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Afghanistan: “A newborn’s riskiest time of life is its first 24 hours”

27 Apr 2016

Since November 2014 Médecins Sans Frontières has been running a specialised maternity department in the Dasht-e-Barchi public district hospital in western Kabul, the capital of Afghanistan. In the newborn unit, the staff are dedicated to caring for premature and sick newborns in their early days of life.

A normal delivery in a private clinic in Kabul can cost up to US$70, while a caesarean section may total US$300 including the cost of hospitalisation--an often impossible financial burden to bear for most women and their families.  Offering medical services free of charge for mothers and babies, our service comprises a 30-bed maternity with a 20-bed newborn unit, including five beds dedicated to Kangaroo Mother Care, or “skin-to- skin.” Zabihullah Kassefee has been working for Médecins Sans Frontières for four years, and in the obstetric service in Dasht-e-Barchi hospital since its inception. As the nurse supervisor in the newborn unit, he explains the admission criteria. “Most of our babies who are admitted into the newborn unit are babies with birth asphyxia (loss of oxygen during delivery), low birth weight, those presenting signs of infection, babies with respiratory distress, and jaundice. We also admit babies with hypoglycaemia (low blood sugar) and hypothermia (low body temperature) for treatment as well as any other critical patients,” says Kassefee.

In Dasht-e-Barchi, the team is trained to provide the highest level of care to manage these complications and prevent potentially fatal outcomes. A newborn’s riskiest time of life is its first 24 hours, so timely care is invaluable to help them survive. In 2015, Médecins Sans Frontières’ doctors and midwives carried out 10,727 deliveries. When the project opened in November 2014, we expected to see an estimated 600 deliveries a month, but by the end of 2015 the number of had increased to approximately 1,200. Not surprisingly the flow-on effect is a newborn unit functioning at high capacity. Over 1,300 babies, sick or at risk of complications, were admitted last year. 

Fatima Nawrozi is a nurse, also working in our newborn unit in Dasht-e-Barchi. “I mainly look after babies that are at risk. Many of them need resuscitation. I help with giving them oxygen, and weigh them every morning. The most challenging cases are premature babies; they take a lot of time and observation. So too do babies with birth asphyxia, because they often have seizures and need to be treated for hypoglycaemia and given oxygen,” says Nawrozi.  “Every procedure we are doing we are discussing with the mother and explaining to them why we are doing certain things. When a baby is cured or a sick newborn is responding well to treatment that is very gratifying for us.”

“We have the trust among the community. They are sure that their babies will receive good quality care that is free of charge. We are neutral and have no borders, we provide the same care to everyone, whatever their economic background,” says Kassefee.