SURREY - Nurses Ruth Stevens and Ruth DeMerchant had no idea the profound effect a missionary trip to Rwanda would have on them.
Stevens and DeMerchant are both nurses at Surrey Memorial Hospital and were part of a group of six Fraser Health nurses who went to Rwanda from March 2 to 15 to teach - and learn from - the locals.
The trip was just one part of a mission organized by Cedar Grove Baptist Church. The church's mission, as a whole, is to build a health-care teaching facility.
During their trip, the nurses visited health clinics and other medical facilities in Kigali, Rwanda's capital.
DeMerchant, a renal nurse, said the country is still recovering from the trauma of genocide nearly two decades ago.
"They're working really hard to get their capacity up, but most of their professionals were lost during that time so a lot of the nurses we worked with were younger, had been more recently trained. They had hands-on skills without theory," DeMerchant said.
She said they really didn't have the equipment they needed. Many of the cupboards she saw were nearly empty, lacking the necessary supplies.
"It makes you want to cry," she said.
DeMerchant said the lack of training the nurses had was astonishing.
In one clinic in Rwanda there were two renal nurses who were trained for four weeks in India, who then returned to teach the rest of the nurses what they had learned.
In contrast, as a renal nurse in B.C., DeMerchant got her RN certification, then took a three-month course at BCIT, two months of hands-on training, followed by two weeks of training by someone on staff in the renal unit and finally two or three days of orientation to the renal unit where she works.
Stevens, a clinical nurse educator in SMH's Neonatal Intensive Care Unit, taught many Rwandan nurses how to resuscitate newborn babies.
One in five babies die before the age of five in Rwanda, Stevens said.
The nurses spent three days at a health clinic called Kimironko, which had 1,032 live births in 2011 with just two birthing beds.
"But they're really more like benches," Stevens said.
She said while one woman is birthing a baby, others are literally lined up, waiting for a bed to be free.
There were 20 births within a 24-hour period when Stevens and DeMerchant were there.
One story that came to Stevens' mind was a first-time mom who had a difficult delivery.
The nurses in Rwanda like to give episiotomies, she said, because they think it makes the process faster.
Stevens and DeMerchant were trying to advocate for the mother and explain it wasn't necessary. She gave birth to the baby without an episiotomy, but the baby wasn't breathing.
Stevens took over and resuscitated the baby.
The director of the health unit witnessed the birth and resuscitation. The following day, he brought the nurses in to teach the procedure to 24 of the 33 Rwandan nurses who worked at that clinic.
Stevens explained that some babies just don't breathe because their lungs don't open and they need a little bit of assistance.
"You have three minutes before there's brain damage," said Stevens.
Stevens and DeMerchant also brought approximately 300 resuscitation bags to Rwandan clinics, which were collected by nurses all over Fraser Health.
"I think they will save a lot of babies," Stevens said, adding she's collecting more bags to send.
Both women agreed they didn't just teach on their trip, but also learned from the Rwandan nurses.
"The nurses were very creative," Stevens said.
She recalled how the nurses identified babies. Here, babies, moms and dads are given ID bracelets.
There, where they don't have access to ID bracelets, the mothers buy matching pieces of cloth - in all colours and patterns - and the mother and baby both wear the cloth around their waists.
No two patterns are the same, and that's how babies are identified.
"That's so creative to me. To think that way: We don't have it and we aren't going to cry about it. So let's do something about it," Stevens said.
Stevens said what she witnessed on the trip will stay with her forever.
"For me, when I came here, my mind was still there. There was things that I saw that shouldn't have happened," she said, choking on her words as she tried to hold back tears.
Things, she said, that could have been avoided if they had just a little more resources at their disposal or education.
"What can we do to make it better for them? You sleep at night and just think of those babies," Stevens said.
Despite the hard things they witnessed on their trip, both women said they would return and do it again in heartbeat.
DeMerchant said she would love to be able to set up some sort of sister unit, where they could continue to mentor the nurses online.