A Time For Dancing

This has been a tough week, but I do not want to talk about the tough parts. Rather, let me tell you about a special moment in that week.

On Monday morning, Vivianne and I were in the big nursery brushing the children's teeth. Close-by, a radio was playing Haitian worship music. One year old Rose-Derline began clapping to the beat. Well, this needs to be encouraged, I thought. Rose-Derline came to us in February from the Bresma orphanage. She was malnourished, extremely quiet and ever watchful. Recently she has began coming out of her shell. She is smiling, laughing and playful. I began clapping along too. Emboldened to have someone follow her actions, Rose-Derline began to dance, and before she knew it, so did the rest of us.

For a few minutes, I forgot that I don't do that sort of thing. When the music stopped, two year old Mishno fell recklessly into my arms, laughing, as the rest of our older babies swarmed in, to embrace me, giggling and smiling. I thought to myself, isn't it so great to be a child?

The dancing was carefree, not restrained, and joyful, as sliding down a banister or singing in the shower. It was emotional expression instead of constraint, and a release that overcame that resolve not to let anything out, for fear of unleashing a tidal wave.

For a brief period in the day, playfulness was allowed to enter a grown-up world, and burdens were lifted.

Isn't it great to be a child? At least, childhood should be great, and yet, too many children, lose their joy and their playfulness to our cruel world. I am thankful, oh so thankful for everyone at GLA and for those who support us from afar, for making it possible for a few Haitian children to experience the fun of their childhood a second time.

Keeping Us Busy

I have just got back from the NICU, where our smallest children are keeping the night staff on their toes....

Abigaelle might be small but she knows knows her rights; a bottle of warm milk, at least every three hours, nappy changes on demand, and a pair of arms to rock her. She is doing very well in her nursery. She came to us almost two weeks ago weighing just less than 3.5lb at two months of age. She is on a high calorie formula to promote 'catch-up growth.' She has a lot of catching-up to do, but we can see her plumping up day-by-day.



Kerline, was by far the loudest baby in the NICU tonight. She suffered 11 weeks of starvation before her Mother removed her from her Father's care and brought her to us. Although she still looks scrawny, she is gaining weight well and she has fed enormous volumes of formula over the past two days. I am sure that she is having growth spurt and I am excited to see her thriving in our care.

Junes is a month old and he was transferred here from Real Hope for Haiti on Friday. His mother is extremely ill, and had to be carried, by relatives, over a mountain range, to a clinic in Cazalle, which, is a rural area North of Port-au-Prince. He weighed 3lb 4 oz on arrival (fully clothed). He is in a incubator and feeding all by himself. Today was a tough day for this tiny boy. He had thrush on his tongue when he arrived. We began treating it right away, but his mouth is very sore today, and I spent a great deal of time drop feeding him with a 1 ml syringe because he would not drink from a bottle.

Then there was Peterson, sucking on his fists, hungry and agitated, but only whimpering. I called his mother to come in an breast-feed him. Peterson came on Friday, weighing 8lb 11 oz at 6 months of age. He was referred by an American Paediatrician in Carre-Four, who considered his malnutrition life-threatening. I am sure Peterson's condition shocking to someone who is not accustomed to working in Haiti, but for those of us at God's Littlest Angels, it isn't possible to experience shock at Peterson's size. He is bright, alert and well, and just needs good nutrition for a while.

This little boy has been raised on small amounts of breast milk and diluted full-cream milk. His 17 year old mother doesn't know anything about child-care. Emotionally, she is very young. She was very tearful the day she arrived, and upset about being away from home. Tonight, she announced that she would like to leave Peterson with Madame John, and take one of our pretty little baby girls home with her, because 'girls are better.' She was not joking, In terms of educating Peterson's Mother, we have our work cut out for us!

A Week Ago Today.....

Around this time, a week ago today, Dixie Bickel and I had just finished stabilizing a very sick little girl.

Leissa is 23 months old and she does not live at GLA. She arrived with Dr Claude, who lives here and works at the Baptist Mission Hospital in Fermathe. He said that they did not have a Paediatrician on staff and that they did not have the equipment they needed to give breathing treatments to this child.

Leissa had a severe respiratory condition that affected her upper airway. There was swelling in her throat and all the way down to the air passages leading to her lungs. Leissa's oxygen levels were dangerously low. She was working hard to breathe, but just couldn't get any air in. She was drifting in and out of consciousness, and the people who were with her said that she had been that way all afternoon.

Leissa's Aunt, who is not her main care giver, was with her, and so it was impossible to get an accurate account of the child's illness, and how it developed. We established that she had been unwell for three days, that she had a cough that was worse at night time. She had had a fever and had not eaten or drank anything that day.

'No', her Aunt told me in reply to my question about whether Leissa was usually 'puffy' and jaundiced. That started yesterday.

With each breath, we heard the child's airway shut off. When she coughed, it was a barking cough. She was able to swallow her saliva, and there was no rash. Did she have croup? Malaria? Tuberculosis? An atypical infection? A cardiac condition? Maybe, a combination of things were leading to these symptoms?

Leissa received Nebulized Epinephrine, steroids and albuterol. There was an improvement, but not as much as we would have hoped to have seen. Without oxygen, her oxygen levels (measured across the skin surface) went down to 56%. These were extremely worrying signs that told us that Leissa's condition was life-threatening.

She was so swollen with fluid, that we could not see any veins, anywhere. Our only choice was to give her medications by Intramuscular injection. The risk: the pain of these injections would cause an airway spasm and Leissa would stop breathing all together!

I gave a steroid, some lasix to help with the fluid retention, and an antibiotic. Leissa regained consciousness and began to cry, but the thing I most feared would happen did not happen. Within 30 minutes, the fluid began to disappear from her face, arms and legs. She passed a lot of urine, and she was breathing much easier.

We continued with steroid injections and round the clock nebulizers. The next day, Leissa was alert, and able to eat and drink. That was a great relief, but it was not until Friday that Leissa finally came off of her oxygen completely.

She tested negative for malaria and Tuberculosis. Our Paediatrician diagnosed croup, a condition in which a viral infection causes inflammation and narrowing of the airways.

Initially, I was concerned about keeping Leissa at this house, where we have may fragile infants in our NICU. Iam glad that we decided to nurse her in an isolation room. I am sure that this is a decision that saved her life.

Leissa is under weight for her age and she shows other signs of malnutrition; she has orange hair, caused by micro-nutrient deficiency, and at almost two years of age, she is unable to walk. We sent her home with a fortified peanut butter paste to help her gain weight. We will see her again in two weeks time. If Leissa become unwell again before this review, her Aunt has been instructed to bring her back to God's Little Angels.

Beauty For Ashes

Abigaelle arrived yesterday, in a moment off chaos, just before the exterminators began spraying the main house for cockroaches.

At 3lb 6oz, she is tiny in every sense of the word. I remember my first glimpse of a desperately thin and pale infant, dressed only in a white bonnet, orange vest, and pink socks. All we knew of her was that she had been given up for adoption, by her recently widowed father.

As I unwrapped the baby, who was cold to the touch, she screeched, and looked around with a frightened expression. I took note of what appeared to be an overgrowth of scar tissue on Abigaelle's neck, and a scab on her right wrist. Taking off the bonnet - a tuft of black, silky curls tumbled out. Her scalp was covered in stubble, and there was a long, thick scab, about a centimetre above her right ear. It looked as though this baby had been hospitalized and on an IV, at least until a few weeks ago - the scars on her wrist and scalp are probably from burns, caused by irritant drugs that leaked out of the veins and into the tissues underneath her skin.

Abigaelle had a difficult time feeding at first. She has a strong extrusion reflex (her tongue thrusts the nipple out of her mouth when she sucks). Mme Bernard and I have been working with her to overcome this. Abigaelle is on a milk formula that was developed for low birth-weight and premature babies. She is managing to suck very good volumes of milk. She is a very hungry baby and it is Abigaelle, and not her nurses who set the feeding schedule - a good omen for rapid weight gain.

She had a fever and a cough yesterday, and our Director, who is also a registered nurse, found a pocket of what appears to be pus, just under the surface of the scar tissue on Abigaelle's neck. We do not take any chances with our malnourished babies. They are very frail, and can quickly succumb to infection. Abigaelle was started on an antibiotic right away.

Yesterday, based on her alertness and physical maturity, Madame Bernard and I estimated her age at 6 weeks. Today, we learned that Abigaelle was born on the 14th of February. Her mother had been unable to find a safe place in which to deliver the infant, and Abigaelle was born on the roadside.
How wonderful to be able to dress her in pretty clothes, cover her with a cozy blanket, and feed her those bottles of sweet, warm milk that she likes so much. How special to hold her close, and sing softly, and feel her tense body relax. This is beauty for ashes.

Healing

Our NICU staff have commented several times in the past week, about how beautiful our babies are, and it is true - they really are beautiful.

Many of them have come as tiny infants. A number of them require a great deal of care. It truly is our privilege to tend to them:

Baby Jude is recovering from an episode of diarrhoea and vomiting that made him very sick, and very weak. His mother, Marie Noel, was with us briefly at the end of the month. Our goal was to teach her to care for her son so that she could return home with him, but we had to ask her to leave after she became hysterical, turned Jude upside down and began spinning him by the ankles! She proceeded to collapse and feign a seizure, before jumping up and launching herself at me.

Most of our Haitian staff believe that Marie Noel is possessed by an evil spirit. A few think that she is mentally ill. Marie Noel herself says that she has is a violent person and that she is cursed and must stay away from Jude because she 'makes' him ill. In her mind, it is her fault that he was sick shortly after he was born. The fact that he became very sick again a few days after she came to GLA, seems to confirm the guilt she feels. Jude's future is uncertain. He is a very fussy and demanding baby, but after nursing him through two serious illnesses, we are all quite attached to him, and we want what is best for this boy.

Beni came to us two weeks ago. He was born weighing less than 5lb, after a difficult and protracted labour, that killed his mother. He developed watery diarrhoea this week and was becoming dehydrated. We received a shipment of pasteurized breast milk two days ago and Beni was started on donor milk within hours of its arrival at the orphanage. I am pleased to say that he seems to be recovering very well. Breast milk contains substances that improve digestion and strengthen the immune system. We are so pleased that Beni is getting better.

Our premature baby boy, Luc is also doing much, much better. He became seriously ill with gastroenteritis last month. He was not able to absorb even the most hypoallergenic formula that is on the market and, as a result, he became very emaciated. His mother has not come to visit in more than a week, so he is receiving the donor breast milk and is in competition with Beni, to see who can drink the most of this 'liquid gold'! Luc is gaining weight again. He is beautiful, bright and appears healthy. What a relief to see him thriving again!

Baby Mickerline (nick-named Kerline by her mother) had a hard start in life. She endured severe neglect and mistreatment at the hands of her father and step-mother and at three months old, weighed 4lb 6oz. We were not sure that she would live, but she gained a pound in her first week with us. Severe malnutrition and extreme stress have made her tiny body stiff. With loving care, an enriched baby formula and gentle physiotherapy, Kerline is beginning to trust us. Her stiff limbs are relaxing. She cries to be picked up and likes to be held close. I am becomming very attached to this little lady.

I am so glad that these babies found their way here, and that we can make a difference in their lives.

Shipping Breast Milk To Haiti

Dixie and I have both received messages from people who want to know how to go about shipping breast milk from North America to Haiti.

The shipment of breast milk that we received last night came from a Breast Milk Bank in Ohio. I understand that there are donor breast milk banks in most states in the USA.

The milk was pasteurized at the milk bank, and was shipped to Haiti by a company called QuickStat, who specialise in the transportation of Biopharmaceutical substances. QuickStat packed the milk on dry ice and transported it to Haiti.

The staff at God's Littlest Angels, are very interested in receiving regular shipments of breast milk for our orphaned, premature and medically fragile infants. There are a few issues:

*Obtaining milk that has been properly screened for infection - donor milk banks have a thorough screening process

*Ensuring that the milk is handled correctly and that it is transported quickly and safely to Haiti,

*Getting the milk through customs with any paper work that may be required

*The financial cost of achieving all of this.

We would appreciate input from anyone who might be able to help us to obtain regular shipments of donor breast milk. There isn't a formula on the market that can nourish infants the way that mothers' milk can. Breast milk is easily digested, it contains substances that are vital to infants' brain development and that support their immune systems.

"Where it is not possible for the biological mother to breastfeed, the first alternative, if available, should be the use of human breast milk." (The World Health Organization/The UN Children's Emergency Fund.)

A Special Delivery

I have just received a special Delivery, and no, I don't mean a baby!

The Mothers Milk Bank of Ohio recently dispatched donated Breast Milk to a premature infant in Les Cayes. Sadly, the baby did not survive, but the people caring for him wanted to make sure that other babies might benefit from the superior nutrition, and the immune boosting antibodies that mothers' milk provides. They called God's Littlest Angels to ask whether they could transport the milk could to us. The answer; an enthusiastic yes!

It is a very rare thing for orphaned infants to receive breast milk in Haiti. The travesty is that these babies are extremely fragile, and desperately need excellent nutrition. This is a country in which the majority of expectant mothers are poorly nourished, and babies are often born prematurely, underweight and anaemic.

At God's Littlest Angels, we see the effects of poor nutrition every day. Last month, Donley, a baby who weighed 4lb, died after he developed gastroenteritis. Another infant, Luc, became extremely ill after contracting the same virus and was unable to tolerate feeds for a full two weeks. Three month old Jude, who arrived at GLA at the end of January and at two weeks of age, was extremely malnourished. Although he has thrived in our care, he also became very ill after he developed diarrhoea and vomiting. It is only today that he found the strength to hold his head up again. The effects of malnutrition can persist for several months after a baby is admitted to us. Minor ilnesses are extremely debilitating to our Haitian babies.

So when our delivery arrived, and I unpacked the boxes to find dozens of bottles of donated breast milk, I was delighted.

Some of the milk had thawed in transit, so a few very lucky babies will benefit from this precious milk right away. Beni is one of them. He weighs 5lb and has had watery diarrhoea for several days. I am hopeful that breast milk will help him to recover quickly.