He Knew Just How To Make It Better.....

Miss Bernadette and I went up to the toddler house today, to vaccinate the older GLA children. Twenty five of our kids were inoculated against preventable, and potentially fatal diseases. Due to the high cost of the vaccines, few orphanages in Haiti run vaccination programmes. At God's Littlest Angels, though, we are able to meet the costs of these vaccines, and we are glad; currently, there are epidemics of measles and Diphtheria in Haiti and there have been reports of deaths among unvaccinated children who have contracted Diphtheria in Port-au-Prince.

Of course, it is unlikely that the twenty five children we vaccinated today could have been convinced that the needle sticks they endured were actually a blessing! That being said, they did very well. It really is asking a lot to expect anyone to endure pain when they can't understand the reason or the purpose of it.

The little boy below, had an especially rough day. He received two vaccines today. Then, after a nasty fall in the yard, he split his head open and had to come to the main house for sutures. It was all a little bit too much!

We did our best to make up for the trauma of the day the only way we could - with sweet treats, hugs, and lots of re-assurances that to Laurore that he really was a brave boy.

Later, Laurore was on the NICU balcony enjoying some particularly tasty German bon bon (biscuits). On the balcony, he met our newest arrival, a malnourished infant named Djovensky. This baby is sick, malnourished and quite fretful. Laurore was exceptionally still and almost expressionless as he watched the whimpering, squirming infant. I explained that Djovensky wasn't feeling well, and we we going to try to make him better.

Entirely without prompting, Laurore extended his hand, and held one of his bon bon's out to the crying infant. To my surprise, Djovensky became quiet and grasped the biscuit in his hand. Apparently, Laurore understood that the baby's misery, he wanted to ease it, and he did, even though it meant giving up a piece of his own consolation.

I hate seeing these kids hurt, and yet, I suppose that without suffering, there would be no basis for empathy, and neither reason or motivation to reach out in compassion to another. Wouldn't that be a loss to the spectrum of emotions that colour our lives and our souls?

Nèg Fè Lide'l Jan Bondye Ba'l Dwa

Man Makes Plans As God Allows

It was the first day that Melissa and I had been left to hold the fort at GLA. The rest of the foreign staff had left for Europe the day before. I had nursed a bad headache and had been struggling with waves of nausea for two days.

My humour was cynical at best. The night before, I had told Vivianne, a long term employee of GLA that I was sure I was feeling unwell because I was heart-sick. Melanie, my room-mate had left for good two weeks before. Dixie Bickel had left with her, and now Laurie was gone. The foreign staff would be out of the country for 3 weeks. To top in all off, Mme Bernard, the head Haitian nurse had chosen this week to take her leave. I was definitely feeling abandoned.

The Haitian staff know my humour well enough to understand that there was an element of truth in that. Vivianne, crooned that she and Magaly (the Haitian administrator) would never abandon me at a time like this. She went on to ask whether ice-cream might make me feel better? I felt myself brighten at the suggestion. Ice-cream. Yes, just the perfect treatment for a migraine. And anyway, I was going to have myself a drama-free month. Yes, Susan, great plans, I said, patting myself on the back. Lay back and relax and enjoy ice-cream. Great plans!

Well, as fate would have it, I was feeling too unwell for ice-cream that night. The next day, Wednesday, I made my way to the freezer in the Kitchen. It was just before 9pm, too late for ice-cream really, but it didn't matter. I had planned for ice-cream, and I was having it.

The ice-cream was too solid to scoop into a bowl. I let it thaw. I would not be put off. As I was spooning the vanilla iced treat, James came into the kitchen, cell-phone in hand, wearing a concerned expression. Melissa had called from the toddler house. One of the neighbourhood boys was there. He was badly hurt and he, James, was going to collect the boy and bring him here.

As he turned and walked out, I wondered what kind of badly hurt would be arriving....A car accident? A head injury? I sincerely hoped not. A broken bone? Heaven forbid it would be protruding through the skin, with the ends grating against one-another! Why did these things always happen when Dixie Bickel was out of the country? The last time she left, Vivianne and Dixie's son, Steve, collided with a sliding glass door and needed dozens of sutures. Would I be dealing with a laceration tonight?

I am not a trauma nurse and God's Littlest Angels is not set up to deal with casualties. Yet the fact is that we are sometimes the closest and only accessible source of medical care for our poorer neighbours. A mother flies into a rage, and brings a plate down hard on her 12-year- old's head. We will clean the stunned child up, remove the splinters, and suture the wound. An 18 year old is beaten by his uncle. We will patch him up. Dixie's son asks us to see his friend's two year old brother. The child is sick with gastroenteritis. We will assess the toddler, give Oral Rehydration solution slowly, and observe the little one for a few hours to make sure that he will keep it down.

Badly hurt arrives through the door. He is tall, thin, maybe 17 years old. He has a name - it is Ashley - and his eyes are glazed over with shock. When I ask where he is hurt, he turns around to reveal a blood soaked t-shirt. Lifting it up, he tells me in a very quiet voice that he and his friends were playing. It seems that a play fight turned nasty. Ashley has been slashed on his lower back with a broken bottle. The laceration is almost 10 centimetres long and over two centimetres wide. He needs a surgeon. Thankfully, there is a team of visiting surgeons at the Baptist Mission Hospital in Fermathe.

Clean the wound, put on a temporary dressing, give a tetanus shot (tetanus is endemic in Haiti and there is currently a vaccine shortage at many hospitals). Send Ashley to Fermathe, take care of the dressing changes afterwards, and pray for Ashley and his fractured relationship with the probably now ex-friend.

I was concerned that there would be repercussions. That Ashley's family would seriously harm the slasher, that they would insist that he be put in prison. Both of these boys are well-known to the staff at God's Littlest Angels and I really hoped that the flames of anger could be quenched that night.

I am glad to serve a good God, who hears my pleas, and honours them, orchestrating the details so carefully and competently. Up to this day, there have been no serious repercussions.

As for me, I am no longer praying against drama, because in asking for that, what I am really saying is don't send your worst cases here. Instead, I am requesting that God give me the wisdom and the grace to deal with any situations that might arise. God knows what is to come, and should a sick baby or an injured child be out there and in need of our care, we want to be the Lord's hands to them.

P.S I had my ice-cream that night!!!!

Result

Peterson came to us last month. At 6 months old and weighing 8.5lb, he was very malnourished. His 17 year old mother didn't seem to understand the basics of child care. Giggling, she told us that she was still a child herself, and that she couldn't be expected to take care of a baby.

We knew that Judith would need a considerable amount of nurturing, training and education, to enable her to look after Peterson at home, and so we set to work. We had no idea of the scale of the challenge that faced us.

Peterson was difficult to feed. He had a weak suck, and a poor appetite and he did not spoon feed well at all. With lots of time and patience, we nurses were able to get Peterson to take enough milk to stay hydrated and encourage weight-gain. We persevered.

Two weeks ago, this sickly infant developed pneumonia. He was started on antibiotics and recovered well, until last Friday, when he began coughing and crying, turned blue, lost consciousness, became floppy and stopped breathing.

It was after 9pm at night and I was upstairs, with the only staff member who was on duty. To my consternation,  Nurse Roselin,  ran in the opposite direction from the resuscitation supplies, when I asked for help leaving me alone in the intensive care  nursery.  I had no choice but to begin mouth-to-mouth. Within seconds, Peterson gasped and began moving. In less than a minute, he was breathing regularly by himself. There are no words to explain the relief I felt when he began wailing and clasping my scrub top, pulling himself up onto my shoulder to be comforted and consoled!

A few days later, Peterson began spiking fevers. His blood pressure shot up and his fontanel bulged. He refused to suck and was unable to swallow. We suspected meningitis and began treating the baby with IV antibiotics and steroids. Although he responded to these drugs. He still would not feed. At this point, his mother told us that Peterson had always fed poorly. I was concerned to hear this. More concerning still, Judith disclosed to the orphanage Paediatrician that had been giving Peterson high doses of an appetite stimulant that is available over the counter in Haiti. I looked at the baby's bulging eyes, and wondered what affects this drug might have had on his developing brain.

As the days went by, and feeding Peterson became more difficult, I worried that this baby might have some brain damage. He cried whenever we tried to feed him with a nipple. He didn't like any of them. I could only get him to drink milk by drop feeding it to him, then stimulating him to swallow. That took several hours a day. I could not get him to feed from a spoon. He would only accept incredibly thick porridge, and then, only if I fed them to him on my finger. Throughout the feeding process, this wide-eyes baby would whimper, and shake his head from side to side. Feeding him was thoroughly exhausting, not to mention discouraging.

Eventually, although the orphanage Director was opposed to the use of feeding tubes, we placed a nasogastric tube to enable Peterson to get the nutrition he so desperately needed. His body was and still is deficient in essential immune supporting nutrients and if he is going to recover from his illness, gain weight and become stronger, he will need optimal nutrition.

Eventually, after a lot of experimenting, and a lot of discussion with his mother, Peterson has had a few key breakthroughs: I learned that Peterson will eat food that is laced with cinnamon and sugar. I also found a 'scoop' inset that fits into babies feeding bottles. Milk trickles through this slowly. Although it still takes a long time to feed Peterson this way, he is calm and doesn't struggle. As I commented on Friday afternoon that the baby no longer seemed stressed when he was feeding, there was a burst of laughter from his mother. She told our horrified staff that when Peterson refused to eat for her, she would slap him hard on his thigh!

Judith is young, and we know that this behaviour comes from ignorance. Peterson is an exceptionally quiet, watchful infant. Now we know why this wide-eyed baby is afraid. We are working hard to impress upon Judith that it is is unacceptable, and counterproductive for her to hit him. This morning, as the Haitian staff patiently explained that a 7 month old was too little to understand and respond to punishment, Judith laughed, and told them that she didn't like her son. He closed his mouth whenever she tried to feed him, she said. He knew what he was doing and so she would continue to slap him!

She is young, I reminded myself. Young and immature,  so I swallowed my anger, and calmly told her that her infant was frightened and stressed. I pointed out that he didn't smile. I told her that unhappy babies often did not eat, in just the way that depressed adults sometimes lost their appetites. For the first time, I told her that what she was doing amounted to child abuse. Judith stopped laughing, and looked at me solemnly as I went on to tell her how we were going to try to resolve this situation:

She would nurse her son, because he likes being nursed. We would supplement his intake with high calorie milk, porridge and enriched peanut butter. At night, Peterson would receive tube feeds to get his weight up, since he needs to eat round the clock, but hates being wakened to be fed. Feeding is no longer to be a battle ground. We will do everything we can to make feeding time a happy time, and in-between times, Judith will be encouraged to hold her son, snuggle with him, sing to him, and play with him. I can only hope that she co-operates with us, and that Peterson responds to gentle loving care.

Note: For the benefit of the medically trained people who are reading this, I do know that performing mouth-to-mouth on a child with meningitis calls for preventative antibiotics and I did treat myself!

A Special Kind of Hug

As baby Peterson snuggled into me during our church service yesterday, melting, I exhaled. It is a little known secret that despite appearances, I really do enjoy hugs.

Earlier in the week, I had one of my toddler boys in the NICU. He is a great hugger, and I wanted one of his hugs that day. 'Give me a...' I began, hesitating for the word in Kreyol, and although my arms were open, and the invitation was clear, my uncertainty caught the little man off guard. He looked at me quizzically.

'What is the word I need?' I asked the ladies. 'A-k-o-l-a-d,' Mme Bernard replied.
'Akolad?' I was surprised. In English, An accolade is a very formal kind of hug, and I didn't want a formal hug, I wanted a soft, snugly one, or a bear hug,

Vivianne came into the NICU at just that moment. Miming, I asked whether accolade really was the word they used in Kreyol to describe a hug. 'Oh, yes', she told me, with enough warmth in her tone to convince me that an akolad was a hug.

Well, I thought to myself, I suppose an accolade, in English, confers recognition, and if, in Kreyol, there is affection in it, then akolad is a special kind of soul-hug and I did want one. Confidently, I asked my young friend for an akolad. It was warmly given and gladly received.

Yes, I really do enjoy hugs. I don't publicize that too much though. Afterall, I wouldn't want an akolad from just anyone......

A Mixed Blessing

"Your Question presumes that poison is bad; that such creations have no purpose. Many of the so-called bad plants, like this one, contain incredible properties for healing, or are necessary for some of the most magnificent wonders when combined with something else" ( From The Shack, William Paul Young).

As Christians, we are taught that our God is good, and that he is forever working through our most difficult and painful life events. If we truly grasp his goodness, then although we cannot understand what he is doing, we trust in him. Yet sometimes, it is hard, so hard, to swallow the truth of God's goodness.

2010 has been a year in which those of us working at GLA have been witness to suffering on a scale we never could have imagined. Out of this devastation, God has worked miracles for dozens of children in our care, who, overnight, were able to join permanent families overseas. Some of these children were extremely sick and might not have survived much longer in Haiti. Our Lord used the brokenness of an entire nation to do something wonderful in their lives.

Several weeks into the year, he has done has again done just this for one of my new babies. She is almost three months old and her name is Abigaelle. She was two months old and she weighed less than 3.5lb when she arrived around a month ago. This precious baby had almost starved to death in hospital. In the aftermath of the earthquake, her mother had not been unable to find a hospital in which to deliver her infant. Abigaelle was born on the roadside and her mother died shortly afterwards.

Abigaelle was admitted to General hospital several weeks after her birth. She was severely malnourished and her impoverished family were advised that she needed formula milk, and that the hospital could not provide this. The hospital started Abigaelle on intravenous fluids. Her Father watched over her, growing ever more concerned as his tiny daughter grew thinner and thinner.

At the same time, in another city hospital, baby Jonathon, another orphaned infant, was also starving to death. His family could not afford formula milk and as his condition deteriorated, Jonathon's Pediatrician appealed to a US human milk bank. A shipment of US donor breast milk was sent to Les Cayes, but it arrived to late for Baby Jonathon. Dixie Bickel received a call from the hospital. They had several liters of pasteurized breast milk. Could we use it?

Meanwhile, Abigaelle, frail though she was, was clinging onto life, had been released from hospital and delivered into our care. She was suffering from diarrhoea, and she had what we later learned was an abscess on her neck. Although she initially thrived, she developed a parasitic gut infection last week, that caused profuse watery diarrhoea.

Abigaelle was on an IV for four days. As she recovers, she is being fed on the donor breast milk that was intended for baby Jonathon. She is healing now, just as Luc and Beni and Kerline were healed by this wonderful milk.

And so it becomes clear that through one family's terrible loss, four sick infants have been been restored to health. This is God at work. I ache for Jonathon and for his grieving father, and I am beside myself knowing that many other orphaned babies in Haiti will face the same fate that Jonathon faced. It is wrong, wrong, wrong that he died! Although such a death can never be justified, I believed that it has been redeemed.

Yes, at GLA, through our great sorrow, we see our God at work. Please continue to pray for our staff and the children, and for the people of Haiti during these extraordinary days.