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.

Monday, 25 October 2010


Rewind to Friday Morning: Sophie Dora has very mild retractions under her ribs, meaning that even with some respiratory support, she has to work slightly harder than normal to draw air into her lungs.

She deteriorated a few nights ago and had to be started on supplemental oxygen. I turned that off just over an hour ago, to see if she could manage without it. She is a few feet away from me in the incubator. The babies are napping. The NICU is peaceful, but as I watch the rise and fall of Sophie's chest, I am troubled. Her respirations have quickened. She may need oxygen again soon, I think to myself. Sophie's respiratory symptoms are not improving, even though she no longer has fluid on her lungs.

Suddenly, the baby is breathing harder and deeper. Her oxygen level falls. As I walk towards her, she is all ready turning blue, and by the time I reach the incubator, her heart rate is dropping. I turn her oxygen back on, but for an hour after this episode, Sophie is floppy. I draw blood to check her blood gas levels. Sophie barely reacts. The blood gasses are abnormal. I had to try her off of oxygen - if I hadn't I would never have known the limits of her coping - but looking at her now, it dawns on me that something is going on inside her body that I don't fully understand. That something is a very real threat to her life.

When I assessed Sophie on Tuesday morning, I had heard a loud heart murmur. It is becoming apparent that this little girl's heart condition is likely to be significant. Over the weekend, I tired removing CPAP and giving Sophie supplemental oxygen. She managed just 2.5 hours, before her oxygen levels and her heart rate began to drift downwards. She was almost full-term when she was born. Her lungs should be mature. She should not need CPAP at this stage, but she can't manage without it. Without both CPAP and oxygen, Sophie quickly destabilizes.

Tonight, her anxious Mummy asked why the baby still had breathing problems. This child is incredibly precious to her parents and to her extended family, and I think they all ready know that something is wrong. I was gentle and direct. 'Yes, I think we have to investigate that. Lets have the Pediatrician do a thorough examination. And lets see what she suggests.'

Sophie's Mum had been incredibly emotional lately, and that of course, is to be expected of a new Mother of a sick baby. There were no tears during this conversation though. Just straight questions, requiring clear and honest answers.

'If Sophie has a heart problem, can it be fixed?'
I hope that it can. I really, really do.

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