tag:blogger.com,1999:blog-17720481391412362282024-02-20T09:55:09.843-08:00SAFE in RwandaPattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-1772048139141236228.post-46154418380090231022013-02-10T04:45:00.001-08:002013-02-10T04:45:15.405-08:00journey back<div class="separator" style="clear: both; text-align: center;">
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Alex and I made the most of our lay over in Amsterdam. It was a wonderful ease back to winter. What a glorious city.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhho-bV4I3VSa1eUMbDb7aidMDLod85sm_L2PDRmHI1N1L3kjNDy-0Ee0e7cnxwnENSdsnJoM0qZ9usyzzcDBLmU1MTVTkASJdq7hHlKaK7ig9J9KcLttJMvGdSTNnkhSuWPOkcQHLLlNQ/s1600/DSCN0603.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhho-bV4I3VSa1eUMbDb7aidMDLod85sm_L2PDRmHI1N1L3kjNDy-0Ee0e7cnxwnENSdsnJoM0qZ9usyzzcDBLmU1MTVTkASJdq7hHlKaK7ig9J9KcLttJMvGdSTNnkhSuWPOkcQHLLlNQ/s320/DSCN0603.JPG" width="240" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeV6da9aIeISqaqB3j6jtk2ErVeLa-Pn07fkzAiPIEeR-SzmFyzaJOUf3o73mRQ9CeBSsRk5BQXIFXaDeJbRIfXZS8kYv9KraKA_RiCroyVL352PS1YWOdOLguDelfkb_IvMx4lmCAbQg/s1600/DSCN0605.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeV6da9aIeISqaqB3j6jtk2ErVeLa-Pn07fkzAiPIEeR-SzmFyzaJOUf3o73mRQ9CeBSsRk5BQXIFXaDeJbRIfXZS8kYv9KraKA_RiCroyVL352PS1YWOdOLguDelfkb_IvMx4lmCAbQg/s320/DSCN0605.JPG" width="320" /></a></div>
<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-32657972730139919142013-02-10T04:40:00.000-08:002013-02-10T04:40:46.585-08:00my two homes<div class="separator" style="clear: both; text-align: left;">
I am back in Canada but still not in Halifax. A large winter storm shut down flights to the Maritimes, so I'm staying with Alex in Toronto. The city is blanketed with fresh white snow, the cafes and shops of Bloor Street are inviting, and the city of 4 million seems so quiet after Nyamirambo. </div>
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I have known for a long time that I have two homes and will therefore always feel a sense of pull. I love Canada: the snow, space, clean air, crossing the street safely, new artistic plastic currency, clean lakes, ocean breezes, our values, decent kind hearted people, our excellent health care system. But it is in Rwanda that I truly feel open heart. It is rare in Rwanda not to find people who greet you with warm smiles and always have time to chat. "You are welcome" is heard many times. This means "you are welcome in Rwanda". There is already a strong pull to the many people in Rwanda who I considered good friends (a number of whom call me Mum) but there is also a wish to be there because everyday the work feels so meaningful. There is such great potential for impact with all the teaching we've been doing in Rwanda. </div>
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So, much as I love Canada, I consider myself Rwandan as well. I have two identities and two homes. As long as I am capable, I want to continue to contribute in whatever way possible to health and well being in Rwanda. </div>
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Here are just a few images of the past five weeks.</div>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiednvA2gK6t2BMa8JPStupkh14ujkxTL1LPcTPIOfA5B_y8qCRfd8QfV0-kixKfgD-G-wUvTnzaH2uhzfj0bwqt7TwLNo3qv-JtsR8ejJAEHVpzZ-lKIxc2Jf7Y93OAE1PGvgmTGr_ws/s1600/DSCN0067.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiednvA2gK6t2BMa8JPStupkh14ujkxTL1LPcTPIOfA5B_y8qCRfd8QfV0-kixKfgD-G-wUvTnzaH2uhzfj0bwqt7TwLNo3qv-JtsR8ejJAEHVpzZ-lKIxc2Jf7Y93OAE1PGvgmTGr_ws/s320/DSCN0067.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">One of the many shops we pass on the way to the hospital</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEif6JoPhhLbbE5NSSJP6i37sZs6cdMlp0_MTrF1uV58ROLj8wTuASB93V0yffs6gcRhcshFQZYbSUK2wbfKSVo21dkF3dw580FJvPwBWFz5HAKjAan13NBwqfALtQqSExzqYEfmhqCgXNw/s1600/DSCN0236.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEif6JoPhhLbbE5NSSJP6i37sZs6cdMlp0_MTrF1uV58ROLj8wTuASB93V0yffs6gcRhcshFQZYbSUK2wbfKSVo21dkF3dw580FJvPwBWFz5HAKjAan13NBwqfALtQqSExzqYEfmhqCgXNw/s320/DSCN0236.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Ready for the SAFE Course</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvBHkkHrwjs1_E3mo-umtKZyHxJwzupaMgKdefY9MJVigOLNJj20bYmpoTVL1vs-FkkUejq-e82LtSvZsWtdVvJiBRBxXF8OA_muo3OeJZivL6S1K7Ozs4-JWBGTnD_Lq8wMJgN4tCGsQ/s1600/DSCN0253.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvBHkkHrwjs1_E3mo-umtKZyHxJwzupaMgKdefY9MJVigOLNJj20bYmpoTVL1vs-FkkUejq-e82LtSvZsWtdVvJiBRBxXF8OA_muo3OeJZivL6S1K7Ozs4-JWBGTnD_Lq8wMJgN4tCGsQ/s320/DSCN0253.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Highly enjoyable teaching at the SAFE Course</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7YBLXrozQ35LNDU2C5OMkO58fByt6CpNijfrng9t7mbqD_rHavgCynktk8c3RD5CoHKYzDIIjqzGYLNzcvXkkHhAIN8QcWTmH0k4BgN6HOH0pTY11Vl9XoZy8-gANdmXTjCwXDlOi6eM/s1600/DSCN0357.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7YBLXrozQ35LNDU2C5OMkO58fByt6CpNijfrng9t7mbqD_rHavgCynktk8c3RD5CoHKYzDIIjqzGYLNzcvXkkHhAIN8QcWTmH0k4BgN6HOH0pTY11Vl9XoZy8-gANdmXTjCwXDlOi6eM/s320/DSCN0357.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Megan welcoming participants</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDkXScpLuixjYXmGd1C9W0qAZvvYJe3MsKMd6DFvnaNi02Ag4hfA-RI61tRsDJz7LN-wdmmU9XvLi5xjrjQJ_qYJYk_KEO11bashVImn0g_-kQIdqvwFi-OeQMDT7a5V_6m6wqy3rSfhM/s1600/DSCN0369.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDkXScpLuixjYXmGd1C9W0qAZvvYJe3MsKMd6DFvnaNi02Ag4hfA-RI61tRsDJz7LN-wdmmU9XvLi5xjrjQJ_qYJYk_KEO11bashVImn0g_-kQIdqvwFi-OeQMDT7a5V_6m6wqy3rSfhM/s320/DSCN0369.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Using hands on teaching as much as possible</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-r9eAeMCWTgLAXdjAfaJQuT4yymMppT_A5ZIjF-ytxXHExOra65vQTtRHOLiZmhH6bwhl2ZZbgOmJ_JzTc__2Al4kH9im9tXHdug6VBzlISpLZbBjizUDNN2EnnVosSSJgCSH6HHIeaE/s1600/IMG_0446.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-r9eAeMCWTgLAXdjAfaJQuT4yymMppT_A5ZIjF-ytxXHExOra65vQTtRHOLiZmhH6bwhl2ZZbgOmJ_JzTc__2Al4kH9im9tXHdug6VBzlISpLZbBjizUDNN2EnnVosSSJgCSH6HHIeaE/s320/IMG_0446.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Michelle bringing joy, and a brand new soccer ball, to a team that had been playing with tied up garbage bags</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwdqMO4w6KY5RB1Zbi69orUkM8oWY8pbC-9LGolc5HZPJPxVLnGF29X5pqDIimMXOzZLPMX5p0TJ62VoR82znfktAcfBgA3y0EW5K3ZN1Yec44ILWkHh1b6ND6JjkEW2352UpQFpHzgcw/s1600/IMG_0524.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwdqMO4w6KY5RB1Zbi69orUkM8oWY8pbC-9LGolc5HZPJPxVLnGF29X5pqDIimMXOzZLPMX5p0TJ62VoR82znfktAcfBgA3y0EW5K3ZN1Yec44ILWkHh1b6ND6JjkEW2352UpQFpHzgcw/s320/IMG_0524.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The "before" picture of the team. 100 kms of up and down on mountain tracks to Kibuye</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuwbI9hSfPCU5kcaufFG2Gau563wbe65ZzVVOmEFLfAwAh_ewXwjULZJ994sdsw2fYcyJSkZg3WSXprjv8Y7bXHYeU4gOkK50c923WtZXMRzX9PWwyRA6bb-9sw6YtSoMI8-5WGOlqq04/s1600/IMG_0543.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuwbI9hSfPCU5kcaufFG2Gau563wbe65ZzVVOmEFLfAwAh_ewXwjULZJ994sdsw2fYcyJSkZg3WSXprjv8Y7bXHYeU4gOkK50c923WtZXMRzX9PWwyRA6bb-9sw6YtSoMI8-5WGOlqq04/s320/IMG_0543.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">We cycled through the heart of Rwanda</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgWoQ634n8HX1oB9Rowpo0BHehcQc7f5zZOE5vrn8K2Ohul7TdoBvmMvB2xdDjGwqo7bE9OJlvOqFUQ2adIsmA9pEusB_1Caqk25-1pmaQFO3UPhq4GKOI2pLFULL37uAbqXoC_q17T9VU/s1600/IMG_0570.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgWoQ634n8HX1oB9Rowpo0BHehcQc7f5zZOE5vrn8K2Ohul7TdoBvmMvB2xdDjGwqo7bE9OJlvOqFUQ2adIsmA9pEusB_1Caqk25-1pmaQFO3UPhq4GKOI2pLFULL37uAbqXoC_q17T9VU/s320/IMG_0570.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Beautifully dressed women on their way to church in the backcountry</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMkn5cWLEXp-fSQ_X3jLINX4bk4bl_8SVzSvUssXPeEJUFwsah4oeq6cuJvp13xVoxRDJcEEZ0HP7hgwoev7rZUywymIWfC-u9Ht3O_Cdc6YXQ8DdLO8pAEhTC47VGICi01ons9SApIg0/s1600/IMG_0671.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMkn5cWLEXp-fSQ_X3jLINX4bk4bl_8SVzSvUssXPeEJUFwsah4oeq6cuJvp13xVoxRDJcEEZ0HP7hgwoev7rZUywymIWfC-u9Ht3O_Cdc6YXQ8DdLO8pAEhTC47VGICi01ons9SApIg0/s320/IMG_0671.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Okay, I really did ask "how much longer". Tom, wisely, refused to say.</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB8pKlOqdMC5d-cm8ZNko3EKezlm7feyYgqFWrau6j1wWqMHb_14iQp5MghOkKIfeh_SsMRYO5-3-aQWw6SjyDRYIqBOz7uN9vmc1rhJMWpB8BlM5-GLSw3o6Pa2dR9-wyvd7OAOh2zwg/s1600/IMG_1291.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB8pKlOqdMC5d-cm8ZNko3EKezlm7feyYgqFWrau6j1wWqMHb_14iQp5MghOkKIfeh_SsMRYO5-3-aQWw6SjyDRYIqBOz7uN9vmc1rhJMWpB8BlM5-GLSw3o6Pa2dR9-wyvd7OAOh2zwg/s320/IMG_1291.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Dean Patrick, truly one of the greatest leaders I've ever met</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwFOSSUb5u-oVKn2BLJzTBiI7xj2k4dclNiSdH1jx_3lXLGJLpBBwX3VSCdhvC6x9kSSxGAPG4PS_9bsOBOA-DckaEgUHUp7pZVmQ0hCyZ704hdDEobxKTY7WRMqebSCppIDZLKT1ZcPM/s1600/IMG_1356.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="226" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwFOSSUb5u-oVKn2BLJzTBiI7xj2k4dclNiSdH1jx_3lXLGJLpBBwX3VSCdhvC6x9kSSxGAPG4PS_9bsOBOA-DckaEgUHUp7pZVmQ0hCyZ704hdDEobxKTY7WRMqebSCppIDZLKT1ZcPM/s320/IMG_1356.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Skills teaching and practice at the sim centre</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZrBu5clvjaOgCx58RS7403KqHCoXIhDSKzV0vjFuHh4ZKmj7Xy77xNezzt0f-Cep3E5av9E0E3GCVW6vnXtPqVFA8-l7tf-IND01h4g5Kx-qrGz50irm_cvJF263mNDBy5cB1crcLBVk/s1600/IMG_1418.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZrBu5clvjaOgCx58RS7403KqHCoXIhDSKzV0vjFuHh4ZKmj7Xy77xNezzt0f-Cep3E5av9E0E3GCVW6vnXtPqVFA8-l7tf-IND01h4g5Kx-qrGz50irm_cvJF263mNDBy5cB1crcLBVk/s320/IMG_1418.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Scenario practice at the sim centre</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR1APAY2R1SRq7O4699alZPkRJ29o0ZPj2FpzpS9nbcJHuzJrVKpCtNaaYHIec_jf4ES-5pOIa0LrFwCCCBVHsyRZ2CFzcRw_qGffPhyXhOA1IUlOQuwSVqyfJvR10opoI9RMpuK2lKgA/s1600/IMG_1426.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR1APAY2R1SRq7O4699alZPkRJ29o0ZPj2FpzpS9nbcJHuzJrVKpCtNaaYHIec_jf4ES-5pOIa0LrFwCCCBVHsyRZ2CFzcRw_qGffPhyXhOA1IUlOQuwSVqyfJvR10opoI9RMpuK2lKgA/s320/IMG_1426.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Peter teaching communication skills</td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiidObm3dayrW_v1dyIMN_02Fdxp68OU_MvNuc67ETno_vZL_wgZjaZDE4UyGCVCx3KPYAbC_5t99rRBmWcRnCQfxSLjZWBmNZh0jfD7D2WLjYW0JiPBIoWhQOqgjVKhJDK-MYbtLfFGFw/s1600/IMG_1469.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiidObm3dayrW_v1dyIMN_02Fdxp68OU_MvNuc67ETno_vZL_wgZjaZDE4UyGCVCx3KPYAbC_5t99rRBmWcRnCQfxSLjZWBmNZh0jfD7D2WLjYW0JiPBIoWhQOqgjVKhJDK-MYbtLfFGFw/s320/IMG_1469.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cricothyroidotomy skills teaching at sim centre</td></tr>
</tbody></table>
<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgukeTet6H9OWy-njNOBxB-rD_RZTw0jgYntLUQ-RMYjcepEUS9a5Is-hoCbwMzg6OpeWidZ4J3lj2S-h43MaSc1lhuw53F3zrWfY1R0OBqIKnyEelZjsNrNLPtvQnAsUeGN4mxpyKvjg4/s1600/IMG_1505.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgukeTet6H9OWy-njNOBxB-rD_RZTw0jgYntLUQ-RMYjcepEUS9a5Is-hoCbwMzg6OpeWidZ4J3lj2S-h43MaSc1lhuw53F3zrWfY1R0OBqIKnyEelZjsNrNLPtvQnAsUeGN4mxpyKvjg4/s320/IMG_1505.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Serena Hotel, our oasis</td></tr>
</tbody></table>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJ2_nRVmmZ78KiBVZFKd2tglwlqxV8sxiT3iNuJjX5-ka2xhpkKUqq5fkY3EE6DIdvL8-aUMw_ffqQ7Wq9eKboRXtMXN3ypB6hgig-xo9Nq7JLBD0Kb-BztUX3k5J6aGkLBuB7KMH8VNw/s1600/DSCN0552.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJ2_nRVmmZ78KiBVZFKd2tglwlqxV8sxiT3iNuJjX5-ka2xhpkKUqq5fkY3EE6DIdvL8-aUMw_ffqQ7Wq9eKboRXtMXN3ypB6hgig-xo9Nq7JLBD0Kb-BztUX3k5J6aGkLBuB7KMH8VNw/s320/DSCN0552.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Joshua and Alex. <br /><br /></td></tr>
</tbody></table>
There are many ways people can help with our work in Rwanda. All you need is a bit of passion to make a difference. We need teachers and supplies for the sim centre. You can sponsor a child, such as Joshua, at the Gisimba Orphanage for $500 per year. Visit the beautiful Land of a Thousand Hills, if you are able. But most of all, remember there are hard working people out there in the world who are able to find genuine happiness in the midst of tough situations. For having made this discovery, I am truly grateful.<div>
<br /></div>
<div>
with love,</div>
<div>
Patty<br /><br /></div>
Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-91890175793327084902013-02-07T08:28:00.001-08:002013-02-07T08:28:13.730-08:00sponsoring Karim and Brune<div class="separator" style="clear: both; text-align: center;">
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<div class="MsoNormal" style="text-align: left;">
Alex and I are going to sponsor two six year-old children at
the Gisimba Orphanage.<span style="mso-spacerun: yes;"> </span>The
sponsorship will cover their school fees and books each year.<span style="mso-spacerun: yes;"> </span>The children are a girl named Brune and
a boy named Karim.<span style="mso-spacerun: yes;"> </span>They are lovely
children who are bright and playful.<span style="mso-spacerun: yes;">
</span>Both are HIV orphans.</div>
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<br /></div>
<div class="MsoNormal" style="text-align: left;">
There is so much more to write about but we are down to the last 24 hours in Rwanda and the pace has not let up. Alex will post to his blog soon about his safari and successful climb of Mount Kilimanjaro.</div>
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<tr><td class="tr-caption" style="text-align: center;">Brune</td></tr>
</tbody></table>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEib92FBZ5xJw9Kh2ODaXBMObduTF_plbl4x2e5kqABU81hDGhtU4jK8BcY0yO1666JYn27Ieo5RbKN-ytdL2j4V3RNxCA9___g7lDpFFGSQra4TYGeGXCHxHe8YX5pXuo9d9N3cV9_-elI/s1600/DSCN0589.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEib92FBZ5xJw9Kh2ODaXBMObduTF_plbl4x2e5kqABU81hDGhtU4jK8BcY0yO1666JYn27Ieo5RbKN-ytdL2j4V3RNxCA9___g7lDpFFGSQra4TYGeGXCHxHe8YX5pXuo9d9N3cV9_-elI/s320/DSCN0589.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Karim, Alex and Brune</td></tr>
</tbody></table>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVxn3skrZjwW4DDkW_ssP1AXeQ1-f2zrWjwpz8BLtKtK4bj6kp6CUGSWIwvkjitGaKmkPPCSPl34Ver9E9c6XWxynDE10SI7wg1krW15yXB4NP4WVKAHSQtXcJBpq_uiisaGqk_OVjF-w/s1600/DSCN0596.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVxn3skrZjwW4DDkW_ssP1AXeQ1-f2zrWjwpz8BLtKtK4bj6kp6CUGSWIwvkjitGaKmkPPCSPl34Ver9E9c6XWxynDE10SI7wg1krW15yXB4NP4WVKAHSQtXcJBpq_uiisaGqk_OVjF-w/s320/DSCN0596.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Brune and me</td></tr>
</tbody></table>
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<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-19806819647424519572013-02-05T08:14:00.000-08:002013-02-05T08:14:06.834-08:00TOT at sim centre<div class="separator" style="clear: both; text-align: center;">
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<div class="MsoNormal" style="text-align: left;">
Today was the first day of our training of trainers course
at the simulation and skills centre.<span style="mso-spacerun: yes;">
</span>Peter, Jon, Michelle, Georges and I have been scrambling to arrange the
course in the last few days.<span style="mso-spacerun: yes;"> </span>It
was a big success.<span style="mso-spacerun: yes;"> </span>We had heads of
department, senior members and residents from surgery, anesthesia, ENT, OB Gyn,
and emergency.<span style="mso-spacerun: yes;"> </span>The morning was
dedicated to teaching a skill at four different stations – knot tying,
intubation, cricothyroidotomy, and suturing.<span style="mso-spacerun: yes;"> </span>The afternoon was spent on multidisciplinary team
scenarios.<span style="mso-spacerun: yes;"> </span>Michelle did a great
job as a simulated patient.<span style="mso-spacerun: yes;"> </span>There
was great enthusiasm about the centre for future teaching of skills and team
dynamics.<span style="mso-spacerun: yes;"> </span>Tomorrow morning 12
medical students will arrive and the course participants from today will teach
the same skills they have just learned to the med students.<span style="mso-spacerun: yes;"> </span>Sara, the catering was stellar!</div>
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<tr><td class="tr-caption" style="text-align: center;">Jon teaching suturing</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Peter teaching cricothyroidotomy</td></tr>
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<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-37209624777644385302013-01-30T23:09:00.002-08:002013-01-31T00:08:11.757-08:00Day one of the sim centre<div class="separator" style="clear: both; text-align: center;">
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<div class="MsoNormal" style="text-align: left;">
Yesterday we made phenomenal progress on the simulation
centre.<span style="mso-spacerun: yes;"> </span>This facility is being
established so that a wide range of learners in the health profession can have
a place to rehearse technical skills, such as suturing, and complex team
dynamic, such as managing maternal hemorrhage, without practicing on
patients.<span style="mso-spacerun: yes;"> </span>There will be capacity
to teach nurses how to set up a table of surgical instruments, medical students
how to insert IV lines, and residents how to manage a patient after severe
trauma.<span style="mso-spacerun: yes;"> </span></div>
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<div class="MsoNormal" style="text-align: left;">
The centre is a free standing building with two bright,
well-ventilated rooms.<span style="mso-spacerun: yes;"> </span>We had an
important meeting yesterday with the Dean of the Faculty of Medicine, the new
Medical Director of the simulation centre, the Head of Anesthesia, and a staff
anesthesiologist.<span style="mso-spacerun: yes;"> </span>Peter, Jon,
Michelle and I wanted the place to look at good as possible before the
meeting.<span style="mso-spacerun: yes;"> </span>We got up early and
scurried around the centre unpacking the many bags of donated supplies Jon and
Michelle had brought from Halifax and all the equipment from the SAFE
Course.<span style="mso-spacerun: yes;"> </span>Then we ran to Nakumatt
(the local Superstore plus) where Michelle bought a refrigerator with money
donated by her soccer team for the sim centre.<span style="mso-spacerun: yes;"> </span>This will be essential for storing animal parts used in
teaching skills.<span style="mso-spacerun: yes;"> </span>After a quick
coffee at Bourbon Café we returned for the 10 AM meeting to a centre that
looked remarkably transformed already.</div>
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<br /></div>
<div class="MsoNormal" style="text-align: left;">
We have been waiting a long time for the official
appointment of Dr. Georges as the Medical Director of the Centre.<span style="mso-spacerun: yes;"> </span>This has delayed spending the money I
received from the simulation grant.<span style="mso-spacerun: yes;">
</span>Therefore the space has not been painted and the cabinets have not been
built.<span style="mso-spacerun: yes;"> </span>During our meeting the Dean
got on his cell phone and in fifteen minutes we had a couple of workers taking
measurements for all the renovations.<span style="mso-spacerun: yes;">
</span></div>
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<div class="MsoNormal" style="text-align: left;">
After a fabulously successful first day on the simulation
program, Peter and I headed off to the market to load up on mangos, papayas,
pineapples, passion fruits and cheese (all the essentials for life).<span style="mso-spacerun: yes;"> </span>There was a lively cooking session with
four of us packing into our tiny kitchen.<span style="mso-spacerun: yes;">
</span>My good friend, Steven, joined us for dinner and shared many of his
insights on justice and reconciliation.<span style="mso-spacerun: yes;">
</span>He will be taking many of our team to visit the church in Nyamata on
Sunday.</div>
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<tr><td class="tr-caption" style="text-align: center;">Peter writing a welcome poster in Kinyarwanda</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Set up for skills and sim</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjSBDVWHjyA_hQYo_3d5fKRQUxO_jGskoZItiil2E0FzslT199llsymKQRCGIz_SsGeb-Fa02Dw0xnQ7bzMrT99x5cK1rhA_ACRUNk4RVhzMDTN58o7bHfH3-5jRjW7FwCALc2qK1oa7w/s1600/DSCN0529.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjSBDVWHjyA_hQYo_3d5fKRQUxO_jGskoZItiil2E0FzslT199llsymKQRCGIz_SsGeb-Fa02Dw0xnQ7bzMrT99x5cK1rhA_ACRUNk4RVhzMDTN58o7bHfH3-5jRjW7FwCALc2qK1oa7w/s320/DSCN0529.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Michelle adjusting a mannequin</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHCBFLiM3kCrfKu9akQyqVLcAHHpTLsWw1LX49UT8t9rNFj8AXEgodbhUOidZGC3FkrJefBd86sY9tbQzs84bJN70XhR200CyaWsSz-PWfR8j3iIlVhQjPdodeVvBWFARg8okM-o4LInI/s1600/DSCN0531.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHCBFLiM3kCrfKu9akQyqVLcAHHpTLsWw1LX49UT8t9rNFj8AXEgodbhUOidZGC3FkrJefBd86sY9tbQzs84bJN70XhR200CyaWsSz-PWfR8j3iIlVhQjPdodeVvBWFARg8okM-o4LInI/s320/DSCN0531.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Drs. Georges and Patrick after a very successful meeting</td></tr>
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Check out this time lapse of sim centre set up:</div>
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http://www.youtube.com/watch?v=-wjYjYo79Mk&feature=youtu.be<br /><br /></div>
Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com1tag:blogger.com,1999:blog-1772048139141236228.post-89887792581531108232013-01-29T06:57:00.001-08:002013-02-14T03:42:49.612-08:00in the back of beyondWe've just returned from what is possibly the hardest thing I've ever done physically. We cycled from Gisenyi to Kibuye over two days. This was 100 km total but most of it was up and down steep rocky trails. The second day was nearly 10 hours of cycling. We saw remote parts of Rwanda with friendly people and spectacular landscape. These photos cannot possibly do it justice. We are ever so grateful for Tom at Rwanda Cycle Adventures and his two porters Mansuet and Twisiere. Tom has been working extensively with the local people along the trail to help with their ability to receive cycle tourists and also to have meal and accommodation options. Our first night was at the Kinunu coffee washing station. It is a little bit of paradise with mangos, papaya, pineapples, oranges, and lots of fabulous coffee! Both days we had dramatic thunder and lightening - fortunately the first day it was in the evening when we were cozy but on day two our last ride was in the rain with sunscreen washing into our eyes and one more rocky hill...<br />
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We could barely move when we arrived in Kibuye last night but fortunately we were staying at a very comfortable hotel with lovely hot showers. </div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvAtD7E1UV0NH4hDvbwTU-ENU7I3wiovQCTJax1TRB9n-mGmolK9XktLdZMO_HlNj7XYum0BtnRPjGkoHJg7tXMLLMN7MWWGysB85v0_hLp4za1eMgW8HWGvC-iQw8AyJdVMzHflGnLNo/s1600/DSCN0489.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvAtD7E1UV0NH4hDvbwTU-ENU7I3wiovQCTJax1TRB9n-mGmolK9XktLdZMO_HlNj7XYum0BtnRPjGkoHJg7tXMLLMN7MWWGysB85v0_hLp4za1eMgW8HWGvC-iQw8AyJdVMzHflGnLNo/s320/DSCN0489.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Shores of Lake Kivu</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg09OF5pdCHTkqbq9xfkurhaIFlD-fM3aWIRJ0ah8lEQ-hcXxlE25Qix7FXC60QLxabFj-15_q5l5iS43UvoYuZhryp73OEIcvUmQ67V7_dySQw3oBW-Ucwkm447F9zDDb-0ajYqoiq2fo/s1600/DSCN0479.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg09OF5pdCHTkqbq9xfkurhaIFlD-fM3aWIRJ0ah8lEQ-hcXxlE25Qix7FXC60QLxabFj-15_q5l5iS43UvoYuZhryp73OEIcvUmQ67V7_dySQw3oBW-Ucwkm447F9zDDb-0ajYqoiq2fo/s320/DSCN0479.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Banana plants and Lake Kivu</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Fishing boats</td></tr>
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We are back in Kigali, safe and sound, and ready to get down to work on the sim centre. Jon and Peter have joined our group. More to come.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTrSZX-WLqU76n12zErTEyahFADFZt87xVIoQrnkefs1o2E7UMjIZfDRN_-pJm_9sgpWak32thw6NV1TvSJqWoB9tIFacgbRuy1hnYDEktT0lXo-U19LlZk4cVw5rYsjJWVSPuOyldW3c/s1600/DSCN0424.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTrSZX-WLqU76n12zErTEyahFADFZt87xVIoQrnkefs1o2E7UMjIZfDRN_-pJm_9sgpWak32thw6NV1TvSJqWoB9tIFacgbRuy1hnYDEktT0lXo-U19LlZk4cVw5rYsjJWVSPuOyldW3c/s320/DSCN0424.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">With our fabulous porter</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7HVEkQDcFYmx-01KXb6q_0Tlja0iQCohleShHm8j8KGN88MhdebtTXX96zYjGipbzItPhqE4V-IWnnSd3Pr6Jqlu9a6BkwFZZ7R2Z0F6f-9PCClfz-7_4zhi4s2RsgfH-xarUiZTjVZ0/s1600/DSCN0417.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7HVEkQDcFYmx-01KXb6q_0Tlja0iQCohleShHm8j8KGN88MhdebtTXX96zYjGipbzItPhqE4V-IWnnSd3Pr6Jqlu9a6BkwFZZ7R2Z0F6f-9PCClfz-7_4zhi4s2RsgfH-xarUiZTjVZ0/s320/DSCN0417.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Just outside Gisenyi</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6xgv8KMzK3ZMvA1evxD-snw0iDwvRiaXX6XYSgm_d-ZzGTdaKuXJjH2YtzYSk1pDKAMPzEiSG0EhJbIDt4pBwSqfRlv5hxyQccd7HnQ5OfisGruFRo6fHQ7yTx5Y5mFLlbrXHzPGGQCY/s1600/DSCN0430.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6xgv8KMzK3ZMvA1evxD-snw0iDwvRiaXX6XYSgm_d-ZzGTdaKuXJjH2YtzYSk1pDKAMPzEiSG0EhJbIDt4pBwSqfRlv5hxyQccd7HnQ5OfisGruFRo6fHQ7yTx5Y5mFLlbrXHzPGGQCY/s320/DSCN0430.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Fishing boats</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDN9RxbS6gC8lvKxiJXCEYLAvrG4ifxj5OIhH6yOV8iAUxDTifUp2ZECRiFjCuSuiY57OoGmOXWRvAMikrLB4NLaQKcywZQT_5DOIBPH1K6d4Q3yGRTNjsj_uqJzNW07Z4noItZ0k_6Ro/s1600/DSCN0448.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="238" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDN9RxbS6gC8lvKxiJXCEYLAvrG4ifxj5OIhH6yOV8iAUxDTifUp2ZECRiFjCuSuiY57OoGmOXWRvAMikrLB4NLaQKcywZQT_5DOIBPH1K6d4Q3yGRTNjsj_uqJzNW07Z4noItZ0k_6Ro/s320/DSCN0448.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Children enjoying the beach where we stopped for lunch on day one</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5vsu-8EAXSHkX72hTsTGWYHe5h0uao-EZm6j7NMmyYdV6qiEz3jdfUSkQ_BIAHfzfk-PSspQAG9aYyXnj_Gqkc4PDmlQ4gyZO2UoDMhiI67jfZ5_2cBacOksmqXGect6gvIF-Tt4J2v0/s1600/DSCN0481.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5vsu-8EAXSHkX72hTsTGWYHe5h0uao-EZm6j7NMmyYdV6qiEz3jdfUSkQ_BIAHfzfk-PSspQAG9aYyXnj_Gqkc4PDmlQ4gyZO2UoDMhiI67jfZ5_2cBacOksmqXGect6gvIF-Tt4J2v0/s320/DSCN0481.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Beautiful Lake Kivu</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Are we there yet? How many more hills???</td></tr>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvAtD7E1UV0NH4hDvbwTU-ENU7I3wiovQCTJax1TRB9n-mGmolK9XktLdZMO_HlNj7XYum0BtnRPjGkoHJg7tXMLLMN7MWWGysB85v0_hLp4za1eMgW8HWGvC-iQw8AyJdVMzHflGnLNo/s1600/DSCN0489.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvAtD7E1UV0NH4hDvbwTU-ENU7I3wiovQCTJax1TRB9n-mGmolK9XktLdZMO_HlNj7XYum0BtnRPjGkoHJg7tXMLLMN7MWWGysB85v0_hLp4za1eMgW8HWGvC-iQw8AyJdVMzHflGnLNo/s320/DSCN0489.JPG" width="320" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkdAuuy8BY_Zk0FyTZSG8IQ1lFt7JkM0PmrOCqYcBrioFPXWviVrwsgySyiCOWvf5cx45z2YmiL4BV5EE_yYCMzlVxFp8hdj72kNg3cDDp94YJyWetgIV7T_pXG_Ze_Nq2Bum6OzUDV74/s1600/DSCN0497.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkdAuuy8BY_Zk0FyTZSG8IQ1lFt7JkM0PmrOCqYcBrioFPXWviVrwsgySyiCOWvf5cx45z2YmiL4BV5EE_yYCMzlVxFp8hdj72kNg3cDDp94YJyWetgIV7T_pXG_Ze_Nq2Bum6OzUDV74/s320/DSCN0497.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">I should have used more sunscreen</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Our first day was hilly</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">The second day was more hilly, and much farther!!</td></tr>
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Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-14629659313352678032013-01-26T04:42:00.001-08:002013-01-26T04:42:40.813-08:00Michelle enjoying Rwanda<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdQ7c0I9Q04P4gQ6sftZ6ANc4BvPH4AZd6OzfFGbdsY2To4HDL1k2crTpDMXPxagZ1F7fd4uL-5iX_wwV_9bNkZ0KiTkMgCsHjEU1ICiKMeVvuZEexowKXSQHP_TDKzbY6spwF8MZbi38/s1600/DSCN0383.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdQ7c0I9Q04P4gQ6sftZ6ANc4BvPH4AZd6OzfFGbdsY2To4HDL1k2crTpDMXPxagZ1F7fd4uL-5iX_wwV_9bNkZ0KiTkMgCsHjEU1ICiKMeVvuZEexowKXSQHP_TDKzbY6spwF8MZbi38/s320/DSCN0383.jpg" width="240" /></a></div>
<br />
Michelle is smiling all the time and very happy to be in RwandaPattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-77772380621948449552013-01-25T22:21:00.000-08:002013-01-25T22:21:14.145-08:00it's a wrap, now to the hills
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<br />
<div class="MsoNormal">
The second SAFE Course has finished.<span style="mso-spacerun: yes;"> </span>The second week ran more smoothly than
the first after a few alterations based on the experience of week one.<span style="mso-spacerun: yes;"> </span>Most session were run in outdoor
gazebos.<span style="mso-spacerun: yes;"> </span>This proved to be an
excellent setting with lively bird sounds throughout the day, a light breeze,
and bright daylight.<span style="mso-spacerun: yes;">
</span>Fortunately, there was no rain until the last day when, just before the
post-course skills test, it came down in bucket loads.<span style="mso-spacerun: yes;"> </span>After waiting out the rain, we were
able to complete the final test before the participants regrouped to write
“commitment to change” forms to identify clinical practice changes they hope to
make based on new learning from the SAFE course.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Most of the course comprised a variety of small group
stations where the participants are engaged in discussion, skills teaching, and
simulated scenarios using mannequins or a participant role-playing as patient.<span style="mso-spacerun: yes;"> </span>There was enough equipment to provide
authenticity to the scenarios.<span style="mso-spacerun: yes;">
</span>Participants worked as teams to manage situations such as emergency
general cesarean section, ruptured uterus, or post-partum sepsis from retained
products of conception.<span style="mso-spacerun: yes;"> </span>They
employed anesthesia knowledge and skills as well as non-technical skills such
as systematic preparation, communication and team working.<span style="mso-spacerun: yes;"> </span>The course participants had to
role-play as anesthesia provider, assistant, or surgeon.<span style="mso-spacerun: yes;"> </span>A faculty member, who was assisted by
one or two trainers, conducted each session; trainers are anesthesia residents
and senior technicians, who had been identified by the local staff as having
leadership capability.<span style="mso-spacerun: yes;"> </span>We ran a
training of trainers course the first day and then mentored the trainers during
the small group sessions so they were able to run the final session
independently.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Planning and preparation for the SAFE Course has taken up
much of the past year.<span style="mso-spacerun: yes;"> </span>It is easy
to ask if all this hard work is worthwhile.<span style="mso-spacerun: yes;"> </span>The last day of the course, I had an experience that confirmed
the need for this program.<span style="mso-spacerun: yes;"> </span>One
participant had struggled with managing a scenario that required resuscitation
of a sick patient.<span style="mso-spacerun: yes;"> </span>She had been
unable to intubate and did not recognize that the intubation was
esophageal.<span style="mso-spacerun: yes;"> </span>When this session was
over I stepped away for a bit but when I returned I found our trainer was
working with that participant to teach her intubation.<span style="mso-spacerun: yes;"> </span>It turns out the participant was
trained on the job (no formal anesthesia teaching) and had never been taught
how to intubate.<span style="mso-spacerun: yes;"> </span>She practices
anesthesia in a district hospital.<span style="mso-spacerun: yes;">
</span>The trainer recognized the problem and taught the participant how to
intubate on the mannequin.<span style="mso-spacerun: yes;"> </span>The
learner had a huge sense of accomplishment when she performed the skill
correctly.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
This situation is an example of both the need for anesthesia
skills and the value in training trainers as local champions for promoting safe
anesthesia practice.<span style="mso-spacerun: yes;"> </span>It also
illustrates the value of active, hands on learning.<span style="mso-spacerun: yes;"> </span>If we had conducted these sessions as lectures, how would we
have found out and corrected deficiencies?</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We cannot hope to have solved anesthesia problems in Rwanda
with one course but we have begun a journey that involves working together for
a common goal.<span style="mso-spacerun: yes;"> </span>Anesthesia
providers have met colleagues from around the country.<span style="mso-spacerun: yes;"> </span>They had a chance to discuss common
challenges they face – lack of equipment, relations with surgeons, and
isolation were frequently mentioned.<span style="mso-spacerun: yes;">
</span>The next step is to implement the anesthesia practice network, which is
a system of mentorship to continue to support the anesthesia providers who work
in district hospitals.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Megan and I had to leave the course yesterday afternoon in
order to transport all the equipment to the simulation centre and for Megan to
catch the evening flight back to Halifax.<span style="mso-spacerun: yes;">
</span>It was too bad to miss the final banquet for the course.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The past few weeks have been entirely dedicated to the SAFE
Course but now it is time to shift gears and work with colleagues in Rwanda to
establish a simulation centre for teaching clinical skills and team training.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Michelle, who runs the skills teaching centre in Halifax,
arrived safely last night.<span style="mso-spacerun: yes;"> </span>She
will be sharing her vast experience with our local partners to help create the
sim centre.<span style="mso-spacerun: yes;"> </span>Before we get to work
on Wednesday, Michelle, Faye and I are going to treat ourselves to a three-day
cycle expedition from Gisenyi to Kibuye.<span style="mso-spacerun: yes;">
</span>“Treat” may be the wrong term as this is route entirely consists of
hills…<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<span style="mso-spacerun: yes;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEinmqNUdlxYe9aoqbV8FYHeL3vk4B3N0jFvN6CVBU6HNml4IMmVejU2fRuhjMGI6rRilevhiXokit05mQjsFoWJywSxxlMpYknUqiyH_RpC6chEg0hSEPuY4V3aL_Q6mdyS3BEcxWAmUIM/s1600/DSCN0380.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEinmqNUdlxYe9aoqbV8FYHeL3vk4B3N0jFvN6CVBU6HNml4IMmVejU2fRuhjMGI6rRilevhiXokit05mQjsFoWJywSxxlMpYknUqiyH_RpC6chEg0hSEPuY4V3aL_Q6mdyS3BEcxWAmUIM/s320/DSCN0380.JPG" width="320" /></a></div>
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Michelle, still gorgeous after 30 hours of travel</div>
<br />
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<br /></div>
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<br /></div>
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<br /></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQ1avilTQadV9Omj-1L8l7UP3eia88JERpN1D_aP6As5nwQh3eumY-cxF3A-Ig0ztmSGyJi0OrHr-IWMzYi2rple396_PxNUgu7n1d97zn27PAKUz6hhGZuMrTFUMzPEf9ou54J7698cc/s1600/DSCN0029.JPG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQ1avilTQadV9Omj-1L8l7UP3eia88JERpN1D_aP6As5nwQh3eumY-cxF3A-Ig0ztmSGyJi0OrHr-IWMzYi2rple396_PxNUgu7n1d97zn27PAKUz6hhGZuMrTFUMzPEf9ou54J7698cc/s320/DSCN0029.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The simulation centre - lots of work to do!</td></tr>
</tbody></table>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNIgNGJGaJNtgmKINTLVs6cJvXfsiDQQsPRbbJ-UwgbFhcJy_M04qlckt8VM6GfyV87FGkhRzw55rbBc5tzAEWu_xo822z7M4qTZMsrkiNqrw1QT3RjYSJXkvCJyUrAKn9iSPEDgjSpoI/s1600/DSCN0027.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNIgNGJGaJNtgmKINTLVs6cJvXfsiDQQsPRbbJ-UwgbFhcJy_M04qlckt8VM6GfyV87FGkhRzw55rbBc5tzAEWu_xo822z7M4qTZMsrkiNqrw1QT3RjYSJXkvCJyUrAKn9iSPEDgjSpoI/s320/DSCN0027.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Entrance to simulation centre on the grounds of CHUK</td></tr>
</tbody></table>
<br />
<div class="MsoNormal">
<span style="mso-spacerun: yes;"><br /></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<!--EndFragment-->Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-41218717457991398912013-01-22T20:57:00.000-08:002013-01-22T20:58:26.070-08:00smooth sailing for day one<!--[if gte mso 9]><xml>
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<!--StartFragment-->
<br />
<div class="MsoNormal">
The second SAFE Obstetric Anesthesia Course started
yesterday.<span style="mso-spacerun: yes;"> </span>The first day ran much
more smoothly than last week.<span style="mso-spacerun: yes;"> </span>We
know what is needed and are ready.<span style="mso-spacerun: yes;">
</span>The participants have been incredible: 100% of people who were supposed
to come last week arrived, fully participated in the course, and completed
course evaluations. Again, 100% scheduled for the second week have
arrived.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The participants and faculty have been very happy with the
program.<span style="mso-spacerun: yes;"> </span>Initially people are shy
but soon jump into role-playing and skills demonstrations in scenarios.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The faculty and participants have greatly enjoyed meeting
colleagues from around Rwanda.<span style="mso-spacerun: yes;">
</span>These personal connections are so valuable and will form the basis of
the Anesthesia Practice Network.</div>
<div class="MsoNormal">
<br /></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_SCEKaJfDLEiq4eMfl9aJXUsYf7D2aK7La0JfTv5MX10EtAvFiv6nK2RnyH-PqoIcWll4qWTKOMZfl6uOVu8fSNyM9rRZk6ypFkbrKSJ22XhkxrS-fTphJdtGrOABd3kgNVAwc5dhExs/s1600/DSCN0351.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_SCEKaJfDLEiq4eMfl9aJXUsYf7D2aK7La0JfTv5MX10EtAvFiv6nK2RnyH-PqoIcWll4qWTKOMZfl6uOVu8fSNyM9rRZk6ypFkbrKSJ22XhkxrS-fTphJdtGrOABd3kgNVAwc5dhExs/s320/DSCN0351.JPG" width="240" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
Preparing materials for SAFE Course round 2</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTUWFh_IdcJmIzxYOJxcsUojwLHtYdBuXN4oSFpCftXNNnlouSRpXioegY7ZKIaXYNdiY6VWohjnCpROmjLWa8Qu0G3wVVnWQTfKB_DB-2_QZsny3FMlur2Fsr7TVw4vgG9F2OQ-qmxII/s1600/DSCN0361.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTUWFh_IdcJmIzxYOJxcsUojwLHtYdBuXN4oSFpCftXNNnlouSRpXioegY7ZKIaXYNdiY6VWohjnCpROmjLWa8Qu0G3wVVnWQTfKB_DB-2_QZsny3FMlur2Fsr7TVw4vgG9F2OQ-qmxII/s320/DSCN0361.JPG" width="320" /></a></div>
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Gaston practicing "giving an interactive presentation" in the Training of Trainers Course</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghfE2K9a76pLao1X7DVExEZkRwksKzatgTX6rUXO9shkRJMjNDtxUv2YdlPHq1JEe7cB25YFjGGDi8Xvp00GBe_53zw2xH5aZ35CqethddfRd8QUr0K2URgNoM4CXt2Y7TGP-QdNBTCUw/s1600/DSCN0354.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghfE2K9a76pLao1X7DVExEZkRwksKzatgTX6rUXO9shkRJMjNDtxUv2YdlPHq1JEe7cB25YFjGGDi8Xvp00GBe_53zw2xH5aZ35CqethddfRd8QUr0K2URgNoM4CXt2Y7TGP-QdNBTCUw/s320/DSCN0354.JPG" width="320" /></a></div>
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Angela demonstrates the Universal Anesthesia Machine</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEU3LM8GI8S29FZpxmTP-7hLkJDSlwzBIbWbwFzQiuKUIjdDeG1b67RJFRLYbVwYmNj944ybFBw6EIs3T2Tc0ZKwC7vGT-SKKwIbScUgmY2kpagCgevcHGnOAQl07RugKw9vtBC2YHoF8/s1600/DSCN0366.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEU3LM8GI8S29FZpxmTP-7hLkJDSlwzBIbWbwFzQiuKUIjdDeG1b67RJFRLYbVwYmNj944ybFBw6EIs3T2Tc0ZKwC7vGT-SKKwIbScUgmY2kpagCgevcHGnOAQl07RugKw9vtBC2YHoF8/s320/DSCN0366.JPG" width="320" /></a></div>
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Adolphe and Alex practice difficult intubation facilitated by bougie</div>
<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-44737570245904738112013-01-21T13:54:00.001-08:002013-01-21T13:54:38.367-08:00The Calm before the Storm--TAKE TWOI had a nice relaxing weekend in Kigali in order to prepare myself for Round 2 of the SAFE Course. I decided not to go to Gisenyi with Patty and Megan as I wanted some time to regroup and relax before gearing up for this week.<br />
<br />
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<tr><td class="tr-caption" style="text-align: center;">Teaching the WHO Surgical Safety Checklist at Kibagabaga</td></tr>
</tbody></table>
This morning I accompanied Angela Enright and Sarah Kessler (from Lifebox) to Kibagabaga to help with some Surgical Safety Checklist Training. For those of you who are not aware, Kibagabaga is a district hospital in Kigali and has been selected as a the site to pilot the surgical safety checklist in Rwanda. Sophie Reshamwalla (from Lifebox) and Beth Riviello have spent endless hours at this hospital teaching the staff about the importance of the checklist and working on local implementation. The process has not been easy but I am confident they will be successful.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipUXiqFVh19-cDkMOeGKycZPy7rAb5GeuLq9VtjBfD11Ap49cGXE664qBu27cDfdE-JvuYrmIJRaVb6IJ1KFwTn-t067JS13-YfZHWqiL2E-oKSuQjb5f7ySxB9dH6K4ZkPXG-doK49uk/s1600/DSC00931.JPG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipUXiqFVh19-cDkMOeGKycZPy7rAb5GeuLq9VtjBfD11Ap49cGXE664qBu27cDfdE-JvuYrmIJRaVb6IJ1KFwTn-t067JS13-YfZHWqiL2E-oKSuQjb5f7ySxB9dH6K4ZkPXG-doK49uk/s320/DSC00931.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Angela Enright with the Rwandan Anesthesia Residents on academic day</td></tr>
</tbody></table>
After leaving Kibagabaga, we stopped by CHUK so that Angela could visit. She had not been back to CHUK in several years and was eager to see all of the changes. She was quite impressed with the new operating rooms and all that had been accomplished over the past 5 years. I had the privilege of introducing her to the anesthesia residents at academic day. Without her initiative and efforts, anesthesia in Rwanda would not be where it is today. She is actually one of the founders of the Rwandan Anesthesia Residency program.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisOjQgDiSRDpR_bWuzkRGMGfiKiQ7hCVFbKxX52fX2MY8u0RwMIomviBc77QCkUhBBb8Qxn2XmV9hRR1KohtYUyDbgGec8r5HnsQrLiRcQkPh-UgbGp4uW-t8mbMCSn92I-qLpWCzmzJk/s1600/DSC00940.JPG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisOjQgDiSRDpR_bWuzkRGMGfiKiQ7hCVFbKxX52fX2MY8u0RwMIomviBc77QCkUhBBb8Qxn2XmV9hRR1KohtYUyDbgGec8r5HnsQrLiRcQkPh-UgbGp4uW-t8mbMCSn92I-qLpWCzmzJk/s200/DSC00940.JPG" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">There is no problem that a nice cup of tea will not solve.</td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgyC7eNLv9uL7nu3-8Uc5d-C9h049YtpqO8KmuMhbeZ6qF57D6Wt_8oPbyPouBJGSshRTPdPLHJy3eja9nSFmt6z9XhsVLazvEwwFzwCKmxTsT986w12Uie9rKF6OXlhtORFt7LpubHL-Y/s1600/DSC00952.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgyC7eNLv9uL7nu3-8Uc5d-C9h049YtpqO8KmuMhbeZ6qF57D6Wt_8oPbyPouBJGSshRTPdPLHJy3eja9nSFmt6z9XhsVLazvEwwFzwCKmxTsT986w12Uie9rKF6OXlhtORFt7LpubHL-Y/s200/DSC00952.JPG" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Simulation using the Universal Anesthesia Machine (UAM)</td></tr>
</tbody></table>
This afternoon, we arrived back in Rwamagana at our home away from home "The Dereva Hotel" to start our preparations for this week's SAFE Course. Now that we had one course under our belt, we know what we need to do to get organized. Despite a new crew of local faculty and participants, we are confident that this course will be even more successful than last week's.<br />
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Stay tuned.....<br />
<br />
<br />fayemazohttp://www.blogger.com/profile/05758692770934153200noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-3602088141175764482013-01-20T21:30:00.000-08:002013-01-20T23:15:56.156-08:00by the shores of Lake Kivu<!--[if gte mso 9]><xml>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcnC1xr6cVGuW5fVHxSdoF8qjcINv9dVUl0oamwfM7M7f3bTxrl9f_f2bXp1v0B6DAue9jyVjCueYv-6lGXddJotFiYrfCW-RjqSdXhqce7QMyCTjzQpnEJ8zot9sSumd93riqVI_9bzk/s1600/DSCN0300.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcnC1xr6cVGuW5fVHxSdoF8qjcINv9dVUl0oamwfM7M7f3bTxrl9f_f2bXp1v0B6DAue9jyVjCueYv-6lGXddJotFiYrfCW-RjqSdXhqce7QMyCTjzQpnEJ8zot9sSumd93riqVI_9bzk/s320/DSCN0300.JPG" width="320" /></a>Faye has already given a great description of the SAFE
Course.<span style="mso-spacerun: yes;"> </span>As difficult as it was to
keep it all together, the course ran smoothly and many people commented that
they had never attended such a well-organized program.<span style="mso-spacerun: yes;"> </span>They did not think it was possible to
teach without power points, so were surprised they could learn so much by
interactive teaching and learning.<span style="mso-spacerun: yes;">
</span>One woman told me, “I used to think anesthesia was boring but now I want
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Megan and I traveled to Gisenyi this weekend for a much
needed break. She had been in Rwanda for nearly a week and had only see the
inside of the Dereva Hotel.<span style="mso-spacerun: yes;"> </span>We
traveled with my son, Alex, and Emmy.<span style="mso-spacerun: yes;">
</span>Emmy is our supreme driver and friend.<span style="mso-spacerun: yes;"> </span>He gave Megan some background on the land of a thousand hills.<span style="mso-spacerun: yes;"> </span>There has been plenty of rain recently,
so the countryside is brilliant green.<span style="mso-spacerun: yes;"> </span>Each year the roads are better than the previous year.<span style="mso-spacerun: yes;"> </span>Now there are highway signs!<span style="mso-spacerun: yes;"> </span>The country looks great.<br />
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The four of us had lunch at by the beach at the Serena hotel
and relaxed.<span style="mso-spacerun: yes;"> </span>Then Megan and I went
to Paradis Malahide but Alex and Emmy traveled back to Ruhengeri so Alex could
visit the gorillas the next day.<span style="mso-spacerun: yes;">
</span>We rested by the water and watched the fishing boats heading out for a
night of fishing on Lake Kivu.<span style="mso-spacerun: yes;"> </span>The
men sing as they paddle out.<span style="mso-spacerun: yes;"> </span>That
evening we had dinner by the fire pit in the lodge and watched a performance by
a group of highly energetic traditional Rwandan dancers.<span style="mso-spacerun: yes;"> </span>The drummer was seriously
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After a delicious breakfast on the shores of Lake Kivu,
Megan and I travelled back to Kigali and spent the afternoon at the Serena
Hotel revising plans for the SAFE Course this week. Sender, our surgical friend
from McGill, arrived yesterday. <span style="mso-spacerun: yes;"> </span>Our big group gathered again for a fine dinner at Khana
Khazana.<span style="mso-spacerun: yes;"> </span>Today it’s back to work
at the Dereva Hotel in Rwamagana…</div>
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<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-28348421372207998062013-01-19T04:42:00.000-08:002013-01-19T04:42:07.831-08:00The Inaugural SAFE Obstetrical Anesthesia Course in Rwanda: We Did It !!!It is hard to believe it, but the inaugural SAFE Obstetrical Anesthesia Course in Rwanda is now officially over. I apologize for not having blogged sooner, but this week has been a big blur. Everyday was packed full of teaching, workshops, planning for the next day, and just talking with our fellow Rwandan anesthesia colleagues about how to improve the quality and safety of anesthesia in Rwanda. After over a year of planning, I can't believe we pulled it off. It is truly amazing and would have been impossible without everyone's hard work and commitment.<br />
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I thought I might give a brief summary of the week. Monday night the participants arrived at the Dereva Hotel in Rwamagana. Despite visiting the hotel last year, I was somewhat apprehensive of the hotel's ability to host the course and whether they could pull it off. Realistically it was our best option. I was pleasantly surprised... the hotel was incredibly accommodating and the service by the staff far exceeded my expectations. Everyone was incredibly kind and eager to help. It was great!<br />
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Tuesday, the day was devoted to a train-the-trainer course for 12 participants who had been selected as future SAFE Course trainers and the remaining 50 or so participants participated in Building Safe Teams which focused on communication and teamwork skills.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg42ihV470gWzv4MRWfSicT2B_o_rK0aRRJvXvsAMX81u12Iy6OkztiCAILbyvrZwT_XBU5X2F5uDUAWs6titaf9saEZIZI8WabiCg-k8-rRlSZJ5ZHtZmLJwb9vFiaSyJrF3j9D-C9N6s/s1600/DSC00721.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg42ihV470gWzv4MRWfSicT2B_o_rK0aRRJvXvsAMX81u12Iy6OkztiCAILbyvrZwT_XBU5X2F5uDUAWs6titaf9saEZIZI8WabiCg-k8-rRlSZJ5ZHtZmLJwb9vFiaSyJrF3j9D-C9N6s/s200/DSC00721.JPG" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Teaching Surgical Airway skills</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAxYJqd7eZXyJzn3rfYxdJSVvi-UDfOwun607pOVn4jA594a1JL_7RlqB0xDD2J9G3Nl9ZeJk61kOggFyerdgNGOWzOV_oEtgVNDlnRXfkqAbsa08uLQL6hETxCUBJOk_yD6hO-upfgLE/s1600/DSC00763.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAxYJqd7eZXyJzn3rfYxdJSVvi-UDfOwun607pOVn4jA594a1JL_7RlqB0xDD2J9G3Nl9ZeJk61kOggFyerdgNGOWzOV_oEtgVNDlnRXfkqAbsa08uLQL6hETxCUBJOk_yD6hO-upfgLE/s200/DSC00763.JPG" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Neonatal resuscitation with neo Natalie</td></tr>
</tbody></table>
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<tr><td class="tr-caption" style="text-align: center;">Simulating Maternal Trauma</td></tr>
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Wednesday started the official SAFE Course. We began the day with a pretest (both obstetrical anesthesia knowledge and skills). The day was then divided into a few didactic lectures that would last approximately 30 minutes, and the remainder of the day was built around small group workshops with 6-8 individuals. Topics included obstetrical anesthesia issues such as: spinal anesthesia (how to improve your blocks), benefits of spinal anesthesia, rapid sequence induction, surgical cricothyroidotomy, hemorrhage, preeclampsia, neonatal resuscitation etc. The workshops were either a discussion, development of a skill, or working through a scenario with a discussion to follow.<br />
<br />
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<tr><td class="tr-caption" style="text-align: center;">Woon Cho our official timekeeper!</td></tr>
</tbody></table>
Thursday and Friday were more of the same with the day starting at 8:00 and concluding around 5:00 At the completion of the course we had the participants repeat the skills and knowledge test. It was amazing to see all that they had learned. I had the opportunity to teach neonatal resuscitation and run the skills test in neonatal resuscitation. It was great to see how much their knowledge and skills improved with the workshops.<br />
<br />
The course concluded Friday evening with a wonderful banquet celebration. Every participant and trainer received a course certificate. In addition, delegates were given lifeboxes to bring back to their district hospitals. At the end of the SAFE Obstetrical Anesthesia Course, we will have successfully distributed lifeboxes to every operating room in 20 of the 45 district hospitals.<br />
<br />
The week has just been amazing! Looking forward to a little R&R this weekend before starting all over again on monday for the second round.<br />
<br />
xo<br />
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<tr><td class="tr-caption" style="text-align: center;">Our youngest participant</td></tr>
</tbody></table>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
fayemazohttp://www.blogger.com/profile/05758692770934153200noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-36668855226572172082013-01-17T11:49:00.002-08:002013-01-17T11:49:55.057-08:00a passion for learning
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Today was the third day of the SAFE Course.<span style="mso-spacerun: yes;"> </span>Each week we are training twelve
anesthesia residents or technicians in teaching methods.<span style="mso-spacerun: yes;"> </span>The trainers had a one-day course at
the beginning and have been paired with faculty members for all the small group
sessions.<span style="mso-spacerun: yes;"> </span>Each session is run four
times with a different group of participants, so the trainers keep taking more
responsibility for the session. They are bright and keen to teach.<span style="mso-spacerun: yes;"> </span>It has been completely inspiring to
watch them jump into teaching with such enthusiasm.<span style="mso-spacerun: yes;"> </span>They truly rise to the occasion.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Many people have commented on how wonderful it is to meet
colleagues from around Rwanda.<span style="mso-spacerun: yes;">
</span>Some people work in very isolated settings.<span style="mso-spacerun: yes;"> </span>One technician told me that she has no help in providing anesthesia.<span style="mso-spacerun: yes;"> </span>If she needs cricoid pressure for
intubation, she has to ask one of the cleaners.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We’ve had very positive feedback on the course.<span style="mso-spacerun: yes;"> </span>One of the teachers commented that he
expected to find people sleeping after lunch but instead saw everyone engaged
with the program.<span style="mso-spacerun: yes;"> </span>It helps so much
that most of the sessions are outdoors in fresh air.</div>
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Dr. Enright running a scenario</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
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This is the supreme gazebo.</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgM3Yh-3_OrmOZM4Ag2B6i1tXoQS87sGJa94kdrbPGxsXQujEVLEry1ML245pKnpo-JX6R9tIMiqqUAX3yHwjBzyJyQZs75hIab9QzwvXoXWxdT49WnWUzw_2-TWWi9GXXWok4FrgszRho/s1600/DSCN0286.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgM3Yh-3_OrmOZM4Ag2B6i1tXoQS87sGJa94kdrbPGxsXQujEVLEry1ML245pKnpo-JX6R9tIMiqqUAX3yHwjBzyJyQZs75hIab9QzwvXoXWxdT49WnWUzw_2-TWWi9GXXWok4FrgszRho/s320/DSCN0286.JPG" width="320" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
Benjamin teaching about sepsis.</div>
<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-84866127177334906322013-01-16T09:15:00.000-08:002013-01-24T12:50:34.018-08:00No Powerpoints....No Problem<!--[if gte mso 9]><xml>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9cK_D_kT-2sED9T-TzPVKuAmCxkdIhiBz5i4sZDFcwMoGZ1KVT6gFr9h8_ADS9G7Ialt_a0IzIG4bnw1lcvmOLD1o6itrFE16Ujg91T2gjV8gR0bRtrlJRESP3J-LzqnSfB-JdH3Bfv4/s1600/DSC00603.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9cK_D_kT-2sED9T-TzPVKuAmCxkdIhiBz5i4sZDFcwMoGZ1KVT6gFr9h8_ADS9G7Ialt_a0IzIG4bnw1lcvmOLD1o6itrFE16Ujg91T2gjV8gR0bRtrlJRESP3J-LzqnSfB-JdH3Bfv4/s200/DSC00603.JPG" width="200" /></a><span style="font-size: 14pt;">After over 1 year of
preparation, it was an amazing first day.</span><span style="font-size: 14pt;">
</span><span style="font-size: 14pt;">The first day of the course was really a prelude to the SAFE course. 12 participants
participated in a train-the-trainers course which focused on skills to be a better
teacher and the remainder of the group participated in “ Building Safe
Teams.”</span><span style="font-size: 14pt;"> </span><span style="font-size: 14pt;">The buzz word for the day
was</span><span style="font-size: 14pt;"> </span><span style="font-size: 14pt;">“communication.”</span><span style="font-size: 14pt;"> </span><span style="font-size: 14pt;">How do you communicate better with your
students, anesthesia colleagues, and colleagues in the operating room.</span><span style="font-size: 14pt;"> </span><span style="font-size: 14pt;">Topics included such things as Non-technical
skills, an Introduction to the WHO Surgical Safety Checklist, the Universal
Anesthesia Machine, Life Box Pulse Oximetry and more.</span></div>
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<br /></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEMDzs3lu9ijjahoRNudy9ou5Rd0_MzFjHnh8IgB-r3SDJtMLhjvzbWzW5nB-muSaQGpl2NEP-iR2MYxEMtrtFBf0_cZwommzRezVnGa1TQ0gm1hNOl1O5qgvu4v6gk4C2TJ1DGFtenyQ/s1600/DSC00640.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEMDzs3lu9ijjahoRNudy9ou5Rd0_MzFjHnh8IgB-r3SDJtMLhjvzbWzW5nB-muSaQGpl2NEP-iR2MYxEMtrtFBf0_cZwommzRezVnGa1TQ0gm1hNOl1O5qgvu4v6gk4C2TJ1DGFtenyQ/s320/DSC00640.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Week 1 SAFE Course Participants</td></tr>
</tbody></table>
<span style="font-size: 14.0pt;">Since the majority of the
participants prefer french as their primary language, discussions were
conducted in French, English, Kinyarwanda, or some combination of the
three. For those of you wondering about
my language skills, English is definitely my preferred language so I clearly
had some help.<o:p></o:p></span></div>
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<br /></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgi6roQmKL0nHa8Hq53H9e2SfQxV1_6HdpyVr9JnEUXw5cNdpzi1NpjmIkP7R7Lz4RkJCQUYevBgaqtX582N1IzP8zV2lh0Drt_eAuyTsVsXb1a7sTjF8VlHSuz5Yev5ZWRPJ4lc3Jy8BM/s1600/DSC00704+5.26.39+PM.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="195" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgi6roQmKL0nHa8Hq53H9e2SfQxV1_6HdpyVr9JnEUXw5cNdpzi1NpjmIkP7R7Lz4RkJCQUYevBgaqtX582N1IzP8zV2lh0Drt_eAuyTsVsXb1a7sTjF8VlHSuz5Yev5ZWRPJ4lc3Jy8BM/s200/DSC00704+5.26.39+PM.JPG" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sophie from Lifebox explaining the WHO Surgical Safety Checklist</td></tr>
</tbody></table>
<span style="font-size: 14.0pt;">Despite all the preparation
and three different projectors, we were unable to display our slides for our
WHO Surgical Safety checklist
presentation (there were only a few) but it just didn’t matter. Willy, one of the local Rwandan faculty,
moderated the session and it was absolutely amazing. He did a brief overview of the importance of
the Checklist in patient safety and we then demonstrated how to perform the
checklist by acting out various scenarios . It was quite humorous but also very
effective. The audience really enjoyed it and asked great questions. <o:p></o:p></span></div>
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<span style="font-size: 14.0pt;">Much of the equipment I
brought over from the US including the mannequins, ambu bags, and
criocothyroidotomy trainers are finally going to good use. A special thanks to all who donated. I am very appreciative of everyone who has
donated their time and energy into developing this course. It is hard to believe it is actually
happening. Very exciting….<o:p></o:p></span></div>
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<tr><td class="tr-caption" style="text-align: center;">2 broken projectors. The 3rd one sort of worked:)</td></tr>
</tbody></table>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgi4lmmaP3vKcoEB4BMV0xIG6ZcdYykamN7_suZS8TqJiCOPkabxvfxyFaROdt5WrnJXKuP8LnEoOz3odmBJk0Mn1IjnfPv35Ev2uU_eJM6cva45HVnzp9FTxz1jsqe1Ub9KoGCDpRQo5Y/s1600/DSC00689.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgi4lmmaP3vKcoEB4BMV0xIG6ZcdYykamN7_suZS8TqJiCOPkabxvfxyFaROdt5WrnJXKuP8LnEoOz3odmBJk0Mn1IjnfPv35Ev2uU_eJM6cva45HVnzp9FTxz1jsqe1Ub9KoGCDpRQo5Y/s200/DSC00689.JPG" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cricothyroidotomy from Synatomy. Very lifelike!</td></tr>
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<span style="font-size: 14.0pt;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 19px;">The day finished with what turned into a 2 1/2 hour discussion with several of the participants about the Anesthetic considerations for Cleft Lip an Palate surgery. Smile Train asked me if I could provide some additional training in this area for some select individuals from these four district hospitals. A special thanks to Paulin who helped me give this lecture as 1/2 of our audience spoke English and the other 1/2 only french. From their questions, I realized how fortunate I am to have the resources available at home to take care of my patients. Despite their excellent knowledge, the lack of anesthetic equipment and medications makes caring for children in Rwanda incredibly challenging.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;">Stay tuned for Day 2 but
really the first day of the SAFE Obstetrical Anesthesia Course…..It is going to be another crazy day<o:p></o:p></span></div>
<div class="MsoNormal">
<br />
<br />
<br />
<br /></div>
<!--EndFragment-->fayemazohttp://www.blogger.com/profile/05758692770934153200noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-50305508680891059822013-01-15T08:24:00.003-08:002013-01-15T08:24:46.865-08:00we ran on time!
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<span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">Today was the first day of the SAFE Course.
After one year of planning, we finally launched the baby. It
exceeded expectations. We have a great facility at the Dereva Hotel.
It is a peaceful setting where the only outside sounds are from birds.
Most of the sessions are outdoors in gazebos, so there's lots of fresh
air and light. Even though we had little time for the Rwandan and
visiting faculties to prepare together, we still managed to adapt to what was
required. <o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">The whole day has involved lots of hands on, interactive teaching.
We've been running scenarios with role-play and teaching hands on
skills. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">Megan, who works with me in Halifax, has been a stellar course
coordinator.<span style="mso-spacerun: yes;"> </span>Who would have
believed that we could run on time?? Megan has had to deal with many unexpected
events, such as participants showing up with young children.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">We are all exhausted and working full out, so this will be brief.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<!--EndFragment-->Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-9241634261984287712013-01-12T07:24:00.001-08:002013-01-12T11:16:08.976-08:00the calm before the storm<!--[if gte mso 9]><xml>
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We’ve had a whirlwind past few days and sincerely apologize
for not posting sooner.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
I keep coming back to the theme of happiness, which is seen
with a few examples:</div>
<div class="MsoNormal">
Aimée, who is helping us with the conference, has overcome
her own suffering to form a group that supports mental health and
happiness.<span style="mso-spacerun: yes;"> </span>She shared her insights
on what makes people truly happy – family, friends, community, and respect.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The children at the orphanage where Alex has been
volunteering live with very little but Alex says they are the happiest children
he’s seen. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
There were more moments of shared happiness at Khana Khazana
for dinner on Wednesday.<span style="mso-spacerun: yes;"> </span>Our group
was Alex, Faye, Emmy, Steven, Paulin, Bona, Adeline, Sophie, Christian and I.<span style="mso-spacerun: yes;"> </span>Steven, who five years ago was sweeping
the streets of Kigali, is currently clerking in a law firm and attending law
school.<span style="mso-spacerun: yes;"> </span>He proudly told me that
instead of jeans he now wears nice pants, shirt and tie.<span style="mso-spacerun: yes;"> </span>The most striking change is his affect;
instead of feeling hopeless and dwelling on his tragic experiences during the
genocide, he is moving forward with great determination.<span style="mso-spacerun: yes;"> </span>He calls me Mum, so it was a great
pleasure to introduce him to my son, Alex.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Bona and Paulin were reminiscing about the six months they
spent with us in Halifax.<span style="mso-spacerun: yes;"> </span>Once
they put the wrong kind of soap in the dishwasher and created a lake in the
kitchen.<span style="mso-spacerun: yes;"> </span>Paulin, brought a large
supply of corn into Canada (clearly he got it past customs?) because he didn’t
think he’d be able to find corn in Canada.<span style="mso-spacerun: yes;"> </span>They were laughing about their first day in Canada when we
were walking to the hospital after a large snowstorm.<span style="mso-spacerun: yes;"> </span>Bona let me go first and was very careful to place his feet
only in my footprints to avoid falling into what he assumed were inevitable
holes in the sidewalk.<span style="mso-spacerun: yes;"> </span>I guess he
was willing to let me take one for the team.<span style="mso-spacerun: yes;"> </span></div>
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<br /></div>
<div class="MsoNormal">
The evening at Khana Khazana was warm, touching, funny,
poignant and magical.<span style="mso-spacerun: yes;"> </span>We all stood
out in the parking lot late into the evening, not really wanting to say
goodnight.<span style="mso-spacerun: yes;"> </span>There was laughter and
many hugs.</div>
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<br /></div>
<div class="MsoNormal">
Since then, I’ve visited the Gisimba orphanage where Alex is
volunteering.<span style="mso-spacerun: yes;"> </span>In the mornings he
is teaching at a kindergarten next door to the orphanage.<span style="mso-spacerun: yes;"> </span>My work is easy in comparison.<span style="mso-spacerun: yes;"> </span>He has a room of 45 lively four to five
year olds who speak little English.<span style="mso-spacerun: yes;">
</span>It was great watching him teach the kids numbers and all of them singing,
“if you’re happy and you know it clap your hands”. </div>
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Yesterday we travelled to Butare to meet Drs. Jeanne, Theo
and Gaston for faculty orientation for the SAFE Course.<span style="mso-spacerun: yes;"> </span>We look forward to having more time
with them soon.</div>
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We continued on to Nyungwe Forest in southwest Rwanda.<span style="mso-spacerun: yes;"> </span>It is a beautiful rainforest that is
over 1,000 km<sup>2</sup> and full of a rich array of flora and fauna.<span style="mso-spacerun: yes;"> </span>There are many hiking trails, including
one that leads to a steel canopy above the treetops.<span style="mso-spacerun: yes;"> </span>It is 200 meters above the ground at the highest point.<span style="mso-spacerun: yes;"> </span>It is a most marvelous feeling to be in
mid air looking out over the rainforest and mountains with the only sound being
calls of birds or monkeys.<span style="mso-spacerun: yes;"> </span></div>
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We slept at a lodge near the tea plantation and hiked to the waterfall this morning.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8hcaHmjlcXUiDTE0F_OlxAng25ntlNdM81TCKE4U-evVbGSTU_bQObikaOyGvyw8S2Uj2HCafU0ORSk5H8BncsgV8EdiniYD4h4de4dSjMA6dSdgzNGRjC_5Fb8yzE_vdTUE_ittmfJk/s1600/DSCN0199.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8hcaHmjlcXUiDTE0F_OlxAng25ntlNdM81TCKE4U-evVbGSTU_bQObikaOyGvyw8S2Uj2HCafU0ORSk5H8BncsgV8EdiniYD4h4de4dSjMA6dSdgzNGRjC_5Fb8yzE_vdTUE_ittmfJk/s320/DSCN0199.JPG" width="320" /></a></div>
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<span style="text-align: -webkit-auto;">Our time in Nyungwe was a badly needed break and chance for us to rest before we head to the Dereva Hotel on Monday to set up for the SAFE Course.</span></div>
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<!--EndFragment-->Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-88239849266433792042013-01-09T23:09:00.002-08:002013-01-09T23:09:53.475-08:00Safe Course Orientation
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<span style="font-size: 16pt;">It is good to be back in Rwanda. Each of my visits here has been so
different. The first was to survey the
district hospitals, then I was in Gitwe on a short term service trip, last march
I worked as a CASIEF volunteer to help teach the Rwandan Anesthesia residents,
and then this trip to help coordinate the first SAFE Obstetric Anesthesia Course
in Rwanda. Each trip has been an amazing
experience and has brought its own set of challenges and successes. It is
amazing the progress that has been made, but there is still so much left to be
done. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-size: 16pt;">We have literally been spending endless hours over
the last year organizing the course. It
is exciting to see that it is actually happening. Even though we are now in Rwanda, there is
still much to be done in preparation.
Patty has nicely highlighted all that has been going on since we
arrived. <o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 16pt;">The last few days have been quite a whirlwind as we
have been busy orientating the Rwandan Anesthesia faculty to the specifics of
the course. The course has approximately16
faculty but only 4 are from outside of Rwanda. The SAFE course is different
from many other refresher courses offered in Rwanda as it has very little
didactics and really focuses on small group workshops over a 4-day period. We are are excited about the active teaching
but at the same time it is much more challenging to coordinate and actually
implement.<o:p></o:p></span></div>
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<span style="font-size: 16pt;">Patty and I agreed it would be much better to have
small groups sessions. Trying to coordinate all of the faculty from the various
schools and hospitals would be almost impossible. We are conducting 2 trainings a day. One at each of the hospitals where the
various faculty work. We are definitely getting better at it but it can be
quite difficult. All of the faculty speak English, but my accent and the fact I
speak quickly doesn’t help. The common
theme among all of the faculty is they are very excited about participating in
the course and the prospects for improving anesthesia care and safety in Rwanda.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-size: 16pt;">Just to highlight all of the training this week:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16pt;">Tuesday we went to Kanombe Military Hospital and
then to King Faisal <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16pt;">Wednesday we spent at KHI and then CHUK and Friday we will head to
Butare to orientate the faculty at CHUB. <o:p></o:p></span></div>
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<span style="font-size: 16pt;">In addition to our training sessions, we are working on a plan to distribute
all of the lifeboxes donated by CAS to the district hospitals. As you can
imagine, we have been quite busy. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16pt;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 16pt;">Last night we celebrated Patty's birthday with many of our Rwandan friends at a wonderful Indian restaurant. Emmy brought a birthday cake and the restaurant turned down the lights and everyone sang happy birthday Rwandan style. It was a wonderful evening with old friends.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjNCK5VSoVFc4MCpoGk0sW0MJMIe9RYbo6O7nQ4ty8ad9OIytx6x5NRoR3eMvEAHUv1HBOk5TCndEcesL1r_gg5s7jhCaNSIwtGQf473QC78QY1zydH7WRlOZb2y6OqvrWtbDrF_gE05HA/s1600/DSC00526.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjNCK5VSoVFc4MCpoGk0sW0MJMIe9RYbo6O7nQ4ty8ad9OIytx6x5NRoR3eMvEAHUv1HBOk5TCndEcesL1r_gg5s7jhCaNSIwtGQf473QC78QY1zydH7WRlOZb2y6OqvrWtbDrF_gE05HA/s320/DSC00526.JPG" width="252" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGsTm-62JGOdjpZHGm8mP0X_hHPcxjVecOyBSWsGHpjJfJHGrOgSEiXUi6nPRbw5oNWDM7UhILsSF3948T-970fJ35nfn419YrrlbHm5M03-Ho3YjUAuKtx_oPlkU6Q_mxlq_Tl6q6P6g/s1600/DSC00527.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGsTm-62JGOdjpZHGm8mP0X_hHPcxjVecOyBSWsGHpjJfJHGrOgSEiXUi6nPRbw5oNWDM7UhILsSF3948T-970fJ35nfn419YrrlbHm5M03-Ho3YjUAuKtx_oPlkU6Q_mxlq_Tl6q6P6g/s320/DSC00527.JPG" width="320" /></a></div>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEht96BZ_KQ3_sSG1keUaZPP32_qprbL-PifkVy-vhrmb0-3XkVOhLsL7zWWaAxtpRJ1LPT9SGb41uKZQzW_LRm4v4HzW3ZDty0gEG_3zR8ch2B1XIKSiLAk_rmnJeYtk7TIj4WYhXw_P2k/s1600/DSC00520.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEht96BZ_KQ3_sSG1keUaZPP32_qprbL-PifkVy-vhrmb0-3XkVOhLsL7zWWaAxtpRJ1LPT9SGb41uKZQzW_LRm4v4HzW3ZDty0gEG_3zR8ch2B1XIKSiLAk_rmnJeYtk7TIj4WYhXw_P2k/s320/DSC00520.jpg" width="248" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>A special thanks to the AAGBI and the WFSA for donating Anesthesia Handbooks to the all of the Anesthesia Tech students at KHI</b></td></tr>
</tbody></table>
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<span style="font-size: 16pt;"><br /></span></div>
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<br /></div>
<!--EndFragment-->fayemazohttp://www.blogger.com/profile/05758692770934153200noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-54075233163920360222013-01-09T07:58:00.003-08:002013-01-09T08:00:12.300-08:00Visit to Dereva<br />
<div class="separator" style="clear: both; text-align: left;">
Yesterday I finally got to see the Dereva Hotel, which will
be the conference location for the SAFE Course.<span style="mso-spacerun: yes;"> </span>It is about one hour east of Kigali.<span style="mso-spacerun: yes;"> </span>We selected a relatively isolated
location with the hope that people would be able to focus completely on the
course and also get to know each other. </div>
<div class="separator" style="clear: both; text-align: left;">
<span style="mso-spacerun: yes;"><br /></span></div>
<div class="separator" style="clear: both; text-align: left;">
The hotel is not fancy but
the grounds are beautifully landscaped.<span style="mso-spacerun: yes;"> </span>The SAFE course is almost entirely small group workshops.<span style="mso-spacerun: yes;"> </span>There will be eight
stations running concurrently.<span style="mso-spacerun: yes;">
</span>Some of the teaching will be in outdoor gazebos, so we hope there won’t
be torrential rains. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Our dear friend, Emmy, drove us to visit the Dereva and we
also travelled with Aimée, who has been helping with the course.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We've spent the last three days doing faculty orientation by going to visit people at their hospitals. Faye will write more about that. It has been very helpful to meet the course faculty in small groups to make sure we have a common understanding. </div>
<div class="MsoNormal">
<br /></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdl7vqyLN4A6VIdTg5tw54tkoCC-DOcuF8jSuhT87bddy2GxcqMyB-08wFCrKpZzQeK4_yutjSHpn9wDS5DNuYNr9GoCO7_gsMmq3a8-CnSXREnycvZvRsxLuB_t7qaShnti-jDumltw8/s1600/DSCN0037.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdl7vqyLN4A6VIdTg5tw54tkoCC-DOcuF8jSuhT87bddy2GxcqMyB-08wFCrKpZzQeK4_yutjSHpn9wDS5DNuYNr9GoCO7_gsMmq3a8-CnSXREnycvZvRsxLuB_t7qaShnti-jDumltw8/s320/DSCN0037.JPG" width="320" /></a></div>
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We will attempt to run simulated scenarios for groups of eight in these little gazebos. </div>
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPJXYK-qaMd-1PQCgkP493ZF5RoI4HKweNGm8YKjKF1z5Nv41b7UY0O7eyHR7g6-Et-Uobx7akhuajmRCxMKH8iIg5bOOiLU0dl5x1uHNLetpwv13n7U6WPYN7UCB3xjU5EuiQtwtExv4/s1600/DSCN0041.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPJXYK-qaMd-1PQCgkP493ZF5RoI4HKweNGm8YKjKF1z5Nv41b7UY0O7eyHR7g6-Et-Uobx7akhuajmRCxMKH8iIg5bOOiLU0dl5x1uHNLetpwv13n7U6WPYN7UCB3xjU5EuiQtwtExv4/s320/DSCN0041.JPG" width="320" /></a></div>
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<br /></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzS9G8mjtAygFB-LPlCz9Fq4QBVNVWtpb92lfH9oILmlD9j_8yuKXIps9qZ-ui-plUjIAMbGbEhmQmt_pREXAn_juTyrl_sVK0rH7qYfzArI44MjW63fSB2JcZk8aU5zdsJC5eiJou_g4/s1600/DSCN0048.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzS9G8mjtAygFB-LPlCz9Fq4QBVNVWtpb92lfH9oILmlD9j_8yuKXIps9qZ-ui-plUjIAMbGbEhmQmt_pREXAn_juTyrl_sVK0rH7qYfzArI44MjW63fSB2JcZk8aU5zdsJC5eiJou_g4/s320/DSCN0048.JPG" width="320" /></a></div>
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Emmy and Aimée - warm hearted and joyful.</div>
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Today we visited Etienne and Christine at Kigali Health Institute for faculty orientation. Etienne is in charge of education for the anesthesia technicians. He has been kind enough to receive the remaining 200 Lifebox pulse oximeters that will be distributed in Rwanda. These will make an incredible difference to patient safety. </div>
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We are, quite literally, hiring a pick up truck to bring all the equipment to the course.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4ocBp0z-JJYZ8SLnNtJvaEZ4Ov5cyBnD9XVWBq2Hi2gp_ezhegHoLzr7atDyYKpT502fTO92frRBbpdyGy_ejDdFWt99n8x3NyczMeVaQWbPKJoBlO0kNe3jurIpSjTbYL1CZdCGbQH8/s1600/DSCN0056.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="234" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4ocBp0z-JJYZ8SLnNtJvaEZ4Ov5cyBnD9XVWBq2Hi2gp_ezhegHoLzr7atDyYKpT502fTO92frRBbpdyGy_ejDdFWt99n8x3NyczMeVaQWbPKJoBlO0kNe3jurIpSjTbYL1CZdCGbQH8/s320/DSCN0056.JPG" width="320" /></a></div>
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This is Etienne with 200 Lifebox pulse oximeters.</div>
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Of course we had a little swim and relaxation at the Serena Hotel.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj97_y_tg8Wk8A-HVxJ22CK3Mu-main5DkqKwheHYWqVxME3D2Y__AU3fQt3d-Xw01Mp7BeOWwW4nDU9hPOg-JfXPr7nj7xUzRIGV0EcgKWKA2OsQZI3lvtwx8T3uvstYkn0JA-D3Z-mEs/s1600/DSCN0049.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj97_y_tg8Wk8A-HVxJ22CK3Mu-main5DkqKwheHYWqVxME3D2Y__AU3fQt3d-Xw01Mp7BeOWwW4nDU9hPOg-JfXPr7nj7xUzRIGV0EcgKWKA2OsQZI3lvtwx8T3uvstYkn0JA-D3Z-mEs/s320/DSCN0049.JPG" width="320" /></a></div>
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Alex has been having an incredible experience volunteering at the orphanage. His blog is great reading:</div>
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http://rwanda2013.blogspot.com/</div>
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Love to you all,</div>
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Patty</div>
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<br />Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-19358372041982252312013-01-07T11:57:00.002-08:002013-01-07T11:57:32.190-08:00first day on the job
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This morning we attended the anesthesia team meeting where
anesthesia staff, residents and technicians discuss difficult operations from
the previous night and challenging cases for the day.<span style="mso-spacerun: yes;"> </span>The complexity of the cases is remarkable.<span style="mso-spacerun: yes;"> </span>It is a great pleasure to see my good
friends again and to meet some of the new residents.<span style="mso-spacerun: yes;"> </span>At long last there are two women in the program!</div>
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Faye and I spent the rest of the morning sorting out
equipment for the SAFE Course.<span style="mso-spacerun: yes;">
</span>After the course we will be leaving the equipment at the simulation
centre so that future courses can be run there.<span style="mso-spacerun: yes;"> </span>This will be infinitely more sustainable than trying to
fundraise for hotel expenses, as we’ve done this time.</div>
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In the afternoon we visited Christian at the military
hospital. We are running a series of faculty orientations for the SAFE Course
and this was our first one.<span style="mso-spacerun: yes;">
</span>Christian is a new anesthesiologist, having just graduated from the
Rwandan residency program.<span style="mso-spacerun: yes;"> </span>He
spent six months in Halifax and it is wonderful to watch his journey from
trainee to staff person.</div>
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We caught up with Alex for dinner and heard about his first
day at the orphanage.<span style="mso-spacerun: yes;"> </span>I’m sure he
will blog about that tomorrow, so I won’t say much.<span style="mso-spacerun: yes;"> </span>It sounds incredible.<span style="mso-spacerun: yes;">
</span>He’s gone to bed early – still sorting out the jet lag.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLDM9FYY7cSF-QpsMXrvbi-toC5YeD3OVigwq12uD7svIboMWzz-XH8WVxL11MRhS4Vsymk0y4It7ha190olw53xLC6ytBLJ0a-pgywD2LopwuRUD3k9xioJ5T70BZrh0mqIfsv7xbW4s/s1600/DSCN0022.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLDM9FYY7cSF-QpsMXrvbi-toC5YeD3OVigwq12uD7svIboMWzz-XH8WVxL11MRhS4Vsymk0y4It7ha190olw53xLC6ytBLJ0a-pgywD2LopwuRUD3k9xioJ5T70BZrh0mqIfsv7xbW4s/s320/DSCN0022.JPG" width="320" /></a></div>
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<!--EndFragment-->Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com1tag:blogger.com,1999:blog-1772048139141236228.post-29258599543175661752013-01-06T02:41:00.000-08:002013-01-06T02:41:07.618-08:00Safe arrival<!--[if gte mso 9]><xml>
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The travel to Rwanda went about as well as any thirty-hour
journey could.<span style="mso-spacerun: yes;"> </span>Our flights were on
time and last night we stepped off the plane into the warm, moist, sweetly
scented air of Kigali.<span style="mso-spacerun: yes;"> </span>Emmy
greeted us; it is a great joy to see my good friend again.<span style="mso-spacerun: yes;"> </span></div>
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Alex likes Rwanda and will be keeping his own blog at:</div>
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http://rwanda2013.blogspot.com/</div>
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Last night Alex and Emmy went to the all night, lively pub
across the street to watch Manchester play Arsenal followed by a bar fight by
rival fans.<span style="mso-spacerun: yes;"> </span></div>
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This morning Alex and I met my friend, Faye, and her husband,
Drew, at the Serena Hotel for bunch.<span style="mso-spacerun: yes;">
</span>We’ve made the usual trips to Forex for money, MTN and Tigo for cell and
internet access.<span style="mso-spacerun: yes;"> </span>Faye, Drew, Alex
and Emmy will be making a city tour this afternoon, while I unpack about eight
huge bags of equipment we’ve brought, or had brought by other volunteers, for the
SAFE Course.<span style="mso-spacerun: yes;"> </span>Faye will be joining
me in posting this blog.<span style="mso-spacerun: yes;"> </span></div>
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I’ll try to write more and post some pictures soon.</div>
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<!--EndFragment-->Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0tag:blogger.com,1999:blog-1772048139141236228.post-8550413300176933612013-01-01T12:42:00.001-08:002013-01-01T12:42:36.938-08:00From snow to simulationI'm looking out over the snowy fields, a high of minus ten is forecast for tomorrow, and it is hard to believe that in three days I'll be heading back to Rwanda for the fifth time. This visit will be very different than the others. Alex, my 25 year old son, will be coming to work in an orphanage in Kigali and then to climb Mount Kilimanjaro. He is bringing chess sets, soccer balls and tennis rackets for the kids. Alex is a former national chess champion; it is wonderful to think of him sharing his talents in Rwanda.<br />
<br />
In the past, I've been focussed almost entirely on anesthesia resident teaching. This time I will be working with Rwandan, Canadian, American and British partners to deliver two courses in obstetric anesthesia safety for anesthesia providers from district hospitals in Rwanda. Most of these practitioners are non-physican anesthesia technicians. They often work in tough situations with little support. Our goal is to equip these anesthesia providers with essential knowledge and skills to manage routine caesarean sections as well as maternal emergencies. We plan to support people after the course with a countrywide mentorship network to help apply new knowledge into practice change.<br />
<br />
The Rwanda SAFE Obstetric Anesthesia Course has been developed over the past year. The original program was created by British anesthetists but we've made many adaptations and refinements for Rwanda. It has been a massive undertaking! The course would never be happening without the phenomenal commitment of Faye, an anesthesiologist from Atlanta, and Megan, my colleague in Halifax. We have also been very fortunate to have highly dedicated partners in Rwanda. <br />
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The four-day course will run twice for two different groups of participants. There are forty small group stations in each course. I've worked hard to make these stations hands on and highly interactive. Quite a few of the stations will involve simulation where an emergency situation is recreated with props and a mannequin or person playing the role of the patient. The course participant must respond to the situation using the materials provided. We hope this type of learning, where an authentic situation is recreated as well as possible, will allow people to have more comfort in managing a similar situation in clinical practice. There will be 128 participants in the two courses and about 16 faculty. We've heard back from many people who are very excited to be attending the program.<br />
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The second project I'm involved with is creation of a simulation centre in the teaching hospital in Kigali. The hospital administration has committed two rooms in a small free standing building for the centre. I will be working with Rwandan colleagues to renovate the space, provide equipment, train teachers, and help plan programs. This will be a permanent space for simulation teaching for multiple groups of health care providers, such as nurses, medical students, residents and staff physicians. Our goal is to have a venue for people to practice everything from simple technical skills, such as suturing, to complex team response to emergencies.<br />
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Needless to say, all of this will keep me busy. I hope to be able to update the blog when possible. It is very satisfying to be able to share. I am thrilled to be returning to Rwanda; it truly feels like my second home. I can't wait to be back with all my close friends. Pattyhttp://www.blogger.com/profile/18161806713976609032noreply@blogger.com0