Newborn babies are fragile. And systems to take care of newborns are also fragile. As readers of this blog would know, one of our main achievements on the hospital so far has been improvement of the neonatal ward. But the last few weeks we have had a set back. It seems like it all started with failing of following the daily routines like measuring and documenting temperatur, pulse and so on as often as planned. The next thing was that a few meals are skipped for the newborns that has mothers who are too sick to come and feed them. Then blood test are not being done as planned, and like that things gradually fall apart. And when you need help from the staff, they are no where to be found.
I was worried two weeks ago because I saw the tendency with routines not being followed any more, but it was not until Tuesday last week that it culminated with five deaths within a few hours. After that, we have discussed with the hospital administration, who then had meatings with the staff, and it seemed like we were back on track when I left work on Friday. Now my family has come to visit me in Zanzibar, so I will have two weeks vacation to join them, and I am not sure how I can expect to find the department when I come back. It can be a difficult balance between taking control and leting other people be included in the work.
This set back has illustrated how fragile newborns actually are. There are a lot of routines we follow in Norway that may seem like a waste of time. But I have experienced that for newborns it can actually be life threatening when basic needs like feeding, warming and changing of position of the body and full pampers are not being taken care of. And if you do not measure body weight on babies routinely, you might not know that they need more food before it is too late.
I have also learned something about my own fragility. Even though I knew that whatever we accomplish here might be temporary, it is hard to see it fall a part. But then it is good to have thought through these things up front like we have, so that we can remind ourselves on what we know: Changes come slowly, and often with three steps forward and two steps back. So we just have to be persistent and patient.