COTW: Neonatal Jaundice

By Alyssa

We have been slowly developing a neonatology service here at Kibuye. We now have a renovated dedicated room for the service, five incubators, nasal feeding tubes, oxygen (sometimes), official protocols, and a trained pediatric team to evaluate and care for these tiny patients on a daily basis. But until now we have not had any treatment available for babies with jaundice. Neonatal jaundice is very common and is easy to treat with special blue lights. If left untreated, however, the babies can have serious consequences including neurologic damage and even death. We searched for the blue lights in Burundi but were unable to find them, so I began looking at options for purchasing them elsewhere. An option from India fell through as it was too difficult logistically to arrange for shipping the materials to Burundi. Finally a google search resulted in a perfect solution for our situation - the Bili-Hut created by Little Sparrows Technologies. What is the Bili-Hut? "Low-cost portable phototherapy to treat neonatal jaundice. Anywhere."

Conversations with the brilliant founders of this company (Donna Brezinski, MD and Gary Gilbert, MD) resulted in the generous donation of a device for our use at Kibuye Hope Hospital. A visiting surgeon brought the machine out in his suitcase. Our engineer set up the battery back up system so the machine can run continuously despite power outages. I trained the peds staff on how to identify and treat jaundiced babies. Eric met with the Bili-Hut creators in the US. And voila! We've now treated five babies with neonatal jaundice. And it works!

I remember previous cases of neonatal jaundice. I would explain the risks to the families and recommend they take their baby to Bujumbura for phototherapy. Out of dozens of cases, though, only one or two had the resources to travel to Bujumbura for care. We treated the others with sunlight, but that's certainly not the most effective treatment and it runs the risk of skin damage from the sun and hypothermia due to the babies being outside in the cold (yes it can get cold here). We had at least two babies die from complications of jaundice (kernicterus for medical readers).

But this week we cared for a jaundiced 3lb premature girl. Her initial bilirubin was quite high - high enough to cause neurologic damage. We placed her in the Bili-Hut and within 2 days her bilirubin was down to almost normal. She's doing well now after the phototherapy, and the Bili-Hut is available for the next patient. I'm thankful to be part of the ever-expanding team of people who make this care possible for our tiny patients.