Photo: Evan Shuurman/Save the Children
Just over two years ago the world was celebrating the birth of a Philippine baby girl, Danica, the world’s 7 billionth person. Today we find hope in the stories of Yolando, Jolie and of Bea Joy. We mourn with those families whose babies have not survived, and those who have brought new life into the world amidst much loss.
In the Eastern Visayas region of the Philippines around 60% of women give birth without a skilled attendant present. However, many women in the devastated Tacloban, the region’s most urbanized city, would have been planning for a facility birth when the storm hit. Instead, new mothers like Jolie’s gave birth in an abandoned concrete building with only a midwife present. An estimated 200,000 pregnant women have been affected and are at risk.
Mothers and babies already in the hospital at the time of the disaster have had to move vulnerable babies to makeshift wards with little equipment, unhygienic conditions, and overburdened healthcare workers. Maternal stress is a known contributor to preterm labour and it is plausible that the storm contributed to an uptick in preterm births during a week when communities across the globe observed World Prematurity Day. The humanitarian community and the Philippines national health system is struggling to cater for the needs of premature babies in the typhoon-impacted areas. With incubators unavailable and water supplies compromised, support for mother-led interventions like Kangaroo Mother Care and early and exclusive breastfeeding are more needed than ever.
As Save the Children Philippines Deputy Country Director Ned Olney told CNN, pregnant women and newborns are most at risk. “Anywhere in the world the first day of life is the most dangerous day of your life,” he says, “and in a situation where there is little medical care, no clean water, and no electricity, no antibiotics, and very few doctors and nurses, it’s really a crisis statement that a newborn could survive there.“
While the setting is undeniably more challenging, the interventions for the major causes of newborn mortality—prematurity, intrapartum-related deaths, and infection—don’t change in humanitarian crises. The need for efficient, rapid implementation coupled with information and innovation just becomes even more pressing. In stressed health care systems, low-tech interventions like Kangaroo Mother Care are essential.
Recognising the vulnerability of every newborn, and noting the lack of specific guidance for newborns in humanitarian crises, an inter-agency collaboration including representatives UNFPA, UNICEF, WHO, the U.S. Centers for Disease Control and Prevention (CDC), Columbia University, Save the Children, the Women’s Refugee Commission and World Vision have come together to address this important gap. The forthcoming field guide and tools are intended to be used in concert with the 2010 Inter-agency Field Manual on Reproductive Health in Humanitarian Settings (IAFM) and The Sphere Handbook as well as other tools designed to strengthen maternal, newborn and child health services in emergencies.
This work galvanizes efforts to ensure that life-saving care is available even in the most difficult of circumstances. Many of these deaths could be prevented if women can access care for themselves and their babies and if health workers are enabled to deliver these services, particularly at the time of birth and during the first week of life. The current disaster in the Philippines reminds us the critical role of disaster preparedness for both communities and health facilities and the need to safeguard care for newborns and their families.