Tiny triplets' medical triumph

Triplets Thelma, Amanda, and Juliana at their home in Kisumu West, playing mobile games. [Rodgers Otiso, Standard]

It is 4pm in Kisumu West, the clouds heavy and promising rain a welcome change after weeks of scorching sun across the region. As the wind gathers, I arrive at the modest but warm compound of Mama and Baba Triplets in Tiengre.

Before I can knock, three girls rush to the gate, moving in perfect synchrony, smiling alike, dressed identically. Their resemblance is unmistakable, the kind only siblings who have shared not just a womb but a journey of survival can possess.

Thelma, Amanda and Juliana are more than children; they are living testaments to resilience, hope and the power of determined parenting. They recently turned 10 years old.

Born at just 27 weeks at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), each weighed under one kilogram. Their survival was considered unlikely even by seasoned medical professionals.

Their mother’s unwavering commitment, combined with skilled medical care and community support, gave life to three fragile infants who defied overwhelming odds to thrive today.

“My name is Judith Achieng. I am the mother of the triplets,” she begins, her voice woven with pride and nostalgia.

The pregnancy was unexpected. After giving birth to two children years earlier without complications, she had gone nearly a decade without conceiving. Learning she was pregnant again at 14 weeks brought both shock and hope. Yet uncertainty lingered, particularly with a multiple pregnancy.

Initially, everything seemed normal, and Judith continued running her clothing import business. But at 25 weeks, unusual symptoms pushed her to visit a gynaecologist, who ordered immediate bed rest, warning of the pregnancy’s fragility. Travel and physical strain were forbidden; the stakes were perilously high.

Unexpected delivery

Despite careful monitoring, the delivery came unexpectedly early. Originally scheduled for April 28, 2015, the babies arrived prematurely in January 2015, months ahead of the predicted date. Judith recalls the emotional strain vividly.

“When I went to the hospital, I knew that survival was minimal. They told me it could be a matter of life or death for the babies. I was terrified,” she says

The triplets were astonishingly small, their bodies fragile and underdeveloped. Judith describes their first moments with a mix of fear and awe. “They looked like rats. Their heads were disproportionately large, and their bodies were tiny. I didn’t know if I could manage them, but the medical team reassured me. They taught me how to feed them, how to interact with them, and even how to perform the Kangaroo Mother Care method,” Judith recalls.

The early days in the neonatal unit were grueling. Feeding three micro-preemies meant that each session involved meticulous tube feeding, a process that could take hours. Judith tirelessly expressed breast milk, ensuring that each baby received adequate nutrition.

Nurses played an indispensable role, guiding her through every procedure and teaching her how to monitor the babies’ vital signs, keep them warm, and manage their delicate condition.

A cornerstone of the triplets’ survival was Kangaroo Mother Care, which involves continuous skin-to-skin contact. Judith recalls the painstaking routine of placing one baby at a time on her chest, rotating them carefully to maintain warmth and stability.

“It was not easy. I had to adapt. But over time, I began to see them respond. One would smile back when I smiled, and I became hopeful,” she adds.

The babies moved through multiple stages of care, beginning in the emergency resuscitation unit, then progressing to intensive care for infants weighing under one kilogram. Once they surpassed 1.5 kilograms, they were moved to the nursery and eventually to the Kangaroo Care Room.  Despite the remarkable progress, challenges continued.

At one point, the triplets were diagnosed with a congenital heart defect, a condition that required surgery beyond the family’s financial reach. A Good Samaritan eventually funded their open-heart surgeries providing the girls with a renewed chance at life.

Judith’s journey underscores the crucial role of public hospitals in high-risk pregnancies and neonatal care in Kenya. Without access to JOOTRH’s neonatal unit, specialised staff, and life-saving interventions, the survival of these triplets would have been nearly impossible. 

According to World Health Organization (WHO), globally, 13.4 million babies are born preterm each year, accounting for more than 1 in 10 births.

Prematurity remains the leading cause of death among children under five, with nearly 900,000 deaths in 2019 attributed to complications from being born too early. Significantly, research shows that three-quarters of these deaths are preventable with cost-effective interventions such as KMC, early initiation of breastfeeding, and basic neonatal care.

In Kenya, prematurity is a major concern, with the Ministry of Health estimating 134,000 preterm births annually. Between 13,300 and 33,600 newborn deaths occur each year due to prematurity-related complications.

The prevalence of preterm birth in Kenya is 18.3%, meaning nearly 1 in 5 babies is born prematurely. Sub-Saharan Africa experiences the highest burden of neonatal mortality at 27 deaths per 1,000 live births, representing 43% of global newborn deaths. 

Raising preterm triplets brought emotional and financial strain. Judith and her husband, Vincent Ochieng, reorganised their lives around the children.  Feeding three infants, ensuring proper medication, and monitoring health required unwavering vigilance.

Vincent adds that navigating public spaces was also demanding, as strangers often stared at their identical children. Managing schoolwork and daily routines demanded patience, careful planning, and teamwork.

Fathers play a critical role in providing emotional support to mothers, while mothers ensure physical care, bonding, and consistent feeding, all crucial for the survival and healthy development of preterm multiples.

“It has not been easy. Even when going to a mall, people stare at them because they are identical. Managing homework for three children at the same time takes patience and time. You have to go one by one,” Vincent explains.

Prematurity often leads to developmental delays, and the triplets were no exception. For the first 18 months, they were unable to sit, walk, or speak normally, and their vocabulary was limited to “Mama.”

Judith devoted herself to physiotherapy, massage, and consistent care, gradually helping them achieve critical milestones. While one of the girls developed slightly slower than her siblings, Judith attributes this to natural variations among multiples.

“I massaged them every day for six years, following guidance from physiotherapists. today, they are active, healthy, and in school. None has major disability,” she says.

Preterm birth is not only a medical concern but a social and economic issue. In low-income settings, 36 per cent of low-birth-weight infants die due to lack of cost-effective care. Kenya’s neonatal mortality rate is 21 per 1,000 live births, with prematurity as a leading cause. Interventions like Kangaroo Mother Care have been proven to reduce mortality by 36 per cent for low-birth-weight babies. 

According to WHO, globally, survivors of preterm birth often face long-term risks, including learning difficulties, sensory impairments, and chronic health conditions.

However, the Kisumu triplets show that with dedicated care, timely medical intervention, and community support, these risks can be mitigated.  

Triple challenges

Vincent reflects on the emotional toll of watching their babies in the neonatal unit, uncertain of their survival, facing devastating moments when one was pronounced dead. Remaining strong in the face of fear, making quick decisions, and maintaining hope required resilience.

For Judith and Vincent, the financial load remains heavy: school fees, clothing, books and healthcare stretch the family budget. The emotional burden, too, is indelible — nights spent fearing for their children’s lives, the memory of a moment when one was pronounced dead, and the constant pressure to remain strong.

Despite these challenges, the family remains positive. They advocate for awareness about premature birth, access to public neonatal care, and the importance of support networks for parents raising multiples.

Judith urges parents to love and care for preterm babies consistently, and husband encourages fathers to actively support mothers, assuring that preterm multiples can thrive like any other child.

“There is life for preterm babies. If you take care of them, feed them, and love them, they will survive,” she says.

“Embrace your children, especially preterm multiples. Support their mothers. Love them, and they will thrive like any other child,” Vincent adds.

The family named the triplets in honor of medical professionals who played a key role in their survival. Amanda Akula is named after Dr Akula, their gynecologist. Thelma Robina Sara honors the healthcare worker who resuscitated her at birth. Jeanine Juliana recognizes the nurse who provided critical care in the neonatal unit. According to Judith, these names serve as a daily reminder of the collective effort and dedication that made their survival possible.

For Judith and Vincent, the journey continues with schooling, growth milestones, and raising their children with the same love and determination that sustained them in their earliest days.