“I tried to save the life of my fourth newborn baby,” says Yasser Mahmoud. “She died soon after being admitted into the incubator ward.” Mahmoud’s three previous children were all born premature. Despite their father’s best efforts, they never reached an incubator and died soon after been born. Mahmood’s wife delivered his fourth child at a private hospital where a doctor administered a cesarean. The baby was born premature again: six month and ten days old.

“I tried to save the life of my fourth newborn baby,” says Yasser Mahmoud. “She died soon after being admitted into the incubator ward.” Mahmoud’s three previous children were all born premature. Despite their father’s best efforts, they never reached an incubator and died soon after been born. Mahmood’s wife delivered his fourth child at a private hospital where a doctor administered a cesarean. The baby was born premature again: six month and ten days old.

Despite finding an incubator at the Land Transport Hospital, Mahmoud’s baby died soon after. “It (the various procedures) cost me thousands of pounds,” says the devastated mechanic from the village of Grivs outside Senouras City, in the Fayoum Governorate, central Egypt.

Born to die

Mahmoud’s story is not uncommon in the region.  Rabi’ Mustafa Essa, a resident of Fayoum and a father of five girls, underwent a similar experience in finding an incubator for his premature born infant. Essa’s wife gave birth at a private clinic. The baby was born two months premature. Essa found a temporary incubator, but it lacked the necessary respiratory equipment. After endless delays, Essa managed, with the help of local organisation Monitor Participate and Expose, to get his baby into an incubator at Fayoum Public Hospital (FPH) and later into another at Abu Errish Hospital (AEH). The baby died within 12 hours of being admitted to the latter.

Despite these reports, the local health undersecretary in Fayoum, Dr. Marwan Abdulfattah, denies there is a shortage of incubators. “I will find an incubator for any patient who contacts me,” he says. “There is no problem in this regard.”

Abdulfattah says there are more than 100 incubators available at health centres in the governorate: 55 in the Fayoum Public Hospital (FPH), 15 in the Central Ibshaway Hospital, 15 in the SCH, 12 in the Etsa Central Hospital, and 22 in the Tamiya Central Hospital. “There are only four incubators with artificial respiration units,” Abdulfattah told Correspondents. “They all exist in the FPH. Certain obstetricians are trained to use them. There are also ambulances equipped with incubators to ensure safe transport of patients to other cities in case no incubators are found in Fayoum.”

Yet the incubator shortage in Fayoum has been highlighted by official complaints. Sayed Hasan Sayed, a 42-year-old driver living in the village of Munsha’et Abdullah, filed a report at Fayoum Police Station against the Fayoum Public Hospital for failing to secure incubators for four twin babies delivered by his niece through a cesarean section.

Life is expensive

Some local health professionals stress there is a shortage. “The cost of ordinary incubation service per day is as high as LE. 2,000 (US$ 225). The poor find it difficult to find an incubator at public hospitals.” says Dr. Mohssen Gomaa, secretary general of the Fayoum Medical Syndicate (FMS). “Many babies die because of poverty and their parents’ inability to pay the charges of keeping them in private incubators for a long time.”

Dr. Gomaa says most pregnant women want to have cesarean operations because it is considered easier. The same applies to obstetricians who find cesarean deliveries to be more profitable since the cost is approximately LE. 500 (US$55) more than a normal delivery. This has led to increased number of premature babies. Gomaa points out that it is necessary to advise pregnant women to avoid cesarean births, except in certain medical situations.

But Dr. Mervat Abdulazim, a Fayoum gynecologist and obstetrician and also a Fayoum Medical Syndicate (FMS) member, denies that the increased number of cesarean sections is due to doctors seeking quick profits.  Cesarean births are simply on the increase, argues Dr Abdulazim. She maintains that many doctors prefer cesarean deliveries because they are safer for both mothers and babies. “Pregnant women themselves are more inclined to have cesarean deliveries to avoid pain and the fatigue resulting from normal births,” she says. “Cesarean births have become more popular over the past five years, including in rural areas.”

New incubators not enough

The government however seems to be taking notice of the crisis. Fayoum Governor Wael Makram recently inaugurated a premature infant unit replete with 20 incubators at the Fayoum Public Hospital (FPH). Makram says the governorate is expecting delivery of five more incubators for Fayoum’s hospitals, aimed to “help low-income people afford the incurred charges and accommodate all premature babies.”

 The Minister of Health and Population, Dr. Ahmad Razi, has also recently announced measures to refurbish the national Care and Incubation System to provide information on occupancy rates of beds and incubators. As part of the new program, digital tablets will be distributed to care units and incubator centers in public hospitals.

Civil society is also stepping in to fill the gap between the demand for incubators and the increasing number of babies born premature. Ahmad Sani of Monitor Participate and Expose has launched a campaign to operate a delivery room at the Senouras Medical Center and establish an incubation ward in the Senouras Central Hospital (SCH), the largest in the city.