Abibatu Conteh, 22, stands close to the cradle which has kept her baby girl safe since she was born prematurely four weeks earlier at Ola During Children’s Hospital (ODCH) in Freetown. A few weeks ago, Abibatu had also visited the cradles of her two other babies, as she had delivered a set of triplets. Two of her babies did not survive past two weeks of life.
“When the babies were born, they were very tiny. I was very confused, while also trying to recover from the operation,” says Abibatu as she explains the emotions which fogged her mind at the early sight of the three premature babies. “I was unsure about how to look after the babies and did not believe that any of them would survive.”
At birth, each baby weighed less than 1kg and needed the specialised support which is provided at the well-equipped Special Care Baby Unit (SCBU) located at ODCH. Despite the incredible loss she felt losing the other two babies, Abibatu is grateful with the steady progress that her baby girl is making.
Across Sierra Leone, the chances of survival for babies who are born too soon is small. Neonatal deaths are at 34 per 1,000 live births according to the United Nations Inter-Agency Group for Child Mortality estimates of 2019. Some of the main causes of newborn deaths are birth asphyxia, sepsis, congenital deformity, and prematurity.
Since 2017, UNICEF, with funding from the UK Foreign, Commonwealth and Development Office (FCDO), has been supporting government efforts to improve life chances for babies born too soon. SCBUs have been established in nine hospitals, where specialised equipment such as incubators, phototherapy machines, resuscitators and oxygen concentrators have been positioned to provide for the immediate special care of babies who are born too soon or those who are born sick. An average of 25 new babies come into the SCBU at ODCH each week and the availability of this special machinery has helped to increase their chances of survival.
Apart from relying on the efficiency of the state-of-the-art equipment, the nurses at ODCH also place a lot of importance on keeping the SCBU sanitised and clean to prevent infections. The units are occupied solely by the new-borns, while mothers visit their babies during designated times. The visits are controlled and guided by specific infection prevention and control (IPC) measures, which have played an important role in saving babies’ lives.
“Every time I come into the unit to see the baby, I have to wash my hands at the entrance and follow the other instructions which we have been told will reduce the chances of babies getting germs from outside,” says Abibatu, who has become accustomed and appreciative of the managed IPC routine which is in place at the SCBU.
In the in-born unit where Abibatu’s baby is being kept, 12 other babies are also receiving specialised care and support from Sister Hawa Jabbie and her team of specialised nurses. Sister Hawa explains that keeping the babies in a clean and controlled environment is a deliberate effort to speed up the recovery process.
“Babies who are born prematurely can easily catch infections. We therefore make sure that the SCBU remains clean, and we also make sure that all mothers adhere to the specific infection control measures which are the standard of this unit,” says Sister Hawa, as she explains the importance of hygiene and sanitation in improving the chances of keeping the babies alive. For babies who have not reached the capacity to suckle from the mother’s breast, Sister Hawa also helps mothers to express milk in a hygienic manner. Mothers are advised to keep themselves clean, wash their hands before expressing the milk and ensure that the utensils used to contain and feed the baby are clean.
The combination of appropriate machinery and IPC training for the hospital staff means SCBUs across Sierra Leone stand out as model centres to increase the survival chances of vulnerable new-borns. Already at these facilities, more than 12,000 new-borns, some of whom weighed a mere 800g at birth, have received quality care, survived, and are now thriving. Without the right care and support they had received at the SCBUs, these babies would not have survived.
“Evidence has shown that if timely quality care is provided, neonatal deaths can be prevented. The lessons and best practices which have been seen in the SCBUs across the country are today serving as a yard stick of what is required if every birth is to have a happy outcome,” says UNICEF representative Dr Suleiman Braimoh.
Abibatu is happy with the care that her baby is receiving and looks forward to the day that she is discharged and able to go home.
Story by Tapuwa Loreen Mutseyekwa, UNICEF Sierra Leone Communication Specialist
Image © UNICEF Sierra Leone/2021/Mutseyekwa