Raphael

We had technical difficulties yesterday. Sorry to keep you waiting.....

While I was traveling last Tuesday Tom called to tell me a new baby had been brought to the orphanage. His mom had just died and he was 3 months old. I asked them to send the baby's family to get the necessary paperwork from the Social Welfare department as well as get a check up for the baby from the clinic.

The next morning everything had been done and Raphael joined our little family. I asked Jasmine how he was and all she could say was that he had big eyes.

When I got home on Friday morning I found out Jasmine was right. Those are some eyes. Raphael was also very tiny. I weighed him in our clinic using our trusty fish scale. He weighed only 3 kg. (6.6 lbs) at 3 and a half months old! I looked over his paperwork and found out that he has been exposed to the HIV virus. According to his grandfather, Raphael's mother was the victim of sexual hit and run--his words. Raphael's father had not been involved at all and married another woman. When a child has been exposed to HIV in utero the normal procedure is to start them on an antibiotic to help keep infections away since their immune system is most likely compromised since the mother's immune system was not doing its job.

I noted that Raphael was eating well--3 ounces at a feeding--and keeping it all down. For his size it wasn't a bad amount. Saturday morning the nanny informed me that Raphael was starting to cry about 30 minutes before his feeding scheduled every 3 hours. I told her to increase his formula to 4 ounces since he seemed able to handle it and did look pretty miserable.

That evening Debbie told me she thought that he was looking listless in the afternoon. When he joined us for Family Playtime I immediately saw that he was not doing well. I didn't know whether to be sad or proud when Jasmine took one look at him and could tell he was dehydrated. I was proud of her for having that knowledge but sad that at 14 years old she has been around enough sickness to spot it right away.

We immediately called for the village medical officer to come up and put in an IV. About an hour later he showed up and we got to work. We started the examination in the dining room using the table directly under the light but then moved down to the clinic.

The first step was to get an IV line in so we could administer fluids as well as antibiotics. Miraculously we were able to get a line going on the first try.

Debbie was a real blessing holding a flashlight and shining it wherever it needed to go. We had a light in the clinic and electricity (Thank goodness) but it wasn't really bright enough for the work we needed to do.

Here Debbie is watching the IV drip carefully. Such tiny babies can go into cardiac arrest if the fluids go in too quickly. This is one of the things that keeps me up at night when we have such sick babies. I constantly monitor the drip rate because it can change depending on the angle of the needle, the activity of the baby, etc.

Here Raphael is finally all fitted out with his drip and splint to keep it in place.

After getting fluids in him Raphael began to perk up a bit but is still a pretty sick baby. The following day we introduced a third antibiotic. The next morning (today) I had the medical officer insert an NG tube allowing me to feed the baby with a syringe. Raphael has been so weak that he hasn't been able to suck much from the bottle. The NG tube gives me a way to continue to feed him all the milk he needs. I offer him the bottle first for about 15 minutes and then I use a syringe to push the rest of the milk through the tube. 

He had two tube feedings today and it made an immediate difference. He has been crying more and letting us know his needs. This afternoon he drank two ounces by himself and I only had to add another ounce through the tube.

He is still quite sick and needs plenty of prayer but I am cautiously optimistic. I will continue to update you as time goes on. Thanks for praying!