So it has been a long time since I made a blog post. To be honest, it has been so busy here I just haven’t had the time. Great news for MSF Timergara though: the neonatal ward officially opened for business on the 30th of April!
This has simultaneously been a huge relief and also added pressure – now I have sick patients to treat. It’s a relief because finally we have somewhere to treat the babies born in the mother and child health unit; it’s a small room but it’s clean and cozy. Now babies who just need a little bit of help – some oxygen or fluids in the first few days of life – are surviving and parents are taking home normal, healthy babies. The babies are being treated appropriately with international standard protocols and free, high quality medications – something very unusual for this region.
Also babies who are very sick, with little chance of survival, are at least kept warm and comfortable, dying with dignity in their mothers’ arms, instead of an overcrowded, noisy ER or nursery. I know dignity might be a strange word to use to describe the death of a baby but it’s something that I feel very strongly about. Birth should be a time of joy and celebration, and when it’s not, I believe we should do whatever possible to support the mother and give her time with her child, letting it pass peacefully and comfortably.
There have already been 27 babies admitted to the neonatal unit and most of them, thankfully, have been discharged home very well, but one little baby who has been there from the very first day has touched my heart. Sometimes you just fall for these little ones!
I have nicknamed him “Baby Chinda” (chinda means frog in Pashto) due to his uncanny resemblance to the animal. Even his mother now calls him Frog – I think it’s stuck. He was born at 11pm the night the ward opened. I was called to see a premature baby: 28 weeks old, weighing 1.2 kg. He had been delivered feet first, was bruised up to above his hips on both sides, had two black eyes, and a little wrinkled, shriveled face, but he screamed and roared and demanded to live. We gave him a chance. We had a long talk with his mother and grandmother and said that he was very small, very early and that we would support him as best we could, but if he deteriorated, we would have to let him go. They understood and agreed.
Seven days later he was fabulous: breastfeeding every two hours, off all fluids and oxygen, had finished his antibiotics and was only happy when he was being cuddled in somebody’s arms. We were all thrilled – he was gaining weight and looked to be heading home soon. Then one morning he decided to stop breathing. I couldn’t choose not to resuscitate him; it would have broken my heart.
We used a bag and mask for five minutes and got him back, but he really didn’t look great. His mother was devastated. She had lost one son to an accident at 11 years of age and I think seeing this one being treated brought back memories of her other son as well. We started antibiotics, put him back on oxygen and stopped his feeds. We told his mother we weren’t sure what would happen, but that we would give him 24 hours and see how he did. We sent her home to shower, sleep and spend time with her family, with a promise to call her if anything changed.
He slept, lethargic and quiet – not something I like to see in a baby – and by the next day I had made up my mind to let him go after talking with his mother. I think he heard me discussing this with the nurse, however, because he opened his mouth and roared! I was surprised by how happy and relieved I was. I normally don’t get this attached to these babies – there are just so many – but this little one’s wrinkled, old man face, and sheer determination to live have completely stolen my heart.
His still an inpatient and we’re taking things very slowly but he is doing so well. Every day his beautiful mother brings him a brand new knitted top from the bazaar. It’s always five times to big for him but we manage to wrap him up neatly in it and now he is the most stylish, and probably most loved, little frog in Timergara!