Somerset paediatrician is saving babies’ lives in Afghanistan

Dr Michael Fernando, who is also a Somerset NHS Foundation Trust’s associate medical director, decided he wanted to try to find a way to help Afghans to give their babies the best possible start to life.

During the years of Taliban exile in Afghanistan, teams from UNICEF, and other non-governmental organisations, were very active in the country, along with the more rural areas of neighbouring Pakistan too.

But when the Taliban retook power in Afghanistan in the summer of 2021, many western charities and organisations also pulled out of the country, as the world waited to see what would happen next.

Despite the ruling government, there are still thousands of babies born every day in Afghanistan, and access to decent healthcare is particularly problematic in the more remote and poorer areas of the country.

Michael had previously led a programme through Rotary International, in the Sindh Province in Pakistan, to train the trainers in remote and rural areas on how to resuscitate babies at birth.

He said: “It all started five years ago, when I attended a ‘Helping Babies Breathe’ course in London where professionals came from around the world to learn how to train trainers in resource limited settings.

“I met a doctor from Pakistan, which at the time had the highest neonatal mortality rate in the world, who asked me to introduce him to Rotary to help spread this training further."

Two years ago, Michael was asked by the Rotary International President’s Special Representative to Afghanistan, Katerina Kotsali-Papadimitriou, to run the ‘Helping Babies Breathe’ programme in Afghanistan, along with Rotary clubs in Afghanistan – led by Rameen Javid from Rotary Kabul City.

Michael added: “Data suggest that the number of babies who die per 1,000 births in Afghanistan has been reducing in recent years, down from 40 in 2019, to 35 in 2024, but this is still way too high, as it’s about 1 in 30 births.

“When a baby is born, there’s very little that needs to be done in the vast majority of cases, apart from babies needing to be dried, kept warm and given back to mum.

(Image: Somerset NHS Trust)

“Some need to be stimulated to breathe; a smaller number need air to be pushed into their lungs.

“Fewer than 1 in 100 need more advanced treatment such as chest compressions and medication, like adrenaline.

“There’s a golden minute of life where a baby’s life can be saved, by ensuring that the baby breathes.

“That first minute is the most important part we teach in our training sessions, and we deliberately kept things simple, such as teaching people how to position the head – that can be lifesaving in itself.”

Michael and the team in Rotary Afghanistan have managed to work past every single obstacle they faced, and successfully ran the course earlier this year, which he said was an incredible feeling.

“We set out on our trip to the capital city, Kabul, but still had a number of obstacles to overcome,” he continued.

“It was difficult to get people to go, and also tough to get a visa – in the end we were told, a week and a half before planned departure, that we’d get that on arrival.

“All trainers self-funded their travel and came from differing parts of the world.

“We arrived at the airport, which was pretty modern, and we were hosted in the Intercontinental Hotel, which has a chequered history, and is now owned and run by the Afghan government.

“We were hosted very well and were provided with a lot of government security, both at the hotel and during our sessions.

“We had about a 50/50 split of women and men at the training and we worked sensitively through this while being able to run effective sessions.

“I was the course director and led the team who trained doctors and midwives at a teaching hospital in Kabul, to train other people on how to resuscitate babies in remote settings with limited resources.

Katerina Kotsali, Rotary International (RI) President Representative to Afghanistan, added: “Afghanistan, along with Pakistan, are the two-remaining endemic-to-polio countries and Rotary International is a pioneer in the fight against polio.

“As RI President Representative to Afghanistan, I encourage the implementation of any project alleviating the severe humanitarian crisis in the country.

“The 'Help the Babies Breathe' project not only contributes to improving maternal health and decreasing neo-natal mortality, but also elevates the role of Afghan women, and opens opportunities for the accomplishment of more projects in Afghanistan.

“Heartfelt congratulations to the volunteer doctors and team, with Michael Fernando ahead, for creating hope in a country that desperately needs humanitarian aid.”