When Dr. Alyssa Pfister, a Serge missionary and pediatric physician, first arrived in rural Burundi with Serge’s team of medical professionals in 2013, the state of affairs for neonatal care was bleak. She discovered preemies kept in cardboard boxes covered in layers of wet blankets. Not expected to live for long, premature infants went uncounted and largely neglected. Unsurprisingly, most could not survive in those conditions.
Alyssa began to address the problem by taking little steps that made a huge difference in preemie survival rates.
“We started by just counting the preemie babies as patients,” Alyssa said. “In Burundian culture, babies don’t get named until they’re home and a few weeks old. So preemies would not have a name and would not be cared for as a separate patient from the mother. I began to open charts for the preemies, round on them daily as a pediatric service, give them antibiotics as needed, and attempt ‘kangaroo care.’*. With just a little extra TLC, the bigger ones started to survive.”
Soon after, Serge missionary and surgeon Jason Fader designed and hand built several incubators using wood and Plexiglas, equipping them with light bulbs and a thermometer to regulate the temperature.
“They’re just simple structures, but they do a great job of keeping the babies warm,” Alyssa said. “Little by little things started to improve.”
The makeshift, handcrafted incubators were put into a tiny room at Kibuye Hope Hospital, where the team serves. With the beginnings of a Neonatal Intensive Care Unit (NICU) in place, Serge doctors trained Burundian pediatric nurses in neonatal care until they were proficient at caring for the tiny babies. The simple, makeshift incubators worked well, but when 12 preemies were admitted into the tiny, four-bed NICU this past spring, the Kibuye medical team realized they needed more space.
“That’s when I talked to our team engineer, Caleb Fader,” Alyssa said. “He came up with this great design to expand the NICU.”
The new space is larger, with space for 11 preemies in unique beds designed and built by Caleb. Instead of simply having the little wooden incubators by themselves, they are now attached to a bed for the mother with a mosquito net covering both the incubator and the mother’s bed. This allows the mothers to be more easily present at all hours, which is key because the hospital does not have enough nurses to have someone posted in the NICU at all times.
The funding to build the NICU came largely thanks to the care and fundraising work of the Grant family from Alyssa’s church in Birmingham, Alabama. Two of the Grants’ children are NICU survivors and the family was impacted by a story Alyssa shared about the need.
“They realized that neither of their boys would have survived if they had been born under these circumstances,” Alyssa said. “They wanted to give the same chance that their kids had to Burundian babies, so they raised funds to start the NICU. It was their dreaming and support raising that really made it all possible.”
Practicing medicine in a rural African context takes ingenuity and adaptability. Technology and infrastructure that are taken for granted in a western context are often unavailable or unsustainable.
“At one point, the hospital received a donation of a fancy U.S. incubator to the hospital,” Alyssa said. “It broke and was repaired about four times before it finally broke for good. Donated equipment is great when it works, but there’s nobody here that knows how to fix it. Plus, our power supply is not that great, so power surges often fry machines.”
“All that to say, I’m sure we could find somebody to donate 10 fancy incubators and send them out here,” Alyssa said, “but that’s not necessarily a sustainable, long-term solution.”
Sustainable, long-term solutions are the heartbeat of the Serge team in Kibuye whose desire is to bring high-quality, compassionate medical care in the name of Jesus to the poor in rural Burundi. They are there to not only invest in long-term medical equipment solutions, but also train a new generation of medical doctors for the region. Burundi’s infant and maternal mortality rates are among the worst in Africa.
“It’s still a long road ahead, but as far as I’m aware this is the only NICU anywhere near us,” Alyssa said. “These babies wouldn’t survive if we didn’t have this for them.”
*Editor’s note: kangaroo care a method of caring for premature babies in which the infants are held skin-to-skin with a parent, usually the mother, for as many hours as possible every day.
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