Lau­ra Dowrich-Phillips

In the small, el­e­gant­ly fur­nished of­fice dec­o­rat­ed by the Ro­tary Club of San Fer­nan­do (as a small plaque pro­claims) a pho­to from world fa­mous ba­by pho­tog­ra­ph­er Anne Ged­des hangs. The pho­to, ti­tled Jack hold­ing Ma­nee­sha, shows a tiny ba­by nes­tled in the palms of a man's hands. Ma­nee­sha, born pre­ma­ture­ly at 28 weeks, weighed 680g and the im­age is used to in­spire and give hope to par­ents of pre­ma­ture ba­bies around the world. Dr Safeeya Mo­hammed us­es the pho­to to do just that in the of­fices of Sup­port­ing Our Sick (SOS) Ba­bies, a fledg­ling non-gov­ern­men­tal or­gan­i­sa­tion whose aim is to pro­vide sup­port for par­ents of pre­ma­ture ba­bies.

Dr Mo­hammed, 31, a pae­di­atric doc­tor who works at the San Fer­nan­do Gen­er­al Hos­pi­tal, is the chair­man of the or­gan­i­sa­tion and found­ed SOS Ba­bies in April, to­geth­er with Dr Ker­ryn Brahim, Dr Sabi­ta Har­rikissoon and at­tor­ney Ron­nie Bisses­sar. "Par­ents need to know that they are not alone in their feel­ings of guilt and anger, ask­ing what they did wrong and why this hap­pened to them. Talk­ing to an­oth­er fam­i­ly that went through a sim­i­lar sit­u­a­tion can con­sid­er­ably ease their pain in the ag­o­nis­ing months of their ba­by's hos­pi­tal stay," says Dr Mo­hammed, ex­plain­ing the ra­tio­nale be­hind SOS Ba­bies. She says with med­i­cine evolv­ing, doc­tors now have an in­creas­ing abil­i­ty to treat and save ba­bies born pre­ma­ture­ly or with con­gen­i­tal de­fects and com­pli­ca­tions. But there was a re­al­i­sa­tion that while ba­bies were get­ting treat­ment, the par­ents need­ed spe­cial at­ten­tion too.

"For any par­ent, dis­cov­er­ing your ba­by is in the neona­tal care in­ten­sive unit (NCIU) is like­ly to be one of the most stress­ful and dif­fi­cult life chal­lenges ever faced," she says, ex­plain­ing that fam­i­ly-cen­tred care is be­com­ing the stan­dard in NCIU'S around the world. Fam­i­ly is a child's pri­ma­ry source of strength and sup­port. She cit­ed par­ent sup­port groups such as March of Dimes in the Unit­ed States and Bliss in the UK as ex­am­ples of such or­gan­i­sa­tions. Dr Mo­hammed, who says vol­un­teer­ing is in her genes, was in­spired to start SOS fol­low­ing the birth of ba­by Reezan­na Ma­haraj in 2006. Born at 26 weeks ges­ta­tion and weigh­ing one kilo­gramme, the ba­by was born with res­pi­ra­to­ry dis­tress, blue and with a foul smell. "That meant there was in­fec­tion. I was at the end of my shift and ex­haust­ed but I knew her risks, the pos­si­ble out­comes and did every­thing pos­si­ble to help her. That changed my life," re­calls Dr Mo­hammed.

To­day, Reezan­na is a healthy, nor­mal three-year-old and her moth­er Shelly Ann was able to pro­vide emo­tion­al sup­port to one of Dr Mo­hammed's close friends who gave birth to pre­ma­ture triplets a year lat­er. The triplets, born 13 weeks pre­ma­ture, suf­fered with mul­ti­ple com­pli­ca­tions and one of them died soon af­ter. "The two moms coun­seled each oth­er and I re­alised how well it worked," says Dr Mo­hammed, whose em­pa­thy and com­pas­sion comes from a per­son­al place as well. Sev­en years ago, her broth­er Jaleel died in a car ac­ci­dent. His trag­ic pass­ing still hurts. "You go through some­thing like that, you know what loss is, you know what hurt is. I don't ever want any­one to feel that pain alone," she says, fight­ing back tears. Apart from pro­vid­ing sup­port, SOS Ba­bies dis­trib­ute hand­outs and book­lets to im­prove pa­tient in­for­ma­tion. They dis­trib­ute HOPE bas­kets to par­ents when their ba­bies are dis­charged and is en­gaged in an an­te­na­tal care cam­paign to high­light the im­por­tance of an­te­na­tal care. They en­cour­age net­work­ing among oth­er NGOs and clin­i­cal staff, among oth­er things.

Lack of an­te­na­tal care

We are sit­ting in SOS Ba­bies' of­fice on the neona­tal ward on the third floor of the hos­pi­tal. It's a small space but taste­ful­ly dec­o­rat­ed to pro­vide a calm­ing en­vi­ron­ment for par­ents whose ba­bies are fight­ing to live in ven­ti­la­tors fur­ther down the cor­ri­dor. Just hav­ing the room is a ma­jor ac­com­plish­ment for Dr Mo­hammed and her team. Pre­vi­ous­ly, any con­ver­sa­tion with par­ents took place in the midst of the NCIU ward where the tiny ba­bies and the beep­ing ma­chines were ob­vi­ous dis­trac­tions. The unit has so far ben­e­fit­ted from the kind­ness of cor­po­rate bod­ies; Il­lu­mi­nat do­nat­ed the print­er and Flu­or the com­put­er. Daren Dho­ray, a Web mas­ter, is build­ing a Web site free of charge. Un­til the group can at­tract more vol­un­teers, doc­tors and nurs­es coun­sel par­ents as need­ed. "As more coun­selors and ad­min­is­tra­tive staff be­come avail­able, once you have a ba­by that re­quires neona­tal care, one can au­to­mat­i­cal­ly join," says Dr Mo­hammed. She hopes to repli­cate SOS Ba­bies in neona­tal ICUs at Port-of-Spain Gen­er­al Hos­pi­tal and Mt Hope, pend­ing the avail­abil­i­ty of more vol­un­teers.

SOS Ba­bies has net­worked with March of Dimes and Dr Mo­hammed will be trav­el­ling to Wash­ing­ton, at the be­hest of the Unit­ed States Em­bassy, to meet with the glob­al or­gan­i­sa­tion next month, which is Pre­ma­tu­ri­ty Aware­ness Month. March of Dimes is on a mis­sion to in­crease aware­ness of preterm births as a glob­al prob­lem. In a white pa­per on preterm births, the or­gan­i­sa­tion re­veals that wher­ev­er qual­i­ty trend da­ta are avail­able, the rates of preterm birth ap­pear to be in­creas­ing. In the Unit­ed States, it has in­creased 36 per cent in the past 25 years. Con­tribut­ing fac­tors in­clude as­sist­ed re­pro­duc­tive tech­niques that in­crease the rate of mul­ti­ple births, a rise in the pro­por­tion of births to women over 35 and changes in clin­i­cal prac­tice such as the ear­ly in­duc­tion of labour or per­for­mance of Ce­sare­an sec­tions. In T&T, da­ta on the rates of preterm births is not avail­able. Cit­ing from anec­do­tal re­ports from a con­sen­sus by con­sul­tant Dr Brahim and the neona­tal unit, Dr Mo­hammed says it seems to be about one in 12 ba­bies born pre­ma­ture­ly or ill. In the US and UK, it's one in eight and one in ten re­spec­tive­ly.

"Preterm births can hap­pen to any­one and some women who have pre­ma­ture births have no known risk fac­tors. For un­known rea­sons, African women are twice more like­ly to ex­pe­ri­ence preterm labour and pre­ma­ture births than women of oth­er races," says Dr Mo­hammed. Top­ping the list of known risk fac­tors is the lack of ad­e­quate an­te­na­tal care dur­ing preg­nan­cy. Many women still do not at­tend clin­ics dur­ing preg­nan­cy or they wait un­til the third trimester to make their first vis­it to a doc­tor. Oth­er fac­tors she lists in­clude the use of il­lic­it drugs, al­co­hol and cig­a­rettes dur­ing preg­nan­cy, be­ing un­der­weight or over­weight dur­ing preg­nan­cy and stress­ful life events such as do­mes­tic vi­o­lence or over­ly de­mand­ing work sit­u­a­tions. There is no da­ta for the rate of sur­vival of pre­emies lo­cal­ly but Dr Mo­hammed says an in­ter­nal au­dit done be­tween Jan­u­ary 2004 and Au­gust 2006, found that 82 per cent of the ba­bies ad­mit­ted to the unit sur­vived with a non-sur­vival rate of 45 per cent for ba­bies weigh­ing one kilo­gramme. How­ev­er, the unit can boast of the sur­vival of a ba­by that once weighed 620gm. Re­fer­ring to the Anne Ged­des' pho­to Dr Mo­hammed says, "Imag­ine the ba­by in this pic­ture is 680gm, the small­est we've had and sur­vived is 620gms. And one of my lil flow­er­girls, So­phie, was 750gms, four years ago and she's thriv­ing well and grow­ing nice­ly. We're not do­ing too bad eh!"

Who is at risk for Preterm Birth?

�2 Women with no an­te­na­tal care

�2 Pre­vi­ous preterm labour or preterm birth

�2 Cur­rent preg­nan­cy with twins, triplets or more

�2 Ab­nor­mal­ly shaped uterus, in com­pe­tent cervix or large fi­broids

�2 Bleed­ing eg pla­cen­ta prae­via

�2 Teenage preg­nan­cy

�2 Women smok­ing or us­ing al­co­hol dur­ing preg­nan­cy

�2 Se­vere kid­ney and uri­nary tract in­fec­tions

�2 Ex­ces­sive uter­ine con­trac­tions be­fore 36 weeks

�2 Women with un­usu­al­ly phys­i­cal or men­tal stress.

For more in­for­ma­tion on SOS Ba­bies,

con­tact Dr Safeeya Mo­hammed at sos­ba­bies@gmail.com or 652-5215