Many Hands Extended - Thank you Calvary Reformed Christian Church

Over the past few weeks, I have been very aware, more so than ever, that the staff at God's Littlest Angels in Haiti are not alone in our efforts to care for our babies at the orphanage's main house.

That fact was underscored two days ago, when my precious baby Jusmy choked on his morning medications, stopped breathing, turned blue, and needed basic resuscitation measures to help him recover.

Mme Bernard and I lept into action, suctioning the baby's airway, and turning on the new oxygen concentrator machine. The oxygen concentrator arrived a month ago, and was, I knew, donated by Calvary Christian Reformed Church in Michigan.The oxygen concentrator is the shown on the bottom right of this shot.

Two of GLA's children attend that church. When he first came the orphanage, one of these children,  Aiden, was recovered from malnutrition in the main house nurseries. Two years after their children arrived home in Michigan, Jeff and Marrisa Brinks were mindful of the children GLA continued to nurse to health and they encouraged their church  to support our work in the intensive care nursery.

Calvary Reformed Christian Church also donated a syringe pump (shown on the incubator shelf). This arrived in Haiti the very day that GLA received the call about Jusmy - a malnourished, baby, born prematurely with a severe cleft lip and palate. We were able to use that syringe pump to infuse a lipid solution and antibiotics at a controlled rate, to stabilise this extremely fragile infant.

It was a great encouragement to the NICU staff and to me, to realise the warmth and appreciation with which these pieces of equipment were given. In turn, we would like to encourage the Brinks family and their home church with the knowledge that Jusmy, who, was critically ill when he was admitted to God's Littlest Angels, is doing very well. This baby, who was turned away from the hospital in which he was born as a hopeless case, is re-gaining his health, growing and gaining weight in our NICU in the Haitian mountains.

Your generous donations helped to make that possible. The oxygen concentrator and IV syringe pump are gifts that will pay forward, long after Aiden and Samara have forgotten their time with us, giving hope and life to many babies.

No, the Haitian and foreign staff are not alone as we care for these children. There are many hands extended out to them. Thank you for being those hands.

With heart-felt gratitude

Susan, Jusmy and the NICU staff

A Letter Home

Stabilising Jusmy was a tough job for an orphanage in the Haitian mountains.

Jusmy came to us as a 3 week old premature boy with a cleft lip and palate. He was extremely malnourished and suffering from an infection. For several days, we wondered if his heart had been too weakened by starvation to continue beating.

The picture below was taken this morning. No more wires and tubes.

Jusmy, nestled in his incubator

Although I had to be in the NICU until 1-2am for the first week he was with us, I was not working alone. Jusmy received very particular attention from our Haitian nannies and nurses, while our staff and volunteers and supporters all over the world sent up prayers on his behalf. It seemed that God had already answered those prayers, before they were even offered.

The day that Jusmy was admitted, Jean Bell, who manages the US office flew into Haiti. This was a blessing for two reasons. Firstly, Jean had expertise as a former ICU nurse that she was able to share with me. Secondly, she was carrying with her a portable breast milk pasteuriser, that was donated by a friend and by members of my church in Scotland.

Jusmy was so frail and so ill, that he wasn't able to tolerate formula milk. We gave him IV fluids and intravenous lipids. Since his mother reminded in hospital and was unable to produce breast milk for him, we also started Jusmy on small amounts of donor breast milk, which was safely pasteurised in a low technology, but scientifically backed system, purchased from a company in England. The single bottle breast milk pasteuriser resembles a thermos flask. It allows us to treat up to 200ml of donor milk at a time. The pasteurised milk is sterile but most of the antibodies along with other immune boosting substances the nutrients and the digestive enzymes in the milk are preserved.

The single bottle pasteuriser, donated by friends of  our Haitian babies in Scotland!

Although he arrived in a critical condition and we had to advance his feeds very slowly, Jusmy's weight increased from 1.34kg to 1.92kg in 10 days! So thank you to the milk donor and to Irene Gillies from Brechin, and the tea ladies at Saint Margaret's Roman Catholic Church in Stirling. Thank you also, Jennifer.  Your gifts have meant life and hope for a tiny, and gravely ill infant. The best thing about the money you donated is that it will keep on giving. The breast milk pasteuriser will allow God's littlest Angels to treat donor milk for many babies over the years to come.

Three Three Pound Babies

Last night, Jusmi took a turn for the worse. He was not responding to his antibiotics and was still showing signs of infection. At 4pm his IV line stopped working and had to be re-sited.  His heart rhythm had been abnormal over the past couple of days, as his electrolyte levels stabilised. Now the rhythm was extremely irregular. His heart wasn't  pumping enough blood to his tissues. His metabolic imbalances worsened and his body went into shock.

Although I treated Jusmi as well as I possibly could, it was a very anxious time. The treatment of preterm infants who have been without medical care for several weeks and who are sick and severely malnourished is a specialised field. I have spent hours researching what is known about the management of infants like Jusmi. The truth is, there are lots of gaps in the knowledge base. I find myself drawing upon theory, guidance as well as the opinion of experts from different fields. Filling the gaps is often a judgement call.

Knowing this, and knowing that Jusmi's heart, one of his  most vital organs was failing, and that I couldn't do everything that a fully resourced Neonatal Intensive Care Unit would do to help him, Iwas fully aware of how precarious his situation was. I worked, watched and prayed. Worked, watched and prayed.

As I was talking about Jusmi's care with Jean Bell, who is a former intensive care nurse, we heard that a 3lb baby girl, from our area had been discharged from hospital that day. Could the mother bring the baby by for a check up in the next couple of days?

I didn't want to see the baby in a few days, I wanted to see her right away! She had been discharged from an excellent neonatal unit outside of Port-au-Prince. It is several degrees warmer down there, I was concerned that she would get cold now that she had moved up the mountain. A few days from now, the baby might be profoundly hypothermic.


At 8pm last night, with Jusmi still in a serious condition, Christy arrived. She was slightly cold, and she had a low blood sugar. We began treating her. Two hours later, the baby was warm, pink, and chewing on her hands.

No, you are not seeing double! Christy (shown on the left) and Erline are the same size, and exactly the same weight. With three babies needing incubators, and space in the NICU for two incubators, we had to improvise. These girls are not twins but they are incubator sisters.

This morning, Christy was started on antibiotics for diarrhoea. She is doing very well. Erline, who has gained over 300g since she was admitted last Friday is learning to breastfeed, so that she will continue to grow and thrive when she is big enough to leave us. My little man, Jusmi, is doing better now that his antibiotics have been changed. As the hours pass, my confidence grows. Maybe this one will live.

I really hope that he will.

Jusmi

Jusmi arrived yesterday. 3lb. 18 days old. Severely dehydrated. Malnourished. Cold. With an intestinal infection. And in shock.

He was born 2 months prematurely at a rural Haitian hospital. The staff there said that there was nothing they could do for him. I am so glad that he made it up to God's Littlest Angels. There is plenty that we can do for Jusmi.

He has needed a lot of intravenous fluid and careful re-warming to get his body out of its shocked state. He needed antibiotics to treat his infection. He had metabolic imbalances that are gradually correcting. As he continues to stabilise, his heart rate and rhythm and his tissue oxygen levels are being monitored continuously. His temperature, blood sugar, his electrolytes and blood gasses are being measured regularly.

The extreme stress this preterm baby's body has been under has the potential to damage his liver, his kidneys and his intestines. I watched the signs keenly. As things stand tonight, Jusmi's blood isn't clotting quite as it should and is only tolerating very small feeds of donor breast milk.


Jusmi is getting the very best medical care we can provide, delivered with the love and tenderness that he deserves. Love and prayer, after all, will be every bit as important to his recovery as the technicalities of what we will do for him.

Please pray for Jusmi's continued healing.

Erline: Compassion's Face

Seven week old Erline was born prematurely. She arrived this afternoon,  weighing 1.14 kg (2lb 8.5 oz). Erline's suffering began the day she was born. That was the day that her twin brother died. It was the day that her own battle began.

Her mother tells us that the baby was discharged from hospital two days ago. She had beat an infection in the Paediatric ward there, and was sucking expressed breast milk from a bottle. I learnt that the overcrowded hospital had sent Erline's mother home when the baby was a week old. Separated from her baby, Erline's mother did not produce enough milk to keep her hydrated, so the baby was given intravenous fluids for several weeks. Today, seeing the loose skin hanging from the infant's stick-thin legs, I struggled to understand why she had been discharged. At just over a kilogramme and suffering from malnutrition, it was unlikely she would survive. The head Haitian nurse explained to me that overstretched hospitals in this country routinely discharge the least critical cases, to make space for sicker children. Erline was one of their less critical cases. 

The baby was mildly hypothermic and slightly dehydrated, when she arrived at God's Littlest Angels today.

Over the next 48 hours, she will be constantly monitored and will need regular blood draws to ensure that her glucose and electrolyte levels stabilise. 

occasionally I receive comments from people who consider the Erline's of Haiti, hopeless causes. I am not sure that I have always answered these people well. If she were yours, wouldn't she be worth it?

We make all kinds of distinctions in this world, creating political and geographical borders; logical reasons not to extend charity and compassion outside of those limits. 

But when it comes down to it, compassion is utterly illogical. Not something we are duty bound to do, but something we can do out of love. Because of people all over the world, I  able to provide care to this extremely vulnerable baby. The compassion of all these people is utterly illogical and because it is freely given and not extracted from them, it is magnificent. 

Today is good Friday. Today I saw Jesus in Erline and I was reminded that if compassion has a lovely face, it also has a suffering face and that for us, the sacrifice involved in extending compassion is a very small thing.

Dachka: An Orchid Transplanted

The first thing I noticed about my new baby were her dainty features. Her tiny eyes have a slight upward slant and are framed by elegantly shaped brows. She has a button nose and although she is pale, her skin in flawless. Her's is an exotic and fragile kind of beauty that took me by surprise, as though an orchid had been transplanted into the nursery. A flush of colour and a faint perfume were my first impressions of her.

The second thing I noticed, a second later, was the flat bridge of Dachka's nose. Next, I saw her low-set ears. I took her bony hands in mine. Turning them over, palms upwards I noted a single crease, cutting straight across each palm.

Dachka is four and a half months old and she weighs 7lb 3.5oz. She is significantly malnourished. First I saw that she was beautiful. Next I saw that she  had Down's syndrome.