How an inconspicuous slaughterhouse keeps the world’s premature babies alive

A treatment that saves the lives of children around the world is made from a surprising raw material: foam from cow lungs that a small Canadian company collects from a…

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LONDON, Ontario — On the night before his weekly trip into the slaughterhouse, Fraser Taylor stepped into the back of the truck to make sure everything was in place. The hold still smelled faintly of cow — a subtle whiff of something grassy — but the equipment inside seemed better suited to a day of spelunking through the sewers. There were hard hats and hoses and straps. There were huge conical tanks, and a valve-laden contraption that might come in handy for siphoning off the contents of pipes. The truck itself was white. It bore no sign of the company it belonged to or the strange journey it was about to take.

Taylor looked tired. It was almost 5 p.m., there was a snowstorm, and the team was already running late. Snow drifted down into the lights of the loading dock as Taylor slid the truck door shut. The roads would be terrible, just tire marks through slush instead of lanes. They had to go tonight, though. Lateness was not an option on Tuesday mornings. If they didn’t get onto the floor before the cattle started coming by, there would no way to load their equipment in, and they would get none of the precious liquid they’d come to collect.

It’s a substance that most meat processing plants hardly think about: Just another fluid in the fluid-filled business of turning an animal into a side of beef. But Taylor would panic if he saw any spill on the slaughterhouse floor — those lost drops could have saved babies’ lives.

This small firm had carefully courted slaughterhouses so that its workers could be allowed inside to suck this off-white foam out of cow lungs. Then, they purified the hell out of it, and shipped vials of it across Canada, and to India, Saudi Arabia, South Africa, Ecuador, and Iran, where it was shot into the lungs of struggling premature infants.

Preemies’ lungs, like the rest of them, aren’t quite ready for birth, and some — almost all of those born very early — haven’t started producing this foam themselves. It’s called pulmonary surfactant, and without it, their air sacs could collapse. In the 1980s, doctors had tried squirting surfactant collected from other creatures in through the tiny nostrils and mouths of babies with respiratory distress syndrome, while also putting them on ventilators. The transformation was immediate: Newborns went from blue to pink. Their chests filled with air.

The arrival of surfactants in the neonatal intensive care unit was “huge,” said Dr. Paul Jarris, chief medical officer of the March of Dimes. “It was an absolutely major groundbreaking development.”

It also led to a global trade in foam — an odd corner of the pharmaceutical industry whose existence depends on the whims of the livestock business. Just across the American border from Taylor’s loading dock, on the outskirts of Buffalo, N.Y., another company buys calf lungs by the truckload. A multinational corporation based in Parma, Italy — a city famous for its salt-cured ham — gets its supply by making a kind of pig-lung haggis. One American pharma giant is doing something similar with minced cattle bits, while in India, researchers are trying to suck the stuff out of goats.

But farm to pharma doesn’t quite

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