Thursday, May 28

Last Wednesday afternoon, the prenatal nurse, Lori and I sat down with a 15 yo girl who was in for a visit. She had been seen several months ago for her pregnancy and for several reasons, including her age was identified as high risk and encouraged to come back with a family member so the nurse could work with them during pregnancy. The area we are in is very rural and the closest hospital is about an hour away. They wanted this young mama to be to establish care with the hospital so when it came time to deliver she would be accepted and have a chance at a safe and healthy delivery.

The young girl disappeared for awhile and had not been coming for care. The staff here spent quite some time trying to find a neighbor or family member who might know how to find her. They finally got ahold of an aunt and the young girl came back last week for a visit, by herself. When we sat and talked with her, we stressed the importance of coming for care and wanted to know who was responsible for her and who would be supporting her during the birth and after the baby came. We told her we loved her and wanted to do what we could to help her, but that every woman needs a support system. In her immaturity, she was unable to give us much helpful information but ensured that she would come back the next week with an adult.

This Tuesday afternoon, clinic was running normally when the gatekeeper yelled to Lori that there was a pregnant woman coming in who was not good. I ran out in the yard to find a several people carrying a pregnant woman who was not responsive. The laid her on the ground and I took a quick glance between her legs to make sure there was not a baby coming. I could tell she was not well and they were yelling that they brought her in because she kept passing out. We all went into emergency mode and got her into the dressing room. I checked her and established that she was definitely in labor but not close to having a baby. As we were attempting to get a blood pressure, she started seizing. After stopping and taking a closer look, I realized that this girl looked very young. At that point the prenatal nurse came in and we realized that the patient was in fact the young girl we had seen last week. Thankfully we were able to get and IV and some oxygen while drawing up some magnesium sulfate to treat the eclampsia. Her blood pressure was severely elevated and thankfully we had some IV medication we could give for that.

After she was stabilized, we started to come up with a plan. We would need to transfer her to a hospital that is about an hour away to be delivered urgently. Everyone started mobilizing but no one could find a car in the village who could take her in. Lori called the governmental ambulance service but they informed us that the one ambulance for this area was taking someone into Port au Prince and would likely not be available for a couple hours. They asked if we could wait until then. Ha. Thankfully someone was able to take a motorcycle to the next town in and find a car to come out and get her. It was about 30 minutes before a car was able to come for her. Thankfully in that time she did not have any more seizures and I was able to get good heart tones on her baby. We worried about the car trip in, but did what we could and made an IV bag of medication that could be given while they were riding. We wrote a referral letter with her chart information hoping that the hospital would receive her and urgently get her delivered. We saw them off in the back of a truck and hoped and prayed God would protect this baby and mama until they could get care, but honestly we would be surprised if either one of them would come home alive.

What most of you don't understand is that eclampsia is a sever life threatening emergency of pregnancy for both mom and baby. If this incident took place in the US, we would have been back in an operating room and the baby would have been delivered by c-section in 5 minutes.

Yesterday, we did not hear anything from the family about what happened, and we assumed the worst.

This morning, the prenatal nurse had heard through the grapevine that mother was indeed alive and the baby was alive but in an incubator. We were shocked and thoroughly surprised. I had gone upstairs for lunch and when I came down to the office this afternoon everyone was quiet and said we have a surprise for you. I looked in Licia's arms and realized she had a baby in her arms. A big, healthy baby boy.

Here is what we know about what happened between Tuesday afternoon and today. Mom and baby made it to the hospital one hour away where they were told that she was too sick and they needed to go into the government maternity hospital in Port to be delivered. The extended family member who brought the baby said that mom had a vaginal delivery, and by the baby's bracelet we realized it's time of birth was 7:10 on Wednesday morning. Mom is still in the hospital but the "machines" for the baby broke today so he was discharged and told to go back to the clinic that helped them before.

Y'ALL. This is nothing short of a miracle that both mom and baby are alive today. The chart said the baby had meconium aspiration and antibiotics had been ordered. He looks great for us and we will keep him here until mom is discharged and we can make sure they are both safe to go home. I don't pretend to understand the broken healthcare system here in Haiti and why the delivery was so delayed. This is why maternal health matters so much in this country. It's overwhelming to think that this is just one story of thousands of mamas who will deliver in Haiti this year.

For the moment we are rejoicing in His goodness and soaking up all the snuggles with precious Samuel.

Wednesday, May 27

Last Sunday afternoon Lori, Licia and I were sitting in the office chatting when the gatekeeper told us there was a sick child outside the gate. Sunday is not a normal clinic day, but the doors at Real Hope for Haiti are always open for urgent care. When Lori and Licia went to the gate, they found a small group of people on their knees praying for a very fragile baby. They took one look at the baby who was pale and breathless and ran back with it to the dressing room and yelled to me to come, "the baby is almost dead." We immediately starting working to get an IV, raise his glucose and put him on oxygen. He had to be stimulated just to breathe every 5 seconds. The baby's mother sat outside the door praying and terrified that her baby was dead. None of us would have believed that 11 days later he is still with us.

Over the next couple hours we sat close, helping him to breathe and learned more about their story. Mom had been to church Sunday morning and some people at her church saw how ill her child was and had heard of a clinic in Cazale that helps sick children. Jolicoeur was born in late January at full term, but has always been small. Mom breastfed religiously but says he has never grown and began to have swelling just a few weeks after he was born. In the week before they came to us, the baby became very sick and stopped taking breastmilk and Mom knew it was time to get help. She spent several days going around to different pediatric hospitals in Haiti, only to be turned away because there were no beds. On his first day with us he weighed 4.1 pounds at almost 4 months old. He was severely dehydrated but his hands and feet were shiny due to serious swelling from malnutrition. He was obviously extremely anemic and has a severe heart murmor. Since that day, he has been stable with oxygen on and continues to breastfeed with supplements through an NG tube. His glucose and fluid balance is constantly monitored and he is up to 4.8 lbs with a decrease in swelling. We are hoping we can continue to get him well so we can send him in for a referral in the coming weeks. 

His mama has stayed very close by his side since the moment they came. She is steadfast and loyal and loves this baby boy so well. We have enjoyed getting to know her and hear more of her story. She is a single mother to 4 other children, her oldest is 16 and the youngest is 2 1/2. They live in a small house in a part of Port au Prince called Canaan. This area was originally a tent city after the Earthquake in 2010 but more permanent houses have been built there now. Since she has been here with Jolicoeur, her 16 year old has been taking care of the other children. On Monday afternoon she called her family and heard that the wind from the storms had blown the tin off the roof of their house and her kids were having to stay with neighbors. She was very upset by this and had to leave Tuesday for the day to go in and check on them. They are all in school at this time so it is important for them to stay there, but she obviously feels the pull of needing to be here with Jolicoeur, as the breastfeeding is crucial if he is going to have any chance of surviving. We have no idea how long they will need to be with us.

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I am so amazed by this mother's sacrifice and her fight to do what she can to care for her kids. I would love to be able to bless her with the funds to repair her roof and make sure her other children have a safe place to stay in while she is away. We are in need of $300 for the materials, labor and transportation to cover this for her. I'd love for you to pray for this family and if you are in a position to give money, I know this mama will be overjoyed. 

You can click this link below and give via Paypal to Real Hope for Haiti and your donation will automatically go toward this need specifically.

Monday, May 25

Little ones to Him Belong

It's late and a rainy breeze is blowing through the open air windows and I can't fall asleep.

There is a line of people sleeping outside the gate who are waiting to be seen in clinic tomorrow, hopeful for healing.

And there is the body of sweet baby girl, bathed and dressed in a white dress who took her last struggling breaths in my arms tonight as I rocked her and sang to her about the hope I have in Jesus.

I get to share in lots of joys when I am in Haiti. I love this country, the vibrant people, the colors and the smells.  There are births and beautiful babies and recovering children and wounds healing and I get to use skills that are long lost at home. I love the adventure, the challenges, and my dear friends who live here full time and the wisdom and grace that just oozes out of their lives into mine. I love how being in this country makes me brave. The joys are some of the highest I have ever experienced on earth. But these joys come with unbearable loads of heartache. Life in this country is complicated. It is twisted and backwards and unfair and maddening and it begs me down to a place that I don't often go where a deep groaning in cries for His redemption.

Baby girl came to us late Thursday afternoon with her young mother after being referred by someone who recognized the gravity of her condition. She was 7 months old and wasting away, severely dehydrated and struggling to breathe. We immediately got to working on her, and Licia with years of wisdom took one look at this child with her mouth full of thrush (a fungal infection) and said "We need to get an HIV test." Two solid lines, clear as day. Our hearts sank and we immediately started thinking about her mother, who was 20 years young, bright and healthy, and hopeful for her only child to be rescued. The staff gently pulled her aside and counseled her, she was unaware of any existing infection and stated she had been breastfeeding her baby since she was born last fall. Two solid lines, clear as day. I would like to say "as you can imagine" but I'm not sure you or I actually can imagine. She was devastated and hysterical and confused and frightened and alone in a strange place with her dying child. She wanted to leave with her baby immediately, she just could not begin to process all that was going on and she certainly could not be dying herself of HIV. The staff was kind and gentle and respected her privacy but explained to her that her baby would likely not make the trip home and if she wanted, we would do what we could to save her. She could stay or she could go and come back at any point, but we wanted to give her baby girl a chance. She agreed to leave her baby and got a phone number where she could reach us. We stabilized baby girl but it was very clear to us all that she was still dying. We prayed for minimal suffering, but also hoped for some peace and reconciliation for mom. She would go home that night and talk with Dad. The next day called several times throughout the day to check on baby. We reported that she was stable and hoped they would come to visit. She and the young father came on Saturday morning and spent a few minutes with the baby, but did not touch her or talk to her, they just watched. I imagine they were and still are grieving how their lives' took a most devastating turn in a matter of seconds on that Thursday afternoon. We have not heard from them since they left. Baby girl struggled over the weekend and it was clear this morning when she started having seizures that the end was close. We did our best to keep her comfortable today and as it neared tonight, I held her and rocked her just hoping she sensed that someone was near. She was fighting hard for air for what seemed like eternity and then finally she was still. No more struggle, no more pain. Her little body that has only known disease in her short time here is finally whole.

Last week I caught a baby who was born severely premature and had a difficult entry into this world. We worked to resuscitate him and got him stabilized without the luxuries of NICU full of equipment and staff. It was exhilarating and miraculous and we were so grateful for this little life God gave us. Baby was doing okay and for many complicated reasons we decided the best thing for baby was to go home with mom and dad who were equipped with all the tools we could give them to care for him. A few days later, baby Wesley died at home with his family in the rural mountains of Haiti.

Complicated, twisted, backwards, unfair and maddening.

The paradox of the joys and heartaches I experience in Haiti is where life is born for me. I love God and sense his unmatched graces in the most real way. I know Him deeper and want to taste every bit of beauty and joy this earth has to offer because He is so good and He is so near to us. And yet, I long for heaven and His ultimate and eternal healing because this world is broken. His beautiful creation and the people He made in His image are groaning for new life, a whole life, apart from this brokenness. He promises us that and all those promises are made true in His son Jesus.

Little ones to Him belong, this is my only hope.