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Needs are many at UHWI's Special Care Nursery

BY KIMONE THOMPSON Associate editor — features thompsonk@jamaicaobserver.com

Thursday, January 23, 2014    

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THE University Hospital of the West Indies (UHWI) is the only health institution in Jamaica with an intensive care unit for premature babies and other critically ill newborns, but it is faced with a chronic shortage of life-saving equipment such as incubators and ventilators.

According to head of the Special Care Nursery at UHWI, consultant paediatrician Professor Minerva Thame, the shortage puts the infants at greater risk and impacts the infant mortality rate.

On the priority list, she said, are eight incubators — which stabilises the babies' temperature; six ventilators — which breathe for the babies until they can do so on their own; six vital sign monitors — to track their heart rate, blood pressure, etc; eight photo therapy lamps — used in the treatment of jaundice; four radiant warmers; and six infusion pumps — used to ensure that the correct amount of IV fluid is being delivered.

"We have more beds than we have ventilators for these (premature babies)", Dr Thame said of the facility's 30 beds, six of which are in the neonatal intensive care unit (NICU).

Of the pumps, she said at this week's Jamaica Observer Monday Exchange, "We have four now. Ideally we want 30, but we can start with six more, which will take us to 10."

"For us, (the need) is very critical because we're the only NICU in the island and we take babies from all over. If somebody calls and says we have a baby who needs a ventilator but we don't have a ventilator what do we do?" she asked rhetorically.

"That is the dilemma we face each and every day," she continued, adding that the hospital has had to turn some babies away as a result of the shortage.

Plugging the gap is one of the targets organisers of the Sagicor Sigma Corporate Run, a 5k event which started in 1999, have set for this year.

President and CEO of Sagicor Investments Jamaica Donovan Perkins, who was also a guest at the Exchange, said that they expect to raise at least $17 million from the 16th staging of the event next month. The proceeds will be divided among the Special Care Nursery, the Sickle Cell Unit at UHWI in conjunction with the Sickle Cell Trust in Mandeville, and Jamaica Kidney Kids Foundation.

Perkins was accompanied by president and CEO of Sagicor Group Jamaica Richard Byles, and assistant vice-president for group marketing Ingrid Card. Other attendees were Dr Maolynne Miller from Jamaica Kidney Kids Foundation, chairman of the Sickle Cell Trust Professor Graham Serjeant, and Dr Jennifer Knight-Madden, head of the Sickle Cell Unit in the Tropical Medicine Research Institute at UWI.

"This year we wanted to choose two charities, but when we looked at them it was very difficult," Perkins said.

The run is set for February 16 and already 22,000 persons have registered. Over the years the event has supported entities such as Sophie's Place & Mustard Seed Communities, Jamaica AIDS Support for Life, Chain of Hope Jamaica in support of the cardiac unit at the Bustamante Hospital for Children, Jamaica National Children's Home and Best Care Lodge Children's Home.

The Special Care Nursery at UHWI accepts infants as small as 500 grams or one pound. Currently, some equipment is shared between the nursery and the NICU, but that is not optimal as there is a risk of transferring illness.

Over the last seven years, the average neonatal mortality rate at the facility is 21 per 1,000 live births. That means that for every 1,000 children born, 21 have died in the special care nursery.

Having the critical pieces of equipment in the correct numbers could bring this number down, said Thame, who is also a professor in the Department of Obstetrics, Gynaecology and Child Health at the University of the West Indies, Mona.

"The infant mortality rate in Jamaica has remained relatively the same over the past couple of decades, but when we look at what is contributing to [it], it's really our perinatal mortality, with prematuring being the number one cause which is pushing up our infant mortality rates," she said.

"So, if we could sort of have better control or better care of our premature infants and certainly let them live, then we could decrease that infant mortality rate to more than it is today," she added.

Dr Thame said the nursery also needs a bilirubinometer to assess infants with jaundice, and a sterile lab to prepare intravenous nutrition for premature babies unable to feed on their own.

"Another major need which we must start to think more and more about is nutrition," she said. "We would like to give (premature babies) what we call total parenteral nutrition, but to make the solutions you need a special area in which to do so.

"We used to have the equipment in the pharmacy, but I think it's no longer there and therefore what we do is a sort of partial nutrition which is not good enough," she added.

In spite of the challenges, however, Thame said the facility "produced some good work" and that Sagicor's intervention will aid in the furtherance of that end.

"It's very heartbreaking sometimes to make a choice when you have one ventilator and you might have three infants, and for that reason we are overjoyed about this because at least we will be able to contribute to improving the equipment in the unit as we try to continue the work that we do," Dr Thame said.

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