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.