Today, and in collaboration with World Vision Akkar, www.worldvision.org.lb, and  Sheikh Zennad's Local Committee, SANA's team travelled the sea-side road to Sheikh Zennad, a village in Akkar’s Valley, right alongside orange groves, and where the mountain tops glistened with snow in the distance…

SANA’s team was able to meet the “Mukhtar” of Sheikh Zennad (the people’s representative) who welcomed us and informed us that there were approximately 100 annual births in Sheikh Zennad, however there is no local clinic or health dispensary in the village.

The team then got very busy transforming the provided room, at one of the village's public meeting sites, into a fully equipped prenatal clinic. Several of the local mothers then gathered in our meeting room with more mothers standing than sitting. An educational session about proper nutrition in pregnancy was carried out followed by an open discussion targeting various issues, questions and concerns voiced by the attendees, relating to women’s and child health and well being.

Some of our patients waited 2 hours to be examined. Though there was no electrical power while we were there, SANA's team was able to provide counseling, blood pressure checks, hemoglobin and glucose screening in addition to obstetrical sonography. Our patients ranged in age between 26 and 36 years, and of the patients seen, 80% were on their fourth or fifth pregnancy, and 60% had had minimal prenatal care. The team identified 2 cases of anemia one of whom was very severe in need of medical attention, one patient with high blood pressure, corrected wrong dates to 2 patients using ultrasound, and provided basic nutritional supplements. In addition, Safa’, a vibrant member of the Sheikh Zennad community, expressed her eagerness to help SANA’s team and to start learning the basics of prenatal care in hopes of being an active participant in the founding of the village’s own health dispensary. Safa’s then shadowed SANA’s team members through each medical service rendered.

After several intense hours, SANA’s team completed its mission and was immediately asked to set the date for the next trip to Sheikh Zennad given the satisfaction felt by the attendees. As such, and with the help World Vision Akkar as well as Sheikh Zennad's Local Committee, plans have been set for a December trip. And back along the orange groves, SANA’s gratified members travelled home…

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…