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Bénédicte, pictured here, was born early. Her mother, Bibiche Azoko Milembo, can’t afford to pay for an incubator, so she lights a fire near her baby in the morning and evening. Françoise Mbuyi Mutombo, GPJ DRC
Health

In DRC, Parents Make Homemade Incubators for Infants. But Do They Work?

Democratic Republic of Congo

Pre-term births are a big problem in Kisangani, a city in Democratic Republic of Congo. There’s a shortage of incubators and those that are available are too expensive for many parents, who instead take the preemies home and create incubation rooms there.

KISANGANI, DEMOCRATIC REPUBLIC OF CONGO — It’s around 7 a.m., and cold air hits Mangobo, a commune in the city of Kisangani. Angèle Mafuta Bahati, a 38-year-old stay-at-home mother, gave birth to her sixth child two months ago.

The baby, a girl, came early. She needs specialized care, but she’s at home with Mafuta Bahati instead of in a hospital.

“I had no idea what I could do to protect her,” Mafuta Bahati says. “The thing is, I didn’t have much money to afford her stay in an incubator and I finally decided to bring her home with me.”

In Kisangani, incubators are only available in two of the city’s 25 hospitals, even though it’s a city of nearly a million people. Using incubators results in costly medical bills that many parents can’t afford.

So, like Mafuta Bahati’s infant, many preemie babies wind up at home, where their mothers try to keep them warm by placing them in draft-free rooms heated by fires.

“Every morning, I light a brazier in my room next to my baby’s bed in order for the warmth of the fire to help the baby stand a chance to stay alive,” Mafuta Bahati says. “I do it every morning and evening, keeping a close eye on it for fear the baby may get burned.”

Pre-term births are a serious problem in Kisangani, in part because there’s a shortage of incubators in the city’s hospitals.

The only two hospitals that have incubators are the clinics at the local university and the public Hôpital du Cinquantenaire. There are eight total incubators at the clinics and six at the public hospital, says Franci Baelongandi, the province’s chief medical officer. Even if parents can get to those places, the cost of caring for preterm babies is still prohibitively high.

Patrick Ilunga, a pediatrician who works at Hôpital du Cinquantenaire, says parents can pay a flat fee of $200 or pay $10 per day for an infant who needs to be in an incubator.

The national government doesn’t provide enough funding for the city’s hospitals, says Franci Baelongandi, the chief doctor of Tshopo provincial health division.

I had no idea what I could do to protect her. The thing is, I didn’t have much money to afford her stay in an incubator and I finally decided to bring her home with me.

Increasingly, babies who are born pre-term don’t survive, Baelongandi says. In 2016, 12% of pre-term babies died, but that rate jumped to 18% in 2017. Now, 27% of all pre-term babies in the city die, he says.

There’s no data tracking whether more babies are born prematurely now than in the past, but the availability of pharmaceuticals might be contributing to the current problem, says Jean Lucien Abedi, a pediatrician in Kisangani. It’s common for pregnant women to get medicine from local pharmacies if they’re not feeling well, not realizing that the medicine might negatively impact their pregnancies, he says.

When those babies are born prematurely, homemade incubation efforts cause further problems, Ilunga says.

Fires built for warmth can cause babies to choke or develop fevers, he says. Plus, he says, while babies need warmth, they also need clean air, unsullied by smoke or pollutants.

The city’s available data isn’t complete, but according to data collected from hospitals in 2018, 194 babies were born pre-term between February and December, says Antoine Bombele Asonga, the head of Tshopo provincial health statistics office.

Despite the risks, some mothers say they have no choice but to try to care for their vulnerable infants at home.

Bibiche Azoko Milembo’s daughter Bénédicte was born early in December at Hôpital Général de Référence Makiso-Kisangani. That hospital has no incubator, so she was referred to Hôpital du Cinquantenaire. But she wasn’t able to pay the usage fee.

“I chose to return home with my baby and save its life myself,” she says.

Azoko Milembo says she lights a fire every morning at 6 a.m. and again in the evening at 6 p.m.

“I saved the life of my kid,” she says.

Ndahayo Sylvestre, GPJ, translated the article from French.

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