HANDS for Babies: June 2013 Update


by Mesfin Woldesenbet, President and Founder
Horn of Africa Neonatal Development Services, Inc. (HANDS for Babies)

The HANDS team is pleased to report some noteworthy accomplishments since our March news update!

IKARIA Grant Funds April Travels to Ethiopia

IKARIA inc., the company who is responsible for providing inhaled Nitric Oxide to our sick babies, awarded us a generous grant that will fund our medical team’s travel expenses to Ethiopia in June 2013. HANDS is very grateful to IKARIA for its financial support.

Ethiopian Airlines and Boeing Deliver Medical Supplies, Equipment to Jimma

Neonatal supplies and equipment shipment to Jimma

Figure 1 — First Jimma Shipment


Our first major shipment (Figure 1) was delivered to Ethiopia through the collaborative efforts of Ethiopian Airlines and The Boeing Company. The shipment cleared customs and reached Jimma in time for the HANDS team’s visit to Jimma University Hospital. HANDS sincerely appreciates the Ethiopian Airlines’ and the Boeing Company’s assistance in transporting these much-needed supplies and equipment to Ethiopia and ensuring their timely arrival.

Three Neonatal Specialists Travel to Jimma in April

Neonatal Specialists at Jimma University Hospital

Figure 2
HANDS for Babies neonatal specialists
Raymond, Cassandra, Mesfin

On April 11, 2013, a team of neonatal specialists including a neonatologist (Dr. Mesfin Woldesenbet), a neonatal nurse (Cassandra West) and a neonatal respiratory therapist (Raymond Laberge) travelled to Jimma, a city located in the southwestern region of Ethiopia (Figure 2).

During our stay, we delivered our first major shipment of medical supplies and equipment, including Masimo pulse oximeters and Teleflex Bubble CPAP sets, to Dr. Netsanet Workneh, head of the Pediatrics Department at Jimma Hospital. (Figures 3a and 3b.)



Figure 3a
Dr. Mesfin Woldesenbet (R.) delivers oximeter to Jimma University hospital neonatal ICU

Teleflex Bubble CPAP set delivery to Jimma University Hospital

Figure 3b
Teleflex Bubble CPAP set delivery




 

Bedside Training Provided

We provided bedside training to pediatrics residents, interns and nurses on how to use the donated equipment. (Figures 4a and 4b)

Bedside Training Pulse Oximeter

Figure 4a
Bedside Training

Practicing CPR on Baby Mankin

Figure 4b
CPR Training with Baby Mankin




 

Just one year ago, this unit had very sick babies with no cardio-respiratory monitor, pulse oximeter nor adequate respiratory support (Figure 5). Babies from different parents had to be managed on the same bench, exposing them to cross infection.

Babies sharing bench at Jimma University Hospital

Figure 5:
Sick babies sharing bench

Thanks to the local medical professionals at Jimma Hospital, each baby now has its own separate crib. Furthermore, HANDS was able to deliver valuable neonatal equipment that was generously donated by multiple organizations and individuals.

Now, for the first time ever, Jimma University Hospital’s neonatal unit can monitor all infants in the neonatal ICU using Radical 7 pulse oximeters (Figure 6).


Jimma University Hospital Neonatal ICU unit equipped with Radical 7 pulse oximeters

Figure 6: Neonatal ICU unit equipped with Radical 7 pulse oximeters



We were also able to provide adequate breathing support to those who needed it (Figure 7).

Ethiopian baby on breathing support

Figure 7: Baby on Breathing Support

Many Babies’ Lives Were Saved Through Our Joint Efforts

The timing of these pulse oximeter deliveries was perfect. The team who travelled to Jimma was able to resuscitate infants who would have had little or no chance of surviving otherwise.

“Baby M” is just one of many babies whose lives were saved through our teamwork. He was a 7-day-old baby, born at 32 weeks gestation. He had been being managed since birth in the NICU at Jimma Hospital, when he developed signs of overwhelming infection. “Baby M” looked sick and lethargic, but the hospital staff had no way of monitoring his vital signs continuously and no way of knowing his oxygen saturation (i.e. the amount of oxygen in the infant), as there were no monitors in the neonatal unit. The best they could do was to monitor Baby M’s breathing rate and heart rate manually, every few hours.

Masimo’s Pulse Oximeter Saves Infant Lives. The HANDS travelling team from the USA happened to be at the hospital the following day, and Baby M. was put on the pulse oximeter that was donated by Masimo. To everybody surprise, the infant’s saturation of arterial oxygen (SpO2), read by the Masimo pulse oximeter, was showing mostly 75-85% in nasal cannula oxygen (normal SpO2 > 93%). Within an hour of attaching the pulse oximeter, the infant deteriorated with his heart rate (HR) down to the 30’s (normal heart rate is >100/min), SpO2 in the 40’s and no breathing rate (BR) to record. The USA team used this opportunity to involve and guide the local medical professionals on how to provide full cardio-pulmonary resuscitation (CPR). After 26 minutes of full CPR, using T-piece resuscitation equipment (purchased from Mercury Medical) and chest compression, the team was able to resuscitate Baby M. He started to breathe and was put on bubble CPAP (donated by Teleflex). During this resuscitation process, Cassandra, our travelling neonatal nurse, was continuously updating the team on the infant’s HR and SpO2 from the Masimo pulse oximeter reading. This helped the team to decide on the appropriate CPR procedure to be provided to the infant. See Video.

The availability of the pulse oximeter monitors now makes it possible for Jimma hospital staff to identify infants with Apnea (cessation of breathing) and Bradycardia (low heart rate) and manage them with simple and gentle stimulations. Were it not for the Masimo pulse oximeter monitors, many of these infants would have been found dead in their cribs, as vital signs were only taken manually at a certain time of the day.

After extensive bedside and classroom teaching, the local health professionals were able to set up all the donated equipment on their own and use it to manage sick infants, without the oversight of the HANDS team from the USA. It was a very rewarding thing to observe.

The travelling HANDS team from the USA witnessed many lives that were saved during our brief visit. More infant lives continue to be saved as a result of our team contributions. We are deeply grateful for the generosity extended by companies like Masimo and Teleflex in supplying essential equipment, as well as the professional contributions of the staff of Memorial Hermann Southwest neonatal ICU and other individuals.

The HANDS team from USA has learned that there is much that remains to be done to improve the survival rate of these precious babies. There is still a dire need for monitoring devices, respiratory equipment and laboratory facilities. We also need ongoing funding to pay the travel expenses of our volunteer neonatal specialists, who are willing and ready to travel to Jimma.

Lastly, we applaud and congratulate the local Ethiopian medical professionals including the medical staff, nurses, residents and students and the health administration staff of Jimma University Hospital and Ministry of Health, for their ongoing efforts and commitment to improve neonatal care in Ethiopia. The HANDS team is also very grateful for their hospitality.

With deepest gratitude,

Mesfin Woldesenbet, MD

Founder and President of HANDS

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