Between 1981 and 1987 60 village midwives from six language groups in the Southern Highlands Province have been trained. The customs of these groups and how the training course was modified to adapt to traditions are discussed. Suggestions are presented for consideration by future village midwife tutors.

child ; Human ; Infant ; Measles - immunology ; Measles - prevention & ; control ; Vaccination

Aid post orderlies in one district of the Southern Highlands Province were trained to give immunizations to children as part of the Expanded Programme on Immunization. The performance of the aid post orderlies (APOs) as immunizers is compared with that of the traditional maternal and child health (MCH) team. Also the results of the combined efforts of the APOs and MCH sisters in this pilot district are compared with those in a control district. The joint APO-MCH effort was more successful than the traditional approach in reaching national immunization targets.
Allied Health Personnel ; Human ; Immunization Schedule ; Infant ; Papua New Guinea

In mid-1987 a baseline microfilarial prevalence survey was conducted among five villages in the Mt Bosavi region of the Southern Highlands Province of Papua New Guinea. Through use of the Nucleopore filtration technique, it was determined that 48% of villagers had detectable microfilaraemia. The highest prevalence was documented in Fogomaiyu, where the microfilaraemia rate was 92%. On the basis of this initial survey and the expressed interest of the community, the Division of Health in the Southern Highlands Province undertook an integrated community-based pilot control program. The project used two principal control methods: (a) drug treatment with low-dose diethylcarbamazine citrate (DEC) distributed to the community weekly and (b) vector control with permethrin-impregnated bednets. Results six months after the intervention indicate that the program was successful in reducing microfilaraemia at Fogomaiyu village from 92% to 6%. The reduction is principally related to the effects of DEC, although the bednets, by limiting vector-person contact, are expected to reduce the incidence of both filariasis and malaria.
Adolescent ; Altitude ; Bedding and Linens ; Community Participation ; Elephantiasis, Filarial - epidemiology

BACKGROUND: Transesophageal echocardiography (TEE) is used in the emergency department to guide resuscitation during cardiac arrest. Insertion of a TEE transducer requires manual skill and experience, yet in some residency programs cardiac arrest is uncommon, so some physicians may lack the means to acquire the manual skills to perform TEE in clinical practice. For other infrequently performed procedural skills, simulation models are used. However, there is currently no model that adequately simulates TEE transducer insertion. The aim of this study is to evaluate the feasibility and efficacy of using a cadaveric model to teach TEE transducer placement among novice users. METHODS: A convenience sample of emergency medicine residents was enrolled during a procedure education session using cadavers as tissue models. A pre-session assessment was used to determine prior knowledge and confidence regarding TEE manipulation. Participants subsequently attended a didactic and hands-on education session on TEE placement. All participants practised placing the TEE transducer until they were able to pass a standardized assessment of technical skill (SATS). After the educational session, participants completed a post-session assessment. RESULTS: Twenty-five residents participated in the training session. Mean assessment of knowledge improved from 6.2/10 to 8.7/10 (95% confidence interval [CI] of knowledge difference 1.6-3.2, P<0.001) and confidence improved from 1.6/5 to 3.1/5 (95% CI of confidence difference 1.1-2.0, P<0.001). There was no relationship between training level and the delta in knowledge or confidence. CONCLUSIONS: In this pilot study, the use of a cadaveric model to teach TEE transducer placement methods among novice users is feasible and improves both TEE manipulation knowledge and confidence levels.