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Majority of newborns dies for lack of treatment facilities

NAIMUL HAQ
On June 6 Pinky gave birth to a male baby at her house in Narayanganj. As the baby appeared pale and had breathing difficulties, relatives rushed the newborn to a nearby private clinic called Life General Hospital.
But the clinic had no facilities to provide life support to a baby at such high-risk. The parents, determined to safe their baby, rushed to several hospitals throughout the night. At each, however, they encountered the same disturbing conclusion: no one could help them.
The baby, meanwhile, was in grave danger. It had been exposed to wind, fluctuating temperatures and dust, the most common factors that can instantly kill a newborn.
Finally, the couple landed at Dr Salahuddin Hospital in Dhanmondi, where the baby was immediately put in intensive care with a ventilator to enable breathing. It was a close call, doctors said.
"If the baby arrived ten minutes later he would probably have died. In fact, the infant may have already suffered damages to his brain and lungs," commented Dr Salahuddin, a pioneerin neonatal intensive care, or treatment for newborns born at risk.
Pinky's baby is lucky to have survived. But everyday the majority of babies born with a low birth weight and breathing difficulties die simply because there is not enough trained manpower and available equipment to support them.
Proper treatment of at risk babies can mean the difference between life and death. "The first ten minutes after birth of a baby is the most crucial period that calls for close supervision," described Dr Salahuddin, who has 22 years of experience in neonatal care and now runs the largest complete neonatal unitin the country.
He added, "The most common reason why newborns born to high risk pregnancies facelife threat or suffer and live with disabilities is after delivery the baby is not attended by a pediatrician, which is pre-requisite for every delivery. The second most common reason why babies face risks is that delivery wards are not attached with a neonatal unit."
Despite such urgency, there is no complete neonatal intensive care unit in any public hospital in the country. Instead, limited neonatal units are
scattered throughout public and semigovernment organisations, or available onlyin private hospitals.
When contacted, the Director General of Health Services, Dr Abdur Rahman Khan, said, "It is true that [intensive] healthcare for newborns is very scanty at government hospitals. In fact, the country has no recognised neonatologists or separate wards for the newborns."
Meanwhile, the total number of incubators and ventilators, the most essential devices required during emergency for newborns, are 47 and 20 respectively, all of them located in the capital.
Experts said this deficiency is a major factor behind the country's infant mortality rate (IMR), 42 deaths for every 1000 live births, considered one of the highest in the world.
Efforts to address the problem appear to be lacking. The government's Strategic Investment Plan (SIP), a healthcare vision for 2010, lacks a specific plan to address the high infant mortality rate, except for preventive measures.
Even United Nations agencies like Unicef and Unfpa, which have commit-
ted to provide technical support to reduce infant mortality, have no separate programmes for proving neonatal intensive care at public hospitals.
A concerned Unfpa official, Dr Jebunnessa, acknowledged the problem, and said, "Babies who face life risk are referred from all 64 Mother and Child Welfare Centres (MCWC) that we are supporting as part of Unfpa's technical assistance." Nonetheless, such babies must be referred to government hospitals, where the care they need is lacking.
The situation is likely to persist. As of now, there are no graduate neonatologists or newborn care specialists. Only a few such experts are in the pipeline, currently undertaking academic courses at Banghabandhu Sheikh Mujib Medical University (BSMMU) and BIRDEM.
Advanced neonatal care facilities exist largely in the capital, in a dozen or so private clinics and public or semigovernmentinstitutions.