Our Twins Came Pre-Term

Tears and Triumphs Through The Muhami’s Journey with their sons

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Sam: I am a 43 year old Auditor working for the National Treasury. Mercy, 38 years and I have been married since December 11, 2004. We have four children; Dennis who is 10, Cynthia, and then the twins Alex and Felix. We experienced no challenges in our first two pregnancies. I attended pre-natal clinics with Mercy and even went to the labour ward for the birth of our second child Cynthia. When Mercy fell pregnant a third time, we thought it would be as easy. At the 7 weeks clinic, we were told that it was one baby, but the sixth month scan revealed that she was carrying twin boys. It was then that we started attending Gynaecologist Dr. Kagema’s clinic. We saw him twice or thrice before Mercy went into premature labour at 7 months. He was the one who prepared us for the possibility that the babies would be born early, and administered an injection that was intended to strengthen the lungs of the baby. We were to go for another but Mercy went into labour.

Mercy: I have never smoked, drunk alcohol, I had no issues with blood pressure and my husband is very supportive and nonviolent. When I was young, I had asked God that when it was time to name my father, He would allow me to have twins so I could name him and my eldest brother at the same time. This was before I got married. I was there for ecstatic when a scan revealed that I would be having twin boys.  My father had died while we were still young, and my eldest brother, who is about 20 years older than I, had taken us through school. I never missed a day of school due to fees.

I started experiencing a pain on my right side, and the doctor said my small frame was being taxed by the twins within me. We had been to Dr. Kagema’s on June 22, 2013. He had told me that everything was progressing well with my pregnancy. So when I started having cramps the next day from around 10am, Sam and I were convinced it was not labour. We finally decided to go to hospital at 4pm. I had dilated 7cms already and had they delayed more, I would have had the twins naturally. I was in theatre at 10pm when I delivered them. Actually I opted for it since the babies were so tiny and I did not want to loose either of them through the birth process. They scored high during the birth, they cried well and Alex weighed 1650 grams while Felix weighed 1480 grams. They actually brought them to me soon after birth for a short while before I was wheeled to the ward and then to nursery. The next day, I was in a lot of pain from the operated area so I was not able to see them. Sam however came and told me they were well. I had no reason not to believe him. I was to find out later that Felix was admitted straight into the ICU. He reduced to less than 1000 grames and Alex to 1200grams. Neither of them were able to feed.

Sam: When I first visited them I was informed that the children were very sick. I was also advised not to share this information with my wife since she was still in extreme pain from the operation the previous day.

Mercy: The next day, however, I felt I needed to see them. I steeled myself against the pain, and walked the distance to the nursery. I was told that they were in the ICU as they were critically ill. They took me to see Felix first. I was horrified. He was tiny, and in respiratory distress, each breath lifted him off the bed. I fainted. I did not see Alex that day. The resuscitated me and took me to the ward. I wept and was not able to talk to my visitors. I didn’t think I would ever be able to look at my babies again. After some hours I gathered courage and went and saw Alex. He was helpless and in an incubator. I was advised to express milk, and I tried but could not since I was stressed up. I looked at the other mothers in there. They seemed to have their act together, and easily expressed, and fed their children.

Sam: They prescribed and administered Surfactant for the development of the lungs. It normally costs Kshs, 60,000 for a 10 ml bottle of which they only use 7ml. We asked the staff to keep the remainder for a parent who was not able to afford it for their child.  I would visit daily. The children were on I.V.s. Mercy is strong, and would diligently express milk for them as they were not able to suckle on their own. Preterm babies, cannot like other babies, suckle, breath and swallow simultaneously and risk chocking or even dying if they try. She would divide the expressed milk between the children according to the doctors recommendations. They started with 1 ml each through N.G. tubes.

Mercy: They would feed after every three hours. I had to go to the nursery despite the fact that my wound had not yet healed. To check if they had digested the milk we would stick a syringe into the N.G. tubes, and pull it back. If something was drawn from the child it would mean that they were not digesting well. Alex despite being the bigger of the two was admitted into ICU on his fourth day as he had lost weight due to his inability to digest food.

They need also to make smaller diapers for preterms. The smallest pampers almost covered their entire bodies. Huggies had a smaller one that fitted better but was still way too big.

Sam: The back and forth between the ward and the ICU every three hours was depressing for my strong wife. The doctors tested the babies’ blood constantly to see if infections had set in, in order to treat these.

IMG_3128.JPGMercy: KNH has about one nurse to 50 babies so we have to be involved. I would wake up and go clean my babies from that day. I forgot about my wound and have no idea to-date exactly when it healed. They had administered Surfactant to Felix and he was breathing more normally now. Since he was in ICU, the nurses would clean him but I still was the one to feed him. Alex on the other hand had not been able to digest food for four days, and was admitted into the ICU as well. After two weeks, a Professor recommended that he be taken to theatre the next day and be put on a central line. I was depressed. He was the bigger baby, and the one on whom I had hope and now he was scheduled for theatre.  I talked to another mother about this and she discouraged me saying that most babies died during the process of this procedure. I wept again. I made three calls to my brother, to my cousin and to my friend and didn’t say anything just cried and disconnected.  I then called my Aunt Nancy who is a nurse. She came to see me. She told me that God was able to do a miracle if I prayed. I asked God not to allow the operation but to heal Alex. I did not sleep that night but talked to God about Alex.

The next morning I determined to feed Alex which was not procedural before surgery. The nurses tried to stop me but the doctor finally allowed me to exercise my faith. I began with 2ml, then 5ml, and then 7ml. By the next morning he was taking and digesting all of 10mls. The doctor was amazed and in short, he did not go to theatre. He was fed and eventually put on 600gms. Putting on even 100gms for a pre-term baby is a miracle. I was also Kangarooing Alex, he was jaundiced and was also put under blue light.

Both my babies needed transfusions and my husband and brothers in law had donated blood for them. Bureaucracy made it sometimes complicated for them to be transfused. I remember one day just going mad and going to the nurses station when I discovered that they had not been. I made a scene and they ended up giving them the blood.

IMG_3041.JPGAfter a week Felix was discharged from ICU. One day I was feeding him in the nursery and the nurses came and asked for him. He was throwing his hands and feet. One nurse shouted something like ‘Apnea’. I did not know what that meant. I went back to the nursery after 3 hours and found so many doctors around him. One of them was telling the others that he hoped I would not walk in when I did. My baby was purple. I was shocked. I called my husband, my pastor and my cousin who is an elder. I would call, cry and disconnect. I run to the nurses room and hid under a bed. I cried bitterly calling out to God. He heard me. The now late Nurse Judy came for me. She simply said “Mercy, toka chini ya kitanda. Mtoto ameamka.” Felix was in ICU attached to a machine. His SPO2 – flow of oxygen was almost 100. This was a good sign. He was doing fine. My cousin had been at a Gospel outreach Pastor’s forum when I called. He interrupted his colleagues and they prayed for me without knowing what was the matter.

After this I could go the ICU and find the readings at 70, but as I stood there, they would rise steadily to 100. One mother noticed this and asked if I practised magic, I told her it was simply the power of prayer. I prayed a lot. I sang, and I cried.

One day my friend Grace’ baby who had been stronger than mine died. Not just hers, but three babies around Felix. I was not able to feed him that day. The other mothers were holding me and crying and calling me. Every three hours, a baby would die. They were taken to the Sluice Room. When we came in for feeding we knew whose it was by either checking into that room first or if a nurse called a mother aside to sit with them.

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I cried a lot during my time in hospital. I was known as ‘mama wa kulia, na kuomba na kuimba’. One time our couples’ fellowship – Precious Couples visited me. The women just came and cried with me. The nurses were shocked at this. The next day one of them pulled me aside and on confirming I was Christian, read to me from Philippians 4:6-7 “Do not be anxious for anything, but in everything, by prayer and petition, with thanksgiving, make your requests known to God. And the peace of God which surpasses all understanding, will guard your hearts and minds through Christ Jesus.” My now late mother coincidentally visited me at this time, on the insistence of my brothers who were concerned that I could not stop crying. She was 78 years then, a mother of 10 children. She told me that Kikuyu customs did not allow for tears to fall on nursing breasts. I don’t think this is true but it worked – I never cried after this; well not as much anyway.  My brothers have never let me forget this.

After this, whenever I was with my babies, I would talk to them telling them that they would survive their beginnings. I would create time between the feeding schedules that lasted one hour for each child to do KMC. My husband was only able to support me in this when the babies came home for hygiene reasons.  I was vigilant about accessing my babies to what they needed to survive.

Before we were discharged, the doctors ensured that the twins were able to suckle. Finally August 9, 2013 came round. I was called by a doctor and told I could go home. I was ecstatic. I just wanted to be home and sleep on a mattress. We were sleeping in the Mothers Mess where we shared beds or mattress on the floor by now. I just wanted to sleep in my own bed.  I could hardly wait for my husband, my sister Purity and my friend Nancy to get there.

Sam: I paid for most of the general drugs and test while NHIF paid about Kshs 500,000/ to cover their time in hospital. We are not rich but have never lacked for anything. God provides. For instance they were able to use Huggies throughout.

We had chosen Kenyatta National Hospital for the delivery because we had faith in the doctors there, and that the hospital was more than adequately equipped for any eventuality. It proved a good choice but I also think we also played a role; parents must follow the instructions of medical personnel. Upon their discharge for instance, the nurses demanded total hygiene on and around the children. Their room had to be disinfected and the nursing cups washed and handled only by my wife and myself. They were to have no visitors initially as their immunity was low. This was really hard to effect.

Mercy: I would plead with Sam sometimes to allow friends and relatives to see the children. Some came from really far away to see them but he was firm; especially when Felix got an infection two weeks later, and we had to be readmitted for a week. Some people took real offence.

When Felix got sick two weeks later and we had to go back, I was devastated. I refused to pack but somehow when we got to hospital, our things were all packed. He was put in the isolation room, diagnosed with mild pneumonia. Shortly afterwards another baby was brought in diagnosed with menegitis. I cried then but was told the kind of menegitis this baby had was not infectious. I was concerned also about Alex. How would he feed without me? Sam and the nurses assured me that Sam would be able to handle Alex. Still they would fight over the milk I expressed.

Sam: When one twin gets sick at this stage both are admitted along with their mother, so it gets really costly. The sick that is not sick gets exposed to infections and may end up unwell too. To avoid this, I requested to keep Alex with me, and signed him out into my custody. This meant I had to be at KNH thrice daily to get breast milk for him; at 6am, lunch time and evening. The milk needed to be warm. One time, I was flagged down by a police man for over-speeding at night. Alex had been crying and I had his milk. I told the police man to take my car and allow me to get food to my two month old son whose mother was in hospital. The policeman had compassion on me and released me. Sometimes the nurses in hospital wanted to keep the expressed milk for Felix, as he was their priority. We would literally tug over this.  Alex on the other hand would through fits throughout the night.

Mercy: Felix was discharged a week later, and thankfully the twins have never been admitted since.

Sam: We were grateful for the care of Drs. Miriam Karanja, Kihara, and Opondo of KNH, but met and have been seeing Dr Ngugi Maina at Kasarani’s Josma Medical Center. Since we were afraid of infections and hardly took the twins out in the sun, Felix got rickets at 7 months. Thankfully these were treated. He had to go through physiotherapy  and at some point had straps on his legs. He just begun walking on May 20, this year at the age of 3. Alex had started at 14 months and experienced normal milestones. We learnt from our doctors to never measure our children against the achievements of another child, not even each other.

Mercy: Felix also spoke later, and is now learning to form sentences.

Sam: The twins are both poor feeders. Mercy, who is a qualified accountant, has stayed indoors voluntarily since 2013. We try to feed them as many times as possible. They have even been on appetizers from time to time. One would wake up at night and then wake the others. We started taking shifts sleeping so we could face the next day.

IMG_3045.JPGThey are fraternal twins. They love being together but fight a lot too. Alex who is older is domineering and manipulative. He is also friendly and remembers faces and names of those he meets. Felix is a worshipper. He loves dance and music. He persistent, determined, focused and strong willed. He is a fighter. Alex fluctuates in his weight whereas Felix keeps the weight he has gained.

We keep two house girls; remember the two older ones are still babies themselves. We had our househelp Cugu who has been with us for 9 years, but needed a new one so we could handle especially the mornings. Initially for the first two months we did not sleep. Our other children understood why we gave most attention to the twins. Mercy’s elder sister Purity was really supportive and lived with us for 9 months.

Mercy: It was hard for Robert and Cynthia initially with me being away for two months in hospital with the babies, and their father trying to cope between home, office and hospital. He would bring them to the hospital to see me from time to time.

Sam: I have a very understanding boss who is also a parent. Understanding my challenges, he would allow me to work on flex time. I needed to be available for all hospital visits and emergencies.

Mercy: Back at home a week later, we were now even more paranoid about infections.  We would not take them out of the house. Felix developed Rickets. We found a good nutritionist and were given some powder from the UN called Prampinot I think, and another medicine.

Until they were three years, my life has been a whirlwind. I had physiotherapy with Felix and would cry when they massaged him. He finally began walking at the age of three and is now stringing words together to form a sentence. I can now think about engaging in income generation outside the house.

Sam: We have actually been able to get away twice on our own without the children. For three days each time. It is important for me that my wife is happy and rested.

Mercy: Sam has supported me throughout this journey. We are grateful to God, to the staff at KNH, to our siblings , our pastors, and the very many visitors who came and who sometimes did not get to see me. I was touched by the plight of many of the mothers of preterms. Some were married but were never visited by their husbands. Some of their husbands would encourage them to abandon their babies there – hence the presence of so many KNH babies. Some mothers loose all their babies, like one who remains childless as all her three babies have been preterm. One time a mother stole her own child out of ICU presumably to go throw it away.

On the children’s first birthday we went back to celebrate with the mothers then at the nursery. We had noticed in our time there that they had a shortage of heaters so we gifted them with a few, and brought cake for the nurses. It really encouraged the mothers there to see Alex and Felix. I remembered while there I had wished that I could have a mother come back and just say “Mimi nilikua hapa and these are my babies”.

Pre-term children can survive and thrive. I know one who is now studying at JKUAT, and one who was born in KNH at 900grams and is now a doctor there. Once they overcome, they perform well and are like other children. As a parent, the words you say over your children stick to them. Be careful therefore. Never give up on them – even when the doctors do.

Sam: In the last three years, we have lost four people who stood with us during this ordeal. My father, my eldest sister who even lived with us for a while, My mother and my mum- in law. Its been difficult but we know to be strong. My late mother in law told us at the very beginning that she knew the boys would be well enough to visit her fun and she could see them in her mind’s eye running around. This prophesy has come to pass, many times.

vipslit@yahoo.ca

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The making of … a hero

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Kangaroo Mother Care: What is it

IMG_9841.JPGBy Dr Angela Muriuki, Head of Child Survival, Save the Children – Kenya

Definition and History: KMC is continuous, prolonged, skin to skin contact between a baby and a mother or any other adult for at least 18 hours a day for several weeks. It provides warmth, promotes breastfeeding, reduces infections and links with additional supportive care, if needed. It is a powerful easy to use method to promote the health and well-being of infants born pre-term as well as full term. There are two types s KMC- contious which is skin to skin contact for at least 18 hours and intermittent where contact is brief and at least for 3 hours.

KMC begun in Bogoa, Colombia in 1979 by Dr. Edgar Rey and Hector Martinez in response to a shortage of incubators and severe hospital infections.

Who qualifies for KMC? The current Moh recommendation for KMC in Kenya is for stable babies (not on oxygen, not receiving intravenous medicines) as long as they meet the criteria: baby less than 37 weeks or completed gestation and the mother willing to provided KMC for at least 18 hours, mentally sound, not ill etc. It is hard to objectively say who is most likely to use it i.e. which mother is likely to accept KMC, early involvement of their partners and family in the process and promotion of support systems at home but also using mothers who have successfully practiced KMC.

Challenges that face premature babies and which of these can be resolved by KMC: In the simplest forms, small babies are at risk of death due to hypothermia (they are not able to regulate their body temperature very well), hypoglycaemia (also not able to regulate their blood sugar very well as their systems are not fully developed),and respiratory diseases (they get severe problems with their respiratory system in part due to the fact that their lungs are not fully developed and that they get infections very easily) as well as problems with their eyes, brain and gastrointestinal systems all because of being born too soon.

Some of the benefits of KMC for the baby include thermoregulation (the constant contact20150303_183400 between mother and baby keeps the baby warm), it promotes exclusive breastfeeding (hence addressing the issue of hypoglycaemia), babies gain weight faster (due to better thermoregulation, feeding and bonding which reduces stress for the newborn) and therefore it shortens the hospital stay (reducing the risk of exposure to infections). For the mother, it gives her confidence in caring for her newborn, it improves bonding between mother and baby and empowers the mother to be the primary caregiver. It also reduces stress for the mother since she is with her baby constantly as opposed to conventional care in the newborn unit where the mother only comes to feed her baby every 3 hours (and in between feeding times is constantly worried about whether her baby is still alive). For the hospital – engaging mothers in the care of their babies means that the nursing staff available can focus on the very sick babies and work with the mothers to care for the stable babies, incubators are in short supply and often shared so KMC ensures that incubators are left for the sick babies who really need them and the shorter hospital stay for babies is also advantageous
Some of the benefits of male involvement: There are several reasons why men should be involved (especially when mother is discharged to practice KMC at home)

–        Financial support for the care of the baby especially if the mother has to be away from work (her daily source of income) to care for the baby

–        Emotional and psychosocial support for the mother

–        Fathers themselves can practice KMC giving the mother some time to rest or carry out other household activities

–        They can help around the household so that she focuses on care for the baby (or get some help for the household)

–        Financial resources so she can attend the monthly follow up visits at the health facility

Women experience the lack of male involvement differently depending on their support networks.

When is the best time and for how long? KMC is initiated immediately (and as long as mother and baby meet the criteria described above). KMC is practiced for at least 18 hours a day. When a baby gets to 2000gm, they can be discharged to go home and continue KMC until the baby is 2500gms (with frequent visits to the facility to make sure the baby is ok and gaining weight).

Can it be practiced instead of/along with incubator care and when?KMC is not a replacement for incubator care or an intervention for poor countries/communities. It is the current recommended care for small babies (in the west, even unstable babies are put on intermittent KMC – can send pics from internet though copyright could be an issue). KMC is practiced alongside incubator care because as I mentioned, there are babies who still need incubator care and don’t qualify yet for continuous KMC according to the Kenya guidelines  – very sick, on oxygen, on IV medicine etc. even these sick babies can be put on intermittent KMC and returned to the incubator.

Is KC beneficial for babies born term? No, term babies don’t tolerate KMC at all.

KMC should be differentiated from skin to skin care for all babies – this is where any baby born should be put skin to skin with its mother to keep it warm until it can be wrapped warmly. This is standard practice for all babies at delivery. KMC on the other hand is for small babies (preterm, low birth weight), and is continuous (at least 18 hours)

Which institutions within and outside Nairobi are equipped to and encourage KC?

I can only speak for the ones we support. We have supported county MoHs to set up KMC in Bungoma and Busia counties and provided technical support to other organisations to set up KMC services. From August 2016, we will be supporting Nairobi County to do the same and Wajir County later in the year.

We also extend an offer to any organisation/county which requires technical support to set up KMC services. If they get in touch with us, we are happy to provide this support (technical support since financial resources are limited).

End

Photography by: Nash of NaMeD Afrika Studios and Family File

https://viphealthyleadership.wordpress.com/2016/08/23/kangaroo-mother-care-saved-baby-winnie/

Kangaroo Mother Care Saved Baby Winnie

IMG_9851Phyllis Wanja Kariuki

Age: Early 30s

In her own words:

I lost my first pregnancy at 15 weeks. I had 20150303_183406begun bleeding, and doctor in Mandera, where I worked as a Logistics officer with Save the Children, Kenya, recommended two weeks bed-rest. I came back home to Nairobi and all went well. The day before my scheduled return to Mandera, my friend and I went shopping. I started feeling funny, like cramps and remembered that the doctor had permitted me to take regular painkillers for this, so I took a Panadol. I did not expect that there would be any adverse effects, and it helped. At night however, I woke up to the same cramps, intense pain. When I went to the toilet, some water came out. I did not understand what to make of this, as it was my first pregnancy. I was rushed to Nairobi hospital, and on getting there, they discovered that the amniotic fluid had leaked out. Their prognosis was not good. They suggested a termination of the pregnancy as it had only a 90% chance of being viable. I resisted this and sought a second opinion. I went to Aga Khan hospital. I was given the same story. The doctors there meet and make sure that by the time they are giving you your report, they have tested you, they have discussed it together and allow you to make the final decision based on their thorough analysis of the your case. I had stayed for so many hours, and since this was my second stop, I felt I had no other choice but concede.

It was a horrible experience. They started with the treatment, and I was discharged and moved on with my life. After six months I conceived again, and I still had issues. I started bleeding at 8 weeks. This time I was more cautious, and able to see the warning signs. I went to the nearest clinic, St. Bakita in Utawala, and was injected with Buscopan. They suggested I go for a scan.  I went home and the next morning went to Agakhan for the scan. I was frightened of loosing my child. During the scan, the doctors were discussing the point of bleeding around a certain spot. But there was another spot and when I asked what that was, I was told it was another baby. I understood them the magnitude of what I was carrying and how careful I needed to be. After the scan at the ER, I was referred to Dr. Obura, a Gynaecologist. He looked at the results and gave me hope.  He gave me medication to strengthen the wall of my uterus, and advised me to avoid strain.

At around 18 weeks I started spotting again, but this was not serious.  Both at home and in the field in Mandera, I took very good care of myself. Mandera was less strenuous for me as I only had short distances to walk, and we are basically taken care of. I did not have to cook or do anything for myself. I stayed there for six weeks and then came back for R&R. At the airstrip, the flight attendant asked me how far along I was. She alerted me to the fact that I could not travel in a small aircraft beyond that point, and I understood that to mean that I would now be working from Nairobi. I worked for one more month before I started swelling. One of my colleagues, Eric Muthiani adviced me to have my blood pressure checked to rule it out as a cause for the swelling. My pressure was normally but now my feet begun to swell as well. It was during clinic test. I was to do a HCG test to determine my glucose level. It takes time, but they advised I change the clinic date as it was too late in the day. But I wanted to understand what was causing the swelling. The doctor insisted on a urine test. I had to do it twice for them to determine what the problem was. The doctor told me that my urine had a lot of protein in it, and suggested for additional tests to determine the functionality of my kidneys. This came out normal. They connected me to someone closer to home who would monitor my blood pressure daily, as they had noticed that it was fluctuating. I was to call the hospital daily to give them the readings.

This was on a Friday, but on Saturday, I was planning on going shopping for baby clothes so I did not go to check my pressure. I went in on Sunday, it turned out high. It read 170/100mmhg. The doctor recommended I go home and rest. I rested, and went back for another reading in the evening, this was even higher after then rest. I know High Blood Pressure is serious, but had no reference for people having it around me, and therefore did not see it endangering the pregnancies. The doctor recommended that I go into hospital immediately. I went home, got ready and then went to hospital. I was alarmed to find a team waiting for me on my arrival at the hospital. I was feeling fine, and wondered why they found this reception necessary. The scan showed that the blood was not flowing into the second baby as it should. I was admitted, but even then I thought it would just be for a night. At around 1am the doctor came to check on me and informed me that they would have to do an emergency Caesarian Section if my blood pressure did not go down. I had no idea that HBP could lead to one giving birth to pre-terms.

In the morning, a group of four doctors, took me to radiology for a scan. They sat around me and studied me. They told me they needed to do the emergency CS, in order to save my life and try save the lives of my babies. I therefore signed the consent and the CS was done at 3pm that day. This was on February 2, 2015. Everything went well. They did a spinal epidural, where I can see what is going on. They did a good job, they engaged me a lot. I heard my babies cry and I was excited. I was not able to see them immediately as they needed to be taken into the ICU, as they were a bit small. My daughter was 790grams and my son was 970grams. My son was a bit bigger. Everything was completed and I was taken to the ward. I wanted to go see my babies but I was not allowed then. It was too early, I was still numb. I saw my babies the following day.

It’s quite bad when you are in the ward, can hear other babies crying and you don’t have yours. You deal with a lot at that point, even the bills. I went to see the babies on February 3rd, around mid-day. I remember the nurses telling me that I needed breast milk, even if it was just two drops. Imagine there is no way I can be able to stimulate…you need the baby to stimulate it to produce milk. The nurse told me to be strong, calm down, focus on the babies, and try to express. There are other liquids they give the babies for feeding. I tried to express and nothing was coming out. By evening I had two drops and the staff was quite encouraging. The biggest trauma was when I saw the babies and how tiny they were, and wondered when they would ever grow to the size of the other newborns in the ward. I remember my daughter was the size of the 300mm soda bottle, she could be held in a hand. A nurse advised me to be strong and to take every single day at it comes. Her words remained with me through my darkest times.

The reality of the bills started hitting me. My insurance had been exhausted and my family began counselling me towards moving to a cheaper hospital. I was spending about Kshs 50,000 per baby per day in the ICU. On the 4th the doctor attending to the babies came to the ward. I sensed that something was wrong. The previous night, my son Jaden had been transfused. She started with the positive, telling me that my daughter Winnie was doing well, but the boy was struggling. I did not want to hear anymore. I told her to take me to them. She got somebody to take me to them in the ICU. I found them trying to resuscitate him. They did this while I watched. I told them to do all they could, within their power to make sure he was well. A male doctor assured me that they were. They kept encouraging me that girl was doing well. Unfortunately Jaden passed him while we were looking at each other. I felt like he was telling me ‘mum do something’ or ‘you are going to be okay just take care of my sister.’ Everything was done. I cried a lot. But I turned to the girl, and prayed to God ‘God I am going to walk out of this hospital with this one, and I know you can make it happen.’ I kept telling my close friend and colleague Jane the same. She was there for me through it all. I told her I was sure God would answer my prayer to the affirmative.

20150203_214802I did not want to mourn a lot because I needed to be strong for the girl. I had no choice. I remember the nurses counselling me and telling me, “this one was not yours, let go.” I could not let go the first day. It could hit me and I could cry, and then remember that this one was not mine but I had one surviving. I also remembered that the first time I came to this hospital, I had left without a baby, this time I had a chance to leave with one. I gave it all my energy, I did everything possible to get enough milk. I did not want stress to be a reason for not having milk for my baby. We paid a fee for the hospital to take care of my son’s remains as I did not have the energy to handle it. The hospital recommended some counselling, but most times I cannot and help me move on during dark times. I stayed for a while as they needed to monitor my pressure, but I was doing well. I was discharged on the 6th of February.

The bills were also increasing but my colleague encouraged me to focus on the baby as the money would somehow come.  Miraculously everyday passed. When I was told to give a deposit of Kshs 600,000. I borrowed this. I did not care where it came from as long as I could save a life. The credit office kept calling me and one day I went there and just told them “you are ladies like me, and am sure some of you are even mothers. You call me every time. I know you are doing your job, but at some point try and engage someone. My baby is in these wards, meaning I have not running away. Meaning I cannot run away. At this time my baby was in ICU. She stayed there for two weeks, and luckily she was doing well. She had the oxygen tubes from the 2nd to the 7th then they removed them because she was able to breath on her own and her oxygen saturation was normal. We moved out of ICU to the normal HDU ward. She had a oxygen desaturation, so she was put back on oxygen. I remembered the nurses words about living a moment at a time. She had also told me about how much pre-term babies were affected by movement. Moving mine from 1st to 2nd floor had had this effect.

Proffesor Aketch, told me that they would put the baby on medication to strengthen the lungs, and this caused the sugars to rise up to 21 and its supposed to be between 6 and 8. It really stressed me. I tried to get information for myself, from Google. The pain of seeing my child on injections, tubes and the thought of them having to put down her sugars. I cried a lot, it was very painful to watch.

I started doing Kangaroo at 800grams while she was still at the ICU. She was very tiny. I remember the feeling of putting her against my chest, how nice it felt. It was the first time I was touching my baby and she was calm. Every time I was doing Kangaroo I was happy and not tense. I could sense how happy she was as she could pray. Whenever I arrived in the hospital in the morning, she would play as though she sense I was there. I would do at least two hours daily. I would split this between morning and evening. I sometimes extended depending on how available the baby was in between procedures. The nurses used to encourage us and I used to Google the importance of Kangaroo MotherCare. It improves oxygen saturation, helps in weight gain which was very important for me since I needed my baby to gain weight, and also the bonding thing. These three are the three things that made me keep at it. It really motivated me.

There is this powder they normally mix with the milk call suffactor that helps them to gain weight. Winnie’s body rejected this, so they needed to lower the quantity they put. She got an infection after getting it. Imagine this was her chance for boosting weight gain. I could look at other babies, and though we were told not to compare our babies. I was jealous. They had their own problems but not those challenging weight gain like mine. I never lost hope. I even encouraged others. We had a group and I was considered the experienced. We had a room and we would chat and I discovered that others had problems that made mine. For instance one lady told us how her cousin had triplets and stayed in hospital three weeks and then they suddenly died, one by one. This really challenged me, as I still had a baby. Every time I remember that situation I remember her. I realised how blessed I was. There were others who were crying, and I needed to motivate myself to care for my baby. These helped me get stronger daily.

It was my job to wake up in the morning like I was going to work, get to the hospital, express milk as I could not kangaroo with the milk as it would leak, and then kangaroo. The fact that our babies could not breast feed by themselves, they were too tiny for it. For Aga Khan, until the baby is 1800grams they are still kept in an incubator. After that they are put in a cot. The first time when I saw my baby in cloths it was really happy, it was exciting. I would tell the other mothers “am nearing the door”. In her first two months Winnie went through several lung treatments and two blood transfusions. I did Kangaroo for two months and increased the hours. I could do several 1 and a half hours sessions. I used to cry a lot when I had to leave her especially when she was under treatment. She went through two transfusions. These were the worst since I connected the death of my son with the transfusion he had undergone the night before he developed breathing complications that led to his death. From Google I learnt that transfusions sometimes cause complications in pre-terms.

Some of effects of Kangaroo on Winnie Wakanyi is that she is very close to me, she is alsoIMG_9869.JPG friendly and independent. She is still small bodywise though she weighs 8.3kilos, but this does not discourage me. I knew this would happen. The nurses taught us that when we went to the clinic and were asked the age of my baby…even now when I tell them that she is 1 year 5 months, I see the shock in their faces. I don’t explain unless I feel it’s necessary. One time a nurse responded by asking me if my child was picky about food. She is doing very well, I make sure that I don’t miss clinic. She has never been put on a special diet on her hope. She is now walking on her own and is really fast. I remember the nurses telling us to never compare our children’s milestones with another child’s. The pace does not really matter as long as they get there. As long as everything else is normal, they are good. For pre-terms, don’t mix yourself with pressures from outsides, its her time. If its kangaroo, her time is her time.

vipslit@yahoo.ca

Photography: Nash of NaMeD Afrika Studios and from Family Files

First published on the Sunday Magazine, Sunday Standard, August 21, 2016 (shorter version)

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