PANJSHIR PROVINCE, Afghanistan (June 20, 2008) — Six Afghan medical providers learned basic lifesaving skills at a Panjshir Provincial Reconstruction Team CPR course held at the Rokha Clinic in Rokha, June 18.

Air Force Staff Sgt. Janine Duschka, a PRT medical technician deployed from Andrews Air Force Base, Md., taught the course.

“It is important to teach the local medical providers because it gives them another tool to save lives,” said Duschka.  “The tools they take home with them today are not ones they have to carry in their medical bags, and they’re not something that they have to spend their money on.  They’re taking home knowledge that they can share with the rest of their staffs.”

The medical providers were from six different clinics and four of the province’s seven districts.

“This training is crucial because most of the province’s healthcare providers are in rural locations, so they need to be able to do this process [CPR] in order to get their critical patients to the hospital or to a better clinic,” said Dr. Shirdell, Panjshir Health and Medical Services officer.

The class is the one-day American Heart Association Healthcare Provider CPR course authorized by the Military Training Network in Bethesda, Md.  It covers not only CPR for patients of all ages, but how to handle someone who is choking and the proper use of an automated external defibrillator unit.

The course also focuses on how to assess a patient to see if CPR is even necessary, and Duschka sees patient assessment as one of the main tools taught by the course.

“Now the medical providers know how to assess the signs the patient is giving instead of just reacting to a patient when they arrive,” said Duschka.
“Many of the Afghan medical providers I’ve dealt with in the past would have immediately started to give artificial breathing or CPR just because a patient’s eyes were closed or they were unconscious—even if the patients were breathing normally already.”

While some of the medical providers had learned prior forms of resuscitation, this course was new to most of them.

“They didn’t have a preconceived notion of what CPR should be, since they’ve never taken any of the older CPR courses, so it was actually easier for me to teach them than it is teaching American students,” said Duschka. “These providers all know how important this training is and they all came ready to learn.”

Some of the basic questions asked were, “How many times can I give a patient artificial respiration,” “How long do I continue chest compressions,” and, “Is there a sign in the patient for when I should start or stop CPR?”

This is the first class out of a 15-class schedule, and I think it went very well and we all learned something from the class, said Duschka. 

While Duschka taught her ‘students’ the requirements from the course, they taught her some creative ways they’ve come up with to handle some of the trickier everyday medical situations.

For example, if a pregnant woman were choking, the providers said they’d use a head-scarf to wrap around the woman if they couldn’t reach their arms around her.  Their solution uses an item that every Afghan woman keeps with her.

“Even though we’re taught to use everything and anything that you have available to save the patient, using the scarf is an ingenious option that I never would have considered,” said Duschka. “Although using the scarf is not a treatment of choice, the solution shows the providers clearly think outside of the box to help their patients in any way they can.”

After spending the day teaching and learning from the local providers, Duschka was comfortable they would be able to provide better care to anyone who came into their clinics.

“If I came into their clinics I know they could assess me, understand what was happening and treat me properly,” said Duschka. “Hopefully they won’t ever have to use this course, but I’m happy to have been able to give the extra knowledge.”

Shirdell agreed with Duschka.

“Whether they need to use [CPR] or not, they are learning that they always need to be in touch with the patient and it is important to know what to do with a patient in any emergency situation,” said Shirdell.

The PRT’s CPR training program will continue throughout the year, and Duschka hopes to get out to different clinics in each of the province’s seven districts.