HBB Begins

Today was the first day of our first Helping Babies Breathe course. We had 50 midwives attend. To start off the course, the mayor of Dapaong and the Prefect (regional governor) joined us for the opening ceremonies and presented (very) formal remarks to begin the conference complete with local TV coverage.

I interpreted for our team leader as she made a short speech to thank the officials for inviting the team from LDS Humanitarian Services.

Several of the midwives brought their children with them today, most of the time carried on their backs. They were all dressed in beautiful African fabrics.

 

Our local instructors taught most of the lessons, and the midwives learned quickly.

Training of Local Instructors

After driving 6 hours yesterday (on mostly paved roads) and 3 hours today (on mostly unpaved roads)  we arrived in Dapaong, the main city in Northern Togo. The UNICEF director and some of the Togolese physicians and I walked down to the Prefecture to meet the Prefect (governor of the region) and the Mayor of Dapaong to thank them for allowing us to teach the courses and to be officially welcomed by them. Tomorrow, the Prefect will come and speak at the opening ceremonies of the course.

Today we taught 10 midwives, OB/GYN’s, and pediatricians who will help us teach our course this week. Most had attended the LDS Humanitarian Services course in Kara, Togo, last year. We conducted a 7-hour review course for them, and they did some practice teaching.

I learned today that about 40% of the births in the northern region of Togo are home births.

 

Why is twilight so short near the equator?

Lomé, Togo is located about 5° N Latitude. Because it is so close the equator, the length of a day and the length of a night are about the same year-round. At the equator, darkness falls almost instantly after sunset; there is no twilight. Why? As an amateur astronomer, I wanted to research this. Here is what I found out:

The earth is rotating on its axis. It rotates once every 24 hours and the earth is about 24,000 miles in circumference. So at the equator, the earth is turning at about 1000 miles per hour. At the poles, the surface speed is nearly zero. At this speed, the sun rises and sets very quickly. You do not notice the speed of the earth on the surface, but the sun appears to rise and set rapidly. At or near the equator, the sun rises at about 6AM and sets at about 6 PM every day of the year. In the morning, at 6 AM, it is almost totally dark. By 6:30 AM, the sun is up and full daylight is everywhere. Similarly in the evening, it is daylight at 6 PM and dark at 6:30. The sun "plunges" below the horizon at a steeper angle, therefore it gets dark quicker.

Furthermore, at low latitudes (near the equator), the sun sets perpendicular to the horizon, while at higher latitudes, the sun can set at a more oblique angle, allowing it to remain close to the horizon after sunset for a longer period of time.

When the sun sets in the north, it "disappears" over the horizon in a sharp angle. So it takes a while for the "whole disc" to disappear. So a big part of its movement is about going along the horizon, not about setting. Therefore, it sets slower.

In extreme cases (summer in the Arctic) it never completely disappears but just hugs the horizon.

At the equator, this angle is about 90 degrees. So the sun goes over the horizon straight down rather than in an angle.

If you're near the poles, the Sun sets in a skew angle relative to the horizon.

Yes, it does change from day to night, and vice versa, faster near the equator (actually in the Torrid Zone between the Tropics of Cancer and Capricorn). The reason is at those latitudes, the sunlight passes through less of earth's atmosphere than at high latitudes. The angle of the sun's descent toward the horizon is closer to the perpendicular, and for those two reasons, (a) the sun's light is refracted less at lower latitude, and (b) the sun "plunges" below the horizon at a steeper angle, therefore it gets dark quicker.

On the two equinox days (March 21, the first day of spring, and September 21, the first day of autumn), the whole world gets 12 hours of daylight and 12 hours of darkness. On those days, it's the same in Colorado, on the Equator, and in Australia.

Teaming up with UNICEF

This morning we met our colleagues at the UNICEF office in Lomé. One of the Togolese doctors who will be teaching with us attended medical school and received Pediatric and Neonatology training in Bordeaux, France, where I served my mission. We figured out that we were there at the same time in the early 1980’s. Another Pediatrician who will be part of our team in Dapaong went to medical school in Shanghai, China. She studied Chinese there for a year and then attended medical school. Our third Togolese colleague is a Public Health specialist. He did his training in the neighboring country of Benin. The final member of our team is a Belgian public health specialist who works with UNICEF. She completed her training in Belgium. Her prior UNICEF position was in Ethiopia where she also organized joint sponsorship of neonatal resuscitation courses with LDS Humanitarian Services.

The United Nations Children's Fund (UNICEF) is a United Nations Program that provides long-term humanitarian and developmental assistance to children and mothers in developing countries.

UNICEF was created in 1946 to provide emergency food and healthcare to children in countries that had been devastated by World War II. In 1953 its name was shortened from the original United Nations International Children's Emergency Fund, but it has continued to be known by the popular acronym UNICEF based on this previous title.

UNICEF relies on contributions from governments and private donors. Governments contribute two thirds of the organization's resources; private groups and some 6 million individuals contribute the rest. 92% of UNICEF revenue is distributed to Program Services. UNICEF was awarded the Nobel Peace Prize in 1965.

Rural Health in Togo

Togo is  one of  the 49 least developed countries. 69% of children nationwide live in poverty-affected families. Rural poverty is deeper than urban poverty , and strong discrepancies exist between regions.

Health indicators also vary significantly between urban and rural areas in Togo and throughout Africa.  86% of those in urban areas but only 40% in rural areas can access safe drinking water. 

Up to 36% of children in the northern region where we will be teaching have stunted growth due to malnutrition. In the south, 62% of the population can access health services within an hour's walk. But only 30% of the population in the Savanes region where we will be teaching can access health services within an hour's walk.

Mortality of children under 5 stands at 123 per 1,000 live births, with 35% of the deaths occurring during the neonatal period. Outside of the neonatal period, malaria, diarrheal diseases and pneumonia are the main causes of death. 

We have arrived in Lomé, the capital of Togo. Tomorrow, we depart for Kara which is in northern Togo.


When I changed planes in Paris, I met up the 3 nurses who are part of our LDS Humanitarian Services team. Two of them have 10 grandchildren and the other one has 11 for a grand total of 31!

Helping Babies Breathe in Togo

On November 29, 2013, I will travel to Togo, West Africa. I will be volunteering with LDS Humanitarian Services. Neonatal Resuscitation is a major humanitarian initiative of the Church of Jesus Christ of Latter-day Saints. This will be my 8th time serving with the Neonatal Resuscitation program and my 5th time serving in Africa.

Our courses in Togo will be taught in Dapaong, about a 12-hour drive from the Lomé, the capital of Togo. We are grateful to provide this training as a joint venture with LDS Humanitarian Services and UNICEF.
 
Visit this link for a video which features Elder Jeffery R. Holland of the Quorum of the Twelve Apostles telling about the Neonatal Resuscitation Training program.

Video:
 "A Child's First Breath"

 Here is a video about Neonatal Resuscitation Training in Africa. I have taught NRT several times in DR Congo with one of the doctors in this video.

Video:
"Neonatal Resuscitation Training-Africa"

Here are some other excellent videos about the humanitarian efforts of LDS Humanitarian Services or LDS Charities:

http://www.lds.org/media-library/video/humanitarian

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