Rishard Khan

Re­porter

rishard.khan@guardian.co.tt

This coun­try’s first pri­vate­ly-run neona­tal in­ten­sive care unit (NICU) aims to sup­port the pub­lic sys­tem. Housed at San­ji­vani Women’s Hos­pi­tal in St Au­gus­tine, the Lev­el 2 NICU pro­vides care to “short-stay” ba­bies for four and five days.

Su­per­vis­ing neona­tol­o­gist Dr Mar­lon Tim­mothy said the fa­cil­i­ty will sup­ple­ment rather than com­pete with or re­place NICUs in the pub­lic health­care sys­tem.

As chair­man of the Na­tion­al Neona­tal Pro­gramme in T&T, Dr Tim­mothy has re­spon­si­bil­i­ty for the NICUs in the coun­try. He said there are five neona­tal units in the pub­lic health­care set­ting but giv­en the num­ber of ad­mis­sions to these units an­nu­al­ly, the ad­di­tion­al two spaces at San­ji­vani will ease some of the bur­den.

“Be­tween them we have about 30 ven­ti­la­tor beds. How­ev­er, we have about 1,500 neona­tal ad­mis­sions per year in the coun­try, so of­ten times you find that those ven­ti­la­tor beds run out very quick­ly or we have to be jug­gling some kids off of vents, some kids on a vent etcetera,” he said.

“When you get a call from a pri­vate hos­pi­tal where a de­liv­ery just hap­pened and there’s nowhere to put that ba­by, some­times you have to re­al­ly jug­gle in be­tween or make up some­thing to try and help and we no longer have to do that. We can ac­tu­al­ly add or just bring that ba­by here and that ba­by can re­ceive care. So, it’s ac­tu­al­ly re­al­ly im­por­tant to add two ven­ti­la­tor beds.”

The high­est lev­el of care, Lev­el 3 NICUs, are lo­cat­ed at the Port-of-Spain Gen­er­al Hos­pi­tal, Mt Hope Women’s Hos­pi­tal, and San Fer­nan­do Gen­er­al Hos­pi­tal. There are Lev­el 2 NICUs at the San­gre Grande Hos­pi­tal and in To­ba­go.

Health­care pro­fes­sion­als be­lieve hav­ing the ad­di­tion­al fa­cil­i­ty will ben­e­fit prac­ti­tion­ers and, most im­por­tant­ly, the pa­tients.

Sec­re­tary of the Pae­di­atric So­ci­ety and con­sul­tant in the neona­tal unit at Mt Hope Dr Maria­ma Al­leyne said of­ten when a new­born needs to be trans­ferred to a pub­lic NICU af­ter be­ing born at a pri­vate fa­cil­i­ty, the moth­er is not ad­mit­ted with them.

“De­pend­ing on mom­my’s con­di­tion, mom­my may not be able to see her ba­by for days on end. Now this is go­ing to in­crease mom­my’s stress, this is go­ing to in­crease her anx­i­ety and we know if mom­my is not well, the whole fam­i­ly is af­fect­ed,” she said.

“When mom­my is anx­ious and stressed, she doesn’t pro­duce breast milk well so all of that not on­ly af­fects her and the fam­i­ly but it ul­ti­mate­ly af­fects the ba­by. It af­fects the bond­ing. This time that is sup­posed to be your ex­cit­ing time, you’re ex­pect­ing this bun­dle of joy, and now its the most stress­ful time in your life. Hav­ing your ba­by ad­mit­ted to the NICU, I al­ways tell my par­ents, is the most stress­ful ex­pe­ri­ence, so imag­ine hav­ing your ba­by ad­mit­ted to a NICU in an in­sti­tu­tion you are very far re­moved from.”

Ob­ste­tri­cian and gy­nae­col­o­gist Dr Mary Singh-Bho­la said a NICU in the pri­vate sec­tor al­lows doc­tors to con­tin­ue on the birth jour­ney with their pa­tients in­stead of hav­ing to hand them over to the pub­lic sys­tem.

Those are the rea­sons why Joan­na James wished it was an op­tion avail­able when she gave birth four years ago and her twins were ad­mit­ted to a NICU in the pub­lic sec­tor.

“When I was 30 weeks (preg­nant) . . . .my doc­tor was telling me that I’d have to go to the pub­lic sec­tor to be able to se­cure a bed be­cause if you’re not in the clin­ics you can’t get a bed for the kids and I was hav­ing some dif­fi­cul­ty. That de­ci­sion to move from my pri­vate doc­tor to the pub­lic sec­tor was so scary,” she said.

James said even af­ter her son and daugh­ter were born with a com­bined weight of five pounds, it was dif­fi­cult to get space for them in the NICU, de­lay­ing their ad­mis­sion by two days. She said it was two weeks be­fore she could hold her son and a month be­fore she could do the same for her daugh­ter.

“We could on­ly go there and vis­it and it was un­der strict pro­to­cols. You couldn’t go through the glass and hold them. So some­thing like this . . . I wish they had it four years ago. I think it’s a great ser­vice to moth­ers be­cause that time away from your child, it’s very dif­fi­cult,” she said.

Clin­i­cal di­rec­tor at San­ji­vani, Dr Prakash­ban Per­sad. it was be­cause of such ex­pe­ri­ences that they de­cid­ed to open the unit.

“Very of­ten when we have to trans­fer pa­tients to the pub­lic sec­tor, it’s not on­ly al­most trau­mat­ic for doc­tor and pa­tient and in­con­ve­nient but we of­ten feel we lose con­trol of our pa­tients. They go to (the) pub­lic sec­tor and they call­ing us five times for the day (say­ing) they’re not hap­py with what’s hap­pen­ing and can they can come back,” he said.

“We say you can come back and look af­ter you, we’d look af­ter the mom, but what hap­pens if your ba­by is de­liv­ered? And that’s why you’re sent to the pub­lic sec­tor. Be­cause of that, we felt if we have our own NICU, then we don’t have to put our pa­tients through that trau­ma.”