I found out recently that the moms in the neonatal intensive care unit call me "the mother."
They have put so much trust in me to care for their little ones. I get to know many of the moms, as they can be admitted for several months at a time depending on how preterm and how many complications their child develops. The babies in this room are so tiny and delicate, the majority weighing less than three pounds at birth.
I have had some of my hardest days in this room and some of the greatest joys have come from this room too.
Before coming here, if someone told me I was going to have a room full of premature infants with very few resources and you are going to get a majority of them home, I would have said that’s impossible! I have been amazed over and over at the ability of these babies to not only survive but to thrive.
My "neonatal unit" is an interior room of the hospital. It has nine beds but most days there have been 11-13 babies in the room.
In the USA each baby less than 21 days old would have its own incubator (costing more than most cars) to control the temperature and humidity for the neonate. In South Sudan we control temperature by keeping all the windows closed to the room and wrapping the babies in blankets. I spend my mornings dripping in sweat while I round. If a baby gets too cold we put them in kangaroo care; skin to skin against mom.
At home, we have unlimited labs to check how the baby is doing, here I can check a blood sugar level and a hemoglobin for anemia.
At home, we have monitors to let me know respiratory rates, heart rates, temperature. Here we have mom who says, "baby is not breathing or baby is breathing fast".
At home, we have ultrasound, echo, X-ray and MRI for imaging when something goes wrong; here I have nothing.
At home we can feed by IV or central line. We have specialized formulas when babies are ready to eat and we have milk fortifiers and additives. We have nurses that calculate exactly how much the child feeds. Here, I have one term infant formula and breast milk, if mom makes enough, and I have to rely on how much mom tells me she feeds the baby.
At home we have different devices such as ventilators to help babies breathe; here I have a nasal cannula.
The list like this goes on and on, but amazingly these babies are making it. There are days babies get really sick and stop breathing and have to be helped. I hope for the miracle that the baby will continue to remember to breathe once we stabilize the child. There are babies dependent on oxygen with heart murmurs and trouble gaining weight. It is congenital heart disease and I know it can not be treated in South Sudan There are days we lose a child and it is tough on the whole ward, as many of the moms have become friends. But most days here are good days and while the weight gain is slow and the complications reoccur, I have been amazed how many of the babies are making it home!