Born too early: Rwanda's smallest babies

Better care for these newborns could save a life. UNICEF brings paediatric mentors to Rwandan hospitals, so more babies survive to their first birthday and beyond.

By Veronica Houser
Chantal Ingabire holds her newborn daughter close to her chest using the "Kangaroo Care" technique.
20 June 2019

KAYONZA, Rwanda - In the calm of her shared hospital room, Jemimah Nyirabimana sits relaxed as she holds her twin babies against her bare chest. Jemimah’s twins were born premature, weighing less than two kilogrammes at birth.

She gently pats one of her babies on the back, looking around the room where she rests with other mothers cuddling their babies.

Jyamima Nyirahabimana holds her twins, both born premature, in the Kangaroo Care room at a hospital in Rwanda..

A few weeks ago, when her twins were born too early, Jemimah was terrified that they would not survive.

"They were both so small..."

Premature babies are more likely to have chronic health issues, some of which may require hospital care. They are prone to infections, health issues like asthma, feeding problems, and even Sudden Infant Death Syndrome. As they grow, these children are more likely to be chronically malnourished, which can lead to stunted growth. 


Kangaroo Care

Jemimah’s babies are sleeping peacefully. “The doctors taught us to hold our babies like this,” she says, gesturing gently at the tiny bundles wrapped tightly to her chest. “When they feel the mother’s skin and warmth, they sleep better.”

This “Kangaroo Care” technique also helps premature infants gain weight and grow. It promotes bonding between parents and their babies due to decreased stress and crying.

In fact, the Kangaroo Care room at Gahini Hospital is nearly silent. Although three other mothers occupy the room with Jemimah, none of their children are crying. The room is clean and comfortable, the atmosphere is serene. The mothers chat quietly, occasionally giggling at a private joke.

Jemimah holds her twin babies close to her body at a hospital in Rwanda, using the "Kangaroo Care" technique to help them sleep better and grow faster.
Jemimah holds her twin babies close, using the "Kangaroo Care" technique to help them sleep better and grow faster.

Mentorship from abroad

Gahini Hospital was not always a haven for mothers with risky pregnancies. Doctors and nurses in Rwanda often lack the training and equipment they need if something goes wrong during pregnancy or child birth.

“When I had my first child here in 2011, the hospital was small,” she says. “I was nervous about being a first-time mother, but the doctors were not confident when caring for us.”

Jemimah gave birth again in 2015, but this child did not survive.

Jemimah, right, sits with two other mothers in the Kangaroo Care room at Gahini Hospital in Rwanda.
Jemimah, right, sits with two other mothers in the Kangaroo Care room. Gahini Hospital did not always have the best care, but with more medical equipment and better trained doctors through the clinical mentorship programme, mothers like Jemimah feel safer and happier giving birth here.

For every 1,000 babies born in Rwanda, 50 of them will not live to see their fifth birthday. Over 40 per cent of these deaths occur within the first month of life - the neonatal period.  

UNICEF’s clinical mentorship programme is helping reduce these deaths by providing Rwandan doctors and nurses with more knowledge and equipment to save lives.

In partnership with the Royal College of Paediatrics and Child Health and Rwanda Paediatric Association, UNICEF brings paediatric specialists from the United Kingdom to spend six months mentoring Rwandan health care providers. These mentors work alongside Rwandan nurses every day, advising on individual cases and teaching weekly modules on caring for premature infants.

Dr. Evelyn Little, centre, and nurse Lizzy Smeaton-Russell, left, work with a new doctor at Gahini Hospital in Rwanda to care for a newborn resting in an incubator.
Dr. Evelyn Little, centre, and nurse Lizzy Smeaton-Russell, left, work with a new doctor at Gahini Hospital to care for a newborn resting in an incubator. Mentors like Evelyn and Lizzy spend six months mentoring doctors and nurses in Rwandan hospitals to help them build skills to better care for newborns.

With funding from Takeda Pharmaceutical Company Limited and support from the Japan Committee for UNICEF, Gahini Hospital also has new medical equipment. The doctors and nurses are trained to use this equipment and apply new knowledge in a crisis.

“Look around!” Jemimah says. “Now the hospital has enough beds for mothers. Before there were only two; we had to share, so we could not even spend time with our babies.”

While Jemimah speaks, a nurse attends to her babies, adjusting their tiny knitted hats more securely on their heads.

Jemimah’s eyes shine when she talks about her babies. “Our babies are growing well now; thanks to the new advice the doctors give us.”

In Gahini Hospital, two paediatric mentor-trainers from the United Kingdom are training Rwandan doctors and nurses to better care for newborn babies who are born premature. The Rwandan health professionals then pass this knowledge to their peers and to the mothers and fathers of these babies.