Air Force Fills Void in Naval Hospital Neonatal Care

Just before her ambulance arrived to deliver her to the Kadena Air Base flight line and the waiting C-141 aircraft, her physician halted the evacuation. "He decided I couldn't survive the flight and the only thing that would save me was an emergency C-section," the young wife of Marine Sgt. Michael Daywalt recalled.

Within hours, Sue was on her way to a full recovery, and the Daywalts were proud parents of a 2 pound, 5 ounce girl, Rachel. Born 2 1/2 months prematurely, Rachel would spend the first months of her life in intensive care.

Six years ago, Camp Lester Naval Hospital couldn't have provided the intensive care Rachel required. Instead, such care was handled at distant Tripler or other, more-distant military medical centers along the U.S. West Coast. However, with the eruption of Mount Pinatubo and subsequent closure of Clark Air Base, the Philippines, the Air Force suddenly had a surplus neonatal staff and equipment. Assigned to the 18th Medical Group at Kadena, the staff accepted the Navy's invitation to open a neonatal intensive care unit at Camp Lester.

"We're the only Air Force neonatal ICU operating in another service's hospital," said Dr. (Maj.) Mark Bertagnoli, who helped set up the unit in 1991. The staff includes Bertagnoli and three other neonatologists, 18 nurses (including one from the Navy) and 12 technicians (including a Navy medical corpsman). It's the second largest neonatal ICU in the Air Force, receiving more than 250 admissions a year.

Patients come from U.S. bases in Japan (including Okinawa and Honshu islands), Korea and Guam. "We can take care of 'preemies' born after less than 37 weeks [gestation] and term babies born with infections and birth anomalies," Bertagnoli said. "We typically send a team to get them and bring them here." A physician, nurse and technician using a $60,000 neonatal transport system fly medical evacuation aircraft to U.S. bases to pick up the sick babies and their parents. The infants remain hospitalized from one to four months, depending on their degree of sickness.

"Half our patients are Level 3 -- very sick," Bertagnoli said. "We have several sad cases each year -- children born with noticeable birth defects and those who don't survive. But we also have some great success stories." He cited one, a baby born four months early and weighing just 1 pound, 2 ounces. Four months later, the baby went home healthy.

"About 70 percent of the parents are younger enlisted," Bertagnoli said. "Because their extended families aren't here to support them, we play an important role."

"We establish strong bonds with the parents and the babies," added Air Force nurse Capt. Debra Egan. "It can take months to heal sick infants, and during that time the babies go from being totally dependent on us to the point where they're crying and demanding attention. So we get to know the baby and the parents quite well."

While the Air Force medical team cares for their infants, parents can stay free at Storks Nest. The Navy operates the temporary lodging facility comprising two four-bedroom homes, and volunteers bring in meals several times a week.

"The Storks Nest is typical of the support we get from the Navy," Bertagnoli said. Naval medical staff specialists provide consultations, he said, and the hospital performs all follow-on care after the infants are released.

The unit's 24-hour operation allows service members like Daywalt, a military policeman at Marine Corps Base Camp Courtney, to visit their babies despite irregular work hours. The sergeant has double cause for celebration. "I'm just very grateful," he said, "that the Navy Hospital gave me back my wife and the Air Force [neonatal intensive care unit] is giving us a healthy, beautiful daughter."