24 April 2019

Namibia: Inside Namibia's First Children's Intensive Care Unit

Hospital rooms are stereotypically synonymous with penetrating and distinctive odour associated with various forms of medicine and treatment apparatuses. As cliche as this may be, it is widely accepted as a norm in many healthcare centres.

But in the Ongwediva Medipark Pediatric Intensive Care Unit (Picu), one is greeted by the aroma of baby oil and scented nappies, complemented by that of fresh, clean linen.

A Picu is an intensive care facility for critically ill children, which was recently opened at the Ongwediva Medipark - the first of its kind in Namibia.

In a room just accross the nurses' station is Baby Hope's room. 'Baby Hope', named as such to protect his identity and that of his mother who wishes to remain anonymous, is critical ill. Having been born prematurely in February this year, he suffers from severe complications relating to his heart, kidney and intestines.

Baby Hope was first admitted in a neonatal or Newborn Intensive Care Unit (Nicu) shortly after his birth. This is a place in a hospital that is specifically designed for critically ill newborn babies.

As he did not get better, he was transfered to the Picu, which is designed for older babies.

Specialist paediatrician Togara Pamacheche, based at the newly opened unit at Ongwediva, said once a newborn is released from the unit, they are not readmmited into that unit.

"A baby will not be re-admitted once discharged from this ward, but rather referred to the paediatric unit if it is still critically ill. This is because during the time that the baby left neonatal, it could have picked up all sorts of germs out there. So, in avoiding exposing the other newborns to all types of germs and infections, we avoid readmission," Pamacheche explains.

According to Pamacheche, Baby Hope was first admitted in the neonatal ward for a few weeks and later discharged. After some time, he was rushed to the hospital again with severe complications.

After doing a quick round on Baby Hope, Pamacheche emerges from the room.

"He is improving, although critical. Baby Hope is a little brave fighter,"Pamacheche said.

Baby Hope has been operated on three times, after being referred to the paediatric unit from the Oshakati Intermediate Hospital.

On the other side of the hospital in the neonatal ward is Baby Kandjala who is a few weeks old, having an intimate moment with his mother, Lydia Hakaala (30).

Nurse Tuyeimo Hailombe is helping them with kangaroo mother care (KMC), a practice of providing continuous skin-to-skin contact between mother and baby.

Baby Kandjala was about 830 grammes at birth, and grew to about 1,4 kilogrammes.

Hakaala, who said she is happy her baby is alive all thanks to the doctors and nurses at the neonatal unit.

"When I was between six and seven months pregnant, I started bleeding and was paining so I was rushed to the hospital and my doctor had to perform an emergency C-section. I did not think then my baby will survive because he was very small and I was weak. The staff here in neonatal are taking so much good care of my baby, they are very thorough and professional," Hakaala said.

Both the paediatric and neonatal units are only open to state patients under refferal.

What the PICU?

The PICU is the section of the hospital that provides sick children with the highest level of medical care. It differs from other parts of the hospital, like the general medical floors, in that the paediatric unit allows intensive nursing care and continuous monitoring of things like heart rate, breathing, and blood pressure.

The paediatric unit also allows medical staff to provide therapies that might not be available in other parts of the hospital. Some of these more intensive therapies include ventilators (breathing machines) and certain medicines that can be given only under close medical supervision.

Who Sent to the PICU?

Any child who is seriously ill and needs intensive care and whose medical needs can't be met on the hospital's main medical floors goes to the paediatric unit. Kids in this unit might include those with severe breathing problems from asthma, serious infections, certain heart conditions, some complications of diabetes, or those involved in a serious automobile accident or near-drowning.

Some kids may have been stable enough to initially be cared for on the hospital's medical-surgical floors, but may be transferred to the paediatric unit if they become more acutely ill. Following major surgery, many children are cared for in this unit for several days.

How long kids will be in the unit depends on their condition -- some might stay a single day; others might need to stay for weeks or even months. As always, ask the doctor or nurse caring for your child if you have questions. (kidshealth.org)

Reasons Why Your Baby

Might Be Sent to the NICU

1. Prematurity: Babies born early (less than 37 completed weeks) is the most common reason for a neonatal admission. Premature babies aren't quite physically and developmentally developed and are unable to transition to the outside environment as well as full-term babies.

2. Respiratory Distress Syndrome (RDS). RDS is the most common respiratory problem in infants because of immature lungs. Severe cases are treated with a breathing tube, as well as placing the baby on a ventilator.

3. Sepsis or infection. Sepsis or infection is the most common reason for neonatal death and poor outcomes.The earlier a baby is delivered, the more likely the baby is to have an infection, as the immune system can't fight it off.

4. Hypoglycemia. Hypoglycemia, or low blood sugar, is usually seen in premature infants, infants born to a mom with gestational diabetes or infants who have an infection.

5. Perinatal depression. Traumatic delivery, or problems during delivery, can lead to decreased blood flow and oxygen to the baby.

6. Maternal chorioamnionitis. One reason a baby might be sent to the neonatal unit actually involves the mom's health. Maternal chorioamnionitis is an infection and inflammation of the placenta, and/or the umbilical cord, before or during labor, and this puts the baby at a very high risk for an infection. (unitypoint.org)

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