Keeping every child alive during COVID-19 pandemic
Doctors, nurses, midwives and lady health workers are working hard during the pandemic to save newborns' lives
Lahore, Pakistan - July 2020: Dr. Ammara Naeem is one of many doctors, nurses, midwives and lady health workers who work hard to keep every child alive in Pakistan, which has one of the world’s highest rates of neonatal death. Her commitment to save newborns’ lives has not faltered as she faced the outbreak of the coronavirus COVID-19 pandemic.
While many health and front-line workers helped fight the virus despite the risks, Dr. Ammara Naeem and her colleagues helped deliver healthy babies as mothers who continued to give birth and the children who continued to be born during the outbreak. This was did not come without risks. A Consultant and Assistant Professor of Pediatrics at Sir Ganga Ram hospital in Lahore, Dr. Naeem had two close colleagues who tested positive for COVID-19.
Dr. Ammara Naeem has continued to oversee the health of newborns in the labour room and in the nursery as life became challenging.
“The Government has restricted movements and asked people to practice physical distancing. This pandemic is unprecedented but of course pregnant women cannot postpone deliveries, babies are still being born, and some are still sick and being brought to the emergency ward by their parents,” Dr. Naeem tells. “They still need a safe pair of hands, which we will continue to provide no matter the challenges.”
Neonatal mortality rate in Pakistan has been stagnant at a worrying 42 per 1000 live births since the last three decades. Many newborns do not have access to basic interventions pertaining to the biggest killers such as birth asphyxia, sepsis & prematurity. Equally worrying is the fact that only 38 percent of children are exclusively breastfed during the first six months of life, with 44 percent of children under the age of five stunted.
As COVID-19 impacts countries and places burdens on health systems, mothers continue to give birth and newborns are still coming into this world. Mothers still need quality care before and during pregnancy and labour; sick or small babies still need emergency attention and special care; and new families still need support and guidance, like breastfeeding initiation, promotion of kangaroo mother care (skin-to-skin contact), and essential medicines and vaccines, to keep their newborn safe and healthy.
To ensure that health workers, mothers and newborns are protected from the virus, the Ministry of National Health Services, Regulations and Coordination and Punjab’s Health Department have developed standard operating procedures.
“We are taking all necessary precautionary measures to make sure that we are protected against COVID-19. We wear masks, gowns and gloves. We change clothes every day. We keep a safe distance as much as possible but of course it is a hospital and sometimes we have to come close to patients to check the health of newborns and infants in the arms of their mothers. We cannot know who is carrying the virus, so we know that in the end, we are exposed to risks”, Dr. Naeem says.
The hospital has put in place a process to screen patients for symptoms of COVID-19. Moreover, sick children and mothers are kept separately and anyone testing positive is sent to an isolation center for COVID-19 patients.
“Th Neonatal Intensive Care and High Dependency Units are crowded. We cannot know who has the virus and who does not. We have to treat children by relying on information provided by the parents or caregivers, who often do not cooperate. They are unwilling to share facts on their children’s history because they fear the stigma, should they be tested positive for the coronavirus. They fear that their child will be isolated from them in case of testing positive for COVID-19. Not to mention that some have irrational fears, like thinking that the police will forcibly isolate their entire family. All of this makes our job very difficult and risky,” states Dr. Naeem.
“In a situation when we don’t have any factual information on the patients and people coming to the hospital, we have to consider every visitor a possible COVID-19 case. This causes a lot of mental stress and exhaustion for all the staff. Not to mention that people have been afraid since two colleagues were tested positive for the virus. I feel good that I am providing critical services to sick babies, despite so many challenges,” adds Dr. Naeem.
These fears are not baseless – a number of health workers have lost their lives to the virus since the pandemic reached Pakistan at the end of February 2020.
"In a situation when we don’t have any factual information on the patients and people coming to the hospital, we have to consider every visitor a possible COVID-19 case. This causes a lot of mental stress and exhaustion for all the staff."
Despite the risks and the fear of getting infected and infecting their families, the hospital’s staff remain committed to helping children and women, and to not let them down during these difficult times. They are providing services beyond means. There is no pediatric surgical unit but some surgeons giving helping hand in paderaite surgical cases.
All women have the right to a safe and positive childbirth experience whether or not they have a COVID 19 infection. A woman with COVID-19 should be supported to breastfeed her baby safely, hold her newborn skin to skin and share a room with her newborn practicing safe hygiene measures such as wearing mask, washing hands and disinfecting the surfaces. BCG, Hepatitis B and Polio vaccination are to be given to every newborn as per standard EPI guidelines.
During public health emergencies, human and financial resources are often diverted from essential health programs to respond to the disease outbreak. Emergency response to COVID-19 must not result in the diversion of resources for essential maternal and newborn health. With or without a pandemic, every child has the right to survive and thrive.