Volunteer Reflection: Reducing the rate of infant mortality in Pakistan through Helping Babies Breathe

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By Dr. Paul Holtrop

By Dr. Paul Holtrop

Neonatologist

“Imagine you are at the delivery of a baby and the baby does not breathe or cry when born. No one knows what to do and the baby dies and the mother weeps. Now imagine you are at a similar delivery where the baby does not cry, but because you are there and have completed training in Helping Babies Breathe, you help the baby to breathe and she cries, becomes pink, and is then held by her mother.”

I forgot how powerful the opening of a Helping Babies Breathe (HBB) course is. Participants close their eyes while a leader tells the above story – which is especially potent in a country like Pakistan where the infant mortality rate is ten times higher than that of the United States. Fortunately, for the continuation of the human race, about 90% of infants breathe spontaneously when born. Most of the remaining 10% will breathe with basic resuscitation maneuvers, but in poor and underserved areas of countries like Pakistan, such babies are often simply left to die and are considered stillborns.

I recently returned from a mission in Pakistan with MedGlobal where I taught HBB to several participants. I am happy to say that I think we helped to decrease the number of infants who will not get adequate care if they do not breathe at birth. A variety of students attended the course – several of which were physicians in Pakistan whom we trained to be Master Trainers of HBB, people who are now qualified to go out to areas to run their own HBB courses. The idea is to have better resuscitation practices spread exponentially. The Master Trainers will move on to train more trainers and providers, and so on, until caregivers even in the most remote areas know how to help babies breathe at birth. We also taught several students, who are now qualified to assist with newborn resuscitation at deliveries, as well as students who can help master trainers teach HBB courses.

It was also a rewarding time for me, personally. The people of Pakistan were gracious and appreciative of our efforts. In addition to seeing HBB benefit the people of Pakistan, it was great to be part of the MedGlobal team. We ate breakfast and dinner together and bonded over our experiences. It’s not often that a guy like me gets to be part of a team anymore, so I enjoyed that in Pakistan.

Although I knew that Pakistan was far from a first world country, I was still taken aback by how poor it is. A common sight is a family of three or four, including very small children, riding together on one motorcycle, not a helmet in sight. Car seats? I did not see one in my week there. On a tour of one of the hospitals and clinics there, I asked our host, a family physician, if they advised their families to use car seats. She smiled at me benevolently and said, “the families I care for cannot afford cars.”

Maybe I should not be surprised that in a country that lacks such basic health and safety resources, some children are simply left to die because they do not breathe on their own at birth, but it is heartbreaking none the less – the health care needs are vast. It was gratifying for me to make a small dent in the need by teaching HBB, yet there is so much to do.

If you are like me, you are inundated with charitable donation requests, and you like receiving these requests about as much as I like making such a request. But the simple fact is that the projects that MedGlobal runs to improve health disparities in countries like Pakistan cost money, so please consider donating. Having been there, I can tell you this: it is a worthy cause.

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