Volunteer Reflections: Training health care professionals in Karachi, Pakistan

By MedGlobal Volunteer, Dr. Aisha Mirza, Associate Clinical Professor University of Alberta Department of Emergency Medicine

“One thing at a time, and all things in succession, that which grows slowly endures.”

Have you heard of the flow state? Flow state is the ability to be deeply immersed in the moment of being that time loses meaning. Some people achieve this feeling only while on vacation, where the days pass so quickly and before you realize – it is all over. Flow state is a mindful state of being and can be the source of much personal growth, reward, and happiness.

People often ask, “how can you work in the Emergency Room without burning out?” The ER is a place of chaotic structure – the ultimate juxtaposition of life. A place where life begins, ends, and everything in between. It is humbling to witness the circle of life so acutely and without filter. 

In the ER, I am using my capabilities at maximum capacity and interacting fully with each person. My ultimate goal is to align the care I provide with the patient’s needs at the moment. The energy and commitment it takes will often take me to a flow state and, before realizing it, my shift comes to an end. 

While at the MedGlobal Pakistan Mission in Karachi, done in partnership with The Indus Hospital, I was in a flow state for the entire week.

The mission had four principal concurrent components, which were; Compassion & Empathy Workshop, Helping Babies Breathe, Obstetrical Emergencies with Antenatal Ultrasound, and Adult Point of Care Ultrasound. It was a privilege to play a role in such a profound initiative. 

First, I gave primacy of place to the Compassion & Empathy Workshops. These workshops had over 500 attendees, with diverse backgrounds, who partook in role-playing and intense discussions. Physicians, nurses, health care workers, administrative staff, researchers, hospital greeters, and many others gathered to learn new ways of demonstrating empathy for patients in difficult situations. It was the ultimate reminder of our collective goal for reducing healthcare disparity in the world. The course would not have been possible without Dr. Minal Ahson (the founder and creator of our Compassion & Empathy curriculum) and Dr. Abdul Bari Khan. 

Second, the Helping Babies Breathe group worked hard to deliver life-saving training through a novel, hands-on, and role-playing methods using baby ‘Natalie.’ Many participants taking part in this course felt that it provided a strong base to approach births in low resource areas. A secondary goal was to train local master instructors within the class who would continue to deliver the course to future participants. Dr. Henna Qureshi and nurse Harriet Hawkins were instrumental in leading a team of physicians who put in long hours towards this initiative.

Third, Obstetrical Emergencies and the Antenatal Ultrasound course included an expert in the field of maternal-fetal medicine, Dr. Jeff Pollard, to train physicians. The principal at a local midwives college called our MedGlobal lead Dr. Hena Ibrahim to share her gratitude.“Never in a million years would I have imagined that my graduates would have the opportunity to take part in such an advanced care initiative and learning opportunity. I am so proud of my learners for elevating their knowledge through this course,” she expressed. The team lead, Dr. Mike Drusana, put in countless volunteer hours to the creation and implementation of this course.

Finally, my role was to work with a group of physicians and provide two Adult Point of Care Ultrasound Courses. Through comprehensive lectures and breakout, hands-on sessions with the ultrasound machines, our participants learned and practiced the art of Point of Care Ultrasound (POCUS). Many participants traveled from low-resource areas to take this course. 

Donations from MedGlobal donors funded the purchase of ten new portable ultrasounds, called Butterfly iQs, for distribution within the lowest resource areas in Pakistan. Our goal is to continue to provide support to our graduates through online assessments of ultrasound images past participants generate over the next few months. We hope that graduates of this course continue to develop their skills and deliver this course to their colleagues. Dr. Sarah Shihadeh, our team lead, put in countless hours of work to ensure our POCUS providers, Dr. Mark Supino, Dr. Bess Storch, Dr. Sharad Patel, Dr. Ludwig Koeneke Hernandez and myself were well-equipped to provide a value-add course to the participants. 

During our last scanning days in the hospital, one of the resident physicians, Dr. Hajira Nauman, shared how she was able to utilize her new skills. She imaged right heart strain in a patient with portal venous thrombosis after only two days of training. This experience motivated her to continue using this skill and building her bedside ultrasound expertise. “Thank you, Dr. Aisha,” she said, “I can’t believe I was able to do this, and I am so excited to continue to use the skills I have learned in this workshop.” 

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