Sunday, October 30, 2011

Cholera Broke My Heart

I have no words for what happened this heart broke. It broke into so many tiny little pieces that it is almost impossible to repair....

Where do I even start? 

Saturday morning was like any other morning here at the orphanage. Children were playing. Babies were crying. I was busy checking if everything was functioning alright at the orphanage. I went into the babies' room to play with little Precious* (the 4 year old little girl who is developmentally delayed and is in therapy of learning how to walk) like I always do. We played and laughed and I massaged her legs. She gave me the biggest hugs and kisses ever. She is a real sweetheart. I stayed in the babies room for about an hour or so and then I went to check the other rooms. I ate my lunch and then proceeded to the office to work on my reports for the children. At around 3pm, a nanny runs frantically to the office and says "Lori, come quick, we need you!" I ran over to the babies room, not knowing what I am running for? I was thinking that maybe they ran out of supplies again and need me to go get more in the depot for them or that a nanny didn't show up for work, so they needed my help to change the babies. As I got closer and closer to the babies room, something was not right. People were crowding in the incubation room and there were chatters all about. I got into the room and I see little Precious* laying on her back on the table with an oxygen tank hooked up. Her eyes and mouth wide open. 

She wasn't breathing.....

I immediately asked what happened? I started to give her CPR and yelled for someone to call for a driver to take her to the hospital. We didn't have the mouth pieces in stock so I could not give her mouth to mouth. Her jaw was locked and we did not have the equipment to put a breathing tube in her. I grabbed her and ran for the  front entrance. Of course, our driver was still in town, so no one was here to take us to the hospital. 

*There is no such thing as calling for an ambulance here in Haiti. The roads are in bad condition, there are no real addresses for people to identify, no one can afford it, and most of all, by the time they do get to you, you might as well driven yourself to the hospital in the first place to save time. It is always getting a Tap-Tap or use your own private vehicle to transport someone to the hospital. 

We finally got a hold of the president of the foundation and she came rushing to our aid. We all ran for the truck, two caretakers and myself. I held little Precious* in my arms and we sped out of the orphanage. The route to the hospital is a very long one. I was hoping that traffic today would be better, but of course it is not. It is just like any other day. Traffic everywhere and barely moving. We were all anxious because we had a dying child in the car. We saw some police officers go by on a motorcycle and we stopped them. We asked for their help to clear the roads for us. They were kind enough to do so. So we followed them into the  pileup of traffic on the main road. We were very lucky, because there just happened to be another police car right behind us. So there we were, weaving through traffic like a snake. There is absolutely no order in the Haitian traffic. No one follows the rules. If there is an opening, you take it! It doesn't matter if that opening is on the side of the road, on the sidewalk, or in the opposite direction. You take every chance you get! So what normally would take about 45 minutes to get through, we got through in about 15 minutes, thanks to the police officers. The police could only take us so far before we found ourselves in another traffic jam. At least we got through the worst part of it, I was very thankful for their help. Every minute that passed by I am getting more worried for little Precious*. I continued to give CPR but there was no response. Needless to say, it took us about an hour and a half to get to the hospital.

I ran with little Precious* in my arms to the hospital. No doctors were to be found. We finally found a nurse and she just took her time and looked at us like, "What are you doing here?" I told her that the little girl was not breathing and she just responded with, "Well, then why did you bring her here?" Oh my goodness!!!! Are you kidding me? The nurse just started to yell in Creole, saying what is this white person doing here with  a baby that is not breathing. So I spoke back to her in Creole and French saying, "We need help. If you cannot help us, please point us to the direction of someone who can!" She looked at me speechless and went toward the other room. She finally came back with a Haitian doctor. The Haitian doctor wouldn't touch the girl and said that she needs to wait for someone to get some gloves for her. OMG!!!! Are we not in a hurry here to save a life???? Why are people so unprepared and not caring???? Finally the gloves arrived, and the Haitian doctor said there was no pulse on the little girl. She just took her gloves off. I said, "Isn't there anything else we can do? CPR? Where is the Defibrillator to restart the heartbeat? Don't we have anything to save a life here at the hospital?" The Haitian doctor just looked at me and said, "Well, I mean if you want to try, I guess we can try." OH MY GOODNESS! I was so frustrated. I ran toward where she was leading me and apparently that was where the "real" emergency room was at. I ran in there and all I see are foreign doctors around. So I yelled in English, "Can someone help please! THIS LITTLE GIRL IS NOT BREATHING!" All the foreign doctors came rushing toward me and started to save the little girl. This was the normal reaction at an Emergency room. But it was too late....

The doctors said that she was already in Rigor state, which means post-mortem. It is where there is a stiffening and contraction of all the muscles and her pupils were dilated already. The doctor told me that there was not much they can do and there was no good to try to revive her because her organs had all failed by this time. It would not be a good idea, because even if they did successfully restart her heart, she would still be brain dead from the lack of oxygen all this time. We put a white sheet over little Precious* at the emergency room. I couldn't believe it. I was in shock. Her body was freezing cold, but her hands were still warm, because I had held her hands throughout the car ride. The doctors asked where we were from and I told him that we were from the orphanage by the border of Haiti and Dominican Republic. That was why it took us so long to get to Port-au-Prince. The doctor asked if there were any other sick babies at the orphanage and I told him yes. He told me that if it is at all possible to send them over as well, because we don't know if they had the same thing as little Precious*. We immediately called the orphanage and two children were in the process of being transported to the hospital. The doctor said that there was no possible way of knowing what caused the death of little Precious*, only an autopsy could find out. Since little Precious* was declared dead at the scene, the doctors needed to make a dead certificate for her in order for us to take her to the morgue for final procedures. Thank goodness I was there at the hospital, because none of the doctors could speak French or Creole, only English. They were all American doctors that were here for a week or two at a time. For many of them, it was their first day at the hospital. The doctors explained to me what I needed to do to clean the entire orphanage and what prevention measures needed to be administered for all the caregivers. I called and informed everyone and massive cleaning process started back at the orphanage.

The president of the foundation took little Precious* to the morgue in Croix-de-Bouquet, which was closer to the orphanage. I said goodbye to little Precious*, gave her a kiss on her freezing cold forehead, padded her hair, and shut her eyes for her. I whispered "You have been a really good girl in this life time. It is your time to go now. You are leaving this life with lots of love and be sure to come back soon with more love to give to others. You will be dearly missed! I will see you soon my darling! A Mi Tou Fou!"

I stayed after at the hospital with another caregiver to wait for the other two children to arrive. When they finally got here it was around 7:30pm. We quickly took them to the Triage center to be admitted. Both of the babies had been sick for around three days already with intense bouts of diarrhea and vomiting. They did not look good at all when they came. When the doctors were checking on the little girl, she had a really massive diarrhea on my lap. I was covered in diarrhea and everyone freaked out. I, however, didn't. This happens all the time, I am pretty use to it. I grabbed some baby wipes and wiped off most of it. The doctors suspect the babies have Cholera, but is not sure, because the color of the diarrhea doesn't quite look like it. Either way, the babies were losing fluid fast and they needed to be re-hydrated. So the doctors gave me and the other caregiver each bottles of Pediatrics Electrolytes to give to the babies. They needed to drink tons of fluids, because they were so dehydrated. We were put in an isolated area, because if it is indeed Cholera, it is highly contagious to others. So we sat there and gave the bottles of Electrolytes to the babies for about 4 hours at the hospital. They were having bouts of diarrhea every 30 minutes or so. We would change them every time and put the diapers in a sealed bucket. At around 11:00pm, the babies started to doze off to sleep. I didn't want them to sleep at all, because this was what happened to little Precious*. The nannies thought she was just sleeping, but actually she was slipping away. Couple of times I woke the babies up and they were just fussy, but at around 11:30pm, the little girl had no response! She wasn't waking up, no matter how much we moved her or squeezed her. She wasn't responding! I yelled out to the doctors and they quickly started to administer an IV in the baby's arm. I kept trying and after five minutes of trying to wake the little girl up, she finally opened her eyes! OMG!


The doctors administered IV lines for both of the babies and they send us on our way to the Medicine Sans Frontier (Doctors Without Borders) in Delmas, where they have a Cholera Center. So there we were, two babies with IV lines with our driver in a Toyota pick-up truck, zooming through Port-au-Prince in the dark at midnight! I was cradling the baby with my left arm with her IV in and holding the actual IV bag with my right hand. I had the IV bag up high just outside the window. We had to force more fluids in the babies so we had to keep squeezing the IV bag to make the fluids go faster. The car was rocking back and forth due to poor road conditions and I kept yelling and shaking the baby to keep her awake during the car ride. It took us about 20 minutes to get to the Cholera Center. We ran in with the babies and we sat in the admission tent. They were kind enough to hang the IV bag on a hook for me! Oh my goodness! My right arm was burning from keeping it high up for the past half hour and constantly squeezing the IV bag with one hand. They asked all sorts of background information and once again, good thing I do the reports for the children, because I was the only one that could answer these questions about the children. The two babies were quickly admitted into what they called "The Observation Tent" at the Cholera Center. We got all settled and the on-site doctor said to stopped the IV drips! What??? Come again? Stop the IV drips??? Why?? This whole center is ran by Haitian doctors and nurses. They said that in the observation room, we only give the fluids orally. I told them that we almost lost these two babies in the first hospital we were at, that's why they had IVs put in. And also we had already lost another child this afternoon with the same symptoms. They just looked at me and said great, but we need to observe. OMG! I was, once again, very frustrated with the Haitian doctors. This seems to be a pattern today!

So the babies were still very weak, but we had to keep administering oral hydrating fluids for them. They gave me a syringe to give the fluids to the babies with. The other baby was doing a lot better than the one I was taking care of. She does not like to drink the fluids orally (This was why at the other hospital they gave her an IV line!!!!). I kept on forcing her to drink more and finally she started to take in more fluids. Thank goodness! The babies were having diarrhea every 15 to 20 minutes or so. The doctors kept on saying that it does not look like Cholera, it might be some viral infection. So this went on all the way till around 5am. We were giving the babies oral fluids every 15 minutes or so throughout the night. I would be changing their diapers every 30 minutes or so to clean their bottoms. We were surrounded by people with vomiting and diarrhea and there were a lot of them. The beds there were like emergency stretchers. They all had a hole in the center of the stretcher for easy access when you go to the bathroom. There is a bucket right beneath the hole, so the doctors/nurses can continuously see what color diarrhea you are having and how much. It is also easier for the people to clean, bucket after bucket.

*The typical signs of Cholera are vomiting and diarrhea. Which leads rapidly into dehydration and electrolyte imbalance. The diarrhea in a typical Cholera case is usually whitish in color, almost like rice water. For children, they are often accompanied by extreme drowsiness or even coma, fever, and convulsions. And in cases of extreme dehydration it can lead to shock, this is where low blood volume leads to a decrease in blood pressure and then a drop in the amount of oxygen that is in your body. Extreme shock can lead to death in a matter of minutes. 

The babies were looking worse and worse as the night went on. At around 5am, their pulses were getting very weak. I couldn't find a pulse in their arms, so I tried their feet. I found one, but the pulse was very weak. The babies eyes were sunken like they had not slept in months. According to the doctors in the first hospital, when a patience's eyes are sunken like that, it means that they only have 10% of fluids left in their body. It means severe dehydration! Life threatening. I yelled out for the nurses and doctors. They were about to switch swifts and just going through the transitioning process. I told the doctor that the babies do not look good and they need faster fluid in-take. They need IVs right now. I told them to take their pulse, because it was getting weaker and weaker by the minute. Their eyes were sunken so badly and their skin is very slow to bounce back, meaning SEVER DEHYDRATION! The doctor took one look and said, "Yeah, they don't look good. Let's keep observing!" So this was when I lost it! I didn't yell, because that doesn't help no one. I very calmly called the doctor over again and said, "We are going to lose these children if you don't do anything right now!" The doctor said that we must be prudent in what we give to the children, we don't want to give them something that they do not need and then make the situation worse. I responded with "Yes it is good to be prudent, but when one is too prudent, it becomes medical negligence." I begged the doctor that one child had already passed away and we don't want that tragedy to repeat itself. I told her that even though these children might not have confirmed cases of Cholera, but they are having symptoms that makes them dehydrated, so the treatment will still help. She went and got another doctor and finally after  an hour of talking, reasoning, and begging....two IV bags were brought in for the babies. They finally transferred them over to the Pediatric Intensive Care Unit in the Cholera Center. We got there and a new team of Haitian nurses and doctors greeted us. They were competent and nice, which was a good scenery change.

At around 8am, the babies started crying! This was the first time that they were crying and because they were HUNGRY! Thank goodness! Before, they had absolutely no energy to smile or cry. The fluids were doing them good. They are getting more energy back and their eyes are looking brighter and more alert now. I was so comforted to hear them crying. Everyone was trying to stop them from crying, but I just sat there, smiling with tears coming down my face. Everything was going to be alright little ones!

At around 9:30am, two nurses from the orphanage came to replace me and the other caregiver. I didn't want to leave, but I had more things to do back at the orphanage with the other sick children. I gave all the instructions to the replacements and said goodbyes to the babies. I felt slightly relieved because I know they were in good hands and now they were stabilized with fluids and medication. My job here was done!

It took us about an hour to get back to the orphanage and it was a silent car ride. I kept looking out the window and thinking about little Precious*. Her helpless face was forever stuck in my mind. When we got back I immediately went to take a shower. I put all my clothes in a trash bag to be washed and sanitized later. I scrubbed my skin so hard that it turned bright red. I had to get all the vomit and diarrhea residue that soaked through my pants and shirts off my skin. After the shower, I went and started to wash my clothes. It was the first time that I was actually looking at my clothing. There were vomit, diarrhea, and blood stains all over. No wonder everyone was starring at me at the hospitals. It wasn't just because I looked different than them, but more so that it looked like someone just gave birth on me.

We did all the nessassry cleaning procedures at the orphanage and more sick babies were place in the isolation room. The orphanage doctor came over and we started to administer all the Cholera medications. The doctor gave me medication for Cholera, as well, since I have been in high exposure over the two days. I gave a very strict talk with the staff and aunties on how to properly wash their hands and to put gloves on when they take care of the babies. We are not going to make the situation worse!!! Not possible under my watch! Bottled water were brought in to the orphanage until we can double check if the water is treated okay. I went all around the orphanage to make sure all the nannies were doing the proper procedures to protect themselves and the children. If any children showed any signs of diarrhea or vomiting, we had to observe and give medication. If it gets worse throughout the day, we needed to take them to the hospital immediately. I went over to the president's house to write up an incident report for what happened over the weekend and send it to the executive directors to inform them of the situation.

I remember when I was at the Cholera Center last night, the nurses were speaking in Creole saying that "This little white person should not be here. She should just go. It not her place. The child can be left here alone, not a problem." I looked at them and responded with, "I will not leave the child here all alone. The two babies here are my responsibility. I am not going to abandon them. It happens way too often and it is my job to be here to prevent that from continuously happening. I don't care that I am the only foreigner here, but I am here to stay until the babies are stable. You can say all that you want, but we are all the same. Just because our skin color is different, it doesn't make either one of us better or worse than the other. I am here to do my job and so please do you job to help the child get better, as well. Thank you!"

I went to bed that with a very heavy heart. I hugged each and everyone of the children at the orphanage and kissed them goodnight. Life is short! You never know if tomorrow is going to come first or the end of your life is going to come first. We must seize every opportunity and do good for others!

I looked at the moon night and blew a kiss for little Precious*. With tears running down my face, I closed my eyes. With flashbacks of me playing with little Precious* coming in and out of my thoughts. The frame stopped at her smile. Her smile will always be in my heart!

Goodnight little Precious*! Sleep tight, don't let the bed bugs bite!


  1. My heart broke. It broke into so many tiny little pieces.....for little precious, for the sick children and for the brave girl-my PUSA daughter Lori.....for what she went through. With tears running down my face, I had to stop reading couple times.....I closed my eyes and prayed for the children and Lori's health.

    May I send you a box of 乖乖!

    Mom with tears

  2. Lori,
    You are an amazingly a strong heartfelt young woman.
    I am so sorry you lost your little Precious.
    I am so sorry.
    I am so proud of your actions and your words.
    You are truly an amazing woman and doing amazing work.
    How can I help you? Help the children?
    Anything I can ship from the U.S.?
    If it is faster to deposit money into your account,
    let me know how I can do this.
    God Bless you and your heart for others.
    May God Bless you with all that you need to carry on.
    Love you Lori, Marilyn Bowman

  3. May little Precious rest in peace!
    Death is not the end,
    it could be the beginning of a brighter life.
    She may come back to this world with healthy body and surrounded by parents and family members who love her as much as you did.
    Little Precious was blessed.
    And Lori, you are blessed too, brave girl!

  4. Lori my prayers are with you and little precious! You are an amazing and a true example to all of us! Thank you for loving those beautiful children and being there for them!! God bless you!!! We love you and are so grateful for your service!!! We will continue to always pray for those children!
    The Sorensons