By Priscillar Nyamahunge
Masindi General Hospital, which has a capacity of 100 beds and attends to more than 100 patients daily in the Out patients’ department, has no “space” to accommodate only one incubator.
The incubator, which was supplied to the hospital more than one year ago, has been lying idle in the stores not that its use is not required, but health workers complain that they have nowhere to fix it such that it can be put to use. Masindi hospital has been undergoing renovation but a provision for the incubator was not even considered.
The hospital delivers about five mothers with premature babies at least in a month. Premature babies are those born before reaching the normal gestational age of 36 weeks.
However, most of the babies, who could have accessed services at the facility, are often referred to Masindi-Kitara Medical Centre, a private health facility about 2 kilometers from Masindi town, which has incubators in use.
According to a worker at Masindi-Kitara who preferred anonymity, premature babies who are born in a poor health condition are normally kept in an incubator for one or more months and a parent has to part with more than Shs.1million to have a baby kept in an incubator for about a month.
However, the bills vary from one health facility to another. Brenda Kyosaba, a 20-year old, gave birth to her twins at Masindi Hospital one and a half weeks ago.
The twins, who were born at about 27 weeks, are Kyosaba’s first children. A resident of Kabango village, Budongo Sub County, which is about 10k from Masindi town, Kyosaba used to go to Kinyara health center II to receive antenatal treatment.
She didn’t know she was carrying twins because she had not yet carried out an ultra-scan. The only information she had was that people told her she was carrying a big baby in the womb.
Kyosaba said that at only four months pregnancy, people thought she was already seven months. One and half weeks ago, Kyosaba started experiencing premature contractions. She was rushed to Masindi hospital at around midnight, only to receive information that she had to give birth.
She gave birth to her first baby normally but due to fatigue, Kyosaba’s second baby had to be born through Cesarean.
“It was such a horrible experience. After my first baby came out, I had a sign of relief because I thought I was through, only to be told by the midwife that I still had another in the womb. I got shocked and immediately lost my energy”, Kyosaba said.
Kyosaba, who gave birth on Friday, was kept at Masindi hospital for four days. The babies were however not put in incubator. Kyosaba and her caretakers were advised to completely cover the babies using bed sheets.
After four days at Masindi hospital, Kyosaba was referred to Masindi Kitara-Medical Centre for better management of the premature babies.
According to Dr. George Bateganya, the Masindi general Hospital Superintendent, Kyosaba’s babies would have a better care at Masindi-Kitara. Kyosaba’s caretakers at first hesitated because they were afraid of the medical bills at Masindi-Kitara. However, due to dire need for incubation service, they had to give in.
Kyosaba however said that the babies were kept in an incubator for only two days and later discharged because they were responding fairly to the environment.
Fridah Atuhairwe, the in charge Maternity ward, said they have no other option but to refer the parents to Masindi-Kitara.
“It is really absurd that a full hospital has only one incubator which again has no space where it can be put. The hospital receives about five premature babies a month and all we do is refer them to Masindi-Kitara Medical center since it’s the only facility which has the necessary equipment,” Atuhairwe said.
“All we tell the parents is that we need to save the babies. Therefore, they always have to find means of paying the bills,” Atuhairwe said.
Atuhairwe said that the premature babies stand a high risk of experiencing coldness which can easily turn into sickness thus posing a big risk to their lives.
“Some people lose their babies because they fail to ably take care of them. Keeping a baby in an incubator helps it to experience utmost warmth as though it were in its mother’s womb,” Atuhairwe said.
Dr. Cosmas Byaruhanga, the district chairperson Masindi said that premature babies are preferably supposed to be kept in an incubator because it is hard for them to adapt to the environment like maturely born babies.
He said that in case such a baby got affected by fever, it would be difficult to save it if it’s not kept in a worm environment. Byaruhanga said that one of the causes of a fever in premature babies is exposure to coldness.
According to Bateganya, a baby can only be kept in an incubator until it starts to normally regulate its temperature. Therefore, there is no specified time that a premature can be kept in an incubator.
For a peasant who cannot afford a million shillings or more, all they opt for are the natural methods of keeping the babies warm.
Justin Wembabazi, a resident of Kyakatabuka cell, Nyangahya division, said that they had premature babies in their neighborhood but parents were advised to use the Kangaroo method.
The Kangaroo method is where a mother ties the baby around her bosom tightly to help it absorb the warmth directly from her.
Susan Amukia, an elderly woman in Kijura cell, Central division, said that in deep villages, people always get two bottles with warm water and place them near the baby’s covers side by side such that they can pick the warmth.
According to one source in Masindi Hospital, there is another method called “the warm bottle” method but it requires technical skills to operate it since it requires someone to keep regulating the bottle’s temperature.
She said that parents are discouraged from using such a method for fear that they may fail to follow instructions.
When contacted, Dr. John Turyagaruka, the District Health Officer-Masindi said, “Some people produce from home. All they need to do is make sure that the mother keeps in contact with the baby to provide warmth, and always cover them fully with heavy and warm stuff to keep them very warm,”Turyagaruka advised.
According to Dr. John Turyagaruka, different factors cause the birth of premature babies. “Some people consume drugs while pregnant and they end up affecting the baby thus leading to premature births,”Turyagaruka said, adding that, “There are some cases in which pregnant mothers get stressed maybe because of sickness or other issues and once the mother is stressed, it may induce the baby to be born prematurely,” Turyagaruka added.
Other causes, according to Turyagaruka, include malnutrition among mothers, complications in the uterus, heightened sexual activity during pregnancy among others.
Most at risk
Turyagaruka said that premature births are common among teenagers. “When those girls get pregnant, most of them get psychological stress because they are not even ready to be mothers yet. Some can’t even support themselves in terms of proper feeding and they end up upholding the stress which may lead to premature births,” Turyagaruka said.
How to avoid giving birth to premature babies
Turyagaruka advised that women always need to maintain proper feeding, get pregnant only when ready, avoid the use of drugs during pregnancy and always visit health centers for reviews to avoid cases of illnesses that might affect the baby inside.
Acording to Turyagaruka, the main cause of premature births in Masindi is untreated malaria among pregnant mothers.
Michael Muddu, the Principal Medical Officer Masindi Municipal council said that sometimes, premature births sometimes vary basing on the cause.
He however said that they can be avoided if a woman always attains medical assistance through antenatal routines.