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.

Saturday, 24 October 2009

Time is Marching On

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

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

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

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

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

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

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

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

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

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

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

Monday, 5 October 2009

A Cup of Water

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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