October 6, 2022

By Holly Paul
Health Units (HU) at U.S. embassies worldwide have long played a key role in providing medical preparedness training and ensuring that diplomats serving overseas are safe and ready for medical emergencies.  
Embassy Skopje’s HU, looking for an efficient way to provide trauma training to more than 100 local guard force (LGF) employees, implemented a train-the-trainer program modeled on courses provided by trainers from the Operational Medicine program in the Bureau of Medical Services (MED). Train-the-trainer has proven to be a force multiplier, greatly augmenting the HU’s capacity to respond to crises.
Led by Tatjana Hadji-Andova, a senior HU nurse, the HU coordinated with the Regional Security Office, Marine Security Guards, and LGF supervisors to identify trainer candidates. Hadji-Andova and fellow HU nurse, Hristina Lazarevska, translated the MED massive hemorrhage, airway, respiration, circulation, head injury/hypothermia (M.A.R.C.H.) trauma skills presentation into Macedonian, included information on training techniques, and added the voice of HU Administrative Assistant Slavko Mitanoski, who narrated the presentation.  
After delivering the training sessions to 13 trainer candidates , the nurses set up a schedule to observe the first cohort as they trained other LGF employees, providing additional tutoring, feedback, and support. Using a standardized checklist, they evaluated each trainer candidates’ skills. Depending on the evaluation, the candidate either “graduated” to a trainer—being able to provide the training independently—or continued with additional observed sessions to further hone their skills. Each graduated LGF trainer was then assigned a cadre of LGF colleagues for whom they are now managing trauma skills training. On May 16, the newly minted trainers provided M.A.R.C.H. first aid training to the entire embassy, as part of a mission-wide disaster drill. 
Holly Paul is the medical provider at Embassy Skopje.

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