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Here is the first step- Quality Assurance. We have selected our problem and are in the process of analyzing it before implementing changes. This is Pashtoon.

The nurses and doctors writing their "wish list " for the nursery. This is the next step in strategic planning !

i discussed our low blood issue with Dr. Shkuhmand (from the Ministry of Health) and he agreed to donate blood. This is the beginning of our drive to increase blood donations to 4 /week - men as donors (women are too skinny and anemic). So we have to do a PR campaign. See below. Dr. Nasreen (Hospital Director - extraordinare) accepts the gift of blood.

I also cornered Dr. Sameh after lunch. He "eagerly" gave 1 unit!

Here is our Afghan lunch with the attendings, Craig Hostetler from DHHS. There were many other important players there. The food was GREAT.

This is one of my favorite Afghan citizens. He is too old to donate blood but agreed to be the spokesman for blood donations by men. He is very poor and heads a huge household , working long hours at Rabia Balkhi.

The lobby at night-time. What you must realize, the air temperature is 40 degrees and the women sleep on the cement floor.

I helped a physician from RBH get her father care. He had a heart attack and there is no diagnostic evaluation available. Suffering from chest pain, we got him into an ambulance (Kabul Ambulance - no O2) , transported to ISAF ER (for soldiers mainly). There he got appropriate labs, pain control, an ECHO and diagnosis. Here he is being re-loaded into an ambulance for return to Kabul. See next picture for more.

This is an ambulance tank, followed by military police. He was transported to a hospital in Kabul (different one than we removed him from). What a happy ending. The German MDS treated him with respect, dignity and gave me no trouble in granting the request for medical attention. Please keep him (Mohammed) in your prayers. He is 65 years old and a retired teacher.

A re-painted and high-cleaned nursery. Top to bottom scrubbing was done over a 24 hour period to get the place back to a perfect newborn environment. The babies in front are bundled and covered with "afghans".

A new floor for the nursery

The first day of the STABLE program for pediatricians

True Success...Dr. Fahima, new pediatrician new to resuscitating newborns did her first successful resuscitation today. The baby arrived after 10 minutes of being trapped in the birth canal (breech): not breathing, white, pulse of 60 and floppy as a noodle. With direction and patience, Dr. Fahima restored this baby's life - Oxygen sats at 100 45 minutes of age. Meet him in the next picture.

Our future-this little Afghan baby boy at age 4 hours: alert, vital signs all normal.

I am mentoring Dr. Fahima. Here she is teaching aiway management at our FIRST annual Neonatal resuscitation course for Kabul pediatricians.

Dr. Fahima teaching the skill lab on intubation.

Dr. Fahima again - the participants are all seasoned pediatricians.

The Director Of Neonatology from India Gandhi Children's Hospital practicing CPR

The Intubation Lab - RBH

Another successful delivery born by emergency C/section.

Dr. Linda Bartlett, visitor from CDC (and expert on Afghanistan M/M-did the landmark study 2 years ago) got a chance to practice her intubation skills in the RBH nursery, under the guidance of Dr. Farima.