Dolls teach people in Kenya how to save infants through Helping Babies Breathe.
Bucher says the NeoNatalie doll simulator has been a life-saver. It's part of the Helping Babies Breathe program, which trains health-care workers in developing countries to prevent infant deaths. "This program gives the people a sense of empowerment and confidence," Written by. Barb Berggoetz.
On Sherri Bucher's trips to Kenya, she always brings a brown baby doll. But, more importantly, she brings hope to those who see newborn babies die needlessly.
The doll is called NeoNatalie, a lifelike newborn baby simulator. She is used to train birth attendants in developing countries simple, but essential, skills of resuscitating newborns, as part of the global Helping Babies Breathe program.
"Hope is a very limited resource (in Kenya)," said Bucher, assistant professor of research in the Department of Pediatrics at the Indiana University School of Medicine. "Babies are dying all the time from preventable diseases. It's almost a fatalism that pervades the hospitals."
Training on NeoNatalie, Bucher said, gives health-care workers and birth attendants optimism that they can save babies who have trouble breathing immediately after birth -- during what is called "The Golden Minute."
Bucher, 42, who has a doctoral degree in child development from the University of Connecticut, is a master trainer, global instructor and principal investigator of the Helping Babies Breathe-Kenya site. She returned recently from her fourth trip to Kenya, where she was heartened to see a child named Job -- one of the first babies saved -- now a healthy 1-year-old.
Why is the Helping Babies Breathe program needed?
Worldwide, about 10 million babies are born with breathing problems each year. It's a tragedy that about 1 million of them die from birth asphyxia, according to the World Health Organization. Many could be saved if only the people attending births had the knowledge and skills to perform basic neonatal resuscitation.
In Kenya, 57 percent of babies are born at home, often with birth attendants who aren't well-trained. In other developing countries, the rate is higher. An estimated 55 babies out of 1,000 die in Kenya each year (about 83,000) before their first birthday. About 60 percent of them die in the first month of life, and about a quarter of those deaths are from birth asphyxia, usually within 24 hours after birth.
How was the program developed?
The American Academy of Pediatrics was the primary developer of the program, in collaboration with the World Health Organization, the U.S. Agency for International Development, Saving Newborn Lives and other groups. The Laerdal Foundation for Acute Medicine, of Norway, provides funding. In late 2007, the AAP called for applications to develop a global site to teach and evaluate the curriculum. The challenge was to make the instruction simple and cheap and able to be taught to anyone delivering a baby anywhere, regardless of education level. The targeted areas are mostly in Africa and Asia and some in South and Central America.
How did IU get involved, and what is your role?
In 2008, I applied for a grant, on behalf of the School of Medicine, that we received in 2009 to be a global site. I knew the site of the existing IU-Kenya Program would be a good place to test the curriculum.
As of now, I'm one of 10 master trainers who have trained 16 facilitators in Kenya, and together, we have trained more than 400 birth attendants since July 2009. They are trained at the Riley Mother Baby Hospital in Eldoret, Kenya. Within six months, we had reports of some two dozen babies being saved. I go back to Kenya every four to six months to do training, monitoring and evaluation.
What skills are taught using NeoNatalie?
The newborn baby simulator, which looks like a baby doll, feels soft and weighs as much as a real baby when she's filled with either air or water. Basic neonatal resuscitation does not require any fancy equipment or drugs. Techniques taught are: drying the baby thoroughly; keeping the baby warm by wrapping her in dry, warm cloth and putting her skin-to-skin with the mother; clearing secretions from the mouth and nose (with suction bulb); and gently rubbing her back.
If the baby fails to breathe within one minute after birth, attendants are taught to use a bag-and-mask ventilation device covering the nose and mouth. When air is pumped into the baby, the chest rises up and down so the attendant knows the baby is getting air.
These techniques are replacing what they are used to doing -- holding the baby upside down, patting him on the the back, putting him under a heat lamp and praying. At first, Kenyan people were skeptical, but in January, they started to see this really worked.
Why is this initiative important to you?
As a researcher, I thought, "When do you get a chance to be so close to the solution to a big problem and to be part of that solution?" When I first went to Kenya in 2004, I saw they didn't have enough equipment and drugs and they were quite understaffed. But what struck me most was the lack of hope. This program gives the people a sense of empowerment and confidence. They're seeing the fruits of their labor and that they can bring the baby back. It's a great program. I feel very fortunate to be a part of it.
What impact can this program have?
This program can be a springboard for families adopting other healthy behaviors. Mothers whose babies have been saved are telling others about having babies at hospitals. They are making sure their babies are fully immunized.
Once this program gets rolled out globally, it can really make a significant difference. It's being started in India, Ethiopia, Pakistan, Bangladesh and Tanzania. But we need more funds to implement it fully.
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