Diversity enriches. In simulation and beyond!

Delegates from the CSTC Iraqi simulation center in Italy for an international cooperation project: a moment of cultural and professional exchange

“A center like the CSTC is unique in all of Kurdistan”, “The CSTC is unique in all of Iraq”, “The CSTC is unique in the Middle East”. These phrases pronounced at the inauguration and presentation of the project are obviously hyperboles that, however, give an idea of ​​how visionary it was to open an advanced clinical simulation center, equipped with cutting-edge technologies, in a place like Iraqi Kurdistan, within the framework of an international cooperation project implemented by AISPO.

AISPO, the Italian Association for Solidarity among Peoples, is a Non-Governmental Organization specialized in the implementation of projects in the health sector and operational in many crisis areas, such as Iraqi Kurdistan, Sudan, South Sudan, Egypt, Sierra Leone, Mozambique and Colombia.

In December 2019, AISPO started a project, funded by the German government, which aimed to create a simulation center in Duhok in parallel with the opening of a new emergency room. The challenges were many: importing and installing technologies and ma, nikins, training personnel in use and maintenance, preparing trainers who were not familiar with simulation-based teaching. Then came the pandemic: closed borders for goods and people, shortage of materials, inability to travel.

But the AISPO team was not discouraged and, with the advice and help of Dr. Pier Luigi Ingrassia from CeSi Lugano, organized an online course on the Moodle platform to prepare future trainers, which involved international teachers and experts in simulation. After a thorough renovation aimed at creating efficient spaces for simulation training, 57 manikins and task trainers were installed, as well as computers, servers, cameras, microphones and projectors. In December 2020, the center was officially opened in the presence of the Kurdish Minister of Health, Consuls and Ambassadors. After a few months of preparation, courses for emergency nurses in Duhok’s hospitals began in June 2021.

A little over a year after the opening of the CSTC, fellowships were organized at the SimLab simulation center of the Vita-Salute San Raffaele University, directed by Dr. Giacomo Monti. The director and deputy director of the CSTC, five nurses and doctors and two managers from the Duhok Health Directorate arrived in Milan for a ten-day training course, which was attended by various experts: a multicultural and multidisciplinary team facilitated a moment of cultural, professional and experience exchange. The visit to the IR & TeC-AREU Training and Simulation Center, ad hoc meetings on the fundamental operating principles of simulation equipment, carried out directly by the companies [Accurate e Laerdal], allowed a better understanding of the potential and limits of the simulators and task trainers available at the CSTC. The work on team working and team building, together with the psychologist Luca Mingarelli, showed that working in a team implies individual sacrifices, in favor of an inclusive approach of the values, principles and thoughts of the group, which are different from that of the individual, and richer. We also talked about how in Duhok a spoon is used to cut meat and that in Milan it would be more comfortable to eat pizza if it arrived already cut into wedges, we laughed heartily but no one intended to change their (sacred!) customs about food. The briefing, debriefingand feedback sessions allowed to strengthen the execution of simulations. Together with prof. Giorgio Capogna and Dr. Daniel Pasquali, we discussed the choice of individual words or phrases, the proxemics of the body and what we communicate with it, the importance of organizing the stage in line with the target. Finally, a workshop also dedicated to Basic Life Support: an exchange of ideas between the Kurdish colleagues of the CSTC, whose experience also derives from many years of conflicts and emergencies, and the Italian colleagues, has brought important advantages both from a methodological and content point of view.

From these days we have learned that there are countless ways of working, all appropriate (although different) and effective to achieve the same goal in diverse contexts. The path of growth was stimulating and challenging: the exchange inspired us to shift habits and create a space in which diversity can express itself, enriching educational and human relationships.