allAfrica.com: Uganda: Another Day, Another Hope for Premature Babies (Page 1 of 2)

A healthy, beautiful, bouncing baby. This is what every mom longs for. But for Hawa, the story was quite different. She had to depend on the incubator, a special facility where babies born before their due date are kept to give them enough warth.

Hawa's baby, Tabitha Tika, was born at 24 weeks. She weighed only 1.2kgs.

A standard pregnancy lasts 40 weeks (though at 36 weeks, the baby if fully developed) and a normal baby weighs at least 2.5kg.

"I did not think she would survive," says Hawa. "She was so tiny. Her father abandoned us saying they do not have a history of producing such kids in their clan."

Hawa gave birth in a tiny room at her home in Naguru, a Kampala suburb. Her neighbours rushed her to Mulago Hospital with her baby after the husband vanished.

"I had no relative here. I come from Arua. I stayed in the prematures' ward for three months. We were discharged when Tika was three months old, the time she was supposed to have been born. She weighed about 3.7kg," says the 35-year-old who lost her first child at six years, when she was pregnant, leading to a premature birth because of shock.

Now, at six years, Tika has so much to look up to.

Comfortably sitting on her mother's lap, she shyly stretches her hand to greet Dr Margaret Nakakeeto, the woman who, through a simple cost-effective intervention known as Kangaroo Mother Care (KMC), helped her to live.

KMC is the care given to premature infants. The mother carries the baby skin-to-skin, the same way mother kangaroos carry their babies in a pouch.

Pioneered as a home care system for premature infants in Bogota, Colombia, KMC is an alternative method to inadequate and insufficient incubator care for premature babies.

A mother holds her infant skin-to-skin between her breasts, ties a cloth around it and the baby pops the head above the chest like a baby kangaroo. It has proven to be a powerful method in promoting the health and well being of infants born preterm because of the effective thermal (temperature) control, breastfeeding and bonding between the mother and the newborn.

Small babies can be discharged early as the mothers can express the milk and feed them manually while keeping them warm with the warmth from the bodies.

"I started the Kangaroo project in an attempt to reduce premature deaths here. It was heartbreaking. Infants were dying, especially after being discharged from hospital," Nakakeeto says. "I realised they were okay in the hospital but back home, the mothers could not cope. I wanted continuous care."

Well, doctors are supposed to mend and save lives. But few go an extra mile to make a difference in the people's lives.

However, when the Ministry of Health appointed Nakakeeto, a consultant paediatrician/neonatalogist, head of the neonatal/special care unit at Mulago Hospital in 2000, her immediate task was to find an alternative way to save newborns who were dying mostly because of low temperatures.

The numbers of the infants were too many for the health and social systems; there was inadequate supervision and monitoring. She also realised about 60% of mothers were giving birth at home under unskilled care. Besides, some were being discharged early, with poor postnatal attendance and consequent high neonatal mortality (death of a baby within 28 days after birth).

Nakakeeto sent the unit's head nurse to Bogota for training in KMC and on her return, the nurse passed on the knowledge acquired in Bogota to other nurses and made a plan on how to implement KMC.

"We were admitting 70 babies, though we had the capacity of only 20 babies. I had about nine nurses yet such infants need close observation. I wanted to introduce KMC here so I could save as many babies as possible, using the meagre resources," Nakakeeto says.

With no special funding for such a programme that required a lot of training for the staff, Nakakeeto embarked on the implementation.

"I approached the hospital administration for extra beds and managed to secure eight adult beds. I turned the space for admission and a room next to the unit into a KMC area.

"Everybody was involved, from the cleaner to the consultant. We started by recruiting the bigger premature babies. I removed them from the incubators and left them with their mothers. I knew the administration would not buy the idea so I dared on my own, with the support of my team. The results were amazing.

"The babies were surviving. Previously, I had to keep them until they reached 2.5kgs. This meant that the mothers would stay in the hospital for months, but I started discharging them after few weeks.

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