November 2022 by Jeffery Flynn
On Thursday, Nov. 17, John Wiseman, chairman of Phalarope and I drove to the Manchichi office in San Felix. Thursday is the day they assemble in the office to have access to wifi so they can enter data in their tablets to be uploaded to Phalarope Google drive. It is also an opportunity each week to have virtual meetings with Dr. Rittmeyer and other members of Phalarope. Having just arrived from the U.S., I had collected some of the remaining pending equipment for the midwives. The official count for the 6 communities are: 27 midwives and 4 traditional medical doctors who also consult with the pregnant women and thus are also receiving training.
Approximately 60 babies have been born in these communities since the start of the training back in June, including a set of twins born last month. All babies and mothers are doing well. Currently there are 15 expectant mothers and 15 recent births (post partum) that are being evaluated by the midwives and Manchichi trainers. Interestingly, nearly all births have occurred in the San Felix hospital and in almost all cases the midwives have accompanied the pregnant moms to the hospital. Both of these are notable points – previous surveys indicated than the majority of births were still occurring at home in the remote villages. Our newly trained midwives are able to detect in advance when labor is imminent and have been encouraging the women to go with them to deliver in the hospital (previously many women were less trusting of the care they would receive there). When the midwife accompanies the expectant mom, she is able to provide the hospital with current patient information, vitals and history; all valuable and previously unavailable information. The referral sheets containing the information collected by our trained midwives are forms developed by Phalarope with both their name and logo and our Boquete Rotary Club prominently displayed to provide a somewhat official presentation. Regardless, there have been instances at the small village MINSA clinics that the clinicians discard the forms or refuse to accept them.
Regardless, there is abundant evidence that the pilot project is successfully achieving it’s goals of training the midwives and improving health outcomes. In January, the Manchichi staff will begin their community education seminars, enrolling ca. 15+ adults from each community for a series of health modules (nutrition, diabetes, cardiovascular disease, etc.). The midwives in each community will participate as well so they can be available to reinforce the lessons. Also, in January, we are hoping to add in some gluconometer training for our Manchichi staff.
February 9 is the tentative date for invitation of the various principals involved in the program to Panama city for the legislative forum being organized by INAMU, the Panama Women’s Institute. This will be an important opportunity to educate the Panama Government on the tremendous potential of this approach in health care delivery for reducing Maternal and infant mortality. Supposedly, representatives from all the Comarcas will be present as well representatives from the successful Guatemalan-Mayan pilot programs run by Phalarope. Regarding MINSA, we still have only the original letter of intent the Secretary general provided back when we were applying for the Global Grant. Despite any number of phone calls, emails, zoom meetings over the past 18 months, no signed document (memorandum of understanding) has thus far been provided for us to sign. Without a formal agreement with the Health Ministry, it is unlikely that we could expect approval for a second Rotary International Global Grant to expand the project. The work required to apply for this is considerable. We will be exploring whatever options are available to garner support in order to at least support the current 6 communities.
The Grant duration is set to expire in March, 2023. During this month, Dr. Miriam and her team will make their 4th and final vocational team visit as there will be graduations in each community for their midwives and for the community members participating in the community education seminars.