2h Project - Training and Education

No Small Thing
It takes 9 months for a human baby to be born. 40 weeks of preparation. Time to get used to the idea I guess.
It’s such an everyday part of life. Not uncommon to see at least one pregnant woman as you travel through your day. In some ways we take it for granted. Pregnant women have babies. One day they’re pregnant, the next a baby is born.

Some 130 million babies are born worldwide each year. Over 350,000 a day!

Unfortunately not every pregnancy ends with ‘and they lived happily ever after’.

Having a baby is no small thing. Having a baby in a developing nation; that can be life threatening.

With Woman
Midwife; with woman. Not exclusively a woman’s domain. But traditionally it’s women who are at hand when babies are born. In developing nations it’s usually the role of a Traditional Birth Attendant (TBA).

In November of 2006 The 2h Project met with the Cambodian Minister of Health with an outline of plans for the training of Cambodian TBA’s in rural and remote areas. The Cambodian government recognises the vital role that TBA’s play. Nearly 90% of Cambodia’s women are assisted in labour, delivery and the immediate postpartum period by a TBA. Most of these learn the art of midwifery by observing others or by trial and error.

In the following 12 months a pilot program was established for the training of 400 midwives.

400 Midwives
With an official welcome from government representatives and local health directors our first Safe Arrivals Training Program was underway in September 2007. The small team of Australian midwives traveled to six health centres in two provinces in six days. Kompong Speu is approximately one and a half hours south west of Phnom Penh. 80 midwives (chmob in Khmer) were waiting at the local health centre; some had walked up to 5 hours to be there.

‘It was obviously important; an air conditioned health centre, we’d expected to be sitting under a tree’

A combination of TBA’s and State Trained Midwives came to the clinics. Each province has at least one provincial hospital networked to a string of health centres throughout the country. Typically the State Trained Midwives work from the hospitals or health centres. The TBA’s are more local, more remote; working in villages, often times the first point of contact for a pregnant woman. Some had received a comprehensive education, others not so, in some cases as little as half a days training. Several women recalled stories of being forced into the role of midwife as young as 13 under the Pol Pot regime.

The clinics began just after seven o’clock in the morning with a quantative research questionnaire. The survey was put together by Adelaide University’s Lois McKellar to gather information on each of the midwives education and competency. Most TBA’s are illiterate.

After morning tea the training began in earnest. Topics covered antennal, intrapartum and post natal care; including basic hygiene and sanitation, neonatal and maternal resuscitation, septicemia or general infections, eclampsia, postpartum haemorrhage, obstructed labors, malpresentations and family planning and STI’s.

The presentations were highly visual, hands on and interactive with question and answer time being a real highlight. The ‘resus’ doll literally brought the place alive!

The Road Less Traveled
The road to Prey Veng was straight and flat. It leads to Vietnam. Its approximately 3 hours out of the Cambodian capital in a south east direction. Another hour or two further on from Prey Veng a clinic had been arranged. The Safe Arrivals Program funds transport for each of the midwives to attend, meals, training and a days wages. Another 60 chmobs were waiting.

Three 4 wheel drives traveled along the dirt highway. The Governor and provincial medical director led the way. It was sunny when we left.

Surprising how quickly something can turn. The weather. A road. Your frame of mind.

Not sure how it happened but as the rain came down like closing curtain at the theatre the road turned to slop. In a matter of minutes the 4WD turned ‘no’ wheel drive. Trapped in the cabin the foreigners became the local comedy sideshow. It’s a good thing people’s misadventures are both hilarious and strangely attractive, the crowd of onlookers were paid a dollar each to push the vehicle out of the bog.

The clinic turned out to be one of the more remote but one of the best.

And on the way back. The road was firm in at least one place. Rock hard possibly. Hard enough to rip the sump out from underneath the 4WD. Just one more delay.

That’s ok, midwives are patient people!



‘The enthusiasm of TBA’s and State Midwives to gain knowledge of differing birthing practices and their willingness to participate certainly made the experience a very positive one. I gained as much if not more from the experience in Cambodia than the TBA’s did.’ Ms Beth Grinter Bachelor of Midwifery Course Coordinator, University of South Australia ‘It has been exciting to collaborate with 2h. It’s anticipated that the findings from the survey will enable the program to be enhanced and tailored to meet the unique needs of the Cambodian people.’ Lois McKellar PhD Candidate, B.Nurs (Hons). B.Mid. Grad. Cert. Int. Studs. Newborn Health • Of the 130 million babies born worldwide each year, about four million die before they are 28 days old. • Almost all of the funding and research worldwide focuses on high technology solutions for the 1 percent of neonatal deaths which occur in rich countries. • Seventy percent of the newborn deaths could be saved with affordable and proven solutions. • These solutions cost less than $1.00 per person in the 75 highest infant mortality countries.		No Small Thing It takes 9 months for a human baby to be born. 40 weeks of preparation. Time to get used to the idea I guess. It’s such an everyday part of life. Not uncommon to see at least one pregnant woman as you travel through your day. In some ways we take it for granted. Pregnant women have babies. One day they’re pregnant, the next a baby is born. Some 130 million babies are born worldwide each year. Over 350,000 a day! Unfortunately not every pregnancy ends with ‘and they lived happily ever after’. Having a baby is no small thing. Having a baby in a developing nation; that can be life threatening. With Woman Midwife; with woman. Not exclusively a woman’s domain. But traditionally it’s women who are at hand when babies are born. In developing nations it’s usually the role of a Traditional Birth Attendant (TBA). In November of 2006 The 2h Project met with the Cambodian Minister of Health with an outline of plans for the training of Cambodian TBA’s in rural and remote areas. The Cambodian government recognises the vital role that TBA’s play. Nearly 90% of Cambodia’s women are assisted in labour, delivery and the immediate postpartum period by a TBA. Most of these learn the art of midwifery by observing others or by trial and error. In the following 12 months a pilot program was established for the training of 400 midwives. 400 Midwives With an official welcome from government representatives and local health directors our first Safe Arrivals Training Program was underway in September 2007. The small team of Australian midwives traveled to six health centres in two provinces in six days. Kompong Speu is approximately one and a half hours south west of Phnom Penh. 80 midwives (chmob in Khmer) were waiting at the local health centre; some had walked up to 5 hours to be there. ‘It was obviously important; an air conditioned health centre, we’d expected to be sitting under a tree’ A combination of TBA’s and State Trained Midwives came to the clinics. Each province has at least one provincial hospital networked to a string of health centres throughout the country. Typically the State Trained Midwives work from the hospitals or health centres. The TBA’s are more local, more remote; working in villages, often times the first point of contact for a pregnant woman. Some had received a comprehensive education, others not so, in some cases as little as half a days training. Several women recalled stories of being forced into the role of midwife as young as 13 under the Pol Pot regime. The clinics began just after seven o’clock in the morning with a quantative research questionnaire. The survey was put together by Adelaide University’s Lois McKellar to gather information on each of the midwives education and competency. Most TBA’s are illiterate. After morning tea the training began in earnest. Topics covered antennal, intrapartum and post natal care; including basic hygiene and sanitation, neonatal and maternal resuscitation, septicemia or general infections, eclampsia, postpartum haemorrhage, obstructed labors, malpresentations and family planning and STI’s. The presentations were highly visual, hands on and interactive with question and answer time being a real highlight. The ‘resus’ doll literally brought the place alive! The Road Less Traveled The road to Prey Veng was straight and flat. It leads to Vietnam. Its approximately 3 hours out of the Cambodian capital in a south east direction. Another hour or two further on from Prey Veng a clinic had been arranged. The Safe Arrivals Program funds transport for each of the midwives to attend, meals, training and a days wages. Another 60 chmobs were waiting. Three 4 wheel drives traveled along the dirt highway. The Governor and provincial medical director led the way. It was sunny when we left. Surprising how quickly something can turn. The weather. A road. Your frame of mind. Not sure how it happened but as the rain came down like closing curtain at the theatre the road turned to slop. In a matter of minutes the 4WD turned ‘no’ wheel drive. Trapped in the cabin the foreigners became the local comedy sideshow. It’s a good thing people’s misadventures are both hilarious and strangely attractive, the crowd of onlookers were paid a dollar each to push the vehicle out of the bog. The clinic turned out to be one of the more remote but one of the best. And on the way back. The road was firm in at least one place. Rock hard possibly. Hard enough to rip the sump out from underneath the 4WD. Just one more delay. That’s ok, midwives are patient people! Home About us Projects News Getting involved Contact Copyright©2007 The 2h Project