In Septemeber 2008, I traveled 6000 miles to Haiti's Kenscoff mountains. My mission: to care for some of the orphaned and abandoned, the sick, malnourished and premature infants of this beautiful but beleagured Caribbean nation.





Sunday 28 December 2008

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!

Sunday 21 December 2008

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.

Sunday 14 December 2008

....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.

Sunday 7 December 2008

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.