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City struggles to save its smallest citizens

Exactly why Memphis has the nation's leading infant mortality rate isn't clear. But there's a passion to stem it.

December 30, 2007|Erin McClam | Associated Press

MEMPHIS, TENN. — The first thing you notice is how tiny they are: Row upon row of babies, some no older than this day, hooked to grotesque jumbles of tubes. Press your palm against the incubator wall and the infant inside disappears from view.

It takes awhile to realize something much sadder:

In a room full of newborns, dozens of them, there is no crying. The sound of beeping heart monitors, the rustle and murmur of observing doctors, but no crying.

"They're too small and too sick to cry," explains a passing nurse.

This is the newborn intensive care unit of the Regional Medical Center of Memphis, universally known around this city as The Med, perhaps two miles from the blues clubs and rib joints of Beale Street.

And these are the children with a fighting chance.

Some of them, a small fraction, will join the sparse field of little corpses buried in wooden boxes at the county cemetery, distinguished only by little metal plates and identification numbers, perhaps remembered with a stray and shriveled balloon.

Others will go home with mothers in a few days, a week, a year, and they will begin a life fighting impossible odds in this city's worst neighborhoods, forging a struggle against poverty entrenched for generations.

A 2002 federal report put this city at the top of the list for infant deaths in American cities: 692 dead babies over a four-year span, a rate of more than 15 deaths for every 1,000 births, more than twice the U.S. average.

It is difficult to explain exactly why so many babies die here. It is even more difficult to say whether it will get significantly better any time soon.

Ask people here about their city and they are quick to acknowledge the problems -- particularly poverty and racial disharmony, the one exacerbating the other for decades.

They also will physically grab your arm and insist that this is a place with a lot of people pulling for it. And trying very hard, desperately, to figure out a way to save more of the smallest among them.

Infant mortality is not something you catch. There is no vaccine. There is no prescription to make it better. It is not really even something you can describe, beyond the umbrella definition: Infant mortality is a child who never turns 1.

It includes babies born after just five- or six-month pregnancies, children who enter the world with holes in their hearts or devastated lungs and who die in their mothers' arms.

The U.S. infant mortality rate is just under seven for every 1,000 live births, according to the most recent figures from the Centers for Disease Control and Prevention.

Here in Memphis, a few other statistics drive home both the severity and the intractability of the problem:

In 1990, about 20 black babies died for every 1,000 born in Shelby County, and about seven white. In 2006, the numbers were little changed: 19 black, seven white.

Premature birth and low birth weight are by far the biggest causes of infant death. In 2002, they accounted for about a quarter of infant deaths in Shelby County; in 2006 the figure was more than 31%.

Shelby County lost 209 babies in 2006, according to state Health Department data. No other Tennessee county lost more than 93.

And it is a problem with yawning demographic disparities. In Shelby County, which includes Memphis, about 17 black babies died for every 1,000 born in 2004. For whites, it was about six.

"It touches on every inequality and unfairness you can think of in our day-to-day life," says Dr. Sheldon Korones, 83, who started The Med's newborn intensive care unit in 1968 and still roams it day and night.

A helping hand

Rosanna Stepney, an AmeriCorps volunteer, is a foot soldier in Memphis' war on its infant-death problem.

She was assigned to Porter-Leath, a Memphis nonprofit children's center. And now she is holding the hand -- figuratively and, once in a while, literally -- of a 19-year-old named Crystal Owens, steering her through her first year as a mother.

Stepney is driving through the streets of Hollywood in north Memphis, a place with all the telltale pockmarks of poverty in an American city -- graffiti and closed shops, cracked roads with leaning street signs, glares at the unfamiliar.

The topics today are stress management and nutrition -- the former for Owens and the latter for Jaquarius Butler, her 4-month old son, who is smiling up and giggling from an infant seat on the floor of the sparse home where Owens lives.

Where Owens "stays," as she puts it. Her mother kicked her out of the house after learning she was pregnant with her boyfriend's child. The boyfriend's mother has taken them in.

Things are improving: Owens now works as a cashier at Burger King, and has begun taking night classes. She had no job, no classes and no prenatal care when Stepney approached her, two months pregnant, at their church.

They navigated the pregnancy together, and now they are navigating Jaquarius' first year.

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