Week 2: Family Planning Training

I love my job!

With their new Managing Contraception books

Thank you Dr. Hatcher!!

 Day one of family planning training was long but SOOO enjoyable.  Pamela and I are doing a comprehensive competency-based family planning training in five days to 13 providers (nurses, midwives, medical officers) who work throughout Juba in the teaching hospital and two health centers.  Four participants only speak Arabic so it was an adjustment to slow down lectures to await translations.  Fortunately, the language barrier did not stop questions!!!

Again, our training started on the Nile at the Intra-Africa hotel.  Day one was filled with lectures and discussions as we reviewed all family planning methods available in South Sudan, medical eligibility criteria and common myths to dispel in the community.

I think my two favorite moments of the day were:
1.  When I explained continuous use of combined pills and how women can avoid their periods.  Mama Rose (older women in S Sudan are addressed Mama) said to me, "Please wait, this must be translated right now, this message is too sweet!!"  They started clapping!
2.  Starting and ending the day with a prayer in Arabic.  In a country where God is everywhere, spoken everywhere, all the time, they understand how important contraception is to women and families and how it saves lives.  It was really moving to end the day like that, all understanding the importance of what they will be doing, God's will.

Today, day 2 we focused on IUDs and implants.  The CopperT and Jadelle (a 2-rod implant) are the two devices available here AND THEY'RE FREE (a Juba Choice project, to all my FP friends)!!  We spent the morning at the hotel reviewing the methods, watching insertion videos and discussing aseptic technique. 

 After lunch, we moved our training to Marie Stopes clinic in Juba who is graciously letting us work with their clients this week to become competent in CopperT and Jadelle insertions.  Marie Stopes is a private international clinic focused on RH.  They see 8-10 clients a day and according to their director, the IUD and implant are the most popular methods women are using!!!!  She says that women just can't be bothered with taking a pill everyday.

 This afternoon I trained half the group in IUD insertion technique with hand models and how to "tent" the skin with the implant model. 

Madam Zoe

 Meanwhile, Pamela taught the other half of the group how to perform bimanual exams and place a speculum to visualize the cervix using the lovely Madam Zoe model. 

Powerful messages on t-shirts are very common here!!

One of our providers has tribal markings on both hands which you can see in this picture.  We spent a large amount of time yesterday discussing different tribal customs and how they affect family planning and reproductive health.  The most common tribes in South Sudan are those of the president Salva Kiir (Dinka) and the vice-president (Nuer), but there are over 60 indigenous tribes in the whole country!  Some examples providers gave us:  Some tribes practice polygamy and those generally do not support sexual activity for two years after childbirth (the husband will "visit with other wives").  Others believe sex immediately after childbirth brings good health to the new baby.  Most people in South Sudan believe that the husband should choose the contraceptive method.  Luckily the trainers from last week and the providers we are training this week believe in empowering the female patients and encouraging partner support for contraceptive acceptability and continuation. 

We have a lot of work to do this week but hopefully we'll see many clients this week.  I'm thrilled to see them sooo excited to learn about family planning and train for the important role of patient advocate and family planning provider (I'm slightly biased!!!)

Will keep you updated!!!  Tara xoxo