Our Neonatal Tetanus Survivor; Thanks to Round-the-Clock, Specialised Care
In Cambodia, as in other developing countries, it is rare for a newborn to survive neonatal tetanus. However, *Mean – now three months old – is an exception to the rule; after spending a month in our neonatal unit with specialized care, she is now healthy and back at home with her family. Mean comes from a poor Khmer-Muslim family, living in a floating village in Battambang province. From birth her symptoms became worse daily. She experienced convulsions, fever, contracted spine and refused to breastfeed.
Her mother was worried and brought her to the Battambang provincial hospital. Doctors there tried to assist, but Mean’s condition did not improve. After four days at the provincial hospital, the doctors there informed the family that they believed Mean required more skilled neonatal care. They referred Mean to Angkor Hospital for Children, though her mother had never been to Siem Reap before. Mean was transferred by ambulance.
AHC’s neonatal doctors found out that Mean had neonatal tetanus and needed immediate attention. Tetanus occurs when bacteria enter the body through a break in the skin. The bacteria produce a poison that attacks the central nervous system. It can be potentially fatal for newborns because their respiratory muscles can become paralyzed, causing difficulty in breathing and inability to breastfeed.
Mr. Chea Phal, AHC’s Neonatal Unit Manager initially had little expectation of being able to save Mean. However, he brought some hope to Mean’s mother by promising that AHC would try their best to save her baby.
AHC’s neonatal and social work units worked together to provide specialized care to Mean, whilst supporting Mean’s family throughout their stay in Siem Reap. Doctors started her treatment with emergency intubation, allowing poor Mean’s lungs to receive air properly and reducing her body convulsions. AHC’s neonatal team cared very closely for Mean around the clock for the next month. Mean’s condition was very serious upon arrival, but day by day she improved. Remarkably, within a month she had recovered.
According to Mr. Phal, tetanus vaccination is key for pregnant mothers: “When a mother does not get a tetanus vaccine during her pregnancy, her baby is at high risk of contracting tetanus. The practice of delivering a baby with a traditional midwife at home is also a threat to the baby’s health. The tetanus infection can occur via the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. Most cases that we see at AHC are due to this”, says Mr. Phal.
To avoid neonatal tetanus, Mr. Phal warns mothers to be sure to receive the tetanus vaccine and to always deliver their baby at a clinic or hospital, where the equipment used is likely to be sterile. Mr. Phal warned against following many of the old traditions, such as drinking alcohol after giving birth or using unlicensed traditional medicines during pregnancy and after birth. Immunization, hygienic birth practices and proper post-natal care are vital to preventing the disease.
Neonatal tetanus was officially eliminated in Cambodia in 2016 – meaning there is a very low incidence of cases within Cambodia now. During 2016, AHC received four cases of neonatal tetanus. Two lucky infants survived, whilst sadly, the other two died after failing to respond to treatment. Without the intensive and dedicated care provided by our Neonatal professionals, it is unlikely that any of these babies would have survived.
*Patient’s name has been changed for confidentiality reasons.