An Update From The Issolation Room

'She needs someone to Mommy her,' Dixie said, first thing this morning 'She needs someone to hold her a lot.' She was talking about Geraldine, a baby that arrived at GLA last week, in a critical condition.

Geraldine is severely malnourished and weighs 9 lb, no more than some European and North American newborns. Geraldine, though is not a newborn. We were initially told that she was 9 months old, but when her birth Mother visited yesterday, we learned that she is actually 12 months old. Her dry, loose, yellow-tinged skin and bony frame tell a story of extreme starvation.

The IV is out and she no longer has diarrhoea, but Geraldine has been refusing to eat. The nanny who is with her says that she doesn't eat at home either. A combination of micro-nutrient deficiencies and chemical imbalances brought on by neglect and starvation can cause loss of appetite in malnourished children. There is a deep longing in the baby's eyes, stronger even than her apathy.

At Geraldine's orphanage, with just one care-giver for every 14 children, physical affection and coaxing are luxury commodities. Today, though. I indulged this sad little girl's desperate longing. This is a baby who will not recover without a lot of love and patience. I gave her medical peanut butter and Pediasure every three hours. Each feeding took around 40 minutes. I held Geraldine close and allowed her to suck the peanut butter paste from my little finger and sip at her pediasure. This is the only way I can get her to eat. At the end of feeding time, I held her up on my shoulder. She nestled her head against my neck, clinging to my scrub top. I hope and pray that we can get Geraldine past food refusal, before she returns home.

Next to Geraldine, baby Woodley has completely recovered from his illness. He drank 22 ounces of formula and had two bowls of corn meal porridge today, over a 9 hour period. He is sitting up in his crib, playing with toys and babbling in a sing-song voice.

At the back of the isolation room, 3 month old Erik is asleep in his bassinet. This emaciated, 5lb baby came to us from Cazale. The staff at the malnutrition centre there are inundated with cholera patients and asked GLA to admit this infant so that he can get the care he needs, in an area that is not currently impacted by the cholera epidemic. It is rare for babies to contract cholera, but as a precautionary measure, Erik is being kept apart from the orphanage children, for now.

Erik is in a very poor condition. he has some facial swelling and he is bleeding under his skin and from his intestine. His limbs are stiff and he is unable to suck. I fed him with a medicine dropper this afternoon and had to stimulate him to swallow. It is possible that Erik's malnutrition has caused some brain damage.

He is on a hypoalergenic formula, that is easier to digest than typical infant formulas. I hope that it will improve nutrient absorption and reduce the strain on his liver and kidneys. Sometimes, severley malnourished children die from organ failure when they begin to recieve nourishement - their damaged organs cannot process nutrients. I am also giving Erik an electrolyte supplement to help with the swelling, together with vitamins and minerals to improve his blood clotting and boost his immune system.

Erick and Geraldine both come from from extremely impoverished backgrounds, to which, they will have to return. If they survive and recover, it is highly likely that they will become sick and malnourished again once they leave GLA. This is the time for prayer. It is the time to hold tight to faith and to resist discouraging thoughts.

'Now hope does not disappoint, because the love of God has been poured out in our hearts by the Holy Spirit who was given to us.' (Romans 5:5)