A Neonatologist's Experience: From Neonatal Intensive Care Unit to Community Based Newborn Care in an Effort to Save Newborn Lives in Zambia, 1985 to 2011

Abstract

As a young scholar, I looked forward to a fulfilling medical career. Being a paediatrician brought with it the idea of saving lives, the smaller the infant, the greater the achievement, so it seemed. My mentor at the time with the greatest influence on my professional shaping was Professor Chifumbe Chintu, first Zambian Paediatrician, Dean of the School and also head of the Neonatal Intensive Care Unit in C13 and Haematology services for the whole hospital. With this inspiration for a bright and fulfilling career, I set out to train as a paediatrician, with The Royal College of Physicians in the United Kingdom, supported by the Beit Trust. With the further support of my Departmental Head of the department, Prof. Mukelabai, I proceeded to Mie University, Japan where with support from the Japanese International Cooperation Agency, I embarked on my career as a neonatologist in 1989 having worked with newborns from 1985. I was exposed to lifesaving feats in Japan's high technology medical milieu. Infants with necrotizing enterocolitis survived well, while birth asphyxia continued drawing its breath from a ventilator for very long periods. To exemplify this iatrogenic effect of success in the newborn period, I experienced and wondered at a five-year-old child who had been premature at birth, still on the ventilator, with family holding on to hope for more than five years. For me, this was the height of the grip technology on all of us. How far will this go? I have not yet found out, because I remain challenged by the mundane fact that newborns are still dying today, the same if not worse than in the 1980s in my own back yard, and our response is far from adequate1,2. And so my move to the world of preventative care, a stint as Reproductive and Child health advisor at the Ministry of Health and World Health Organisation helped stabilize my understanding of my role in neonatology, child-health and whole care of the child in the family setting.