Newborns in typhoon-wracked Philippines feel lack of hospital care

Newborns in typhoon-wracked Philippines feel lack of hospital care



Updated: November 16, 2013, 10:55 PM


Althea Mustacisa dies Saturday night

EDITOR'S NOTE: After the accompanying story was sent to press for The Columbian's Sunday edition, the report below moved on the Associated Press wire.

TACLOBAN, Philippines — All through her very short life, the parents had squeezed oxygen into her tiny body with a hand-held pump to keep her alive.

In the end, their prayers and whatever little medical care doctors could muster in the typhoon-ravaged hospital were not enough. Althea Mustacia, aged three days, died on Saturday.

She was born on Nov. 13, five days after Typhoon Haiyan annihilated a vast swath of the Philippines, killing thousands. The storm’s aftermath is still claiming victims, and Althea was among the latest.

She was born at the government-run Eastern Visayas Regional Medical Center, suffering from a condition called newborn asphyxia, a failure to start regular breathing within a minute of birth. The consequences are possible brain damage or death if not corrected quickly.

According to the World Health Organization, newborn asphyxia is one of the leading causes of newborn deaths in developing countries, accounting for about 20 percent of the infant mortality rate. In the United States, it is the 10th leading cause of infant mortality.

Althea could have been saved had the hospital’s ventilators had been working. But power lines were down in the entire region. There was no electricity and none of the equipment in the hospital — flooded and wrecked — worked. Not the ventilators, not the incubators, not the suction pumps to feed her oxygen.

Instead, her parents had to push life into her mouth with a hand-held pump connected to an oxygen tank. They took turns to do this continuously since she came into this world without stopping. With her lungs barely functioning, the only sign of life in the infant was a heartbeat.

But Althea’s fragile body could not cope. Even the heartbeat stopped on Saturday evening, a few hours after an Associated Press team visited the hospital.

The attending physician, Dr. Leslie Rosario, told the AP that her parents wrapped her body in a small blanket and left in tears.

By TODD PITMAN, Associated Press

TACLOBAN, Philippines — Althea Mustacisa was born Wednesday, in the aftermath of the killer typhoon that razed the eastern Philippines.

She was still alive Saturday because her parents have been pushing oxygen into her tiny body with a hand-held pump ever since she came into this world.

"If they stop, the baby will die," said Amie Sia, a nurse at a hospital in Tacloban city that is running without electricity and few staff or medical supplies.

"She can't breathe without them. She can't breathe on her own," Sia said. "The only sign of life this little girl has left is a heartbeat."

More than a week after Typhoon Haiyan annihilated a vast swath of the Philippines, killing more than 3,600 people, the storm's aftermath is still claiming victims — and Althea may be the next.

On Nov. 8, Haiyan transformed Tacloban into an unrecognizable wasteland of rubble and death.

The bottom floor of the two-story government-run Eastern Visayas Regional Medical Center was flooded, and the intensive care unit for newborns was left a muddy ruin. Life-saving machinery, like the facility's only incubator, was soiled with water and mud.

As the storm hit, staff took 20 babies from the intensive care unit to a small chapel upstairs, placing them three or four to a plastic crib cart built for one newborn.

All the babies survived the storm itself. But six died later, "because we lack vital medical equipment that was destroyed," said the attending physician, Dr. Leslie Rosario.

Within days, however, 10 more babies born during or after the storm came, including Althea. She was born in her family's typhoon-wrecked home, 5.84 pounds, unable to breathe.

When she was rushed to the hospital, doctors performed CPR on her and since then they have been giving her oxygen from the hand-pump connected to a blue rubber bubble that fits into her tiny mouth and draws from a green tank through a transparent pipe.

Doctors said the storm had not been a factor in the baby's problems, noting that insufficient prenatal care most likely complicated the pregnancy for the 18-year-old mother. The baby was not born premature.

Still, there was a good chance of saving Althea had the hospital had electricity to run a ventilator, incubator and other equipment.

Until Saturday, the makeshift ward in the chapel had no light except candles. On Saturday, one small fluorescent bulb attached to a diesel generator was hung in the middle of the room where a few packs of diapers sit on the altar below a picture of Jesus.

On the floor are a few more boxes of the only medical supplies left — water for IV fluids, syringes, a handful of antibiotics.

The hospital also lacks manpower. In the neonatal clinic alone, only three out of 16 staff are still working, Rosario said. The rest never reported back after the storm. The Philippines Department of Health sent two nurses from Manila to help.

The hospital chapel's windows are all shattered and missing. It is now filled with 24 babies — five in critical condition, the rest with fevers or other ailments. Many were born premature.

Their parents are there too, resting on 28 rows of wooden pews. Three mothers have IV drips.

Nanette Salutan, 40, is one of them. She said her labor contractions began just as the winds began howling. After the storm eased, she walked to the hospital with her husband, an eight-hour trek through corpse-filled rubble and waist-high water.

"All I could think was, I wanted my baby to live," Salutan said.

Her son, Bernard, was born that night — at 2:13 a.m., 5.73 pounds and 17.71 inches tall.

But he did not cry. He was not breathing.

Doctors performed cardiopulmonary resuscitation, and put clear green tubes of oxygen in his nose. He is still so weak that he has to be fed by a syringe that is connected to a tube taped to his mouth.

Rosario said Bernard had a decent chance of survival. But Althea's prognosis is not good.

In a heart-stopping moment, her body turned blue as her breathing became more labored. Doctors rushed in and connected an IV needle into the remnant of her umbilical cord — the one in her wrist had been there too long to be effective, they said. Slowly, life flowed back into her tiny body.

"If we had a ventilator, it's possible she could live," Sia said. "But right now she's very weak, and I don't think she's going to make it."

As she spoke, Althea's mother, Genia Mae Mustacisa, leaned over her baby girl, stroked her forehead and kissed it.

Methodically, her mother squeezed a green rubber bag attached to the tall tank of oxygen slowly over and over, every few seconds, just as her husband had done for half an hour before.

"It's OK," she whispered, tears streaming down her cheeks. "I love you so much. No matter what happens, I love you so much."