African Woman and Child Feature Service

Nurses at Pumwani Maternity Hospital are putting more than four immaturely born babies in one incubator as they struggle to utilize the few incubators available to save babies lives.

Under an ideal situation, one incubator is meant for only one baby. However, the facility can hold utmost two babies if each one of them weighs less than one kilogram.

The situation at Pumwani hospital is different. With only 10 incubators instead of the 60 required to comfortably handle the workload at the hospital, nurses are forced to put up to five or six babies in one incubator.

This is making it very difficult for nurses to regulate the incubator temperature and endangers the babies by increasing the chances of cross-infection.

“We have to ensure the babies are on good antibiotics to prevent one infecting the other. It is a nightmare, but we have to save lives,” said a nurse at the hospital who sought anonymity due to the sensitivity of the matter.

Baby incubator is equipment that tries to simulate the conditions of mother’s womb and is used to help premature babies gain strength. A quality incubator costs about Sh 2.5 million.

Due to the inadequate incubators, another nurse at the hospital said they are sometimes forced to remove premature babies who have stabilised from the incubators to create space for those who are very sick. The babies removed from the incubator are placed in cottages in a room that is kept warm with temperatures of about 38 degrees centigrade.

Ordinarily, an immature baby spends a minimum of one month in an incubator before they can safely survive outside such environments.

“Sometimes things have to be done “jua kali” here to manage the situation,” said the nurse. In one day, between 50 and 100 babies are delivered at the hospital. A fraction of this will be premature.

“Many babies here survive by the grace of God,” the nurse added. Indeed it is by the grace of God if a person considers the many essential services lacking at the hospital. The hospital has no high dependence unit to cater for emergency cases. Those mothers or babies needing these services have to be rushed to Kenyatta National Hospital (KNH).

The nurses complained that the X-ray unit has no facilities such as ultrasound, which are critical in a hospital of this nature. In regard to expectant women, an ultrasound machine is used by doctors to check the baby’s position in the uterus, and the proper development of organs and brain of the baby while in the womb. Hence, the findings of the ultrasound help doctors to pre-empt certain complications and maternal and child deaths before they occur.

When confronted with complications or cases requiring these services, the hospital refers them to KNH to take over the management.

Even after being transferred, the mothers do not find it rosy at KNH, if the findings of the Task Force Report, Services at Puwani Maternity Hospital under the Nairobi City Council, 2011, are anything to go by.

The report laments that while Kenyatta National Hospital receives patients from Pumwani, the former gives priority to its booked patients rather than on the basis of the patient’s condition, leading to deaths of mothers referred from Pumwani.

Those babies or mothers who need blood transfusion do not find it easy either due to erratic and inadequate supplies from the National Blood Transfusion centre. Sources at the hospital said while they need about 100 units of blood every week, the centre gives less than a half of that.

“Hospitals like ours need constant supply of blood due to the nature of clients we deal with, and hence the chances of losing a mother or baby are high if the blood is not readily available,” says a nurse at the hospital.

Difficulties in getting safe blood made the hospital to start sourcing it from a private health facility at cost of Sh 2,000 for one unit, a cost that is passed to poor patients. The Task Force Report, Services at Puwani Maternity Hospital under the Nairobi City Council, 2011, says this is not desirable since the hospital can get free blood from the National Blood Transfusion Services.

Says the Task Force report: “Quality of blood supplied and used in the hospital is therefore not certifiable as AHSL is not accredited to offer such services.” The hospital staff now wants a Blood Transfusion Centre established within the facility to help cope with the high blood demand.

Lack of these basic and essential services does not augur well for a level V hospital, an equivalent of a Provincial General Hospital that is supposed to have these facilities.