Saving mothers and babies

Pibisi podcast ei ole suurin äänsä. Koleen kalleen ilmassa oli alkaavan työystävyyden tuntua, jota varjustivain kalvava epäilys. Oliko työkaverin nimi sittenkään se, millä mikko lihänä koko ajan kutsunut? Va jotanko maan rakoon, vaihtaa junaa, va jopa työpaikkaa? Kaikki ongelmia ei veiren yrityslippukaan ratkaise, mutta se joustaa, jota työmatkoilla olisi vähemmän muredittavaa. Veir! Yhteisellä matkalla. Leitää onnéも taroa saamista muista. Se superheroiä muutat hänä käsitoisin mä sille on onnott ku제neutta si future. slip隊useasta! -Vee 이�illary 1 kaikille. V Nope. Välke demonet Lyppеро Proseokointsausit過 Mitgl planstajilla V V顆 Soldinen. Mitä? Me? Me? Me? Enubi. On tämä program "We Are Devoted Finding Stories That All Brighten Your Day". Stories about incredible people and projects that are making our world a better place. Today we're talking about a subject that's close to my heart. Ways to save the lives of premature babies and new mothers with simple medical devices. Pregnancyi is a very exciting time. I've had two, so I would know. We spend months preparing buying these tiny clothes and counting down the weeks until we meet our babies. Getting gifts and advice from other moms and clinging on to any information we can get about childbirth. Because the truth is it's a very scary experience and anything can happen. I had complications during childbirth. That meant I had to be rushed to theatre and I still get a bit emotional when talking about it because of the risks that were involved for both me and my baby. I spent more than a month after delivering my first child in and out of hospital, getting strong medication. Even then, I was one of the lucky ones. I had access to the best care in well-equipped hospitals. Sadly, this is not the case for many women. Maternal mortality is a global issue that impacts families far more frequently in the developing world. 90% of women who die in childbirth globally do so in low and middle-income countries, according to the World Health Organization. And later on on the programme, we'll look at a simple solution that could have a significant impact on this issue. But first, let's talk about babies. Now, when babies are born before 37 weeks of pregnancy, they are called preterm or premature babies. They need a lot of care and often have to stay in incubators, which are medical boxes that provide a safe and regulated environment at the right temperature. Incubators, however, can be very expensive and scarce, especially in developing parts of the world. However, one Spanish charity is now working to put simple low-cost incubators into the hands of doctors to try and save as many of these babies as possible in countries like Cameroon, where nearly 90,000 children are born prematurely every year. Our reporter, Esperanza Escribano, has been finding out more about these special boxes. In the EU, Bertil sings a song to her three-month-old twins, Eliot and Eliana. Eliot and Eliana came into the world in a bit of a rush. Over a video call, in the EU, what tells me that they came quickly and they came very early. I give back in seven months, two weeks, precisely. Were you scared that they were premature? I was very scared because they came very early, like little details should be like this. Like they came up, they were always 1.7 kilos. The other one was 1.6 kilos. Envyywa was told to take the babies to a hospital in Crivy in Western Cameroon, where they had a device that could help her babies survive, an inquirator. So they told me that they need an incubator in order to gain their virtual economy, whole-l I know my children, I know my newborn children. But when I reached there, I never seen something called an incubator in my life. So I was just wanting to have what is this thing? With some trepidation, Envyywa put her babies in two of these incubators and prayed to God. After two weeks, the twins were allowed to share a single incubator, a big moment for the whole family. When they joined them together, they were very happy. They decided to sleep all night, leaving plates together during the day time. I was going to have a hard time to sleep, I raised also. The incubators that saved Eliana and Eliot were donated by an NGO, and they were not a standard medical devices. They were actually made by university students in Pamplona, Northern Spain. And it was there in Pamplona that I saw the incubator for myself, a large plastic box with transparent blue sides and a couple of strong handles for carrying. Its inventor, Pablo Bergasa, was on hand to show it to me. So these incubators are like an artificial womb. There's a front window where the baby is introduced inside. And then here we have a small temperature probe that is attached to the baby. And the incubator is intelligent enough to separate the baby in the comfort zone. What is the price of this incubator? What is the cost of this incubator? To have a fair comparison, a commercial incubator here in Europe, average cost is around 35,000 euros. That is not accessible to many countries in the global south. And this incubator, the Inquanest, we lower the price to 350 euros. That's 1% of the cost of a commercial one. That's right. And sometimes we even provide them at no cost to the ones that cannot even afford it. 350 euros is just over 400 US dollars. Pablo's Inquanest, known as the Inquanest, can't do everything that a top of the line one can. But then he doesn't want it to. The truth is, if equipment is too difficult to use, there is a good chance it won't get used. So instead Pablo designed the Inquanest to be a study with cheap, replaceable parts and just a couple of buttons to press. It still meets the international standards for incubators, but all you need to run it is a car battery and a bottle of water. Why do you have a bottle of water here? It's not because if the baby is thirsty, but because we can also control the humidity. This is a very important thing to keep the baby warm. Because for example, we lose heat with our sweating, with our sweat. Pablo began designing this incubator eight years ago. He was shocked to learn that many hospitals don't try to save babies that are less than a kilogram in weight. Because they know they don't have the tools they need to do the job. The babies are simply left to die. Imagine you are a father or mother that you give birth to your child and they tell you that there's nothing they can do because they don't have incubators. So I decided to little by little, just donated my spare time to design these incubators and little by little the project started to move. After three years of design improvements and safety tests, Pablo's incubator was ready to send to a hospital in Cameroon. Pablo was able to monitor the use of his first device remotely using a SIM card, just like the one you'll find on a mobile phone. And it's an experience he will never forget. When they were assembling the incubator, a baby that was only 500 grams was born in the last hours and he was discarded. They put a blanket on top of the baby to let him die. And once they assembled the incubator, they say, "Well, we don't have anything to lose. We can try to put the baby in the incubator." So they tried, I saw that in my mobile phone that our first incubator was turned on. And they said, "They told me Pablo don't be excited because this baby is going to die because he is very very very small and in any time you are going to see that the incubator no longer sent information because we are going to turn it off. So minutes and hours passed and the incubator was still turned on and well days passed also and one and a half months later they sent me a picture of the baby that survived and they are in the hospital this baby was called the little miracle and I was so excited that one year later I went to that hospital and I was able to meet a little miracle and his mother and she said being a parent is the best thing in my life so. Pablo estimates that 5,000 more babies like little miracle have been saved in the past five years thanks to his NGO Medical Open World. The incubators have been sent to 30 countries but they are all made right here in Spain by engineering students at the Salisian Technical School in Pamplona, a Christian University. I just entered the room where the students from the Technical School of Salisianos are building incubators designed by Pablo. There's a terrible mix of sounds but Martín and Paula are part of this team. I start building incubators more or less in January and I think I have done like 6 or 5 incubators with my friends and wherever we are proud of our job and its amazing. It feels really good seeing that the babies like move and that are alive from the incubators and that they grow because sometimes they show us photos pictures of when they were born and like a few weeks later and it's really pretty to see that that it works. Now it's a very emotional moment because Pablo and the students of the Technical School here are going to deliver the incubator number 200 to a local NGO that is going to deliver them to a hospital in Senegal. Here you have it Carlos, we're going to say to Senegal thank you for your effort. No thank you very much Pablo, really I'm very proud of you. That is the voice of Dr. Carlos, the president of Hope and Progress. So how many incubators are you taking with you in this trip? In this trip we are taking 5 incubators, 5 units. These incubators are taken to Senegal in a sweet case, special sweet case and every passenger has a sweet case with an incubator. And every passenger takes care of his own incubator. This project is a small scale homemade approach to international aid but that doesn't mean it's not making a difference. Hello, hello, hello, hello. Pablo and I call Dr. Demdj Melanie, a pediatrician in Crivi, Cameroon. She is the same doctor who helped look after baby Celio Taneleana. Her hospital has 4 incubators and she guess is that 50 babies have used them in the last 6 months. But she tells us it's not enough. If it's possible for them to send me more, I'd be delighted because the demand is high. Very often I have babies arriving and I don't have room for them in an incubator. And if I could get more incubators, if Pablo could send me more incubators, that would be great. So do you think your babies would have survived without an incubator? I don't think so because when they were in the incubators, they would take good care of them, give them meat and they eat with the same temperature like the womb. So out of the womb, the womb is not even so wife, I'm not sure whether they are incubators. Do you wish to see them? I love them. Wow, look, this is the boy on. Hello little man. Hi. He's good to you guys. Okay, this is Eliana coming. Let me show you Eliana. Okay. Wow, look. This is Eliana. Oh my god, they are so little. I'm telling you. They have very cute, I love them with them all the time. They are all green. You're listening to People Fixing the World from the BBC World Service and Esperanza who brought us that report joins me now on the line. Esperanza, it must have been so nice being able to see these babies. Hi, yes, it was so cute after seeing how the students and Pablo were making the incubators to see the effect they have had on this thing. It was really, really great. These incubators have been made by students and then they are being put in suitcases and being transported all around the world. It sounds really interesting and different and it seems to be working, but isn't really sustainable? Well, it has been until now, but Pablo is now working to scale up the whole project. One of the things he wants to do is to be able to manufacture the incubators in other countries. He also makes the blueprints available online, so anyone can then load them and make one. What happens if something goes wrong with one of them? If something goes wrong and alarm goes off and he can take what's happening on his phone and then contact the hospital, look for a solution. Because Pablo can actually monitor the incubators from his house. I went there to show him to me and he does that because he really wants to make sure they are being used. Is he the only one who's making low-cost incubators? No, there are other low-cost incubators that are being used in the UK, in Ukraine or in India. They also pair with other interventions like Kangaroo mother care, where mothers have their babies on a skin-to-skin contact for at least 24 hours. We've actually covered this on people fixing the world and if anyone would like to listen, it's very easy. Listen to your podcast and search for Kangaroo care for premature babies from people fixing the world. Thank you so much Esperanza for what we've heard today. Thank you, Maida. It's been a pleasure. Now, here's a sobering statistic. According to the World Health Organization, in 2023, more than 700 women died from preventable causes related to pregnancy and childbirth every single day. Looking a little deeper at those statistics, the leading cause of maternal death is something known as postpartum hemorrhage or PPH. And it's basically excessive bleeding after birth. But a simple and clever idea is leading experts to hope that fatalities from PPH might soon be on their way down. I recently found out more when I spoke to Professor Zahida Kureshi, the head of the Department of Obstetrics at the University of Nairobi in Kenya. She started by telling me about her mixed feelings about her work. I once had somebody say to me, "My profession as a gynecologist's obstetrician is the best out of all the medical fields." Because we take care of women, when they're pregnant, they have a baby. It's just such a joyous occasion. But that was thought about it for a moment. And I said, "A opposite end is the extreme of a maternal death." And maternal death is the most painful thing to happen. Just the thought of a woman who came in to deliver a baby, healthy woman, and now she's no longer alive. So it's extremely devastating. Extremely devastating. And we estimate that we could have anything from around 4 to 5,000 deaths, maternal deaths in a year in this country. That's a large number. Like in Kenya, we have about 40% of due to postpartum hemorrhage. Just help me understand why this is such an issue, postpartum hemorrhage or PPH. Postpartum hemorrhage is excessive bleeding and we normally say up to 500 ml of blood loss after a woman delivers is manageable. But if it goes over that, then we have postpartum hemorrhage. If she bleeds more than that, more than a liter, then it's severe postpartum hemorrhage. Zahida told me that part of the problem is that PPH is often diagnosed very late. Because healthcare workers don't have proper ways to measure how much blood a woman is losing. So now what was happening traditionally, a woman would deliver, they would be blood, you know, around her peridineum. Yes, yes. And we would just look at it and say, "Oh, I think this looks like 200 ml." So this looks like a baby. 400, you know, just a visual estimation. But it's hard to be accurate in such a situation. Exactly. And that can actually cost someone's life. Truly, you really can't estimate very well. So the trial that now we think is the game changer is when we used a plastic tray to put under the buttocks of the woman as soon as she's delivered the baby. So all the blood after that for the first one hour goes into this plastic tray. And Zahida, I have. Yes. One here. It's kind of like a plastic sheet, right? Yes. Yes. The top bit is a bit more rectangular. This is where the woman would kind of lay on. This is what would go under her buttocks. The lower bit looks a bit like a hone, almost like a funnel that basically drains or collects the blood. And then it's calibrated here. So you can measure the amount of blood a woman is losing. Yes, exactly. So the blue part of it, which is the top, is what you would put under the buttocks of the woman as soon as the baby is born. And then the pouch, you roll it out. And the blood drains into it. And we keep it there for one hour. Okay. And it seems like such a simple solution using this plastic drape to collect the blood and measure it as it's being collected. Tell me a bit more about the study and the kind of impact you saw from using these drapes. So the trial that we did in four countries, our cell, South Africa, Tanzania and Nigeria, in about 80 facilities was to diagnose postpartum hemorrhage early. So as soon as the moment she touches 500 line, you know you have to act. So what is the action? The action here was we had a set of activities, you know, like putting the ibeline, giving drugs, giving medication, massaging the uterus, all those to be done within a period of 15 minutes. So you do everything as a bundle, very, very quickly. To stop the bleeding here. The results were just amazing. Because we had thought we would achieve the 25% reduction in severe postpartum hemorrhage, which is one liter of blood loss. Or death, or the woman adding to go into theater for surgery. But what we found was 60% reduction. 60%. It's 60. It's 60. And I can tell how happy you are with the number. It's a big number because it's not just about detecting early. It's about potentially saving lives. Yes. So this was the game changer. So the good thing that happened is soon after the results were announced, we had a lot of support from the funder, the Gates Foundation, which said we are going to supply those drapes to all the facilities. So in Kenya, I'm really happy to report that our Ministry of Health took it this up very, very quickly. So we had together with partners, they could now change the guidelines, you know, how things are done. So that's a lot to talk about. Don't you think it's crazy that just a simple bag could actually save lives? It sounds crazy, but then that is how innovations are, you know. Right. You look at the simple thing and then you do something very great with it. Many thanks to doctors, I heed a question. And indeed, simple things can sometimes have a great impact. Now this brings me to the end of this week's program, but tell me what you think about the ideas you've heard. Either by sending an email to people fixing the world at bbc.co.uk or catch me on what's up. All you need to do is send a message or a voice note to the number plus 448,000 321 721. And join me again next week for more inspiring stories. Until then, thanks for listening. It's been over half a century since humans lost travel to the moon. Now, NASA's Autumus 2 mission hopes to change that. Four astronauts on a journey living around the moon, which aims to take them further from the Earth than anyone has ever got before. I'm Space Scientist, Madeline Daring. And in this special new season of 13 minutes, the BBC Space Podcast, we're telling you the story of Autumus 2 as it happens. Joining me is the astronaut Tim Peek. We're bringing you the inside story of every moment of the mission and chatting with some of the people making it possible. So, buckle up for 13 minutes presents Autumus 2 from the BBC World Service. Listen now, whatever you get to your BBC podcasts.