The shame of getting a premature baby in Africa

A nurse in charge of the newborn unit at Kenyatta National Hospital in Nairobi checks on the progress of preterm babies in an incubator. FILE PHOTO | NATION MEDIA GROUP
A nurse in charge of the newborn unit at Kenyatta National Hospital in Nairobi checks on the progress of preterm babies in an incubator. FILE PHOTO | NATION MEDIA GROUP 

The birth of a baby brings joy, but not to many mothers and fathers in developing countries where those born premature are seen as aborted children. A child born weighing less than two kilogrammes comes with guilt, shame and denial.

‘‘When I was handed the tiny, very black baby looking like he was suffering from malnutrition, I thought the hospital had exchanged my baby. He couldn’t be mine, he was too black and his twin was light-skinned, chubby like a normal baby,’’ said Mercy Kamoni, a mother who got twins weighing 1.8 kilogrammes and 2.5 kilogrammes at 32 weeks.

‘‘I hid the smaller baby. I gave all kinds of excuses for months to keep away visitors. I never wanted people to see him,’’ the mother of three said.

Ms Kamoni is not a bad mother. She said she adores her son who is now five-and-ahalf years old and can never imagine life without him. He has turned into a joyful boy and very intelligent. Ms Kamoni said that she was in denial; despite being a medic she had never seen a premature baby.

Prof Fred Were, the head of neonatal services at Aga Khan University Hospital in Nairobi, said Kenya is doing poorly in creating awareness on premature deliveries despite the condition being the second killer of children under-five after pneumonia.

‘‘Most people in rural areas don’t regard preterm babies as human beings. A baby who dies during the first week or month is not even named. There is a lot of under-reporting in numbers because of this. If a woman gives birth to a one-kilogramme baby before nine months, the untrained grandmother midwife assumes he is an abortee. Nobody would even rush him to hospital,’’ he said.

Prematurity is not a third world problem. Around the world 15 million children are born premature and one million of them die.

Of every 100 babies born in the US, 12 arrive early, accounting for about half a million births each year, according to World Health Organisation.

But most developed countries have created awareness and boosted survival of premature babies with most hospitals building fully-equipped neonatal Intensive Care Units (ICU) and High Dependency Units (HDU) that come with specialised nurses.

For developed nations like England and Wales, there is no shame in having a premature baby. Parents even have a smartphone app that helps one search for experts’ advice; share the baby’s journey with family while in an incubator, and read diaries of other mothers in similar circumstances.

Some African hospitals are making strides in reducing premature babies mortality, even those born weighing 600 grammes. Aga Khan University Hospital is one of the few in Africa with a neonatal ICU and HDU and a team of doctors and nurses specifically trained to take care of premature babies.

90 per cent survival

‘‘Before we opened the neonatal ICU and HDU and these very small babies had to share the intensive unit with adults, the mortality rate was very high. But now 90 per cent of the 20 to 30 premature children we receive every month, with some weighing as low as 600 grammes, go home even after staying in the incubator for four months,’’ said Ms Mary Mathenge, a neonatal nurse at Aga Khan University Hospital.

Prof Were said in Japan doctors save babies weighing 400 grammes using improved technology, but this is not Kenya’s solution.

‘‘New technologies can save small numbers of premature babies, but might not reduce the deaths in Kenya. Make kangaroo mother care better, we don’t have to create highly equipped neonatal units in hospitals in Busia or Kwale,’’ he said.

‘‘We need to make sure all babies are delivered in hospitals, get an incubator or two, get adequate rooms in hospitals for kangaroo mothering, ensure there is oxygen in all health centres, and give more women the steroid injection to mature the baby’s lungs. It’s very cheap. It costs about Sh88 and if we buy it in bulk it will be cheaper.’’

The rise in the number of preterm births is linked to more older women having babies, increased use of fertility drugs, high blood pressure, infection of the uterus, diabetes, smoking, genetic and spacing pregnancies too closely.