Friday Afternoon

'There is a beautiful baby girl waiting outside for you, Miss Susan, fat and pink! She is 6 days old!' Since they told me that she was 'for me' I knew that the baby had been placed in our care pending adoption, and that she would stay at the main house until her adoption was finalized. I could not contain the smile that spread upwards and reached my eyes.'You see Vivianne, Miss Magaly said, playfully nudging Vivianne, Miss Susan is happy, very happy!'

'Send her up to me,' I said. I was still smiling, and yes, I was very pleased by the news. I have admitted dozens of babies to out main house nursery. There is always a sense of anticipation.

Ten minutes later, there were a pangs of grief, where joy should have danced. The baby was pretty, yes, but she was not pink, she was pale. So very pale. She was working extremely hard to breathe. I noted her small, upwards slanting eyes, short neck, and a deep crease, cutting straight across the palm of her hand. Sonya had many of the physical features of Down syndrome. Her toe mails were clubbed, a sign of chronic oxygen deprivation. Even on oxygen, Sonya was blue and her oxygen levels dipped frequently. The baby gazed up at me listlessly. She was floppy. A blood test showed that she was retaining carbon dioxide in her lungs and that the acid levels in her blood were rising. She was critically ill.

Anywhere in the developed world, a baby as sick as Sonya would placed on a ventilator. I had a sinking feeling...... Even if we could find a hospital that would ventilate her, Sonya would never survive the journey down the mountain. Then it occurred to me; we could put Sonya on CPAP. Baby Sophie, who had arrived three days earlier still needed to be on the system. Could we run two? I had the equipment to do that. I would have to make some modifications to the second system to make it operate with the equipment that I had. I didn't know if the circuit would support two CPAP systems. I would have to make it work. Sonya was exhausted. I had no idea whether CPAP would help her, but it was her only chance of survival.

The NICU was highly charged with the activity involved in getting a second CPAP circuit up and running. By the grace of God, a NICU nurse from Canada had arrived the week before, and she was on hand to help with the intense work of getting Sonya onto CPAP, stabilizing and monitoring her. Four hours later, Sonya was on CPAP, IV fluids and IV drugs, She was breathing easily, sleeping peacefully and her blood gasses were almost within normal ranges. I was extremely tired, but elated! I would need this victory to get me through the weekend. One CPAP baby is a lot of work, and now we have two, and both are on IV's and need tube feeds and constant attention and observation. Right now, GLA's NICU is being pushed to the very limit of its capabilities. I will admit to being overwhelmed at times this weekend, and I will share more details about that soon. I am also in awe tonight, though, at what our medical capabilities are, and at what we have been able to do for these babies.