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First Breaths and Frontline Health Workers - Taking Nothing for Granted to Save and Improve Lives

A baby's first breath cannot be taken for granted. Our hopeful expectation at birth is for a wailing cry of life. Yet, hundreds of thousands of newborns die before they can breathe, especially in low-resource settings.
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For countless babies, birth is a near-death experience.

We recently met one such baby boy in a sparsely provisioned hospital ward in rural Malawi. When he was born just an hour before, he could not breathe.

And now here he was, sleeping peacefully next to a tiny girl wrapped in layers of colorful cloth. The two shared the heat lamp of the busy hospital's only baby warmer.

Yasinta, the nurse manager pointed to the simple bag and mask used to save the boy's life. It is a basic tool -- a mask that covers a newborn's nose and mouth with a bag that is hand-pumped to move air into the baby's lungs. Thanks to recent trainings in newborn resuscitation, the nurse midwives at Dedza District hospital are now proudly saving the lives of babies they once didn't know how to help.

A baby's first breath cannot be taken for granted. Our hopeful expectation at birth is for a wailing cry of life. Yet, hundreds of thousands of newborns die before they can breathe, especially in low-resource settings. We lose them to birth asphyxia -- a leading cause of neonatal mortality that occurs when a baby does not receive enough oxygen before, during or after birth.

An infant's first moments and the twenty-eight days that follow are the most precarious, and her risk of death is never higher. Simple and inexpensive techniques, however, such as drying her, clearing her airway, keeping her warm or using a simple ventilation device to stimulate her breathing, can help.

But who will deliver these lifesaving techniques? It's the frontline health workers who receive the training and support to get the job done through an initiative aptly named "Helping Babies Breathe."

The nurse midwives at the Dezda hospital told us that, not long ago, they knew resuscitation existed, but that they had no idea how to do it. They felt helpless and, regretfully, shied away from babies who were not breathing, they said. No more. Now they know what to do, they are saving babies' lives, and they've become agents of lasting change -- teaching more of their peers the new techniques they've mastered.

Frontline health workers -- the community health workers, educators, midwives, nurses and doctors working in remote communities -- are the essential foundation of a responsive health system. They are often the only bridge to vital healthcare services and information for millions of women and children. They counsel pregnant women, safely deliver newborns, immunize children, detect and treat infectious diseases, promote strategies to prevent and treat HIV, malaria, chronic disease and malnutrition and help babies take their very first breath. Frontline health workers are our global health heroes but, according to World Health Organization, we do not have nearly enough of them, especially in Africa, where there may be fewer than two trained doctors for every 1,000 people.

So, as global development officials convene in New York City to discuss progress toward the UN Millennium Development Goals this week, Save the Children, the African Medical and Research Foundation, mothers2mothers, the American Academy of Pediatrics, IntraHealth, ProMujer, Freedom from Hunger and Johnson & Johnson will on Monday honor the role frontline health workers play in safeguarding the health of the most vulnerable people in the world's poorest regions. And we'll promote strategies to train and support more frontline health workers -- who are primarily women -- as a cost-effective and sustainable solution to our greatest global health challenges.

The hospital team that resuscitated the baby we met in Dedza, for example, benefited from training and equipment designed for low-resource settings. Instruction spanned basic hand-washing techniques, warming and caring for the baby and using a bag and mask to encourage respiration. The trainees used a practice manikin created by our partner Laerdal, and they'll keep it to maintain their skills. Finally, the trainees learned how to train others, creating a cascade of learning and impact. It's all part of the Helping Babies Breathe initiative, which a partnership of Save the Children, Johnson & Johnson, the American Academy of Pediatrics and USAID is expanding to Malawi and Uganda.

This is only one example that illuminates the role of frontline health workers in saving and extending lives. Today, somewhere, and again tomorrow, a baby is beginning her life and her new lungs will need help. We must do all we can to ensure that a skilled and equipped frontline health worker is there -- so she can take her first full breath of life. Her family, her community, and her world will breathe a little easier, too.

Please join us every day from Sept. 21-30 on the Huffington Post Global Motherhood page for a thematic week about the importance and need for frontline health workers. We are excited to feature an array of blogs that share stories from the field about innovative ideas and the amazing work that frontline heroes are doing to save the lives of women and children.

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