Article by Janice Gibbs, Temple Daily Telegram – Temple, TX
The woman was in labor and afraid. The thought of having a needle stuck in her back was frightening – she feared paralysis.
The woman was a patient last November in a hospital in the Republic of Georgia and was about to give birth to her first child. Dr. Lisa Councilman, an obstetrics anesthesiologist at Scott & White Memorial Hospital, was also on the scene as a representative of Kybele, a nonprofit humanitarian organization dedicated to improving childbirth conditions worldwide through medical education partnerships. Dr. Councilman and other Kybele team members were at the Batumi hospital training physicians how to use spinal anesthesia during births rather than the more dangerous general anesthesia normally used.
Kybele is made up of anesthesiologists, obstetricians, neonatologists, midwives and labor nurses who travel to host countries to help improve the survival of mothers and their babies. The woman was going to have a Caesarean section, but was afraid to receive regional anesthesia, Dr. Councilman said. With the woman’s husband serving as translator, the Kybele physicians tried to explain that spinal anesthesia was much safer than general anesthesia, a state of total unconsciousness resulting from general anesthetic drugs. When the husband learned that he could be in the room for the birth if his wife had spinal anesthesia she changed her mind quickly,
Dr. Councilman said. “She was very nervous. We did the spinal and she did very well,” she said. It was a joy, Dr. Councilman said, to witness the couples’ delight at being able to see the baby right away. Dr. Councilman said the experience was doubly rewarding because, not only were they providing safer care to the mother and baby, she was able to see the patient component – the happy parents with their healthy baby. Kybele is made up of medical personnel from the United States, Australia, Canada, Belgium and Great Britain. “We work through education in conferences and hands-on demonstrations in hospitals,” she said.
The goal is to find a hospital in the country that will support a teaching effort that continues when the Kybele volunteers leave. “That way, they can set up a good ob/anesthesia service that’s safe and they can teach doctors who are coming from outlying towns and cities,” Dr. Councilman said. Patient education is another goal – providing information so patients won’t be frightened of new procedures. The makeup of each Kybele team varies, depending on the needs of the country being visited. Kybele physicians pay for their own plane tickets. The host countries are supposed to cover team member expenses within the country.
Dr. Councilman is coordinating a trip to Romania this spring. “They want us to come and start an education program to get all of their programs up to the same standards because they have some hospitals that give excellent care and some are near to the same level of quality,” she said. “We try to work within the country’s limitations of equipment and supplies,” Dr. Councilman said. Kybele does attempt to procure medications and equipment it believes are necessary to provide the kind of care it wants for women everywhere.
The group teaches at hospitals on the local level, she said, and seeks change at the higher levels of government. Kybele team members are treated like honored guests and it opens doors, Dr. Councilman said. The Kybele teams range in size from five to 15. A large team goes to Ghana once a year with smaller groups going a couple of times a year. In Ghana, the infant mortality rate is high because when babies are delivered they are just set aside, she said. “They didn’t know the basics of neonatal resuscitation, such as warming the babies and drying them off,” Dr. Councilman said.
In one year, the Ghana hospital Kybele is working with dropped its infant mortality rate by 50 percent. Dr. Councilman has been to Georgia, Armenia and Romania. She’ll be going on trips to Romania and Georgia this year, while other Kybele missions are planned for Egypt and Ghana. Kybele does try to provide new equipment to the hospitals. “In Georgia I was shocked by the lack of equipment,” she said. “The only monitor used for blood pressure in the operating room was a cuff and they put a finger on the pulse of the patient.” The country doesn’t have the financial means to improve and it doesn’t have good relations with its bordering countries, she said. One of the challenges, Dr. Councilman said, is the need to have someone on hand who can fix the equipment if something breaks.
There is the possibility of collaboration between Duke University, which has a global health initiative, she said. The university has biomed engineers who may be willing to go to these counties to do routine maintenance and teach personnel at the hospitals how to fix and maintain the machines.