Sunday, January 14, 2018

Who are the Families Otter Might Touch?

A central tenant of ADE and the Otter project is to continually strive to understand context and stakeholders. We have done a lot of co-design work with healthcare workers, but that is not the whole picture. On this trip we wanted to meet and learn about those who arguably are most impacted by Otter: the patient and parents. 

On the second day of our time in Vietnam, we visited Nam Dinh Provincial Hospital. Our contact at Day One Health, the amazing Hoi who also translates on our trips, arranged with the hospital for us to meet a family who would be taking their child home on the day we visited. The plan was that we would get to speak with the family before giving them a ride back to their home. Unfortunately the day we were visiting was day 23 in the local calendar and no families wanted their children discharged because it was not considered a lucky day. We were able, though, to meet Luu Van Thuoc (father), Ngo Thih Luot (mother) and Luu Van Thao (baby) at the hospital.

Luu Van Thuoc, Ngo Thih Luot, and Luu Van Thao
with team adviser Elizabeth and Hoi from Day One Health

Thuoc and Luot are farmers and seasonal workers who live about 50 km away from Nam Dinh. The couple’s previous four children were born at a local community health center, a “chik-jum”, which is the lowest rung on the Vietnamese health care ladder. Luot is 44 and knew Thao would be a high risk pregnancy and that she would likely have to give birth in a hospital.

The night before Thao was born, Luot experienced a pain in her stomach. Not wanting to travel the 50 km to Nam Dinh at night, she decided to wait until the morning before going to a closer district-level hospital. At the district hospital, the doctors told her she had hypertension and that she must go to the Nam Dinh emergency room.  At Nam Dinh, doctors determined that Thao was not doing well and needed to be immediately delivered by C-section. Luot was told the priority was to save her life. For her, this was “the scariest moment”.

Thao was born with respiratory complications. Thuoc and Luot were told of their child’s condition, but the details and treatment plan were not shared. They were also only allowed to see Thao once during the hospitalization. Since the NICU is so small, parents cannot stay with or visit their children. The hallway outside is also crowded, so parents cannot even look through the window into the NICU. Luot stayed at the hospital the entire time, however, to provide breast milk which nurses bottle fed to Thao. Mothers at Nam Dinh are given a bed to use for this purpose during their infant’s hospitalization.

The team with Thuoc, Luot and Thao

After fourteen days in the hospital (we spoke with Thuoc and Luot on that 14th day), Thao was healthy enough to be discharged. The excitement and relief of parents preparing to take their newly healthy child home for the first time is infectious and it was incredible to get to share that joy with this beautiful family. As we continue to design Otter, we are looking forward to helping other families bring home healthy newborns.

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