Wednesday, April 28, 2010

Neonatal project

4/26/10

I have been negligent in my blogging duties. We have been very busy traveling, and I have been sick. I picked up a intestinal bug about 3 or 4 weeks ago. It got to the point where I was missing work so I finally relented and went to the doctor. He put me on a round of antibiotics and now I am better.
We had to travel north for an LDS Charities co-sponsored workshop for handicapped women and girls. Among other things they were taught to make handbags, baskets, boxes and many other things, even a casket, out of recycled plastic and paper. They cut the materials into strips and weave them into useful things after that they treat the surface with some time of acrylic or shellac. They turned out very nice.
Now our neonatal doctor and his wife are here from the USA and we are busy taking them around visiting hospitals, meeting doctors and planning for the training sessions in the fall for medical providers in neonatal resuscitation. We visited one maternity hospital called Fabella. It was in a very poor part of Manila serving woman with no means to pay for medical services. This visiting doctor had just come from Russia and said the Manila facility was below the Russian standard. The Fabella staff is incredible making do with what little they have. The building is old and in desperate need of repair. It is a 700 bed hospital but there are way more than 700 patients. They average around 108 births per day. There are huge wards with 6 rows of beds with 10 or 12 beds in each row. In each bed we saw there were 2 or 3 women, who layed with heads opposite and babies in between. The rooms were shabby, stifling hot but relatively clean. Low birth weight or babies who would need an incubator were held skin to skin kangaroo style against the mothers chest with an elastic tube top thing to keep them warm. Babies in the critical care unit were in a hot room with nurses monitoring them. They have only a few ventilators so nurses will use a manual ventilator squeezing a bag to keep the air going into babies lungs. We saw a nurse squeezing a bulb in each hand for two babies. They said they manually do this until the baby breathes on their own, dies, or a ventilator becomes available. It was so hard to see these tiny tiny babies knowing what a hard battle they have just to stay alive. There was a large open delivery room that contained about 15 delivery tables. When a woman is at 6 centimeters they let her into the hospital put her on a table and wait until she delivers. There is no privacy, no screens or curtains, the room is totally open, it is a teaching hospital so the walls are lined with chairs where students sit talking and watching. That room was like a nightmare to me, giving birth is such a personal thing, you don't want strangers looking on, or have a woman on each side of you in labor. Unless there is an emergency and a c section is needed there is no medication administered. If medication is needed the family must bring it into the hospital. Women are required to breast feed, and families are in charge of bringing in food for mom. With a normal delivery mom stays 24 hours. Family members must wait outside until the specific times for visiting. In the Philippines the majority of babies are born at home with use of a midwife, a traditional birth attendant with no formal training, or relative. If given the option of that hospital or the latter I would stay home. We took a few pictures and I am including these; a woman in the delivery room, two babies being ventilated, the intensive care unit, and a picture of a ward. If you are interested here is a link to more pictures from the internet. http://images.google.com.ph/images?hl=en&source=imghp&q=fabella+hospital%2C+philippines&btnG=Search+Images&gbv=2&aq=f&aqi=&aql=&oq=&gs_rfai=

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