MANY caring, able and willing ayis don't know basic first aid or what to do in emergencies. They may panic. Finding the right ayi and training her in first aid is essential, writes Nancy Zhang.

For many newcoming expats, one of the great luxuries of living in Shanghai is affordable home help from ayis or housekeepers. Most ayis are migrant workers with varying levels of education, experience and competence.

Accepting a stranger into your home can be risky, so investing in training for your ayi is one way to ensure better skills for them and more peace of mind for you.

You can find ayis from agencies or by personal recommendation. Either way, it's hard to tell much about their previous experience and background. One way to ensure basic levels of training is to go through a government-sponsored housekeeping course at the Women's Education and Training Center.

Established in the late 1980s, the course aims to retrain unemployed women for new careers. It trains more than 1,000 women a year.

The extensive curriculum includes professional ethics, relevant laws and regulations, proper care of children and pregnant women, as well as basic hygiene and practical skills, such as how to clean furniture.

"When you choose an ayi, make your requirements clear. Some ayis specialize in some areas but not others," says a spokesperson for the course. "Go to a reputable agency with a license - many don't have a license."

You can contact the training center for a list of approved agencies.

So widespread is the demand for ayis from foreigners in Shanghai that the course also includes basic English.

But the spokesperson says language is as far as culture-specific training goes.

However, ayis working for foreign families face particular challenges.

Heidi Katherman, a former Shanghai expat and author of "The Ayi Survival Guide," says cultural differences are exacerbated by language barriers.

"Ayis working for foreigners face many new challenges - bigger homes, different appliances, different cleaning methods, and caring for pets. Most can't speak English, and it takes time to explain in sign language every day. Misunderstandings are common."

Katherman's book is a manual for translating common instructions between English, pinyin and Chinese. The training center can recommend agencies specializing in ayis familiar with Western families, though these frequently cost more.

Cultural differences may be more problematic, however, if children are left for long periods of time with the ayi. This is a particular concern in medical emergencies.

Medical emergency

Beatrix Gruen is a stay-at-home mom from Germany. Since last June she has employed a full-time ayi to help look after her two-year-old daughter.

She says it's difficult to tell how competent an ayi is.

"My ayi said she was experienced and already knew what to do in emergencies. She said she had a child care certificate, but you never know how prepared they are," says Gruen.

Though the ayi could handle everyday illnesses such as fevers and sickness, she would often use traditional Chinese remedies that clashed with Gruen's expectations.

"When my daughter had diarrhea, the ayi would give her congee, and for coughing she would give ginger tea. But I was convinced neither was good for the illness," says Gruen. "I had to ask her to stop it."

Other cases of home remedies have serious consequences. Radfan Mahyoub is a trainer for First Aid China, an expat group that teaches first-aid skills. He has run a first-aid training course for ayis for three years and has seen hundreds of examples of ayis who don't know what to do.

"Ayis have little knowledge, they usually get their information from an older generation," Mahyoub says. "For example, if a child drank some chemical substance, the ayi might give the child water or induce vomiting, but this is wrong as it will cause respiratory poisoning.

"If you leave your child with an ayi you need to ensure they don't just rely on traditional methods."

According to Mahyoub, the correct response to this and many other situations is to take the patient immediately to a hospital. Emergency training courses run by First Aid China and other international medical hospitals teach ayis how to move people safely to the hospital, and how to prevent serious injury in the movement.

An equally serious problem is an ayi who does nothing in an emergency. Roxanne Michaud is a United States-registered nurse who has lived in China for more than four years and founded First Aid China. Working as a school nurse in Shanghai, she has seen many ayi panic in an emergency. Fearing they will be held responsible, they may notify anyone but the parents and cause crucial delays before the child is taken to hospital.

"My neighbor's kid had a seizure, but the ayi called a friend, who called me to ask what to do. It delayed things by 20 to 30 minutes, which is really significant in medical emergencies," Michaud says.

Her advice to parents: Have in place a plan for how you want the ayi to make a judgment call in a timely manner.

"For example, if anything happens, get the child in a taxi and call the parents on the way - do not wait to move until after making a call," says Michaud.

"Make sure they know they won't get into trouble for going too far in taking the child to hospital, even if it turns out to be nothing," she says.

Recently Gruen put her ayi through a training course, after she herself took some classes and decided there was important information for the ayi to know.

She has noticed improvements in her ayi's work, though more information on accident and injury prevention is needed. First-aid professionals encourage all family members to take courses to become more aware of what can happen and what to do.

"Unlike the US where you can dial 911 for a walk-through of what to do in an emergency, the hot lines don't do that here," says Michaud. "You have to be absolutely responsible for yourself and your family. Look at how many hours your children spend with your ayi - they need to be just as prepared as you." Ayi training

Shanghai Women's Education & Training Center

Address: 2-3/F, 2281 Zhongshan Rd W.

Tel: 5489-2519, 5489-2510

Website: www.sfgx.org

Community Center Shanghai

Range of courses in first aid, English and Western cooking in Puxi and Pudong courses.

Next course in Puxi on January 24

Next course in Pudong on January 16.

See Website for details and booking: www.communitycenter.cn

Tel: 3382-1770

United Family Hospitals

Address: 1139 Xianxia Rd

Tel: 5133-1900

Website: www.unitedfamilyhospitals.com

Parkway Health (former World Link)

Address: Suite 203W, 1376 Nanjing Rd W.

Tel: 6279-7688

Hongqiao branch

Address: Mandarine City, Unit 30, 788 Hongxu Rd

Tel: 6405-5788

YMCA Housekeeping College

Address: Rm 321, 123 Xizang Rd S.

Tel: 6326-1040 ext 8929

Sino-European International Preschool

Courses on child development and safety

Address: 260 Jinyan Rd, Pudong

Tel: 5045-8668

Website: www.seips-china.com

Books

"The Ayi Survival Guide"

Price: 230 yuan

Garden bookstores

Address: 325 Changle Rd

Tel: 5404-8729

Chaterhouse

Address: B1, 93 Huaihai Rd M.

Tel: 6391-8237

Ayi agency

Shanghai Yash Family Care

With experience of Western clients

Website: www.yashnet.com