Thursday 10 May 2012

My African Experience: Prematurity

This post follows on from Pre-Eclampsia: My African Experience.

The hospital I spent time observing in had a SCBU unit, although how functioning that unit was, was difficult to tell at times.  It seemed to accept any baby who had survived birth.  Although from my time there, I never once saw a baby be seen by a paediatrician post-natally.

The unit itself had three incubators.  Only one of which the temperature settings worked on.  It also had 5 plastic cots, which were covered with a mosquito net.  Although each of these nets had holes in, and on requesting a new net for the cot, the 'new' nets also had holes in.  Each incubator held up to three babies (depending on size and requirements).  The babies seemed to give given very little care.  A 26 weeker was given steroids, as there was no ability to give them to mum whilst baby was in utero.  It had a nappy for a new born, which came up to its nipples.  It seemed so fragile, but due to the local knowledge, technical ability and resources, nothing more was done for it, that wasn't being done for the other babies.  This consisted of ensuring all babies were cup fed every 2 hours, day and night.

'Feeding time' was a different experience in this hospital.  All the mothers with babies in SCBU slept in a dormitory just off the labour ward.  Every 2 hours a bell would be rung.  All of the mothers would then queue up in SCBU.  They'd wash their breasts, take a cup and hand express into it.  They'd then take their child and cup feed it.  Even to the smallest and weakest baby.  They had no NG tubes.  This was the best they could do.  Some of the older babies, could cope with this, but for the younger gestations it was too much.

The midwives/neonatal nurses (who knows what job title they actually held), seemed to do very little, save for 'babysitting' these babies.  In fact the only thing I distinctly remember them doing was sharing their lunch, in the same room these babies were living in.

The 26 weeker, who may have had a chance with maternal steroids, NG tube feeding and other techniques and medications that the western world holds, died after a mere 3 days, lying in a working incubator with two other babies.

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