Saving newborns lives on focus as  Bugando marks golden anniversary

Saving newborns lives on focus as Bugando marks golden anniversary

WHEN a newborn comes out with an intestine out, a problem specialty known as ‘gastroschisis’, the umbilical cord should be cut-off to an abnormal length of between eight to 10 centimeters, then immediately cover the infant in a plastic bag.

The bag should cover three quarters of the body from the legs, to keep the infant warm as well as protecting the intestine from harmful bacteria, health experts in the Pediatric Department of Bugando Zonal Referral Hospital said in the ongoing hospital’s 50th Anniversary celebrations, whose climax is 18th of this month.

Bugando is a medical facility owned by the Episcopal Conference of the Catholic Bishops of Tanzania in collaboration with the government through Ministry of Health, Community Development, Gender, the Elderly and Children.

According to experts, the newborn then should be put in clothes like any other newborn, with some respiratory organs, be it mouth, ear and nose being cleaned.

Next is inserting a NasalGastric Tube (NGT) to absorb what is called ‘gastric juices’, produced in stomach walls and pancreases, as well as preventing the newborn from vomiting, says Dr Kahabi William. Vomiting could lead to blockage of the infant’s trachea and cause the death.

“That is what we teach midwives in Lake Zone and direct them to immediately transfer the infant, after first aid, to Bugando, the only hospital offering services for gastroschisis complications, in the zone,” he says.

According to him, the services took-off in June this year, a step that saves lives of many infants who come out with gastroschisis, compared to the past where many passed away due to lack of medical equipment to fight the problem. It was due to expansiveness of the devices as a single ‘Sillo bag’ that is used for inserting back the intestine into an infant’s womb is sold at not less than 900,000/-, affirms Dr William.

Again, the bag should be accompanied by what is called ‘tegaderm film’, for covering the baby’s wound, after the intestine is taken back to proper place. All about immediate transfer is not only taking inside the intestine, but feeding the infant with special food through blood vessels as she/he is unable sacking the mother’s breast.

When sacking, he/she will vomit since the milk has nowhere to go. However, despite the presence of full medical treatments to infants suffering from gastroschisis, availability of such a special food is challenging, with only 0.5 milliliter being sold at between 150,000/- to 200,000/- , says Dr William.

Again, no matter the infant’s intake/portion (in line with his/her weight) the amount should be over within seven days, or discarded as after such a period the meal gets expired.

Dr William called up on producers and suppliers of such baby’s food to make it affordable so as to serve as every needy, with regard that Bugando receives between five to 10 victims on a monthly basis.

He further explains that many victims are from rural areas, whose parents are of limited financial resources, unable to afford the costs.

It might take some months for the intestine’ system to start operating because it spent a long time swaying in a mother’s womb (after failing to get to a normal place in time), hence, becoming weak. Usually, explains the expert, during human’ body parts’ composition/generation in the mother’s womb, an intestine comes first before the stomach’s walls.

The intestine is therefore to place itself somewhere for some time, waiting for composition of the stomach’s walls, and then get in its proper place. “Failure to get inside the stomach is an error occurring during the generation, and that is when gastroschisis complication comes in,” says Dr William.

In normal infant generation processes, according to him, all body parts should be in their places within 28 to 30 weeks.

The rest days before deliverance is purely for weight gain. Commenting on the causes of gastroschisis, another expert, Dr Nuri Aloyce said that findings all over the world are still in progress to identify the actual reasons. Some have associated the problem with poor nutrition to expectant mothers, but no finding results have proven, he says.

He affirms that what some experts in the Pediatric Department of Bugando have proven is that many victims are from rural areas, and more research on why only remote areas are under cause.

“Even the referrals we receive at Bugando are from hospitals in rural areas…no case has been recorded from urban areas if my memory serves me right,” he says.

Explaining the medical treatment procedures for gastroschisis problem, Dr Aloye says that the first step is collection of intestine to ‘sillo bag’ and slowly it back to the infant’s stomach. Once it is done, the umbilical cord is filling the remaining gap and (umbilical cord) is getting covered by Tegaderm film, for no less than 14 days.

“That is why we demand an eight to 10 centimeter umbilical cord. It serves in covering the whole remaining gap after we take the intestine back into the stomach. The short one (3 to 5 centimeter) also helps but will delay the wound recovery,” he says.

According to him, the function of the umbilical cord is to enhance the granulation tissues on the wound that propels quick recovery.

For immediate gastroschisis treatments, Dr Aloyce advises expectant mothers to conduct regular ultrasound tests, just to observe development of the infant in a mother’s womb. Once anything goes wrong, including the possibility of gastroschisis problem, a mother will be referred to advanced hospitals for timely medical services.

Dr Aloyce assures that the test has no negative impact to either (mother or infant), hence, one should have it as much as possible for the sake of monitoring the coming baby’s development. At the same time, expectant mothers should consider balancing meals, as poor nutrition is somehow associated with gastroschisis complications.

“But this is still an imagination. The ongoing findings will tell the truth,” he insists.

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