VSO Sister for Sister project tackles First Aid training in rural Nepal

In early April 2015 family visitors were kind enough to bring a resuscitation manikin (Anne)  from the UK to Nepal. This was a wonderful present from some good friends who I met at Seale Hayne College many eras ago! Little did we know that a few weeks later the Earthquake would make this teaching device even more important. Ironically due to the extra post-earthquake projects it is only very recently that we started training properly. I did not realise how well this would be received. 

A few months ago I visited a burns hospital near Kathmandu. In view of the recent fuel crisis and a return to more wood burning, fuel being carried around the country in plastic containers, on motorbikes and bus roofs, it was no surprise that there had been a huge increase in the number of burns and deaths.

As always the Sister for Sister Community Mobilisers were very enthusiastic to learn new skills and entered into the spirit of practicing these techniques. In our cramped office in Besishahar we started practicing the most essential components on any syllabus. Embarrassing for a few moments but they were soon all having a go.

Shova practicing the recovery position

 The recovery position is a basic but vital thing to understand especially in a rural setting where you might need to leave a casualty to fetch help. Keeping the airway open might well save a life. To set everything in context it has to be remembered that our communities in Lamjung are mostly in isolated places, many hours walk from the town and the nearest hospital. Having been used to telling First Aid students that they need to call an ambulance and hopefully it will arrive fairly soon I had to think again here. There is unlikely to be a first aid kit, or a vehicle to transport a casualty so we had to think about improvisation.

Samjhana learning to do CPR

Having learnt the basic method of CPR the Community Mobilisers then had a go at teaching a friend. Such a good way to instill the knowledge and share with others.

Sarita showing Mamata where to place hands for the chest compressions.

Menuka soon became the choking expert and "Anne" was happy.

Sarita improvising a sling by using a welcome mala. 

 Finding an improvised sling is not difficult here. Most of the women wear scarves so elevating a wound is easy.

All trussed up.   Making a triangular bandage is simple.

After a bit of practice we were ready for the next step and an opportunity came our way. The Adult Champions, an Auntie, Uncle and Female Focal Teacher from each of the 12 schools, were invited for refresher training and were delighted to have a theory and practical First Aid session.

Uncle learns how to take his pulse.           Photo thanks to: VSO/Suraj Ratna Shakya

While taking a pulse is not a vital skill it really helps to explain the work of the heart and what happens during times when it is not working well. Jogging on the spot also makes everyone relax and join in with later activities. We asked the Adult Champions what they wanted to learn. Thankfully the list was exactly the same as the skills that we had been practicing!

Menuka teaching methods of treating a choking casualty

 Choking is quite common here especially on chunks of dried meat and bones. Butchering skills are basically the hacking of everything so most meat dishes have gristle and bones covered in delicious curry sauces. I was told on more than one occasion that they had been taught to give a quick, sharp chop behind the neck to remove the offending item so it was a relief to teach an approved method!!

An Auntie practicing 5 back slaps

And our Uncle from Baglungpani enjoying an acting role in preparation for the abdominal thrust position.

 With only one manikin and many participants we had to demonstrate on each other without actually doing the technique - obviously not recommended.

Most of the participants had a go at CPR. 

 The ultimate First Aid skill is being able to do CPR. We know that it might not work but the value of trying is immense. Again this is so important in a rural setting where medical help is hours away.

Sunita is demonstrating immobilising a broken leg.

 Fracture treatment was high on the participants list of priorities. With very uneven ground, physical work and a huge amount of tree climbing for fodder and wood collection, broken limbs are common. There is usually a stretcher in most villages but the route is rough and usually down uneven steps so carrying is painful. Immobilising the limb is very important.

I later read two of the quotes from participants. They brought a tear to my eyes. I knew that everyone was enjoying the training but I had not appreciated the impact.

From a Female Focal Teacher.

What have you learnt from training today?

"I really respect Judith. She is very inspirational and despite her age (this made me chuckle!!), she is far more active than many of us. A few weeks ago, we had actually requested some training related to first aid and today Judith gave us what we were hoping for. The training was very valuable and we were taught some basic life saving skills. The training also brought to light the malpractice we have been doing while handling patients. She conveyed a lot of valuable tips that could save a person’s life in times of an emergency."

What have you enjoyed the most from today’s training?

"Today’s training’s highlight would be the interactive and practical sessions. There is a whole 

difference when things are taught inside and when we can actually do it practically. Judith had 

brought the manikin for trying out CPR. She also created different scenarios where she and Community Mobilisers taught us how to handle the patients and care for them."  

How will this training help you, your family and your community?

"Being a teacher in Nepal is more than just school teaching. We are looked up for anything in the 

village, specially when it comes to health. Any medical emergency, people come to me or other 

teachers for advice and now with the first aid training, I can provide basic treatment and 

prevent the case from worsening. I am confident now that I can be a first responder in times of 

an emergency with the basic skills taught today."

Judith has been really inspirational and today’s training was really helpful specially considering 

the times we are at now - natural disaster! The tips we learnt today could be a life saver. 

From an Uncle

What have you enjoyed the most from today’s training?

"The most enjoyable were the practicals and real case scenario sessions".

How will this training help you, your family and your community?

"I am a social worker and visit different communities. With this training, I can extend my services 

to the people and be of help in times of need and disaster. Being in a remote place, we don’t 

easily have access to medical help, but knowing basic first aid, I can now make sure that the 

patient gets at least the basic medical help before help arrives. or to ease their pain." 

Finally I would like to thank my Community Mobilisers and Professional Mentor who have taken this training so seriously. They have now decided to take their new knowledge out to their schools where they will teach one subject at each monthly Big Sister meeting. Fantastic. Keep up the good work in my absence. I am so PROUD of you all. Thank you.