LVIV – Irena Suntsova was born at death's door. Delivered seven weeks premature and suffering from oxygen deprivation, the infant needed immediate emergency treatment from trained neonatal specialists in order to survive.
A few years ago, Irena's chances of survival would have been slim. Like many premature babies born in Ukrainian villages with scant medical facilities, she would have died before ever seeing the inside of a major hospital, which would have anyhow lacked the resources needed to save her. But Irena was saved by health care workers trained in neonatal resuscitation who rushed her in a high-tech emergency transportation unit to the Lviv Regional Clinical Hospital, where she was treated in an intensive care facility equipped for her needs. After pulling through a difficult few weeks battling an infection and trying to gain weight, Irena will go home this week for the first time.
Not before meeting Hillary Rodham Clinton, however. The U.S. first lady made the neonatal care center the first official stop on her three-day tour of Lviv Monday Nov. 17. Mrs. Clinton, along with Ukrainian First Lady Lyudmila Kuchma, met with staff members and patients at the facility, which was created with the help of a U.S. hospital and funded by the United States Agency for International Development.
'The center represents a partnership between the government, private sector and volunteer sectors of your country and my country,' Mrs. Clinton said. 'Clearly this model works and we can establish such centers throughout Ukraine.'
A former hospital patient participating Monday in a panel discussion with the first ladies, hospital staff and health care experts agreed. 'I gave birth to a child that weighed 900 grams and had only a 1 percent chance of survival. Now she's three-years-old and healthy,' said Anna Vinglinsky, who had brought her child along.
'I want to thank Hillary Clinton and all the American people who understand our troubles,' she said, tears filling her eyes. Mrs. Clinton stood up, embraced Vinglinsky and kissed her twice.
Later, Mrs. Clinton looked on as the Ford Motor Co., Ford of Europe and the Winner Ford dealership in Kyiv gave the hospital a new $27,000 ambulance.
The neonatal intensive care unit, emergency transportation facilities, and resuscitation training center at the Lviv hospital have saved more than 1,000 babies since 1994 and helped bring about a 40 percent decline in the infant mortality rate in the Lviv Region in western Ukraine. Infants born premature or critically ill anywhere within 80 miles of the city now have access to a specialized emergency care facility staffed by trained medical workers – and thus a much higher chance of survival. The technology and training were provided by the American International Health Alliance, a U.S.-funded program creating partnerships between hospitals in the former Soviet Union and those in the United States, and the Henry Ford Hospital in Detroit, Michigan. Since 1993, Henry Ford Hospital staff have been helping the Lviv doctors and nurses transform their neonatal care facility from an ill-equipped, understaffed unit into a modern, Western-standard medical center filled with essential equipment such as cardio-respiratory and blood pressure monitors, ventilators, and controlled intravenous therapy machines, as well as a staff of doctors and nurses who know how to use them.
In 1996, the Ukrainian Village, a community of Ukrainian senior citizens outside Detroit, helped pay for special equipment designed to transport newborns in critical condition. These transportation units have allowed physicians and nurses rescue endangered babies born in the countryside outside Lviv.
'We are sure that there's one place in western Ukraine that can care for [premature] babies,' said Christine Newman, a neonatal care specialist at the Henry Ford Hospital who has helped train staff in Lviv. 'Doctors who didn't know what to do with these babies before will call and say 'Can you come and get this baby? I can't take care of it.'' According to Newman, the transport unit has dramatically improved the survival odds for premature infants. Before it was available, babies born in critical condition often died in the hospitals and villages where they were born, or were driven in poorly-heated cars to the Regional Clinical Hospital several days after delivery, diminishing their chances for survival, she said.
Crucial to the success of the program was the resuscitation training center, officially opened in January. The center teaches health care professionals from all over the Lviv region how to treat newborns who have trouble breathing and passes on other basic emergency infant care procedures practiced in U.S. hospitals.
'It is very, very important to train people to resuscitate babies appropriately, because the first five minutes of life are the most important. If they get a chance and do well then, the likelihood of them doing well thereafter increases,' said Dr. Sudhakar Ezhuthachan, head of the neonatology division at the Henry Ford Hospital and a participant in the training program in Lviv. Since the classes started last fall, the center has trained over 260 Lviv Region pediatricians, obstetricians, nurses and midwives. Ezhuthachan said this differs markedly from the system used in most Ukrainian hospitals, where only certain specialists, such as an anesthesiologist, are allowed to try to resuscitate an infant.
According to the training center's director, Dr. Dmytro Dobriansky, the Lviv Region Department of Health has helped promote the project by requiring all hospitals in the region to send a certain number of their employees to the training courses.
The national Ministry of Health is now trying to duplicate the Lviv program's success across the country. The second center opened in Kyiv in October, and others in Odessa, Donetsk and Kharkiv are expected to start work in 1998. Newman and Ezhuthacan said the AIHA partnership has created a neonatal care facility that is comparable in quality to any found in the United States. But they complained that the hospital's overall lack of supplies such as blood, pharmaceuticals and laboratory testing equipment keeps the unit from operating at its full potential. The two applauded the resourcefulness and dedication of the unit's Ukrainian staff, who they say have been known to draw and test their own blood for an infant in desperate need.
'We've been fortunate to work with a young group of physicians willing to change,' said Newman. 'We have something to learn from them. They've really gone out on a limb in many cases. They take a lot from the colleagues around them because they are daring to be different in a place where you never do that.'
As part of her commitment to promoting improved health care for women and children, Mrs. Clinton has also visited AIHA centers in Kazakstan and Uzbekistan.