The Health System in Las Tunas guarantees care for pregnant women and infants in the middle of the COVID-19 and exhibits an infant mortality rate of 3.4 per thousand newborns in children under 1 year of age.

Las Tunas, Cuba.- In that place, the hours seem endless, but Enma Cisneros has learned to give color to the days. Inspiration grows inside her, knowing that two little hearts beat to the beat of hers. She has been in the Clodomira Acosta maternity home for more than a month, and the faces that were unknown to her at the beginning, are now familiar.

In her routines, she includes reading and also interesting audiovisual materials. She confesses that she feels protected there amid the pandemic of the new coronavirus that is plaguing the world.

“The staff is very professional and explains the details of each exam and the measures to prevent the spread of the disease. All pregnant women use the mask and we have a chlorinated measure to wash our hands. Also, we disinfect the phone before using it, "says the young mother, convinced that all care is little before the COVID-19.

“Not everyone understands the difficult situation in the country and the psychological climate is complex. My family avoids the visits to this place, in correspondence with the new strategies of Public Health” Enma refers.

Like her, 33 other pregnant women remain in care in that center. Its director, Dr. Belkis Martínez Acosta, tells 26Digital that the current epidemiological panorama requires greater rigor in the treatment of this group of patients, as well as the adoption of preventive measures.

"Family members cannot have direct contact with our pregnant women; when they bring any belongings, the custodian makes them arrive. During the rest, at the large porch, they maintain the established distance from each other. At the entrance of the facility, we have the containers for handwashing, just like in their bedroom. Workers' bicycles are fumigated before entering and the packages too.”

She points out that this home, located on the Jobabo road, receives patients from all municipalities and is guaranteed balanced food, toiletries and change of clothes three times a week.

"Today we have admitted patients for different causes, such as multiple pregnancies, persistent vaginal discharge, understudy for urinary infection and others close to the ninth month of gestation in the rural area," she says.

Martínez - with three decades of experience in the profession - affirms that working in the current circumstances constitutes a real challenge. “It is no secret to anyone that pregnant women are more sensitive and find it difficult to be away from their children, husbands and not being able to see them. With a lot of dedication and patience, I have had to make them understand the need for them to remain isolated for the good of all.”

This statement is attested by the nursing graduate Mercedes Cegueira Rivas, who already has a 36-year work record. “Upon receiving the morning shift we talked with the patients to find out the status of each one; if babies move well, how they slept and we checked uterine dynamics in pregnant women that are close to the ninth month of gestation, among other issues.

“The mask is already part of our outfits and we insist on sanitation. Whoever presents any respiratory symptoms goes to the Ernesto Guevara hospital. "And Mercedes follows the recommendations strictly not only to protect the patients but also her own, especially her mother, who is already an old woman. "I go into the house at the back, wash my hands and go straight to the bathroom."

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In another part of the city, specifically in the Herminia Betancourt maternity home, Yoleydis Pérez spends her days sheltered by Health professionals. She arrived there due to a threat of abortion a few days ago and despite the short time, she recognizes the careful work of those who assist her.

She says that she left his other 8-year-old boy at home. "It is very difficult, but this is the place where I must be now for the well-being of the little one that I carry in my womb," says the 25-year-old woman.

Then an inevitable question arises: Do you feel safe here in the middle of the pandemic? And the answer is immediate: "Yes, of course, we are all very well cared for and complying with the guidelines."

María Teresa Mejías Rojas is one of those responsible for security who embraces Yoleydis and the other 20 women admitted there. This nurse speaks with a sense of belonging to that place that could well recognize her footsteps. "I have been working in this place for 20 years and 36 in Obstetrics", she says and emotions are discovered in her words.

Despite her experience, Mejías Rojas had never before had to work in the midst of a panorama like the one facing the nation today with the COVID-19. “We have had to reinforce the educational work regarding sanitation and the necessary distancing that forces the suspension of family visits.

"We have enabled disinfestation measure at the entrance of the facility for workers to sterilize the soles of their shoes, as well as the containers with chlorinated water. Every day we examine pregnant women in order to verify that they do not have catarrhal manifestations. Nor do we allow any worker to come with respiratory infections.

"If any patient with symptoms appears, a rapid response brigade is activated to transfer the affected one to the " Guevara ". Those who are here are not allowed to leave until they prove the cause of the disease. Recently we were given the situation and they quickly applied the rapid diagnostic test, and we were all negative on the COVID-19."

“Until now, patients have maintained discipline because they know that we do everything for the sake of them and the babies. They are even hanging on the details and communicating their concerns to us.”

A BET FOR LIFE

In this epidemiological context, the Maternal and Child Program continues to be a priority for the country. This is stated by Dr. Osmara López Borrero, head of that section in the province.

“Today we have a total of more than 2,500 pregnant women, of whom some 152 remain in maternity homes, 15 in the hospitalization service in Amancio and 11 in Jobabo; 172 are found in the provincial maternity home.

"The Guillermo Domínguez Hospital is preparing to assist people with the COVID-19, which is why pregnant women and puerperal women are moving to the Guevara Hospital."

López assures that follow-up consultations work in family and multidisciplinary clinics in each polyclinic, as well as performing genetic and obstetric ultrasounds; all under strict compliance with the provisions.

“In maternal homes, the prophylactic homeopathic medicine ProvengHo-Vir is applied to them. Given the suspicion of someone infected with the new coronavirus, a provincial commission discusses the protocol to follow.

“Four women are in isolation centers today with a gestation period fewer than 26 weeks and without associated pathologies. Six others, who exceed that time or suffer from other conditions, are under surveillance in “Guevara” hospital rooms which are set up for this purpose. If they are positive, they move to the “Fermín Valdés Domínguez” in Holguín."

Here we have 4,462 mothers with their babies; 855 of them are at high risk for children; with some problems related to cardiology, nephrology, obesity and others. She explains that they receive assistance from the family doctor and the pediatricians of the basic workgroups.

“We have six children under the age of 18 months that are protected from Covid-19 at the Mártires de Las Tunas Pediatric Hospital. At the same time, 78 pediatric patients are kept in isolation centers."

The province shows an infant mortality rate well below the country's average of 3.4 per thousand newborns in children under one year of age. The root causes are related to prematurity. The low birth weight index continues to be a health problem as teenage pregnancy and reduced birth rates.

According to López, the Infertile Couple care program maintains vitality. In the territory, there are 5,944 couples on study and municipal and provincial consultations are open. "We try to ensure transportation for the consultation of patients to the municipal seat."

To date, no maternal deaths have been lamented. "The results come from the actions to control maternal and child morbidities. It is a joint effort between the primary and secondary care levels, led by the Provincial Directorate of Health in the territory”.

The head of the Mother and Child Program in the province requests that pregnant women stay home and only leave for the corresponding exams. “We still see some on the street and when we investigate them we realize that their motives do not justify going out. In the event of any signs of discomfort, they should notify their doctor or call 104 to be transferred to the hospital.

While the COVID-19 takes the lives of so many people in every corner of the planet; there are many hands to protect those who are still huddled in the mother's cloister. They definitely save the future.