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A three-day-old boy in a remote Somali town was struggling to breathe, and no one nearby could perform the lifesaving procedure he needed. A chest X-ray, a chain of phone calls, and a team that refused to give up kept him alive.
GALDOGOB, Somalia
The baby boy was just 72 hours old when his breathing began to fail.
Born at full term in Galdogob through meconium-stained fluid, a sign that he may have inhaled stool before birth, he initially remained stable on oxygen therapy. But within days, his condition deteriorated rapidly. His breathing became increasingly laboured, and he required much higher levels of oxygen to survive.
As his condition worsened, clinicians performed a chest X-ray. A concerned colleague shared the image with Dr. Ubah Farah, a paediatrician and neonatologist based in Mogadishu, who immediately recognized the danger.
"At first glance, I recognised a life-threatening condition," Dr. Farah later recalled.
The X-ray revealed a tension pneumothorax, a medical emergency in which air leaks from the lung and becomes trapped inside the chest cavity, placing dangerous pressure on the lungs and heart. With every passing minute, breathing becomes more difficult, and without urgent treatment the condition can be fatal.
Somewhere in Galdogob, the baby's family watched anxiously as their newborn son fought for every breath.
A Diagnosis, but No One to Treat It
Dr. Farah immediately asked to speak with the physician caring for the newborn. Together, they reviewed the baby's history: a full-term delivery, initial stability on oxygen, and then a sudden and dramatic decline.
The diagnosis was clear. The baby urgently needed decompression and chest tube insertion to release the trapped air and allow his lung to expand.
The response from Galdogob was difficult to hear.
The facility did not have the capacity or expertise to perform the procedure.
Located in Somalia's Mudug region, near the Ethiopian border, Goldogob is one of many towns where access to specialist newborn care remains limited. While frontline health workers manage complex cases with determination and skill, lifesaving procedures and specialist services are often concentrated in larger cities.
"But giving up was not an option," Dr. Farah said.
A Rescue by Phone
With no one at the facility able to perform the procedure, the team began urgently searching for alternatives.
They soon identified a neighbouring hospital where a general surgeon might be able to help.
Over a series of phone calls, Dr. Farah guided the local team on how to stabilize the newborn and prepare him for transfer. Once the baby arrived at the neighbouring facility, a remote consultation brought together the clinician caring for the child, and the surgeon.
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Together, they reviewed the diagnosis, discussed the risks, and agreed on the emergency procedure needed to save the baby's life.
Soon afterward, a chest tube was successfully inserted to release the trapped air.
The improvement was almost immediate.
As the pressure in his chest eased, the baby's breathing became easier. His oxygen requirements dropped, and his condition stabilized. Over the following days, he continued to improve. After 48 hours, the chest tube was removed, and shortly afterward he was discharged home in good health.
A Gap That Phones Are Beginning to Bridge
The boy survived a condition that claims the lives of many newborns in Somalia.
According to UN Inter-agency Group for Child Mortality Estimation, Somalia's neonatal mortality rate is approximately 34 deaths per 1,000 live births, among the highest in the world. When Somalia launched national newborn care guidelines in September, the minister Dr. Ali Haji, emphasized the importance of quality care during the first 28 days of life, the most vulnerable period for a child.
A major challenge is the shortage of healthcare workers. The World Health Organization recommends a minimum density of 44.5 doctors, nurses and midwives per 10,000 people to deliver essential health services. Somalia has about 3.8 health workers per 10,000 people, and most are concentrated in Mogadishu and a few other urban centres.
That leaves towns like Galdogob with clinicians who can recognize a medical emergency but may not have immediate access to specialist expertise or advanced procedures.
In this case, the gap was bridged by a shared X-ray, a mobile phone, and healthcare workers willing to collaborate across hundreds of kilometres.
"For me, this experience was a powerful reminder that expertise does not always have to be physically present to make an impact," Dr. Farah said.
"Sometimes, a timely phone call, the willingness to seek advice, and effective teamwork can be enough to save a life."
Home Safe
A few days later, the newborn was back home with his family, breathing normally.
What began as a life-threatening emergency ended in recovery because a network of health workers refused to let distance determine the outcome. From the clinicians who first recognized the baby's worsening condition, to the surgeon who performed the procedure, to the specialists who provided remote support, every link in the chain played a crucial role.
"It was a victory shared by everyone who came together and refused to give up when it mattered most," Dr. Farah said.
For one family, it meant bringing their newborn son home healthy.
For the healthcare workers involved, it was a powerful reminder that in places where specialist care is scarce, expertise can still travel. Sometimes, the difference between life and death begins with something as simple as a phone call.