GAC008 Assessment Event 4: Academic Research Essay

Breathing for a Better Future:

Addressing Hypoxia and Disability

as Its Impact

Student’s Name: Michelle Christina

Student ID: XI – IPA 4 / 27

Teacher: Ms. Sylvitia Krisnata Priroria, S.Pd.

Due Date: April 10th 2023

Word Count: 1313 words

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Question: Definition: Man-Made Environmental Issues. What is meant by ‘hypoxia’? Explain with
reference to the severity of the problem in your own country.

Every human being entails oxygen. Without oxygen, human metabolic functions cannot be carried
out properly. There are many situations where humans confront difficulties due to lack of oxygen, one of
which is hypoxia. Hypoxia is a condition when oxygen in the body's tissues is not distributed properly
which causes the amount of oxygen in the tissues to be insufficient to maintain homeostasis (Bhutta,
Alghoula, and Berim, 2022). Hypoxia comprises many types, each of which onslaught different body
tissues. Hypoxia itself is a severe problem that can occur in all living things, including infants (babies).
Infants have a relatively vulnerable body metabolism, and the function of their organs is still relatively
weak. That is why infants, especially preterm infants, have been facilely attacked by hypoxia. Hypoxic-
ischemic encephalopathy (HIE) is a specific type of hypoxia. Hypoxic-ischemic encephalopathy (HIE) is a
brain injury or dysfunction which infants encounter before birth, during labor, or in infancy. This brain
dysfunction occurs in infants because oxygen or bloodstream to the brain is abbreviated. The extent of brain
damage is influenced by the amount of time that it drifts without oxygen (“Hypoxic Ischemic
Encephalopathy: Causes and Symptoms”, 2022). Hypoxic-ischemic encephalopathy (HIE) leads many
newborns to serve disabled and have difficulty accessing education and getting occupation. It then becomes
the incentive for the medical industry to develop the treatment of hypoxic-ischemic encephalopathy (HIE),
such as therapeutic hypothermia.

Hypoxic-ischemic encephalopathy (HIE) is more common in premature infants with a percentage

that reaches 60% worldwide and Indonesia cannot be disparate from being one of them. The prognostic of
infants to evolve disabilities is also classified into three, specifically mild, moderate, and severe hypoxic-
ischemic encephalopathy (HIE). In moderate and severe hypoxic-ischemic encephalopathy (HIE), the
infants not only have the potential to acquire severe disabilities but also the potential to succumb (“Hypoxic-
Ischemic Encephalopathy (HIE)”, n.d.). There are several circumstances that cause hypoxic-ischemic
encephalopathy (HIE), such as complications from the upkeep of the umbilical cord, placental abruption,
infection, and others (Dr. Lovira, 2022). Regardless of these causes, it is necessary for parents, especially
the mother, to take early steps in maintaining the growth of the fetus during pregnancy. A few things that
can be done by the mother are avoiding smoking and not drinking alcohol. A mother is also the one who
provides food resources for the infants so she needs to eat healthy and nutritious food. An addition that is
notable is to do routine pregnancy control. This helps the parents to comprehend the development of the
fetus and the irregularities that may occur during pregnancy. There will be signs or symptoms to identify
hypoxic-ischemic encephalopathy (HIE) in infants. These signs are divided into three stages. First, signs
that emerge before birth are receding fetal movement, anomalous fetal heart rate, and vaginal bleeding.

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Second, signs that emerge in the neonatal period or newborn (4 weeks old) are seizures, breathing
complications, and faint or absent crying. And third, signs that emerge during infancy (0 to 1 year old) and
early childhood (1 to 3 years old) are impaired motor function, delayed growth, and hearing or visual
impairments (Signs and Symptoms of HIE, n.d.). Signs of hypoxic-ischemic encephalopathy (HIE) crucially
need to be acknowledged so that children who acquire can receive medical assistance for convenience.

Brain injury or dysfunction caused by hypoxic-ischemic encephalopathy (HIE) proceeds

developmental delays and disabilities, such as cerebral palsy (CP) and epilepsy. Approximately 30% of
children with hypoxic-ischemic encephalopathy (HIE) proceed cerebral palsy (CP), a muscle disorder that
impacts someone's ability to move and maintain body balance while 16% of the children with hypoxic-
ischemic encephalopathy (HIE) proceed to epilepsy, a brain disorder that causes seizures when nerve cells
do not signal duly (“HIE Facts and Statistics”, n.d.; “What is CP?”, 2022; “Epilepsy”, 2022). With this
large proportion of disabilities, many children undergo discrimination and do not have many opportunities
to pursue education. In 2021, the Indonesian Central Bureau of Statistics (BPS) reports that the number of
disabilities of school age (5 to 19 years) is around 2.197.833 people. Meanwhile, recorded at the Data and
Information Center of the Indonesian Ministry of Education and Culture, approximately 269.398 children
are studying in inclusive schools (Hasna, 2022). Both parents of children and children with disabilities still
show deficiency enthusiasm for schools. As evidenced by the Indonesian Central Bureau of Statistics in
2020, reported 29,35% of disabled children in Indonesia did not fulfill elementary school and 20,51% of
them never went to school. Education is necessary for children. It helps them to learn their best potential
and expand it for the better. However, due to the absence of self-confidence, plenty of children are not
willing to enter school. This can cause children to be seen as abortive in society, especially in Indonesia,
where most people place a high value on formal education. In addition, discrimination that is encountered
by children with disabilities will affect their future when they enter employment. Between 2020 and 2021,
based on the Indonesian Central Bureau of Statistics (BPS), there was a decrease in the number of people
with disabilities who work in stores or companies. The decline occurred by 0,61% from 5,98% in 2020 to
5,37% in 2021, and still decreasing up to this day. It is proven that stereotypes regarding disabled people
do not meet the work standard still roam in society, although many of them surely are competent.

Hypoxic-ischemic encephalopathy (HIE) is not a curable disorder. Nevertheless, when a newborn

is diagnosed with hypoxic-ischemic encephalopathy (HIE), there will be immediate prevention by using
therapeutic hypothermia. Therapeutic hypothermia is a treatment for newborns by reducing body
temperature to minimize the brain damage caused by a deficiency of oxygen (“Therapeutic Hypothermia”,

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n.d.). This enables the infant's brain to reduce the level of disability as they grow. According to current
guidelines, the treatment should be given within six hours of birth and transpire for about 72 hours (about
3 days) to retard the infant's metabolic rate. This is done to prevent further damage known as reperfusion
injury, which occurs when brain cells get oxygen too fast (“What is Hypoxic-Ischemic Encephalopathy
(HIE)?”, n.d.). The therapeutic hypothermia procedure consists of three phases, specifically the induction,
the maintenance, and the re-warming phase. First, the induction phase utilizes several methods such as
surface cooling by air, surface cooling by fluid, and core-cooling to reduce the body temperature
immediately. Next, the maintenance phase aims to maintain the patient's condition to remain stable. In this
phase, body temperature, vital signs, and serum electrolytes are tightly controlled for 12 to 24 hours. Lastly,
a re-warming phase is a process of gradually increasing the central body temperature until it returns to
normal, and body temperature is monitored every 15 minutes for 2 hours (Lega, n.d.). In addition to
therapeutic hypothermia, the medical team must assist to control the infant's breathing and prevent seizures,
minimize brain swelling, and much more.

In conclusion, hypoxic-ischemic encephalopathy (HIE) is a serious disorder that people should be

aware of. Long-term disabilities in newborns lead them to be unable to maximize their potential due to the
inconvenience of accessing education and the difficulty of participating fully in society. There are several
treatments that can be used to prevent hypoxic-ischemic encephalopathy (HIE) from getting worse, one of
which is therapeutic hypothermia. Although disabilities that have been caused are unable to be cured, it
does not mean these children cannot have a normal life. If they are incapable of learning the way other
children are taught, adults can teach the way they learn. Every single child has their own potential. It needs
to be acknowledged that discrimination is not able to show their capability. We need to have a sense of
responsibility to spread awareness regarding hypoxic-ischemic encephalopathy (HIE) and give these
children chances in life.

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