LUTH tops newborn survival rates with Recycled Incubator Technique
Health Aug 10, 2010By Sola Ogundipe
MORE newborn babies survive at the Lagos University Teaching Hospital (LUTH), Idi Araba, Lagos today than in the past and currently, the tertiary health institution is reputed to have a newborn survival rate that is almost three times the national average.
The presence of a reliable neonatal unit which ensures greater chances of survival for premature babies in particular, has also contributed signifcantly to increased patient admissions and reduced length of stay in the hospital.
These facts came to the fore in the wake of last week’s successful delivery of a set of quadruplets at the hospital. – a feat largely attributed to the installed neonatal unit comprising 29 fully functional incubators, including 25 refurbished units that were reactivated under a novel Recycled Incubator Technique (RIT) initiative.
In an exclusive interview, designer of the first RIT system, Dr. Hippolite Amadi, a Consultant Orthopaedic Biomechanist said LUTH currently had the higherst number of functional incubators nationwide. Amadi, who is also an expert in Musculoskeletal Biomechanics, at the Department of Bioengineering,Imperial College London, Consultant Orthopaedic Biomechanist, essentially a specialist in cutting edge medical technology and branch of paediatrics known as Neonatal thermoneutrality, observed that the RIT could be considered Nigeria’s gift to the world, because in 2007 when it was described in medical literature, The RIT was a big story to the world that incubator systems that had been obsolete for as long as 15-20 years had come back to life and were saving lives in Nigeria.
Amadi stated emphatically that the RIT is partly Nigerian and partly foreign. “The whole idea is picking what has been thrown away and bringing it back to life.The incubator has the shape of what it used to be, maybe 20 years ago when it was thrown away, but what is inside is up-to-date technology.
According to him, it is interesting that LUTH came to benefit from RIT in January 2007. “As at January 2007, there wasn’t a single functional incubator in the hospital, but today LUTH has the highest number of incubators in Nigeria.” He added that the development could explain why many newborns were not surviving previously because they required incubator use.
“It was quite bad for the hospital at that time, but when the present management invited me for collaboration, they had an advantage that most of the carcasses of the old incubators were still intact.
“Many of the patients were leaving because they could not cope and even this development affected the training of clinicians in the field of neonatology because you cannot effectively train doctors when the patients are not there. It is a chain reaction.”
Noting that it is avery big advantage for a hospital to have good patient flow, the biomedical engineer observed that with good patient flow, a hospital would have enoughitsyopur doctors and the institution would improve. He said:
“Patient demography is sensitive to functionality. When functionality drops, the patients stay away. But the momemt a unit becomes functional, they begin trooping back, and that’s what’s happening at LUTH. Patient demography in the last three years has just surged to 56.4 percent. It’s a record number and they can hardly cope. the hospital is extending and expanding because people are coming from all over Lagos. LUTH is really functional and needs decongestion.
Further, the medical expert said: “The present management at LUTH tackled the problem headlong. They had asked questions about what had happened in other hospitals and were ready to give it a trial. They began with an initial 10 carcasses that were recycled and every year have recycled five.
“From nothing in 2007, LUTH today has a total of 29 functional incubators and this is a record number because there is no other hospital that has up to 20 incubators. The hospital with the next highest number is the University of Port Harcourt Teaching Hospital, which is one of the longest applying RIT in their hospital. Some Teaching Hospitals have had their RITs in the last seven years, but LUTH which began in 2007 is leading. For instance, the University of Benin which began the technique in 2005 has 11 RITs.”
He recalled that the UPTH maintained the lead from 2004 until LUTH stepped into the picture. “Apart from LUTH and UPTH, many other teaching hospitals have less than 10 functional incubators. Yet these are places that require at least 15 functional incubators each at any time.’
Talking about the RIT, he said: “ I designed it in 2002 and in 2003 put together the configuration at the University of Enugu Teaching Hospital (UNETH) for human clinical trials. The result was success ful and we now started introducing them in different teaching hospitals. It is thanks to the RIT that LUTH has newborn survival rates that are higher than the national average. ” Findings also revealed that for most of 2009, RIT was No. 1 in the world chart for top medical 50 findings under incubators. The chart, which is renewed every month has never witnessed the RIT going further than the 10th place.
“Can we really save our babies,” he asked? “Data from the Federal Ministry of Health (FMOH) states that 781 babies die everyday in Nigeria. It is disturbing. What solution do we have? It would be a fool’s paradise to think that the white man will come here.All these led to the solution All these babies cannot be going to the grave. It is the quest of this solution that made me start to reequip the neonatal unit across the country. It is a research work that lasted five years project that started in 2007.”
Quoting a recent 6th-year follow up of RIT in Nigeria, Amadi said he and his research team concentrated on the systems the initiative has functioned on in Nigeria for seven years. “So the 6th year study for all the systems, and aggregated it over another 69 incubators that have covered three years plus to characterise the whole idea of RIT and the result was impressive.
“It chronicles where the hospitals stand within the column of the national average and what has happened in the last three years when the RIT was introduced here. Still deliberating on the 6th-year follow up, Amadi said it wasthe kind of result that is exciting.”
Amadi opined that from the view point of the Thrid World, the instruments used to procure thermoneutrality (i.e., incubators) are very expensive to procure. “Some-state-of-the-art incubators in this country cost as much as N9 million. This is a huge sum of money when you come to a standard hospital such as LUTH that requires as many as 30 incubators, where does it get the money to procure these incubators at the average cost of N6 million each? It may have to shut down so many other units just to run the neonatal unit, which is just a tiny bit of the paediatrics department.”
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