Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

Project MOTHER –CHILD HEALTH in TAÏZ REPUBLICAN HOSPITAL,

In TAÏZ and the REGION

OBJECTIVE OF THE PROJECT

Targets : Contribute to the reduction of children mortality during pregnancy and delivery in TAEZ and
surrounding areas.

General target : improving taking in charge pregnancy and normal or pathological delivery in TAEZ’s
Republican Hospital.

Specific targets:

- increasing the proportion of women being medically followed and delivering in the Republican Hospital
-Teaching mothers about basic hygiene and care in motherhood together with spreading these
informations all around.
-Training all medical staff concerned by pregnancy and delivery, together with pregnant women in Taiz in
order to detect, prevent and take in charge pathological or risky pregnancies.
-Improving the training of Yemenis health professionals in prevention and taking in charge pregnancy
toxemia , delivery bleeding and new borns medical care.

ACTION PLAN

The means
Suppliance of non existing materiel at the hospital:
- Fetal monitoring equipment which is absolutely necessary in order to attend first targets. Latter on, the
management would like to have five others monitors (one for each delivery room.
- An ultrasound colour Doppler that is absolutely necessary for the monitoring of normal or risky pregnancies.

Experts missions in TAEZ

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

- Twelve expert missions for a period of one week (1 mission of 5 expert, 1 mission of three experts, 2
missions of 1 expert, 1 final evaluation mission of 2 experts) are scheduled over a period of one year
(October 2009-May 2010) to ensure minimal training of hospital professionals.
a) monitoring clinical and ultrasonographic pregnancy, delivery, using fetal monitoring, prevention
and management of pathological bleeding deliveries
b) taking in charge pregnancy toxemia and prevention
c) mother’s and new born’s healthcare and hygiene .

The experts’ French trainers are multi-sided in their professions: obstetricians, midwives, sonographers,
pediatricians, nephrologists. All of them are trained and experienced in working with developing countries.
Each mission will include at least one doctor familiar with Yemen and Taiz and who has already practiced
under the French Yemen Medical Association.

First mission : from 2 till 12 October 2009, five experts

o Participants :

- M.D. Hélène BERSENEFF, former medical internal of Hospitals, gynecologist

obstetrician, Hospital Practitioner at the Hospital of Pontoise (France), member of
FYMA and coordinator of this project.

- M.D. Benoit MENNESSON, former medical internal of Hospitals, gynecologist

obstetrician, Hospital Practitioner at the Hospital of Pontoise (France), specialist in
obstetrical ultrasound.

- M.D. Jean-Michel MURAY, former medical internal of Hospitals, former CCA,

gynecology and obstetrics Head of Department at the Hospital of Pontoise (France).
Experiences in Togo and Vietnam.

-Mme Christine TAUZIN, midwife, Hospital of Pontoise (France).

- M.D. Jean-François HIANCE, former medical internal of Hospitals, former CCA,

Cardiologist who has been working for 7 years in TAEZ President of FYMA.

o Topics : training of midwives and gynecologist of the unit

1) Monitoring of normal pregnancies:

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

• Establish a repository of knowledge for clinical, biological and ultrasound used by midwives and doctors
of the unit;

• Theoretical and practical courses together with training for midwives in screening of diseases :
Hypertension, Diabetes

2) Normal delivery :
c
•Using a diagram for labour and delivery
•Training for using fetal monitoring
•Detection of abnormal delivery and post-partum
•Prevention of delivery bleeding.

3) Post-Partum

•Theoretical and practical courses for midwives on quality of healthcare and hygiene for mothers and new
borns.

4) Training of doctors

•To Ultrasound scan

•To forceps, instrumental extraction and caesarean section
•To take in charge delivery bleeding.

Estimated forecast of the mission: (the program presented on 5 full days can be broken down into
several half days in order to accommodate half-time activity of most hospital doctors Yemeni)

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

Day 1:
-Morning: Check up of available skills and means, number of births and caesarean sections.
-Beginning AM: Presentations
• M.D. Muray: point on mortality in delivery from bleeding in Taiz
• M.D. Mennesson: general principles of fetal echocardiography : principles evaluations of the reports of
ultrasound
• Mrs. Tauzin: universal precautions and hygiene rules. Developing a plan for delivery at a hospital and at
home
Day 2:
-Morning: Presentations / Workshops practices
• M.D. Muray : reminder about the risk factors of delivery bleeding
• M.D. Mennesson : ultrasound of fetal heart
• Mme Tauzin : pregnant woman consultation, normal and pathological
-Miday, afternoon
• M.D. Muray : hemorrhagic shock and its specificity concerning young women
• M.D. Mennesson : consultations and practical demonstrations
• Mme Tauzin : consultation with midwives
Day 3:
Morning: Presentations / Workshops practices
• M.D. Muray : taking in charge obstetrical bleeding : resuscitation, medicines, using simple small ways,
basic surgical techniques
• M.D. Mennesson : cephalic and renal fetal ultrasound
• Mrs Tauzin : beginning of delivery signs, danger signs, how to get ready to face complications.
Afternoon:
• M.D. Muray: practical discussions in delivery rooms
• M.D. Mennesson ultrasound demonstration and consultation
• Mrs Tauzin: following up with midwives of women in labor
Day 4:
Morning: Presentations / Workshops practices
• M.D. Muray : Prevention of obstetric hemorrhages: delivery third time and OMS recommendations.
• M.D. Mennesson : normal fetal cardiac rythm (monitoring)
•Mrs Tauzin: patient examination during labor and complications stage detection
Day 5:
Morning: Presentations / Workshops practices
• M.D. Muray: management of pregnancy anemia
• M.D. Mennesson: pathologic fetal cardiac rythm
• Mrs Tauzin: Managing complications and difficulties during labor and delivery
Afternoon:
• M.D. Muray and Mrs Tauzin: establishing protocols for full work that took place on days before and
display it in work rooms.
• M.D. Menneson: fetal cardiac rythm analysis in work rooms

Second mission : from 4 till 10th of January 2010, three experts

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

o Participants :

- M.D. Patrick de BOISSE, pediatrician, former medical internal of Hospitals, former CAA, member of FYMA,
President of the association “Around AMFY, mother and child health in TAEZ, Yemen Republic” and leader
of a similar project in Burkina-Fasso since over five years

- M.D. Camille JAUFFRET, gynecologist obstetrician former medical internal of Hospitals,

experienced in similar works with the association « Around the child »

-Mme Paule PUEYO, field supervisor, health lawyer, experienced of the theme in Burkina Faso with the
association "Around the Child".

o Topics :midwives nurses and doctors training for taking care of newborns and infants. Prevention of
nutritional and infectious problems. Training mission assessed on site.

Estimated forecast of the mission: (the program presented on 5 full days can be broken down into
several half days in order to accommodate half-time activity of most hospital doctors Yemeni)

Day 1 :
•inventory, number of births and cesarean sections
•checking equipments and needs in local area
•competence of nurses, midwives and doctors
•if possible workshop practice
•examination of normal new born

Day 2 :
•training in basic hygiene, maintenance and checking of equipment
• nursing (simple protocols)
•taking in charge a new born in breathing distress. Presentation
•workshop practice

Day 3: Training on:

•fetal -mothers infections (prevention, taking in charge)
•fetal distress (prevention, taking in charge)

Day 4: Training on
•managing and nursing fever, paludism and diarrhea

Day 5: managing a premature baby

Third mission :one expert, 2 missions in December 2009 and 1rst quarter of 2010 (to be confirmed

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

o Participants:

- M.D. Yves TURPIN, nephrologist department of nephrology and medical internal at the hospital of
Angoulême, former medical internal of hospitals, former CCA, former VSNA of FMM in Yemen, member of
FYMA, experienced in hospital partnership on same theme in SEGOU, Mali (Ministry of Foreign and
European Affairs)

o Topics:

-taking in charge hypertension due to pregnancy toxemia

-prevention, detection and taking in charge hypertension due to pregnancy toxemia
-prevention, detection and taking in charge eclampsia

o Trying to organize a three steps mission :

Inventory /Surgery or transfer of knowledge/Evaluation of results.
Only the two first steps will take place in this project, wishing all these actions will be perpetuated after
June 2010 without FSD financing.

o Estimated forecast of the mission “taking in charge pregnancy toxemia”: (the program presented on 5
full days can be broken down into several half days in order to accommodate half-time activity of most
hospital Yemeni M.D.’)

Day 1:
•Morning: meeting with the manager and head of department
•Visit of the unit in order to meet the full staff
•General exposition about pregnancy toxemia
•Specificity of the Republican Hospital of TAEZ
•Afternoon: Clinical Files
•meeting with the biology laboratory of the hospital

Day 2:
•Morning:
•Risk Factors of pregnancy toxemia
•Research and quantification of proteinuria
•Pregnant women hypertension
•Afternoon:
•Pregnant women oedema syndrome

Day 3:
•Morning: pre eclampsia support: Check up, clinical and laboratories follow up.
•Afternoon: looking through all files
•Outlines for a general protocol
•Contacts with other obstetrical structures of TAEZ
Day 4:

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

•Morning: urgent treatment of eclampsia

•Afternoon: clinical files
•Epidemiological indicators making up.

Day 5:
•Morning: Check up, and pregnancy toxemia follow up
•Afternoon: pregnancy toxemia referees appointment
•Unit protocols: choice and establishment
•Conclusion and critical review

Final mission and evaluation : two experts, one week mission in april-may 2010

o Participants :
- M.D. Hélène BERSENEFF, former medical internal of Hospitals, gynecologist
obstetrician, Hospital Practitioner at the Hospital of Pontoise (France), member of
FYMA and coordinator of this project.
- M.D. MENNNESSON or M.D. MURAY, gynecologist, obstetricians, hospital of Pontoise (France)

o Topics:

-Evaluation and improving taking in charge normal and pathological pregnancies, pregnancy toxemia, right
monitoring using (fetal monitoring, ultrasound). Monitor provided for this project.
-Evaluation of pregnant women received in Republican Hospital of TAEZ and, if possible, mother-infant
mortality in the obstetric unit.
-Setting up and functioning of the local association: structures, activities and number of professionals and
women contacted and trained.
-Check up and prospects : extension of hospital actions to other obstetrical structures of the town and
surroundings (Ibb, Mokha) and eventually to first care centers located in rural zones that are part of Taez

Calendar
- 2009-06-20 : submission of the project to the FSD (Fonds de développement Social)
-July 2009 first week : agreement signature
-July 2009 : purchase of equipment (ultrasound colour Doppler available, cardiotocography
material to be ordered)
-July-August 2009 : shipment equipment to Yemen, customs clearance, transport to TAEZ, setting up
and testing
-2 till 10 October 2009 : First mission of five experts. Theoretical and practical training for pregnancy follow
up, delivery, and for using fetal monitoring. Workshop practice about obstetric
ultrasound Doppler.
-7 till 13 Decem. 2009 : M.D. Yves Turpin’s mission. Taking in charge pregnancy toxemia and eclampsia,
1rst part.
-4 till 10 January 2010 : Mission of three experts, training of Doctors, midwives and nurses for taking in
charge new born and infant, mother-child hygiene.
-11 till 17 January 2010 : M.D. Yves Turpin’s mission. Pregnancy toxemia, and eclampsia, 2nd part.
Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise
Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr
 Association Médicale Franco Yéménite

AMFY
Association loi de 1901. N° 3218 du 24 septembre
1990,
et N°2337 du 12 juillet 1995.
N° SIRET 433 186 020 00015

-April-May 2010 : Calendar to be settled: Evaluation mission with two expert of the hospital of
Pontoise (France)one of them being M.D. Berseneff coordinator of the project.

Implementation responsibilities

1) M.D. Hélène BERSENEFF, Hospital Practitioner unit of gynecology and obstetric, at the Hospital of
Pontoise (France), is responsible and coordinator of this project.
2) M.D. Muray,de Boisse and Turpin, are responsible of contents and terms of trainings during their own
missions (workshop practices, clinical cases discussions, frame of references, courses support when needed
and evaluation indicators definitions.
3) The FYMA office (M.D. Jean-François HIANCE, President, M.D. Jean-Louis GEORGES, Company Secretary,
M.D. Jean CAZIN, treasurer, and Mrs Christiane NASR, secretary) will be in charge of writing and sending the
project, establishing the projected budget, contact with French and Yemeni authorities, contacts with the local
Yemeni association who is partner of the FYMA, contacts with FSD, signature of contract between FYMA and
FSD. They are also responsible for necessary French customs formalities and clearance. They will also organize
logistics from France (booking flights, hotels, reimbursement of mission expenses, advances per diem if
necessary).
4) M.D. Arwa Y. BAHRAN, manager of TAEZ Republican Hospital, President of AMFY’s local partner, is
responsible for receiving missionary doctors in the gynecology obstetric unit, trainings organization in TAEZ
(local medicals and paramedics timetable, premises, technical means), Yemeni’s customs clearing
formalities of furnished material, and taking in charge their commissioning and maintenance(organization
of maintenance and ordering consumables) and will guaranty right use of this material.
The Yemeni local association office and M.D.ARWA will also:
-Checking the spreading of informations outside the hospital
-Be watchful on respecting established protocols during the missions
-Inform by email about evolution of situation in order to establish a balance sheet by the end of the year.

Siège social : chez le Dr Hiance, 2 sente des cheminées 95300 Pontoise

Secrétariat : jgeorges@ch-versailles.fr Site : http://www.amfy.fr