An Update On My "Problem Children"

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

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

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

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

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

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

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

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

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

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

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

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