I have not blogged so much recently about the orphan work, not because nothing is going on (there is, overwhelmingly so), but because I didn’t feel like reliving the roller coaster ride of emotions yet again.
But I think I have sufficiently recovered by exploring green spaces, reading books made out of paper, and distancing myself from unnecessary computer time recently.
Today we went on our weekly pilgrimage to the city orphanage.
We are trying to figure out a strategy to help the large proportion (27%) of <3rd percentile kids in the under 5 building, so the residents reviewed about 7 or 8 weight check follow ups with me.
I saw the 7 month old kid who we brought hydrolyzed formula for last week after they told us they suspected a milk allergy, since the orphanage only has milk based formula.
He had not gained an ounce since April, and now in one week he gained 200 grams!
Will try to recruit more formula for this guy from a group who wants to help specific kids at the orphanage (it’s about $40 for a can he went through in less than a week!)
I was also told he is not being moved to be with the regular kids because of his eczema.
He actually had terrible eczema the first 3 months, then it disappeared (probably when they stopped feeding him milk based formula and he stopped gaining weight).
I think he would thrive if placed with the other kids, where they get a broader diet than formula and rice cereal.
The challenge is always how to communicate effectively with the orphanage doctors.
A volunteer spent a couple hours holding and providing tactile stimulation to another 2 year old.
He especially loved the (new) toothbrush being stroked on his face and arms.
He has a feeding tube and cerebral palsy, and I suspect he does not get very much physical touch on a daily basis.
Our non medical team is finally starting to use the bags of special items that were thought up and made this spring. Yay!
Change always takes a while for everybody.
I saw a kid who has hand and foot deformities, probably acrorenal syndrome according to my reading tonight.
He had a heart murmur not heard previously and toe walked with one foot.
Normal intelligence and language development.
Many of these defects we see are “once in a career” type diagnoses.
I am opening my congenital syndromes and deformities textbook a lot. [my kids like to leaf through it when they are looking for something to do].
I checked up on the 2 month old, 3.1 kg kid with Trisomy 21 and a huge heart defect, laying there puffing away, bright-eyed and interested in me.
We saw a perfectly healthy and well-developing 5 month old rolling and cooing on the floor.
The caregivers actually do a very good job with their young charges.
Most of the “regular” kids are in cohorts of 3-4 kids per caregiver, with 3-4 clusters per room.
Recently the orphanage advertised for 20 foster families to come and care for 3-4 kids, apartments near the orphanage provided. I hear over 200 responded.
They had done a trial with a smaller group of families, and it was so successful they want to expand it to all the typical kids.
So most of the kids spend the day (8a-3p) in a daycare-like setting at the orphanage, then are picked up by their foster moms and taken home for the evening.
I think this is fantastic and a huge step in a positive direction for these kids.
Today we managed to catch one of the moms as she picked up our young patient, and she said she’s only been fostering her for one month.
We were able to discuss a couple of pointers with her about the child, and reassure her that she was doing a fine job.
And our residents are also doing a very fine job.
I’m thrilled to work with them.
And so we persevere, one day, one child at a time.