well. Every neonatologist in the Mongolia attended the training, plus a few teachers from medical colleges, several quality managers, and a couple of doctors from a private hospital. This is something that is not possible in most countries. Seventy six attended and received certificates and credit from the Ministry of Health. They were very pleased with the training. Even though they are neonatologists, many of them had not received this type of hand-on training and were very grateful for this experience.
The neonatologists thoroughly enjoyed the additional lectures given by Dr. Cornish on "What's New in Neonatology." Dr. Enkhtuur the head of Pediatrics at the MCHRC said, "I promise I will implement these procedures in my hospital. I promise."

Many who attended said this training was the best training they had ever received and that it felt to them they were being trained abroad. The training room on the third floor couldn’t have been better. It was just the right size, well equipped, flexible, and close to nice restrooms. DIC reimbursed those who traveled in from the countryside for their travel and hotel costs, plus provided lunches, drinks, and snacks for all training sessions.

Doctors were able to leave training kits and a supply of respirators, bulb syringes, and training manuals so they could train the delivery room doctors and midwives in their home hospitals and provinces. The participants brainstormed plans to perpetuate training by teaching in their home provinces during the next six months. They were also asked to report back to DIC and the MoH about what training they were able to accomplish.

Dr. Preece and Dr. Cornish commented that this was the most remarkable training they had been involved in—-a “landmark” training, because with Mongolia’s small population they were able to train all the neonatologists, and with perpetuation training, it is conceivable to actually attain the goal of having a trained birth attendant with the proper equipment at the birth of every baby in Mongolia. Mongolia is also unique because 98 percent of the births take place in a hospital where trained birth attendants would be able to take advantage of the training and equipment. In the countryside, most expectant mothers come to a hospital one or two weeks prior to their delivery to assure they will be there when the baby is born--that is at least when there is not a dzud disaster going on like this past winter.

During the next six months DIC and the Ministry of Health will monitor the NRT perpetuation training and then assess with Dr. Preece and the Ministry of Health what additional training and/or equipment donation may be needed for Deseret International Charities to donate in following years in order to reach the goal. Now that all of the neonatologists in all 21 aimags are trained, Dr. Preece and Dr. Cornish would like to find someone to do a study on the change in infant mortality rate in Mongolia to measure the effectiveness of neonatal resuscitation training. This isn’t possible in most countries because of their vast populations and the small percentage of birth attendants they are able to train, but here it is a different story.

Over all, this NRT training was very successful. It is a tribute to the LDS Humanitarian Fund which DIC administers.