22 November 2018

Namibia: 208 Babies Die At Oshakati

Photo: The Namibian
When practised correctly and consistently, kangaroo mother care can help save premature babies. This photo was taken at the commemoration of world prematurity day at the Oshakati State Hospital.

Forty-eight hours - that is how long most newborn babies survive at the Oshakati State Hospital in the Oshana region.

At least 150 premature babies out of more than 1 000 who are either admitted or born at the Oshakati State Hospital yearly do not survive.

This year alone, the hospital recorded 208 neonatal deaths against 395 neonatal deaths registered in the last two years.

The hospital records an average of 100 admissions monthly.

These are some of the revelations made by a paediatrician at the hospital, Dr Lona Mwenda when she spoke during the commemoration of world prematurity day at the Oshakati hospital on Friday under the theme 'Supporting premature babies to grow and develop well'.

Mwenda said premature babies born outside a health facility or in an environment with too little medical and nursing support, cold, or exposure to infections, have a higher risk of dying.

She said the premature baby's breathing can be helped by using special breathing machines, as well as adopting proper and consistent kangaroo mother care methods.

Mwenda added that those handling a premature baby should wash their hands regularly to prevent transmitting any infections.

Exclusive breastfeeding should likewise be done carefully, as the underweight premature babies need help with feeding by using a special tube until they are mature enough to suck from a cup, and then from the breast.

The World Health Organisation estimates that globally, about 15 million babies are born prematurely or before 37 weeks of pregnancy, which translates to at least one in 10 babies.

An estimated one million premature babies die each year globally. According to the 2013 demographic health survey, the overall neonatal mortality rate in Namibia was 20 deaths per 1 000 live births.

One mother, Katrina Kambonde (44), who lost one of her premature twin babies in 2015, spoke about how she almost lost hope at the time.

She said what started as a typical pregnancy quickly turned into a nightmare.

"It was just after 20h00 on 10 August 2015. I took a shower, and I could feel the babies moving lower, down into my abdomen. A few minutes later, my water broke," she recalled.

Kambonde, who was five months pregnant, was concerned and called her mother, with whom she lives. Within 30 minutes, she was rushed to the Onandjokwe State Hospital.

She did not feel any pain.

"The doctor told me my water broke, and the only option left was for me to deliver. There was no incubator at the hospital, and the doctor said I should be transferred to the Oshakati hospital to give birth there," Kambonde narrated.

Six hours later, she arrived at the Oshakati State Hospital.

Kambonde said she was hospitalised, and given medication to delay delivery. Around 12h00 the next day, it happened - she gave birth to twin baby girls who weighed 950 grammes and 700 grammes, respectively.

The babies were rushed to the hospital's neonatal intensive care unit soon after birth, and hours later, Kambonde went to see them.

"They were tiny, and they lay there in the incubator. The other twin was on a machine to help her breathe," she recounted.

Kambonde said: "I wasn't sure whether I had to keep going to the incubators.

"One of the babies barely looked human. I wanted to run away. It got worse when the one who weighed 750 grammes dropped to less than 500 grammes. I nearly lost all hope, but the nurses kept encouraging me that they would make it."

At 11h00, a nurse told Kambonde that her daughter who had weighed 900 grammes and looked stronger and healthier of the two, had died. She had spent two days at the hospital.

Today, Kambonde describes her surviving twin as a "hero baby".

Mwenda warned that babies who are born weighing less than one kilogramme rarely survived. This means doctors make heartbreaking choices as they triage infants' conditions, forcing them to allocate scarce resources such as incubators to babies with the best chances of surviving.

"Premature babies who have good support from antenatal time in the womb and who are born in a health facility with good medical and nursing support given early and their complications detected early and treated early, should be able to survive," she continued.

But death rates among newborn babies delivered in public facilities - mostly at district hospitals - have not changed much in the past years.

Unsurprisingly, prematurity remains the leading cause of these deaths, which most often happens within the first week of life.

"Other babies may survive the initial days, but then develop life-threatening complications of prematurity a bit later, or infections, and die after 2-3 weeks," Mwenda stated.

Health minister Bernard Haufiku said the work to end infant and maternal deaths needs to start long before babies and mothers are in the delivery room.

"We need better antenatal care so that women are better taken care of during pregnancy. When you discover that you are pregnant, do physical exercises, and stay away from alcohol," he urged.

Haufiku said neonatal mortality at the Rundu State Hospital reduced at least by 27% after the number of ventilators at the hospital was increased. He said the Oshakati hospital is overwhelmed by referrals, many of which can be addressed at district level.

"We need to get primary healthcare out of the Oshakati hospital," he stressed.

The minister also used the platform to urge the fathers of the children to support their pregnant partners and their children throughout life.

"It takes two to tango. That means that formula must be maintained. Too many children are cared for by only the mothers. Fathers, please come to the table," Haufiku said.

"If we say only 6-10% mortality, who wants to be part of it? Unless we answer that question, we cannot be satisfied that a certain percentage of our people must die and be part of this very little number, even if it's 1%," he stressed.

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