INTRODUCTION

In October 2008, CIMIT’s Global Health Program Leader, Kris Olson, MD, MPH, DTM&H, and Global Health Associate, Aya Caldwell, traveled to Aceh, Indonesia as consultants to the International Organization of Migration (IOM). In Indonesia, they worked with local midwives, doctors, and the (IOM) team. The trip’s primary objective was to conduct a beta test for an outcome assessment on a neonatal resuscitation training program, which aims to prevent asphyxia in newborns. Dr. Kris Olson, other clinicians, IOM, and the Indonesian District of Health, implemented this neonatal resuscitation program for midiwives in 2005 after the 2004 Asian Tsunami. Up until this program, however, midwives had not received refresher training courses for 5-10 years due to the tsunami and the preceding civil conflict. The program continues today through a Training of the Trainer (ToT) network where over 500 midwives have been trained.

The outcome assessment consists of a survey, resuscitation device evaluation, and a focus group discussion. The assessment will be conducted in two districts, Nagan Raya and Aceh Barat, which have received the training program as well as midwives in a control district have yet to receive the training. See Birth Asphyxia Training Fact Sheet for more info.

Meulaboh, Aceh Barat: International Organization of Migration (IOM) Health Staff, Dr. Kris Olson (far right),
Aya Caldwell (second from the right), and Melva Sihombing (third from the right). Melva Sihombing will
lead the IOM Health Staff as the principal data collector after Dr. Kris Olson and Aya Caldwell’s departure.

 

Ujong Fatihah, Nagan Raya: Dr. Kris Olson and Aya Caldwell with midwives after completing the assessment for the training program. Though the training was initially designed as a humanitarian response and not intended as a trial, unique attributes of the training and the role of technology warranted evaluation. One component of the assessment included testing the resuscitation device’s acceptability and sustainability of use. This tube and mask resuscitation device, a lower cost alternative to the bag valve mask, is manufactured in Indonesia, but was not yet scaled until the training.

 

 

 

 

 

 

Drien Rampak, Aceh Barat: Asphyxia Outcome Study in a Puskesmas (village clinic). Dr. Kris Olson, Melva Sihombing, and a midwife evaluate the device longevity by testing whether it could generate 30cm of air pressure.

 

 

 

 

 

 

 

 

 

 

 

Meulaboh, Aceh Barat: Dr. Kris Olson rounding on patient in Cut Nyak Dhien Hospital.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Meulaboh, Aceh Barat: Dr. Adillida, head Pediatrician, nurses, and Aya Caldwell in Cut Nyak Dhien Hosptial. A six-day old baby after an averted death from sepsis. The incubator was donated from France, but unfortunately, none of ten incubators donated in 2005 after the Tsunami to the hospital in remain functional.

 

 

 

 

 

 

 

 

 

 

Meulaboh, Aceh Barat: General medical ward rounding with residents, Dr. Akbar, and Dr. Kris Olson.

 

 

 

 

 

 

 

 

 

 

 

 

Meulaboh, Aceh Barat: Dr. Kris Olson with Dr. Adillida, head Pediatrician at Cut Nyak Dhien Hospital with a new mother and her two-week old baby now improving after an infection.

 

 

 

 

 

 

 

 

 

 

 

Meulaboh, Aceh Barat: Dr. Kris Olson and Dr. Mohammed Ali from IOM presenting to doctors and nurses at Cut Nyak Dhein Hospital. The presentation focused on the importance of continuum of care from community care with midwives to hospital care with doctors and nurses. The discussion focused on the importance of IOM’s work on the grassroots, community level, asphyxia outcome survey, and the “car part” incubator in hospitals (See Car Part Incubator Fact Sheet). Considerable excitement was generated with the incubator and the possibility that the mechanic down the street could repair it if something broke.