In February this year, 26-year old Jennifer Kapuri lost her week-old baby due to the non-availability of an incubator at the St Martin’s Catholic Hospital at Agroyesum in the Ashanti region.
Jennifer was delivered of her baby boy after carrying the pregnancy for 29 weeks.
But the baby was born premature, weighing one kilo and needed to be incubated.
The hospital was compelled to refer the baby to the Komfo Anokye Teaching Hospital (KATH) in Kumasi for incubation.
Unfortunately, Jennifer’s baby could not survive for more than 5 days on arrival at KATH.
“We went to Komfo Anokye Teaching Hospital to get our baby boy incubated but upon reaching there, we realized the situation over there is even worse. The hospital had incubators but not enough so four babies, including ours, were put in one incubator and this led to cross-infection leading to the death of our son,” the poor mother recalled.
Jennifer’s husband, Isaac Peprah, was hesitant in sending the baby to the KATH because of the facility’s known challenge of inadequate incubators.
“It was heartbreaking but we had to accept fate,” he said in a trembling voice. “I am very sure that if there were available incubators at St Martin’s Hospital, the four babies would have survived”.
In the Ashanti region, premature deaths account for 40 percent of neonatal deaths.
The situation at St Martin’s Hospital
The St. Martin’s Catholic Hospital at Agroyesum serves as the only referral centre for the over 30 health centres in Amansie West district of Ashanti Region.
The facility provides health care services to about 150 thousand residents in the over eighty communities within the district; which is considered as one of the most deprived in the region.
The hospital is one of the leading facilities for the effective treatment of Buruli Ulcer and Telemedicine care.
But mothers giving birth to premature babies at this facility are often in a state of mixed-feelings.
They are joyful that after waiting for days, weeks and months, the baby finally arrives.
But the mood turns to that of anxiety and worry when they realised they cannot access an incubator to keep the baby warm and effectively monitor the temperature.
A premature or preterm birth takes place weeks before the baby is due. It occurs before the start of the 37th week of pregnancy giving the baby less time to develop in the womb.
The incubator is a life saver for premature babies. Most premature babies need to be in an incubator or in a heated cot for two to four weeks to help maintain their temperature in a Neonatal Intensive Care Unit (NICU) before reaching their original due date.
The only incubator at St. Martin’s hospital broke down beyond repairs five years ago. Since then, hospital authorities have had to resort to an improvised wooden radiant warmer with onion bulb to keep preterm babies warm.
But health personnel are unable to regulate temperature and other key supporting elements available in real incubators.
They are also unable to prevent infections and control humidity in the provisional incubator.
“We have for the past years managed to use this improvised wooden radiant warmer to save several preterm babies but because it is not enclosed as an incubator, we are unable to prevent infections to the preterm. The worrying situation has resulted in loss of some preterm,” observed the Matron of the hospital, Reverend Sister Mary Assumpta Taabazung.
Helpless mothers look on as their precious ones give up because there is little health officials can do.
The St. Martins Hospital recently acquired two new radiant warmers when it constructed a new maternity block to improve maternal and child health.
But medical officer in-charge of the Neonatal Intensive Care Unit, Dr Nana Osei Appau says preterm death continues to be a nightmare.
“Fifty percent of the neonatal deaths recorded in this facility were due to the absence of incubators to keep preterm babies. Six preterm babies have died in October 2017 alone. These deaths could have been prevented if we had some incubators,” he said.
The hospital needs at least three incubators to effectively deal with preterm cases.
Resorting to Kangaroo Mother Care
From January to October 2017, the St. Martin’s hospital received over 800 neonatal admissions, out of which 20 died. Fifty percent of the 20 deaths were premature cases.
Preterm babies who need to be incubated have to be transported about 60 kilometres from Agroyesum to Komfo Anokye Teaching Hospital (KATH).
Apart from the challenge of distance, the road network is in terrible state. The situation is compounded by the absence of an ambulance in the hospital to transport referred patients.
In the absence of incubators, Kangaroo mother care has been recommended to mothers, though the survival rate is not as effective as an incubator.
Kangaroo mother care involves a mother holding her child close to her breast – skin to skin – while covering the baby’s head and feet to prevent heat loss.
The method enables bonding between mother and child, creates warmth for the baby, and allows it suckle the mother’s breast.
Incubators cost between 5,000 and 20,000 US dollars, depending on the size and functions.
The administrator of the facility, Paul Ralph Odom, says the hospital could not procure incubators due to its high cost.
“The hospital’s finance is a bit stretched making it difficult for us to raise money to buy an incubator. Currently the National Health Insurance Authority owes us 8 months claims and a chunk of the money we generate internally is used in fuelling our plant due to frequent power outage by Electricity Company of Ghana,” he said.
Concerned parents like Isaac Peprah have pleaded with the government and other benevolent institutions to assist the hospital with incubators to curb preterm deaths.
Attaining sustainable development goal on health
According to the World Health Organization (WHO), an estimated 15 million babies are born too early every year, out of which about one million die due to complications of preterm birth.
More than 60 percent of preterm births occur in Africa and South Asia.
In Ghana, 140,000 babies representing 14 per cent are born premature every year.
A total of 8,700 of these preterm babies die even before reaching 30 days of their life.
This means, every hour, one newborn baby dies because he or she is born premature.
Ashanti regional health director, Dr. Emmanual Tinkorang, is advocating the availability of an incubator for each district hospital.
Recommendations by the WHO on interventions to improve preterm birth outcomes, unstable newborns weighing 2000 grams or less at birth, is that they should be cared for in a thermo-neutral environment either under radiant warmers or in incubators.
With the non-availability of incubators in referral centres like St Martin’s Catholic Hospital and other major health centres in the country, achieving the Sustainable Development Goal three, which among others seeks to reduce child mortality, will only be a mirage.
By Ibrahim Abubakar|3news.com|Ghana