Christmas Week

In the week leading up to Christmas, many of the babies in the high care room picked up a respiratory infection. They were coughing, sneezing and wheezing. Their noses were running and their eyes were streaming. It looked as though they had RSV, a very common virus that causes inflammation and congestion in the tiny air ways of babies lungs.

We were very busy monitoring the infants and giving them the extra care and attention they needed to get better. We used saline drops and bulb aspirators to help unblock their little noses so that they could suck from their bottles. Breathing treatments helped a few, and everyone extra love and hugs from their nurses and nannies.

After a few days, most of our little ones were recovering. Our preemie girl though, wasn't doing very well. She was working hard at breathing and was started on oxygen, suction and nebulizers and an IV.

On Christmas Eve we welcomed a 1lb 14oz boy into the NICU. He was emaciated and profoundly hypothermic but he was also very hungry and we were hopeful... cautiously hopeful. When William stopped breathing that night, Dixie and I began resuscitating him and prayed for a miracle. Two hours later, his tiny body was failing, and there was nothing for it but to hold him and rock him. As William slipped away, God whispered that his fragile child had survived 24 hours, and that in that time, 5 nurses from 3 countries had fought for his life. God said that was William's miracle, and that now he was going home, and there was no greater miracle than that.

Our preemie girl continued to deteriorate over the days that followed.This baby weighed 3lb 6oz when she arrived at GLA a month ago. Premature babies are very susceptible to infection.

We turned up the oxygen to support her airways, we changed her antibiotic and we started her on steroids. Our 6 1/2 lb fighter rallied. Today her oxygen requirement is down and she is strong enough to bottle feed. Thank you God!

Hope for Baie D'Orange

High in the mountains above Jacmel, in the South East of Haiti, lies the remote community of Baie D'Orange. Following media reports that 26 severely malnourished children died there in November, the Association of Haitian Orphanages planned a mission to deliver aid to the area. On Thursday night, 5 trucks were loaded with emergency food packets, medical supplies, seeds, tools and banana plants. At 5 am on Friday morning, GLA staff piled into two of the trucks and headed for Port-Au-Prince to join a convoy of 3 other vehicles which would make the 6 hour journey to Baie D'Orange.
We skirted alongside bustling city slums, where, at 6am, men and women were all ready bartering for goods that were assembled on rickety stalls, set up a few feet from gutters where raw sewage flowed and drifts of rubbish collected. Here and there tires had been been set alight at the side of road. Merchants and customers nimbly side-stepped and weaved in between the honking vehicles until gradually, the urban scene faded into sugar cane plantations, and then onto a winding but smooth road through the mountains.

Several roadside markets slowed our route to Jacmel. When we finally arrived at the sparkling coastline it was 9am. Jacmel is a colonial port town where the streets are lined with buildings that display an understated French elegance and distinctly Caribbean colours. We were a world away from the gang violence of the capital as we passed through Jacmel and I think we all inhaled some of its tranquil ambiance.

Beyond Jacmel, the paved road petered into a dirt track. Clouds of dust hung in the air and as the convoy trundled on we were able to take in the sights of rural Haiti; Children sweeping the yards in front of faded and peeling candy-coloured homes that were fenced by woven screens and bushes. Bare-breasted woman washing clothes in a river. Weary donkey's, weighed down by the weight of the people and the supplies they carried. And every time I saw one of those donkeys, making their way over the harsh terrain, I was reminded of the Christmas story, and our mission became all the more poignant.

We crossed a rocky river bed and came upon a rural village at the foot of a mountain range. In August and September, four hurricanes pounded this area in quick succession and the scars from the assault were clearly visible. Piles of rocks that were several feet high lined the route towards the mountain road. They were right up against the homes and and the store fronts. Off to the left, the tree trunks were partially buried in the rubble. A concrete grave had been opened up, and ahead, a cascade of powdered limestone spilled over a rocky verge. There was silence in our vehicle as the realization of the storms brute force sunk in.

The final ascent to Baie D' Orange was torturous. The road climbed steeply, clinging to the mountain-side as we negotiated hair-pin bends, mindful of the sheer unguarded drops down into the valley below, and mindful that a few weeks ago, a truck had overturned on this road, killing an aid worker. We rounded a bend and either slopes of bare pasture land opened all round the vehicle. The land was shrouded in mist, and scattered with volcanic rock. There were no crops and very few trees. We passed mud and stick houses and naked children. There were no signs of infrastructure here. A few miles on, a small sign pointed to the Cassak's office. This was Baie D' Orange.

We parked the vehicles and got out. We were lead through a crowd of several hundred people and were directed to sit on chairs which had been placed under a tarpaulin. There were speeches by Gladys Thomas, who lead the convoy, and by Dixie. The ladies explained to the people that we had heard about their plight and that we had come with food aid and medicines because we didn't want any more of these children to die. The crowd cheered when they heard this and were glad to hear that the convoy had also brought seeds, tools and plants, so that beyond the immediate crisis, they could provide for themselves. The Cassak (the local official) then expressed thanks, and we began unloading the trucks.

Before long fights were breaking out. There was not enough food for all 500 people and those who hadn't received anything were becoming desperate. To the right of our vehicle, a tiny infant with elfin features was sucking at her mother's sagging breast. A thin little boy with a receding hairline came towards us with his mother. The red mountain earth was was caked around his mouth. It hurt to know that his hunger pains were so bad that he was eating dirt. It hurt to think about how many times he had gone to bed hungry. And how many days he had been without food.

There were pleas for help from all directions. It was discouraging to have to explain over and over that we had nothing more to give the people. A little boy, who might have been around 10 or 11 years old told us that he hadn't received a food parcel. We told him that he needed to find a grown-up to collect one for him. The Cassak was not distributing aid to children because it was inevitable that a hungry adult would pounce on them. The skin was drawn tightly over the boy's cheeks. He pleaded that his father had gone to Jacmel and that his Mother was sick with a fever. The boy was directed to one of GLA's Haitian workers. A few minutes later a call went out that all the children were to proceed to the Cassak's office and that the adults were not to follow. I have to believe that the official found a way to get food to these hungry children.

As I looked around, I knew I was seeing a community of people that were carrying themselves with as much dignity as their situation afforded. The women and girls all wore scarves over their heads and if the people's clothes were worn, they were also clean. However, as we watched people snatch packets of rice from old women, it was also clear that it was every man and woman for themselves, and that the experience of famine was cruel and inhuman, and that it had made these people lose a vital part of their own humanity. And yet, as we played with the children, and as I heard a very tiny girl exclaim that she had been blessed today, and as I looked into her shining eyes where a few minutes before, a listless despair had sat, I knew that hope was not dead in this place.

As we left Baie D' Orange, I thanked God for the opportunity to go there. The day before Dixie had announced that we were going on a mission trip into that area, I had confided to my room-mate that I was struggling with the knowledge that some of the sickest children in Haiti were dying before they reached GLA's gates. The journey South was an answer to prayer. I am praying that God will open the door for me to make further trips, to bring medical help to the most vulnerable children living in Haiti's remote and unreached communities.

....and I am in love!

At 12lb, our newest baby boy was petite for a 6 month old. With wide eyes, long lashes and a perfectly round baby face he was also extraordinarily beautiful.

Whenever a new baby arrives, the nannies bathe them right away. They lotion them up, they apply baby powder to their neck, underarm and groin areas, and then they dress them in clean clothes. Many Haitian Mothers simply sponge their babies down rather than immersing them in a bath tub. Our hygiene rituals must seem quite strange to the new arrivals. This little boy, like most, voiced his protest quite loudly!The baby was clean, fresh smelling and distinctly unimpressed when the nanny passed him to me to be weighed and fed.

New admissions arrive in the high care room regularly and it is always special to give them that first bath, and that first bottle of warm milk.

Our new boy, though, spat the teat out. 'He doesn't know how to suck', one of the nannies observed. No-one was surprised. When Mothers die or abandon their infants in this country, their families are rarely able to afford bottles or formula. They feed the babies whatever they have in the house; usually broth or porridge. With this in mind, we offered our new little friend some milky cereal, which he ate with great enthusiasm. It is possible that he had been spoon fed all his life.

It took several weeks and a lot of patience to get him to accept liquids, even from a spoon. Initially, we gave him milky cereal and gradually made it thinner and thinner as the days passed. Although the baby is able to drink from a bottle now, he still prefers to eat.

But you see, the little man in question is blessed with many beguiling ways, and so this intensive work was no burden at all. From the very first day, when those liquid eyes fixed on me, and those tiny arms reached up, I knew I would do anything for him.

And when I lifted him up, and pinched his cheeks (I couldn't help it, and of course, that's not my fault) he squealed with delight and threw his arm up over my shoulder. I knew then that I would do anything for him a thousand times over. Then, when he fell asleep with his head on my chest, breathing softly on my neck...

...Oh my goodness, I though, I am in love!

And I absolutely maintain that it is his fault, not mine.

Baby Youlene

At 3pm last Monday, there were whoops of joy in the NICU when 'Mama Youlene' burst into the room with a a sunny smile and an enthusiastic 'Bon Swa'.

She had gone home 3 weeks earlier with her premature baby. Youlene was born at the end of July weighing 1lb 10oz. Everyone was amazed when they baby survived and thrived with minimal medical intervention. After 4 months at the orphanage, the fiesty infant and her mild mannered Mama had all our hearts.

Youlene's Mama was pleased to be back, but as I looked down at the yellow-skinned baby and noticed her laboured breathing, I knew this was not a social visit.

The baby was always crying at home, her mother told us, and the family thought she must be hungry. Four days before, they had decided to give her infant formula. Youlene didn't know how to feed from a bottle, so her Mama cut the end off of the teat so that more milk would get to the baby. Youlene coughed and spluttered. Her eyes wattered and she turned blue. She eventually caught her breath but didn't seem so well after that.

She had aspirated milk into her lungs and was developing a pneumonia. When the baby was unable to feed, her Mama brought her back to GLA. By the time Youlene made it up to the NICU, she was working very hard to breathe. Her respirations were 80/minute. Her nostrils were flaring and the muscles under her ribs were being drawn deep into her chest with each breath. Her heart was beating 200 times a minute and she was jaundiced. Youlene was extremely sick.

We gave her oxygen and nebulizer treatments and we sited at IV. She was given a strong antibiotic and fluids through the line. She was producing a lot of secretions and needed suction to keep her airway clear and physiotherapy to help move the mucous from her lungs.

The Haitian staff were desperately disappointed. They liked the 18 year old girl they affectionately called 'Mama bebe' ( the baby's mother.) She had always been cheerful and eager to help the orphanage staff when she was here. She had soaked up any advice they offered and had been loving and attentive towards her little girl. When the young Mother left with Youlene, they had every faith that the baby would do well.

Mama Bebe was scolded by the head nurse for 'drowning the baby with milk' and the nannies shook their heads in dismay. They felt that she should have known better. She loves her daughter dearly and would never intentionally harm her. Unfortunately, once Mama Bebe left our property, she was surrounded by ignorance about infant care and nutrition. She absorbed that ignorance. If she had known better she would have done better.

The baby's condition was precarious in the first 24 hours after she was re-admitted to our NICU, but she responded to her treatment and has gradually improved over the course of the week. Her oxygen requirement is much lower now and she doesn't need suction or physiotheapy. She is feeding well at her Mum's breast and the IV has been taken down. We are all very relieved and excited to see her big round us follow us as we go about our work.

On Thursday afternoon as Madam Bernard turned on the nebulizer machine, a look a realization crossed Youlene's face, she pouted, threw back her head, clenched her fists and let out an angry cry. She hates her nebulizer treatments! There was fond laughter from everyone. Our little lady is intelligent and strong willed and we are glad!

We are hopeful that Youlene will make a full recovery. Please join us in praying that she will not suffer any lasting effects from her pneumonia. Malnutrition, poverty, illness and lack of access to health care make Haitian infants fragile. This baby is more fragile than most, but she is also very blessed.

On His Way To a Happy Ending

This baby was admitted almost a month ago. This photograph was take a few days after he arrived. He was 8 months old and weighed 9lb 8 oz but almost a lb of that was "water weight." You can see that his face is puffy and that his hair is yellow and very sparse. There are many areas on his body where his skin is light due to loss of skin pigment. His growth is so stunted that he is wearing newborn clothes. These are all signs of Kwashiorkor ( a type of malnutrition that makes children swell.)

No-one knows exactly why some malnourished children develop kwashiorkor and others do not. Scientists agree that lack of protein in the diet is one of the main causes of kwashiorkor but it seems that liver damage and deficiencies in particular vitamins, minerals and fats also contribute to this type of malnutrition.

The baby was sleepy when he came in but he seemed hungry and he was not showing signs of serious illness. Our first priority was to start re-feeding him so that his blood sugar would stay up and so that he would get the fluid, salts and nutrients he needed. We soon learned that the baby could not suck from a bottle. He hadn't had any milk since Mum had died when he was a few weeks old. His Dad had spoon fed him maize porridge ever since.

We started him on folic acid and iron supplements and within a few days, we started to give him a richer milk formula.

This little man had been very hungry at home. He had sucked his fingers so often and so vigorously that two of his finger nails had come off. The area around the cuticles were red and hot. Knowing that babies with kwashiokor are very vulnerable to infection, we started him on antibiotics right away.

The second photograph shows him 10 days after he was admitted. He is alert, he is beginning to gain weight.... and he is still sucking on those fingers. I suppose old habits die hard!

I am pleased to say that he is recovering well from his malnutrition. Although he is still very little for his age, he weighs over 12lb and is quite chubby. He is a happy baby, with lots of personality and a very cheeky smile.

Only time will tell whether he will fully recover from the effects of kwashiorkor. Some children have permanent issues with learning and concentration following an episode of severe malnutrition.We are stimulating this little man with toys and I am encouraging him in his development. I am very glad that he is doing so well just now and I enjoy having him in our room.

27 Reasons To Be Thankful

Today we celebrated American Thanksgiving. I'm sure that the festivities were tinged with sadness for many of the staff and volunteers; thanksgiving is a family holiday and they were not able to spend it with their loved ones this year.

This though is not a time to dwell on sad thoughts. In the spirit of thankfulness, we were each asked to share two or three things that we were grateful for. This was a good way of focusing my mind on the reasons I came here, and on the things that make me happy and give me hope.

Since today is the 27th of November, I would like to share with you 27 things that I appreciate about my life and my work in Haiti.

1) I am thankful for all of the doors God opened to get me here
2) And I am thankful for the call to serve in Haiti, to learn and to share what I know and what I do well.
3) I am thankful that God has blessed me with excellent health.
4) I am thankful for each and everyone of the 92 little ones who live at the baby house. Some are cute, some are strikingly beautiful, smiley, and energetic while others have attitude! They are all unique and utterly irreplaceable.
5) I thank God for showing me, before I met these children, how to celebrate every happy moment with them, and each milestone.
6) I am am thankful for all the healing I have witnessed. A particular toddler is on my mind. Her final HIV test came back positive this week, but she is well and thriving. It is really something to see this in a developing country,where children face so may health challenges, whether they are sick or well.
7) I thank my heavenly father for teaching me neither to dwell on the sad times, nor to run from them.
8) I am thankful that every emotion can be both right and good and that experiencing them all makes me whole.
9) I am thankful that God took Doubidson home; we could not heal him but God could.
10) I thank God for all the sick children who live.
11) I am thankful that the haitian nurses, the nannies and I are privileged to nurse many children back to full health.
12 I am thankful for every sick, premature and malnourished baby that finds their way to us, what ever the outcome of their journey.
13) I am thankful for our children's birth parents. For whatever reason, they couldn't raise them and they gave them up, in the hope that they would live a better life one day. I admire their honesty and selflessness.
14) And I am thankful, also, for all the families who have been led to adopt them.
15) I rejoice with the Haitian staff every time we hear that a new little one will be going home (to their adoptive families) soon. 'Li gen anpil chance,' they say (he/she has so many opportunities now.)
16) I am thankful that these families will be able to tell their children that they were loved and cherished while they waited to to go home, first by those brave birth parents who relinquished them into our care, then by the nannies and nurses and by the volunteers who worked with them every day, one-on-one.
17) I am thankful for the good, nourishing food that the staff, children and volunteers are able to enjoy.
18) I am especially thankful for the avocados; soft, creamy and delicious.
19) And I am thankful that our fresh fruits and vegetables are so fresh, never refrigerated, and eaten when they are perfectly ripe.
20) I am glad that everyone here is called Miss, Madame or Msye. Haitians are mannerly, respectful people. They are unique and special.
21) I especially like that I am called 'Miss See-zan'. Kreyol speakers find it difficult to pronounce my name and so they have adapted it. That makes me feel good. I don't quite know why. It is as though they are making me theirs.
22) I am thankful to have received some encouraging words from Dixie and from the head nurse in the NICU in the past week. These words came at a time when I was feeling discouraged, and I don't think they knew that.
23) I am thankful for the opportunity to encourage the Haitian staff. Their work demands a lot of love and a lot of patience. They work long days caring for the babies.
24) I am thankful for for the love and prayers of so many people at home and elsewhere. When I first came here. I asked them to pray that I would develop positive relationships with the Haitian nurses. God answered that prayer.
25) I am glad that I grew up in a loving and stable home. That has given me a strong foundation for my work here.
26) I am thankful that I miss home sometimes: the fact that I do means two things; my family and friends are important to me and I am in Haiti by choice. I am not running away from anything.
27) Tree frogs: Their soprano drives some visitors crazy. In the dark of the Haitian night, I find their cacophony soothing. I can't explain why.

"whatever is true, whatever is honorable, whatever is right, whatever is pure, whatever is lovely, whatever is of good repute, if there is any excellence and if anything is worthy of praise, dwell on these things." Phillipians 4:8).

In His Fathers Arms

Our new baby did not look well on Monday. He was not tolerating his formula as he had been and he cried when ever we handled him.

As the days passed, his body began to swell and his skin became inflamed and broke down. He became upset when we offered him his feeds and soon after that, he developed diarrhoea and vomiting. He was irritable, and it was becoming more and more difficult to comfort him. We started him on antibiotics, we gave him regular pain killers, we changed his formula and we prayed.

On Thursday, his condition worsened. His stomach was distended and his mouth was ulcerated. Pain killers and anaesthetic gels were not helping and he was becoming dehydrated. We started an IV to give him fluids but it soon became apparent that his little body was failing. His breathing became laboured, and his body became bloated.

It was difficult for the nurses and nannies to watch his condition decline over the afternoon. There was nothing for it but to hold him and ask God to take away his suffering. I played some gentle classical music for him and told our little man that I desperately wished I could make it all better.

As I left for dinner, I promised him that I would come back to say goodnight. When I returned he was no longer crying. He held my gaze for a minute or so and his breathing settled into a slow and regular rhythm. It wouldn't be long now.

I held Doubidson and told him to look for his angel. His eyes were unfocussed but I didn't doubt that he was seeing things we could not.

Shortly after 8pm, he passed from my arms into the arms of his angel. He knew he was going to heaven to be with Jesus and he knew that we looked forward to meeting him there soon. I made sure of that.

We are left with a sense of sorrow for the suffering that this innocent baby endured. Yet I know that for Doubidson, all of this has faded away. He is is in his Fathers care now, and God will heal what we could not. This knowledge is more precious than gold and it is beautiful beyond hope.

Please pray for the nurses and nannies. Many of them are mothers and one lost a baby a few moths ago. This adds extra layers to her sorrow.

Update: Today, on the 7th of November 2012, I learned that Doubidson Junior probably had congenital Ichthyosis, a rare and often severe congenital skin condition, characterised by overgrowth of a tough, protective protein called keratin.The skin becomes so thick and tough that it forms scales that have been described as being like body armour. As a result of their very tight skin, babies with this condition develop deformities and are often unable to breath because their rib cages are constricted. Without meticulous skin care, deep cracks form in the skin. Babies with Ichthyosis overheat quickly,  dehydrate readily and have very high energy needs. They often die from severe skin infections or respiratory problems.

The Stork Came Twice!

The stork made two deliveries yesterday. This beautiful newborn boy came in at 9 days old. His admission weight was 5lb 4oz. This is normal by Haitian standards. Many Mothers in this country are malnourished and so it is not unusual for infants to be born with low birth weights. Our new little man won't be underweight for long though - I take great satisfaction in fattening up skinny babies and so do the nannies!

I had the great honour of naming this little fellow. I wanted to chose a name that would work in both English and Kreyol. After consulting with the Haitian staff, I selected a good biblical name that seems to suit him well.

The second baby was referred to GLA by an orphanage in Port-au Prince. This infant is a month old and weighs 3lb 6oz. On the advice of medical staff at a hospital in the city, the baby's Mum had fed her formula milk to try to get her weight up. The baby developed diarrhoea and vomiting, probably because her family did not have access to safe drinking water to prepare the formula.

The baby's Mother is staying at GLA with her daughter. The baby was emaciated and severely dehydrated when she came in. Under the guidance of our orphanage Director, I successfully sited an IV line. We are working on increasing the Mother's milk supply and re-establishing breast feeding. Please pray that this will be successful. Breast feeding will increase the baby's chance of survival when she returns home.

Fearfully and Wonderfully Made

This little man has been with us for a week. At 3 and a 1/2 months old he weighs just over 6lb. He has a severe dermatitis and although he is very thin, his face and feet are swollen. These are signs of severe malnutrition.

The baby also has special needs. His airway is restricted. He has difficulty feeding. He is unable to close his mouth or his eyes, his eyelids often turn inside out and his hips don't move as they should.

A local hospital refused to admit this little man. His desperate Mother heard about our orphanage and came seeking help. At GLA, the baby is getting the very best care we are able to offer. We have started him a special milk formula and various multi-vitamin and mineral supplements. With good nutrition and expensive ointments his skin condition has improved.

This is good to see, however, our new boy faces significant health challenges and he does not have access to the expert care that medically fragile children in North America and Europe enjoy. We don't know at this point what has caused his health problems and we don't know what his potential might be, or even if he will live.

We do know that our new angel likes to be held close and rocked and sang to. It is difficult to put into words how we felt in the NICU a few days ago when the baby reached up and touched my face. 'He plays!' one of the nannies said in wonder, and as the two tiny hands brushed over my mouth and cheeks, I asked God to give us the wisdom we need to nurture this very special baby.

Update: Today, on the 7th of November 2012, I learned that Doubidson Junior probably had congenital Ichthyosis, a rare and often severe congenital skin condition, characterised by overgrowth of a tough, protective protein called keratin.The skin becomes so thick and tough that it forms scales that have been described as being like body armour. As a result of their very tight skin, babies with this condition develop deformities and are often unable to breath because their rib cages are constricted. Without meticulous skin care, deep cracks form in the skin. Babies with Ichthyosis overheat quickly,  dehydrate readily and have very high energy needs. They often die from severe skin infections or respiratory problems.

Please Pray

Late this morning, a 3 story school building collapsed in Petion-ville. Over 500 children aged 5-18 were in class at the time.

The news reached us over the radio. There was a hushed silence in the NICU as our minds and hearts struggled to grasp the magnitude of the tragedy. Tears sprang into our eyes as a distraught mother wailed 'my child, my child'.

She might not know, even now, whether her little one is dead or alive. 30 are known to have died and the death toll is rising by the hour.

The UN and the Police are on sight. They don't have rescue equipment. Ordinary Haitians are digging through the rubble with shovels and with their bare hands. Ordinary Haitians are co-ordinating efforts to get water to those who are trapped. Many have gathered to pray in the vicinity of the school. There is so much to admire about the Haitian character.

My mind is drawn back to another school tragedy that happened 1/2 a mile away from my own school desk in Dunblane, in 1996. A sea of flowers lined the route to that school. The eyes of the world were on us for months. I can't help but wonder if the world will remember the children and families of College Promesse Evangelique school a month, or even a week from now? Please pray for them.

Our Littlest Angels:Growing and Thriving!

As part of our strategy to limit the spread of chicken pox, the babies in the high care nursery are being kept apart from children who come from nurseries that have been affected by the virus.
That means that our NICU babies can not go up to the balcony where volunteers spend time doing one-on-ones.

It would be impossible for me to give all 15 NICU babies individual attention for an hour a day but I want them all to be stimulated and to feel loved and secure. I decided to work with small groups of children who were at similar developmental stages. I am delighted to report that all of these little ones are are happy and progressing well.A little angel learning to sit on the NICU balcony

Two of them have received individual attention for part of the isolation period. Both are around three months old and both were having trouble gaining weight. This is no longer a problem for "Ti Cherie" now that I have found a formula that agrees with her. She now weighs almost 11lb and is smiling, cooing and paying close attention to her care givers and to her toys. It was a privalege to work with her and to see her restored to good health. I can't help wondering why God placed this beautiful baby in my arms, or what she will become.

This little man was living full time with Miss Vicky for the 3 weeks that she was here. Miss Vicky is a nurse from the USA and she has volunteered at GLA many, many times. After her first night with her little charge, she commented that he had a strong personality, and so she was sure he would live! The young man in question has gained over a lb. He is still very small but otherwise, his development is right on track. I believe he has great potential. Look at those bright eyes!

It occurred to me a few weeks ago that the NICU boys are incredibly flirtatious.... and that their nurses and nannies (including yours truly) are encouraging that flirtatiousness! We smile, we wave, we kiss them, we make eyes at them, and we take full responsibility for the consequences!

Take this little boy for example (Shown above.) Isn't he gorgeous? He is the sweetest little boy in NICU. All my babies have fine qualities, but this is the sweetest. So mellow, so smiley.

These two boys are heart-breakers all ready. They applaud me when I come into NICU in the mornings. The little boy on the left has made great strides in his development and is now more or less on track with his European counterparts. The little boy on the right was very sick when I arrived a few months ago. Now that he is well again, he is getting bigger and stronger every day. These boys are bright and beautiful and I know that they will go on to do big things in their adoptive countries. How do I now? I just do!

I feel blessed to witness my babies growing and thriving. Many are sitting, cruising or showing signs of being ready to crawl when a few weeks ago it didn't look as though they were anywhere close to doing these things.

This young lady thoroughly enjoys sitting upright - it gives her a whole new perspective. Her personality stands out all ready. When she is happy her face lights up into the most wonderful smile; when she is mad she yells! She is strong and healthy in every way and I am sure that she will carry these qualities all te way into womanhood.

My babies have bright futures. They have been born in a troubled country, but I have a strong sense that the Lord's hand is on them and that they have been set apart. They are Haiti's hope and I pray that they will remain close to the God who conceived them in spirit millenia ago, and who intended them to be born here and now "for such a time as this."

Life and Loss

A week ago, we heard about a baby girl, born two months prematurely in the north of Haiti. She had been taken to a local orphanage. There were no medical facilities for such tiny babies in the area, so the infant was airlifted to Port-au-Prince along with some of the orphanage staff. We don't know how that came to be, it is almost unheard of for an orphan to be airlifted. We do know that the baby was born in a region that was hit hard by the August-September hurricane season. Perhaps then, she was carried to the capital city by a returning relief flight.

The orphanage staff arrived at one of the hospitals in Port-au-Prince, where Doctors said that they would not admit the baby. They didn't think there was any point; they expected her to die. The orphanage staff hoped that GLA would take the infant.

We were in the middle of a chicken pox epidemic. Our Director was in the States, and there were so many unknowns. We didn't now if the baby would be coming as a medical admission or whether her parents had relinquished her into the care of staff at the orphanage in the North. We didn't know whether the baby's mother had traveled with her to Port-au-Prince, and we didn't know whether the baby was ill, or just premature.

Lori, who is a permanent staff member at GLA knew two things: 1) of course we would take the baby because 2) she would have a fighting chance here.

We got an incubator ready. The nannies were full of questions. We checked our oxygen, our suction and our monitors. We wondered how big the baby would be... if she would need an IV, or maybe just tube feeds? There was expectation in the air in the high care room.

The next morning, the incubator was still empty. 'Did you hear about the baby?' one of the office staff asked.
'What happened?'
'She died'.
'Oh'.

I went upstairs, feeling deflated. I turned the incubator off. All the while, I was asking myself why I should be affected by the death of I baby I had never known. The eyes of the nannies were on me. 'The Little baby didn't come,' Jacqueline observed.
'No, the baby died.'
The words did not register. 'Why did the baby not come?'
'Because, Jacqueline, the baby died.'

There was a pause. and a look of surprise that quickly gave way to disappointment and sorrow. We were all feeling it. The lines in the old lady's face seemed to deepen.

There is something about a new baby.

A fresh untarnished life.

Life

Hope

Possibility

And it seemed so cruel, that a mission of mercy to save this precious new life should end there and then. And like that. Please pray for the orphanage staff who tried so desperately to save the life of this precious baby, and pray for her family. It is doubtful that this is the first child they have mourned.

I draw strength from knowing that the tiny baby who died on route to us is safe in our Father's arms, in a far better place. Still, it seems wrong that her life in this world was so short. It is wrong. Very wrong.

The Dreaded Pox

A month ago, we admitted a 15 month boy with severe malnutrition. His bony arms and legs were covered in pimples. We thought he had scabies.

I was alarmed to see the little skin coloured bumps spread, grow and change a few days later. By the time he was diagnosed with Chicken Pox, many of our babies had all ready been exposed to the virus.

Most children in the developed world who get chicken pox scratch furiously and are thoroughly miserable for a week or so. Occasionally, someone gets infected spots and will be treated with antibiotics. A few children with lesions in their mouth or nappy area might need local anaesthetic creams or sprays to make the more comfortable. Every now and then a child will be too sick to eat or drink and they will need IV fluids. It is a rare thing to come across a child with more serious complications.

Here in Haiti, many children are underweight and anaemic. For them, chicken pox can be more serious. Ester is one of the Haitian nurses who works at God's Littlest Angels. She vividly recalls having chicken pox as a child. She was was extremely ill and her Aunt feared she would not live.

The Director and the staff at GLA received the news that we had a case of chicken pox at the orphanage with varying degrees of of dread. The last time they dealt with a chicken pox epidemic, over 60 children contracted the virus. It was quite the challenge nursing all of these sick children at once!

The children who had been directly exposed to the boy with chicken pox were quarantined. We hoped that this would limit the spread.

In the weeks that followed, I found myself laying in bed at night worrying about our frailest children. I had worked here for a few weeks but all ready, the children had my heart, and I didn't want any harm to come to a single one of them.

When I was awake, my mind was in overdrive. I was on a mission: I was determined to fatten up the thinnest children and I started some of them on multi-vitamins and iron. I began treating the most vulnerable children for parasites. It seemed inevitable that the virus would spread, and I wanted to give every baby the best possible chance of fighting the pox.

I also wanted acyclovir in case any of the HIV positive children became unwell. Acyclovir is a medication that it is used to treat certain viral infections. It must be started as soon as the first lesions appear to effectively treat chicken pox.

I scoured the orphanage for the medication. I was checking the smallest and frailest children daily for signs of illness. I was also checking children with confirmed cases of chicken pox for signs of complications.

Despite my fears and anxieties, I have not seen the raging epidemic I expected, and no-one ha been too sick. Some were very very spotty, most were not. One child had an infected spot. She has completely recovered.

We have gone through several bottles of calomine lotion, and I gave piriton to children who remained uncomfortable. Many thanks to the Scottish nurses who donated bottles of this liquid anti-histamine before I left for Haiti. The children at GLA really appreciate it.

As for the malnourished boy who brought the chicken pox with him, he flourished in issolation, where he got one-on-one care.

I thank God his for keeping his and on our babies, and pray for all the Haitian children who do not have access to the loving and competent care, the sound nutrition and the the medical services that our angels enjoy. Without all of this, I am sure the outcome could have been very different.

In Prayer and Thanks Giving

I have a new room mate. She joined Stephanie and I two weeks ago. Before you ask, no, it wasn't my idea, it was Dixie's.... She didn't have to ask twice though!

This little lady had been on an IV for a week. She was refusing to feed and our Director felt that she needed some extra TLC. The long and short of it is that TLC worked. Ti cheri (the little darling) came to us weighing 7lb 4oz. Her weight today is 9lb. She is a chubby, beautiful girl and she is starting to do all kinds of amazing things. She smiles, she coos and she pushes her self up when she is lying on her stomach... at risk of being called a baby bore, i'll say no more about her, but can you tell I am in love?

A 15 month old boy was admitted just over two weeks ago. At 13lb, he was marasmic. We had to put him into isolation when he arrived, because he had a contagious skin infection and we didn't want it spreading to the other children. He was angry and depressed when he arrived, but has blossomed with one-on-one attention from Viviene, who cared for him while he was in isolation.
The new little man in our lives is shown here with one of our older children

At 15lb 12oz, this toddler boy's muscles are still wasted, and the skin still wrinkles at his knees, but he has a feisty spirit, and so I believe he will recover. His first word after he arrived was 'Hallelujah!' (that was Vivienne's doing). His second was 'no.' There was no tantrum, just a shake of the head and a quiet but firm refusal to take the medicine on the spoon!

And the little boy we admitted last month, the one who weighed 10lb at 9 months, is now just short of 14lb. He is great fun and very loving. He is always patting the crying NICU babies. Make no mistake, I am head over heels is love with this boy!

Please join me in praying that we will find a wonderful adoptive family for him, and lets give thanks that both of our malnourished boys are doing so well!

Also in need of prayer is this little man. He has been unwell and he has been losing weight. I had a conversation with one of the senior nannies last Thursday. I was holding him, encouraging him to feed. She looked at the baby with a tired, knowing smile.

'He is very thin'
'Yes Jocelyn, he is.'
'Does he have anemia'
'Yes'
'So you are giving him fer-in-sol'(iron supplement).
'oui'.

Jocelyn nodded, still with that same knowing look, and her voice dropped as she advised me I
had to get him to eat. 'You have to make him strong. If you make him strong, he might live.'

'Might.' That got me. I nodded, but couldn't say another word.

Nothing can be taken for granted. Many Haitian babies are born malnourished, because the mothers themselves are undernourished. This makes the babies fragile, and Haiti is not kind to fragile babies. The staff here know the downward spiral of malnutrition and ill health only too well.

We are doing everything in our power to restore this precious little man to good health, and there is reason to be hopeful. Although he is tiny, he is strong enough to hold up his head, and he has an amazing, cheeky smile. He is also getting one-on-one care from a wonderful, compassionate Christian lady with a gift for nurturing tiny babies. We will do what we can, the rest is up to God.

" I know the plans have for you says the Lord. Plans to prosper you and not to harm you. To give you hope and a future."

Life goes on

My days have settled into an easy rhythm and I am enjoying a much more relaxed pace than I am used to.

The sun has fully risen by 6am. I am usually awake by then, and I spend some quiet time by myself. Around 7am, I start getting myself ready for work. I usually make breakfast in the guest house, then, stroll across the the main orphanage building, which is just a couple of meters away. The older babies are all ready playing up on the balcony by 8am. I never pass by without waving to the and blowing kisses. They shout "hiya" with great toddler enthusiasm. Their little bodies are pressed against the railings and their eyes shine with excitement, even though I might be the 10th person to have they have passed by that morning, even though I might be passing for the 5th time that day, even though I have been here a month all ready... and I feel all warm and fuzzy inside every single time.

Up in the high care nursery, I greet Madam Bernard, the staff and Youlene, who is the mother of the premature baby we are nursing at the moment. The baby is growing fast and now weighs in at an impressive 5lb 7oz. She will soon be big enough to be discharged. The baby and her mother will be missed when they return home. Youlene has been so friendly to me and so helpful around the nursery

Madam Bernard and I go round all the babies, review their charts from the night before, check their temperatures and give medications. On Tuesdays we weigh all 100 babies and assess them for some of the common problems we see; fevers, rashes, and pink eye for example. We treat any problems we pick up. Every Wednesday afternoon, a Haitian paediatrician visits the orphanage. It it wonderful to be able to have her review sick children on site.

Some days are very busy, caring for children on IV's or nebulizers. Other days, everyone is well, and there is plenty of time to give the children extra attention and to work on some of their developmental needs.

Today I spent time with a gorgeous little man who is teething. He was feeing absolutely miserable and was very grateful for teething gel from Scotland, for a teething ring a thoughtful volunteer had put in the freezer, and for a dose of pain medicine. I like to think that my hugs made a difference to him too.

Calebasse Christian School

Today was special. We visited a local mission school. The school is run by a Haitian couple and serves some of the poorest children in our area. These children receive a basic education and a hot meal every day that they attend.

To get there we had to take a bone jarring journey across rocky, pot-holed mountain roads. The 5 mile drive took almost 30 minutes as we made a tortuous ascent that narrowed and wound around cliff edges. The sheer drops down into the valleys below were unguarded. The route must be absolutely trecherous when it rains.

The trip was well worth it. We traveled to the Calebasse Christan school with 3 Canadians, who are volunteering at GLA. Jack, Caryn and John are in Haiti with Active Christians with a Mission (ACWAM). Their organisation has partnered with the Calebasse mission. ACWAM run a sponsorship programme and they raise funds and gather supplies to support this rural Haitian school.

The Haitian primary schools have been closed until October. It is hoped that by then, some semblance of normality will have returned to this nation, which was devastated by 4 tropical storms in August-September.

Although school is not in session at the Calebasse mission, the The principal (Nixon Dorlus, shown below in the green shirt) and most of his staff, were present today to run Sunday school, which is operating as normal at the school. The principal greeted us with hugs on our arrival. His wife and mother kissed us.


It brought tears to our eyes to hear the childrens' singing. Theyhad all arrived in their best clothes. Many of the girls wore ribbons in their hair and were dressed in old-fashioned knee-length dresses with puffed sleeves. In Haitian churches, females must dress modestly. Midrifts and shoulders are always covered. Some children brought their toddler siblings and an elderly couple also attended.

Everyone was encouraged to participate. Some of the boys had tambourines. 3 of the teachers played guitars and flutes and a reluctant Caryn was roped into several duets. Some of the children also got up to sing, alone or in pairs. The songs were in English and Kreyol.

I was glad to have the chance to observe older Haitian children. They watched us shyly. For the most part, they were quiet and respectful, although an hour into the service, they did begin to squirm, and chat among themselves. If I am honest, my concentration was also drifting at that point. Gift bags filled with sweet treats from Canada soon got the childrens' attention!

Afterwards we toured the school and were treated to a traditional Haitian meal of fried chicken, plantains and salad. I wondered why the principal's wife, mother and children had not joined us at the table. Later, I learned that in traditional Haitian households, women and children eat after the men. Apparently, Caryn, Amanda and I were elevated to the status of Haitian men for the day. It is a dubious honor but I for one appreciated the humility of this family. Nixon helped to set the table and even cleared our plates away when the meal was finnished.

His passion for the children in his community is plain to see. This morning, his teachers preached to the children about being humble before God. The little ones in these photographs are blessed to have the chance to receive a basic education, provided by dedicated teachers, who are such true and honest witnesses to the Christian faith. In the context of an extremely patriarchal culture, these men teach the children that they are first in God's Kingdom. God's love for them is not just something they talk about at this school.

I am enjoying my work at the orphanage very much, but it was good to see and experience another side of Haiti. I left the mission with a sense of hope for these children and this country.

A New Arrival

I'd like you all to me my newest angel. He was admitted on Friday. At 9 months of age he weighs just 10 lb.
I heard him wailing from the other side of the orphanage. I spend a lot of time in the high care nursery and after two weeks in there, I know all my babies by their cries. None of them wail quite like that.

He kicked. He Squirmed. And he would not let the nannies comfort him. They handed him to me. For a few moments, the crying stopped. Our new arrival had never seen such a pale face in all his months on this earth!

The novelty was short-lived. The baby scowled, opened his mouth wide and began wailing all over again.

At 9 months of age he desperately wanted his Mummy. He was sick with gastroenteritis, and had been breast-fed up until that afternoon. The little man wretched when we put a bottle in his mouth. He absolutely refused pedialyte (oral rehydration solution) and was not impressed with our formula milk. Eventually, with coaxing, he took some soy milk from a syringe.

He was not able to keep much fluid down, and within a few hours, was started on an IV.

I was feeling a bit homesick myself. I visited the nursery over the weekend to deliver extra TLC. I wanted to help him through his sadness.

In no time at all, the baby was allowing me to hold him and rock him. He began taking small feeds and to our surprise, sat himself up on my knee and gazed around with wide eyes. We soon learned that he did not like to to be laid down in his cot. Tiny though he is he is able to sit unsupported, and he prefers to be upright so that he can see everything that is going on.

The IV line is out now. our boy is able to suck from a bottle and he loves the high calorie milk we are giving him (it is very sweet.) My little man is still sad sometimes, but he has given us a few shy smiles. How wonderful it will be to see him grow, change and fill-out over the next six months!

I'll update you on his progress

Meet Some Of My Angels

We have 16 babies in our high care room. It's time you met some of them:

She was a tiny angel when she arrived, weighing just 1lb 12 oz. She is now thriving on Mummy's milk and weighs in at a hefty 4lb 1 oz. "The Littlest Angel" is our miracle baby; she survived for 10 days at home, without any medical intervention. When she arrived at GLA, the nurses placed her in an incubator and started her on oxygen and tube feeds. The Littlest Angel agreed to remain in her incubator but was quick to tug out her tubes. I wasn't here at the time but I imagine everyone was glad to see such a fighting spirit in such a tiny, fragile baby.



This beautiful and engaging baby boy needs lots of love and encouragement. He is a happy, flirtatious and contented little man who just loves being a baby! He enjoys lots of attention in his room, where he is busy with the business of charming all the ladies he meets!


I have a special place in my heart for a 5 month old boy
(shown here on the right.) At first, he didn't grow as he should, but with extra TLC, he is beginning to fill out. Plenty of hugs for this little man! He responds well to interaction and to stimulation.We had a pep talk last week and he really took the part about the importance of good nutrition to heart; he has increased his formula consumption by a third! He refused to try weaning foods from his nanny but was more than obliging when I offered him pureed banana! This baby may have some special needs, which just makes "Miss Susan" love him all the more.



This pretty little lady is strong, healthy and developing normally. I tend to focus my attentions on the children who are medically fragile, but there is no child here who is more or less deserving of our love and care. They are all special.

A Real Little Angel in Heaven

See this moving video of "Alicia", who became a real Little Angel the week before last. I truly believe that she knew where she was going, and that nothing would hold her back. Thank you Rhyan, for creating this production in memory of a beautiful and beloved baby.



Those of you who know me know I have a huge heart for children infected with and affected by the AIDS virus. My sympathies are with those who grieve for Alicia; I lost some precious babies to AIDS, when I worked in South Africa.

I am sure that 50 years from now, our churches will be judged on what they are doing, here and now, in response to the global HIV pandemic. Our children and grand-children will ask us to explain why, if we knew what was happening, we did nothing. My own experiences with AIDS infected children and adults have taught me that this cruel virus strikes indiscriminately. Please consider what God is leading you to do. Won't you at least pray?

Taking no chances

I have been finding my feet here over the past week, but even at this early stage, I am learning a lot about health care in Haiti.

This country does not have many medical resources, so some things are done quite differently. Last Monday, I met a 3 month old with a fever. She had a runny nose and a cough and although she wasn't showing any signs of having a chest infection,the fever was high and it persisted in spite of the medications we had given to bring it down.

The following day, Mme Bernard, who is the head nurse here,took the decision to begin treating the baby with antibiotics. In the developed world, these medications are prescribed by Doctors; here in Haiti, there is a critical shortage of medical staff and so the nurses are permitted to prescribe a number of drugs, including antibiotics, on the basis of their own assessment of a child.

We are fortunate at God's Littlest Angels to be visited by a Paediatrician once per week. She examines all the new admissions and reviews children that we are concerned about. Dr Nathalie was in support of the decision to give antibiotics to our feverish baby and asked that they be continued for a week.

In Scotland, We we would probably have waited to see how the baby's symptoms developed. In Europe, most illnesses are viral and we are concerned about the overuse of antibiotics. However, experience has taught the Haitians that “waiting and watching” can be dangerous. Most families would not be able to afford a second trip to see a Doctor if their baby became sicker and the Doctors and nurses are very aware that malnutrition leaves many Haitian children vulnerable to severe bacterial infections, which develop slowly and then suddenly become life threatening. The child mortality rate is unacceptably high in Haiti and there are no Intensive care facilities for children at the government hospitals.

So although our little angels are fortunate to have access to basic medical care at their orphanage, we can't afford to take many chances with their health.

I am pleased to report that the baby we began treating with antibiotics last week is recovering well.

"Ike" passes by

The winds picked up between 4 am and 5 am, driving a spattering of rain against the window panes. By around 6am this morning, all was calm.

It is now 10:30am. Outside, hurricane Ike is whistling and howling through the orphanage compound.

The gate to the guest house is off its latch and clangs with every gust of wind. Leaves are rustling, branches are twisting, and the palm trees are swaying and bending.

The winds, are strong enough to take down the power lines, I am sure. The occasional bang and thud is reaching my ears, when from time to time, the winds pick up, but generally, the storm does not seem to be growing in strength.

The sky is a light gray, not too foreboding, and the mountain vista is hidden behind a veil of mist.

It is not dark. My desk lamp is on and if it goes out and I need light, I will use my “shake” powered torch.

I decided too fore go church today, but I have heard at least one vehicle leave our property. I doesn't feel as though we have been given a direct hit, but this does not diminish my concern for the people in Gonaives; the winds may not be destructive, but Haiti's water-logged soil cannot take any more water, it just cannot. UNICEF has estimated that 250, 000 people have been affected by the flooding that tropical storm Hanna brought earlier in the week. Hurricane Ike will hamper the relief efforts.

I am reminded that there are many things in this world that are out with our control. Strangely, this does not provoke anxiety in me. Certainly, I am experiencing the storm in the relative safety of the Kenscoff mountains. However, for the most part, I feel safe in the knowledge that my God is lord over everything, even the storm.

Storm Update

Apparently, news of tropical storm Hanna's impact on Haiti has reached Scotland. If I had known that, I would have updated you sooner. Please know that everyone at GLA is ok.

This particular storm took us by surprise; we had expected it to pass by Haiti, but it changed course at the last minute, catching everyone unawares.

Our staff though, responded quickly and efficiently. They got everyone and everything inside, battened down the hatches and waited until Hanna passed. Inside, daily life went on as normal.

There were some anxious moments for the grown-ups; from the second floor balcony the office staff and I cringed as we observed the a gust of wind raise the corrugated tin sheeting that shelters the area where volunteers work with the children.

Wind and rain came through the closed windows and whistled through the baby house. Doors slammed and downstairs, smaller kitchen utensils clattered.

On the first floor, the paediatrician wondered aloud how she was going to get home. I wasn't sure she would.

As we ate dinner amid high winds and torrential rain, John Bickel, who co-directs God's Littlest Angels with his wife Dixie, looked out at the palm trees whipping furiously. He nodded, and with a knowing look and a faint smile, observed that this was the worst storm he had experienced in Haiti in the 17 years he has lived here.

Later that night, part of the dining room table was flooded. A monopoly game was in progress. The players moved a few meters across the room and continued their game.

We surveyed the buildings and the surrounding area in the aftermath of the storm. We lost corrugated metal sheeting that covers one of the balconies at the orphanage. At the toddler house, the gate was damaged and they lost a satelite dish and some solar panels. In the wider community,trees were uprooted and stones walls had been toppled.

Elsewhere in Haiti, a major river in the port city of Gonavies burst its banks. Over 500 people are thought to have died in the floods. We will never know how many rural people lost their homes and crops. We have heard that humanitarian aid has began to arrive in the worst affected areas, where some homes are completely submerged and thousands of people lack access to safe drinking water and food.

At GLA, we are thankful that no-one who lives or works here was hurt. The morning after the storm, Haitians were out clearing debri that was blocking the mountain road. We have plenty of food here and water trucks continue to deliver water to our properties. Repairing the storm damage, though will be costly.

We have prayed for people who remain in the path of the storm, and we are relieved that hurricane Ike lost some power over the Atlantic on Friday.

Although hurricane Ike is not expected to take a direct hit at Haiti, the soil is waterlogged, and the rivers are all ready overflowing. Any further rain could be devastating for this country, which has been hit by 3 storms in 3 weeks.

In the meantime, life at GLA continues as normal...

My role at GLA

The view from the roof of the guest house: we are surrounded by mountains

I had my meeting with Dixie on Friday Afternoon. She would like me to focus my attentions on the babies in the high care nursery, because these little ones are the most fragile. Dixie would like me to review the babies height and weights and, she has asked that I help organize the emergency medical equipment.

I will have the opportunity to work alongside a Haitian paediatrician, who visits the orphanage one day per week. This will be a great opportunity to learn about tropical infections, how to recognise them, and how they are managed in Haiti. The Haitian nurses will also be able help me get handle on this.

They will be teaching me to site IV lines and, in return, I will do my best to pass on specific paediatric nursing knowledge that they might be lacking. There is a lot we can learn from one another.

During quiet times, I will be free to give TLC to individual babies. I will introduce you to some of them later this week. They are all beautiful; several all ready have my heart.

Specific prayer points:

• That I will be able to develop positive relationships with the nurses and nannies.
• That both the Haitian nurses and I will be open to the new ideas, new knowledge, new kills and new ways of working and that we will learn for one another.
• That my presence will bless the nannies and and the babies here.
• That God will protect our health: I had a touch of "Haitian Happiness" over the weekend (They might call it "Delhi Belly" on other continents!) It was very minor and, thanks to God, I recovered quickly.
  

Day one

Friday the 29th of August 2008

I was given a tour of the main orphanage when I arrived last night. I am staying at the guest house, which is on the same property that houses 90 children, under the age of three. I have one room mate, Stephanie, an American women who co-ordinates the orphanage's adoption programme. Our bedroom floor is tiled (easy to keep clean) and there are insect screens on the windows. We have our own toilet, a television and a DVD player and I am able to access wireless internet from my room. I am quite comfortable and very pleased with the staff quarters.

At the orphanage, Several "nannies" are responsible for the day-to-day care of the children in 4 nurseries that re located on the 1st floor of the baby house. The high care nursery is for neonates, sick and malnourished children. Children are grouped in the other rooms according to their ages and how far along they are in their development. The rooms are bright, airy and spotlessly clean. The children swoop in on you when you enter their room. They will cling to your legs, reach up to be held...and if you sit sown you wil not be able to get up...it will take two nannies to extricate a dozen toddlers from you.

There are few facilities for hand-washing, and no-where to isolate children with infectious diseases. Many of these little ones have diarrhoea. This is normal in Haiti. However, the storeroom, here, is full of donated baby care items and the staff do the best they can with what they have. They wash, dress and feed the children, and make sure they have appropriate toys and that they get plenty of fresh air. Unless they are sleeping, the little ones are on mats on the floor or in bumbo chairs.

***

Dixie Bickel, who founded and directs GLA with her husband had planned to introduce me to the project, the staff, and children, today. I was to meet with her to talk about what my role here will be over the next 6 months.

The Director, is, of course, a busy lady so I had to occupy myself until she was able to see me. That was not difficult! We usually have a full team of volunteers here, who work one-on-one with the children under 2 years old. There is no-one working in that role just now. With the help of nannies and the office staff, I identified some of the children who were most in need of "TLC" and took them out of their nurseries for a while. I was a bit concerned that I couldn't get eye-contact from some of the babies. They did warm up after a while, though, and responded well to the staff they knew. These are positive signs that the little ones are attached to their care-givers. It is very encouraging to see that in an orphanage environment.

At 10:30 in the morning, I was called to help in the High care nursery. A baby girl (lets call her Alicia) had developed a fever and seizures the night before. The nurses had put in an IV and Dixie had given Alicia steroids, IV antibiotics and fluids through the line. Alicia had suddenly stopped breathing when they had called me.

When I arrived Dixie, who an ITU nurse before she came to Haiti in the mid 1990's, was there with two of the Haitian nurses, and they were trying to resuscitate Alicia. Her chest sounded "gurgly", and we suctioned bile from her airway. It looks as though our baby had aspirated bile into her lungs. She was blue around the lips, floppy and did not respond when I stimulated her.

I learned that this beautiful little girl, with almond shaped eyes and elegant cheekbone was HIV positive and had been sickly ever since she had arrived at God's Littlest Angels. She was not on Anti-retroviral drugs because her CD4 count (the type of immune cells that the HIV virus destroys) was over 200. A count of 200 is when adults are considered to have full blown AIDS. However, children's counts run much higher, and their immune systems are severely compromised long before their count fall to 200. In the developed world, Alicia would have been started on anti-retrovirals long ago, but this is Haiti.

We worked on Alicia for 40 minutes. The solemn eyes of the nannies were on us, and all the while, visitors were coming in and out of the nursery. There is little privacy here.

To everyone's relief, Alicia began breathing on her own. I was asked to give her constant nursing care until she stabilized. The Haitian nurses were not comfortable with resuscitating this child. Children are not resuscitated in Haitian hospitals, therefore, the staff do not know how to give basic life support. I stroked the little girl's forehead and told her that her job was to rest, to use all her energy to get better, and we'd do the best we could to help her.

Alicia never regained consciousness. An hour and a half later, her breathing became shallow, her heart rate dropped and the left side of her chest became sunken. I started resuscitating her again, sent up a prayer and asked one of the nannies to call for Dixie.

The little girl's lung had collapsed. In Scotland we would have put in a chest tube to re-inflate the lung, but there are no chest tubes in this country.

20 minutes later, Alicia was making no effort to breath on her own. There were some tough decisions to be made. There are no life support machines in Haiti. Our baby was showing signs of brain damage, and there was nothing that could be done about it.

The Haitian administrator arrived. The child's mother had not visited for several years, and no one knew where she was. We stopped resuscitation, took out the tubes, switched off the monitor. I drew Alicia close to me, and told her we would all prefer if she stayed, but that it looked as though she was leaving us. 'Don't you worry about a thing baby. You are going to a better place. No one gets sick there, or sore or sad there.'

Alicia had a strong heart, which continued beating for a full 10 minutes after we stopped resucitating her. She would have lived had she fallen ill in Scotland, I don't doubt it.

In Africa, when a child was near death, the staff used to gather to pray over the little one, and sing to her. Others would hold her, rock her, tell her she was loved and that they hoped to see her again in Heaven. The Haitian staff didn't do any of these things.

They say that in Haiti behind the mountains, there are more Mountains. That certainly seems to be true. Similarly, I think that in Haiti, there is sorrow, so deep that you will never reach the bottom.

I suspect people see too many child deaths in this country. Madamn Bernard, the head nurse in the high care nursery, shook her head in despair. No-one wept or wailed in that room. Is this their professional reserve? Maybe. I get the feeling, that the staff protect themselves from grieving too strongly, the many many things they cannot change. 1 in 5 Haitian children never see their 5th birthdays. Alicia was one of them, just one.

Alicia's face was washed and she was dressed in a cream dress, with puffed sleeves. She was photographed; Dixie explained that this was necessary, to prove to any family members who might come, that the baby really did die.

There won't be a grieving rite. There isn't time; GLA provides direct care to almost 200 children. They are all in need of care and attention. An undertaker will be called, and Alicia will be laid to rest. Please pray for the staff, that God will give them strength and courage for their work. It is not easy.

Friday was a tough day, yet, I have seen and heard enough to know I have probably seen a lovelier side of Haiti, where people will do all they can with what they have, to save the life of a beautiful, but stricken child.

I have arrived

I arrived in Port-au-Prince on an overcast day, and so, the ocean mirrored the sky's light grey-blue hues, not the vivid Caribbean blue of tourist brochures. Some of Haiti's problems are clearly visible from the air. The bare earth and the rusty coloured inland waters are signs of deforestation and of landslides. I can well imagine that the floods caused by hurricane Gustav's onslaught over the past few days will have washed away a lot of precious top-soil, and polluted some of the fresh water sources with the blood of the land.

The moment I landed, I knew I was in a developing country. No question. The airport is a collection of rusted outbuildings, with a no-frills, concrete arrivals terminal. Stepping off the plane I was met by the moist heat – with temperatures in the high 80's and humidity in the 90's, the atmosphere wasn't sticky, it was wet. Inhaling, my nostrils filled with hot air, and the aroma of wood smoke. This was so familiar from my time in Africa that I felt I had come home.

The pass angers were inside the airport for over two hours, waiting for luggage that didn't arrive but 'would be on the next flight, due to arrive in 10 minutes.., the flight after that; 15 minutes... soon.' It was absolute chaos, in the unlit interior, sans air conditioning, with an increasing volume of luggage that had been destined for other cities, in other countries, and a growing swarm of travellers. Most of the people on the flights were Haitian nationals. Among them were a few missionaries, and a nun here an there. Next to me, there was a Brazilian man, who was with MINUSTA (the UN stabalisation mission). On the opposite side of the carousel, a UN peacekeeper in camouflage gear and blue helmet.

As far as I could see, there were no toilet facilities, and there certainly weren't any shops. Sweat was glistening on fore-heads, coursing down backs, and running down thighs.

I got through customs without issue, and was physically restrained on my way out of the airport by a set of Haitian hands on my trolley. He 'needed' my luggage. Forget it pal. He wanted my baggage tags. Why? And if you think you are getting the tag for the case that didn't arrive, you can think gain. After challenging the lean Haitian, who sighed theatrically and threw up his hands in despair, I did surrender the tag for the case I had with me.

Proceeding into the fenced yard, I was met by a porter, holding a sign with my name on it. Negotiating the trolley over the uneven ground, he led me to a secure paring lot, with high walls and gates. We were admitted by gatekeeper and past by rows and rows of 4-by-4's and SUV's. I was greeted by GLA's friendly driver, Ernst, James, the directors foster son, and an armed guard, who stood out in a smart tan uniform; his mission (and he chose to accept it) was to get me through the city safely.

After waiting another hour or so, for a lady who had been due in on my flight to meet her new son, a toddler she was adopting from GLA's orphanage, we set off across Port-au-prince.

I wish I could have taken pictures. I wasn't sure it was safe to be waving a digital camera around, so I didn't. I was wide-eyed with wonder. The poverty in the airport district is striking. The areas of Port-au-Prince we drove through were crumbling. Crumbling pavements, worn, pot-holed roads, eroded breeze-block walls. This though, is a vibrant city, with bright hand-painted shop fronts. 'VIP Unisex Salon', 'The superior institute of American English and Computing','Sipure water.'

We passed by slowly, in nose-to-tail trundling traffic, among battered vehicles. Some were without head lights, many had long since lost break lights, and indicator lights. This last issue though is minor, since no-one seems to use indicators. Horns are blasted frequently, though. If there is a high way code, or rules of any sort that govern how one behaves on Haitian roads, it was not apparent that day. Drivers give way if they feel so inclined, and if no-one gives way to you, you simply edge your vehicle in the direction you want to go in, and you go, even if that puts you in the way oncoming traffic. Ernst was, unflappably, and showed signs of being only mildly perturbed. From the state of the vehicles, it was clear there are a lot of accidents. One car had a splintered windscreen. There were a number of UN vehicles: mostly troop carriers, most not carrying troops. I saw only one, lone UN soldier paroling the streets. I get the feeling I may have seen a nicer side of the city.

The Haitian “Tap-Taps are a sight to behold. Most are modified pick- up trucks with camper van canopies. The back is kitted out with benches, and the vehicle bodies and canopies are painted in bright murals, and many religious slogans and bible verses.

As the line of traffic slowly snaked along, a moving panorama of Port-au-Prince played out across the windscreen and the vehicle widows. All along the route, vendors sold their wares. Fresh fruit, vegetables, and wooden crafts under tarpaulins. Across the street, paintings hanging on a breeze block wall. Cell-phone top-up cards in home made booths. New and used clothing hanging from trees. Some vendors walked up and down the rows of traffic, selling soft drinks and plantain chips. Rubbish lined the streets. Skeletal digs sniffed and the sweaty, sweltering, rotting heaps, and a teenage girl in a shapeless raggedy dress and bare feet sorted through it with a stick.

Women carried there loads on their heads, and they moved so gracefully that they almost seemed to float. There was a post Gustav rain shower, and many people were wearing shower caps and even bin bags over their heads; apparently, Haitians do not like getting wet!

Suddenly, the street widened and, buildings were profesionally built and meticulously maintained. The signs above the shops were commercially produced. There were parks with slides and swing sets for the children. We were in the suburb of Petion-ville. Our guard got out here, and we turned left up the Kenscoff mountain road. It was a winding twisting, bumpy road up to the orphanage. The rainy season has recently come to an end, so there is plenty of greenery. As we climbed, the temperature dropped a few degrees. There was a dip in the road, and then a big metal gate. With a honk of the horn, the gate was opened. We had arrived.