Beating The Odds...

Sometimes encouragement comes just at the right time, and with all the recent upheaval in the Baby Unit, Sarah was definitely in need of encouragement.  Meet Survivor. 

Her mother came to Kitovu Hospital at 27 weeks gestation.  What you need to know is that in Uganda, the official “survival age” for babies is 28 weeks gestation, therefore any baby born below that is called an “inevitable miscarriage”.  Their mothers aren’t even given steroids by doctors (giving the mother steroids helps the unborn baby’s lungs to develop), as after all “what’s the point” if they’re going to die anyway, right?

Survivor’s mother reasonably asked whether she could go home – she would rather be in her own surroundings if this baby was inevitably going to die.  Our baby unit nurses encouraged her and counselled her that some of these babies CAN survive.  So she stayed and gave birth to 1.08kg Survivor.  Survivor is now a month old.  Yes, of course, there was more than encouragement involved – there was a glucose infusion to keep her going when she couldn’t start to feed initially, a tube to help her mother give her expressed breast milk, antibiotics to prevent infection, medicine to help prevent her from stopping breathing, and warmth (via our overhead warmers, the Embrace sleeping bags, and mum herself doing kangaroo care).  But actually the thing that I am most proud of is our nurses taking the time to encourage a confused and scared mother, and thereby save a little baby from actually being the “inevitable miscarriage” that she was declared to be!  She is very well-named, isn’t she?

As well as an “inevitable miscarriage”, we also have an “intrauterine foetal death” on our unit!  After midwives couldn’t hear her heart beat, they told her mother that she had died.  I can’t imagine how distraught that poor mother must have been, especially since this was her seventh pregnancy, of which she had lost all but one baby.  Two days later, by caesarean section, doctors were a bit taken aback when this little baby was born alive, if in poor condition.  Amazingly, though, she is doing really well, and is even breastfeeding!  So here’s to babies beating the odds this month!

On other Baby Unit news, Sarah, and her trusty side-kick Baby Noah, have been continuing in their work to train all the midwives from the Maternity Ward in neonatal resuscitation, newborn care, and the workings of the Baby Unit.  However, staffing has really been a challenge over the past couple of weeks, which has prompted a number of strategic discussions.  It has been agreed that we should hire another nurse to be based permanently on the Baby Unit with Head Nurse Cathy, with the rest of the staffing offered by the newly trained (and certified.... yup, they have a practical and written test to be sure they’re up to scratch) midwives who rotate through the unit for a month at a time.  Since some of the midwives were unable to calculate a heart rate correctly in their tests (!!), the pool of midwives eligible to work on the Unit is quite small, but growing!

In addition, we’ve had an influx of exciting new Baby Unit equipment brought by visitors, and have got a new oxygen saturation monitor (the previous one having headed to that fluffy place in the sky), neonatal monitors, and a number of other treats that we’re enjoying putting into action.  So THANK YOU SO MUCH to Joy, Jo, Jan and Tracey!

Meanwhile, on a course last week, Sarah was somewhat baffled at the large number of new “facts” that she learnt from their (non-medical) trainer in the “health” module.  New revelations included....

·       You can catch sexually transmitted infections from toilet seats

·       You can figure out if you are pregnant with a girl or a boy depending on your age and the month you fell pregnant in

·       Family planning causes disabled children

·       Milk causes cancer

... and a whole host of other factoids which can only be described as twaddle. 

Hilariously, when Sarah decided to object as the presentation of spina bifida was being totally incorrectly described, the trainer looked at her and basically implied, reminiscent of Ron Burgundy (a.k.a. Anchor Man), that we should “agree to disagree”.  In HIS experience, he said, this was how it presented.  I guess 16 years of medical training and work doesn’t match up to his case study of 2 individuals!!!!

Things we’ve learnt about parenting the hard way...

#4: if you stand cooing over your naked son, there’s a decent chance you will get pee in your eye.  Normal saline is a far better eye irrigation fluid (though it doesn’t make as good a story).