Experts say for Bangladesh, which had achieved UN’s Millennium Development Goal for success in cutting down child mortality rate, letting children die due to the unavailability of basic medical support like incubators is a failure.
Shafiqur Rahman had to watch his child, who was born prematurely, die from birth asphyxia within two days of being born in a local health centre in Manikganj. Placing his child in an incubator could have saved it, but the lack of both availability and affordability made him helpless.
Shafiqur’s situation is not an exception, but the harsh reality in a country where officially, 240 children die everyday. Most of these deaths are from neonatal infections and birth asphyxia. Neonatal infections and birth asphyxia both require an incubator to maintain body temperature during treatment because the bodies of pre-term babies cannot produce enough heat.
“At a time when we should have been moving forward, such technological drawbacks are making us fall behind,” said Dr Subrata Karmakar, neonatal and child health specialist.
Child researcher, Dr Talukder said: “Infection is the leading killer of neonates. The second is birth asphyxia, which causes one of every five neonatal deaths. Therefore, we have to ensure incubator support for every new-born.”
He said low birth weight caused by poor maternal nutrition and teenage pregnancy is the direct cause for another 11% of child deaths and that incubator support is not available.
There are roughly 200 incubators in around 1000 government hospitals in the country. The number is low by itself and the fact that most of them are out of operation due to technical faults or lack of operators, just clamps the lid on the future of these children.
Experts claim that if all the incubators available in government facilities were being used, the child death rate would be reduced.
According to National Institute of Population Research and Training, 11 children are born every second in our country, Dr Talukder said. “What can we do with 200 incubators, most of which are non-operational?”
Dhaka’s Shishu Hospital, the government’s central childcare facility, has only 20 incubators, about eight of which are operational. To accommodate as many patients as possible two children have to share one.
Private hospitals and clinics have their own incubation facilities. However, the cost of these is very high. Incubation facilities at the private clinics in Dhaka city cost from Tk9,000 to Tk12,000 a day. Due to the high demand, the authorities receive advance payments of roughly Tk35,000 to Tk40,000.
The authorities can also decide whether or not to accept patients and in most cases, children in critical condition are not allowed treatment.
The United Nations Children’s Fund research said, 30 out of 1000 newborn babies die within the first 28 days. 22% of infants are born with a low birth weight.
Government records claim that around 85% of births take place at home and it is impossible for government hospitals to provide incubator services to all of the remaining 15%.
A senior official of the Department of Health’s Hospital Division said: “Many of the incubators at different hospitals or health centres are out of order. Those that are operational cannot be used because there are no trained operators.
“It is not like we do not know the situation; we just cannot change the it. We have to recruit some expert hands, but due to budget constraints, we are unable to make new appointments.”