The Neonatal Epidemic: An Income-Based Battle

By Zipporah Orbisi, CAPM

Quality Engineer and Consultant

The Neonatal Epidemic: An Income-Based Battle

Imagine, what is supposed to be one of the most beautiful times in a woman's life also being one of the most fearful times in her life. A seed sown to blossom and grow, now facing the rockiest terrain with an impending storm on the homefront. 

Recently, due to the novel coronavirus, women all across the globe have had a taste of what it means to be fearful of every little action they take as they nurture the life growing inside their wombs. Even mothers located in countries that we would deem more economically well-off have had to adjust to the idea of a virtual babyshower and birth scenarios without family members present.

However, many women, especially those located in countries associated with the Global South, have been raging against this age-old battle of raising a child in the womb and rendering fierce protection from the first breath, even though we are well into this 21st century. 

Photo by: Paolo Patruno from the Birth is a Dream Project

The neonatal period is the first twenty eight days of life. These days are the most vulnerable days of a child's life. According to UNICEF in 2019 there were about 2.4 million children who died in their first month of life, approximately 6,700 a day globally.

When you break down the numbers by geography you can see that there is a heavy concentration of occurrences in the Global South, specifically Eastern and Southern Africa and South Asia. 

Statistics show that Somalia had about 36 out of every 1000 children die during the neonatal phase while North America has 3 out of every 1000. If we take that 6,700 a day value that would put over 200 babies falling victim to neonatal issues in this one small country alone. 

The meaning of the word epidemic is: an outbreak of disease that spreads quickly and affects many at the same time. We believe the current neonatal crisis is an epidemic.  A close examination of the reasons for deaths during the neonatal phase reveal that they are often riddled with underlying infectious diseases like Malaria, HIV, Dysentery, and Tuberculosis. These are all considered communicable diseases just as COVID-19. 

So why is COVID-19 a pandemic? It’s effects and repercussions are being felt worldwide. This means on top of the high mortality rate from neonatal issues, countries in the Global South are now adding an additional factor contributing to their leading causes of death.

Still, one should at least question  the prevalence of neonatal deaths in the world. Technology has come a long way making it possible for so many women to have access to safe and happy birthing facilities, right?

The short answer is, yes. Medicine, whole foods, vitamins, psychology, and even the internet have provided the means for many women located in the privileged nations of the Global North to have ideal “butterfly” births and picturesque “4th trimesters”, even in the midst of the COVID-19 pandemic, well minus the glamorous baby showers and perfectly planned doula birth scenario. But still we find neonatal deaths are the number three cause of deaths globally. Deeper still, neonatal deaths are not even amongst the top ten deaths in middle to high income countries according to the World Health Organization.

All of the world's advancements in technology and medicine come at a cost. 

According to a World Data Report it is shown that average annual income in Kenya is 1750 USD, Ethiopia is 870 USD, and Sudan 590 USD. Subsequently, the Oxford journals released average costs of vaginal births without complications in the Sub-Saharan at about 18 USD. While the average cost to have a baby in the United States is 10,808 USD (Business Insider).

Yes, even in the Global North, many Black and Latinx families struggle to not only find the money needed for quality care but also to secure compassionate physicians and the best equipped facilities to help. 

And in many countries in the Global South, major advancements have been made  to slow the deaths caused by neonatal complications as of 2019. But now with COVID-19 much attention has been averted from this issue to focus on assisting the fight against the global virus.

Photo by: Paolo Patruno Birth is a Dream Project

As the world continues to re-open and we begin to rebuild, it’s important now more than ever that we recognize that we can get back on track and help turn this neonatal epidemic around by offering development assistance at the community level. 

To be effective helpers, we must start by listening. 

We can only help after stepping into the shoes of these women and families through their experiences and stories. 

What do they consider to be their most important needs in ensuring a safe child-bearing process? 

How can we help all members of the family continue to help our child-bearing women and newborn infants?

Truly collaborating with communities involves not only providing the education and resources needed but regularly engaging with the people to hear their ideas about solutions, and ensuring that their needs are being met through the education and resources. 

As with any other area of impact, we must work to ensure that the allocated aid is really what is needed and being requested.

Acknowledging but not Leading with COVID-19

By Zipporah Orbisi

FHG Quality Engineer and Consultant

Defining A New Normal in 2021 and Beyond:

Acknowledging but not Leading with COVID-19

The novel Coronavirus continues to be a very real epidemic that has hit many countries very hard. Many of us have lost loved ones amidst this fast-spreading illness, and for that reason, we have seen many of us  band together to show our remarkable collective strength and to assert a renewed belief in human-kind. It's interesting how a virus helped us to realize our likeness, those things we have in common. We truly became a global community. In moments of quarantine, we all longed to be social, we all wished for the health of our loved ones—family and friends. In all the races and creeds of the world none stood superior in immunity to the virus. Yet with all the progress we made, we are still witnessing devastating cultural and civil wars being fought all over the world—from ethnic conflict in Ethiopia’s Tigray region, to cities such as Aleppo and Damascus in the Middle East, to heightened racial tensions in the U.S. 

So what are we missing? 

Now that the world is slowly starting to emerge from the shadow of COVID-19 and reopen, there are several questions around Development that we must consider as we define a new normal in 2021 and beyond:

Photo by Tim Mossholder

Did the pandemic set us back in our  progress with communicating with communities? 

Are we still assuming that the main plight in every neighborhood is still COVID-19? 

Yes, COVID-19 should continue to  rank high on our list of global concerns. And of course we should  take every precaution recommended by the World Health Organisation and Centers for Disease Control to keep from spreading it.

However, the time has come to focus our efforts on rebuilding, and creating true sustainable change for people while preemptively increasing our global preparedness for future epidemics and pandemics. We must continue to trust our medical experts to focus on the COVID-19 crisis, while we do our part to define a new normal that benefits all people.

COVID-19 has done more than infected over 150 million people, including taking the lives of over 3 million people, globally. Over the course of this past year, people in both the Global South and the Global North have experienced harrowing economic effects, while others have more than tripled their net-worth. The gap in quality education widened exponentially as those who do not have access to the internet, did not have access to online-based, remote learning. Even as COVID-19 ravaged populations, neonatal conditions and HIV continued to be amongst the leading causes of death on the continent of Africa (According to a 2020 Statista Report).

We must continue to acknowledge COVID-19 and all its devastating effects. And as we seek to rebuild, one community at a time, we must be mindful that we cannot  lead with COVID-19, which is to say we cannot enter  communities, especially those that may be different from our own, and  make  the virus itself the center of everyone's attention, without first seeking to understand the community’s most urgent needs. 

In addition to impacting the health of individuals and demolishing economies, COVID-19 successfully managed to exacerbate the conditions of those who were already forced to live on the margins. Those who were already “at risk” faced even greater risk. The people “at-risk” were not simply the older population or those with pre-existing conditions. Everyone who has not been afforded the opportunity to create meaningful change for themselves and their community are “at risk”. Those who are vulnerable. Those who have been marginalized and underserved. Those who are often rendered invisible by the dominant society. These people still matter. And their plight is a serious one. Even after COVID-19 officially passes, their situation will continue to be a matter of life and death, the difference between mere survival and the opportunity to thrive.  

Rebuilding, defining a new normal once more, requires setting an agenda. But let us not fall back into the old habit of creating community, global and political agendas that only benefit the privileged few. Let us commit to the inclusion and well-being of every person. Let us first listen. Let us first seek to understand. Only then can we begin to offer true assistance and benefit people using our complementary areas of knowledge. It’s time to dream up and create a new normal, a better world, one that benefits us all.