January 10, 2018
By Janice Biehn
In the June 2017 issue of Under the Sun, we told you about baby Shining, resuscitated at birth by Dr. Jocelyne Uwinkesha, a young Rwandan doctor who had just learned the lifesaving technique. Dr. Jessica Bradford, a pediatrician with Partners in Health Rwanda, tells us the rest of the story.
It’s been quite a year for new parents Ingabire Ruth and Miringa Innocent. Last Christmas, they received a surprising early gift. The 23-year-old’s pregnancy had been uneventful until early December when a slight scare late in her second trimester brought her to the maternity clinic at Rwinkwavu District Hospital, in Eastern Rwanda. She thought the problem was resolved, but then on December 24, at the start of her third trimester, she went into labour. She returned to Rwinkwavu District Hospital and was taken to the operating room. Her daughter Shining was born at 27 weeks, weighing a mere 750 grams.
Read about her resuscitation and the training program that made it possible here.
Ruth was the second born in a family of five children. She grew up on the outskirts of Rwanda’s capital of Kigali in a town called Kabuga and completed secondary school. Prior to giving birth to a premature infant, she never had any experience with low birth weight or premature infants. She didn’t know anyone who had ever had a baby that small.
Shining was taken to the neonatal unit of the hospital. For weeks she lived in an incubator, with her mother sitting attentively at her side. She received support to help her breathe through a CPAP machine. The nurses in the neonatal unit taught Ruth how to feed her tiny baby using a feeding tube that went through her nose into her stomach. She learned how to watch the equipment the baby was connected to, and how to adjust the oxygen when it became disconnected or out of place.
At first people from the community told Ruth the baby was too little to survive. But Ruth received support and encouragement from her husband, who visited the hospital every day to see his tiny daughter and his wife. She also received support from the nurses and doctors working in the hospital. With the support of the All Mothers and Children Count program funded by The Primate’s World Relief and Development Fund, the staff had been well trained in caring for infants born prematurely and with low birth weight. They helped educate the family about what the baby needed.
As Shining grew, the nurses taught Ruth how to perform Kangaroo Mother Care, or KMC, by placing the infant on her chest to help keep her warm. Shining graduated from the incubator and moved into the ward. She progressed from using the tiny feeding tube to taking her mother’s breastmilk from a cup. Eventually she was strong enough to try and breastfeed on her own.
For more than two months, Shining and Ruth stayed in the neonatal unit at the hospital. Every day she was weighed. Finally, in early March she was allowed to go home. A plan was made for her to attend Rwinkwavu’s Pediatric Development Clinic, a follow-up clinic for infants with special medical, nutritional and developmental needs. Shining continues to be monitored there for complications related to prematurity, but she is thriving and weighed 6.2 kg at eight months.
Ruth and her husband credit the care they received at the hospital for Shining’s condition. They fear that if she had been born at a health centre further from the hospital, Shining may not have received the immediate respiratory support she needed. But now they have a little girl who is healthy. She smiles and laughs. Both Ruth and her husband are optimistic for Shining’s bright future.