A most exciting second outreach trip was carried out today by SANA’s team to  Btourmaz amidst roads lined by beautiful red-fruit-laden Sumac trees, at the peak harvest time of the year for Pomegranate.

Ms. Ghinwa Fareek, the nurse in charge, had again gathered Btourmaz’s mothers for an informative session during which SANA’s team discussed the postpartum period concentrating on breastfeeding and contraception. The team tried to dispel many myths and to clarify several misconceptions. Subsequent to that, the medical care commenced despite the absence of electrical power: luckily all the medical devices had been  fully charged. The waiting room was continuously filling with more patients than the team was managing to examine, leading to a waiting time of 3 hours for some of our mothers. And to the good fortune of all, the electrical power came back on  just as the laptop-based ultrasound read “low battery”. And inspite of the long wait, the patients all left satisfied and anxious for SANA’s next outreach trip.

Today, there were several new patients, not having been seen by the team on the last trip. Of today’s patients, 50% had had no prenatal care this pregnancy, 70% had anemia, and 13% were planning a home birth with the local midwife. Several patients had wrong dates and there was one very sad case of a patient at 15w6d whose baby was found to have no heart beat. There were several high risk patients: a mother who had had severe preeclampsia and delivered in her 7^th month the prior pregnancy and who was not getting any prenatal care this pregnancy, and a 47 year old mother on her 14^th pregnancy who was 5 months pregnant. The team provided all the necessary counseling, and supplements were made available to all courtesy of MEDICEA LTD.

For SANA’s team, the gratification from caring for the patients was further intensified as SANA’s team took its first steps in its bigger educational mission: educating the local health care team and introducing ultrasound to the local care takers. Today, Reem S. Abu-Rustum, MD form SANA had a session with Ms. Ghinwa Fareek, the nurse in charge, on the key constituents of prenatal care. In addition, she introduced her to the very basics of ultrasound: identifying the fetal head and its location, localizing the placenta, seeing the fetal heart beating and identifying the fetal stomach. By the end of the day, Ms. Fareek was gaining confidence in orienting herself as to the fetal presentation, and she could tell an anterior from a posterior placenta. Ghinwa also could tell something was not right with the motionless baby who had no heart beat. As such, she was promised hands-on-scanning at SANA’s next outreach visit…

And at the end of a long long day, the team was served the crispiest local apples as the dates were being set for the next outreach trip. SANA’s team, filled with the hopes of fall and the harvest, headed back home along roads lined by Sumac trees and Pomegranate groves…

Amidst a beautiful array of autumn leaves, spanning all shades of reds to greens, SANA's medical team travelled to our highest mountains, back to Bsharri. Bsharri’s outreach trip was organized in collaboration with World Vision (www.wvi.org) and Bsharri’s Governmental Hospital. The meeting venue was Bsharri’s Governmental Hospital that neighbored the house in which the philosopher Gibran Khalil Gibran was born.

Amidst all this natural glory and mental aura, 2 concurrent sessions were carried out. Dr. Norma Rizk held an elaborate educational session covering and answering all questions pertaining to pregnancy, prenatal and post-partum care, breast feeding and post-partum blues and preventive medical care for women throughout their life span. Meanwhile, Dr. Reem Abu-Rustum, Katia Fajloun RN and Noura Kassir carried out the medical aspect of the mission providing individual counseling to our ladies who were mostly on their first pregnancy, and at 8-21 weeks of pregnancy. Basic maternal evaluation including glucose and hemoglobin testing, as well as ultrasonographic assessment, were provided, and prenatal vitamin supplementation was made available.

The outreach mission was heralded as a success by all in attendance and as a consequence, requests for future missions were voiced, with a special focus on education, where the goal is to plan further educational missions for patients, as well as specific missions targeting the hospital's medical personnel to further enhance their own basic knowledge and their medical know-how and medical skills.

SANA's team descended back home amidst the splendor, infused with such a sense of purpose and much much gratification...

SANA recently participated in ISUOG's Outreach Workshop, "Training the Trainers", as part of the 21st World Congress of the International Society of Ultrasound in Obstetrics and Gynecology. It was a most inspiring workshop that provided us with many ideas and much guidance, and it served as a catalyst to further enhance our determination to fulfilling SANA's mission. For more details on the workshop, please visit:

www.isuog.org/EducationAndTraining/Outreach+Program/World+Congress+2011/