In the Neonatal Intensive Care Unit of the Dr. Manuel Núñez de Maturín University Hospital, a bacteria is ending the lives of the newborns admitted there.
By: Jefferson Civira / Correspondent lapatilla.com
This has been the situation for several weeks now, and all the hospital director, Juan Carlos Gómez, has stated so far through a press release is that “it is very important that both family members and those close to the patient know and understand that: the main source of contamination within a hospital center is what comes from outside, which worsens if health control measures are not met.”
The Single Health Authority of Monagas, Yérika Alzolay, gave the guidelines for the creation of the Committee for the Control of Infections Associated with Care in Healthcare Centers, which means that from that government institution they admit there is a serious situation.
The alarming number of deceased children was made known through social networks, where a woman reported the death of her nephew, who was born after an eight months pregnancy and after five days confined in the main healthcare center of Monagas State, he died from sepsis as a result of an infection by Klebsiella pneumoniae, a multi-drug resistant bacteria and therefore, very difficult to eradicate and fight.
Specialized pages state that this type of bacteria is very common in hospitals and clinics because these are capable of adhering to plastic surfaces and spread easily through the contaminated hands of healthcare personnel. Health experts warn that the bacteria Klebsiella pneumoniae has become a global problem as a result of the resistance to multiple antibiotics that this pathogen has developed.
This microorganism is also usually transmitted through contact with clinical materials and instruments that have been contaminated such as catheters, probes or assisted ventilation, as well as the surface of operating rooms. In the case of the Maturín Central Hospital, babies admitted to the Neonatal Care Unit test positive in the blood culture test that parents must pay for in a private laboratory.
Many dead babies
Andreína Aray, who went viral for a post published on the social network “X” (formerly known as Twitter), disclosed that her sister had an emergency cesarean section was performed on October 25th and the baby developed respiratory distress, a common disorder of premature newborns in which the air sacs (alveoli) in their lungs do not remain open due to lack or insufficient production of the substance that coats them.
“Our baby, because we welcomed him as he was the first child, nephew and grandson. He was expected by the whole family. He was born weighing 2 kilos 300 grams. In those 5 days we experienced terror, because we saw more than 15 children die from pulmonary hemorrhage due to this bacteria. In many of the cases the families did not have the money to pay for the blood culture, which costs $30, but the few of us who could afford it tested positive for this bacteria,” said Aray, aunt of one of the many newborns who have died at the Maturín Hospital.
She questioned that in the health center there is no control system to eradicate this bacteria, while she pointed out that no type of tests can be performed in the hospital, because they lack reagents and supplies.
Furthermore, all laboratory studies must be performed in private institutions. Ms. Aray said she saw with pain how many parents could not pay for these tests, including arterial blood gases, which are only eventually performed at the hospital. The rest of the other studies are carried out outside the healthcare center and the cheapest laboratory costs $60.
Routine tests such as urea, creatinine, CRP, VDRL, hematology, among others, are not being done in the hospital laboratory either and must be performed for every patient almost every day.
Many parents barely had enough to eat, said the citizen. She added that parents must sleep in very poor conditions, even on the floor, with the hope that their babies will come out alive.
“The authorities practically mocked us because they know what is happening, what one experiences daily, the anguish that family members experience and they do nothing to stop this neonatal mortality. In any other country in the world this would be an epidemiological crisis, but the authorities act as if blind, deaf and mute. Although they can no longer give us our baby back, more deaths can be avoided, so I want the Government to take action on the matter,” Aray said.
Unsanitary conditions
In relation to the areas where the new mothers are kept once they give birth, she indicated that there is no water even though it is essential to clean themselves, which is why she affirms that they are exposed to great contamination. She added that the area is not cleaned daily and the bathrooms are in deplorable conditions, which is why many mothers want to be medically cleared immediately to leave.
“You can’t even imagine the conditions in the bathrooms. There are rats that can be seen running across the ceilings that are falling and the walls are full of mold, and it is not fair for a mother who just gave birth to experience everything that is experienced there,” says Aray.
No official data
The President of the Venezuelan Society of Childcare and Pediatrics, Huniades Urbina, points out that the last yearbook published in 2016 by the Ministry of Health, reported the death of 141 children under one year of age, a figure that was equivalent to 68% of the total neonatal mortality.
He adds that the most frequent causes of deaths are: sepsis, pneumonia, hyaline membrane disease, all preventable with effective health programs.
The intensive care specialist and also Vice President of the National Academy of Medicine, when asked about the situation that occurs in the Neonatal Intensive Care Unit, recommends that that area should be closed, absolutely everything should be washed, disinfected and when reopening, extreme asepsis measures should be taken and always there must be water and basic soap.
Likewise, he adds that until a bacteriological culture is done on the surfaces, which he highly doubts they will do, it is most likely that everything will remain a guess.
He presents as an example what is happening at the Doctor Luis Ortega Hospital in Porlamar, where also neonatal deaths have been recorded. A situation that he attributes to the lack of adequate asepsis in the facilities, which also does not have water or soap for hand washing, among other basic hygiene measures.
Exhausting days
Milena Alarcón, mother of one of the many deceased babies, narrated the nightmare that she lived during the 17 days that she was hospitalized with her little one. On October 4th, she gave birth in an early delivery, so she was considered premature and admitted to the Neonatal Intensive Care Unit of the Maturín Central Hospital after being detected respiratory failure.
Once admitted, she is ordered to perform a blood culture test, a particular blood test to detect bacteria. Her family does not know why they assumed that she had this bacteria and wanted to blame the mother for having a urinary tract infection during pregnancy.
However, the mother claims that this infection was treated and cured, but they still claimed that it was her fault. Although the baby underwent a series of laboratory tests, the bacteria that the mother presented during pregnancy never appeared in the newborn.
“They did many studies on the baby and applied countless treatments, because they insisted that it was the bacteria that I presented and almost every day they applied more than three types of antibiotics that degenerated her organs. When they finally accept that the bacteria the doctors were looking for was not the culprit, they decide to repeat the blood culture, and the clinical bacteria responsible for my daughter’s death, Klebsiella pneumoniae, appears. She was subjected to a central line catheter to treat the infection because it is a multi-resistant bacteria and none of the antibiotics they gave her did anything,” Alarcón said.
She stated that once the central line catheter was placed, the baby’s kidneys began to fail due to the treatments. She began to bleed and the next day, October 21th, the newborn died.
She is fearful that the babies who are admitted to the Neonatal Care Unit have the same type of bacteria, and although some children manage to recover, by continuing to be confined in that unit they become prone to be contaminated with another bacteria.
She assured that between Thursday, October 19th and Saturday, October 21th, eight children have died including her own. This she considers not normal, and what they ask of her to counteract the bacteria are commercial chlorine, disinfectants and even vinegar to: “decontaminate the area.”
“As a responsible mother, it seems illogical to me that they request for these items because they say that this will kill the bacteria, but those bacteria are resistant and are produced during the intubation of children, because that is what I have investigated. In my case, I was able to extend my daughter’s lifespan, but there were others who couldnot, because her children were physically more sensitive or simply did not have the economic resources. Just buying a bottle of immunoglobulin costs $320, which must and should be supplied by the Regional Health Directorate. In those 17 days I was able to see more than 20 newborns die and on the death certificate they present the same bacteria, that is not normal,” commented the affected mother.
The morgue: a horror movie
Daymar Silva, aunt of another of the many deceased babies, also wanted to present the case of her sister-in-law who was admitted on October 25th for an emergency cesarean section and that night her nephew, being premature, entered the neonatal intensive care unit. She said that the little boy had a digestive hemorrhage. However, it is only at noon the next day when her family is informed of the bleeding.
“They sent us to do a blood culture and it came out positive to the Klebsiella pneumoniae bacteria, the same one that comes out in all the children who are there. Children begin to die from digestive or pulmonary hemorrhage, which in this last case was when my nephew died and it is the same diagnosis that is given to all babies on their death certificate, because that is how I was able to see it. Another thing is the morgue, which is a horror movie: corpses on the floor, blood everywhere, bad odors and many flies, apart from the fact that you have to enter with a flashlight, because there is no lighting,” Silva explained.
She called on the Chavista authorities to address this situation that she describes as serious, not only in Neonatal Care, but in the ward where the recently given birth women are kept, which presents uncomfortable conditions. Some patients are even held in wheelchairs due to a lack of beds. Although she is aware that her nephew was a premature baby, she does not justify that between October 25th, when her nephew was admitted to Neonatal Care, and October 29th, the day he died, she saw 11 newborns die .
Those interviewed for this report agreed that the days they were at the Dr. Manuel Núñez University Hospital, no healthcare center authority or head of service informed them about this serious situation with the newborns, nor did the Single Healthcare Authority of Monagas director, Yérika Alzolay.