WORLD PREMATURITY DAY: SHARING OUR KNOWLEDGE GLOBALLY

BY DEBBIE LESTER, CLINICAL PROGRAMMES AND USA COUNTRY DIRECTOR

A few short weeks ago I experienced one of the most inspirational two days of my professional career. Adara stood with our dedicated partners at Kiwoko Hospital, PATH, Seattle Children’s Hospital, University of Washington and through the Saving Lives at Birth initiative held our first workshop for newborn healthcare providers from across Africa. Held at Kiwoko Hospital, the workshop saw 60 clinicians come together to deliberate and share experiences on the usage of a device called Bubble Continuous Positive Airway Pressure (bCPAP).

Pre-term infants are often lacking a vital coating in their lung called surfactant. Surfactant is necessary to keep the tiny air sacs inflated and decrease work of breathing. Without enough surfactant, the lungs collapse and each breath requires tremendous work. Without another form of respiratory support, eventually their little body tires and they cannot maintain adequate respiratory status. CPAP is a device that uses continuous mild air pressure to keep an infant’s airway open therefore decreasing the work of breathing until the infant produces enough surfactant. It is used to treat pre-term infants with immature lung development and babies who are in respiratory distress.

We had spent many months working to pull this workshop together and many times we always made sure to ask ourselves, would this type of forum be useful, to bring clinicians from around the world together in one place to discuss Bubble CPAP and its use in resource limited settings to save newborn lives?

When Adara first started on this journey in sub Saharan Africa some 18 years ago, newborn health was not seen as a global health crisis and subsequently there were no other programs to emulate. Luckily with the evolution of the Millennium Development Goals the world’s global health priorities shifted and it was recognised that in order to affect change in childhood mortality, the 24-48 hours around the birth of a child is the most critical time in their life. We also know that globally, prematurity is the leading cause of death in children under 5. Sub Saharan Africa accounts for 60% of pre-term births worldwide.

As the MDG’s come to a close at the end of 2015, there is still a long way to go to ensure access of health to our most vulnerable people.

At our workshop, plastic bottles filled with water, medical grade tubes flowing from their top, connecting to what looked like plastic baby dolls were scattered around the room. If you walked around, you may have heard doctors and nurses from as far and wide as Nigeria or Thailand speaking about things like ‘nasal cannulas’, oxygen delivery, pressure and bubble CPAP.

I was so incredibly moved to witness the extreme dedication of clinicians from all over the world sharing ideas, validating the challenges, brainstorming the way forward and best of all, creating a network of new friendships and professional support all working towards a common goal.

What I saw as I looked around at the engaged faces of more than 60 newborn health professionals from across the world, was the coming together of many years of hard work and incredible partnership, and the next big step in Adara’s journey to share and reciprocate knowledge with a new network of people dedicated to saving newborn lives.

The workshop gave PATH and our teams the opportunity to demonstrate and receive valuable feedback on an air and oxygen blending device they have developed for implementation with bubble CPAP. Many hospitals in resource limited settings are using CPAP that can only provide the necessary therapy to the infant using 100% oxygen. Although this is effective and lifesaving, oxygen only CPAP can damage the small and immature vessels in an infant’s eyes, and could even cause blindness. Availability to blend air and oxygen with a easy to use, adaptable and low cost device can perfect bCPAP therapy and decreasing the morbidity of infants worldwide utilizing this treatment.

On what is the eve of World Prematurity Day we celebrate the advances in saving pre-term infants across the world and we will continue to move towards our goal in that access to health care is a basic human right and that every birth has a skilled attendant present. With the announcement of the new Global Goals just a few weeks ago, particularly the audacious target of ending all preventable deaths of newborns by 2030, it has been heart-warming to see emails flowing in over the past weeks from participants from the workshop who are already establishing plans to roll out bubble CPAP in their own hospitals and across their home countries. Complications of prematurity are still responsible for the death of approximately one million babies per year, and respiratory distress syndrome is also associated with a high rate of morbidity. Interventions, such as CPAP could play a big role in helping reduce those statistics, save more newborn lives, and help us achieve the Global Goals.

The workshop “Expanding the reach of bubble CPAP devices” was co-hosted by Kiwoko Hospital, the Adara Group, Seattle Children’s Hospital and PATH.

It was funded through the Saving Lives at Birth partners, including the United States Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the UK Government. We are so grateful for the support.

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