My first exposure to a neonatal ambulance was in 2003. S. Jayam, chairperson of Sasthinatha Trust, who introduced the ambulance in the city, explained that it was important to have a dedicated vehicle to transport infants to an intensive care unit and ensure that they did not suffer while being transported.
“Babies are not add-ons for a mother,” she said. According to her, infants are individuals who need their own beds. The ambulance which Dr. Jayam introduced in June 2002 is equipped with a warmer, an incubator, oxygen cylinders and facilities to administer fluids to the infant as it is transported to a hospital with a neonatal care unit. In eight months, the high-tech unit helped to save 54 infants.
Since then, various measures have been introduced across hospitals in the state to provide better child care. Some of them are kangaroo care (where the baby is strapped on to the mother's body for warmth), intensive neonatal care units in major tertiary care hospitals, supply of cribs for newborns at the Chennai Corporation's maternity hospitals and regular antenatal check up with financial incentives attached to institutional childbirth. All these efforts have brought down Infant Mortality Rate in the State to 24 per 1,000 live births. This year, in its policy note, the State government announced that it aims to reduce IMR to less than 15.
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In 2011, the government introduced the concept of neonatal ambulance through EMRI 108 and today, there are four such ambulances, three of them stationed in Chennai and one in Chengalpet Medical College Hospital to cater for infants in the districts of Chennai, Tiruvallur and Kancheepuram. The government, in its health policy this year, announced that it aims to provide one neonatal ambulance in every district.
Hypothermia is among the leading causes of infant deaths in India. When pre-term and low-birth-weight babies already vulnerable to infection are not kept warm enough, they succumb to infection, said Selvan Rathinasamy of Lotus Medical Centre in Erode. “The best way to transport a baby is in-utero. If that is not possible then it should be transported with adequate protection,” he said.
A Bangalore-based company co-founded by four US-based entrepreneurs including two IIT graduates, has launched a low-cost infant warmer. The warmer is being marketed among small private nursing homes in Andhra Pradesh, Karnataka and Tamil Nadu. The portable warmer does not need continuous supply of electricity, said Jane Chen, co-founder and chief executive officer of Embrace Innovations.
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Dr. Selvan, who invested in the warmer in January, recommends it for nursing homes in small towns. “In a town like Gobichettipalayam, there are not enough hospitals with neonatal care units and sick infants must be transported to a better hospital. Nursing homes could invest in these warmers and thus reduce complications,” he said. “Sometimes the mother may be sick and unable to provide kangaroo care. A warmer would come in handy,” Dr. Selvan said.