"Agrisiz dogumlar (painless births) are going well and I think we came to the point where I always longed to be, because they are routine now, and it is all because of you and I am grateful to you for this..

"Now, obstetric analgesia number is rapidly increasing in our hospital. Before this program, it was our job to convince the patients; now obstetricians guide patients and send us for obstetric analgesia ... the program was very beneficial for us. Once again, we want to tell you that we really appreciate giving us this opportunity and support.

"Through this program, we had the opportunity of meeting esteemed, distinguished scientists. Instead of going to conferences and being able to only discuss limited topics in limited times there, they came here and paid attention to only our problems for a whole week. These are not only my feelings but also those of all other participating hospitals in the region. Thus, we had the opportunity of knowing each other and comparing our studies and operations in obstetric anesthesia creating new ways to collaborate regionally... Their positive comments and criticisms were great for us. We are very touched and grateful because our guests were very attentive to our problems, open to all of our questions, and enthusiastic to help us in all ways. As one of the best part of this program, we'll keep in touch and continue to communication in terms of problems, questions, and new projects. Together with beautiful memories, pictures, friendships, and cultural awareness, this program also helped us realize what we're doing, plan future projects, set new goals."

"Dr Medge Owen and her group have proven beyond reasonable doubt their commitment to a collaborative program to help improve obstetric anesthetic practice and neonatal resuscitation in Ghana and worldwide."

"Thanks to Kybele, I've had a chance to visit and get familiarized with the practice of regional anesthesia at the Wake Forest University Medical School and the Duke University Medical School. The experience l've gained during my visit there has helped me enormously. We've managed to organize lectures for colleagues, seminars for pregnant women and a special TV show on local TV. …... Nowadays, epidural analgesia for delivery is performed for every woman that expresses her desire to have one. Our biggest support are the women that have had regional anesthesia and passed on their experience to other woman. ...Me and my colleagues are putting lots of hopes in the education program for Croatia designed by Professor Owen, since it is a legacy that will provide every woman in Croatia with opportunity to have a cloice, and option to have an epidural analgesia at the most significant day of her life."

"What the trip to Croatia meant to me: It was on a par with my marriage and the birth of my children! The land was of great beauty, the people extraordinarily gracious. They were all so hungry for information, and at the same time wanted to show off their country and its heritage. I could not believe the gratitude they displayed for my presence, and the simplest acts of kindness.

"I would like to take the opportunity to thank you deeply for allowing me the privilege and the honor to represent Kybele on this historic mission to the different Hospitals in Egypt as part of this workshop on Labor Analgesia. It has been an honor to work side by side with such a variety of excellent Clinicians from all over the world and be involved in this remarkable opportunity. My report to you is in the making, but meanwhile I wish to raise up the entire group for their contribution, and especially mention the outstanding welcome my group in Ismailia has received and the exceptional collaboration we received from all of the Ismailia General Hospital Staff. Dr. Nazieh especially has done a phenomenal work in setting up a workshop of very high quality.

"The obstetricians told us that they were going to do a cesarean section for a woman who had had two previous sections, both with general anesthesia. Dr. O. told the woman that we wanted to do a spinal, and at first she objected vehemently. She was afraid she'd be paralyzed and she was afraid of hearing and seeing the operation. There was quite a bit of discussion back and forth, but finally the woman agreed to the spinal. We performed it, using 0.5% hyperbaric bupivacaine, and she had an excellent block without hypotension or nausea. The baby was delivered very quickly. When the patient saw the baby, she was ecstatic, and told the team that she was really happy she had had the spinal. (In fact she came back several days later to thank us again! The anesthesia team and the surgeons were very impressed with how pink and active the baby was, and were impressed with how happy and comfortable the mother was.

"There is also an aspect of this program that is difficult to convey on paper, that was perhaps the most important aspect of this trip. We were in CONSTANT contact with our hosts, often through breakfast, lunch, and dinner. I felt lucky to take a shower by myself some days. We were always accessible for their questions, learned about their families, talked shop for innumerable hours into the evening, etc. Simple gestures and comments generated immense appreciation and goodwill. I feel as if I have made some long-term relationships that I hope can be helpful to their practice of medicine... As a personal addition, in this era of suboptimal sentiments abroad over American international politics, this sort of gesture is especially timely."

"The trip was very satisfying - personally and professionally - and has given me much momentum to make this type of development part of my career as well. You have done an amazing job setting up the support structures for this and are really making a difference. You are a role model and a leader!'

"At the trip's end, everyone meets together to share experiences. We are all happy we have had a great professional experience. Tomorrow, we will fly back to our families. Within less then 15 days we were nearly 16 brothers and sisters. Another family much more then a medical group.

What was the best part of the Kybele program? " wouldn't be able to choose one; everything was excellent. However, if I have to choose, l'll say this: The Kybele team is really human, and we need more of that in this world."

It has always been a dream of mine to do global health, it feels like a privilege and the Kybele team feels like family.

We (Kybele team members and health workers) are connected by passion and a quest for knowledge...it is an empowering feeling...I am forever grateful for the privilege of being able to give back.

It was the best time of my life. didn't know what to expect living among Americans in Ghana but it feels like I stepped out of my home and moved into another home. Everyone is so proud of me at home in Uganda and I feel humbled and want to go back and do the same thing there...I am so thankful.

Your selfless spirit and always eager to explain until the very last person understands. Ghanaian Medical Professional

I have been blessed by your visit. I never knew anesthesia could be this interesting.

(Dr. Matt Hatch) is very patient and enthusiastic to teach. I feel like he has emptied all his knowledge into my brain. He is such a great mentor to emulate.

"We would like to thank to you and Kybele for your help...Dr. Neeti Sadana visited us twice. She has helped us to improve patien quality care in obstetric anesthesia...We did the first skin to skin contact during her first visit. We have continued to do that...Neeti also had organized a special dinner party on her own. She invited anesthesiologists, obstetricians, neonatologists, anesthesia and L&D nurses - all members of team providing peripartal care. This party made anesthesiologists and obstetricians more connected, and more easily discussing about labor analgesia. It seems that we develop more friendly connections in everyday clinical situations after that party...We hope that our obstetricians will understand the benefits of analgesia for vaginal delivery and that practice will become a standard procedure in a close future. We really hope that Dr. Neeti will visit us again."

"It has truly been a wonderful trip! It has been amazing to see all of the progress that has been made, thanks to Kybele and the local partners! There is so much enthusiasm for learning, and for improving the birth experiences, outcomes, and safety for these women. It's been so inspiring to see how powerful education is!"