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, 19 December 2011

An Amazing Thing

In the past week, three children from the big nursery were admitted to the NICU for short-term care. The first was17 month old Frantina. She had a pneumonia that did not respond to oral antibiotics. On IV antibiotics, this little lady soon recovered.

The second child was Faland, a two-year-old girl, with chronic digestive problems. She developed severe, watery diarrhoea and wasn't able to tolerate Oral Rehydration Solution. She was on IV fluids for just a day. That was all it took to restore her to health.

Geraldson, also needed an IV to help him recover from gastroenteritis. His recovery was even faster than Faland's!

By Friday, all three children had returned to their nurseries. where they were cheered by their nannies and the 'brothers' and 'sisters' in their groups. 'I'm are so happy!' nanny, Chantalle exclaimed'. Her hand gestures were exaggerated but her facial expressions were very sincere. She told me that one year old Naika, had missed Frantina so much that she wouldn't eat. The other children in Frnatina's group were also out of sorts, Chantalle reported.

As we were caring for these children. an  epidemic of cold symptoms, coughing and wheezing developed at the main house. Yesterday, two of the premature babies were struggling with this virus, and showing signs of bronchiolitis, a condition that causes the air sacs in the lungs to fill with fluid and collapse. At mid-day, Louna vomited and aspirated her feed. Her panicked mother responded by hiding Louna under her jacket. We don't know how long she was struggling for breath, but intuition told the day-nurse  to check in on Louna. Ginette found the baby pale and gasping. 

Although I suctioned her airway, sited an IV and gave preventative antibiotics and started her on oxygen, the damage had been done. She had breathed the milk she vomited into her lungs and Louna had several spells of apnoea over the afternoon, which means that she stopped breathing frequently. We were unable to keep her oxgen levels up, and by dinner time, Louna had to be started on CPAP. She went on to have seizures. It took two hours of intense effort to stabilise this baby, who became so irritable as a result of all the medications she was given that she pulled out two IV lines. Louna is doing much better today, and we hope to get her off of her CPAP in the next day or two.

Rivens, another premature baby boy also had to be started on oxygen yesterday, and today, he was too tired to feed. Bronchiolitis can be very serious for premature babies. He has a feeding tube down and we will be observing him carefully, constantly assessing him to make sure that he is not become exhausted.  He will receive IV fluids or CPAP if he needs them. 

It is an amazing thing, to be able to offer bubble CPAP to our babies who are struggling the most with bronchiolitis. Even in the developed world, some babies become so sick with this condition that they need to be ventilated. CPAP prevents our babies from getting to that stage. This is extremely important -to all intents and purposes, they are no Paediatric Intensive Care  services in this country.

Sunday, 11 December 2011

The Winning Side

I have three photographs for you that were taken a few minutes ago.

Do you recognise her?

This is Bianka, now sporting a double chin -  a beautiful, healthy baby. Bianka has had no further seizures and she is smiling. I am hoping to see continued progress in her development. Most babies who suffer severe, life-threatening malnutrition have developmental delays as babies, and learning difficulties later in life. Whether Bianka heals with or without 'scars', her life has been salvaged. She is precious to us, and more than that, infinitely precious to her Father in Heaven.

Charilson became seriously ill, late on Sunday night with severe dehydration. He caught a bad cold on Tuesday.  We have increased the strength of his formula, using guidelines that were provided to us by a dietitian. This baby needs to beat the cycle of sickness and malnutrition. The best way to do that is to re-nourish him as quickly as possible. So far, he is filling out nicely. Of all the fragile infants in the NICU just now, Charilson, the one who came in healthiest has been the most difficult to recover to health.

Remember Mario? He was admitted in October, suffering from Kwashiorkor. He was treated for suspected  meningitis the week after he arrived at GLA. Thankfully, the tests that our Paediatrician ran showed that Mario did not have meningitis, but a severe intestinal infection. Once he beat that, the excess fluid quickly left his body, and was almost immediately replaced by fat stores (smile). Very few ladies, Haitian or foreign can resist Mario's charms - he is a terrible flirt!
Three faces: Three victories for GLA, for life, for hope and for love. I love being on the winning side!

Sunday, 4 December 2011

A Job Well Done

As I wrapped up the week yesterday, I took stock.

Alaine, was off of her nasal cannula. She'd had a sudden growth spurt, and was now stable without the constant flow of compressed air. We will continue to observe her carefully. The nannies will be pleased to do that. Alaine is ridiculously cute - her face is so round that I call her my cabbage patch doll. Her  eyes cross badly whenever she tries to focus on us. That only makes the Haitian staff all the more fond of her. 'You have to send a photograph of Alaine for her mother, Susan. Maybe if she sees how fat the child is, her mother will have hope.' Alaine's Mother has lost 17 infants. We wonder if these babies had a genetic syndrome. Alaine has had airway problems and her ears are small and set very low on her head. God knows. We just enjoy this sweet girl and stay watchful for any health problems. Alaine's mother deserves to have one child, this side of heaven.

Bianka is going from strength to strength. She came to us severely malnourished, with swollen hands, feet and eyes. We almost lost her to renal failure, and she went on to develop heart failure and seizures as she stabilised. She was severely anaemic and her protein deficiency was so severe that she had very few immune cells. I was afraid that infection would claim her life. She had an ethereal, waxen pallor and her skin was coming off in sheets. The Haitian nurses were convinced that she had been burned. Her skin was so thin and raw that we had trouble keeping this baby warm and hydrated. I treated her like a very premature baby. Today, Bianka is recovering from her malnutrition, filling out, and tipping the scales at almost 6lb. Her survival is a work of God, and I am blessed to be a witness to her healing.

Want to see another miracle? Charilson is a premature baby who was transferred to our care by Real Hope for Haiti, a Christian mission run by our friends in Cazale. Charilson was very small for his gestational age when he was born last month.. He became malnourished when his mother fell ill and died. His grieving father dearly wanted this frail boy to live and in his sorrow, he gave thanks to God that there was someone who could nurture Charilson through the fragile newborn period, in which so many Haitian babies die. Touched by his gratitude, I promised his father that I would do all I could to ensure that Charilson grew strong and healthy. Charilson had mild diarrhoea and was very anaemic when he arrived. He contracted an intestinal infection and overnight, became severely dehydrated. When Mme Bernard reported for duty at 7am in the morning, Charilson's gut had shut down and dehydration and infection had sent his body into shock. He almost died.

Charilson was not doing well last night. The night nurse said that she couldn't get him to feed. He has mild diarrhoea and a swelling at the site his IV line was placed. He is now back on antibiotics and he has been started on Elecare, an expensive milk formula with pre-digested protein and fats and sugars that are easier for him to digest. He is sucking better today. Please pray that he and Bianka will receive a full healing.

Rivens, who was born 6 weeks early is off of CPAP and  no longer needs a feeding tube. He is a beautiful baby, who is growing and thriving and very active in his incubator.

'Celia', came from an orphanage up the road, suffering from severe diarrhoea and protein-energy malnutrition. She is also on the mend today. Her admission weight was 14lb 7 ounces. We rehydrated Celia and then began treating her infection and renourishing her. We gave Celia medical peanut butter and a specific blend of minerals to help her absorb protein. Her weight dropped to 12lb 14 ounces at it's lowest point. Believe it or not, this was progress - a sign that celia had metabolised the protein in her diet, and that the fluid in her tissues had been pulled into her bloodstream and left her body. Celia is regaining her appetite. We hope that she will lay down fat and build muscle as she recovers. She smiles and waves at the NICU staff now. If Celia continues to do well, she will return to her orphanage later in the week.

 Anyone walking into the NICU now, seeing it so calm, without a CPAP system or an oxygen cannula or even a feeding tube in sight, would have trouble believing that just 2 weeks ago, we had five critically ill babies and that the room was full to bursting, with medical equipment and  monitors alarming all over the place.

That's a good thing: a sign, I think, of a job well done.