What a difference a week makes!

For the first few days after he arrived, our new boy didn't have the energy to do anything but eat and sleep.

The week following admission is a time to stabalize severely malnourished children; we keep them warm and observe them carefully. They are treated for dehydration and any infections that they have, and, we introduce feeds. Children are offered small amounts of milk formula every 2-3 hours. More often than not, they are past the point of feeling hungry. They tend to have poor appetites and they are unable to tolerate anything but small amounts of food or liquid.

Yet from the day he arrived, this boy has defied all of our expectations. A week after he arrived at GLA, he has gained 2.5 lb.

Pulling faces at us!

He has enough energy to play, to crawl around the NICU, pull himself into a standing position, and HE can even walk for short distances, holding the hands of his nurses and nannies.

We would have expected a child of his age to be sad and withdrawn on entering the orphanage: this boy is neither. He smiles and giggles. His eyes are full of hope. And not only is he ready and willing to accept affection, but he reciprocates it.....

We got our first smile from him on Thursday. Friday was the day for our first giggle. On Saturday there was a kiss, a hug, and an invitation to play ball.

As I experienced this miracle, I found myself wondering what our new little man was thinking. If his heart could speak, what would it say?

I believe his heart would say, 'I am whole. For I am loved and I love.'

"We are each of us angels with only one wing, and we can only fly by embracing one another." (Luciano de Crescenzo).

Click here to make a donation to God's Littlest Angels

In Gratitude....

On the 26th of November, we celebrated American Thanksgiving here at GLA. Many of the visitors asked whether we celebrate this holiday in Scotland. Of course, we do not; Thanksgiving pays tribute to the Native Americans who helped the pilgrims survive their first winter in a new and strange land. I do not share in that heritage, yet I have been very much in the spirit of the season this week.

I am thankful, of course, for the abundance of rich and delicious food we enjoyed on Thanksgiving day. Turkey, delicately seasoned and cooked to perfection, fluffy mashed potatoes, green bean caserole, cranberry sauce, and pumkin pie. Yum! And at the end of the day, enough lefteovers to feed everyone all over again on Saturday. And an entire uncarved bird, still sitting in the fridge at the main house today!

Yes, we are trully blessed, and the poignancy of this blessing is all the more apparent, because the abundance comes immediately after the arrival of a new baby. Aged around 18 months old and severely malnourished, he weighed all of 14lb 1oz the day he arrived.

This frail baby is ravenously hungry, devours almost everything we give him, and then looks for more. The wonderful thing about this is that he will, in all likelhood, recover from his malnutrition very quickly. He is gaining weight all ready and the change in him is visible. Less loose skin, and, the hint of a double chin. But oh, how I wish he had never known the agony that starvation brings.

By the time this photograph was taken, just 3

days after he arrived, this tiny boy had all ready

gained 10 ounces.

His mother is 17 years old and pregnant. She has lived on the streets for several years, and is in a difficult place today. She is very sick, she has nothing and no-one in her life but this little boy, and, knowing that she cannot provide for him, she is now faced with a difficult decission; should she leave him here, just long enough to revover from his malnutrition, or must she give him up?

How glad I am that I have always had a home, parents who loved me; a place where I belonged. I never had to wonder where my next meal would come from, or if it would come at all. I had everything I needed, and so I did not have to do degrading things to survive.

This baby is all his mother has. If she decides to keep him, I cannot condemn her. If she gives him up, my heart will ache for her and I will be in awe of her sacrifice.

'This is the child for which I was praying, and Yahweh has granted

me what I asked of him. Now I make him

over to Yahweh for the whole of his life.' (1 Samuel; 26-27).

I don't know that I have Hannah's kind of faith. Please join me in prayer for our new boy, and his mother. Pray that God would touch both their lives, and give thanks that GLA is here, and that tight though our finances are, we were able to say yes when we got a call about a toddler boy who desperately needed us. It is thanks to the generosity of friends and strangers, that GLA can continue it's ministry. I am so grateful for their gifts.

If you feel led to give, click here.

Memories of the power outage

Two weeks ago, we lost power at the main house. The second and third floors were affected, meaning no lights, no refrigerators and no electrical appliances in the nurseries.

By the grace of God, we had no sick babies at that time; no-one needing oxygen or an incubator, no real crisis. Dixie's teenage sons were real troopers. On their own initiative, they strung extension cords upstairs for us.Thanks to their hard work, we were able to light the nurseries for the smallest babies with desk lamps and we had a source of power to drive our nebulizer machine.

I will remember that as the week that the night nannies and I played Florence Nightingale, doing our evening rounds in the big nursery by torchlight. A few of our little ones are scared of the dark but they all giggled and oohed aahed as I made light patterns on the ceiling for them. The memories are fond, and untainted by worry or anxiety.

I will also remember suturing my first knife-wound by the light of a lamp, that week. A neighbourhood boy came for help after he got into a disagreement with his 12 year old sister. His poor Grand-mother sat with her hands covering her face the whole time I was cleaning and anaesthetising and suturing.

A few days later, when he came back for a check-up, I asked him how he and his sister were getting along. His family at home had beaten her, he told me. Did he think she deserved that? Did it make him glad. No! He shook his head back back and forth rapidly, as though trying to shake of the memory. Why not? Because she is his sister, that's why not. It was touching to hear that.

Over the past few months, we have only admitted children whose cases have been critical. It is taking up to 2 years to process adoptions and with donations down and space at a premium, the staff here have a responsibility to guard the well-fare of the little ones that are all ready with us; to ensure that we do not have to compromise on the quality of care they receive.

This gorgeous baby boy (don't be fooled by the peach tones!) came just before the power outage,
at a little over a week old, and weighing 5lb 13oz. His Mother had died shortly after he was born. He was dehydrated, jaundiced and showing signs of weight loss. His family could not afford to buy infant formula and so he had received only water since he was born.

Baby N's case was therefore critical and he was admitted right away. A few days after he arrived he developed a cold and began having diarrhoea and vomiting. The NICU nannies and our head Haitian nurse were very clear about what they wanted to do for this little one.

The previous week, we were blessed to have a nursing mother come to visit her adoptive son, here at the baby house. The lady's birth son had not travelled to Haiti with her and so she was expressing milk, so that she could maintain her supply during her trip. She donated the expressed milk to us, to be frozen and used to help any fragile baby we thought could benefit from it.

The Haitian staff wanted me to thaw some of this milk for Baby N. This is quite remarkable because Haitians are not fans of giving a mother's milk to an infant that is not her own. The ladies here, though, have seen a great many premature infants thrive on breast milk, while others have struggled to tolerate formula. They had seen that Breast milk was easier to digest, and they were very open to hearing about the immune boosters in 'Mummy milk.'

After just two days of being fed breast milk, Baby N was no longer showing signs of illness and he was gaining weight. What a precious gift this Mother has given to this sick, orphaned baby! We really are so grateful to her.

Time is Marching On

The pace of life at GLA does not compare to the frenetic environment of a general Paediatric ward. Yet somehow, three weeks have passed since I last blogged, or journalled.

There have been trying times, but lets not dwell on those. Instead, let's take a look at the moments from which I have drawn my strength; those that have sustained me.

A few short days after I last posted, we were visited by Ti Mirak (our little miracle boy, Jonathon.) Jonathon came to us in May, after his Mother delivered him and his twin brother 8 weeks before her due-date. He was close to death on arrival, and stopped breathing a few days later.

Whenever we discharge a preemie, we tell their Mamas that if the little one becomes unwell during the first year of life, they may bring them back to GLA to be assessed. Jonathon's Mummy was at home in bed with a nasty cold. Jonathon had been feverish for three days and he arrived here with two Aunties and an uncle.

Jonathon was thoroughly examined. He was bright and alert, if a little bit miserable. He was feeding well and didn't have any diarrhoea or vomiting. There were no signs of infection in his chest but his throat and ears were a little bit red.I prescribed paracetamol syrup(Tylenol)and an antibiotic.


At Five and a half months, Jonathon weighs in at over 12 lb. That is quite good for a Haitian baby and it is fantastic for one that was born over 2 months premature! Mme Bernard advised the family that they could start offering Jonathon some weaning foods. His Aunties were horrified.
'No!' one exclaimed!' He isn't 6 months old yet!' We counselled his mother to breast-feed Jonathon exclusively for the first 6 months of his life so that he would have the best chance of survival. Apparently, Jonathon's family are following this advice very carefully! It was encouraging to see Jonathon thriving and so well loved and cared for!

After 11 days, Ti Fi was finally able to breath without supplemental oxygen. She health remains unstable but she continues to make great strides in her development. She is now able to roll from her front to her back and vice-versa. She can shuffle across the floor when she is sitting and she scoots backwards when she is lying on her belly. Last week, I found her underneath her crib!



Two week ago today, I was called to the waiting area to assess a preemie, who had arrived with his Daddy. Lyovens was born around 6 weeks early and we found him to be very tiny for his age (just 3lb 3oz). He is a beautiful boy. He was well wrapped up but cold . He had been born 3 days earlier and hadn't received a single drop of fluid. He had a good, strong cry and I felt hopeful, if in a cautious way that he might live. I'd had a tough week, and Lyovens arrival coincided with a bi-monthy volunteer and staff outing. I wouldn't be able to go, but it didn't matter. Suddenly, I was re-energised. It felt as though God was smiling down on me.

Many of our parents are very afraid of their premature babies, and the things that we do (medically) to sustain them. Lyoven's family however, are very laid back about it all. His Father told me that GLA previously helped Lyoven's older sister, who was also born premature. She is now 6 years old and in school!

Lyovens needed a feeding tube for the first week he was with us. I am pleased to report that he is now breast-feeding. He lost weight initially. We started him on just 5ml of milk, every two hours and gradually increased the volumes. Today, he weighs 3lb 7oz. He still needs to be in an incubator. The biggest risk factor for him is that he is so small for his age. That means he wasn't getting what he needed in the womb and is starting off at a disadvantage.

Yet if there were no difficulty in his life, there would be no scope for a miracle.

A Cup of Water

Monday: We are all up on the third floor balcony. 'We' being (close to)100 babies, 20 nannies, 3 nurses, and a handful of volunteers. Absolute madness! Little bodies darting everywhere. Into everything, pulling, tugging, pushing, bumping and crashing. The Haitian ladies sit in the shaded areas, oblivious to the chaos, seeming unperturbed the cacophony. But then, the atmosphere up here is only a little bit crazier than the big nursery.

1pm: It is after lunch. 'These babies need to sleep,' I declare. My Haitian colleague looks at me disbelievingly. 'These children will not sleep.'

An hour later, I am sitting amongst a sea of sleeping tots. I have single handedly managed to settle all but three of the toddling babies. Everyone is glad. Looking around, I sigh. Each tiny girl and boy has their unique quirks. Some have been rocked to sleep, others have had their backs rubbed or their bottoms patted. Some have fought nap-time. Others were out within seconds. One little man is holding his ear. Another has his hand inside his nappy. Oh Oh!

Seriously though; they are all so different and special. I have been hot, tired and irritable, but watching all these little chests rise and fall I am suddenly overcome with feelings of warmth and tenderness.

Tuesday is weigh-in day. The numbers aren't good. Overnight, we have been hit by an epidemic of diarrhoea. and vomiting. A few children are looking quite dehydrated. All are in need of pedialyte (oral rehydration solution). Some cannot keep down even sips of fluid. They need injections of anti-emetics to help with the vomiting. Amazingly no-one needs IV fluids.

Wednesday: We are still in the throws of the epidemic. We have also had an outbreak of hepatitis among the grown-up's at the orphanage. Some of the newer children have tested positive and many others have been having mysterious fevers, and symptoms of possible hepatitis infection. All of them need to have blood drawn drawn. It is a major operation. Lollipops are placed in mouths. With a few notable exceptions, there is very little crying or flailing.

Thursday: Ti Fi went back to the NICU at the end of last week. Many of the babies have colds but she has developed a high fever and we cannot get it down. She had a chest x-ray a few days ago. it showed a pneumonia. Ti Fi was started on an antibiotic last night, but she has deteriorated overnight. She needs oxygen. She is fractious and looks at me pleadingly. I pick her up. She burns in my arms. She is panting and I can feel her heart hammering under my palm. The monitor reports a heart rate of 210 per minute. I get 208!

Ti Fi is so fragile and we are concerned that her little body will tire. Our paediatrician does not think that she can keep up this level of effort for long. She is seriously ill but although I desperately wish I could take away the hacking cough and the raging fever, and although I am anxious for my Ti Fi, I have an inexplicable peace that she can overcome this.

Late morning: I am asked to go to see a premature baby. His Aunts have brought him here. I learn that he was born in Delma (close to Port-au-Prince) earlier today. It is immediately obvious that it is too late. He is is waxen and very still, but oh so, beautiful. The sorrow I feel is strangely sharp.

I have been thinking lately, that I am in danger of shutting down emotionally. Now, a still, small voice whispers in my subconcsious that I am not to harden my heart. I cannot fullfill his commission if I do that.

Friday: I am in my room, and I hear Ti Fi's oxygen machine bleeping. Stepping outside, looking up at the NICU, I see that the first floor of the Main House is in darkness. The generator has failed. There is no power to light the house or drive the oxygen concentrator.

I rush up to the NICU to find Ti Fi struggling to breathe. By the light of a cellphone, I see that she is blue. The Pulse oximeter tells us that her transcutaneous oxygen saturation is 73%. That is life threatening!

The power comes and goes. I hastily gather together a bag of emergency supplies. It has been decided that Ti Fi and I will spend the night at the toddler house (about a mile up the mountain). They are not set up to deal with very sick children, but at least they have a more reliable power source than we do.

3am: after a rough night, Ti Fi and I finally catch some sleep. The IV has become dislodged and is out and my little lady remains feverish. She has a spasmodic cough and is constantly reaching for me.

I have missed her so much since I returned her to the NICU last week. I am glad to have this chance to love her through her sickness.

I wake just after sunrise, and am rewarded by a tiny smile from Ti Fi. Sometimes, I think, it is the little things that make the greatest difference in the lives of my babies. To be touched, to be held....

Shortly after lunchtime, we are heading back to the main house. Everyone at Kay B (the toddler house) has been so gracious but I am overwhelmed by relief to be headed back to the main orphanage building, and to have some medical back-up again.

The rest of the weekend: don't ask because I don't know. I got all of two hours sleep on Friday night, and was unable to nap when I got back to my own bed the next day.

One thing I do remember: being slightly thirsty, and desperately tired, and not having water in my room or the energy to go and get some. I had been complaining to my room-mate, the night before, telling her how much I missed Scottish water. I absent-mindedly reached out my hand. I don't why, and I found a cup of water where there had been none. It was cold, clear and pure; just like the water at home. I know my God is near me!

Like Springtime

Ti Fi,

Ill-equipped though your grand-father was to raise a baby, he did not visit the magistrate for a full two months after your Manman died. Surely, his steps were leaden on the way to the court that day. There must have been some level of struggle in his mind, between the desire to hold fast to you, his tiny grand-daughter, and the need to give you up for your own sake. If there had not been such a struggle, why would he have waited?

You arrived at our home, sick and emaciated, parched in body, and with eyes that betrayed a heart, equally parched by grief. A beautiful flower, scorched and uprooted. That was you, Ti Fi. And so I planted you in the garden of my own heart.

There was no relief in her countenance. There were gentle hands to tend to her, there was treatment for her dehydration and there were medications for the fever and infections that wracked her little body. Still, she refused to feed, and was in a state of decline. She needed love, I knew, and an abundance of it. Dixie was in the States with Vivianne, a key member of the Haitian staff. I was tired with additional duties I had taken on, and yet, a still small voice urged me to open my arms and draw Ti Fi close. And that is how he ended up in my room.

Sure enough, within a matter of days Ti Fi smiled. They say that the best prognostic indicator (of survival) in a severely malnourished child is a smile. Here it was. Hope born in both our hearts.

As the days and weeks passed, I saw a rejuvenation in Ti Fi's spirit that spoke of the miracle of God's creation; the capacity of a child's heart to heal. New growth as in springtime. She began looking at the NICU nannies and nurses with wonder and she became very interested in toys and in her surroundings. Soon, she she found a voice. 'Ah haa haa' (the cutest giggle), Hi nah (a greeting), 'aaah' (to express her delight) and 'hey' (this one is to get our attention.)

Did I mention that she sings too?

She found the strength to sit unsupported, when, a few days before she couldn't even hold her head up. Within the month she was not only weight bearing on her legs but she was "climbing" from my lap to the top of my head, beaming and triumphant.

Yet love alone has not been enough to restore this precious girl's broken body. She has had an NG tube for 6 weeks now, much longer that I am comfortable with. It seems that Ti FI has health challenges, the extent of which we do not fully understand at this point. She becomes breathless when she sucks her bottle or eats from a spoon. Her heart races and she sweats. She is only able to tolerate formula that is comprised of partially broken down proteins, and she must be feed small regular volumes if she is to hold her feeds down.

Her weight gain is slow, even now that the diarrhoea and vomiting are under control. If early indications are anything to go by, it may take three times longer to recover this baby from her malnutrition than I would have hoped.

More time, more work, more patience than I thought I had. More laundry and more frustration than I thought I could deal with. And looking at this precious girl, who has suffered so much sickness, loss and pain, and who is so absolutely brimming with joy, how can I possibly say that I am overburdened? What reason have I to complain?

'I am he. I am he who will sustain you. I have made you and I will carry you...' (Isaiah 64:4).

Ti Fi weighed 8lb and 40z on admission. Today she has gained 3lb. She is becoming chubby, and she is a beautiful, delightful baby who absolutely has my heart.

Ti Fi with 'M' (left). He is my boy, she is my girl and M has whole heartedly accepted Ti Fi as his baby. They are so cute together. He is very protective and will not allow the other children to touch her. He points out a great many things of note to her. Ti Fi, much to M's delight is smiley and responsive.

She seems to have turned a corner this weekend; I haven't used the NG tube at all. She needs continuing prayer for healing. So Lord, heal this precious baby of ours according to your perfect will, and give her for every sickness, every sorrow and every pain she has suffered, a double portion of joy.

Amen

An Update On My "Problem Children"

Sandia Laura's family were unhappy that we would not be able to care for her here. Before we could organise a car to take them to a hospital, her 16 year old Mother left with the baby. We heard that they kept Sandia at home for a day. Somehow, she ended up in General Hospital in Port Au Prince. We do not know what her diagnosis was or what kind of care she received. What we do know is this; a few days ago, Sandia Laura passed away. It is difficult to understand why such a tiny baby should suffer so much in the few days she lived on this earth. We are comforted to know that she exchanges all this pain for an eternity in Heaven.

***

Baby Mike became very sick a few days into his stay with us. His abdomen was distended, his colour changed to a deep red, and he began bleeding from his mouth and nose and under his nails. By the time he became ill, we had received devastating news from his Aunt.

Baby Mike's Mother had been carrying twins. Her Labour had progressed so rapidly, that, caught unawares, she had delivered Mike into the bucket she used as her toilet. She was unable to deliver the second twin. She went to a hospital, where she had a caesarian. It was too late for Mike's twin, who died in utero. Mike's Mum died the following day.

We contacted a Neonatal Nurse Practitioner in the USA. She felt that Mike was suffering from an overwhelming infection, possibly listeriosis, which his Mother would have contracted from eating contaminated food.

We learned that with treatment, there was a 20-40% chance that Mike would die. To our great distress, we were unable to site an IV line to give this baby the fluids and antibiotics he needed. It was late at night and there was nothing for it but to provide unconventional care. I gave antibiotics by injection. I then placed a tiny needle under his skin and connected it to a bag of IV fluids. IV fluids were slowly infused overnight. It was not ideal but fluid was gradually absorbed into his system.

The next morning, Mike was alive and crying loudly. We were so impressed by our courageous boy, and as you might understand, desperate to do everything that we could to save his life. Our Paediatrician arrived and managed to start an IV. Things were looking up. The Doctors were optimistic that he might live, and Mike definitely had fighting spirit.

Unknown to us, there was trouble brewing. At home, Mike's Grand-Father was demanding that the women of the family go to GLA and demand that we return his Grand-son to them. We explained that Mike was critically ill, and that he would die without oxygen,. IV antibiotics and fluid. We explained that he was too small and weak to survive out of the incubator, but that in a few short weeks, things might be very different. There was no talking with them. No reasoning.

When they returned the next day with Baby Mike's Father, GLA's hands were tied. We re-iterated them that Mike would die, but they were insistent that they wanted him home. The Haitian nurses were obliged to remove the IV, take off the oxygen prongs, wrap the baby warmly and hand him over to his family, all the while knowing that death was inevitable for him now.

One of the staff tells me that Mike's parents are not from this area. Their home town is a Voodoo stronghold. Haitians are deeply spiritual people and it is likely that the family believe that an evil spirit caused the death of the Mother and Mike's twin, and that this spirit was still attached to Mike. This being this case, they would have no faith in the power of Western medicine to change a thing.

Mike's Aunt lives a few hundred yards from our gate. Minutes after the family left, as I sat on the NICU balcony cursing his family and grieving for Mike and for them and their country, this spiritual shadow land where people live bound by beliefs that hurt and harm, the steady beat of traditional drums began sounding...

***

Baby D's blood work indicated that she was suffering from a severe bacterial infection. We never did find the source. As the days passed, her colour improved and her heart rate slowed. We kept her on a strong antibiotic for two weeks, so that we could be as sure as we can be that the bacteria that made her sick has been eradicated from where ever it was growing. Baby D is back to her usual happy, smiling self. We will continue to watch her closely.

***

And Ti Fi.... We have had a hard few weeks, but she has turned a corner.Hers is a story for another day.