It seems like I only got home to Hawaii yesterday, but will be leaving for Kathmandu tomorrow. In truth, there are seven months before summer 2014 break. In the past I start planning in November or thereabouts.
There is nothing that says the 2014 trip will be the exact repeat of the 2013 trip. The whole idea is to evolve the training so that it is “owned” by Nepali nurses and docs, and to rely less and less on myself and other videshis.
what are we capable of doing?
first step is to look at organizational capacity. here is what I am thinking:
it’s time to take steps to support and promote Nepali nurses who can teach the content.
it’s time to reach an even wider group of nurses.
time to develop doctors, probably from among the recent crop of MBBS grads now working at Nepal hospitals, to include docs as well as nurses.
still not ready to offer an American-style “official” ACLS course, but steps can be taken to make it closer and closer when we finally do. for now, finding a cost-efficient way to deliver the training is an over-riding factor. Also, delivering a course that serves the needs of Nepal, as opposed to certifying a small number of persons whose goal is to go overseas.
second step is to actually say what I propose:
1) develop a one-day course, and at the end of the day the participant gets an “official card” similar to the ACLS card used in USA. Not a certificate. just as official though.
2) train nurses and doctors who would teach the lecture component using the model of mega-code and practical focus.
3) organize and conduct even more sessions than we did in 2013. we did sixteen 3-day sessions and trained 534 persons. thirty in each cohort.
why not still keep thirty in each cohort and offer fifty sessions? or seventy? In USA this training is offered widely and “owned” by everyone. Why not in Nepal? if we did a one-day course, five days a week, we could reach 2,100 people. wow!
4) devote time to gather equipment that helps the simulation aspect. for example, an actual defibrillator (or more than one) at each session, more mannikins, etc (should we/can we get one location to serve as the sole permanent host site in Kathmandu?)
5) develop a network of resource persons from throughout the country, with even more focus on cities in the Terai, who can also teach this.
6) explore the idea of partnering with some sort of NGO or existing professional group for this purpose. Maybe form our own!
7) make better use of Nepali-language multimedia to promote ACLS in Nepal.
the trick is to find a logical next step which builds on what we did but which does not over-reach into the impossible.
What do you think?