Francisca

By the time the staff at Real Hope for Haiti called on Wednesday, to tell us that rioting in Cabaret was preventing them from transporting Tania to GLA, another tiny infant, born 7 weeks prematurely and weighing 3lb 2 oz was in their care. Would we accept this infant for medical care as well? Dixie Bickel said, yes.

Francisca is here with her young mother. Francisca's blood sugar was low when she was admitted and within hours of arriving, her oxygen level had dropped and her breathing became laboured. She was given IV dextrose and she was started on bubble CPAP. 30 minutes later, she had stabalized.

Over the past few days, Francisca has been unable to digest breast milk. She began to have apnoeas (periods during which she stops breathing, and her heart rate drops.) Her CPAP is running with compressed air and a small flow of supplemental oxygen. The force from the CPAP gasses helps Francisca with her breathing and prevents the apnoeic spells.

While this baby fights her infection, she is receiving respiratory support in her incubator, together with IV fluids and antibiotics.

Three sick infants: Two in incubators, one on oxygen and cardiac medications, one on CPAP, two receiving IV rehydration and antibiotcs, one on continuous feeds, all requuiring close monitoring and round-the-clock care.

In terms of the space and technology that is available to us, GLA's NICU has almost reached the limit of its capacity. I am so glad that we are able to care for these three sick infants, simultaneously. I feel blessed beyond measure, by Sonia, Tania and Francisca and I am glad that we were able to say yes to each one of these beautiful girls.

Tania

Two babies arrived from Real Hope For Haiti on Thursday. Both were in need of urgent, specialized care that very few hospitals or NGO's in Haiti are in a position to provide.

Tania is 6 weeks old and weighs 3lb 5oz. Hers is an incredible story of love and survival against the odds. Tania was born in the amniotic sack, an unusual phenomenon that almost cost the baby her life. Although she survived, her mother did not.

Tania was admitted to a poorly resourced hospital, where she experienced neglect and starvation, before developing diarrhoea and vomiting. Recognising that her condition was life-threatening, her widowed Father transferred Tania to another hospital, where the staff were unable to start an IV. His last hope was Real Hope for Haiti, a rural clinic in Cazalle, close to the family's home. By the time Tania arrived there, she was so dehydrated that her tiny veins had collapsed.

By God's grace, an experienced Paediatrician was volunteering her time at Real Hope for Haiti. The Paediatrician managed to site an intra-osseous line (a needle that is screwed or drilled into the bone marrow. It was an intervention that saved Tania's life.

Tania arrived at GLA 36 hours after Dixie Bickel received the call, asking us to accept this baby for medical assistance. Riots in Cabaret prevented the clinic staff from travelling with Tania. Without that needle in her bone, Tania would certainly have died of dehydration. This tiny girl, all jutting bones and loose skin is very fragile. Her sodium and potassium levels were dangerously low when she arrived and she is extremely anaemic. She has barely been fed since she was born and is not able to tolerate enough milk to stay hydrated, even if it is drip fed continuously via a feeding pump. We have to be extremely cautious with her IV fluids - dehydration is often over-estimated in severely malnourished children and in her present condition, too much fluid could send Tania into heart failure.

With antibiotics, her diarrhoea and vomiting has are under control and she is able to tolerate larger volumes of milk. She had a set back this afternoon, when we ran out of pasteurized breast milk and started her on formula. Tania went on to vomit, what Dixie and the Haitian nurses estimated to be around 15 ml of fresh blood. We have taken emergency measures to stabilize Tania, until we can send her blood to be 'typed and cross-matched' when the lab open on Monday. It looks as though baby Tania needs a blood transfusion.

I am in awe of this tiny baby, so incredibly weak, so stricken, and yet, surviving!

October's Child

My three month old baby, Sonia, is sick, critically sick. Today, she was sicker than she has ever been. She was unstable, even on CPAP, and I feared for her life.

She is a sweet, alert, contented baby when she is well. When she is not, she fights and flails and roars angrily, until her puffy eyes bulge. Today, the battle for breath sent Sonia into combat mode. 'Sonia, enough!' I pleaded, from across the room, as a nurse tried to adjust the prongs in her nose. Hearing the command, Sonia stopped fighting, and turned, fixing her gaze on mine. What does that tone mean, Miss Susan, she seemed to ask? I think I better pay attention to you......

Pay attention she did, following me through a 120 degree angle, as I crossed the NICU floor. Oh my! 'Ladies,' I declared to the nurses and nannies, 'my girl is really bright!'

'She is not October's child!' Madame Bernard replied. 'October's children are not inteligent.'

'Pardon? What do you mean by that? October's child? Do Haitian's call all people born in October, dim?'

Monday's Child is fair of face,

Tuesday's Child is full of grace,

Wednesdays child is full of woe.....

My heckles were up. Sonia probably has Down syndrome. I am determined that she will not be cast under any sterotype.

'No, Susan,' the nurse replied, patiently. 'I meant that babies born in October of last year aren't really doing anything intelligent, yet.'

'Sonia wants to hold her bottle,' Someone said. I nodded, beaming with pride. That's usually the work of a 5 month old, not a 3 month old!

As we talked, I was changing Sonia. Her arms were inside her sleep suit, so that she would not mess with her nasal prongs while I did that. Suddenly, thorough the arms holes, out pop both of Sonia's arms! At what age do babies learn that?

We all laughed! Sonia does this consistently. She can also remove mittens that are taped on to her!

'She is October's child' I told the nannies.

'With lots of spirt!' someone added.

At the end of this rough day, I am hearing Sonia's monitor alarming, even though it is not, and I know I will be hearing it in my sleep.

I love this little lady, who needs a passport and US medical visa, as a matter of absolute urgencys so that she can receive life-saving surgery and medical care that cannot be provided in Haiti.

In my heart, I feel confident that this will happen 'in time' for Sonia. I have an assurance, as inexplicable as it is absolute, that God has a plan for Sonia, that includes, life, hope and a future. I believe that her 'spirit' is God-breathed and that it will sustain her.

The Dawn Of Remembrance

Everywhere I turn, there are reminders that the date is approaching. On the Internet, on television, on posters outside the store, on the radio, at church.

Though I wish they wouldn't, memories rise and swell out of the darkness, pressing against the dam..... The terror of the day the earth groaned and convulsed. The bewildering aftermath. The uter devastation. The fear. Overwhelmed exhaustion. Terrible grief. Doubt.

2010 stunned Haiti. The Christmas and New Year festivities were muted. A heaviness hung in the air, a bitter perfume. Tangible, like myrrh.

All celebrations are not festive. Sometimes, the steps of the dance are slow, the violins trembling, as shoulders heave, tears fall.

This dawn of remembrance is streaked by bruised hues.

'Blessed are those who mourn, for they will be comforted'.......

Christmas Came Late......

On Christmas day, Sonia was sick, and on CPAP, and it didn't seem right or fair that this bright-eyed baby should miss out on her first Christmas. Christmas celebrations were postponed in her nursery. By Monday, her condition had improved to the point that she had been weaned off of CPAP, onto oxygen. So it was on Monday that we marked our saviour's birth the NICU babies.

Most fixed theireyes on the brightly wrapped gifts. Some, young though they are, were absoloutely delighted by their new soft toys.












For Sonia, the bright tissue paper was at least as facinating as the tiger that I unwrapped for her!














It was on Monday that Sonia smiled for the first time. The poignancy of that smile goes without saying. I returned the smile, blinking back tears.

I have never known a tiny infant quite like Sonia - so sickly but so strong, so alert, and, despite being critically ill twice in less than three months, almost on track developmentally.

Oh Sonia, my feisty, but fragile fighter. My gorgous little girl, you need advanced respiratory support everytime you catch a little cold..... You will give me grey hair and wrinkles, and I am far too young for either of these things! I, your very own Maren (God Mother) want to wrap you in cotton wool and I feel like cursing anyone who coughs sneezes or sniffles within 100 yards of you.

My prayer for you in 2011: that you will grow big. Become strong. Thrive developmentally. And that a wonderful family, hand-picked by God, will choose you to be their daughter.

A Touch Of Christmas' Magic'

There are things about Sperancia, who just turned two, that worry those of us who work with her. Sperancia is afraid of many things, and she often shows signs of extreme anxiety. There are two working theories about Sperancia. One medical professional who assessed her thinks that she might be on the autistic spectrum. The other suspects that she has been abused.

When I took Sperancia up to the third floor balcony yesterday, to open Christmas gifts with the other baby house children, I did so with reservations. Sure enough, seeing the large group of babies up there, she sensed that something out of the ordinary was happening and she began to howl.

I lifted her up onto a wicker sofa, wiped her tears, and, pressing my hands either side of her face, re-assured her that everything was all right. Staying close-by, I invited her just to watch, as the other little ones tore through the brightly coloured tissue paper, to reveal teddy bears, dolls, and soft balls. With her thumb in her mouth, Sperancia observed them intently.

One boy cheered as he unwrapped a fabric book. Another, Elverson, backed away from the teddy bear that he had unwrapped, doubt and trepidation dancing across his face. What was that thing? Would it move? He didn't want to be close to it if it did!

The owner of the fabric book swapped gifts with Elverson. There was no prompting. The older boy was not afraid of teddy bears, but he recognised and responded to the fear of the younger boy with an empathy and grace that touched me.

Sperencia watched the other babies unwrap their gifts. Peterson was so awed by what he was seeing and experiencing, that his mouth gaped open. He has never seen so many toys just appear like this! Other children, like Wislande, seemed to be more interested in the wrapping paper than the toys. There was laughter as Wislande impishly feigned alarm, threw her toys away, and erupted into a fit of giggles when the toys were fired back towards her.

Sperencia was perfectly calm when I extended my arms and asked if she wanted to come down from the sofa to join us on the tiled floor. Sperencia reached back. She was ready.

With help, she tore off the tissue paper, and underneath, she found a panda. I was unsure how she would react. We do not keep soft toys in the nursery. An unfamiliar furry bear might precipitate a melt-down from her. She looked from me to the Panda. Realising the opportunity 'oohhed' and 'aahhed'. Sperencia, taking the que, brought the bear to her chest in an embrace, and patted it. 

I was sure that the next gift she unwrapped would break the spell. It was a red-haired barbie doll. Sperencia is deathly afraid of Dixie Bickel's two year old, red-headed Grand-daughter...... To my surprise, Sperencia stroked the dolls hair, and explored it's moving limbs. Then, picking up the barbie, she broke out into a wide grin, and toddled away from me, doll in hand.

I can't know exactly what it was that soothed Sperancia's heart yesterday. I get the feeling it wasn't so much about the gifts, as it was about the mysterious, miraculous spirit of God, a heavenly Father who knows her and a saviour sent to heal all kinds of brokenness.

The Best Teachers

I have some of the most wonderful and special children at the main house. Yes, I am biased, but I am also right:

Take Merudjy, for example. She is two. She has a nickname, 'Piman', which means 'pepper' in Kreyol, as in chili pepper. They say little girls are sugar and spice. Well, Piman has a bit more spice in her than most little girls!

One night, several weeks ago, we held a joint birthday party, for Merudjy and for Michno. The older babies were enjoying cake and sprite dowstairs, in the dining room. There were balloons and there was singing, and the party was flowing well, fun and festive, until, for no apparent reason, Merudgy reached over and slapped one of her little guests!

My heart sank. It was her party, but I couldn't let this go. Merudjy was removed from the table, and reprimanded. I made it brief, but I told her she had to say sorry. Back at the party table, Loveson was told that Merudjy would like to give him a hug, to make up for the slap. Merudjy drew close, raised her hand, and, smack!

Time Out!

Two minutes later, the scene was repeated. Loveson was indignant.

Time out, and take three:

Not to be twarted, I restrained Merudjy's hands this time. Seeing the opportunity, Loveson reached across, and made a grab at Merudjy's cake. Merudjy squirmed let out a hoarse cry in protest. 'No, Loveson, don't provoke her,' and there was stiffled laughter from the adult guests.

'Say sorry Merudjy.' Her eyes, though were stony, her lips were tight.

'You are a nice girl. You need to be nice.' Merudjy barely shook her head. Her eyes were piercing. She was not sorry.

Honestly, I wasn't quite sure what to do next. As I considered my next move, out of the corner of my eye, I saw Loveson take a spoonful of cake, and extend it towards Merudjy. A reward for bad behaviour? I am a principled person, yet something told me not to interfere this time. I closed my mouth, and watched the scene unfold. There was absolute silence around the table, as all of the guests watched expectantly.

Merudjy's expression softened. She looked at Loveson, whose eyes were smiling across at her. Merudjy opened her mouth, and allowed her friend to spoon feed her the cake: forgiven without apology.

'Merudjy,' I whispered, 'give him a hug now, darling.' And she did. Grace had broken through her obstinacy, in a way that reprimand, reason and time out had not. Loveson had extended grace, Merudjy, for her part, had accepted it. I had intended to teach these little ones about repentance and reconciliation. Instead, I was the one who had learned the lesson.

Loveson went home to France in October, and later this week, Merudjy and 5 other little ones from the main house, will also leave, in time to spend Christmas with their adoptive families in France.

I will miss them so much. Each and every one, leaves an impression on me, as real as a thumb-print and as utterly unique.