It’s all relative


Samia Saleem April 30, 2010

KARACHI: They say good things have a short life and in Francis and Nasreen’s case a very short life indeed.

The quadruplets who were born to the couple were reduced to two hardly 30 days after they were born. The ‘happy’ couple has been caught in a whirlwind of problems since the birth as they have been making trip after trip to the hospital as one baby or the other kept falling sick. Nasreen Francis, 27, had a normal delivery, giving birth to the four tiny babies on March 19 at Civil Hospital, Karachi, but the premature tots showed signs of illness right after birth.

After Nasreen’s delivery, one baby was immediately kept in the incubator due to sepsis, a body inflammatory state due to an infection. The other two were also kept in the incubator and received medical aid for almost ten days. Unplanned family Nasreen and her husband Francis were expecting only three children. “We got the news of a triplet when I had my ultrasound in the fifth month, but we were not prepared for the fourth one,” she said. Nasreen had a normal delivery and claimed to have the “usual” pain-free pregnancy the entire eight months.

Her doctor said that because the babies were in different sacs, she was carrying almost 7kg by the last month. The babies were delivered pre-term in 30 weeks. As they were all in four different sacks inside the uterus those below 1.5kg were kept in an incubator. Normal weight should be 2.2kg but three of them weighed 1.3kg, 1.4kg and 1.4kg and the fourth one was slightly normal at 1.7kg.

Health challenges “Underweight and pre-mature babies have poor suction, poor reflexes and need to be kept in a warmer temperature,” said the doctor, explaining the need for the incubator. The duty officer told The Express Tribune at the time of the birth that the ratio of triplets is 1 for every 80 children born - quadruplets have hardly a 0.1 per cent incidence. Such cases are happening more and more because of the increased use of ovulation-induction medicine to stimulate fertilisation.

“Sometimes it results in hyperstimulation of the overies and there multiple eggs that are fertilised at the same time, resulting in twins, triplets, quadruplets,” she said. After the children were brought home, one of the three boys, who had not yet been named, was admitted again to the paediatrics ward. He passed away due to heart and respiratory problems on April 11. Mary, the only girl from the quadruplets, died on April 19 from Apnea, a condition in which external breathing stops.

“She was admitted on March 15 with problems with feeding and respiration,” said the doctor on duty at Civil hospital’s paediatrics ward. Stephen, who is the first of the quadruplets, was discharged on Thursday after being admitted to the hospital on April 14 with similar respiration problems. Financial issues Cobbled together in a one-room house in City Railway Colony, the couple are struggling to make ends meet with the unwell but surviving newborns and their other three children - twins Simon and Samson, 5 and Rosemary, 7.

The quadruplets’ birth was much celebrated by the media. However, Francis John, who has not been to work at his call centre since the delivery, said that all the aid that they were promised after the media hype was not given to them. “I am not even sure if I have a job or not,” he told The Express Tribune. “We received a cheque of Rs50,000 from the Baitul Maal on March 21. They also promised us a monthly stipend of Rs5,000 but we still have nothing,” he said.

Talking about their current condition, Francis said they have already spent Rs35,000 on their children’s medication. “We still have to take our babies to Civil hospital three times every week which is very costly, especially after the transport costs,” Francis said grimly. About the joy that children bring, Nasreen said that it is overwhelming but when the children are constantly ill and dying, it becomes very difficult for parents. “I didn’t even get a small operation done, but my poor babies have had to suffer so much.”

Nasreen has now had Tubal Ligation done as a permanent contraception measure. “It is always good to have as many children as possible but their upbringing becomes extremely difficult when there are hardly any resources,” said Francis. “We broke the family record with seven children when our quadruplets were born, but they are not seven anymore,” he said sadly.

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