Sylivia Kaindoa: A superhero in a scrub
Apart from looking after patients as a Reproductive and Child Health (RCH) in-charge at Mugana Hospital, Sylivia Kaindoa, 38-year-old nurse, is taking care of an abandoned child (Renata) whose mother died shortly after giving birth when she was eight months pregnant.
Ms Kaindoa, who is a resident of Mugana, a small town in Kagera and mother of two narrates to Your Health that Renata, who is now 11-months-old, was born premature, weighing 1.8kgs.
A birthweight less than 2,500 grams (5 pounds, 8 ounces) is diagnosed as low birthweight. Babies weighing less than 1,500 grams (3 pounds, 5 ounces) at birth are considered very low birthweight.
Ms Kaindoa further recalls that Renata was brought to Kangaroo Mother Care (KMC) centre at the hospital while she was 1 day old for further neonatal intensive care in 2018.
“Renata’s mother gave birth at home and died due to severe bleeding,” Ms Kaindoa tells Your Health.
Adding, “Renata was brought here at the KMC centre by her father who introduced himself as Richard (36) from Bugorora village.”
At the age of 2 weeks, Renata was abandoned by her own father at the hospital due to her preterm condition, since then Ms Kaindoa has been taking care of her like she is her own.
“Her father told us that he was going back to the village to meet his relatives and promised that he would come back after a couple of days but since then, he didn’t,” says Ms Kaindoa.
According to Ms Kaindoa, Renata is the sixth child in the family, also citing that her mother’s death was maybe caused by poor family planning. “Imagine at such a young age, she already gave birth to five children. I suspect her death is associated with poor family planning,” Ms Kaindoa tells Your Health during a recent visit to the hospital.
Ms Kaindoa is among the health professionals in the region who were trained and equipped with modern health methodologies under the $32 million Maternal and Child Survival Programme (MCSP) implemented by Jhpiego funded by the USAID.
After Renata turned one month and two weeks old, she was shifted from the neonatal intensive care unit (NICU) to a normal hospital ward for further specialised care, by the time she weighed 2.5kgs.
It is after this that premature babies start gaining weight. They gain around 112-200 grams every week, and this continues until they turn 4-months-old. The weight gain in the case of premature babies is usually lesser. Tiny infants gain as low as 5g each day while this goes up to 20g each day for large preemies.
Referring to the daily expenses that she incurs to make sure that Renata has access to basic needs like food and clothes, Ms Kaindoa tells Your Health that she spends at least Sh15,000 per day to cover the daily costs for food and pampers.
“Some of the money is used to cover other expenses for laundry and clothes. But sometimes good Samaritans donate clothes for her,” says Ms Kaindoa.
At present, Renata weighs 8.7kgs and she lives at the hospital building.
“When I am off duty, other registered nurses at the hospital are taking care of her. She has become one of the hospital staffs, everyone is happy to have her for many years to come,” says Ms Kaindoa.
Adding, “She will grow up here and maybe she will become one of us (nurses) because she spends time with us from morning till night daily. I am sure she will like to become a nurse when she grows up.”
Referring to the rapid increase of premature babies in the country, Ms Kaindoa revealed that the hospital has so far received over 150 premature babies since the establishment of the KMC centre at the hospital.
Referring to the positive impacts of the MCSP project, Ms Kaindoa further highlighted that the number of deaths in preterm babies has now declined in the region.
The MCSP Project Director, John George, says the establishment of the centres has helped the health professionals in the region to attend and reduce deaths of preterm babies.
“At least 1000 premature babies are now attended in the hospitals compared to 500 attended previously,” Mr George tells Your Health.
According to Ms Kaindoa, in 2018, at least 70 premature babies were born at Mugana hospital, citing that only 2 didn’t survive. The KMC centre at Mugana Hospital is among the 25 newly constructed centres funded by Jhpiego under MCSP project aimed at addressing maternal deaths in the Mara and Kagera regions.
According to the recent statistics availed by the World Health Organisation (WHO) indicated that every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.
Globally, prematurity is the leading cause of death in children under the age of 5 years. And in almost all countries with reliable data, preterm birth rates are increasing.
Inequalities in survival rates around the world are stark. In low-income settings, half of the babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all of these babies survive. Suboptimal use of technology in middle-income settings is causing an increased burden of disability among preterm babies who survive the neonatal period.
The solution
More than three quarters of premature babies can be saved with feasible, cost-effective care, such as essential care during childbirth and in the postnatal period for every mother and baby, provision of antenatal steroid injections (given to pregnant women at risk of preterm labour and under set criteria to strengthen the babies’ lungs), kangaroo mother care (the baby is carried by the mother with skin-to-skin contact and frequent breastfeeding) and antibiotics to treat newborn infections.
The WHO’s antenatal care guidelines include key interventions to help prevent preterm birth, such as counselling on healthy diet and optimal nutrition, and tobacco and substance use; foetal measurements including use of ultrasound to help determine gestational age and detect multiple pregnancies; and a minimum of 8 contacts with health professionals throughout pregnancy to identify and manage other risk factors, such as infections. Better access to contraceptives and increased empowerment could also help reduce preterm births.
