During the summer after my first year of medical school, I had the opportunity to visit one of Bangladesh's most sophisticated children's hospitals. I spoke with one of the pediatricians there and asked him why the hospital did not have a neonatal intensive care unit (NICU). He replied, "It is too expensive to save the lives of sick newborns. Our hospital can't afford the fancy technology that you have in the US."
This conversation in Bangladesh inspired me to explore whether it was actually true that saving newborn lives in poor settings was too expensive. This past year, I completed a Master of Public Health (MPH) at Harvard to pursue this passion of mine. During this year, I had the opportunity to attend a training session for Helping Babies Breathe, a newly created neonatal resuscitation training program designed by the American Academy of Pediatrics, USAID, Save the Children, NICHD, with input from the WHO.
HBB is an exciting, unique curriculum that is designed specifically for resource-limited settings and does not require fancy technology. In fact, the WHO estimates that one million babies die each year from birth asphyxia (inability to breathe immediately after delivery). Many newborn deaths from asphyxia can be prevented with simple, non-invasive interventions such as giving supplemental oxygen. HBB's curriculum is designed to prevent newborn deaths from asphyxia in the first few minutes of life.
A series of simple steps is mapped out in what is called The Golden Minute®--focusing on the assessment of every baby, temperature support, stimulation to breathe, and assisted ventilation as needed. The equipment needed is basic devices like a bag and mask, stethoscope, timer, gloves, cloth, a suction device, a hat for the baby, scissors and cord ties.
So, to respond to the Bangladeshi physician, based on research and a consensus around key interventions, I do think it is possible to save newborn lives almost anywhere-- not with fancy technologies, but with simple, affordable interventions such as Helping Babies Breathe. I will be teaching HBB to community health workers in Lesotho, Africa in the Spring and will let you know how it goes in a future blog post!
Jessica Shiffman just compelted a Master's Degree at the Harvard School of Public Health. She is also an MD candidate, Johns Hopkins School of Medicine, class of 2012