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How 'Kangaroo' Care Saves Premature Babies In Senegal

First established in Colombia, kangaroo care for underweight babies relies on constant mother-child contact and avoids costs and complications of incubators that rarely arrive in Africa.

Twin boys strapped to their grandmother’s chest in Malawi.
Twin boys strapped to their grandmother’s chest in Malawi.
Rémi Barroux

DAKAR — Three moms are occupying the cream-colored room of the Albert-Royer Children Hospital, in the Fann neighborhood of Senegal's capital. Each is caring for her newborn of little more than four pounds. Resting skin-to-skin, the contact between mother and child provides the warmth necessary to treat premature babies. This is called the "kangaroo method."

As she is cuddling her little Adama, one mother named Comba Fall wears a special homemade T-shirt that has a slit to let her son's head out. The 23-year-old mom has been there for four days, after realizing that her son, born during the eighth month of pregnancy, was losing weight. He was only 3.5 pounds at birth. But so far, the kangaroo method is working: Adama is gaining around 0.3 ounce per day.

From their beds, the two other mothers report similar progress, and all are expected to soon be allowed to go back home.

"We have to be sure that the child is regaining weight and that the mother understands the instructions, that she breastfeeds her baby every two or three hours, because the child is sleeping most of the time and doesn't indicate when they need to eat," explains Fall Aida, who heads this special Kangaroo Unit in the Dakar hospital.

Three nurses and a pediatrician are in charge of the service. Issa Niang, 22, is set to go back home. Her child weighed 3.7 pounds at birth. "He will stay in kangaroo until he will weigh 6.6 pounds, the mum will have to carry him strapped to her until that moment," Aida adds.

The Albert-Boyer hospital was created in 1982 with Canadian aid, but this service was inaugurated in 2011 and it has already helped care for 181 children. The first baby the Center took charge of was from Tuba, around 125 miles east of Dakar. Born in the sixth month of pregnancy, he weighed only 28 ounces at birth and was declared "non-viable." A few months later, the child went home, healthy.

The Colombian pediatric team of Edgar Rey and Hector Martinez inaugurated this method for the first time in 1983, in order to treat preterm newborns. It represents an alternative to cumbersome and expensive incubators, a solution particularly welcome in countries where malnutrition risks weight loss for already premature babies.

Emotional advantages

Supported by the World Health Organization (WHO), this technique helps fight against infections and gives a "thermal protection" to the babies. It also allows for mothers to breast-feed their children and it is positive for the newborns' development as "emotional connections" are easier to establish.

"Our incubators could not solve all the problems," explains Haby Signaté, Head of the Hospital Neonatal Unit. "The whole concept is based on the mothers. At the beginning, many of them are afraid, and it goes against the custom of mothers here carrying the babies on their back. But the kangaroo method is reliable and affordable."

The model's simplicity is the secret of its success. It was borrowed from the Kangaroo baby and its development inside a marsupial pouch, that typically lasts for 250 days. "We decided to expand the kangaroo to a national scale," declared Dr. Bocar Daff, Head of Reproduction Health and Child Survive to the Senegalese Health Ministry. "Since we lack the means, it is a priority. We have ten units like the Albert-Boyer, but it is not enough." With the help of UNICEF — United Nations Children Fund — pediatricians and nurses are trained in the method.

Neonatal health troubles are still significant in Senegal, with the rate of assisted labor by qualified staff at just 65% in 2012. "All the others are giving birth helped by traditional birth attendants or grandmothers," says Nestor Pepe Azadegbe, Health Advisor for the United Nations Population Fund. "In 2000, this rate was 47%, so the evolution is positive."

To support Senegalese health policy, France contributes to the Muskoka Health Fund, which help 11 countries in Western Africa to decrease mother and child mortality, as part of the Millennium Development Goals. "The international help represents a third of the health expenditures in Senegal," notes Daff.

The beauty of the kangaroo method, notes Nestor Pepe Azandegbe, is that it is innovation that eventually can arrive at zero fixed cost.

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Anne-Sophie Goninet, Jane Herbelin and Bertrand Hauger

👋 Asham!*

Welcome to Tuesday, where Pyongyang test fires a suspected submarine-launched missile, Colin Powell is remembered, Poland-EU tensions rise, and yay (or yeesh): it's officially Ye. Meanwhile, our latest edition of Work → In Progress takes the pulse of the new professional demands in a recovering economy.

[*Oromo - Ethiopia and Kenya]

🌎  7 THINGS TO KNOW RIGHT NOW

• North Korea fires missile off Japan coast: South Korea military reports that North Korea has fired a ballistic missile into the waters off the coast of Japan. The rocket, thought to have been launched from a submarine, is the latest test in a series of provocations in recent weeks.

• Poland/EU tensions: Polish Prime Minister Mateusz Morawiecki has accused the EU of "blackmail" and said the European Union is overstepping its powers, in a heated debate with EU Commission President Ursula von der Leyen over the rule of law. The escalation comes in the wake of a controversial ruling by Poland's Constitutional Tribunal that puts national laws over EU principles.

• Colin Powell remembered: Tributes are pouring for former U.S. Secretary of State Colin Powell, after his death yesterday at age 84. Although fully vaccinated, Powell died from complications from COVID-19 as he was battling blood cancer. A trailblazing soldier, he then helped shape U.S. foreign policy, as national security adviser to President Ronald Reagan, then chairman of the Joint Chiefs under Presidents George H.W. Bush and Bill Clinton, and served as the nation's top diplomat for George W. Bush. Powell's legacy is, by his own admission, "blotted" by his faulty claims of weapons of mass destruction to justify the U.S. war in Iraq.

• Russia to suspend NATO diplomatic mission amid tension: Russia is suspending its diplomatic mission to NATO and closing the alliance's offices in Moscow as relations with the Western military block have plunged to a new low. Foreign Minister Sergei Lavrov announced the move after NATO expelled eight diplomats from Russia's mission for alleged spying. Relations between NATO and Russia have been strained since Moscow annexed Ukraine's Crimean Peninsula in 2014.

• Ecuador state of emergency to battle drug crime: President Guillermo Lasso declared a state of emergency amid Ecuador's surge in drug-related violence. He announced the mobilization of police and the military to patrol the streets, provide security, and confront drug trafficking and other crimes.

• Taliban agrees to house-to-house polio vaccine drive: The WHO and Unicef campaign will resume nationwide polio vaccinations after more than three years, as the new Taliban government agreed to support the campaign and to allow women to participate as frontline health workers. Afghanistan and neighboring Pakistan are the last countries in the world with endemic polio, an incurable and infectious disease

• Kanye West officially changes name: Some say yay, some say yeesh, but it's official: The-artist-formerly-known-as-Kanye-West has legally changed his name to Ye, citing "personal reasons."

🗞️  FRONT PAGE

The Washington Post pays tribute to Colin Powell, the first Black U.S. Secretary of State, who died at 84 years old from complications from COVID-19.


💬  LEXICON

Jashn-e Riwaaz

Indian retailer Fabindia's naming its new collection Jashn-e Riwaaz, an Urdu term meaning "celebration of tradition," has been met with severe backlash and calls for boycott from right-wing Hindu groups. They are accusing the brand of false appropriation by promoting a collection of clothes designed for Diwali, the Hindu festival of lights, but giving it a name in Urdu, a language spoken by many Muslims.

📰  STORY OF THE DAY

Work → In Progress: Where have all the workers gone?

After the economic slowdown brought on by the coronavirus pandemic, companies all over the world are taking advantage of loosened lockdowns and progress on the vaccine front to ramp up operations and make up for lost productivity. But the frenetic spurts of the recovery are getting serious pushback. This edition of Work → In Progress looks not only at the coming changes in our post-COVID economy, but also the ways our world is re-evaluating professional obligations.

🗓️ Hail the 4-day week Across the planet, the shorter work week trend is spreading like wildfire. Four is the new five. Spain began experimenting with the concept earlier this year. New Zealand launched a similar trial run in 2020. And in Iceland, efforts to curb working hours date all the way back to 2015, with significant results: 86% of the country's workforce gained the right to reduce work hours with no change in pay.

🚚 Empty seats In the United States, meanwhile, a severe lack of truck drivers has the country's transportation industry looking to hire from abroad. The only problem is … the shortage is happening worldwide, in part because of the e-commerce boom in the wake of worldwide quarantines. The Italian daily Il Fatto Quotidiano reports that companies will be scrambling to fill the jobs of 17,000 truck drivers in the next two years. The article blames low wages and the dangerous nature of the job, stating that Italian companies are making moves to employ foreign workers.

💼 Key help wanted It's all well and good to question current working conditions. But what about 20 years from now? Will we be working at all? A recent article in the French daily Les Echos posed just that question, and posits that by 2041 — and with the exception of a few select jobs — automation and digitalization will decimate employment. The piece refers to the lucky few as "essential workers," a concept that originated with COVID lockdowns when almost all labor halted and only a minority of workers capable of performing society's most crucial in-person tasks were allowed to carry on.

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📣 VERBATIM

I'm worried for my Afghan sisters.

— Nobel Peace Prize recipient Malala Yousafzai Nobel Prize tells the BBC that despite the Taliban's announcement that they would soon lift the ban on girls' education in Afghanistan, she worries it "might last for years."

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