Neonatal Deaths At Thimphu National Referral Hospital

Thimphu hospital
Thimphu hospital
Sri Lanka, Bhutan, Nepal and Bangladesh

According to the hospital’s record, about 59 babies were admitting; at the NICU between January and April, this year. Of this, about 17 babies (28%) died. Of a total of 208 babies admitted to the NICU last year, 53 preterm deaths (25%) were recorded. But the death of eight babies at the Neonatal intensive care unit (NICU) at the national referral hospital; Thimphu was not due to hospital-acquired infection (HIA), claims the hospital. However, the parents claim otherwise

The Parents Kuensel claimed thateight babies died between March 11 and first week of April at the NICU. They accuse the hospital for their negligence. Medical superintendent, Dr Gosar Pemba, said that the recent death of babies in the NICU; reported in the media were not because of hospital-acquired infection.

According to the hospital records, seven babies died in March, two in February and nine in January. “When you say outbreak, the cause of the death of all babies; should be a particular bacterium like in the earlier case where it was Klebsiella;” Dr Gosar Pemba said. “This time, the cause of the death of all babies was their primary infection; because of which they were admitting to the NICU; and primary infection could be from anywhere.”

Allegations on the hospital

During their stay at the NICU, the parents said that they noticed poor hand hygiene; among health workers at the NICU. A parent said that parents and attendants were advising and informing of hand hygiene; by the hospital staff and the parents were strictly complying with it.

However, he said that the staff are observed to be touching one baby after another; and not using hand sanitiser or hand rubs. This, the parent said, was transmitting infection among children causing sepsis, shock and death. Another parent said there was excessive handling of babies by the staff. The parent said the babies were touched at least about two to three times an hour on an average; which increases their risk to infection and hypothermia.

The parents claimed that there was no dedicated specialist at the unit over a course of treatment and the examining health workers are either pediatricians or residents and not specialized in neonatal or preterm babies. “They carry out the treatment and intervention posing an increased risk of wrong diagnosis and wrong treatment.”

Claims by the parents

The parents also claimed that trainees from the Faculty of Nursing and Public Health were frequently carrying out some investigation without the supervision of seniors. “Newly passed out nurses should limit the insertion of needle (cannulation) on babies as their blood vessels are very small and they have difficulty to cannulate.”

Dr Gosar Pemba said specialist doctors are posted to the seven units of the pediatric department. The resident doctors, he said provides 24/7 service to the patients and this has improved service delivery at the hospital. Parents also alleged that they were not informed of what was happening with their babies because of which they doubt the doctor’s competency. Delayed response to death/ serious health problem and harsh behaviors of some of the staff were other complaints.

Questioning the hospital staff

When parents of babies admitted in NICU asked the staff regarding rampant deaths, a parent said that they did not respond well. The NICU was emptied and cleaned with some chemicals only after the death of the fourth or fifth baby. A parent of the baby who died on April 4 had questioned the hospital staff for intubating his child without their permission. To this, Dr Gosar Pemba said that when the doctor was informed of the baby’s condition, the parents were not at the hospital.

The parent claimed that his baby’s health started deteriorating after the baby had a transfusion of a unit of blood for the second time. “After that, the baby started swelling and did not move.”