Sarah Needs Prayer

On Tuesday, I wrote that baby Sarah was an answer to prayer. Today, she needs prayer.

Sarah made wonderful progress this week. She was being weaned off of CPAP yesterday. She was alert, crying for feeds, drinking from a bottle, sucking on her fists and enjoying some snuggle time.

Overnight, though, she became sick. This morning, she had a fever and her blood oxygen levels and her heart rate were unstable.

We are able to run a limited number of blood tests on our iSTAT machine. The results of these tests show that Sarah's lungs and kidneys are not functioning normally. She was highly stressed in her Mother's womb, and this stress has made this weak baby all the more vulnerable to infection.

Sarah is back on oxygen. We have changed her antibiotics and we are also giving fluids through her IV line, to try to correct her electrolyte imbalances.

This photograph was taken yesterday. Sarah is too unstable to be photographed today. It is heartbreaking to see her now, so pale and exhausted. In the blink of an eye, everthing changes.

Pray with me that God will work through us to heal Sarah.

Sarah: An Answer To Prayer

Dear Sarah,

35 weeks was bit early to be making your entrance into this world. Having said that, I am very glad that you arrived when you did.

I began praying for you long before I ever saw you, or knew that you existed, and God answered my prayers.
Many months ago, I asked our heavenly Father to send you here, before you got too sick, before the best we would give you would not be enough.

You were 5 days old when you arrived at God's Littlest Angels orphanage. You weighed 3lb 4.5oz. You hadn't eaten much, if anything since you were born. You were so tiny, and so weak from hunger that you caught an infection. The nurses noticed right away that you were not breathing very well. You had pneumonia, and oxygen didn't help. You were to tired to breathe by yourself.

Thankfully for all of us, God orchestrated a plan to save your life. He knew you would special care. He knew that your Mother's womb could not sustain you. He knew that your parents did not think that they could raise you. He knew that the hospital they couldn't even afford did not have the medical equipment that you needed. And he knew an orphanage that did.

So you came here, to GLA, where I placed you on CPAP. Soon, you were breathing normally. Peace for fretfullness. A rosy glow for ashen pallor.

I sighed as I watched you sleep that afternoon, nestled in my arms. A day ago, my heart had trembled - another precious baby girl had flown off to the United States for heart surgery. That same day, God sent you to bless me. The timing of your arrival was perfect for both of us.

Over the next few days, I knew, you would rest as you healed, all the time, growing stronger. You are precious, Sarah. God made you, and he ordred your steps from the very beginning. You are precious, Sarah. You are an answer to prayer.

About A Boy

Over the past few weeks, I have been working on individualised care plans for babies who are at particular risk of falling behind in their development. This has meant paying very close attention to children who were born prematurely, or who are, or who have previously been malnourished or chronically ill. Wadley came to us in February. He was three years old and he weighed 16 1/2 lb. I wrote about him in my online journal, soon after he arrived;

"Wadley is extremely underweight. His growth is stunted and his hair is orange. He is weak. He is anaemic. His bones are soft from severe Vitamin D deficiency. His liver is damaged from years of malnutrition. His immune system is compromised from lack of protein, and, he has contracted an antibiotic resistant ear infection.

My heart ripples as I watch him shuffle across the nursery with a hunched back, and bowed legs. I hurt, every time I stick him with a needle; Wadley doesn't react. There is no sound from him. His nose wrinkles, slightly. Otherwise, his expression is unchanging. It is frightening to watch this lack of emotion. It is a sign of severe physical and emotional deprivation. Wadley has learned that all the crying in the world will not make a difference in his life."

With relief, we have watched Wadley begin to express both joy and pain, in ways that were emotionally healthy. The heart and mind of a child can be remarkably resilient. Traumatised, scarred, and atrophied, they have the capacity to sprout and blossom at the first shower; everyday acts of caring that meet his needs, the light of love's smile, the warmth of its embrace

I am not naive. Wadley is stronger today. He has gained 9lb in 2 months. He is making progress, but he continues to show significant delays in his development. My assessment of him confirms my general impression; physically and cognitively, he is performing at a 12-18 month level, while socially and emotionally, he behaves like an infant. Only now, is Wadley beginning to understand some basic verbal and non-verbal ques: a harsh word vs a joyful whoop, a smile vs a frown, and, what these thing tell us about what someone might be thinking and feeling, and how we should respond. He isn't even sure what the word, 'no' really means.

Seeing this on paper and playing out in the nursery, I hurt for my happy-go-lucky little man, who is so eager to learn but who still lags behind our oldest babies. Wadley is a boy who desperately wants to engage with us; we communicate in a language of gestures, expressions and subtle nuances that are implicitly understood by children half his age. Wadley, though, does not understand them.

Even as I hurt for him, I celebrate each sign of progress: that he cries when someone he likes leaves the room; that's a sign that he wants to attach to us. That I saw him co-operate with a two year old in 'pretend' play the other day: that means that his imagination is growing. Co-operation is an age-appropriate behaviour. Given the delays Wadley shows, this is exciting to see!

Realising how deeply his brain and body have been traumatised by the deprivation he has experienced, we are at least a little bit more aware of what Wadley is going to need from the nursery staff and his volunteer over the next few months. With focussed attention, I hope that he will progress in his development.

Ordinary Wonders

When Kerven's was first admitted, his body was rigid. His limbs were so stiff that his legs 'scissored' at the knees. After a few days of treatment, the electrolytes in his blood normalized. Still, his muscles remained extremely tight.

He had a poor appetite, he was not digesting his feeds well and he was irritable and difficult to console. When he was not crying and writhing, he would slip into an exhausted sleep. The tension was clearly evident on his taut, bony face.

We soothed him as best we could and we prayed that he would receive God's healing and his peace. With gentle care, encouragement and good nutrition, Kervens began to relax. It took time and patience, but he did become more settled and alert. He began to suck better and his weight increased.

Now, holding him nestled in my arms, and hearing him coo, I am filled with wonder. It is a very normal thing, to cuddle a baby, and to hear them coo but it always feels special. This week though, I appreciate the beauty of everyday wonders in a new way. Just a short time ago, Kervens was anxious and fretful, and so highly stressed that he 'constricted', and became tense inside and out. Now he is contented and happy, and I am experiencing all of his baby behaviour, and the world he is awakening to, as a phenomenon, just as Kervens is.

Dream and Memory

As the the dawn broke and my fretful sleep lightened, a spirit glided into my dreams and with it, a sense of dread. She was alone. Her expression completely void. She was not quite solid, and she was utterly unaware of me, or the buzzing travelers at the train station of my dream world. Why was her baby not with her? My chest was taught. An ache settled there. 'Dear God, you promise your plans are to prosper and not to harm...'

...And then I woke suddenly, with the whisper of that unfinished prayer, still on my lips.

Yesterday afternoon, Peterson returned home into the care of his Mother. She does not want him, but she wont give him up. Peterson was referred to the orphanage for medical assistance last spring. His Mother left in October, telling us that she knew her son would not survive at home, with her, and that she wanted to give him up for adoption. She never did sign the papers that would have provided the authority to seek an adoptive family for Peterson.

I counselled Peterson's Mother thoroughly before she left with her son. He needs daily medicines, that are provided free of charge by a government clinic, close to her home. She must take Peterson there on a monthly basis. If she does not, he will become very sick again. Then, he will die.

Peterson is returning to a volatile family situation. Everyone here knows that he is unlikely to receive his medicines at home, and there isn't a thing we can do about that. The truth is, that thousands upon thousands of Peterson's live and die in Haiti. There is no legal recourse, here, for abused or neglected children.

Here, we prepare children to join loving homes, either in Haiti or overseas. We are not accustomed to waving off the Peterson's of Haiti. No, not to that. They - the Peterson's, raise all kinds of questions about God and suffering.'For he wounds, but he also binds up; he injures, but his hands also heal.'(Job 4:18). There are no easy answers to these questions.

Yesterday, I smiled at Peterson and congratulated the fat, beautiful baby, telling him he was returning to his home stronger, far stronger than he had left it. I doubted he was strong enough: I couldn't let Peterson see that.

Sending him home is the only choice that was open to us. I know that we made the right choices, until there were no more choices left to make, and I suspect that just as last night's dream lingers with me, so will the memory of the last time I saw Peterson;

As I step away, he reaches for me. There is a high five, a wave, a kiss blown to him, another returned to me. He laughs his throaty laugh, his eyes round, and shining, his trust absolute and unquestioning.

Under God's Heaven

The Haitian administrator's assistant was taking down the family's details in the reception area of God's Littlest Angels orphanage. One twin sat fat and contented in her Mother's lap. The other, even fatter, gazed up at me sleepily, cradled in her Fathers arms. Mentally, I took in the girls pristine, blue dresses, glowing skin, thick, black hair, and shining eyes. They were obviously well cared for. I wondered why their parents had brought them here.

Upstairs in the nursery, the nannies gleefully filled me in. 'The girls are not twins, they have a triplet brother, who died,' one nanny began.' I know that when I heard that, my expression mirrored the sorrow I felt for the girls. Isn't there something deeply affecting, about the loss of their sibling, who was conceived with them, and who shared their mother's womb with them them?

The mother has been pregnant six times.....five times with twins, and one time with triplets!' one lady added mirthfully!' And I barely, just barely, concealed my shock! I am not sure I believe it. Do you?

'The work of a demon!' someone exclaimed, slapping her thigh. It was a revealing comment, that spoke volumes about Haitian spirituality.

A missionary to Haiti, once said that this country is 90% Catholic and 100% Voodoo. Voodoo spiritual beliefs are certainly extrememly prevalant here. Twins are viewed as a blessing and a novelty in western cultures. We believe that they share a deep and unique spiritual bond, ties that are never broken. In resource poor countries, though, the birth of twins means not one, but two extra mouths to feed, and for the poorest families, this is more a burden than it is a blessing. Their voodoo religion teaches that the spiritual bond between twins is a negative force, underpinned by jealousy, rivalry and malevolence.

I recalled earlier discussions with the nannies. One has a set of twin girls. She beat her five year old daughters with a stick one day, the ladies told me. The next morning, the Mama's fingers swole so badly, that she could not use her hands. She apologised to the girls, and the swelling went down. Twins, I was told, had magical powers, and they could be truly wicked! If you punish twins, you have to apologise afterwards, otherwise there is no saying what they will do to you!

You also have to be careful, very careful to treat twins equally, the nannies told me. Ignite the flame of jealousy between them and it is inevitable that one twin will be seriously harmed by the other. The hopeful thing about this discussion, is that unlike their voodoo counterparts, the nannies here believe that the tensions between twins can and should be managed. That twins should be loved equally, treated fairly, and given the same chances in life. Those who hold tight to voodoo teachings, by contrast, believe that the curse that the birth of twins heralds, can only be broken by the death of one of the twins. They see this as profitable, not just to the surviving twin, but to the family and community, who will no longer be at the mercy of the twins' supernatural powers.

It is not unusual at GLA, when twins are admitted, to see massive disparities between them. Often. one is fat and thriving, and the other, smaller, frailer, weaker. Their families have favoured one infant over them other. They do not have the means to care for two babies. Anyway, it is natural, they believe, that one twin will dominate the other. They do not believe there is anything that they can or should do to prevent one twin, from draining the life-force of the other.

Guerdine, and Guerline, at 8 months old are very different, both physically and in personality. Guerdine is two pounds lighter than her sister. She is small but she is strong-willed, demanding and developmentally, more advanced. Guerline is chubbier, contented and has a very sweet disposition. I am happy to say, that both are fat and thriving. My heart was brimming with joy and gratitude for our newest arrivals, as the nannies and I agreed that yes, the girls were very different, but wasn't there space for all kinds of people, under God's heaven.

All the way from their birth family, through their life at GLA and into the fold of their adoptive family, they will carry with them a wonderful heritage of love. This love transcends a culture that holds very negative views about twins. As such, this love is treasure.