The Wee-ist Ones

33 tiny ones with room for 50 and 2 nurses. This is what I saw when we entered the NICU in the hospital in Silchar.  Little tiny ones...with sticky, transparent skin. So thin that I could see their blue veins and their little hearts beating in their chests.  Many were so sick that I knew they wouldn't be there the next day.  A few, I was certain, were taking their last breaths right there in front of us, irregular respirations and unable to cry, their mouths open in an weak attempt with tearless eyes.  The NICU was a far cry from what we would see in the US. There was only one ventilator, a lack of equipment and not many Mothers.  A group of Mothers sat in a small room right in front of the entry door.  Holding their babies and feeding them.  To enter, we had to remove our shoes and the nurses or Moms would give us some sandals, sometimes their very own, that were allowed in the ward, "for infection." I met a young Doctor that chose to work there. I asked him if he was a resident and had to work there in the government hospital and he answered "No. I want to work here."

The great Dr. that keeps an eye on all the babies in the NICU

 And so, we added a trip by the NICU to our daily rounds that included the men and women in the burn unit and other wards.  Bed by bed, we walked with him as he told us their stories. There were sets of twins, septic workups, malnourished, and "brain injuries during birth."  They had handwritten tags attached to them and were doubled up in the beds.  Many, many times, he would get to a baby and say that they were abandoned and almost all of the abandoned were baby girls. I started to ask questions. The ones with a Mother, why weren't the mothers there to hold them as they died?  He explained that the mothers came every 2 hours and were allowed to breast feed but that they didn't understand due to their lack of education. I asked, talking about the ones that were near death, "Im sure they want to be here, Im sure they care." Then he said something that I cannot get out of my mind or heart. He said to me, "Its not that they don't care. They cant care."  As he explained the differences in a government hospital and a private one, I started to think of the situation there.  What it means to have a girl baby.  For the most part, girls cant grow up and and make money, and in fact, a girl costs the family money in the form of a large dowery once it is time for her to marry.  Add this to the stress of daily life without shelter, money, health care, or enough food to feed the mouths that are already starving and one can see why abandoning a tiny girl is a choice for many parents in the area.

Double bunked with handwritten tag

      I grew fond of a chunky little girl, she was healthy and was going to be discharged to a state orphanage in the following days. Abandoned. I would hover a bit longer by her bed, touching her arms and fat legs, praying, racking my brain and for a split second trying to think if it would be possible for me or a friend to adopt her.  Just this one.  What future would she have if she had a family. Would she grow up in Assam and be adopted, would she change the world? And then one morning, I was searching for her and I asked him, "Where is my baby?" He said, "She expired last night, she had convulsions." On that same morning, I looked around the room and saw more then one "expired" baby still in their beds or moved to a metal shelf, ones that did not survive the night. I think of her and them often.

     We were lucky enough to also visit the L & D ward and even met a brand new baby, minutes old. Women are not allowed to have anyone with her during birth except for the doctor.  They deliver alone, on a cold metal bed of sorts.  I hope one day this will change.  We also checked in on the mothers with babies that were not sick enough for the NICU but were not able to go home. Full of smiles, they would proudly unwrap their wee ones for us to see each and every morning.  Growing them up, hopeful for discharge home. 

I will never forget the alone, beautiful, abandoned, precious girl babies.  They DID leave their mark in this world.  As small as they were and as short of a life many of them lived, they changed someone. Me. The translators. The nurses. The doctors. Their Mothers. I think about how, simply because of where they were born, they will never have the chance to become what they could have been.  I am grateful that I can do and become whatever I would like. This, I will not take for granted.

Happy Birthday, today is your day!

The Burn Unit

The post-op ward was down a long hallway. A long hallway that other team member referred to as the walk of death. You left the operating theatre and playroom with what felt like loads of fans and smiling playing beautiful children, and made a right than another right. Through the young hospital security guys, always smiling and loudly blowing their whistles with an occasional hollar to get the crowd to separate and allow us by with the abbreviation P.I.S.S. on the lapels of their uniforms.

Our friendly neighborhood PISS security

Down a long, often dark hallway, past several large wards separated into men and women. Filled with people laying in beds...skinny, sick, screaming in pain. People with large wounds and dirty dressings. People with tubes draining in to cut up used water bottles, improvised drainage bags...tubes from everywhere...arms, noses, chests, and abdomens.  People just trying to pass the time in the heat, chatting and often laughing in a noisy room. People with a caregiver and children playing between the beds and mats on the floors.  Rusty IV poles with all kinds of unknown things hanging from them like chandeliers.  People with bright smiles, warm welcomes and hope in their eyes.  I walked that path so many times a day that I couldn't begin to count.  You were often overtaken with smells, mostly walking past the bathrooms.  We became professionals at holding our breath for extended time in certain parts of the walk. If you look left, instead of just going right and down the hallway, you see the Burn Unit. In a almost humorous twisted way, the sign was made to look like it was on fire. There is 2 doors, the windows have long since been broken, just a door with a hole in it. Again, separated into ladies and gents.  Im not sure why it happened, I was walking up the hall to the OR and looked up, straight ahead. I saw her there, in the frame of the broken out window, a young girl, with gauze and bandages, looking straight at me, smiling.  And so, I waved. Her young face lit up and she waved back in this excited style that I grew quite fond of and I continued on. As did a new ritual. Every time we walked down the hall and she saw us we would wave, blow kisses and smile.

After the first cases went in to the OR, in post-op we would have a bit of time after discharging our patients. On the second day, my partner in crime on what would become our daily rounds in the hospital said, "Lets go and see the girl in the burn unit and visit the pedi unit." And so, I packed up my glittery pink nail polish, some bubbles and stickers, talked a translator into joining us and off we went. As I walled down the hall, I felt fear creeping into my heart. A small voice inside told me that this would change me.  I knew it would would be hard,  seeing and meeting the patients covered in burns with such limited resources, many would die from things that could have been fixed in the US.  I also knew that I had to go. If not us, then who would paint the little girls nails?  We walked in and patient by patient, bed by bed, we went.  It was a room with 2 rows of beds. I asked each one of the women why they were there and what had happened to them as I sat there trying not to hurt them while I painted their fingernails.  Most had been burned by fire during cooking. 2 had been caught on fire by their husbands for unpaid dowery.  Most had full body burns. Burns that were oozing, painful, wrapped in gauze that was dirty, discolored and moist. Patients without monitors or oxygen, exposed burns, infected burns. Women trying to fight for life, next to the ones that were dying or screaming in pain while dressings were changed, blood drawn, IV started, or even just repositioned.  As I was sitting or kneeling next to each bed, I asked the translator to tell them to be strong, that I would be praying for them, and that I would not forget them. I listened as they shared their stories. I looked for a small piece of skin on each woman to touch while I said a silent prayer and I searched for unburned foreheads to lean over and kiss.  I had to stop myself more then once when I tried to hug them. Sometimes, all I could do was to lightly touch an ankle or shin with one finger. I talked with one of the younger ladies, about what happened next, would she have to go back to the husband that had set her on fire?  She was going to be going home with her father. He stood by her side, taking care of her. I encouraged her to get up and walk, she wasn't eating, had lost weight and had a horrible cough.  Her burns made it difficult for her to turn her head or sit up to cough.  I met each one of their gaze and without words, they always would attempt a smile. I will never forget the small perfect voice that I heard when I stood next to the little girl. "Good Morning, Madame." and "Thank You" after we glittered her tiny nails up with polish and covered her in bright stickers.  I continued to go. Every single day. I visited these ladies, the mens burn unit, the NICU, and the room of babies that were premature but stable.  

And as promised, I have not forgotten them. What I learned is that I didn't need to tell them to be strong.  They are the strongest group of ladies that I had ever had the gift of meeting.  They continue on, with inconceivable pain, lacking basic medical supplies and knowing that is very possible that they wouldn't survive. They are still able to hold on to hope. Even able to comfort me in the 148 degree, difficult working conditions and help soothe my breaking heart from the knowledge of extreme poverty with their beautiful smiles, laughs, words and love.  I left them a piece of me and in return, they taught me that I am strong, that I must continue on even when it seems impossible, scary or hard.  

This is what love looks like.