We continue to build the capacity of the local staff to expand our traditional birth attendant program whether we can go to Niger or not. We did not go in 2023 because we were saving our money to drill a new borehole at Tamesna, but a coup in July put everything on hold and we are still waiting for the drilling equipment to arrive. The coup has not stopped our training sessions however, and in January we selected our most successful, experienced and respected matrones and our staff Rabi and Assalama put them through a course that would enable them to train new candidates. 
Using cards created by Dr. Becky and Pat to illustrate the program and films produced by Global Health Media and Medical Aid Films that we translated into Tamacheq, Rabi, left, and Assalama, right, begin training eight women who will help us continue to expand our program. We have a long list of applicants.
Assalama and Rabi have assembled the required supplies and medicines to replenish the matrones medical bags.
Each matrone’s supplies are calculated based on her needs. These are established from her report of births since the last mission. Since the matrones are illiterate, we created a reporting system based on illustrations so we have been able to establish the first public health statistics among the nomadic population.

Taking blood pressure is an important tool for the matrones If high blood pressure is present it can lead to preeclampsia and eclampsia, potentially fatal conditions, Although our matrones cannot treat high blood pressure if they know their patient has it, she needs to consult a doctor who can. They arrange for their patient to be near a maternity or hospital at the time of delivery.
The graduates from left Abarta (and her son) Azarra, Fatima, Assalama, Lalli, Mariama, Amoena, Allow, Rabi and Fatima. Their bags are refilled and their knowledge is refreshed.
When we return in November we will organize our annual training to be conducted by our new trainees with the oversight of Dr. Becky, midwife Pat Manzon, and Dr. Jen. With ten people training we will be able to accomplish a lot more than with only three.




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