I was just about to leave the Children Emergency Room after a long night when I heard ‘doctor, please you have a patient’. Turning back, I saw the patient – he was a newly born baby – sleepy and peaceful. He was sleeping on the back of a woman who came to the hospital with 2 men and 2 other women. The baby appeared healthy but the entourage that came with him suggested something was terribly wrong.
What is the problem?
“The baby was delivered this morning with something like a swelling on his back,” the man said.
Before I could ask my next question, the baby was undressed, lo and behold, it was a very prominent swelling with some discharge coming from it which stained the wound dressing (gauze and plaster) put on the swelling by the birth attendant. Apart from the swelling, the child appeared normal – big male neonate, fine hair distribution, nice lips, well positioned ears, pink coloration, healthy looking, sleeping calmly on the grandmother’s laps.
‘What happened,” I asked. The mother bursted into tears, her eyes red and swollen already from crying. She appeared swollen all over from the face to the legs and I can relate to her predicament. She just gave birth to the baby the previous night and had not eaten since the deformity was discovered.
“I was barren for 6 years, this is my first baby. Doctor, tell me, is everything going to be alright?” she asked amidst her tears.
I looked into her eyes and with reassuring confidence, concern and compassion, I responded: “madam, everything will be alright”.
This was what I gathered from her. She got pregnant after 6 years of being married as a second wife to a farmer, she had been to many places including hospitals and the herbalists. When she eventually got pregnant, she assumed it was one of the medicines given to her by one of the herbalists that worked which was why she git her antenatal care at the herbalist’s place and delivered there as well. The baby was however referred to the hospital for expert management when the swelling was discovered.
On close observation, I discovered that the swelling isn’t esoteric, spiritual or previously unheard of. It has a name, it is spina bifida and it was the third one I would be seeing within the month. It is a neurological problem no mother should ever pray for.
Spina bifida is a congenital deformity of the spine which occurs in about 2-3 per 1000 life births. According to recent Nigerian study, the prevalence of neural tube defects is 2.2/ 1000 deliveries of which spina bifida was 72%.
Neonates with this condition may have a gross swelling on the back which may be pronounced, or a dimple, port-wine staining or pigmentation of the overlying skin. They may have neurological disorders which may include the shortening or deformities of the limbs, inability to walk, inability to control urine or faeces etc.
Can it be treated?
Just like several other medical conditions we consistently report here on HealthNewsNG, management of spina bifida can vary from conservative management to surgical management based on severity of the condition and the benefit to patient. It will involve a team of pediatricians, social workers, orthopedists and urologists among others, before the rupture of the sac if patient is considered suitable for surgery.
Personally, I think ‘is it preventable’? should be the question we should all be asking. The answer is yes. Surprisingly, it is very cheap also. All women of childbearing age, those preparing to have children or already making attempts to have babies should be on folic acid as advocated by the World Health Organization (WHO), this is to save a lot of mothers pain, sorrow, regret and loss from this kind of condition.
Health education is an integral part of patient management; awareness should be created in other to prevent this kind of case in our communities. Churches, mosques, hospitals, higher institutions and others should create channels through which the gospel according to folic acid supplements can be disseminated to people.
Pregnant women should also ensure that they get antenatal care at standard hospitals in order to access adequate care, monitoring and screening of the fetus and safe delivery.
I discussed the case of the baby I described earlier with one of our paediatricians, let’s call him Dr F. He mentioned that the increasing demand for – and preference of fast foods, snacks, carbonated drinks and other unhealthy lifestyles could also be posing as significant risks since women nowadays are too busy to prepare healthy, nourishing and nutritious meals that will benefit both the mother and child. Instead, when hungry, they quickly grab any available snacks which contained neither vitamins, nor proteins needed by the growing fetus therefore increasing their chance of having babies with congenital abnormalities.
Without mincing words, good diets including nutrients-laden foods, fruits and vegetables are very important for pregnant women.
Dr F added that the cost of care in our environment is another reason why pregnant women prefer to go to the herbalist or church for care. He suggested that registration, ultrasound scanning, blood investigations, urine tests, injections and drugs in pregnancy should be subsidized or made free. This can serve as incentives for pregnant women in our various communities to seek good healthcare services. We both agreed that the government also has roles to play and can come to the aid of our ailing medical institutions.
Without any doubt, the pain a mother has when she realizes that her newly born child has a very little chance of surviving a condition that could have been prevented by something as simple as folic acid, can not be quantified. But truth be told, it is the true status of our healthcare system – many are dying of highly preventable diseases.
For more information on spina bifida and other medical conditions, drop a comment below or contact Dr Vickie at firstname.lastname@example.org. This piece is in line with HealthNewsNG Foundation – an initiative aimed at enlightening and educating Nigerians on health issues affecting them. To partner with us or to know more about the initiative, send an email to email@example.com