Wednesday, April 23, 2008

More Volunteer Photos from Project HOPE mission in Liberia

Check out the Project HOPE Web site for more photos of volunteers at work in Liberia.

Sunday, April 20, 2008

Project HOPE Volunteers Complete Mission

Project HOPE volunteers completed a successful and memorable health education mission at the JFK Hospital on Friday. After traveling home, for up to 38 hours in some cases, all arrived safely and happy to see family and friends.

While the mission is complete, there are still more stories to tell, accomplishments to acknowledge and photos to post. Check back with the Blog and the Project HOPE Web site later this week for more volunteer stories, more photos and a recap of all the accomplishments of the mission.

Thursday, April 17, 2008

Project HOPE Volunteers Celebrate Birth in Liberia

Yesterday I had the honor of watching Project HOPE midwives, Margaret Canter and Nancy Ward delivery a baby at the JFK Hospital in Monrovia. The setting was unlike any other labor and delivery room I had ever been in. Laboring women, and those who have just given birth, occupy six side-by-side beds with plastic coverings draped only by a sheet. If the ward is crowded, sometimes two women share one bed. The laboring women are separated by delivering mothers only by a thin curtain.

There is no air conditioning in the labor and delivery ward, only open windows , making it almost impossible to keep out dirt and grime. When I walked into the ward, I saw a mouse running across a counter. On one delivery table, a young woman was enduring a painful post-natal procedure. Right beside her, another patient, Rose, was preparing to give birth.

Margaret and Nancy were attending to Rose, checking her progress and offering compassionate support. Rose had been in labor for a number of hours and while she was fully dilated, her contractions had stalled. She told Margaret that she had given birth to her first child at home and did not want to come to the hospital to have the baby. Margaret encouraged her to stand up, walk around and move a bit to get her labor going. Nancy rubbed her back and legs. At one point, Rose looked up exhausted and in pain and reached her arm out and placed her hand on Margaret’s waist for comfort.

I had to step over puddles of blood still being cleaned up from a previous patient as I made my way to the corner of the room to take photos. I looked down and noticed a mouse skittering across my shoes. I gently hopped to the side and kept taking photos. Rose was getting close to giving birth when the electricity, as it always does at the hospital, went out. The midwives in the department just opened the curtains that separated labor and delivery to let in the sunlight.

While the surroundings sound incomprehensible, the miracle of a healthy birth is always humbling. Nearing the end of her labor, Rose moaned, waved one of her hands in the air and sang words I could not understand. I know she was in pain, but her melody was magical.

Nancy told me later, “It is so interesting how these women, who have not read books about birth and no one tells them how to do it still naturally figure it out their own way.”

As Margaret began to deliver the head of the baby the whole room filled with excitement. The JFK midwives gathered around, offering their opinions on how to do the delivery. Nancy praised Rose telling her she was doing a great job, and Margaret slowly received the beautiful baby boy and laid him on his mother’s belly. Somehow, I was able to keep shooting photos.

Later, I was pulled into the C-Section room by Ms. Cooper, the head of the Labor and Delivery ward at the JFK Hospital. As she pulled me down the dark hall, I was trying to explain, “I’m not a medical person like Nancy and Margaret, I’ m not sure I can handle this.” She just smiled, opened a door and the operation began. It was over in five minutes, but the doctor insisted I take a few photos of the operation. When the baby was delivered, he had hard time breathing. Nancy helped resuscitate the baby, and soon he was bought into the nursery wailing strongly.

Nancy and Margaret have been working hands on with the midwives at JFK for two weeks. They have personally delivered a dozen babies. They have also witnessed heartache, watching a premature baby delivered who didn’t make it. While they deal with circumstances like this in their jobs back home, the environment is very different here and there was not a lot of compassion shown to the mother. She was not shown the baby, and after the birth she was put in a bed with other mothers who had given birth to live, healthy babies. “In the delivery room, the woman whose baby died was encouraged to be quiet,” Nancy told me later that day. “And she was. So I just went over and touched her and told her how sorry I was. The tears started to come. People just need a human touch and need to be with someone when something like this happens.”

In addition to delivering babies, and teaching classes in prenatal care, Nancy and Margaret are modeling an example of caring and compassion to the JFK midwives. “I have been in a high tech hospital and this experience has made me appreciate what women can do without and have a baby,” Margaret said. “It's not the technology and medical intervention, the things that these midwives aspire to, that will make the difference. It’s the comfort and patient care that will really make a difference. I hope we are modeling a different way to treat patients,” Margaret added. “When we deliver, we are rubbing backs, talking to the patients in a reassuring way, just being tender.”

Margaret, who served on a Project HOPE mission to Latin America onboard the USNS Comfort last year said that she has really enjoyed this land-based opportunity. “When we were on the Comfort, we set up clinics, using all our equipment, all our supplies, pharmaceuticals and all our people. Here, we went into their environment, working alongside providers in their actual facilities, using what they have to use. You really see what they have to deal with and can make health education suggestions based on that.”

Over the course of two weeks, Nancy and Margaret have modeled better patient interaction and taught a few practical skills.. Through health education training, they have provided the midwives with information on how to better date pregnancies using pregnancy wheels provided by Project HOPE, and have shown the midwives different ways to count a baby’s heartbeat during contractions to determine if the baby is in stress. “Yesterday there was time when I was listening to the baby’s heartbeat and three midwives came around to see how I was counting beats,” Nancy said.

Nancy, a first time volunteer for Project HOPE is eager to go on another mission. “It has really been inspiring to see women who can deal with the situation at hand. The mothers and the midwives have such resilience and Ms. Cooper, the director of the Labor and Delivery Ward at JFK is very forward thinking and open for education.”

And while the environment at the JFK Hospital may not be the perfect setting for birth, women sometimes find what they need on thier own. "The crowded unprivate labor rooms actually sometimes add a support system to the women in labor,” Margaret said. “On our first day in labor and delivery, the laboring women were walking the room, kneeling on the floor and moving and moaning in a rhythm in their brightly colored wraps, almost like a song.”

Nancy added, “One young woman looked at me with tears rolling down her cheeks and asked me, ‘Sister can you can take a contraction for me?’ I would have if I could.”

Help support the Project HOPE humanitarian assistance and health education mission in Africa

--Melanie Mullinax

Tuesday, April 15, 2008

Volunteers Continue to Bring HOPE to Patients and Staff at JFK

Project HOPE volunteer Cherri Dobson flew all the way to Liberia with a baby in her suitcase...a resuscitation baby that is. Today she, along with volunteer Dianne Bennett, used that baby to teach a class of 28 JFK nurses, respiratory therapists and midwives the basics of neonatal resuscitation.

“I have been a neonatal nurse for 25 years,” said Cherri, a first time Project HOPE volunteer. “This has been the most receptive class I have ever taught. I got the impression that they wanted to be there and they appreciated the knowledge. Here they don’t have the resources that we take for granted and they are interested in any kind of information that will help them have better outcomes for their babies."

In addition to teaching several classes this week, Cherri worked side-by-side with her counterparts in the neonatal unit last week, caring for premature babies in very simple medical settings. One of the highlights of her volunteer experience happened when she noticed her counterpart, Carrie, modeling herself after Cherri. “We had discussed anemia in infants and later when I mentioned a baby looked anemic, Carrie went right over and filled out a lab slip.”

Cherri brought several pieces of resuscitation equipment and books on neonatal care to pass out to her counterparts. “When I gave them a neonatal drug formularies book, the staff took the book and began reading it like it was fiction,” she said.

Like many volunteers, Cherri has found her teaching function has also lead to learning. At JFK, premature babies are often feed by hand with a syringe, one drop of breast milk at a time. Cherri was amazed with the preemie’s ability to swallow on his own. “This has definitely been an information exchange experience for me. I have learned different ways to feed a premature baby that are perhaps less invasive that what we do in the United States. I have seen very simple and effective treatments work that I may have considered archaic before. but have now given me the view technology doesn’t always equate to best care.”

The neonatal resuscitation classes were specifically requested by the JFK administration said Joel Trinidad, the Project HOPE volunteer Chief Nursing Officer on the mission. “They deliver a lot of babies here,” Joel said. “Now if a baby is in distress, the midwives rush the babies to the nurse anesthetist, but they want the midwives to learn to treat the babies in labor and delivery.”

Cherri and Dianne emphasized simple techniques that could save a baby’s life such as warming and drying, stimulation, insuring a clear airway and checking for breathing and circulation. “It was very important to emphasize that they could make a difference without medicines and without equipment to save a baby’s life,” Dianne said.

In addition to several health education classes, Dianne, on her second volunteer mission with Project HOPE has also been spending her time in the Pediatric ICU, the Burn unit and the Emergency Room.

A natural at nursing, patients around the hospital, especially children, respond immediately to Dianne's smile, her gentle words and lots of high fives. “Pediatric ICU is a very serious setting at JFK ,” Dianne said. “Imagine no screens for privacy, and small children seeing and observing all the dressing changes and other procedures going on right in front of them. These little eyes are seeing a lot. If I can find a way to add a little bit of laughter, a caring touch and a few smiles to their day, I think it’s healing.”

Dianne is also aware that she is being observed by her counterparts . “Any interacting I do with patients, families and other nurses is a great opportunity to do teaching and hopefully by doing the teaching the patients will get out of the hospital little bit faster.”

When choosing her career, Diane had planned on becoming a doctor. But after watching her Dad go through an illness, she deiced to change career paths. “When my dad was sick, I noticed it was the nurses coming to his bedside making him laugh. The doctors came in and out. I wanted to be a nurse so I could spend more time with the patients.”

Dianne participated in the Project HOPE US. Navy partnership Mission to Southeast Asia Oceania last year on board the USS Peleilu. In contrast, the mission to West Africa has been land based. But the outcome has remained the same. “Like the last mission I went on, this has been a rewarding and eye-opening experience that really makes me appreciate health care in the States and also reminds me how fragile life is,” Dianne said. “We’ve also formed great relationships and bonds with the JFK staff on this trip. There has been a lot of conversation and a great exchange of information. I hope we can continue what we have built on.”

In anther section of the hospital, Mary Kennedy presented her second trauma workshop, this time on burn wounds. In addition to a full schedule of education classes this week, Mary has spent much of her time working in the Emergency Room, one of the toughest departments in the hospital. “I have been a trauma coordinator in the ER for many years in city hospitals, and I have seen a lot of trauma. But this is one of the poorest places I have been so far. People only come in here with serious stuff.”

She has seen multiple serious bone fractures due to all too common car accidents in Liberia. She witnessed serious infections due to tropical illnesses like typhoid and even cared for a man who was injured with an ax.

There is no insurance program in Liberia, and payment is required of patients before they receive diagnostic treatment. “The payment method is weird here,” Mary said. “There have been patients left in the emergency room for days because they can’t pay to have an x-ray for diagnosis.”

Mary, and some of the other volunteers have had the opportunity to get to know Jimmy while working in the Emergency Room. Jimmy, a 6-year-old boy was abandoned at the hospital quite some time ago. He’s been in the emergency room ever since. He can’t walk and has some mental disabilities, but he smiles and responds happily to everyone who walks by. The nurses say he is unadoptable, and although his environment is harsh and heartbreaking to imagine, it’s better than living on the street alone.

Despite the dire circumstances, there are stories of success. Mary, who taught a class in trauma assessment yesterday lectured about the use of different types of fluids and which were appropriate for different types of trauma. Later in the afternoon, when she returned to the ER to work one- on-one with students in the class, a very proud ER nurse came up to Mary and told her that a very sick patient had been discharged from the ER because she had changed his previous IV fluid to a saline fluid. “This man was very sick, “ Mary said. “And while saline was the appropriate fluid, I don’t think that it healed him. But it’s a start,” she said.

Then there’s the story of 14-year-old Darius. Darius came into the emergency room with severe abdominal pain. “He was very very sick,” Mary said. The boy was suffering from typhoid perforation (a common aliment in Liberia) which requires surgery and a long healing period. Yet the boy remained in the ER for nearly two days. Mary, along with Project HOPE volunteers Dianne Bennett and Amy Bream personally sought out a surgeon and had him commit to the surgery that day. The next morning when the volunteers visited the boy in the ICU ward, they asked to take his photograph. “Like everyone else here, he asked to see the photograph after we took it," Mary said. “But instead of just looking at it, he pulled the camera screen to his face and kissed it and thanked us. The work here we have done has been overwhelming at times,” she added. “And while sometimes you can’t change much, you can see that change can happen with just one person.”

Monday, April 14, 2008

Learning and Training Continues at JFK

Since I’ve been in Africa, I have had a lot of teary-eyed moments, like when I held a newborn baby swaddled in a beautiful piece of African cloth…or spent the morning in the pediatric ICU and observed children having their typhoid perforation surgery wounds cleaned… or when I found myself walking behind a large crowd of people holding up a young woman who was loudly grieving the loss of her loved one. But I have to say, I never imagined Project HOPE’s trademark train-the-trainer methodology would rank among my most memorable emotional experiences in Liberia.

For more than a year I have been writing about Project HOPE’s train-the-trainer program which emphasis the sharing of health care knowledge. A concept that has helped HOPE train more than two million health care workers world-wide since 1958, I always understood the importance of the train-the-trainer philosophy in spreading health education far beyond the original health professional trained. But today, sitting in a stuffy second floor medical ward of the JFK Hospital in Monrovia, I witnessed the heart of the concept.

Jo Doerr, a volunteer nurse educator was holding an informal workshop for nurses’ aids at JFK. After brief introductions, the group decided they wanted to learn more about how to safely move patients, especially patients’ bigger than themselves. Using bed sheets, Jo demonstrated a simple method to move patients, in several different directions and even bring them to a standing position without harming their own backs or pulling on the patients’ arms. The method also required only two nurses’ aids, instead of four to move a patient. The enthusiastic students all wanted to take a practice turn.

After several lively demonstrations, Jo turned it over to the nurses' aids to teach other what they had learned. Working together as a team, the nurses' aids coached each other, offered suggestions and helped each other to insure they were practicing all the skills Jo had taught them. The enthusiastic interaction and their obvious pride in being able to teach their coworkers something new brought tears to my eyes. It was a WOW this really works moment.

A second time volunteer for Project HOPE, Jo is a positive and outgoing nurse educator who cannot walk down the street to the JFK Hospital without greeting at least 10 people and complimenting them on their beautiful dresses, their beautiful smiles or asking them how they are doing. She approaches her health education with the same enthusiasm and optimism. “The education component of this mission is about the staff at JFK and what they need,” she said. “Because we worked with them for a week first, we have focused on them making them feel valuable about what they are doing. If they feel that value and share it with others they feel good about themselves, like they are really doing something worth while.”

A nurse educator, Jo has also learned a lot from her experience working on the medical ward of the hospital. “It just amazes me, the knowledge that they have, and how they are able to do the things that they do for their patients with such limited resources,” she said. “I love the smiles of the staff when we handed out the HOPE bracelets. I also love seeing the positive changes, even if they are small. I know the bracelets will remind them of Project HOPE’s mission here, but I also think the word HOPE spelled out on them will remind them of the premier hospital that JFK can one day return to.”

Jo’s workshop was just one of four classes and workshops held today, the start of a full week of education classes.

Earlier in the morning, Project HOPE volunteer Gabrielle Seibel lead an interactive leadership and documentation class for 19 nurses from varying departments around the hospital. “I think the week we had of working in the departments, side-by-side and one-on-one really paid off for this training portion of the mission,” Gabrielle told me. “It was really hard at first to make a connection with our counterparts at the hospital. But everyday it’s gotten better and better. When it came time to plan the training we understood where they were coming from and what the background issues were. The classes we prepared were focused directly on their needs and the needs of the hospital. I think that was appreciated.”

A second-time Project HOPE volunteer, Gabrielle also said that living in the culture for a week while working at the hospital gave volunteers a holistic glimpse into the lifestyle and work environment of their counterparts. “The first week of working with them helped us form bonds and trust so that the training was more like a collegial activity, working and learning together. It’s been a fantastic experience,” she said. “We have been so involved with the group, that we are not outsiders anymore.”

Each day the volunteers work at the hospital, they are learning more and more about the skills of using what you have to get the job done-- an art that their JFK counterparts deal with on a daily basis.

Gabrielle taught her class in a loud cavernous hallway at the hospital. Sunlight and heat filled the room as noise from outside construction and people walking by posed challenges. A planned PowerPoint presentation was scrapped at the last minute because of the lack of a projector. But Gabrielle like all volunteers on this mission took a queue from their counterparts and adapted.
“Sometimes, we tend to think we need more than we do. By not being able to use the PowerPoint, I think I relied more on my listening skills and engaging with the nurses,” Gabrielle said. “I am also beginning to understand the importance of oral history in the culture and how they pass knowledge from person to person using their verbal skills.”

Mary Kennedy also conducted a trauma assessment and care course this morning. Some of the students attending her class had worked the night shift. “I was impressed with the level of participation in the class,” she said. When the power went out, as it so often does at the JFK hospital, Mary took her students to a table and with the assistance of Amy Bream and Dianne Bennett, she demonstrated the “log roll” as a way for nurses in the ER to turn trauma patients. The students immediately left their seat to try themselves.

More photos of Volunteers at work....

Help support the Project HOPE humanitarian assistance and health education mission in Africa

--Melanie Mullinax

Sunday, April 13, 2008

Volunteeers Explore Monrovia and its Culture

This weekend, volunteers took advantage of an opportunity to see Liberia beyond the several block section they have been working and living in for the past week. On Saturday, we packed into four taxi cabs for a Liberian-style ride to the U.S. Embassy and shopping market. My cab had a windshield busted in two places and absolutely no shocks. As we bounced and swerved down the unmarked chaotic streets inhaling diesel fumes and other undesirable odors through our open windows, we finally got a look at the real city of Monrovia. Like our little corner at the Urban Villa hotel, the city of Monrovia was bustling with energy, yet signs of the war were evident everywhere. High Rise buildings which must have once been part of a thriving city were gutted to concrete, and five years after the war has ended still remain dark and empty.

Still mothers in brightly colored dresses carried their babies on their backs while balancing food and other items on their heads. Kids played near streets and people sold and bought fruits, vegetables, toiletries and other items at make shift markets set up along the busy busy streets. And everyone seemed to be hailing a taxi or walking rapidly to get somewhere.

The pristine tropical and quiet grounds of the U.S. Embassy in Liberia were quite a contrast to the city of Monrovia. Unfortunately we could not photograph the campus. Our cameras were taken from us and passports checked at the gate.

After lunch at the Embassy we shopped in a market set up on the Embassy grounds. Dianne Bennett and Amy Bream, ever the caring nurses made instant friends with the children of the village after buying them lollipops.

With a police escort, we braved the streets of Monrovia on foot for a quick tour of Providence Island. The only historic site in Monrovia, Providence Island marks the spot were freed slaves from the United States landed in Liberia to form their own city, Monrovia, named after U.S. president James Monroe. Before the civil war in the country, the park on Providence Island had been preserved and boasted a restaurant, small hotel and game building as well as the original well used by the freed slaves who landed on the island. Today the buildings are concrete shells. With so much other rebuilding to do in the country, I am sure the historic Providence Island is way down on the list of priorities.

On Sunday, we traveled through Monrovia to Ce Ce Beach, a beautiful Atlantic coast beach somehow affiliated with the United Nations. The UN has a very visible presence in post-war Liberia and it is difficult to walk down the streets more than a block or two before you see a UN vehicle. On the way to the beach, we passed more rural villages, a huge open air market and a few tiny military posts complete with soldiers manning their posts with serious looking guns.

After a much needed weekend of rest, the volunteers are ready for another productive and very busy week at the JFK Hospital. This week, they will turn their focus to specific health education topics that have been designed to meet the needs of the JFK staff. Two congruent sessions will be held each morning with a critical care tract and a nursing tract. In the afternoon , less formal workshops will include one-on-one training with individual staff members to help reinforce the lessons taught in the morning sessions.

Enjoy the photos of Project HOPE volunteers in and around Liberia.

--Melanie Mullinax

Friday, April 11, 2008

Project HOPE in Liberia Week One in Review

Each morning when I open my eyes it’s still a little hard to comprehend that I am in Africa. But a step out my door unto the busy streets of Monrovia, and there is no mistake that I am far away from the rolling green hills of the Shenandoah Valley.

The streets of Monrovia are bustling with people walking, cars and trucks over-packed with passengers zipping down the crowded roads and motor bikes dangerously zipping in and out of traffic. I am beginning to get used to the constant honking of horns and elevated sounds of loud conversations. Women walk down the streets in brightly colored dresses and it is not uncommon to see baskets of fruit, nuts, sausages, even laundry and other daily essentials carried on top of their heads. Most of the buildings are destroyed or patched together as a result of a civil war that tore the country apart. Any building that is in half-decent condition is protected with rolls of barbwire or jagged pieces of glass attached to the top of concrete security walls. Directly across from our hotel, families live along a dirt road in shacks put together with whatever materials they can find.

Despite the poverty, there is energy about the city and in the people that hints at hope and possibilities. It's that hope of change that has motivated our 14 medical volunteers to leave the "luxury" of their modern day hospitals to work for two weeks in the now rundown and very tired looking open air hospital along Monrovia's Atlantic coast. For a week now, our volunteers have awakened early each morning to eat the only breakfast offered at our hotel-- eggs, a piece of thinly sliced ham, a "hot dog" style sausage, cold white toast and instant coffee. They grab an essential bottle of water and make the short walk down a pot-holed laden road to the gate of JFK Hospital where they quickly disperse into their departments. Some work in the main building, the Pharmacy, ER, Medical Unit, Pediatric Unit and X-ray and Ultrasound departments. Others work in the Maternity building which houses Labor and Delivery, Post Surgery Patients, Intensive Care Unit (ICU) and Neonatal Unit.

This week they have witnessed severe traumas, deaths, infections not commonly seen in the United States. They’ve seen patients denied care for days because of lack of money, met babies living in the emergency room and pediatric units because they have been abandon by parents. They’ve also participated in births, received lots of thanks, smiles and hugs and made lasting connections with their medical counterparts.

They return to the hotel tired each evening and soaked in sweat from the heat of the day. Despite the dire circumstances, they remain positive, enthusiastic and ready to return the next morning to do what they can do help heal patients and restore the JFK Hospital to its pre-war status.

After just the first week of work, Project HOPE volunteers working alongside their counterparts have cared for hundreds of patients. I remain in awe of their commitment to their profession, their compassion for their patients and their willingness to adapt to these harsh conditions.

Here are some highlights from week one:

Dianne Bennett a nurse practitioner spent the week working in the Intensive Care and Burn Units, bringing smiles and encouraging healing to the many children in the department. Using minimal supplies, she cleaned and changed dressings of young children recovering from typhoid perforation surgery, burns and car accidents. But mostly, she offered her counterparts and example of compassionate care and made lots of friends. Cherri Dobson has spent a very hot week working in the unairconditioned and closed-in neonatal ICU unit. There she has been monitoring and caring for two premature babies. She has also made an impression on several full-term babies, placed who prefer Cherri’s caring arms to their cribs. Mary Jo Doerr, a nurse educator spent the week working with staff and patients in the medical unit. Her engaging smile and upbeat personality won the trust of her counterparts as they worked side by side treating patients and assessing professional education needs of the department. She also had the rare opportunity of monitoring two adult tetanus patients. Mary Kennedy, Amy Bream and Dr. Allen Webb spent long hours in the crowded and intense Emergency room. They worked with JFK staff to treat car accident patients, patients with broken bones, life-threatening infections and more. David Meador, Jr., a biomedical repair technician brought smiles to many in the hospital with his fix it skills. He's repaired an ultrasound machine, x-ray printer, pulse oximeters to name a few. His contribution has made immediate impact on patient care at JFK. With help from David, Nabil Messiah an ultrasound technician, has also made an immediate impact on patient care by coordinating the repair of a modern ultrasound machine. After discovering the machine among donated items to JFK, Nabil immediately found a very rare air-conditioned room in the hospital to house the equipment, and negotiated to have a table moved in for examinations. He has already performed 23 ultrasounds on patients. Marina Rivera, a radiography tech has spent a busy week making friends and mentoring the seven member x-ray team. Mixing education with patient encounters, she and her captivated team conducted 86 X-rays in two days. Earl Rogers, a Pharmacist has spent his week working one on one with the Chief of Pharmacy at JFK. He is helping to assess systems to develop a better method for tracking incoming medical supplies and large shipments of drugs. He also discovered a poorly working refrigerator in the ER satellite pharmacy, and with the help of David, he is having the refrigerator repaired to ensure pharmaceuticals that need to stay cold will be properly stored. Gabrielle Seibel, a pediatric nurse practitioner worked in the pediatric unit as well as outpatient clinic, helping the staff organize its charting methods and working with children suffering from Malaria, Meningitis and other diseases. In addition to treatment and working with staff, Gabrielle’s supply of stickers and small toys have brought some fun and laughter into the department. Joel Trinidad, an ER nurse has been working with his counterpart and visiting other nurses to plan for an ambitious schedule of education classes next week. Nancy Ward and Margaret Canter have been working in the prenatal clinic and labor and delivery ward and yesterday had the opportunity to deliver two babies.

Next week, the volunteers will turn their attention to a full schedule of health education classes that have been developed as a result of a week or treatment and assessment in individual departments. Enjoy these photos of volunteers at work.