The trade winds blow the mint-colored curtains making them dance in the sunlight over the bassinet. I wonder if Tata Islande will remember that image somewhere deep in his subconscious. It’s been five minutes, sitting in the plastic blue chair next to his bed. In the isolation gown given to me to protect the babies from germs, I sweat profusely. It feels like time is altered, or maybe stopped. He hears my voice, his sweet face contorts into raised eyebrows, his neck arches backwards and to the side, his dry lips suckling a missed hand over and over.
Baby Islande is 1.44 kilograms and is not 32 weeks gestational age. He should be born 8 weeks from today, but he has already been alive for five weeks. Statistically, at 32 weeks, he should have at least a few medical issues: infection, brain hemorrhage, a hole in his heart, problems maintaining his body temperature. This is truly beyond all odds, even if he was born in a first world country! This baby, born at 27 weeks in the jungle, is a miracle indeed.
I arrived in Haiti just yesterday, jumping right into the operating room with the rest of the medical team, My four children are still in my mind, waving good-bye as I pulled out of my California driveway. My oldest is almost six years old, my youngest just turned six months old. After a few hours in the Haitian operating room, I take ten minutes to express my breastmilk, to keep up my supply, and I find I quickly fill six ounces.
The team completes another surgery and then I head out into the wards to find a baby or a child who use my high-calorie milk. Walking into a room full of inpatients, I see than any child here would benefit, from a 3 month old baby to a 5 year old child. The emaciation is striking to me, to the children it goes unnoticed as part of everyday life. As I speak to the unit nurse, through translation by our mission leader, named Caren, a mother sees the milk and her eyes widen. We ask the nurse if it would be ok to give it to her toddler. Mother and child are so grateful for this gift of what the baby so desperately needs, food.
Four hours later, I pump another six ounces and again return to that same mother and toddler. They were gone. The nurse, too, had left for the night. Lacking a translator, I am not able to communicate effectively with this new nurse. I walk to the next room, called the “abandoned babies room,” a misnomer really as there are children from 2 months old to eight years old. I bring someone to translate, but this time the nurse refuses the milk. I now need to find a refrigerator to store the milk while I figure this out. Caren and a hospital assist jim me in the hospital-wide search for somewhere to see this milk cool. In Haiti, a refrigerator is a luxury, even in a children’s hospital.
One of our stops is to the lab, where immediately upon entering, we find a deep freezer and become very excited The lab technician opens the lid, a few words are exchanged between the lan technician and the hospital assistant, and a frown appears on the assistant’s face. The answer, again, is no. No explanation is given. Pumped breastmilk is only safe to dink for about six hours at room temperature. I imagine in the Haitian heat, we only have about four hours, and 3.5 hours have already elapsed.
We walk up to the second floor of the hospital to the neonatology room, The babies who survive the interstice care room transfer to this room to stabilize before being released home. Upon entering, a cheerful nurse named Lyndsay greets us with a beaming smile and “Bon jour!” This is such a stark contrast to the surrounding pain and suffering we are witnessing. The hospital assistant pleads our case, and after a few moments, Lyndsay says, “Of course!” and shows us to their refrigerator.
I place the milk in the lower compartment and utter about a half dozen “Merci”s. Caren and I look down and meet eyes with the most amazing little creature I had ever seen, He eagerly sucks down watered-down formula from a syringe with every force of life he has in his little body. I speak softly to this baby. He slowly turns his gaze to me and focuses on my eyes. “This baby knows a momma when he sees one,” I mutter in awe.
The nurse tells us baby Islande never cries, only fusses when he is hungry. She says he is doing really well and will likely survive, at least until he is sent to the orphanage on the other side of the island. Then it’s up to him. She tells us how he was brought to the hospital by his father just after he was born, his momma died in childhood. While the paperwork was being filled out, the father slipped away and never returned. Baby Islande needed only a short-term IV and a few hours of oxygen. I ask the nurse that the milk be used for him and the nurse agrees.
I returned four hours later to deliver another six ounces of milk. I put it in the refrigerator and notice the first bag was still there. From the apologetic look on Lindsay’s face, i realize there never was a plan to feed the baby that milk. My guess was, like a Jehovah’s witness, once a body fluid loses the connection with the body it came from, it loses what makes it alive and becomes a sort of poison upon entering another person, if is was allowed to stagnate in the interim.
I pick up Islande and pull up a blue plastic chair that has been sitting at the nurse’s station. We sit down and I stare at his sweet face. The nurse knows that I have been nursing my own baby back in the states and she also knows what I am thinking. She looks at me and slightly closes her eyes and nods “Yes.” I raise the baby up to my breast and pray that his instincts are intact enough to remember how to nurse. It takes him all of 20 seconds to figure out the logistics and to coordinate his mouth and tongue. He is an instant professional. After about twenty minutes, Islande passes out in a milk-drunk slumber.
Every 4-5 hours, I run up to the neonatal room. Quickly I fall into a routine of washing my hands outside the room using a port-a-john water pump and soap. I enter the room and grab a blue plastic chair from the nurse’s station. I bring the chair to the baby’s bedside and untie the mint green bag attached to the bassinet that holds my isolation gown. As I slip it over my shoulders, I peer down at this sleeping wonder. How strong he has been and what a road still lies in front of him. I speak softly to Islande, watching his sweet face start coming back to consciousness at the sound of my voice. I pick him up and hold his little body next to mine so he can hear my heartbeat and I sing the lullabies my own children have heard thousands of times. He has quickly learned to trust the source of food and warmth and eats more slowly than he did before. When he finishes, he melts into my arms, give a peaceful, contented sigh, and drifts back into a deep slumber.
I don’t know how long I sit there. My guess is sometime for a few minutes before rushing back to the operatory; sometimes I get to stay for a few hours. Either way, as I sit there, I am lulled into a dreamy state, hearing Creole being spoken, but it never quite reaches my ears through the dense, hot air. On more than one occasion, I have fallen into sleep, and was transported to this life right here, with my sense of life back home slowly slipping away. I have images of bringing this baby into our family, imagining him growing and playing with his new brothers and sister. In this dream, he is happy, he is love.
As I bring my focus to my surroundings, I notice the mint green curtains are made from the same fabric as Islande’s bassinet as well as the isolation gown bag. I imagine these were sheets left behind by a previous volunteer who visited Haiti. Great care and precision were placed into making these articles. Every stitch is perfect; the seams are flawless. These I know were made right here, possibly at Father Risk’s trade school in the orphanage, possible by the matron in the hospital cafe. The matron’s sewing is just as impeccable – she crafts beautiful little dresses from pillow cases and adorns them with a few sparkly beads.
I notice the contrast of a few very high-tech pieces of medical equipment and the lack of other basics. There is a plastic and metal boom that allows for attachment of neonatal resuscitation denies like suction, oxygen and air, The only things attached are bassinets. The chairs next to the bassinets are beautiful high-end leather tangerine-colored dual recliners from Italy. The women sitting in them do not notice, or maybe do not care, about these chairs and their “value”, only that they allow place of respite near the baby, away from the harsh world outside the hospital gates. At the moment, I realize Island never had a tangerine recliner at his bedside, not even a chair. But today as i walked in, someone, likely Lindsay, had a blue chair awaiting my arrival next to his bassinet. Lindsay smiled when I entered saying, “Bon Jour, Momma! Your baby has been waiting for you.”
Islande’s fate is beyond anyone’s control, even that of an American doctor. He is from a strong country, and has an amazingly strong body. His chances are better than most. As they say in Haiti, “Bom ba guy” or, “Everything’s OK.”