About the ‘Calmed’ Programme
Rotary International has now made 3 Programme Grants to facilitate ‘Calmed’ training missions to states in India where the maternal death rate is highest – Sikkim, Bhuj and now Madhya Pradesh.
The First Vocational Training Team (VTT) visited Sikkim State in 2013 to test the ‘Calmed’ approach to training members of the medical and allied professions, including Public Health Workers. A team of UK Obstetricians and Gynaecologists visited the State for a two week period to pass on skills and ‘Best Practice’ from the UK.
The intention was to teach their opposite numbers in these high risk States to become ‘Master Trainers’ who could then go on to cascade their knowledge to others in the same field in Sikkim. Over time the intention is for the Master Trainers to build up continually the numbers of doctors trained in these new skills, so that a real impact can be made on both the skills and culture of medical treatment for mothers.
At the same time, attention is given to the mothers themselves who need to know more about their own pregnancy and treatment, particularly in the thousands of remote villages where proper medical care is distant. In India, there exists a network of public health workers ASHAs (Accredited Social Health Activists) who go to each of these villages to teach mothers the skills they will need for a successful childbirth. It makes good sense to target ASHAs for similar best practice training.
The 2nd VTT / Calmed expedition went to Bhuj in Gujarat state in November 2014. The same methodology was repeated to the local medical profession and ASHAS, again leaving behind a cascade training model to grow through the new local Master Trainers.
Our 3rd VTT / Calmed visit (in Setember 2016) is to visit another needy part of India with high maternal death rate – the state of Madhya Pradesh. We will be basing our team at Indore, a major city of some 2 million people, but surrounded by thousands deeply rural villages. Here the death rate for mothers is high even by Indian standards, and implementation of the Calmed approach to improving childbirth care will make a real impact on the problem.
Our teams attack ‘the three delays’ which together cause of countless unnecessary deaths to mothers and babies, which can be substantially reduced through some simple and often low tech solutions. The Three Delays:
- Delay in Recognising Emergency Problems – Mothers in Remote Rural villages not recognising problems in their pregnancy / childbirth and seeking immediate help
- Delay in Reaching Medical Institutions – When problems occur, delays in getting the mother to the hospital or medical treatment, often long journeys away with poor or non existent transport links
- Delay in Receiving Treatment At the Institutions – On arrival at hospital, delay in recognising the danger symptoms and urgently getting the mother access to appropriately skilled and trained medical assistance.
We will be dealing with the education of the doctors and medical staff at the hospitals, education on the need for rapid emergency transport to those hospitals, and right at the start, the education of the mothers and their families in the rural villages to recognize the deadly hazards that can so easily be avoided with a little knowledge and training.
Again we will use the successful formula of 7 UK Gynaecologists / Obstetricians who will teach the prospective Master Trainers their skills over four days. They will then oversee the Master Trainers conducting their first course to their medical peers for a further four days, and then they will separately train the ASHA Trainers in the aspects of Calmed which most meet the immediate information needs of mothers in the remote districts. In Madhya Pradesh we hope to begin reducing the UK input by using 2 of our previous locally trained Master Trainers to join our initial VTT mission.
See ‘About Calmed’ on our Papers & Resources page for more information on the Calmed rationale and these exciting projects.