“She was one of the smallest babies I had ever seen”
In Maiduguri, northern Nigeria, an MSF obstetrician recounts two life-threatening emergency cases that reveal the stark realities of maternal health in the region—and the lifesaving difference timely care can make.
"Chinara* was born in one of our birthing centres in Maiduguri, northern Nigeria. She was one of the smallest babies I had ever seen. When a baby is born this prematurely here, their chances of survival are extremely low.
Chinara’s mother, Adeya*, suffered from eclampsia, a pregnancy complication involving seizures that can be life-threatening for both mother and baby. When a mother experiences an eclamptic seizure, their baby needs to be delivered within 12 hours, even if not at full term. That is why Chinara was so premature.
Adeya had multiple seizures before she reached the hospital. Thankfully, she was stabilised inside the ambulance on the way. When she arrived, she was rapidly triaged and taken straight to the operating theatre.
When Chinara was born, she weighed only 770 grams – lighter than a bag of flour.
Neonates are a lot harder to treat than older babies. Their tiny bodies are adjusting to being outside the womb and trying to cope with conditions new to them. Their organs are still developing. We have to constantly monitor them for any changes to their condition and adapt our care. At times it can feel like firefighting.
As Chinara was admitted to our neonatal intensive care unit, or NICU, I rallied the nursing team around. “With such a low birth weight, we are her best chance of survival,” I told them. “We are going to put our all into this tiny baby.”
We started by focusing on Chinara's weight. She was too small to breastfeed, so Adeya had to express her breast milk, and we passed it through a tube in Chinara's tiny mouth, down to her stomach.
We no longer use incubators in Maiduguri. For us, kangaroo mother care (KMC) is more effective. This is where the mother holds her baby directly against her bare chest. The skin-on-skin contact allows the child to synchronise their breathing, helps to regulate their temperature and digestion, and promotes bonding between mother and baby. Adeya held her close day in, day out. It was touching to see their bond grow as she became stronger.
We had a scare when Chinara began to show signs of neonatal sepsis, a serious risk to such a tiny baby’s life. We administered antibiotics fast to fight any infection.
After 52 days, Chinara had nearly doubled in weight. The antibiotics had worked, and Adeya was able to take her home. Our team was overjoyed. Her chances of survival had been so low; now, with our help, Chinara had a whole life ahead of her.
When I saw Chinara again for her routine vaccination, I felt extremely emotional. Considering the challenges Chinara faced in the NICU, it was very heartwarming to see her growing and thriving. She was smiling, nuzzling up to Adeya and being very brave for her injections.
Despite the challenges, we provide a really high quality of neonatal care in our birthing centre. Each time I see a baby return for vaccination, healthy and happy, I am reminded of why we do what we do. It makes me proud to work for MSF.
I’m forever grateful to the people who donate to MSF. Even though I don’t know you personally, I can see the very real way your gift touches lives. You inspire me every day to put in my best work with the resources we have.
Thank you for supporting our life-saving work in Maiduguri and beyond."
As told by Lazarus Mago
MSF neonatal nursing supervisor, Maiduguri, Nigeria
*Names have been changed
