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A premature baby's hold on life is undoubtedly fragile, but when six infant deaths occurred within two days at the Matara General Hospital last month, Health Authorities were alarmed. Infection at the hospital premature Baby Unit is believed to be the cause but the inadequate facilities provided for these babies who need special care could well be a factor.
On April 2 twenty-eight-year old Indu Liyanage having lived since marriage, at her husbands home in Kandy, returned to her Maha Gedera in Matara for her confinement. Keeping to the Sinhala custom that the birth of a first child should take place at the girl's home town the couple decided to have their baby in Matara.On April 6, Indu having got her labour pains was rushed to the Matara Hospital. That night she delivered her baby daughter. Though a normal birth, this being her first delivery, the mother was in some discomfort and thus the baby was not given to her that night. However, by next morning feeling better Indu asked for her baby only to be told that the infant had needed special care and was being kept in the Premature Baby Unit. By evening the baby's situation had not improved and at 11.20 pm., she gave up the fight.
A grieving Indu refused to accept her baby's death. She openly accused the hospital of negligence and claimed that an infection at the Unit had caused her daughter's death.
Blaming the unhygienic conditions in the hospital which could breed infection, Indu said, "the ward was in a bad condition when I was admitted. The floor had been washed but the dirty water was not mopped up. I did not have a bed and I had to keep standing in the water. Even the baby Unit is not upto standard".
"It's true that the chances of a premature baby surviving are low, but mine was a healthy baby. Maybe she needed special care, but definitely not as much as a premature baby. She would have had the strength to live," said Indu.
Indu pointed out that until her ninth month of pregnancy she had attended the clinic in Kandy regularly. "The doctors did not find anything wrong with me. My weight was correct, I took the prescribed vitamins, but still my baby could not live. I regret coming here to have my baby," she said.
On April 3, Wasanthi delivered her seven month baby, at the Matara Hospital. Despite the warning of doctors that she would have a difficult birth since she was only 15 years Wasanthi's confinement had gone smoothly.
The baby was immediately transferred to the Premature Baby Unit.The baby lived for three days and died on April 7. Wasanthi's mother Siriyawathi told The Sunday Times that on the day of the delivery she had gone upto the Baby Unit to check on her granddaughter and found three babies being kept in a single cot."
After about two days, I told my daughter to go into the Unit and feed the baby. When she went there she was told that her baby had died. The staff claim that they had informed her the previous night but Wasanthi has no recollection of this," said Siriyawathi.
Senior Pediatrician Dr. S. D. K. Weeraman denied that a bacterial infection in the Premature Unit had caused the deaths but said that an infection might have been brought in by transfer patients, which would have spread to the other babies, causing their deaths.
"The Matara hospital gets several transfer babies. We found out that 60 percent of deaths were from the transfer babies. The four deaths occurring on one day was also among babies who were brought in from far off places. The condition in which the babies are brought is very bad. Thus it is obvious that they carry an infection. Once they are brought here, we immediately put them into the unit. The babies who are generally weak easily get infected," said Dr. Weeraman.
The hospital's Premature Baby Unit which had facilities to accommodate only ten to twelve babies, generally has to house over 25 babies. Of the seven incubators at the Unit, only four are functioning. The ten cots at the unit do not have a single bulb, which is necessary to keep the baby warm. It is learnt that a 100 watt bulb has to be fixed on the cot, to provide the baby with a temperature akin to the mother's warmth. There are hardly any blankets on the cots. Usually a Premature Baby Unit would be able to accommodated even a 28 week baby, but the Matara Hospital does not have the equipment to do so. Further three babies are kept in one cot and when a baby dies the procedure of sterilisation and carbonation is not carried out before the next baby is put in.
A sterile environment that is a vital factor in units of this kind is sadly lacking here. All ten cots are crowded close together and with the PBU now being closed, the baby unit is next to a ward, separated only by a curtain.
According to Dr. Weeraman, the Matara Hospital records one infant death per day. This, he said is not unusual as their admissions are 30 per day. "The birth rate in Matara is very high. This is largely due to poor family planning methods. Most of the women come to deliver their fifth or sixth baby. We don't refuse them but what I say is they can prevent it. If they do, the death rate would be reduced," he said.
Commenting on the wide publicity given to the deaths, Dr. Weeraman said that long before the press was alerted, the hospital was carrying out investigations. "On our part we did our best. Sops taken from the incubator, wall and other places were tested by one of our nurses. They proved negative. The MRI too tested them. Still some of our officers were assaulted. It is after this that we decided to close down the BPU and carry out a thorough check," he said.
At present, the hospital has stopped all admissions and shifted the Baby Unit to a ward. Dr. Weeraman said that even here the unit was not protected from germs. It's not fully sterilized, and we have only a few cots but we are doing our best. It's very disheartening to note that we are blamed without knowing the real facts and our difficulties," he added.
Medical Superintendent, Matara Hospital, Dr. P. Ekanayake too confirmed that the reason for the increase of the deaths was largely due to overcrowding of the Baby Unit.
President of the GMOA, Dr. Lak Kumar Fernando , who is a paediatrician at the Lady Ridgeway Hospital explained that a bacterial infection could take place if instruments are not properly sterilized. "The staff too had to be clean of germs. Most importantly the unit should be sterile. The babies who are put into these units are those who need special attention, because their bodies are not able to resist infection. Special sterile gowns should be worn by the staff. The moment these procedures are not followed a germs could get in," he said.
Dr. Fernando also expressed concern over the high death rate and the lack of facilities at the hospital.Obviously, the Matara General Hospital has more births than it can cope with. But it is upto the health authorities to take urgent action to provide the necessary facilities that could meet this demand.
"Winged survivors", the third Art Exhibition of Lester Perera will be held from May 7-12 at the Alliance Francaise, Colombo. The exhibition which will have 36 water colour and acrylic paintings will portray some important bird species in Sri Lanka and focus on the little known bird life of the island.
The artist who has been interested in bird watching from childhood explains that in 1980 he took to painting, these attractive species. Anyone can draw birds, but to accurately depict them one must know the birds and be able to capture all the minute details scientifically. It also requires a lot of concentration, he said.
Lester travels out of Colombo at least once a month especially to Bundala to observe birds and spends a lot of time watching, sketching and making notes of the birds."I also have the various nooks and corners of the forest at the back of my mind. Upon returning home I first draw the background and thereafter fit the birds into it, including all details," he said.
A wild life enthusiast Lester worked at NARA for two years where he did a project on turtle nesting behaviour single handedly. This was followed by a project on flamingoes on which he hopes to present a paper soon.
According to Lester it is very important to capture facial details such as the colour of the eyes of the birds which may differ from males to females and adult to young birds. Other features such as feathers, scallation of the legs of the birds also need consideration in this type of art.There is no particular time of the day when he paints but he says he must be in the correct state of mind. A painting may take a week to finish and sometimes even upto one year, he added.
Lester said that he does not follow the style of any particular artist and believes that he has his own, unique style.
When asked about art in Sri Lanka, Lester said that people do not have a good eye and are less exposed to art. Therefore they try to follow the style of artists such as George Keyt.
"We also lack a good art gallery. Our schools lack the proper infrastructure and students are not encouraged to pursue their own style of drawing. They should be taught the fundamentals, but this does not necessitate deviating from their natural style", he added.
Lester who is employed as a field officer at Hemas Pharmaceuticals also breeds game birds known as "Asil" which he says, is one of the oldest breeds of poultry in the world."Winged Survivors" will be declared open by Minister of Transport, Environment and Women's Affairs Srimani Athulathmudali on May 7.
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