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 Comments or suggestions about our newsletter?  Contact Editor, Helen Akinc.   

Message from the President    PresidentMessage 


We've reached 500!  Yes, Kybele has reached the 500-participant mark this week as a group of three of us travels to Ghana. Growth is wonderful, but even more so are the friendships that develop across the globe as we work to improve childbirth conditions.  


The past few months have been exciting. In February, we sponsored three Ghanaian midwives who traveled to Friarage hospital in England, where they were hosted by midwives Liz Floyd and Kerry Morgan and obstetrician Fiona Bryce (see press release).  


We also had our second Team Leader Summit in Winston-Salem, N.C., February 21 through 23. This was momentous and attended by team leaders from as far away as England and Germany. We lingered until the wee hours of the night to share ideas, debate approaches and plan programs. I continue to be amazed by our team leaders' and team members' generosity and commitment to making a difference.  


A highlight of the Team Leader Summit was the preview of a film clip being developed by Wake Forest University documentary film students Kathi Barnhill, Joe Jowers and Walidah Muhammad. This talented group of filmmakers traveled with us to Ghana in September and November to highlight Kybele's partnership with the Ghana Health Service at Ridge Regional Hospital. Be on the lookout as versions of their work will be presented during the Consortium of Universities for Global Health (CUGH) May 10 through 12 and the Society for Obstetric Anesthesiology and Perinatology (SOAP) meetings May 14 through 18.  


Kybele Team Leaders L to R: Yemi Olufolabi, Liz Floyd, Medge Owen,  
Fiona Bryce, Melvin Seid, Gordon Yuill, Ivan Velickovic, Virgil Manica, Ashraf Habib

I look forward to seeing many of you at the annual SOAP Kybele dinner Friday, May 16. This year's event will be a bow tie screening of the documentary film. The filmmakers will be present to provide their perspectives on compelling global health needs.


Until then,

Medge Owen Sig  

Medge D. Owen, M.D.

President, Kybele, Inc.

Professor Obstetric Anesthesia

Director of Maternal and Infant Global Health Programs

Wake Forest University School of Medicine

Phone:  336.718.8278     




Meet our Team Leader Summit Trainer, Romeck van Zeijl  Romeck         

Article by Erin Pfeiffer 

Romeck van Zeijl has worked as a psychotherapist, coach and trainer since 1996 and as a supervisor and consultant since 2002. He specializes in enabling teams of people, individuals and couples to find their creative edges - the edge of learning where transformation takes place - because he believes not only a person's intellect but also his or her whole being is touched by the experience.

Romeck originally trained in body-centered and transpersonal psychotherapy in the Netherlands and Germany. He also studied supervision, mentoring and coaching in the United Kingdom. He has designed and facilitated a number of training programs in counseling and psychotherapy as well as a 2.5-year training program on supervision, mentoring and coaching in Slovakia. His program was the first of its kind in that country.  


Apart from designing training programs in experiential learning, Romeck is also an expert in gender communication and knowledge management. He drew on this expertise when working with NGO's in Southeast Asia. Romeck has also devoted time to work related to trauma and post-traumatic stress, and he has facilitated many seminars focused on relationship and communication skills. He is currently involved in the leadership development program of VBNK, an organization that serves facilitators of development in Cambodia.


As a specialist in NGO's and organizations interested in becoming more ethical and sustainable, Romeck also works as an executive coach. His background and experience in psychotherapy and supervision give him an "edge" when it comes to quickly assessing the strengths of individuals or organizations. His background also helps him identify negative leadership habits and systemic dynamics that can hold organizations hostage. His background in mediation and conflict resolution enables him to work skillfully with tension and conflict in an organizational setting.


Romeck has been involved with Kybele since 2013 and provided leadership training at the Team Leader Summit in February 2014.

Sharing Good Practices Worldwide England          

Press Release:  Dated 02.13.14 NHS Foundation Trust, UK

Liz Floyd, Cecilia Tetteh, Fiona Bryce, Susana Asamoah, Kerry Morgan and Victoria Ahwireng at the Friarage maternity unit.


South Tees Hospitals NHS Foundation Trust welcomed three midwives from Ghana as part of a project involving Kybele - a non-profit humanitarian organisation dedicated to improving childbirth safety worldwide through educational partnerships.


Kybele's role is to bring professional medical teams into host countries, to work alongside doctors and nurses in their home hospitals, to improve healthcare standards.


Fiona Bryce, clinical director for obstetrics and Kerry Morgan, risk midwife at the trust and Liz Floyd, midwife, are all involved with the Kybele project, working together with Ghana Health Service.


They also work alongside the Institute of Health Improvement (IHI) to see what other organisations are doing to improve healthcare around the world.


As part of an developing working partnership to share knowledge, learning and good practice, the trust team regularly visit Ghana in an advisory role, two or three times a year to help improve efficiency and healthcare practices and ultimately to help reduce neonatal and maternal mortality.


In Ghana, maternal mortality is estimated to be around 560 deaths per 100,000 live births. The leading causes of maternal death are pre-eclampsia, acute haemorrhage, sepsis, obstructed labour, non-hemorrhagic anemia and unsafe abortion.


Overall, 92 % of women attend at least one antenatal clinic, but only half of all deliveries are attended by a skilled health professional, such as a midwife or physician.  


Susana Asamoah - labour ward manager and triage midwives Victoria Ahwireng and Cecilia Tetteh from Ridge Regional Hospital, Accra, Ghana, visited the Friarage Hospital in Northallerton and The James Cook University Hospital in Middlesbrough to see how their maternity unit's work.


Their aim was to learn from other areas of practice and develop innovative ideas to benefit patient care in their own busy regional hospital in Ghana.


The main focus of their visit was to... READ ON. 

Kybele Volunteer Focus:  Rohit Ramaswamy  Rohit 

Interview by Sebnem Ucer
Dr. Rohit Ramaswamy, a clinical associate professor at the University of North Carolina Gillings School of Global Public Health, has been involved with Kybele as both a board member and a volunteer. Currently, he is one of our key volunteers in Ghana, where he spearheads Kybele's quality-improvement program. Erin Pfeiffer had an opportunity to sit down with Rohit at our Team Leader Summit in February to discuss his past, present and future with Kybele:

Erin: How has Kybele changed since you first became involved?  
Rohit: Kybele has become a lot more strategic and organized; it has consolidated its focus, identified [the] right people needed to achieve the objectives. Therefore, from visit to visit, both the teams and activities that are going to take place are much better planned.

Erin: How does your work with Kybele influence your work at Chapel Hill? 

Rohit: A lot of  the work I do with Kybele is now about systems improvement. I use that work as examples in my classes and courses. The learning from how to implement programs in real life is very useful for my students who are looking for practical examples of implementation.

Erin: How did you become interested in quality improvement? 

Rohit: When I graduated with my Ph D, the first job I had was with AT&T Bell Labs. At that time, AT&T had just stopped being a manufacturing company and turned into a service provider. They were looking for how to improve the quality of services since there was no framework for service quality improvement. I started to work with the team developing service quality-improvement standards.

Erin: What are the biggest obstacles to a successful quality-improvement program?   READ ON

Kreating Change:  Introducing Kybele Yearly Memberships      Kreating    


Kybele has enjoyed rapid growth and program success in recent years.  We are very grateful for the support of our individual contributors and monthly donors.  However, with rapid growth comes the need to be able to pay for expanding programs, staff, resource materials, and training. 
As a Kybele "member", you are making a commitment to Kybele with a small yearly membership fee that will enable us to sustain the growth of the organization.  Kybele membership is open to anyone - medical, non-medical, students, community and family members - anyone who wants to support women and infant care in developing countries.

A Kybele Membership of $60 USD per calendar year will be required to participate on a Kybele trip beginning in 2014. Current monthly donors and individuals making an annual contribution of more than $60 are already included as Kybele members.  This nominal yearly membership fee allows interested individuals to receive the following benefits of Kybele membership: 
  • Quarterly E-Newsletter and notices of events 
  • 10% discount on Kybele Merchandise
  • Name listed on the Kybele website
  • Certificate of Membership to display

MONTHLY DONORS - Ideally, everyone involved in Kybele becomes a monthly donor.  Monthly donors are individuals with a dedicated, long-term interest in Kybele's work.  Monthly donors give an ongoing, automatically deducted monthly gift of either $10, $25, $50, $75, or $100 per month to the organization.  The process is easy and allows Kybele to best plan ahead. 

One-time donors give financial gifts at various times of the year in any amount.  The average gift is between $50 - $200.  These donations are often unexpected and very appreciated but cannot be planned for in budgeting. 

Kybele Members pay a yearly flat membership fee of $60 to show their support of the organization and receive the benefits listed above.  Kybele memberships help cover the costs of administrative and program expenses and like monthly donors, allows Kybele to plan ahead.  Kybele memberships are a perfect first step to supporting the organization. 

Yes!  I'm ready to show my support.  I would like to become a Kybele Member.

(Please be sure to fill out your name, email, phone and address so that we can properly contact you for questions and recognition.  Thank you for your support.) 

Kybele Country Updates:  Armenia   Armenia      

Kybele Country Updates - interviews by Erin Pfeiffer; Kybele Team Leaders' Summit, February 2014 - Winston-Salem, NC  

ARMENIA (Dr. Gordon Yuill) 
Gordon Yuill 

Kybele has visited Armenia in 2006, 2010, 2012 and 2013. In 2010, Dr. Ashot Amroyan  (Armenian host) and Dr. Lisa Councilman (Kybele team leader) proposed a five-year commitment to provide an annual Kybele team visit. Since then, Dr. Gordon Yuill has taken the lead, and together with our Armenian hosts, we hope to achieve the following goals:

1.  To have all maternity hospitals in Armenia practicing to at least the same minimum standard

2.  To write national protocols for obstetric anesthesiology, to get approval of protocols by the health ministry and to implement the protocols throughout Armenia by sending teams to each region to assist in implementation

Outcomes include the development of national safety guidelines and national practice guidelines in collaboration with the Armenian Society of Anesthesiologists. National safety guidelines have been created in the areas of practice, clinical governance, quality improvement, patient education and analgesia in labor.

Strengths of the program to date include strong local champions, Kybele team members who are making long-term commitments and a strong Kybele-Armenia relationship. Many hospitals in Yerevan have made significant progress. There is now dialogue with politicians and physician leaders to expand the capacity of the work outside the capital.

Some of the weaknesses include past practice based on dated Soviet methods, difficulty in recognizing the need for change, as well as a lack of equipment and drugs due to limited hospital budgets. Too often, there are solitary anesthetists who have very little or no support staff. Understaffing is a problem in hospitals that are often too far apart for easy referrals. Areas of current concern include fear about anesthesia among patients and clinicians. There is also the very real risk of imprisonment if a patient dies under a physician's care. This fear impedes openness in discussions surrounding complication management and can comprise medical practice in that suboptimal practices can continue unquestioned. 

Kybele Country Updates:  Ghana    Ghana     

Kybele Country Updates - interviews by Erin Pfeiffer; Kybele Team Leaders' Summit, February 2014 - Winston-Salem, NC 
GHANA-RIDGE (Drs. Fiona Bryce and Rohit Ramaswamy)
Fiona Bryce
According to Dr. Rohit Ramaswamy, Kybele's ability to "be able to engage with local leadership is absolutely crucial." This strength, however, is also one of its weaknesses. "Because we have had such high-level leadership at Ridge, it has not been as necessary to build systematically the leadership under the head leadership," Ramaswamy said. "[That] has allowed us to coast a bit. [But] to make our model scale-up and sustainable, how do we identify and build the capacity of other leaders and champions?"
Yemi Olufolabi 
Ramaswamy said he sees challenges in Ghana from the multitude of NGO's working in the area. Large donors are starting to focus more on programs that are "systems-oriented" and other organizations could potentially compete with Kybele for the opportunity to work with the Ghana Health Service at Ridge.  

However, Kybele also has opportunities that stem from the introduction of Kybele's "model for excellence," which encompasses clinical excellence, leadership excellence and operational excellence. Kybele will continue to strengthen its position by systematically training and empowering leaders to address underlying causes of maternal and newborn mortality. 

GHANA-TAMALE (Dr. Yemi Olufolabi)

Dr. Yemi Olufolabi shared his perspective on the Tamale project in Ghana. He observed that some of the previous challenges were due to the lack of physical space and that a strong local champion has yet to clearly emerge. There are opportunities to forge new relationships and develop new partnerships. An area of concern is that Tamale sometimes seems secondary to Ridge, at least in terms of how much has been invested.

Kybele Country Updates:  Romania  Romania       

Kybele Country Updates - interviews by Erin Pfeiffer; Kybele Team Leaders' Summit, February 2014 - Winston-Salem, NC  

ROMANIA (Dr. Virgil Manica)
Virgil Manica 
Dr. Virgil Manica provided an update on the Romania program and discussed the importance of the continued Suceava project.  There has been a significant increase in the use of spinal anesthesia for C-section in 2012 and 2013. The obstetricians and anesthesiologists continue to be strongly committed to the project, and hospital management is on board, as well. There are plans to perform a study of patient satisfaction. 

The challenges relate to deep systemic or cultural problems, many of which are beyond the scope of Kybele, at least in the immediate future. There is a huge national shortage of physicians and no relief in sight. This makes it difficult if not impossible to improve the labor epidural rate. Physicians often leave Romania for better-paying jobs in the European Union, and this results in very thin staffing of anesthesia professionals. Many cover operating rooms, ICU's and maternity floors simultaneously when they are on call. There is a cultural perception that the use of pain medication is to be used only for terminally ill cancer patients, so education of other appropriate uses will take time.

Moldova Site Visit - While in Romania in September 2013, Manica was invited to visit two sites in the nearby capital of Moldova. He visited Chisinau Maternity Institute as well as Chisinau Institute of Mother and Child. These institutes handle approximately 4,000 deliveries yearly and have a 60 percent C-section rate. Between 70 and 75 percent of cesarean deliveries involve general anesthesia - mostly due to obstetric decisions. Labor epidurals are almost nonexistent.

Kybele Country Updates:  Serbia  Serbia          

Kybele Country Updates - interviews by Erin Pfeiffer; Kybele Team Leaders' Summit, February 2014 - Winston-Salem, NC  

SERBIA (Dr. Ivan Velickovic)
Ivan Velickovic 
Ivan Velickovic 
Dr. Ivan Velickovic reported that a pair of one-week trips to Serbia occurred in September 2012 and September 2013. Both trips began with a joint conference. The first was regional and featured speakers both from Serbia and Kybele; the second was international and included speakers from Mayo Clinic. Additionally, several hands-on training days were conducted by Kybele team members in the week that followed. Three or four area hospitals sent staff members for training.

Velickovic reported that all work has occurred at a women's center called Klinicki Centrar in Novi Sad, which has approximately 6,500 deliveries yearly and a 25 percent C-section rate. The center is well staffed during the day with seven attending physicians and one resident but only staffs one attending physician and a nurse anesthetist in the evenings. Fetal heart rate monitoring is in place, and there are facilities for neonatal resuscitation in each delivery area. Renovations for a separate ICU and recovery area are underway. Velickovic said he observed that junior attending staff members are enthusiastic to learn but that older members are less convinced of the value of learning new techniques.

The 2012 accomplishments included the demonstration of multimodal analgesia with the host's analgesics, the introduction of intrathecal (i.e., into the spinal fluid) morphine, single-shot spinal for advanced labor analgesia and the post-trip delivery of hats for neonatal head coverage.

2013 accomplishments included training individuals from several surrounding hospitals in regional anesthesia for labor and C-sections, as well as the demonstration of airway rescue devices, which were left for continued use. Plans were also made for a redistribution of anesthesia personnel and a newly introduced protocol for the safety of intrathecal morphine for post-op analgesia.

There is a tremendous opportunity to continue the development of Dr. Borislava Pujic, who is a real champion and stays in weekly contact with the Kybele team leader. Additionally, it might be possible to promote the widespread use of regional anesthesia through continued patient education in obstetric clinics. The next visit will focus on a CPR course, the use of intrathecal morphine for post C-section pain relief and the continuation of efforts to promote Novi Sad as a training facility for the rest of northern Serbia.

Kybele Country Updates:  Vietnam       Vietnam    

Kybele Country Updates - interviews by Erin Pfeiffer; Kybele Team Leaders' Summit, February 2014 - Winston-Salem, NC  

VIETNAM (Dr. Melvin Seid)
Melvin Seid

Dr. Melvin Seid reported on the Vietnam program, which is located in Can Tho, Vietnam. Can Tho is the largest city in the Mekong Delta and the fourth-largest city in Vietnam. Key accomplishments to date include instruction in neonatal resuscitation, regional anesthesia, the first transversus abdominus plane (TAP) block and the loop electrocautery excision procedure (LEEP). Additionally, OB/GYN lectures were given on pre-eclampsia, cervical cancer prevention and prenatal diagnosis.

The strengths of the program include the partnership with Dr. Rob Gertler at Group Health Seattle. Gertler facilitated the connection with Kybele to local physicians in Vietnam. Locals have a strong desire to learn and are especially interested in the most recent guidelines. Seid reported that good contacts and relationships have been made and that a strength of the Kybele program is bedside teaching.

Areas of concern include the host's emphasis on using a lecture format rather than bedside teaching models, bureaucratic challenges and language barriers. Cultural barriers are also important and need to be managed. Especially difficult is the strong local desire to "save face" at all costs and the importance of supervisor hierarchy. As of yet, a local champion has not emerged. 

There are tremendous opportunities, however, given that there is significant need for a Kybele program and that the demand for labor epidurals exists. Currently, the C-section rate is climbing because labor pain relief is unavailable and surgical delivery is more convenient for obstetricians. Potential improvements can also be made related to the use of ultrasound, pre-eclampsia and cervical cancer screenings and prevention. 

"A Rose by Any Other Name..."

Article by Dayne Logan  Rose 

"What's in a name?" When Shakespeare's Romeo poses the question to Juliet, a woman whose last name has threatened to undermine a blossoming love, the implied answer is "Not much." This might be true of family names, but in most cultures, given names are given only after careful consideration.


This is especially true in China, where values of tradition, individuality and fortune all play a role. According to contributor Jeanine Cox, Chinese families go to great lengths to bestow unique names on every newborn. It's a tall order in a country that has ballooned to more than 1.3 billion people, but the task is made easier by the fact that each child gets three names: a surname, a generation name (shared by siblings and cousins) and a given name.


According to an article by BabyCenter's Linda Murray, when it comes time to decide on a given name, Chinese parents often turn to family tradition and the five elements (metal, wood, fire, earth and water) for inspiration. If any of the five elements is missing from the surname or generation name, it's a good bet it will factor into the child's given name. But no tradition-abiding Chinese parent would dare settle on a name without taking the child's birth date into consideration. In fact, it's such bad luck to reveal a child's name before birth that many parents give fetuses an unattractive false name (such as mud or pig) to repulse evil spirits. Only after a successful delivery and a good deal of thought is the child's real name revealed.


What's in a name, Romeo? In China, more than you could have ever thought possible.


More About the Kybele Dinner
at the SOAP Meeting in Toronto Dinner


On Friday, May 16, Kybele will host its annual fundraising dinner in Toronto, a city known for its international film festivals. Dinner will take place a few blocks from the SOAP conference hotel at the beautiful Malaparte Restaurant atop the Toronto International Film Festival Lightbox building. As part of the evening's festivities, Kybele will proudly present a new documentary film that features Kybele's medical work in Ghana. Three graduate-level film students from Wake Forest University traveled multiple times to Ghana with Kybele to capture hundreds of hours of footage and photographs that were subsequently used to create the documentary. The fundraising dinner will double as the premiere for the film. 


And because we will be in one of the world's foremost film cities, Kybele wants to see your best "going to the movies" bow tie. Men, show off your most colorful, fancy, sophisticated, ridiculous, one-of-a-kind, handmade or store-bought bow tie. Ladies, think bows in your hair, on your wrist or ankle, around your neck or waist. Location's irrelevant as long as you're showing off your tidiest tied bows! Prizes will be awarded for the best bow ties worn. Don't own or know how to tie a bow tie? No problem. Bow ties and hair bows will be available for purchase at the Kybele merchandise table during the SOAP conference. 


Seating is limited at dinner and  
film screening. Tickets are
$125 per person, and sponsorship tables for 10 people are available for $2,500.
Proceeds from this event benefit Kybele's medical-education programs. Don't miss out.
 CLICK HERE for information and reservations.

Kybele Partners with Delta Airlines
  SkyBonus ProgramDelta

SOAP Members (and anyone who flies)
Are you flying Delta Airlines to the 
SOAP Meeting in Toronto?   
Check this out and see how you can help.

Kybele is pleased to announce that it has partnered with Delta Airlines in the SkyBonus® program.  The SkyBonus program allows small businesses and organizations who do not benefit from corporate travel rates and agreements to earn points on flights with Delta Airlines, Air France, KLM Royal Dutch Airlines, AlItalia, and Virgin Atlantic.


These accumulated points can be redeemed for future domestic and international flights on Delta.  Travelers will still earn their own frequent flyer miles (SkyMiles) based on mileage flown, while at the same time Kybele will earn SkyBonus points based on the dollar amount of the fare and class of service flown.

Kybele's Delta SkyBonus number is US0038312.

This SkyBonus number is not limited to Kybele volunteer travel, it can be used for personal and/or business travel as long as the ticket was not purchased under a corporate discount agreement or an award ticket.   Enlisting the help of friends and family will help us earn free travel faster.

Kybele's Delta Skybonus number can be added to tickets in several ways depending on method of purchase: 


A.    Tickets purchased on Delta's website:

  • Enter Delta SkyBonus number US0038312 in the Delta SkyBonus number field just below passenger name during check out.
  • If you are a SkyMiles member, please save this number to your profile and it will automatically be entered every time you purchase a ticket on This can be found on the My Profile page under the flight preferences tab.  Enter US0038312 where you see SkyBonus Loyalty #.

B.    Tickets purchased at Delta Reservations

       (phone or airport):

  • Advise agent to add Delta SkyBonus number US0038312 to the ticket (even if you have it saved in your SkyMiles profile).

C.    Tickets purchased from a travel agent:

  • Advise travel agent to add Delta SkyBonus number US0038312 in the tour operator field on your ticket   
D.    Tickets purchased from online travel agency
       (Expedia, Travelocity, Orbitz, etc.)

  • The Delta SkyBonus number cannot be added to these tickets at the time of purchase.  Please email your itinerary with ticket number to and we will be able to enter the tickets manually on the SkyBonus website.

For all other tickets, or any tickets in which you have forgotten to add the SkyBonus number at the time of purchase,  please email your itinerary with ticket number to and we will be able to enter the tickets manually on the SkyBonus website.  We can also retroactively enter old tickets (up to 12 months old).  


Kybele will redeem these points for award tickets to bring practitioners from host countries to the US as well as to provide travel for Kybele team leader summits.

Rohit Ramaswamy and Serbian Team Leader, Curtis Baysinger
at the 2014 Kybele Team Leader Summit

We Thank The Following for Their Support    support 

 PATH  |  Society for Obstetric Anesthesia and Perinatology  |  The Obstetric Anaesthetists' Association     
The International Association for the Study of Pain  |   World Federation of Societies of Anaesthesiologists  | The Lacy Foundation 

Quick Links    quicklinks


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Kybele merchandise is on display at various events in the Winston-Salem, NC area.  Contact us if you are interested in purchasing merchandise or have an event that is appropriate for us to display/sell our items.


2014 SOAP Conference 

Toronto, Ontario  

MAY 14 - 18, 2014


Board of Directors


Medge Owen, MD

President & Founder

Helen Akinc  

VP Strategy & Newsletter Editor  

Frank James, MD 


Holly Muir, MD




Ronald George, MD 

Shannon Koontz 

Virgil Manica, MD

Yemi Olufolabi, MD

Rohit Ramaswamy, PhD  

Michael Rieker, CRNA

Melvin Seid, MD    

Robin Sizemore

Leigh Stanfield  

Kybele, Inc. is a non-profit 501(c)3 humanitarian organization dedicated to improving childbirth safety worldwide through educational partnerships. The role of Kybele is to bring professional medical teams into host countries, to work alongside doctors and nurses in their home hospitals, to improve healthcare standards. Kybele volunteers provide hands-on training in medical techniques during the actual care of patients in labor wards and in operating rooms. Kybele volunteers model teamwork and compassion in real life and death situations, sharing knowledge when it matters the most.
If you would like to nominate a person or person(s) for the Board of Directors or would like more information about Board or Committee Membership, please contact a board or staff member.   3524 Yadkinville Road #124 Winston-Salem, NC 27106