Supporting premature and sick infants in Samoa.

Neonatal nursing has always been my passion and to return to my roots in Samoa in 2008 to share my knowledge and skills was both a privilege and a challenge. It had taken me seven years to find the right contacts to introduce the bubble continuous positive airway pressure (BCPAP) nasal breathing system to the Tupua Tamasese Meaole (TTM) Hospital’s neonatal intensive care unit (NICU) in Apia. This system enhances gas exchange in the lungs, which are compromised in pre-term babies. In 2001, National Women’s Hospital in Auckland was helping to establish the BCPAP in The Kingdom of Tonga. This scheme prompted me to want to do the same for Samoa, as I could see Samoa would benefit from the system and it would make a real difference for our neonatal population. The Bubble CPAP supports spontaneously breathing neonates who require respiratory support to manage respiratory distress syndrome. The system, which uses bubbling to improve gas exchange in the lungs, was developed by Fisher & Paykel (F & P) Healthcare and is non-invasive, effective, easy to set up and monitor. It requires minimal equipment and intense training. It has distinct advantages over the headbox, hood and tent oxygen system more commonly used in many developing countries, including Samoa. Giving oxygen to babies by headbox needs a relatively high flow, and can also cause retinopathy and other complications. Children are very precious to the Samoan nation and, as health care professionals, we are expected to deliver the best care we possibly can to sick, fragile infants. I thank the then executive officer of TTM Hospital, Stanley Dean, for accepting my proposal to introduce BCPAP to NICU, a project which was supported by Middlemore Hospital and the Kidz First neonatal unit where I have worked for the last eight years. A close nursing colleague, David Blee, who helped establish the BCPAP in Tonga, introduced me in 2007 to an F & P) representative Geoff Bold. Thanks to his generosity and vision, the BCPAP equipment is now operating at the TTM Hospital. TTM Hospital NICU consists of a six-bed, intensive care level 3 area that can take up to three more babies if needed, and an eight-bed slightly intensive care level 2 area. Most Samoans in New Zealand are probably unaware that such units exist in the TTM Hospital.