Baby Ian

Baby Ian came to the village on Thursday, just before lunch time. I didn’t know we were getting a new baby, so he was a big surprise! Well, actually a very small one. He was born prematurely and abandoned at the hospital. He is three months old and weighs only 3kg. When we saw how small he was, Rachel Gallagher and I immediately decided he was too small and fragile to move to the Baby Home and would need special care. Since the Gallaghers already have two girls living with them, Ian came to stay with me.

 Ian, all snuggled in his fleece blanket and sound asleep in his basket. 

  

The first day was a lot of running around, arranging to get formula for him from town, getting blankets and baby clothes and bottles and a bassinet moved to my cottage. Mety and I made a basket for him and set it between our desks and held him whenever he woke up. Sitting next to him, I kept thinking of Asha and wondered if I would get attached to Ian as quickly as I did her. Later that night, he smiled at me after his bottle just before bed, and I was hooked.

The next day, Ian was sick. He had diarrhea since he came on Thursday, and it started to worsen. On Saturday he started vomiting and late that night I rushed him to the hospital with Brenda.  He was severely dehydrated by the time we reached the child emergency department. While in the care of the emergency staff, he developed severe respiratory distress. He was placed on oxygen and IV fluids and admitted to the pediatric ward. Shortly after arriving on the ward, Ian was diagnosed with a pneumothorax (a hole in the lung that leaks air outside the lung and causes the lung to collapse). It took 4 ½ hours to get a chest x-ray to confirm the pneumothorax. It took another 5 hours after that to find a thoracic surgeon willing to place a chest tube. We tried multiple times to have him transferred to ICU, but they only had one bed available and would not accept Ian, because they did not have a ventilator for a baby. I and several other Open Arms staff called every medical contact we knew in Eldoret, and every hospital, trying to find an infant ventilator and an ICU bed. There are no baby ventilators in Eldoret, in any hospital. We talked about whether it was possible to transport him to Nairobi, but everyone agreed he was too weak and unstable to survive transport. It was heartbreaking to watch this tiny baby struggle. When the surgeon finally arrived to place the chest tube, I moved to the hallway, and Rachel Gallagher stayed with Ian. As soon as they finished, I went to see Ian. When I reached his bed, he stopped breathing. I immediately started ventilating him, and the surgeon returned and started chest compressions. Ian responded after less than a minute of chest compressions.

I held my hand on his head, struggling to hold back the emotions consuming me as I watched him continue to struggle to breathe. He stopped breathing a second time and I ventilated him again. He started breathing again on his own, and I sat with him, stroking his hair and praying silently. I prayed and prayed that God would save him. But I really felt that he would not survive the night. After a long night and day trying to get care for Ian, there was nothing left we could do. Two more Open Arms staff came to stay with Ian so we could go. I leaned down and whispered goodbye.

The pain I felt walking away from Ian that night was the most heart wrenching I have ever experienced.  When I reached home, I just cried. I asked God why this was happening, why He wanted to take away a little baby he had given us just days before. I had been awake for nearly 48 hours, and when I finally fell asleep, I slept for 12 hours. In the morning, I texted the night staff at the hospital and asked about Ian. They messaged back that he had made it through the night! I was completely overjoyed! I rushed back to the hospital to see him. When I arrived, he was struggling as hard as he had been the night before. For a few minutes I just stared at him in disbelief. Then I thought, we had to find a way to do something, he had such a will to live. I talked to the doctor and then called Rachel Gallagher again and told her how hard he was fighting, and asked if we could again consider transporting him to Nairobi to give him a chance. She wholeheartedly agreed.

Our child welfare director, Hellen, came to the hospital to help me. I got the number for a doctor in Nairobi and called him and asked if he could help Ian, and which hospital he recommended that had an ICU and a neonatal ventilator. He gave me the names of two hospitals and numbers to call to try and find a pediatric specialist. Hellen and I called phone numbers at the same time. We called Aku Kahn hospital in Nairobi, who said they had an ICU bed and a ventilator and would accept Ian! I called the Open Arms office and asked if they could start making arrangements to get checks and cash ready to cover our costs.  Hellen started making local arrangements for an ambulance and portable oxygen, while I found out what else we would need before transport. We needed to get a letter drafted and signed from the hospital describing his care and recommending the transfer. We needed to have discharge orders written and get his bill processed and paid before we would be allowed to leave. The doctor and nurses all started helping and got the paperwork drafted. I was actually shocked at how quickly things started coming together, since things usually move as slowly as they had the day before.

The Nairobi hospital finance department called me and said they would require 1 million Kenyan shillings (about $12,500) cash on our arrival or they would not admit Ian. My heart dropped. We couldn’t get that much money so quickly, especially in cash. I was shocked.

Hellen called her brother and got a contact at another hospital, Gertrude Children’s hospital in Nairobi. She transferred the call to my phone and I talked with an ICU nurse and explained Ian’s condition. She said they had an ICU bed and a neonatal ventilator and would accept his care if we named a doctor that would treat him. I told her I would confirm a doctor and call her right back. I had not even hung up the phone with her when Hellen handed me her phone with another call. It was a doctor from the ICU at the first hospital, she said she would accept Ian as a patient but she wanted him to be taken to a different hospital: Gertrude Children’s. I told her that I had just been on the phone with Gertrude’s and they had already accepted us if we just named a doctor. She said fine, everything was arranged and for us to call her when we left Eldoret. I was absolutely floored! After such hopelessness, God threw open all the doors and made it possible for us to go. We had an ambulance, oxygen, a doctor, an ICU bed and a ventilator waiting for Ian. I reached down to stroke Ian’s head on the bed and whispered for him to keep fighting, that everything was going to be ok - we were going to Nairobi!

Everyone scrambled to get the final forms and documents finalized. Then I was just waiting for the checks to arrive from our office so we could pay our bills and leave. Brenda messaged me that they had nearly reached the hospital, and they had the checks in hand. I looked down at Ian. His breathing pattern had changed slightly. I had a sinking feeling in my stomach. I turned on the flashlight on my phone and checked his eyes. His pupils were fixed and dilated.

Little Ian had fought as hard as he could, but God was calling him home. My eyes welled as I looked up at Brenda standing at the foot of his bed, holding the money for his transport. My voice broke as I told her I didn’t think we could go. I asked the local doctor to come see him again, to confirm what I already knew. I didn’t want to be the one to say that he was gone. I called Rachel Gallagher. I called Nairobi. Then I sat down on the bed and picked up Ian again and just held him in my arms and cried.

Brenda sat down next to me. Hellen pulled over a chair and sat across from us. Mety arrived a few minutes later. We talked and cried and I just held Ian. He lived about three more hours, and then his breathing stopped for the last time. I put my fingers to his pulse and felt his heartbeat fade to a stop. The doctor came over, and when I told her he was gone, she placed him on the bed and said we needed to try CPR. I looked up to ask why, but I didn’t want to argue with her. I picked up the Ambu bag and started ventilations. She did compressions, counting out loud. A number of nurses came and stood around us. I held Ian’s head, squeezing air into his lifeless body and praying that we wouldn’t carry on very long. I think we continued for about 10 minutes, and then the doctor called his time of death: 7:15pm. Mety picked up Ian and wrapped him in a clean blanket and placed him in my arms. I held it together while doing CPR, but now the weight of Ian in my arms again brought fresh tears flooding to my eyes. I cried for Ian, for how hard he fought. I cried to God, wondering why He had made a way for us to go to Nairobi, only to take Ian anyway. And I cried because this was the second baby I watched die at this hospital, simply because there were no infant ventilators. I held Ian until the morgue officer came and took him away.

It’s been a very rough week, but I am finally finding peace in Ian’s death.  Ian is in a happier place than any of us can imagine, and he is in the arms of his Heavenly Father who loves him even more than I did. I’m resting in the hope that I will hold Ian again someday. In the meantime, Ian will never be forgotten, and his death will leave a legacy of improving health care for infants in Eldoret, so that many small lives can be saved.

Ian’s memorial and burial service will be held on Monday March 12, at Open Arms Village.