Punjab, Pakistan – At the busy maternity unit at the Lady Willingdon Hospital, women give birth at a rate of one every hour and often after experiencing complications. And yet, this teaching hospital in Lahore didn’t have in place the most basic measures to protect mothers and newborns from infection. Soiled forceps, scalpels and other instruments were left on trays for hours until someone found time to wash them – with only soap and water – increasing the risk of transmission of hepatitis, HIV and other infections to clients and providers.
Despite dedicated efforts to save women’s lives, these practices continued until senior physicians attended a Jhpiego-led workshop on the postpartum intrauterine contraceptive device (IUCD), the first such training in the Punjab area.
“After attending the training session on IP practices, we decided to start using chlorine right away and decided to use our per diem (received during the training) for purchasing liquid bleach,” said an enthusiastic Dr. Sofia Iqbal, who works at the gynecology and obstetrics unit at Lady Willingdon Hospital.
Dr. Sophia was one of 14 physicians enrolled in the six-day workshop, which focused on teaching doctors how to insert an IUCD following birth, a new service provided at Lady Willingdon and Lady Aitchison Hospitals.
The training is part of ongoing efforts by Jhpiego, in partnership with the Government of Pakistan, to build the capacity of health care workers to strengthen maternal health care and family planning services for women.
Jhpiego recently initiated the Strengthening Postpartum Family Planning Project in Punjab with the support of the David and Lucile Packard Foundation as part of its broader initiative to expand access to and improve family planning services in Pakistan and India.
At the Punjab workshop, participants learned the steps of correct management of soiled instruments: decontamination, cleaningandsterilization as well as safe waste disposal. Soiled instruments are decontaminated with liquid bleach, then scrubbed with a soapy utility brush before sterilization. Trainers also demonstrated and emphasized the use of protective gear such as goggles, masks and boots.
The participating physicians recognized the importance of infection prevention practices for both the client and provider and began implementing them immediately. “It was the first time during my career that I am feeling a change in myself after the training and realized that, yes, trainings can make a difference,” said Dr. Sophia.
She and her colleagues had been anticipating a tedious day of learning, but instead they were energized by an interactive learning experience, featuring new teaching techniques and hands-on practice with anatomic models and checklists. Participants were so motivated that they started implementing their new skills immediately upon returning to the labor room.
Acknowledging that infection prevention practices at Lady Willingdon Hospital, an affiliate of King Edward Medical University at Lahore, needed to be upgraded, hospital administrators asked Jhpiego to organize a similar workshop for all staff. They also agreed to add liquid chlorine to their regular list of supplies.
Dr. Afzal Shaheen, the hospital’s Medical Superintendent, shared his support for the implementation of such preventive practices at the health facility, saying “It is such a cost-effective way of protecting ourselves and the patients. I never realized this.”