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Bringing life back from the brink

920 grams and surviving
© UNICEF/Ranjan Panda/2007
920 grams and surviving

The Sick New-born Care Unit in Mayurbhanj proves that a systematic intervention can do the undoable

By Ranjan K Panda

It was no celebration in Malati Bahuja’s family when she delivered a child a few days ago.  With a birth weight of 920 grams, Malati and her family worried that the baby would not survive.  Their apprehensions did not come without reason.  For a new born in this poor and forested district of Orissa, the journey between life and death is perilously uncertain, at least in the first 28 days of birth during which time there is a 66 percent chance of infant mortality.  However, much to the joy of this poor family from the Masunasi village, a state-of-the-art medical care system was waiting to save Malati’s child.

“This is a miracle,” says Malati. “When I realized that my child was so underweight, I lost all hopes but now I am sure he will survive”, says a happy Malati who is now hopeful of celebrating her motherhood in a few days.  “This child came with a weight of 920 grams.  We have put him on the multiparamonitor.  In seven days, the child has shown remarkable improvement.  We are feeding the baby with 15 ml of mother’s milk on a two hourly basis.  He may soon feed directly from the mother’s breast.” says Basanti Jena, staff nurse at the SNCU. 

SNCU : sophisticated and accessible to the poor

Malati’s is indeed lucky because just a few months her son was born, a neo-natal care unit equipped with modern life-saving equipment was set up at the district headquarters hospital in Baripada.  Called the ‘Sick Newborn Care Unit (SNCU)’, the uniqueness of this unit is that it targets critical neonatal cases and that it is accessible to poor people like Malati. 

Established as a second referral unit it has already treated 85 babies with acute cases of birth asphyxia, premature birth, apnea of prematurity, neonatal jaundice, neonatal septicemia, low birth weight (LBW), extreme low birth weight(ELBW), etc.  The SNCU is equipped with a Radiant Warmer, Oxygen Concentrator, Infusion pump, Apnea Monitor, electronic weighing machines etc., which have made it easy for the doctors to treat serious cases. 

“The sick newborn care unit is at the heart of the IMNCI experiment”, says Dr. Rabi Narayan Kanungo, retired Chief District Medical Officer(CDMO) of Mayurbhanj.  In fact Mayurbhanj is one of the first six districts in the entire country where IMNCI was piloted. 

© UNICEF/Ranjan Panda/2007
Mothers being taught how to breastfeed

IMNCI was introduced in high Infant Mortality Rate (IMR) districts and aims at reducing IMR with a special strategy to reduce the Neonatal Mortality Rates (NMR).   NMR accounts for about 66 per cent of the IMR. 

Says Dr. Pramila Baral of the SNCU, “In the last two months alone the unit has received about 30 premature born infants”.  The patients not only come from the hospital to which it is attached, but also from the periphery.  “Earlier, people who could afford treatment took their children to Cuttack and people who could not, waited for fate to decide” adds Dr. Kanungo.  Things have changed now and the SNCU is increasingly becoming the destination of referred patients. 

Plans to cover remote areas

Although the SNCU at Baripada has come as a boon, it’s not enough to tackle the neo-natal mortality rates of Mayurbhanj.  “Many people from the remote villages cannot afford to come to Baripada because it’s a tribal dominated district and there are still many inaccessible areas,” says Bijay Lal Mahanta, Secretary of CREFTA, an NGO partnering in the process.  “We have initiated establishment of similar facilities in sub-divisional levels and the buildings are ready.  We only need equipments and staff to start those units up and running,” informs Dr. Kanungo. 

At the SNCU, it is not merely a question of combating NMR and IMR.  Mothers are trained in proper neonatal care including breastfeeding and treatment of symptoms and ailments that could harm children and which need immediate attention.  “While discharging patients we advise them on proper child care, importance of breast feeding and symptoms of certain infections and diseases and ask them to consult the health worker and/or doctor at the locality in case of critical cases,” informs Dr. Baral

For Malati and mothers like her, who watch their children struggling for survival, this state-of-the art care system is nothing less than a miracle – a second life for their children just after birth.

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