Huddled in the corner of the tiny NICU the heat is smothering. Sweat is running down my neck and my rolled-up shirt exposes a glossy sheen of sweat coating my arms. I stand over the sink, washing my hands and savoring the cool water splashing up on me. The mamas are busy with their babies, adjusting their covers, preparing feedings, or changing their tiny cloth diapers. The baby on the end has been abandoned by his mother with mental health issues and his high-pitch screaming has been ignored for the past five minutes while the other mamas are busy with their own babies. I reach into the bassinet and arrange the baby boy in my arms, wrapping his blanket securely around his tiny body. Standing in the corner I gently sway in place and watch the mamas, absorbed in the rhythm of the room. The mamas are hot, tired, and ready to go home. At night they sleep on the floor of the NICU while the lucky few share a wooden bench. They spend all day in this tiny room, separated from their other children and family members. And yet they are completely dedicated to their little babies. They have learned how to prepare the syringes to feed their babies through feeding tubes, how to remove the oxygen from their noses when the power goes off, and are constantly “pumping milk” which involves harshly squeezing out breast milk, by hand, into tiny plastic containers, a process that makes my chest ache just watching.When one mother leaves the room and her baby starts to fuss another mama will place her hand on the child to soothe him. There is a sense of community so deeply embedded within the walls of this room that it can be difficult to identify the true mama of each baby. A few minutes pass and the baby in my arms is sleeping quietly. The sweltering heat seems to increase by the minute but the mamas are welcoming and I cannot imagine putting this baby back into his bassinet. I settle into the corner, breathing in the thick warm air that is laced with the chattering voices of mamas and the mechanical breathing of oxygen machines, enjoying the feeling of overwhelming peace that only sleeping babies seem to bring.
I had the pleasure of spending the past weekend (Thursday-Sunday) visiting the hospital in Kibogora, a small town down in the south of Rwanda. It was a beautiful location and there are great people there but my favorite part was spending time in the NICU (neonatal intensive care unit) with all of the babies. It may sound like a bizarre way to pass a vacation, but for me it was heaven. I was able to go on rounds with the nurse practitioner and observe as she examined all the babies and sat in on a neonatal resuscitation course. There were happy moments when mamas were told when they could go home the next day and they threw their arms in the air with ecstatic prayers of joy and gratitude. There were moments of sadness when a mother found out her baby had a mass in her lungs that would require a surgery outside of her financial means in order to survive. There were moments of insanity when a mentally ill mother tried to kidnap her preemie, was chased down by the guards, and later abandoned her baby. And there were moments of pure joy and peace, snuggled up in the sauna they call the NICU, holding babies and chatting with the mamas.
The top photo is of some adorable triplets. I love how they are arranged by size. They were teaching the mama how to feed the smallest first so I think it was easier for her to remember if they were all lined up in order of size. She already has a toddler and her husband left her for another woman so she will have some very long years ahead of her with four young children. If you are at all religious I ask that you keep this mama and her babies in your prayers because I worry about their future success at home.
Here are some other pictures from the weekend:
This is a picture of the NICU from the door. The far side is lined with incubators for the babies struggling to self-regulate their body temperature and the middle has cribs for the babies who still need oxygen, close observation, and maybe an IV, but are able to keep themselves warm. Unlike a NICU in America, babies who are not related often share cribs or incubators because the hospital lacks resources to provide more equipment. This is a risky practice because it could spread infections form one baby to another but it is the only option they have so they make it work! There are two wooden benches that the mamas squeeze onto and the pathways are often obscured by IV lines or the cords of heating lamps. It was a little scary trying to navigate down the aisles without tripping on anything.
Here are some of my new friends from the pediatric ward. The little guy with crutches was just too adorable!
This little guy was super tiny and his mother was not in the NICU to care for him. She had eight other kids at home so she sent her young house girl, Olive, to take care of the baby. When I was there I watched Olive prepare his formula (a mixture of NIDO-powdered milk-water, and sugar) and attempt to feed him with a tiny plastic cup. Luckily the nurse practitioner was there to assist because she didn’t seem to be overly confident with the whole process, but I am guessing she will be soon since he needs to be fed every two hours.
These last few are shots of the area where we stayed. Kibogora is a beautiful place and I had a wonderful vacation!