A Thousand Times Over

For most of the week, the nurses and nannies that work in the nurseries have reflected on Kervens life and his death.

We have experienced the ebb and flow of guilt and grief, anger, doubt and despair. Sandia. Edna Kervens. Three precious lives so hard fought for, and lost. It is hard to bear. Our latest loss is a painful lesson, we all agreed. We wished we had kept Kervens here longer.....

Days before Kervens died, a colleague directed me to be alert for the presence of God. I am going to be completely honest with with you: there were days last week, that I did not feel God's presence. I wondered what we had achieved upstairs in the nurseries. We had nothing to show for our efforts, it seemed, and no hope to offer these babies.

Mid-week, the despair receded and a wave of thanksgiving washed over me. Our God did not doubt the product of our work here, and the hope he whispered, was without question.

[Love] always protects, always trusts, always hopes, always perseveres (1 Corinthians 13:7).

He knew from the outset that Kervens would die. He wanted him to know before he left this world, that he was worth fighting for. And loved.

As Edna's life faded away, I communicated to her the best way I could, that she was going home. I couldn't do that for Kervens. I hope it isn't too naive or sentimental of me to believe that as he made his last earthly journey up the mountain to GLA on the morning of the day that he died, he knew that he was returning to us and that everything was going to be ok.

God knew the outcome at the outset. I am glad I did not, but if he calls us to love a thousand babies into his arms, I will do it a thousand times over.

Deep Calls to Deep

A lament rises from the depths of my soul.

Just after mid-day, the NICU staff called me to come urgently. I ran. Dixie reached the infant just ahead of me. I didn't know the shrunken frame of the baby on the table, I was sure. And then....... Oh God, oh no! It can't be! Kervens was still warm, but he was not breathing, and he had no pulse. We tried to resucitate him. It was too late. Only just. But too late.

Why, Lord? Why! Our miracle baby, the one we pulled back from the clutches of death twice was lifeless in front of us. We had discharged him on Wednesday, fat and beautiful and healthy, with formula and bottles and diapers. Now, the whites of his eyes were blue and his eyes were dark and sunken. The skin covering his stomach and his thighs was wrinkled, and his mother couldn't explain any of it. As I heard how Kervens writhed in pain all night last night, I struggled to see the goodness of God. This just looked like cruelty from where I was standing.

Our God, the one with a plan for each life; a plan to prosper us and not to harm us. Our God , the God of mercy and love had has allowed Kervens life to be saved not once, but twice, only to end like this? Where is the hope in that?

I am not in the mood for plattitudes today. I don't really want to hear that Kervens is at peace, and that his suffering is over. I want justice for him in this world. And I I don't want God to promise to make something good out of this tragedy, I want him to stop any further tragedies from happening.

The answers to the whys, the bible instructs, are too high for me now. I will have to wait for eternity for those. God sees through the darkness that envelops us tonight but we don't.

'My soul is cast down within me;
therefore I remember you
from the land of Jordan and of Hermon,
from Mount Mizar.
Deep calls to deep
at the roar of your waterfalls;
all your breakers and your waves
have gone over me.
By day the LORD commands his steadfast love,
and at night his song is with me.'

(Psalm 42: 6-8).

We are always told to encourage one another in the hope that is in Jesus, but I think we need to be honest too, that the demands of faith, lived by blind sight, are tremendous. The cosolation in this, the only one I can find, lies in that deep calls to deep connection to a God that knows that this is very hard for us, who knows that it hurts, who feels it, and who cries a deluge of tears, roaring at the pain and the injutice of it all. Deep calls to deep.

Dashed Dreams

Two months ago, I had a series of dreams. In these dreams, newborn twins or triplets were admitted to GLA, and all of the babies needed CPAP. I knew that it would be a challenge for our NICU, if a set of multiples did arrive. I decided that I would not be caught out. I made CPAP hats, and got the circuits ready, and I made plans and contingencies for caring for these babies. I was prepared

So when, at 8am on Monday morning, news reached me that a set of tiny twin girls were downstairs, I was ready. The girls weighed in at 2lb 1.7oz and 2lb 0.3oz. They had been born 9 hours before, five miles away at the Baptist Mission Hospital in the mountain village of Fermathe. They were icy cold and they were not breathing well

The rest of the day went by in a blur, as we warmed the babies, and struggled to get them stable. I remember I started working on Sandia, the smallest twin, first. She was showing more signs of respiratory distress. I got her on CPAP, and directed Mme Bernard to start her sister on oxygen.

I remember that we could not keep Edna's CPAP working. Two oxygen concentrators were down. Two incubators malfunctioned. I was glad for my contingencies! I remember being caught between the urgency of Edna's breathing problems, and her twin sister's low blood sugar. I remember getting an umbilical line into Sandia, then Edna.

Starting them on intravenous fluids, giving vitamin K to prevent blood clotting problems and brain bleeds, antibiotics, medications to stimulate them to breathe.... It was difficult to get the girls warm. When their temperatures did rise, the consequences of prolonged cold stress caught up with them. Oxygen levels falling, heart rates fluctuating, me running between the girls at shift change over, both of them apnoeic...


As the days passed, we lurched from one crisis to another. Sandia's temperature would not stay in the normal range, and whenever her CPAP became disconnected, her airway would collapse. She needed a high flow of oxygen through her CPAP and once or twice a day, we would have to hyperventilate her with an ambu bag, to blow of excess carbon dioxide build-up.


Edna's immature digestive system could not process sugar. Her blood sugars were dangerously high and her tiny body was forced to burn fat for energy. There were two problems here: Edna had very little fat to burn, so as the days wore on, she became emaciated. And as the days wore on acids that were produced from the break-down of body fat, accumulated in her blood. She needed regular doses of sodium bicarbonate through her umbilical line, to neutralize the acids.

I worked double shifts with the girls, starting at 5:30 in the morning. The extreme heat in the NICU, and being on my feet all day made my feet and ankles swell, I was dehydrated, having muscle cramps, and my whole body hurt. I was exhausted: I was woken in the night more than once to help get a struggling baby out of crisis. By Thursday, Sandia and Edna were stable, kicking their legs and waving their arms in their incubators.

Sandia had became anemic and needed a blood transfusion, but she improved significantly when she received it. Edna was on room air CPAP. There were reasons to be hopeful, Soon, the girls would be well enough to tolerate milk feeds. They would stop burning body fat for energy. I was running on adrenaline and I was elated. We were winning, I was sure. Finally, we were winning!

I wish that I could tell you today, that everything we did, paid off, that all the knowledge we gained from working with babies like Jonathon and Sophie Dora had saved two twin girls lives.

Instead, I have to tell you, that Sandia died at 11 am on Friday morning, from a collapsed lung, or an airway, obstruction, we don't know.

As we were working on Sandia, her sister, Edna, began having breathing problems. Less than an hour after her sister died. Edna stopped breathing all together. Blood tests showed extremely high acid levels in her blood. Dixie and I worked until late into the night. Edna legs were stiff, and she wasn't moving the right side of her body. Her pupils were dilated and we were afraid that she had had a brain bleed. We made a call to a neonatal nurse practitioner in Pennsylvania. Eventually, after 6 hours of ambu-bagging, and lots of drugs, Sandia responded to treatment. She opened her eyes, she began moving, and eventually she was breathing on her own.

The next morning, her exhausted body gave up the fight. I held her on my chest. There was a flicker of recognition across her face as Edna relaxed to the rhythm of my heart beat under her head. She remembered her mother's womb, I'm sure. A safe, warm, watery place, where she floated, and where there was no struggle. Where her mother's heart beat consistently and reassuringly above her head. I hope she knew in those moments that I held her, that she was loved dearly, and I hope I communicated to her in a way she understood, that everything was going to be OK.

At 9:53 yesterday morning, Edna was pronounced dead.

My dream came true, and then it was dashed. But oh, that is a small thing, compared to the dreams of Edna and Sandia's parents.

What Would Become of Them?

In January last year, I composed several blog posts that alluded to the influence that some of the major international aid agencies were having on childcare policy in Haiti, following the 7.0 magnitude earthquake.

At the time, orphaned and displaced children were taken into 'protective' custody in camps that these aid agencies set up for Internally Displaced Persons. The perceived threat to children who were orphaned or separated from their families? Orphanages. They were considered to be sites of potential child trafficking. It was frustrating to have an empty orphanage - all most all of the children in our care, who were in the adoption process at the time of the earthquake, were evacuated to their waiting families overseas. We had the capacity to provide excellent care to orphaned and displaced children, but we were not permitted to take them in.

Following one of my posts a reader, who was affiliated with one of the aid agencies commented anonymously. He or she told me that orphanages should not exist, since the best interests of children and families were served through approaches to the 'orphan problem' that targeted communities, not just children. Although this person was not brave enough to go 'on record', (s)he wanted me to know that orphanages such as ours were obstacles in the path of development agencies. Why? Apparently, we suck up donor funds that they need to realise their goals.

I don't believe that our donors would necessarily give to larger aid agencies if GLA did not exist. They are inspired to give to smaller charities, charities with hearts and souls.I believe that they care about individual children: faces, names, stories.

In may 2010, a BBC reporter asked a representative from a British-based aid agency,
that is opposed to international adoption, how she would answer grown up orphans like the GLA staff member, who said that international adoption would have been the better option for him. Better than 15 years of institutionalization in his home country. Her answer: this was a sad story, but it was just one story. Her agency had to view the bigger picture.

These were words that chilled me. They chilled me then, and for some reason, they are haunting me this week.


A week ago, two children were admitted to GLA. Julenord was the first to arrive. He cast a pitiful form in the nursery. A faded, ashen skinned, stringy-haired little boy, whimpering, and writhing in his crib. At almost two years old, his spindly legs were too weak to support his body weight. He has never learned to walk. He grieved the mother, who loved him, and he didn't understand, yet, the depth and perhaps the fierceness of this love. His Mother loved him so much, that she surrendered him. 'Do you understand, that if you make this decision,' our Haitian administrator counselled,'You are giving up your parental rights? Do you understand that if you sign this paper, one day Julenord will leave Haiti? Do you know that you may never see him again after that? Are you sure this is really what you want?'
'Yes.'

Melouse, a tiny, malnourished infant with Downs Syndrome,came next. Slowly starving to death since her birth, she was carried here by an aging Mother. A Mother who wept as she negotiated the rocky mountain road, with her precious bundle. Tears of sorrow, of regret, of resignation, and yet accepting this as the best option for her baby. She had tried.

It seems ridiculous to those of us who work at GLA, to even consider the scenario of closing our doors, and sacrificing Melouse and Julenord to 'the bigger picture.'

We hope that one day, there will be a viable social support network in Haiti, to support children and families like theirs. Then, birth families will not be forced to chose orphanages or adoptions versus selling their child into slavery, or raising them in extreme poverty.

Until then, we are standing in the gap, because if we did not, what would become of these children?

Pray for us, that we will continue to make the right decisions for each child that comes through our gate.

Two Special Babies

Late on Thursday afternoon, upstairs in GLA's NICU, I performed a visual exam, of baby Sonia, who had arrived home from Miami an hour or so before.

She had obviously grown, and filled out. She must have spent a fair bit of time enjoying the Florida sunshine, I thought to myself - her colour had deepened. I took in her crown of silky curls, glowing skin and a pretty pink, checked dress. For me, these were signs that she had been well cared for and loved during her three months in the USA.

Undressing my girl, my eyes fell on neat scar, that ran up her chest, stopping just short of her collarbone, and a bony protrusion over her right lung. Soon, I would learn that Sonia's surgeon had corrected six defects affecting her heart and its vessels. I traced that scar with my finger. I needed to do that. I'm not quite sure why.

Sonia's journey to health has not been an easy one. She developed osteomyelitis (an infection in her lower leg before she left Haiti and that required an extensive course of antibiotics. She developed a further infection in her PICC (IV) line together with a blood clot. Then, following surgery her incision line also became infected. She has returned to God 's Littlest Littlest Angels singicantly stronger than she left us. Developmentally, she continues to make impressive progress.

If anyone here needed a reminder that Sonia would continue to require a lot of care, that reminder came in the form of another angel.

Melouse is 4 months old and she weighs 6lb 5oz. I caught my first glimpse of this tiny elfin girl shortly before 8am on Thursday morning. The lady who was holding her, Melouse's mother was crying. I remember that Melouse looked pale, but very alert. When she was brought up to me in the NICU shortly before mid-day, it was immediately obvious that like Sonia, Melous had Down's Syndrome.

Melouse has a skin infection, fevers and swollen glands. Many Down's syndrome babies have weak immune systems. She is unable to drink from an ordinary nipple because like Many Downs's syndrome babies, she has low muscle tone. There are signs that her thyroid gland may be under active. These are the health challenges that are immediately obvious to us. We don't know yet whether, like Sonia, she Melouse has a heart condition and breathing problems. Whether she will have issues with her digestive system, vision and hearing. Whether she will be prone to seizures, or whether she will develop a form of leukaemia that is fairly common in babies children with Down's syndrome.

We have two beautiful and precious girl upstairs in our NICU. Sonia and Melouse. Special because they are unique, but also because they are and will probably always be high needs.

Merciful, Loving and Good

Last Sunday afternoon, the NICU staff called me to see a sick baby.

Kelly, an ex-preterm infant, had suddenly developed severe croup symptoms. He had a strangled-sounding cough, and his airway was so compromised that he couldn't swallow. His blood oxygen levels were low and frothy secretions were bubbling from his mouth and nose.I knew this was an emergency. I knew Kelly needed a competent anesthetist. I knew there were none close-by.

This couldn't really be happening to Kelly! He had been born 2 months prematurely and had survived at home for a month without an incubator, or oxygen. He had bean slowly starving, but he had made it here. He had done so well with us; he had filled out. He had become a beautiful, thriving baby and he had never been sick before..... I exhaled a long breath. I was attached to this baby, I was afraid for him, but Kelly needed me to be calm and confident in this crisis. He needed me with steady hands and a clear head.

Oxygen and nebulized steroids had no effect. Nebulized epinephrine helped to dilate his airway just enough, to make the next stage of his treatment safe. I sited an IV to give Kelly steroids that would reduce the swelling in his throat. Siting the IV was risky. Pain and fear might cause a spasm in his throat that would stop him from breathing all together.

Thankfully, kelly responded to treatment. I gave up a prayer of thanks for this mercy. No sooner had I stabilized Kelly than Dixie received a phone call.....

Minutes later, we were at the home of a terminally ill staff member. Exilia had been diagnosed with a metastatic brain tumour just five days before. Now, she was struggling to breath. She was in pain. She had lost control of her body functions. I found myself praying again for mercy.

The next morning, my prayers were answered, when Exilia lay down, rolled over, and stopped breathing.

Tears and groans and wailing filled our house. Angry, stunned, bewildered, difficult questions were thrown up. It was a painful loss, eased by the knowledge that God had answered our prayers. We knew that cancer was not the end of Exilia any more than croup had been he end of Kelly.

Two desperately ill people, one healed in the world, the other in eternity. One full of promise, an orphan with a hope and a future, a child who would soon be proposed to a family who desperately wanted a son. His whole life was ahead of him. The other had reached the end of her life, but she had left a legacy of dignity and endurance in the children she had raised. I gave thanks to my God. The one who had suffered in this world, the one who knew that we hurt. The God we could cling to - empathic, and eternally merciful, loving and good.

Kelly, recovering from his illness. He is now off of oxygen.

'Give thanks unto the LORD; for he is good: for his mercy endureth for ever.' (Psalm 107:1)

What Are Little Boys Made Of?

What are little boys made of?
What are little boys made of?
Frogs and snails
And puppy-dogs' tails,
That's what little boys are made of.
What are little girls made of?
What are little girls made of?
Sugar and spice
And everything nice,
That's what little girls are made of

(19th century English nursery rhyme)

Most of the families who apply to adopt from God's Littlest Angels request referrals of little girls. Most of the children in my nurseries are boys.

Last week,our Director shared with us that she has no families on her waiting list, for many of little boys that are ready to be proposed.

As I did my morning rounds at the baby house this morning, I wondered which of my boys, would have to wait for a very long time, for someone to say 'yes' to them.

Frantz? He is a chubby, beautiful infant, not quite two months old, and thriving in every way. If he were proposed now, it is possible, a stretch, but possible, that his adoption would be completed before his first birthday. He is a son that would make any Mother or Father proud.

Supposing Dixie doesn't have a family for Frantz, what are the chances that she will be able to place Jamesson, my three month old who has some developmental delays from malnutrition? He is weak, but gaining strength. How long will he wait?

And what about Blanco? At 8 months old, he is the calmest baby in the NICU. He is gorgeous and happy and contented. I'm sure he would be snapped up by a modelling agency. I took it for granted that he would be snapped up by an adoptive family too. Was I wrong?

Giovani....it just doesn't seem fair that our sweet,determined boy, who is so loved by his nannies, nurses and volunteers, and who has been here for over a year all ready, should have to wait any longer.

And then there is Christophe.....I never met a child like him! He arrived in February, severely malnourished, weighing 12lb. He was 16 months old then. This boy has an incredible spirit; highly sociable, engaging, but also extremely dominant. I remember doing his developmental assessment a few months ago. Christophe had to be persuaded to co-operate. After a while, he turned the tables on me. 'Like this', he kept telling me in a tone of authority. I was taken aback. He wanted to be in-charge. He wanted to be a teacher, not a learner, and he was assessing me! I have always said, Christophe will be one of two things: a great leader or the most awful tyrant. It is my mission to make sure that he becomes the former, not the latter. He will bring a lot of joy to his 'forever family', but who are they, and when will they step forward?

I think there are many reasons why, our waiting families request baby girls. Many of them are reasonable. I can certainly understand why a single mother might feel more comfortable raising a female child, for example.

What if we think of it from a different angle? A prospective parent might wait several months, maybe over a year for a baby girl to be available. What if, all this time, the son that God would place in that waiting family, is also waiting.

I think that boys get a bad reputation. They are different from girls, there is no doubt about that but I personally adore them, and I do not find them more difficult to raise, than girls. I wonder if maybe, the single mother who hopes to adopt, has men in her life, a Father, a brother, a friend, a neighbour a priest, a pastor, who could be an excellent role model to her son. No-one can be everything or everyone to a child, girl or boy.

I know that many of you pray for our children. Would you pray that someone will say yes to all of our children? We have many boys, many sibling groups, many special needs children and older children who will be difficult to place. GLA is a good orphanage by Haitian standards. but it is not a family and children need a deserve to be set in families.

If you are a prospective adoptive parent, maybe your dossier is in Haiti, maybe you are in the process of gathering all of your paperwork, I am asking you to pray too. Might God be leading you to consider adopting a boy? If you haven't received a proposal, it is not too late to contact Dixie or your agency, and tell them, you would gladly welcome a boy into your family.