Infant mortality rate a national embarrassment

Aug 24, 2015 Letters

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Dear Editor,
As a member of the health profession I share the deep concern expressed by the Public Health Minister, Mr. George Norton regarding the infant mortality rate at the Georgetown Public Hospital. – 160 infant deaths in five months last year, and the fact that the situation was worsening- Kaieteur News, August 23, 2015. According to the World Health Organization, the death of a baby before his or her first birthday is called infant mortality.
The infant mortality rate is an estimate of the number of infant deaths for every 1,000 live births. The most profound loss that a parent can experience is that of the loss of a child, which then leads to my asking the foremost question, as to why were alternative measures not put in place, seeing that as outlined by the Minister,  the environment lacked trained and qualified nursing and medical personnel, equipment , medical supplies etc. All the trappings were in place for a tragedy to occur and to continue.
Hence, the alarm should have been sounded much earlier, as now too late, too late, is certainly not appropriate.  To coin an old Guyanese phrase, “Post- mortem can’t bring back dead.  In addition let’s stop blaming who we can, and proceed in the name of progress with a new game plan.
Bluntly put, the number 160 is 160 deaths too many, as even after a maximum of less than a dozen deaths professionals and medico legal personnel should have commenced comprehensive infant death investigations forthwith, not to mention  the institution of  a surveillance system to monitor deaths and associated characteristics,  and implementation of a special registry.
Methinks there was certainly something fishy in the state of Denmark. According to Dr. Norton in the majority of cases the infants died from sepsis, although his source of diagnosis or arrival at such a conclusion was not stated.  Has anything been learned by careful review and analysis of what went wrong in 2014 regarding the care of those mothers and infants who would have been alive today?
Seemingly nothing has been done or learned since the recently completed WHO global classification report classified Guyana as the only Caricom country including Haiti that has shown No Progress.
Should medical and nursing staff also be held accountable for this sad continuing saga?  Were nurses taking care of too many patients all at once?  Were there any sabotage plans or unethical behavior?  Please permit me to make it clear from the outset that not every maternal death can be prevented, yet almost all maternal deaths are preventable.
Here in North America, modern medical advances have brought the maternal death ratio (the number of deaths directly related to pregnancy or birth) to such an extremely low point that the issue of preventable maternal death could be considered as being solved.  Now after being a midwife for more than forty years, I am somewhat startled and jolted out of my personal sense of complacency about what it entails becoming a mother in my country as compared to other countries.
It is apparent that the root of the infant and maternal mortality rate is the unequal, uneven and lack of resources.  Let us all be reminded that infants are the faces of the future, so the issue of the rising infant mortality speaks volumes for itself.  The infant survival rate measures quality of life.
In order to avert infant mortality, the infant needs a supportive team composed of family, community, and governmental agencies.  In addition I am calling on the Government of Guyana and the Public Health Department, all healthcare agencies, nursing personnel in Guyana as well as stakeholders to view this situation through lens amenable to change as a national disaster, and put the following recommendations in place as a matter of urgency:
Call on the Minister of Health to address Infection Control as a priority.
Appoint an expert Infant & Neonatal Task Force to advise the Department on issues of Infant Care.
Enlist the services of skilled health workers to assist at birth, emergency obstetric and newborn care.
Establish a Registry of Infant and Maternal deaths.
Periodic review of maternal and infant death to detect possible emerging trends.
Increase in Community awareness and involvement in activities and partnerships to improve birth and infant outcomes.
Surely there will be significant challenges, but the Government and all stakeholders must work to ensure that combined efforts actually benefit the individuals whose lives illustrate the global statistic.  This national disaster must be arrested before it reaches further epidemic proportions.
Yvonne Sam

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