Inside a Kangaroo Unit: where tiny babies’ lives are on knife-edge


For 25-year-old Zione Pilirani (not her real name), this was her tender life’s defining moment. She was basking in her pride-evoking status of being pregnant, in her seventh month.

Mentally, she enjoyed ticking off every day as she looked forward to the mandatory nine-month wait before she could hold her own bouncy baby in her arms.

Zione could not help fantasising how she would show-off her new-born baby to all and sundry in her community.

But then something terrible happened.

On this day, it started with a mere trace of blood when she went to relieve herself in the toilet. Later, the bleeding was serious and she and her husband rushed to see a doctor at the hospital.

The quick-thinking doctor and a team of nurses decided to induce labour—to save both the mother and the baby. They murmured that it would be a ‘bonus’ if both survived.

Luckily, both survived.

But when Zione was first shown her son, who was later named Chisomo, could not belive her eyes as the nurses took her pre-term baby to the nearby Kangaroo Unit.

“This little thing cannot be my child,” she fumed. “Tell me something else! You must have exchanged children and you have ended up giving me this tiny thing… No! It’s unfair: I demand my fully-grown child now!”

Nurse-midwife Linna Phiri—who has been in the Kamuzu Central Hospital’s Paediatric  (Children’s) Ward for 15 years, with the latter three years in the Kangaroo Unit—says she and her colleagues are used to managing such outbursts emanating from the shock and trauma mothers experience when they see their tiny premature babies.

“Many mothers go into denial [technically called post partum depression] and they can be aggressive when they see their tiny babies, who may weigh only one kilogramme [1kg], or less, at birth. The birth weight for normal new-born babies should be twice or thrice this.

“We immediately counsel such mothers, who end up accepting the reality. We quickly teach them how to maximise their children’s chances of survival through love and specific Kangaroo routines,” she adds.

Phiri explains how the mothers are taught the life-saving routine of placing heads of their premature babies between their breasts, while the parents strap their babies on their chests, ensuring continuous stomach-to-stomach contacts between the two.

“The cardinal rule is that the premature baby must be kept warm all the time. Such babies often die when exposed to coldness.

“So, where the mother needs to rest, a guardian, or even a husband, should take over in strapping the baby on the chest. To gain weight, the babies also need to be frequently breast-fed, or given special baby-formula milk where the mothers’ breasts are unable to produce enough milk,” she adds.

In the Kangaroo Unit, babies with critically low weights are kept in the high-risk section. Mostly, they are put in electricity-powered incubators where the heat is carefully controlled and monitored.

As this reporter was fascinated by, if not worried with, the tiny babies showing life through feeble limb movements in the incubators, he could not help asking the question of what happens when there is a power black-out.

“Oh, no!” Phiri exclaimed, adding: “That may mean deaths to many of the children under our care. But, luckily, the infamous black-outs do not affect us in this unit as we have standby generators and back-up for power all the time.”

Marita Samuele, aged 31, has a baby lying critically ill in one of beds in the high-risk section.

She carried her pregnancy for only eight months. She had delivered twins—a boy and a girl—who weighed 1.5 kg each at birth.

Sadly, the boy twin died within 12 hours after birth, reportedly from breathing complications. And the remaining baby is on oxygen-support machine.

“I testify that premature babies shock and worry mothers in their small and vulnerable state,” says Samuele, who is married to a small-time builder and they have three other children.

Alefa Gwande, 19, is also admitted to the unit with pre-term twins. Both are girls who were born weighing 1.5 kg and 1.3 kg, respectively. She may be discharged soon if the babies gain more weight.

At the unit, recently, mothers with children on their lives’ knife-edge were greatly motivated when Lilongwe-based four-year old Zuri and grandmother Evetta Mwangupili paid them a special visit.

The two came to make a K500 000-worth donation—including baby blankets, pails, basins and laundry soap—to the Kangaroo Unit.

What motivated them?

Zuri, now a truly bouncy girl, had also been admitted to the Kangaroo unit’s high-risk section for about a month soon after birth. Her mother, Monica, who gave birth through the Caesarean section after only 28 weeks of pregnancy, also experienced the trauma the other mothers have at nursing under-weight children to normal growth.

Over and above this, Zuri’s grandmother worked hard in nursing both Monica and her child during the time the two were at the Kangaroo Unit.

Mwangupili knew what to do at the unit, to supplement the medical personnel’s work. She is a nurse-midwife and mental health and psychiatric nurse, with the add-ons of a Bachelor of Science Degree in Health Science in Education and a Master’s in Counselling and Guidance.

“There are many needs at the Kangaroo Unit, particularly for poor mothers who lack basics such as food and blankets, for starters. I think the public should be regularly assisting this busy unit,” she says.

The Mwangupilis have been matching their concerns with action. Over the past three years, they have been making annual donations to the unit; in one ward, they even introduced electric heaters there.

“On the psychology front, I like parading Zuri at the Unit and I testify that that as long as they follow instructions from the medical personnel, the mothers or guardians should not be worried about the survival of their tiny-looking babies. I tell them to look at Zuri as proof that there is plenty of life after this unit,” she declares.

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