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Dr. F. Gary Longsworth - CEO, KHMH
"Over a very short period of time beginning last week we had a cluster of deaths in our Neonatal Intensive Care Unit and it went out to the media. One of the parents went to the media, I believe, that actually prompted the investigation because up to that point we were not aware that the situation was developing."

Dr. Adrian Coye - Medical Chief Of Staff, KHMH
"We have seen an outbreak of a particular organism it's called enterobacter cloacae and this organism is not only selecting our Belizean babies but it's an organism that is responsible for major outbreaks in ICU's all over the world. Now we issued a release that there were 12 deaths this month which was unusual because the month is not yet done and 12 deaths that happened where the majority were happening precipitously in the last week and so this form of outbreak does raise alarm bells, adjustments are being made clinically and within the unit, some procedural changes. In despite of that we had the high number of tragic loss. However of the twelve deaths only seven has been shown in our analysis to be positive for this organism. The other deaths happened as a result of prematurity related issues and not related to this infection. This is not a super bug - the profile of the resistance pattern within the organism that we have found is sensitive to antibiotics that we do have in the hospital and made available through the Ministry of Health so it is not a super bug. The problem with this kind of organism it it's very fastidious, difficult to care and there is transmission by direct contact and also indirect contact. This is an opportunistic infection that can be anywhere. The susceptible population is the premature and babies who are in the intensive care unit as they are. Whether is was brought by different parts of the hospital, I cannot say but I know from an epidemiological point of view when you look for an outbreak you try to identify an index case and an index case was identified in February, the first infection of that nature - however that baby was treated and went home. It could be then that from that original infection, colonization had happened and that's how you talk about how things are spread that may be one source."

Dr. F. Gary Longsworth
"Generally we see between 450 to 550 patients per year in our NICU. Our annual mortality rate for that unit vary between 5% - 15% with the median being around 10%. That is what we're looking at in terms of survival rates. We're looking at between 85% to 95% survival rates."

Dr. Adrian Coye
"This number of 12 is unusually high for us. We are more used to seeing rates of 5 or 6 neonatal deaths per month. This rate of 12 and as we've explained it was in a very short period of time that it went above what we recognize as a baseline."

Jules Vasquez
"Is it a failure in reporting and responding in your opinion?"

Dr. F. Gary Longsworth
"I wouldn't refer to it as a failure. As Dr. Coye tried to explain earlier what the time log that is unavoidable between culturing a baby that is getting sick and receiving the report is out of the control of the physicians managing the case."

Chandra Nisbet Cansino - Chairman, KHMH Board Of Governors
"Because my first instinct was to come here and to find the person that was to blame and deal with that person - there are so many more technical issues to that, we got an explanation to the system of the blood culture that takes a week. That is not something that is a deficiency of the lab, a blood culture takes five days to grow and there's no way around that and there was no other way of determining the sensitivity of an organism except by doing a blood culture. While you're waiting five days for a blood culture - babies were passing away. That little cluster of time was where we lost some of the babies without knowing because it was because of this particular bacteria. The second purpose of our meetings is still to have a discussion with staff, we still have not gotten a lot of reports to determine if anybody is culpable, we have not established that at this time and that is a process that is still under investigation. The most important purpose for us being here today was for us to sit-down and have a discussion with some of the parents of the deceased children. Unfortunately they went to the media before coming to us - that is totally understandable, we have no problem with that but we needed to hear from them about their experiences. They shared a lot of information with us - they had suggestions and recommendations for us. We haven't met all of them and we're hoping to meet with all of them but that was basically the most important part of the day for me because we really needed to hear from them."

Reporter
"Accusations being made that there were two deaths in two days would have caused that the NICU be closed."

Chandra Nisbet Cansino
"What was the process of communication? That is important to us - we do not have that answer today but we are definitely working on that answer because we kow that one of the biggest questions the public has and we have an obligation to answer on that."

Reporter
"At this point is the infection under control?"

Chandra Nisbet Cansino
"Yes"

Dr. Adrian Coye
"The answer is yes but there is always a risk. As I said we are always under threat and in this particular case we believe we have it under control. We are making plans and changes that allow us to safely take care of our Belizean babies in the near future."

It is important to note that while the media has been alerted about newborn deaths from infection dating back to December of last year, the administration says those were likely unrelated. The pediatric intensive care unit was built 16 years ago and has a capacity for ten newborns; in May, as in many months prior, it was operating well above that capacity.

A release from the office of the Special Envoy for Women and Children stresses that it is spearheading the construction of a Pediatric and Neonatal Intensive Unit – which will be in a new wing at the KHMH.