Since nurses like Margot Biggs have delivered the WHO’s 'Emergency Triage Assessment and Treatment’ course in Liberia, child mortality rates across Africa have decreased by 45%, according to the African Journal of Emergency Medicine. Without MAF however, it would take Margot days to reach these remote locations by road. MAF’s Katie Machell reports…
During the spring, Nurse Margot Biggs caught an MAF shuttle flight from the capital, Monrovia, to Harper in the far south-eastern corner of Liberia. By car, this would have taken two days because of the poor state of the roads.
Taking time out from volunteering as a nurse at ELWA hospital in Monrovia, Margot and her colleague, Dr Mikey Bryant, spent four days delivering the WHO’s ‘Emergency Triage Assessment and Treatment’ course (ETAT).
ETAT targets healthcare workers and aims to improve how they triage and treat children from the moment they are admitted to hospital to how their cases are prioritised and managed within the first 24 hours.
After completing the course, participants are better equipped at assessing a range of admissions from convulsions to breathing difficulties to malnourished children.
100 Liberian health workers attend the ETAT course every year.
‘The knowledge that we’ve helped them acquire is so valuable. We are literally teaching them how to save lives. I'm incredibly grateful that we are able to fly with MAF, because that is the only way we can do it.’
Margot Biggs, WHO ETAT trainer and volunteer nurse at ELWA Hospital, Monrovia
Training future trainers
There were twenty-five course attendees in total, mostly nurses from the J.J. Dossen Hospital in Harper and the Pleebo Health Centre further afield. They spent four days learning new skills and putting them into practice in different scenarios. Margot explains how it works:
‘At the beginning, everyone does a test to assess their level. People score quite badly - hardly anyone passes. At the end of the course, they repeat the test and most of the participants pass. Even for those who don’t pass, we always see a massive difference between the pre and post-tests. They have still increased their knowledge.’
Margot says that the course was delivered in partnership with local medical professionals so that they could run more courses elsewhere within the next few months:
‘They've never run the course before, but now they’ve done it, they’re equipped to run the course themselves for others. The more people that can participate the better, because it has really good outcomes.’
Margot’s passion shines through
Even though she has delivered the course many times herself, Margot’s enthusiasm is unabated:
‘I love those light bulb moments - someone not knowing something before, and now they do. I also love the group sessions where we do practical work because we can really get hands-on. The participants feel freer to interact and are more open with their questions.’
Margot leads a range of sessions, but she is particularly passionate about some areas:
‘Because of my background in Emergency Nursing, I love teaching basic life support, and about coma and convulsions. I’ve had lots of experience in that so I can include my own personal stories and talk about real-life situations.
‘Part of the reason why I love teaching this course is because I can really show the participants what it means to be a nurse, especially as a Christian. I really hope that passion comes across. Nursing is not just a profession, it’s truly a calling.’
Worth the challenges
Delivering a course in a developing country is not without its challenges as Margot testifies:
‘Especially when it comes to technology! We use our projector, but the electricity often cuts out, so that can be frustrating. There can also be different levels of participants’ knowledge. Some people are already quite good at their job, whereas others have much less experience, so it can be difficult know what level to pitch the training at.’
Despite the challenges, Margot believes that this course has a positive impact especially for staff working in remote settings:
‘You could be the only nurse in the only clinic and when someone turns up with a child who is severely malnourished, dehydrated, not breathing or having a seizure, it’s down to you alone. These workers are even less resourced so the more they know, the more hope they've got.’
According to Dr Mikey Bryant, the pass rate for this course was 85%. In terms of the pre and post knowledge tests at the beginning and end of the course, participants’ marks went up by at least 30%.