KKH helps cut infant deaths in Cambodia

SINGAPORE - For four days last week, staff nurse Tong Yee Seong was impressing upon midwives in Cambodia's Kampong Chhnang province the importance of a practice many take for granted - washing one's hands before handling a childbirth.

The 27-year-old and nine other staff from KK Women's and Children's Hospital (KKH) also taught the midwives how to cope with childbirth difficulties, from resuscitating newborn babies to dealing with massive bleeding, which could kill the mother.

"Despite having fewer resources than us, the Cambodians are still able to do a good job with what they have. I admire that," said Ms Tong. "But we had to stress a lot on hand washing and hygiene because it's very important."

The training programme, now in its second year, is part of a collaboration between KKH and Social Capital Venture Development (SCV), a not-for-profit organisation in Cambodia. It kicked off after SCV told KKH how in Cambodia, in the Chhnang province of 500,000 people, over 15 women out of every 10,000 die in childbirth. In Singapore, the figure is just one.

The programme appears to be bearing fruit. Associate Professor Anette Jacobsen, KKH's director of Paediatrics International Medical Programme, said early numbers seem promising, with only three infant deaths in the first seven months of this year - compared with 10 to 15 a year previously.

Maternal deaths have also come down.

The KKH team, with support from the Tan Chin Tuan Foundation (TCTF), trained 56 midwives last year and a further 60 this year.

From the first batch, 10 returned to help with this year's training, and will eventually become key trainers in the long term, ensuring the programme's "long-term sustainability", said Prof Jacobsen.

These trained midwives also showed initiative by combining the steps involved in hand washing with local tunes, said Ms Yap Su-Yin, TCTF's chief executive.

The exchange is not one-way.

The Khmers were amused when told that Singapore nurses needed to do an ultrasound to ascertain a breech birth, which is when the baby exits feet or buttocks first. The Cambodian midwives relied on instinct and skills developed through experience.

Said Prof Jacobsen: "We learnt that clinical acumen should also be emphasised while reliance on machines can be reduced at times."

Kampong Chhnang is one of 24 provinces in Cambodia.

The team said the training to improve care in pregnancy and childbirth could be scaled up to include the neighbouring provinces.

salma@sph.com.sg

This article was first published on July 27, 2014.
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