The Neonatal Intensive Care Unit (NICU) at the Port of Spain General Hospital (PoSGH) has been running more or less normally since April 10, and has been admitting sick babies and sending home its healthy and stable patients since then.

The unit has been under intense scrutiny since the North West Regional Health Authority issued a media release on April 11 saying there had been a "rapid deterioration in the clinical status of several neonates" from April 4-7. It later transpired that seven babies had died in a "cluster" of deaths between April 4 and 9, reportedly of bacterial infections.

The NWRHA is doing its own internal investigation, as is routine in such eventualities, and the Health Ministry asked the Pan American Health Organization also to do an investigation. The PAHO team of experts arrived this week and on Friday a source close to the NICU reported that its three members have visited the unit.

Since the revelation of the cluster of deaths, the parents of some babies have sent pre-action protocol letters warning of intended legal action over their children's deaths. They have been joined by the parents of other babies who have died at the unit. As of Friday this number stood at 21 babies, of whom 17 died in the past four months.

The source said, "We're always alert and vigilant about the possibility of infection."

But if there is an outbreak in the unit, the source pointed out, "We can't move anybody out; we have to assume they all have it already."

So moving the babies might lead to spreading the infection further; and most of them would not survive being moved from the NICU in any case.

PARENTS MAY ALSO

CARRY BACTERIA

The PoSGH NICU has a capacity of about 24, but has an average of 16-20 inpatients, and sees 12-15 outpatients a day – babies who have "graduated" and no longer need dedicated hospital care.

"We've treated thousands of patients. We treat 400-600 a year. Thousands have been saved by passing through our hands of care...If they weren't admitted to the NICU they'd be dead."

The longer they have to stay in hospital, the more likely it is that babies will be "colonised by the hospital bacteria." In addition, bacteria may be brought in by parents coming from outside the hospital to visit babies in the NICU.

Parents are told what precautions they should observe, and are supposed to wear personal protective equipment to touch their babies, although, said the source, "We may allow skin-to-skin contact sometimes."However, "There are parents who may not adhere to the policies. We'll probably start swabbing parents (for possible infections)."

Even NICU staff can't always predict what may happen to any particular baby.

"Sometimes you think a patient is going to make it and they don't. I don't know if you read about the baby (a case reported this week) with necrotising enterocolitis – the whole gut dies. It happens in the US, Canada – there's no cure. The baby can be dead in a few hours.

"People aren't aware how sick these babies can get. These (premature) babies aren't su