World Prematurity Day
This World Prematurity Day, FAME highlights its Special Care Nursery (SCN), which offers advanced care to premature babies and their families. FAME’s capacity in preterm care has expanded to enable admitting infants as young as the gestational age of 27 weeks with good health outcomes. In 2021, FAME treated 24 preemies; to date this year, we have already treated 33 preemies, a 37% increase from last year, and we expect that number to continue to increase as we come to the end of the year.
The burden and challenges of preterm birth in low-resource areas such as rural Tanzania are enormous because of the complexities of caring for these vulnerable infants and preventing complications. This is why we are excited that this year, FAME’s SCN was fortunate to receive a donation of phototherapy units used for treating neonatal jaundice, which has been instrumental in reducing the number of referrals of babies with newborn jaundice. In 2021 FAME referred at least two jaundiced babies every month to other hospitals but this year, we have successfully treated 40 children with jaundice at FAME, thanks to the new phototherapy units.
The following are stories from mothers with preterm infants admitted to FAME’s SCN. At different stages of preterm birth, we meet Naserian, born extremely preterm at 27 weeks, George, very preterm at 28 weeks and Bernard, born moderate preterm at 32 weeks. These stories of resilience, hope and faith demonstrate how important FAME’s SCN is in our catchment area.
Naserian: Extremely preterm (born at 27 weeks [estimated])
Naserian’s mother holds her little girl.
When Naserian’s* mother was five months pregnant, she began to feel ill. She thought it was normal abdominal pregnancy pains, but as the weeks went by, her condition became worse. She was six months pregnant when she went into labor. She had contractions, vomiting and her water broke. Her children ran to call the traditional birth attendant (TBA) who lived nearby, as Naserian had planned for home delivery. The TBA confirmed that she was in labor and that the baby was coming any minute.
“When the baby was born, she was abnormally small. I could see the birth attendant’s face was shocked and scared. She advised my husband and me to visit a local clinic. I had given birth to three healthy full-term babies at home, so this was all very confusing!”
At the local clinic, the doctor asked them to look for a bigger hospital, as the baby needed specialized care that he could not provide. Determined to save their child, the family got a neighbor to drive them to the hospital; he knew about FAME and that it was the closest “big” hospital, so he drove them 30 miles to get there.
Once at FAME, they were received and the baby was rushed to the SCN. The mother did not know the child's gestational age, but the doctors estimated it to be 27 weeks. The baby weighed 2 lbs.
Naserian
“I am so grateful that FAME helped me. By the time we got here, I was already preparing for the worst. But the doctors and nurses have been so good at caring for her and she’s getting better. I have been here 12 days already and I can see some improvement. She’s 2.5 lbs today. I’m very hopeful. FAME also takes great care of me. They bring me a lot of good food every day. I can’t finish it all and I wish my other kids were here to eat the rest!”
George: Very preterm (born at 28 weeks)
Leah holding her son, George.
George’s* mother, Leah, was only 28 weeks pregnant when she went into labor. She owned a busy restaurant and had no time to attend prenatal classes since she got pregnant. This was her fourth pregnancy and because the previous pregnancies were uneventful, resulting in healthy children born to term, she thought this would be the same.
“I was in my restaurant when it happened. My water broke, and it was a lot of water! Then the blood came. One of my employees rushed home to call my husband, who brought me to FAME in his car. I was crying the whole way. I thought this would not have happened if I had just attended the prenatal classes. I felt very guilty. I felt like I had killed my child.”
Leah’s son, George, was born naturally at 28 weeks, weighing 1.9 lbs.
George
“He was so small! The doctors encouraged me to be positive, and they took him to the special care nursery. We stayed at this hospital for 29 days before I could take him home.”
George was 2.7 lbs when he went home. The doctors and nurses taught Leah how to feed and clean her son, who was still quite small.
“When I came home, because of the support and information I had received at FAME, I was able to care for the baby. So far, he is doing well. He suffers from stomach issues sometimes, but we have made good progress; he's 3 lbs today! He is always on my chest feeding or sleeping, and I have had to close my restaurant to take care of him. I guess I could hire someone to run it on my behalf, but that would divide my attention and I want to give my son my full attention. I cannot let him down again.”
Bernard: Moderate Preterm (born at 32 weeks)
Bernard in a neonatal incubator with a phototherapy lamp at FAME’s SCN.
We meet Bernard's* mum, Linda, in the SCN at FAME’s maternity ward. She is 20 years old and this is her first child. Linda lives in Morogoro, 390 miles from FAME. Her mother, who lives in Karatu, fell ill and asked Linda to come to help her around the house until she was strong enough to do her daily chores. Linda took a bus and came to Karatu. When she arrived in Karatu 12 hours later, she felt extremely sick. She was 32 weeks pregnant.
“Immediately, I got to my mother's house; I knew something was wrong. My stomach hurt in a way it has never hurt before. My mother asked me to rest since I had been on a long bus journey. I went to bed, but that's when the bleeding started. Despite this being my first pregnancy, I knew something was wrong. I was worried since I had done all my prenatal classes in Morogoro and my doctor was there. I didn't know what to do. My mum got very scared and called my uncle, who works at a hospital and asked him if his hospital could help. The hospital turned out to be FAME.”
At this point, Linda was experiencing contractions. Her mother got a taxi that brought them to FAME. Once at FAME, she was taken to the labor ward, where she delivered her baby naturally and he was sent to the SCN. He was born prematurely at 32 weeks, weighing 3.5 lbs.
“I cried a lot. I thought my baby was dead because he was so small! The doctors were nice to me and explained everything. They told me that some babies are born younger than my son and they survive! I couldn’t believe it!”
After 16 days at FAME, Bernard is ready to go home with his mum. His weight has increased by 0.2 lbs and Linda is happy. Every little gain counts.
“I’m very happy that FAME has saved my child’s life. Every day I hold him close to my chest for hours [kangaroo care]; other times, he’s in this box with the light [Neonatal incubator with phototherapy lamp] that you can see. Take a picture of him; I want to show him how small he was when he’s older because I know he won’t believe me when I tell him.”
FAME staff at the neonatal conference. From Left: Jacob Ignatus, Nurse, Martha Jerome, Nurse, Dr. Joselina Mumbee, Catherine Duwe, Nurse and Dr. Ken Karanja.
On top of quality essential equipment, FAME continues to invest heavily in its staff and ensure they are up to date on any developments in the neonatal world. Last month, two doctors and three nurses from FAME participated in a neonatal conference called “Tiny Feet, Big Steps” in Arusha. The five-day conference was sponsored by Arusha Lutheran Medical Center (ALMC) and covered topics such as thermoregulation, neurodevelopment care in NICU and apnea of prematurity, among others. This training helped improve their knowledge, skills, motivation and capacity to care for the preterm infants that pass through our doors.
*While the patients’ names have been changed to protect privacy, permission was secured to share their photos and story with FAME supporters and to raise awareness of available medical care at FAME Medical.