Amina is pregnant again, but still does not know what it is to care for a baby. Just two years ago, she went to this same health center and gave birth to a son who was born with a vigorous cry, but his tiny body of just a kilogram of weight revealed a premature birth, and the sentence of the baby that ended dying at home within a few days.

The midwife who attended the delivery, receiving the small body in her hands, despite throbbing and crying loudly, gave it to the mother with a message: she had to go home and wait for death to knock on the door. Indeed, it did not take long to arrive in the form of sepsis.

Now she goes back to the delivery room. With two fears. To lose his life as happened to his mother in her own birth. And the same thing would happen to your baby as the first one. Again, Amina has not completed the gestation weeks. But now something has changed.

Mulu, the midwife attends the delivery with serenity, until the child shows his head. The umbilical cord strangles him. This episode, just two years ago, would have caused the baby to suffocate as soon as it was born. Now, it won’t be like that. With agility, dexterity and professionalism, Mulu performs a maneuver to release the twist of the cord. But the baby is still not breathing. Without taking a second, he takes the bag with a mask and blows air into his small lungs and the miracle begins to take shape. A vigorous cry floods the room.

Cry, beat, live

The image of the midwife giving the mother the premature newborn is repeated. This time, the matron tells her that she can survive. He needs to be transferred to the new neonatal intensive care unit of the Rural Hospital of Gambo. The young midwife takes the phone and contacts the 24-hour Gambo hospital maternity hospital, activates the ambulance and refers him to the mother following the babysitting method to avoid hypothermia, one of the complications.

Upon arrival at the Gambo hospital, they are received and admitted to the neonatal intensive care unit, the only one in the rural area where we are. We have managed to inaugurate and launch this service, which has four incubators, beds for skin-to-skin method, phototherapy machines, oxygen therapy and CPAP —a method to alleviate the respiratory tract.

The image of the midwife giving the mother the premature newborn is repeated. This time, the matron tells her that she can survive

But the success of these cases is only the tip of the iceberg, what has been important has been the maternal and newborn health program spread as a network by rural health centers and dispensaries.

The basis is the monitoring of pregnancy in rural areas by midwives of health centers. Training to carry out uncomplicated deliveries, detect complications in time and refer them to the referral hospital, in this case the Gambo hospital, so that they can enter, perform an instrumented delivery or cesarean section if necessary.

The neonatal resuscitation training course is part of the program in collaboration with the Ethiopian Ministry of Health. According to the 2016 demography and survival survey, there are 37 neonatal deaths for every 1,000 live births and in rural areas increased to 180 every 1,000. In these territories, deliveries take place in centers without running water and with traditional midwives. Since 2000, Ethiopia has been making a great effort to decrease maternal and infant mortality in children under five years of age. The great objective is to improve the data on neonatal mortality that has practically not improved.

Iñaki Alegría She is a pediatrician and coordinates the maternal and child health program at the Gambo Hospital, Oromia, Ethiopia.

The section On the Front Line is a space in Planeta Futuro in which members of NGOs or institutions that work in the field narrate their personal and professional experiences in relation to the impact of their activity. They are always written in the first person and the responsibility for the content lies with the authors.

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