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Saturday, July 14, 2012

You thought you had a bad day?

Miriam was having a really bad day.  She was only 11-months old and weighed 14 pounds when her mom gave her away to total strangers on Tuesday.  Suddenly she found herself in a big room with bright lights that smelled funny with many sick children coughing and crying.  People were holding her down, sticking needles in her, poking at her eyes, ears and mouth, and then pulling off her diarrhea filled diaper.  To make it worse there was a very, very white lady there with white hair that made the whole experience more terrifying because she had never seen a white person before. On Tuesday, July 10th, Miriam had a really bad day.

Here is the back-story.

On Tuesday morning Helen and I met this young mother who was mentally ill.  She was holding her 11-month-old baby in her arms while she sat quietly at the Social Welfare Office.  The mother’s uncle brought her there and charged that she often went off and left the baby alone, sometimes for a week at a time.  He was desperate for something to be done because if she left again, the child might not live and he already had too many dependents to care for.  We were asked to make El Roi the home for this beautiful girl, and we said yes.

The mother told us how very happy she was that the baby was going with us and she headed off to the bus stop to go home.  The baby was asleep as we got in our van and headed directly to the Baylor Pediatric AIDS Clinic in Manzini because our standard policy is to have every child tested for HIV as soon as we receive them.  Miriam (also known as Thembalethu) tested negative, even though she was exposed to her mother’s HIV status when she was born.  This was good news, but suddenly she got a fever, started coughing, her heart was racing and we knew we had a sick baby on our hands.  Thankfully we were right next to a hospital and headed directly in to see a doctor friend who specializes in malnourished children.  He examined her right away and admitted her immediately.  She has severe pneumonia and is malnourished.  She is being fed F75 formula (which is miracle food for children in this situation) and is on IV antibiotics.  We believe she will be well and come home soon. 

The rest of this blog will give you a few helpful tips if you ever find yourself on a day or night shift at a Swazi hospital.  I hope to not offend anyone in any way, but alas, I will share what I experienced that day with a few pointers for others.
  • You can’t admit a child (or anyone) to the hospital without being there to be the primary caregiver.  There is only one nurse in the pediatric ward and she can’t be the caregiver, so you must be there to cook, clean, etc.
  • You need to sign a paper committing to pay the bill at the end, as this is a private hospital.The
    cost to stay per day is E6 (six Emalangani or six Rand), the equivalent of .73 US cents per day, plus medication of course. 
  • There were 9 children admitted the evening we were admitted so, unfortunately, the nurse wasn’t able to check Miriam’s admission forms until the next morning.  Therefore, no medication or food was given until the morning. Note to self – bring bottles and formula in case the special food doesn’t arrive when it is scheduled to.
  • Other packing needs: You must bring your own sheets, blankets, towels, soap, diapers, formula, diaper cream, food, cell phone charger and chair to sit on beside the crib.
  • Bath time: The time to clean the baby is around 5:30-6:00 AM, so be sure to have your cleaning bucket, soap and supplies ready (oops, we didn’t have those).
  • You will be pleasantly surprised when a lady in charge gets up and starts singing in siSwati and all the women answer in song around 7:15 AM.  They sing about how big and deep and wide God’s love is for us.  It is inspiring and beautiful. 
  • Immediately following prayer, a photo flip chart will be presented to all who are there to explain how you get HIV/AIDS and how NOT to get HIV/AIDS.  There is a reasonable amount of Q&A before going back to look at the babies in the cribs.  You are free to ask questions…in siSwati.
  • Pay attention when the lady in charge starts to explain the importance of proper hand washing with hot water and soap so as not to spread germs around the pediatric ward.  It would be a terrific idea to have hot water and soap in the ward for all to practice with, but alas, there is only cold water.  If you forget your bar of soap at home the whole concept is lost.
  • Don’t pay attention when the woman who usually mops the floor walks through the pediatric ward with a chain saw…I am sure she has a good reason for it.
  • Don’t be offended when the Swazi women start to talk amongst themselves in siSwati across the entire ward and point at you and laugh.  Surely they are not making fun of you.
  • Don’t take it personally when several of them correct you firmly for leaving the cap off your baby’s bottle, thereby exposing it to germs in the room.
  • Don’t act surprised when the ladies who were worried about your bottle cap share a 2L bottle of orange Fanta around the ward OR when their 5-year-old boy stands up on the bed next to you and pees into a plastic grocery bag beside the Fanta.  Maybe that is why they wanted me to keep the cap on the bottle…that makes sense now.
  • If you choose to make conversation with the other women, some will enjoy it, but most don’t speak English.  Asking questions isn’t for the faint of heart though.  You may find out that one child is there because their babysitter broke the 3-month-old baby’s femur while the mother was at work.  You may discover that the little baby beside you is actually 6-years-old and weighs 22 pounds.  You may also wonder if she will be alive when you arrive at your next shift.
  • Feel free to give any or all of your diapers to the woman next to you because her son has chronic diarrhea.  She has no income and the 8-month-old baby’s father died in a car crash before the baby was born, so how could she possibly pay for diapers?  Thankfully she only has one little one.  Her only other child is 18-years-old now.  How old is the mother, you might ask?  She is 30.  Quick math confirms she was 12-years-old when she had her first child.  That is a good moment to look back to your crib.
  • Caution: The hospital kindly provides food for the caregivers/mothers (which I haven’t seen in an African hospital before), but be prepared to stand in line with a plate for your neighbor, even if you don’t want to stand in line with a plate.  She may encourage you (bully you) into doing so, so that she may have two meals.  Be prepared for the glaring eyes of others who will believe that you are eating/stealing their food.  Just close your eyes, hold our your plate and bear it.  Go immediately back to your happy place and look at the baby.
  • There is no need to take an iPod.  There is an old TV suspended from the ceiling with a snowy image, but Justin Beiber is clearly singing in the background.
  • It is good to know that if you have Manna Packs from Feed My Starving Children you may be able to convince the doctor to release the baby from hospital early if you promise to give the oral antibiotics and the Manna Packs.
  • Checking out of a hospital takes about 4 hours and the cost for our 3 night stay (including special food and x-rays etc.) was approximately $15 USD.  Prescription medicine is free.
  • The most important thing you need to know (if you have skin that is as white as mine) is that many babies, including your own new one, might find you absolutely terrifying and there is nothing you can do about it.

I have been in many hospitals around Africa, the worst clearly being the pediatric burn ward in Lilongwe, Malawi, but I was still unprepared for my “day shift” with little Miriam yesterday.  I am thankful for Thabile from the El Roi Baby Home who came back from holiday to do the “night shift” at the hospital all week long.  I am thankful for our interns who are helping out at the baby home this week so that Gcinile and Helen can take turns doing a job that I was totally unqualified and ill equipped to do. 

Thank you for your prayers and support.  We now have nine beautiful babies and we give thanks for each of them.  Caleb celebrated his first birthday on Wednesday and we are giving thanks for his improved health.  We hope that his legs will be strong enough to start crawling and then walking soon!

We need to get started on our Toddler home because when the babies turn two they will move to the “big kids” home.  If you can help fund this or fundraise for this important project, please go to: or contact me directly at  Thank you in advance for all you can do and give.

It’s Saturday morning and I am emotionally drained.



  1. You are such an inspiration to all of us. You are living what Jesus told us to do. Yes, the hospital stay is a tough one.It just amazes me what people who have never been to a 3rd world hospital complain about in the US. A chair to sit on, a diaper, etc. So glad you are there to take of this little one. May she continue to progress under you loving care and Jesus watchful eye.

  2. All I can say is Wow, and cry. My heart longs to be there so bad, and I know I will be one day. Sending all my love from Iowa.

  3. It is quite the experience. Most of us have never had the opportunity (privilege) to travel to a third world country to be His hands and feet. I'm thankful we get to atleast read about it through your eyes.
    It looks like Caleb had a nice birthday. I'm sure he will be crawling about soon....then his little legs will be strong enough to toddle about. So glad to hear that little Miriam is getting stronger too. She looks so very precious.
    We have committed to help you with your toddler home. We are grateful for the opportunity to be a part of the work He is doing through you. God bless. Looking forward to next Saturday mornings update!

  4. Thank you for the post! We are always lifting y'all up in prayer and praising God for all he's doing in Swaziland!

  5. I am praying for God to give you and your staff supernatural straight and courage to care for His children! I must say as I read this blog I ask myself, " can this be true?" and why more of us are not crying out to Jesus!

  6. Thank you everyone for your words of encouragement and for reading this blog. We feel your prayers and give thanks.

  7. Janine, thank you for your heart and willingness to do all that you are called and yet feel 'ill-equipped' to do! You do it anyway with God's strength and humour!! I cracked up envisioning that lady in the hospital who usually mops the floor walking through with a chainsaw...I'm sure you did a double-take. See you soon .. July 28th is approaching! Yay!