Dale Dewar, lead doctor and Quaker, visits with a colleague on a training trip to Iraqi Kurdistan.
Women continue to have babies, even in war-torn countries.
~ Dale Dewar, rural physician and Quaker
CFSC’s “Care to Care”project is concerned for the thousands of women in the Kurdistan governorate who face the stark choice of going to a hospital where C-sections are done practically 50% of the time or delivering at home with untrained lay midwives.
It is also for the obstetricians, gynaecologists and obs/gyn nurses who have not had access to continuing medical education so they do what they think is best, unaware of misinformation or recent evidence-based advances in practice.
Finally, our concern is for those lay midwives—often the closest, most practical resource for rural women—whose role can be developed very positively.
To address these concerns, a project was conceived called “Care to Care: Continuing Medical Education in Kurdistan, Iraq”.
Exploratory visits to Kurdistan began in 2004. Between 2004 and 2006, 900 physicians were given short workshops and asked to identify the type of training most needed. The final decision was the Advanced Labour and Risk Management (ALARM) program, which is the certification course required for delivery-room practice in Canada. The Society of Obstetricians and Gynecologists of Canada (SOGC) has developed an international version. With funding from Canadian International Development Agency (CIDA), Saskatchewan Council for International Cooperation (SCIC) and many individuals, the full ALARM course has been delivered four times. Volunteer trainers from the Society of Rural Physicians of Canada have trained more than 150 Kurdish physicians, all of whom are women. More than 30 of them have been trained as trainers.
A second phase has been proposed to CIDA, to assist these Kurdish trainers to write a Kurdish curriculum for training nurses and midwives, and then to begin delivering that training. The proposal to CIDA also includes a phase one for Burundi (in Central Africa), to train their teaching hospital physicians.
Remarkable changes in medical practice have already been observed in Iraq. There was no protocol to dry and stimulate newborns; if infants did not cry immediately, they were presumed stillborn, and died. Also, some practitioners were not treating women with complications from miscarriage for fear of being judged to have assisted an abortion post-hoc. The rights of women to reproductive health care have been clarified and a standard of practice has been set that all women must be treated.
Project partners with CFSC on the Care to Care project:
- Society of Rural Physicians of Canada
- Kurdistan Regional Government
- Hawler University
- Society of Obstetricians and Gynecologists of Canada
- Canadian InternationalDevelopment Agency (CIDA)
- Saskatchewan Council for International Cooperation (SCIC)
- Canadian Quaker Monthly Meetings (local congregations)
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