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Breakthrough in Maternal care to save mothers & babies

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By Dana Malcolm 

Staff Writer 

 

 

May 15, 2023 – Mothers and newborns are dying at unacceptably high rates according to the World Health Organization because basic care is unavailable to them, but a new invention might help turn the tide.

“Global progress in reducing deaths of pregnant women, mothers and babies has flat-lined for eight years due to decreasing investments in maternal and newborn health, according to a new report from the United Nations (UN). The report shows that over 4.5 million women and babies die every year during pregnancy, childbirth, or the first weeks after birth – equivalent to 1 death happening every 7 seconds – mostly from preventable or treatable causes if proper care was available,” a report released on May 9th said.

Progress on decreasing maternal deaths halted in 2015, with around 290,000 maternal deaths each year, 1.9 million stillbirths and 2.3 million newborn deaths.  COVID-19 only exacerbated that issue.

Along with the report the WHO revealed that a new solution, called E-MOTIVE, could provide a major breakthrough in reducing risk of the leading cause of death in new mothers: childbirth-related bleeding.

It affects an estimated 14 million women each year but despite being treatable, it results in around 70,000 deaths – mostly in low and middle-income countries, the WHO says.

E-MOTIVE is a trial process that measures blood loss using a simple, low-cost collection device called a ‘drape’ and when cause for concern arises, bundles together recommended treatments instead of offering them one by one.

The WHO and UN say to increase survival rates, women and babies must have quality, affordable healthcare before, during, and after childbirth.  E-MOTIVE seems to fit the bill with bullseye precision, removing the element of guesswork involved in using visual markers for blood and instead, collecting the blood as it drips then immediately beginning treatment including uterine massage, medicines to contract the womb, and stop the bleeding, intravenous fluid administration, an examination, and when needed, escalation to advanced care.

It is also not a specialty service and midwives everywhere can be taught to perform it.  The study was performed across Kenya, Nigeria, South Africa and Tanzania.  Two hundred thousand women participated, and the use of E-MOTIVE resulted in dramatic improvements where severe bleeding (when a woman loses more than a litre of blood after birth) was reduced by 60 percent.

Health

Dengue cases rising in Region 

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Dana Malcolm 
Staff Writer 

As of March 26, 2024, over 3.5 million cases of dengue and more than 1,000 deaths have been reported in the region, now, both the US Centres for Disease Control (CDC) and the Pan-American Health Organization (PAHO), are ringing alarm bells about the outbreak as cases swell to record highs.

PAHO on March 28 called for collective action in the region to fight back the growing wave of infections.

“This is cause for concern, as it represents three times more cases than those reported for the same period in 2023, a record year with more than 4.5 million cases reported in the region,” Jarbas Barbosa, PAHO Director said during a press briefing.

For now cases are concentrated in three main countries: Brazil, Paraguay and Argentina which account for nearly all of them, around 92 percent, but infections are on the rise regionally.

According to Barbosa, Caribbean countries must still be vigilant as data is beginning to show increases in areas like Barbados. That is paired with concerns from PAHO that some countries may not be equipped to handle the surge.

Nearly $500,000 was allocated in the 2023 2024 budget to the environmental health department under The Turks and Caicos Ministry of Health and Human Services to help with dengue which had been listed as a public nuisance.

Last year in the Turks and Caicos Islands, only a few rounds of fogging were completed. According to data from the Appropriations Committee around 10% of communities were fogged on schedule. Explaining the low number, representatives of the Environmental Health Department (EHD) maintained that fogging was not the primary defense against mosquito breeding locally.

”Fogging should actually be a last resort, there are preventative measures such as the treatment of swamps, and inspection of residential areas and communities for breeding sites.”

Representatives admitted though that they were still hampered by a lack of resources.

The country declared an outbreak in late 2024. Now there is an ongoing public education campaign to make residents aware of what they need to do to keep their homes safe and free from mosquitoes in addition

The Turks and Caicos Islands EHD also says they have been provided with money to help with garbage disposal in their battle against the vector borne disease.

The Ministry has also contracted entomologists to research what kind of mosquitoes live in the country and how to tackle them.

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Health

31 Turks & Caicos Medical Professionals, Trained in Trauma care

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Dana Malcolm 
Staff Writer 

In a first for the Turks and Caicos and one that some would describe as particularly important, over three dozen healthcare professionals were upskilled in emergency trauma care via Advanced Trauma Life Support (ATLS) certification.

Trauma Care in emergency medicine usually refers to treating patients who are critically ill or have severe injuries and need to be quickly stabilized like gunshot wounds, damaged limbs, crush injuries, and stab wounds.

In 1976 following a plane crash involving a surgeon and his children who experienced substandard trauma care, the first ATLS course was created. It attempts to provide basic training for medical professionals when dealing with acute trauma cases where there is little staff on hand. In fact ATLS is supposed to work with as little as a single doctor and nurse team working together to stop the most critical injuries first, ensuring a better chance of survival.

This is particularly useful for the Turks and Caicos with its small hospitals and limited staff. Health officials admitted this, highlighting what they describe as ‘the pressing need for such training, particularly due to physician shortage, isolated communities in family islands and other barriers to accessing this critical training.’

Recognizing the need, the Hamilton Education Foundation jumped into action, and in collaboration with Massachusetts General Hospital and the American College of Surgeons conducted a Hybrid Advanced Trauma Life Support (ATLS) Demo for 31 doctors in the Turks and Caicos Islands on May 22nd and 23rd, 2024.

Led by Professor Susan Briggs,the foundation describes the course as historic in that it’s the first-ever done outside the United States and says it is;“Crucial for enhancing the quality of healthcare delivery and saving lives in the face of increasing intentional and unintentional injuries.”

With the rise in gunshot injuries in the country, seen through police data since 2020 many residents might be inclined to agree.

While admitting it was difficult to measure if ATLS reduced mortality, a 2016 article published in the National Library of Medicine describes the courses as “very useful from an educational point of view. It significantly increased knowledge, and improved practical skills and the critical decision making process in managing multiple trauma patients”

Rufus Ewing, Former Premier and Executive Chairman of the Hamilton Education Foundation, said, “This initiative aligns with our mission to enhance medical education and improve access to quality healthcare services in the Turks and Caicos Islands.”

The training received broad brush support from the Ministry of Health, TCI Hospital and private sector.

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Caribbean News

Dengue surges in Argentina; Repellent shortage reported

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Rashaed Esson

Staff Writer 

 

#Argentina, April 15, 2024 – Argentina is currently facing a shortage in mosquito repellents, a severely unfortunate development for the nation as it is now fighting a surge in dengue cases, in-line with PAHO predictions that the region will face its worst dengue season on record.

The mosquito repellent shortage was reportedly noticed in March 2024 and Argentina, according to the Ministry of Health, recorded over 163,000 cases with deaths in all age groups, more common for those over 80 years old.

The situation is widespread across Argentina as indicated by supermarkets putting on display “no repellent” signs.

Places where repellents are still available,  online spaces especially, are selling them at high prices.

As to the reason behind the shortage, BBC reports that it was told by one of the production companies (for repellents), that a forecast error was at fault and that manufacturing took months.  Additionally, mirroring this,  Mario Russo reports a supply and demand problem.

The Government is making efforts to have this sorted as soon as possible, but Argentinians, reports say, are not so hopeful as hundreds of thousands have already been infected.

Preventative measures such as repellents are crucial for Argeniniand who reply heavily on them, as they await the dengue vaccine which is already developed, but still In its early stages of distribution.

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