Perfection

Our newest boy in the nursery, 7 month old Mackenson has a cheeky [ornery] grin, that inevitably draws smiles both from his nannies and from our visitors.

Mackenson was transferred to us from another orphanage on the understanding that his right ear was  malformed and that this would make him difficult to place. We admitted him on Monday, exchanging puzzled glances as we searched for the malformation we had been told about. We found that the cartilage of his left and right ears formed a different shape. Foreign staff questioned Haitian staff. Did Haitians have any traditional beliefs about the shape of the ears?


Absolutely not we were told. Nannies, nurses and the Paediatrician were all in agreement. This did not constitute a malformation. One lady inviting us to examine her own ears, pointed out that her ear cartilage took on exactly the same shape as the new baby's did. others told us of friends and family whose ears were just the same as Macekenson's right ear. He was like many Haitians, they said.

And the fact that one ear looked different from the other. Was that important?

No! Haitian and foreign staff were in agreement. The difference was barely noticeable. Interesting but not really noteworthy.

A quick review of the documentation that came with the baby showed that he had initially been sickly at his previous orphanage. Not so now. He appears to be healthy and developmentally, he is on track for his age.

We are all made in the image of God, but not exactly like him. We are all different. All known personally to him. All needing his enduring love, his grace and his healing.

Soon Mackenson will be proposed to one of our waiting families who will, without reservation, accept him as their son. They will watch with keen eyes, taking notes of all the ways that he is special and all the ways that he is perfection.

Unfaded Beauty

We admitted a sibling set to GLA's main house late yesterday afternoon. This morning, with the help of a colleague, I recorded their vital statistics.

Anel, the little boy on the left of the photograph weighed in at 12lb 15.5oz and his length was 63cm. 

Wiseline, the little girl to the right weighed 13lb 14oz and measured 68cm in length.

Twins? The colleague asked.
'No.'
She gazed up from the admission paperwork, looking mildly surprised. 

We have been told that Anel is three months old. Wiseline is his older sister. She turned two at the beginning of March!

Her growth is severely stunted, and she is moderately underweight for her height. When I heard that she could barely crawl, I groaned inwardly. Children like Wiseline, whose tiny bodies have endured years of malnutrition can be extremely difficult to rehabilitate. Often, they have chronic health problems,  remain delayed in their development for years, and go on to develop learning difficulties in school.  Now that I've actually seen her though, I am feeling optimistic about this tiny girl's recovery. 

Her general health is remarkably good and she has surprising strength in her spindly legs. She has a good appetite, a brightness in her eyes and an openness to her new caregivers that makes me hopeful. So long as this child doesn't have any medical conditions that have contributed to her malnutrition, the chances are that she will adjust well to orphanage life, and go on to grow and thrive. 

Malnutrition has a way of stealing so much from children. One thing I am sure you will agree Wiseline has not lost, is her beauty. That is unfaded. 

'I will restore to you the years that the swarming locust has eaten' Joel 2:25

Talia

'This baby will give you trouble, Susan!' the Paediatrician declared.

Talia? That little bundle of baby girl sweetness? Trouble?

Sometimes when medical people talk about 'trouble' we are actually describing a patient who presents us with a clinical challenge.

Talia had a deep red colour when she arrived at God's Littlest Angels, the day before. She was 13 days old and the whites of her eyes were yellow. This was a sure sign of jaundice - a condition that occurs when bilirubin levels rise. Bilirubin is a pigment in red blood cells. Sometimes, newborns' livers cannot excrete bilirubin in the first week or so of life and the rising levels of bilirubin stain the skin. Jaundice has to be monitored - high levels of bilirubin can cause brain damage.Although I was concerned to see Jaundice in a 2 week old baby, wondering if this was caused by something other than just an immature liver, by the time the baby saw the Paediatrician the next morning I was not as worried as the Doctor.

 In early December, our orphanage Director arrived in Haiti with donated equipment from a US based medical supply company called Children's Medical Ventures. One of the pieces of donated equipment was a transcutanous bilirubin monitor. This made it possible for us to immediately screen baby Talia, using a painless test to determine whether her  jaundice level was an immediate threat to her health. We already knew that it was not. We had already tested a few drops of Talia's blood, and determined that she had a very high level of red cells in her blood. We had also done a bedside test that screened Talia for signs of infection. That test had been negative.

Over the days that followed, we monitored Talia's bilirubin levels, and observed her carefully. The Paediatrician was pleased by my report that the bilirubin levels were falling, and that Talia was waking for her feeds, tolerating them well, breathing normally and peeing and pooping regularly. The most likely cause of this baby's high bilirubin was delayed clamping of the umbilical cord. The extra cells would have made her blood more viscous and this could have caused breathing problems, as well as damage to her brain and kidneys.

All the signs indicated that although Talia had not had access to medical care, she hadn't suffered any complications. Her condition was temporary and it was resolving. I peeked at her, sleping peacefully in her box crib. I sighed softly, letting the last remnants of the concern I had harboured for her slip away. I am a Paediatric Nurse. I see lots of sick newborns. Lots of newborns with problems. It is always a blessing and a relief to look upon a  beautiful healthy baby.

Talia is no trouble at all........at this point in her life ;-)

Mitigating the Hurt

There are so many things I will never know about the lives our babies lived before they came to God's Littlest Angels. Those unknowns trouble me sometimes. People tend to assume that early traumas, the kinds experienced by pre-verbal infants are forgotten, and therefore unimportant. I think Mothers of adopted children have long come to know, what science is now uncovering - that early experiences of stress and trauma change the structure of babies brains, forging neuronal pathways that trigger a stress response to particular triggers, well beyond infancy, and even into adulthood.

I can make guess about the things our babies have endured from the womb - exposure to malnutrition, to their mother's stress hormones, and  possibly to toxic drugs. Many are then born into impoverished families, in crowded, unsanitary conditions, with inadequate food and shelter, and without access to medical care. They go on, one way or another, to lose their families, and find themselves in an orphanage.

In the past week, two small infants were admitted to the NICU. Oddison is a month old and he has a very low tolerance for discomfort, crying in short, piercing bursts. and trembling with anxiety whenever he is hungry or needing a diaper change. For now, he is unable to trust that his needs will be met. His mother told us that he has lost a significant amount of weight since birth. She was unable to produce breast milk and was only able to afford one can of formula for him. After that, she fed her tiny infant sugar water. He had severe diarrhoea when he arrived and needed to be re-hydrated intravenously. In his malnourished state, he became fluid overloaded on that IV and developed a mild case of heart failure.

I wish I could fix all his hurts, and make up for everything that has been lacking in Oddison's life. Of course, I can't, but at GLA, we can provide a good standard of medical care, and adequate nutrition. There will be people to care for him and hold him around the clock.Neuro-behavioural scientists tell us that stress and it's affects can be mitigated. I hope that we will earn Oddison's trust and confidence. If we do, there is every reason to believe that he will begin to thrive here. Now, having recovered from his diarrhoea, he is ravenously hungry. 

Daphka arrived yesterday. I haven't gotten to know her yet. Our Director tells me that hers was an urgent situation: she was living with her mother on the streets. Although I have been up to the NICU several times to assess Daphka, I always find her sleeping. First impressions - she is well-filled out and has shiny black hair and beautiful clear skin. Not a single worry line creases her brow. I hope that means  she doesn't carry too many hurts.

A Missed Call

As a little girl, I was absolutely convinced that I was a Princess. Although I was not a child with a birth line that could be traced back to the Scottish aristocracy, I was a real Princess none the less. I knew it.

I was lucky enough, you see, to have a Daddy who smiled wide and told me I was his Princess. He was born in a castle he told me (and that was actually true, my Nana and my great Aunt confirmed it). That made my Daddy the real  genuine article as a king, he told me, and I, his daughter, was therefore an actual Princess, not a make-believe one. The reasoning was tight and I was convinced. 

Knowing this, it wasn't a huge stretch for me to accept that I was my heavenly father's Princess too. And it's not a huge stretch to see that the sick and orphaned children of the world were also his, either.

Last week, I told you about a sickly HIV positive baby. By earthly standards, she is the lowest of the low. An orphan, carrying a communicable disease. Something that is believed to be shameful. But you see, there is a strange inversion on this earth, because the least of these will be the greatest in the Kingdom of heaven, and in eternity. Her sickness and her social status will have no relevance there and they in no way diminish her worth in God's sight.  She is his daughter. She is his Princess.

After two weeks of intense, hard work, trying and failing to re-nourish this little girl, her diarrhoea worsened and she refused even to drink. She was tube fed for two days, and during that time, we took the opportunity to re-nourish her aggressively. In those two days, she gained over a pound in weight and she re-gained her appetite. The diarhoea stopped. Our baby needed protein to heal her gut. She is now drinking protein shakes, with medical peanut butter and fruit blended in. She is standing in her crib, she is re-gaining her energy and mentally, she is very alert and she is playful. We engage in lots of silly games to coax a few extra spoons  of food into this baby. Sometimes she'll initiate the games, teasing me with an imaginary spoon and then erupting in a fit of laughter when I pretend to cry. The baby is a joy and a delight. The loose skin folds under her arms are filling out. Her skin has healed. She is cute, and I look forward to the day when the right family, the one God has chosen for her, take her into their hearts and their home and call her their Princess. She is already his. I don't see a sick orphan when I look at her, I see a child of God.

Do you have children? Were you cherished by a family who loved you? If so, it you should have some concept of the depth of the Father's love for his forgotten children in Haiti, and all over the world.

I've got a baby in the NICU. Her name is Malozie. She came to us a month ago. At the age of 7 weeks, she had some tough odds stacked against her; born to a mentally ill mother and a deaf father, she was in the swollen stage of malnutrition. Malozie was lucky enough to arrive at GLA just in time, before this devastating form of malnutrition damaged her organs too badly. I wish you could see her now, plump and smiling. She is a gorgeous, thriving baby, with long curled eye-lashes and baby soft skin and silky hair. You'd never know from just from looking at her now, that a month ago, her body was riddled with infections. She looks like a healthy baby. Maybe like yours.

Supposing she was your child. Supposing some disaster befell you and continents separated you from her and you got a call that she was was hungry and sick and without care. I know in that situation, you would call your most faithful friends and family, all over the world, You would say, 'I can't get to her, I need someone to go and be with her. I need someone to help financially with her care.'

Well, that is the call the Father puts out to us. 'Defend the poor and fatherless; Do justice to the afflicted and needy,' (Psalm 82:3). Notice that God is telling you, not asking you, and know that that the command comes from a place of deep love, and sorrow. He is saying go to them, they are mine. Over and over, we miss that Call

It's not my place to tell you what to do. Will you give? Pray? Go? That's for you to work out. I am praying that God will ignite a passion in you, in the church and among it's people, for these children. 

I can't upload  photographs this week to ingite that passion. Maybe that isn't a bad thing. 'Hear' what am saying. Close your eyes and 'feel' your way to what you are supposed to do, and then do it with your whole heart. 

A Roll Of Thunder

I have a baby who is sick, so sick.

We drew some blood from her a couple of weeks ago. Although the results are not in yet, I know, deep down what they will show - that the HIV virus is winning the battle over this baby's body

At first glance she is pudgy, but a closer look reveals loose folds of dry, scaling skin. Yes, she has laid down some fat, but her muscles are wasting. Despite a high-protein, high calorie diet, this frail baby has been fading before my eyes. Ten days ago, her feet became puffy. She was in the early stages of kwashiorkor (protein-energy malnutrition). This is the form of malnutrition I dread the most. The puffy feet were a sign that this baby was not absorbing protein. If her blood protein levels were low, so low that her soft tissues were swelling with fluid, surely her immune system (it's cells are composed of proteins) had taken a hit. Oh Lord.

She is on one antibiotic for a chronic ear infection, another to prevent a severe form of pneumonia that often kills people with HIV, and a third for diarrhoea that she suffers from because her immune system is compromised, and because  the antibiotics she takes to combat the infections that have gotten past that compromised immune system have disrupted her normal gut flora. She has thrush in her mouth and is on long-term medications for that. She is on lots of nutritional supplements. Despite all of this, she is having fever spikes every other day. 

For now, the right medications, the right minerals and quality nutrition have reversed the kwashiorkor. She has gained 1/2 a pound this week, but this baby has a long road ahead of her. The baby's paediatrician and I are working in the dark, feeling our way forward, guessing at the facts, and experimenting with different approaches to the illnesses and conditions that afflict this little one. The lab results we need urgently, labs that will guide other diagnostic tests and treatments take 2-3 weeks to be processed.  Governmental and non-governmental agencies do fund HIV programmes, but usually, not for babies. The thinking in this resource-limited climate is that a child isn't proven to be HIV positive until they are at least 18 months old. 

I am praying that my little girl will survive until she is 18 months old, but that is not a given. 

I am endlessly frustrated, ever aware that the best I can give her is so much less than what she deserves. I can hold her dry, burning body, and coax her over and over to drink an enriched formula, or to have just one more spoon of medical peanut butter.In the back of my mind as I do that, I know there is no Pediasure left, and the high protein formula I do have will last maybe another two weeks, if I ration it. I will have to be creative with nutrition. 

She sees me come through the door and starts yelling to be picked up. She wants a Mummy. I can love her and I give her extra attention, but her birth mother chose adoption for her. Honestly, for this baby, a life in a loving family, in a country with a developed health care system is her best chance of living and thriving. I wish it didn't take so long to unite these children with their forever families. Orphanages, even good ones do not hold a candle to a loving family. 

This weekend, I heard rumblings. A roll of thunder in the distance. A rumour of political things that are happening, that might have a significant, and negative impact on Haitian adoptions. I am anxious about what this might mean for my baby girl, and for others like her. 

I love you, angel. I pray that my loving you will strengthen both of us. That loving will embolden everyone who fights the corner of the Father's forgotten children in Haiti. That loving will imbue the key decission-makers with godly wisdom, and with mercy.

Amen

Marked as HIS

This is Miss Susan,' the Haitian lady said, introducing me, for the second time, to a tall, Haitian toddler, whose eyes were bright with fever. 'She is your other Mummy', the lady continued, 'She and Mme John had an utterly miserable time with you when you were a baby!'

The small boy listened quietly, barely blinking as his mother talked, and I laughed, not because she was joking or exaggerating, but because she was telling the truth, and because of the truth she hadn't told.

Jonathon came to us in the spring of 2009. Born over 2 months before his due date, he was several days old and had not received any medical care. Jonathon was icy cold and desperately dehydrated. Had it not been for some exceptional nursing skills, he would have been dead within minutes.

Over the days that followed, Jonathon's condition became more critical. He was resuscitated for over two hours one morning. Unable to revive him, we withdrew treatment so that I could hold Jonathon in his last minutes. Miraculously, he did not die!

I laughed as Jonathon's mother talked, because we did have a truly miserable time with Jonathon. Yet here he was, a big strong boy, ready to start pre-school in a few months. The struggle we experienced then made the sharpened the joy today; Jonathon had survived seemingly impossible challenges as a premature baby. 

We learnt that after he was discharged from our NICU, Jonathon had suffered life threatening croup on a visit to a town in the North of Haiti. He had required surgical intervention and had 'died' on the operating table.  Four times, we counted. Four times in less than 3 years, he had died and risen again.  I was soaring now. My baby was back, and he was T.H.R.I.V.I.N.G. I knew God's hand was on him. I experienced a surge of anticipation. I might never know God's plan for this child's life, but I knew Jonathon was marked as his.