Where there is No Neonatologist

Q: What is a Neonatology?

A: Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or requiring special medical care due to prematurity, low birth weight,intrauterine growth retardation, congenital malformations (birth defects), sepsis, or birth asphyxias. (Wikipedia)

Q: What does a Neonatologist do in a hospital?

A: Supervises and works in the Neonatal Intensive Care Unit making decisions about unwell and premature infacts.

Q: How many neonatologists are there at the Regional hospital that attends to San Cristobal and the Highlands of Chiapas?

A: One

Q: And how many shifts are there?

A: 5. Morning, afternoon, night. Weekend day and weekend night.

Q: And when does the Neonatologist work?

A: Morning shift from monday to friday

Q: When do most births occur?

A: At night and on weekends

Q: So, who monitors the Neonatal Intensive Care Unit at the Hospital on weekends?

A: A Pediatrician

Q: Is a pediatrician qualified to manage an NICU and make decision regarding neonates in intensive care?

A: Not unless he or she has done specific certified training on this issue

Q: So basically you are saying that aside from mornings from mondays to fridays the NICU is not run by qualified staff?

A: Exactly

Q: At what consequences does that bring?

A: That over the weekend babies die that should not die because they are not intubated, ventilated or recieve appropriate treatment.

Q: And what is being done about this?

A: For the moment, nothing.

Q: So babies are dying over the weekend at the Regional Hospital because there is no qualified personel. Is there another hospital that has an NICU in the area?

A: No, the nearest one is the pediatric hospital in Tuxtla Gutierrez.

Q: So what would your advice be?

A: I would suggest that babies born on weekends make sure that they are at term, suffer no asphyxia, do not aspirate meconium or amniotic fluid, do not have any congenital anomalies because they have a very low probability of making to to monday.

Q: Thank you.