Why so many newborns die in this country?

AlterEgo

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Jan 9, 2009
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It's important to remember that this hospital is a public hospital [read FREE], where the poorest women go to give birth. I'm not minimizing the cleanliness issues, but these women, and particularly their babies, are undoubtedly at high risk because of the lack of basic prenatal care.

My husband tells me that 'back-in-the-day' it was a state of the art facility.

AE
 

Trainman33

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Dec 11, 2009
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Why hasn't Sra. Fernandez or someone started a "Head Start" program? As an example, this is what the prenatal care program for poor women in the USA is called.
It is one of the cheapest government programs to run also AFAIK.
 

dv8

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Sep 27, 2006
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i totally agree this is a lack of prenatal care. poor women often have parasites and untreated diseases. childer are already born very sick, they contract additional diseases in a hospital and voila - mortality rate very high. i think that private clinic (that is one that charge money) do way better.
 

NALs

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Jan 20, 2003
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Lack of adequate prenatal care?
Definitely.

Part of the issue (and this maybe taboo on DR1, but what the hell, it's a major part of the reason) is the influx of pregnant Haitian women to give birth in Dominican hospitals. Unlike most Dominican women, Haitian women in Haiti don't have access to any prenatal care (or any medical care at all) until they show up at the doors of Dominican hospitals practically giving birth. Many of these women arrive with all sorts of ailments. This is why the infant mortality rate in the DR is highly inflated and so too the number of mothers that die in labor or post-labor.

I've always wondered why the numbers are not separated, such as keep tract of the total number of infants/mothers in labor that die, then another set of numbers documenting Dominican infants/mothers and yet another one for Haitian infants/mothers.

This way it can become clear what most doctors in Dominican hospitals are claiming, that the influx of Haitians is exacerbating the infant mortality rate and the number of deaths of mothers-in-labor.

Like much in the DR, its not fully due to government negligence (at least, not Dominican government negligence). Same thing is happening with Polio, Malaria and host of other problems that were completely eradicated by the end of the 1970s only to reappear when the large influx of Haitians began in the 1980s and onward.
 

Chirimoya

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It could have been a serious failure on the part of the hospital, but generally the neonatal mortality rate is high amongst babies born to poor underage mothers, who are the least likely to take care of themselves during pregnancy. They may even have actively tried to bring on a miscarriage and weakened the foetus in the process. Another high-risk group would be babies born to poor Haitian women who suffer from poor nutrition, anaemia, etc.

ETA-Not a taboo, NALs but a fact of life. We posted at the same time.
 

dv8

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recently there have been many articles on hospitals in hoy, listin diario, el caribe, el nacional, everywhere. if i remember cortrectly maojority of the births in some government hospitals were from haitian mothers who also had the highest rate of deaths during/after labour.
 

Hillbilly

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Jan 1, 2002
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Chiri is right about the 16 deaths at that hospital.. There was a serious breakdown of procedures.

Other posters are also correct:
Pre natal care near zero. One of the most common complaints I see from maternity hospital directors is the total lack of prenatal care, the horrible nutritional state of the mothers and their compete ignorance regarding maternity per se.

You read the list of issues--hypertension, and all that DV8 mentioned and you wonder why it is not higher.

HB
 

dv8

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plus - a hospital does not privide all medicine. and trust me, there are some people out there who will not spend a 50 pesos on suero for their newborn baby but they will spend it on beer.
 

RacerX

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Why hasn't Sra. Fernandez or someone started a "Head Start" program? As an example, this is what the prenatal care program for poor women in the USA is called.
It is one of the cheapest government programs to run also AFAIK.
Head Start is not a prenatal program. It is a preschool program for 4 & 5 year old children.

Speaking of which infant mortality in the US isnt that high for a "civilized country".

Infant mortality is high at that hospital SOLELY because of inferior medical care from incompetent professionals. People have been birthing for thousands of years in many different situations, diets, activities, climates, and locations so it cant be them being poor.

I have a friend who for the past 3 weeks has had kidney stones and I asked her if she was drinking enough water and she says 8-10 vasos al dia. And then I ask her if she is eating something with excessive calcuim or magnesuim in it. She says she is taking calcium tablets for her and her kids. But yet she has been to the doctor 3 times now and again 6 months back in March when she had the kidney stones before. BUT it never dawned on her doctor that reason she was having kidney stones was because of the overabundance of calcio in her blood, from the supplements?

Why do I have to tell her that in order to drop the kidney stones she has to lay off the pills? What kind of doctor is this? And if this guy is a nephrologist or even a general practitioner who cannot read a blood test that specifies her bloodwork is way out of the range, what good is he? As well as, what kind of idiot prescribes medication without knowing if the patient is using something else, conflicting with or counterindicative of what he prescribes?

Now, I propose that Ob/Gyns and Pediatricians are just as incompetent as the GP/Nephrologist I described above. Which is why they are working in a public hospital versus a private clinic. And this contributes to the large quantity of infants that have died.
 

Chirimoya

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I don't know the facts of this particular case, but I believe that most public hospital doctors in the DR combine their work with private practice. So it's not necessarily that they're under-qualified, inexperienced or even incompetent, just that their heart may not be in the less lucrative area of work.
Then there are some strange beliefs associated with pregnancy here - it is treated as an illness and women are encouraged to be sedentary rather than active - which can't help matters.
 

bob saunders

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Head Start is not a prenatal program. It is a preschool program for 4 & 5 year old children.

Speaking of which infant mortality in the US isnt that high for a "civilized country".

Infant mortality is high at that hospital SOLELY because of inferior medical care from incompetent professionals. People have been birthing for thousands of years in many different situations, diets, activities, climates, and locations so it cant be them being poor.

I have a friend who for the past 3 weeks has had kidney stones and I asked her if she was drinking enough water and she says 8-10 vasos al dia. And then I ask her if she is eating something with excessive calcuim or magnesuim in it. She says she is taking calcium tablets for her and her kids. But yet she has been to the doctor 3 times now and again 6 months back in March when she had the kidney stones before. BUT it never dawned on her doctor that reason she was having kidney stones was because of the overabundance of calcio in her blood, from the supplements?

Why do I have to tell her that in order to drop the kidney stones she has to lay off the pills? What kind of doctor is this? And if this guy is a nephrologist or even a general practitioner who cannot read a blood test that specifies her bloodwork is way out of the range, what good is he? As well as, what kind of idiot prescribes medication without knowing if the patient is using something else, conflicting with or counterindicative of what he prescribes?

Now, I propose that Ob/Gyns and Pediatricians are just as incompetent as the GP/Nephrologist I described above. Which is why they are working in a public hospital versus a private clinic. And this contributes to the large quantity of infants that have died.
But infant mortality tells us a lot less about a health care system than one might think. The main problem is inconsistent measurement across nations. The United Nations Statistics Division, which collects data on infant mortality, stipulates that an infant, once it is removed from its mother and then "breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles... is considered live-born regardless of gestational age."16 While the U.S. follows that definition, many other nations do not. Demographer Nicholas Eberstadt notes that in Switzerland "an infant must be at least 30 centimeters long at birth to be counted as living."17 This excludes many of the most vulnerable infants from Switzerland's infant mortality measure.
 
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dv8

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well, racer, people have been breeding for ages and their kids have been dying like flies. mortality rate has dropped only recently and it is still extremely high in the poorest nations (africa). so yes, lack of nutrition is the key factor here.
as for dominican doctors: i am not a huge fan but in the land of the blind one-eyed is the king. there is no other choice in DR and i am sure doctors are doing the best they can. well, most of them. public hospitals are often staffed with young doctors who have to do some slavery work after they are done with the university. they are unexperienced and they are paid pitiful salaries.
in general i tend to blame parents. they totally lack knowledge, they are often ignorant and would rather belive bruja than a doctor. and then we have mothers who refuse to breast feed because they think their tetas will look bad and their man will leave them.
 

Alyonka

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Jun 3, 2006
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Infant mortality rate can show country's development in so many different levels other than just health care. Usually it is pretty low in poor countries with other educational, political, sociological and economical indicators at the same low level. DR is not really doing that bad comparatively to Africa.
 

Chirimoya

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well, racer, people have been breeding for ages and their kids have been dying like flies. mortality rate has dropped only recently and it is still extremely high in the poorest nations (africa). so yes, lack of nutrition is the key factor here.
This applies to many poor Dominicans, even more so in the case of Haitians.

as for dominican doctors: i am not a huge fan but in the land of the blind one-eyed is the king. there is no other choice in DR and i am sure doctors are doing the best they can. well, most of them. public hospitals are often staffed with young doctors who have to do some slavery work after they are done with the university. they are unexperienced and they are paid pitiful salaries.
This confirms what I've seen, and it is to these doctors' credit that they treat illegal Haitians - the Hippocratic oath means that as humans their legal status and nationality has as much to do with their entitlement to medical care as their favourite football team - but it can't be denied that the already inadequate and underfunded Dominican public health care system is straining under the additional burden.

Remember that in the aftermath of the Haitian earthquake the French (?) international development minister pledged to refund the DR health authorities with the extra costs they had incurred from treating Haitian earthquake victims - providing they presented reliable accounts. I wonder if anything came of that - it may have been more than they could cope with to keep accurate records during all that mayhem.

Whether it was carried through or not, the idea sets a good precedent and if I were Bautista Rojas I would propose a long-term funding agreement with an international entity where the cost of treating Haitian patients in DR public hospitals is covered by external funding - combined with a parallel development plan also funded and monitored with international money for setting up/improving state hospitals on the other side of the border to reduce the numbers crossing to the DR. But for this to work on the DR side the Dominican health authorities would have to submit watertight records and accounting and allow external monitoring. Easier said than done.

in general i tend to blame parents. they totally lack knowledge, they are often ignorant and would rather belive bruja than a doctor.
A gynaecologist I know who works in public and private hospitals described cases just like this to me. Rather than taking the pre-natal vitamins and following the dietary advice they drink some traditional concoction and end up with severe anaemia.

and then we have mothers who refuse to breast feed because they think their tetas will look bad and their man will leave them.
This is almost universal, and has tragic consequences - not just infant mortality but on children's longer term mental and physical development. Especially when they can't afford formula and feed them flour and water, sugared water, herbal tea or Sprite instead.
 

mountainannie

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Dec 11, 2003
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recently there have been many articles on hospitals in hoy, listin diario, el caribe, el nacional, everywhere. if i remember cortrectly maojority of the births in some government hospitals were from haitian mothers who also had the highest rate of deaths during/after labour.
As I recall, there was one study - done in the Southern region, which said that 25% of the births were from Haitian women... Certainly this is a big issue and I agree with Chiri that the stats should be broken down into Dominicans and Haitians and the bill forwarded to the Haitian state... This should be easy enough to do since the babies of Haitian mothers are theoretically given a different color birth certificate (Libra Rosada).
 

NALs

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Infant mortality rate can show country's development in so many different levels other than just health care. Usually it is pretty low in poor countries with other educational, political, sociological and economical indicators at the same low level. DR is not really doing that bad comparatively to Africa.
World Average 44.13

Dominican Republic 25.96 better than 79 countries (41% of total).

Population living in countries w/ higher infant mortality than the DR: 3,099,363,042 (46% of total).


ASIA (20) pop. 2,059,590,370
Afghanistan 153.14
Azerbaijan 54.6
Bangladesh 59.02
Bhutan 49.36
Burma 47.61
Cambodia 54.79
India 50.78
Indonesia 29.97
Iran 35.78
Iraq 44.65
Kyrgyzstan 31.26
Laos 77.76
Mongolia 39.88
Nepal 47.46
North Korea 51.34
Pakistan 67.36
Tajikistan 41.03
Timor-Leste 40.65
Turkmenist?n 45.36
Yemen 58.4

SUB-SAHARAN AFRICA (45) pop. 825,049,608
Angola 180.21
Benin 64.64
Burkina Faso 84.49
Burundi 64.86
Cameroon 63.34
Cape Verde 41.35
Central African Republic 80.62
Chad 98.69
Comoros 66.57
Congo 79.78
Cote d?Ivore 68.06
Dem Rep Congo 81.21
Djibouti 58.33
Equatorial Guinea 81.58
Eritrea 43.33
Ethiop?a 80.8
Gabon 51.78
Ghana 51.18
Guinea 65.22
Guinea-Bissau 99.82
Kenya 54.7
Lesotho 77.4
Liberia 138.24
Madagascar 54.2
Malawi 86.01
Mali 115.86
Mauritania 63.42
Mozambique 105.8
Namibia 45.51
N?ger 116.66
Nigeria 94.35
Rwanda 67.18
Sao Tome and Principe 37.12
Senegal 58.94
Sierra Leone 81.86
Somalia 109.19
South Africa 44.42
Sudan 82.43
Swaziland 69.74
Tanzania 69.28
The Gambia 68.84
Togo 56.84
Uganda 64.82
Zambia 101.2
Zimbabwe 32.31

MAGHREB (3) pop. 144,329,997
Algeria 27.73
Egypt 27.26
Morocco 29.75

AMERICA (6) pop. 63,617,155
Bolivia 44.68
Guatemala 27.84
Guyana 39.11
Haiti 59.69
Peru 28.62
Trinidad and Tobago 29.93

OCEANIA (5) pop. 6,775,912
Kiribati 43.48
Maldives 29.53
Micronesia 26.1
Papua New Guinea 45.9
Vanuatu 49.45

CIA World Factbook 2010