Sunday, 25 April 2010
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.
Monday, 19 April 2010
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!
Monday, 12 April 2010
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.
Thursday, 8 April 2010
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.
Saturday, 3 April 2010
Friday, 2 April 2010
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.)
Thursday, 1 April 2010
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.