Bo'me Q&A

Working on a daily basis as a fellow at TTL, sometimes you forget how attached you are to the babies in the safe-home.

On any given day, there are so many things that hold your attention other than the babies. Still, they are always there as well, always ready with a smile when you are tired of work and slip into the playroom for a baby boost. Through incremental interactions, you become close to the babies -- some more than others, but all of them in some way. The babies who stay the longest make their way deepest into your heart.

I thought of all this today because of yet another departure: Nthati left this morning after having been here at TTL for more than six months.

Born on November 2, 2009, Nthati arrived at TTL on January 19, 2010, severely malnourished and exposed to HIV and TB. Her mother had passed away, and she was just over 4 pounds.

Today, she is a chunky baby girl at 18 pounds, who we have confirmed through testing is HIV-negative and TB-free.

She still has the chronic skin rash that has persisted for months and which has stumped multiple doctors, but it should be manageable under her grandmother's care with the continuing help of TTL outreach. And believe it or not, the rash might even clear up in a less sterile environment, with fewer soaps and products. It's happened to a TTL client before. We are crossing our fingers that it happens again.

When I said my good-byes to Nthati, I thought about all the times I'd held her and all the giggles -- and pouts -- I'd gotten out of her.

Then I thought about the bo'me, and how much more time they'd spent with her. I wondered how they were feeling about Nthati's departure. Happy? Sad? Both, like me?

Suddenly, I felt what I used to feel working my old job as a reporter: a desire to go straight to the source. So, I asked M'e Mamosa, our safe-home coordinator, to answer a few questions for me. Below is a condensed version of our quick Q&A:

How do you feel about Nthati leaving?

"I'm feeling happy because she is good now, but I'm worried about her skin."

Do you and the other bo'me miss babies when they leave?

"Hey! Too much…When they are back at home, we are still missing them"

It's easy to get attached to the babies here, huh?

"Mm, yes, very much. We know them like our own babies, and we are friendly with them like our babies."

M'e Mamosa said she and the other bo'me often reach the point where they feel a motherly connection with the babies in the safe-home. They sometimes want to take a baby home and raise him or her as their own, to help protect the baby from the hardships that are all too common in Lesotho, especially in rural Lesotho. But they know the babies must and should go home, and are fully cognizant of their temporary but critically important role in the babies' lives.

The hardest times are those when a baby goes home from TTL healthy and happy, thanks in large part to the care they received from the bo'me, and then TTL hears down the line that the baby has passed away.

With watering eyes, M'e Mamosa recounted one such instance not long ago, when a baby boy named Retsilisitsoe, who she had grown extremely close to, passed away after leaving the safe-home healthy.

"That one…," she said, trailing off. "When we found he (had died), I was feeling so sad."

I didn't think it was possible, but with Nthati's departure and the subsequent conversation I had with M'e Mamosa, I now have an even greater admiration for the bo'me here at TTL, who put their hearts and souls into the babies in TTL's care.

Every TTL success is a testament to their dedication, including healthy little Nthati.

Never far away

The way life works here is that death is never far away.

Sadly, I was reminded of that once more last night, when Bokang, our security guard, came calling my name at around 11:45 p.m.

The same dreaded words as last time -- "Sir, there is a problem" -- met me in my bed.

"With the babies?" I asked in the darkness.

"Yes."

Again I rushed down to the safe-home to find a tiny infant -- this time Pulane, one of the premature twins I recently wrote about -- dead on a pillow. So small, so vulnerable, she'd suddenly stopped breathing. The three bo'me on the night shift sat around her, obviously emotional and looking to me for guidance.

In that moment I thought how sad it was that I already knew what to do, that the death of a baby in my life has a precedent, that I knew the steps to take.

We wrapped her in a sheet and I cradled her in my arms -- so tiny, like a doll.

Despite the emotional haze, I thought how profoundly present death makes one feel -- in a room, in a moment, among the living.

I took Bokang with me, locking the gate behind us, and drove to the hospital as Bokang sat holding Pulane in the back seat. At the gate I spoke with the guard, asked him to join us at the mortuary.

Inside that cold room I found a freezer compartment that was empty, one of the few that didn't have "Se kenye mofu ka mona" -- "Don't put a body in here" -- written on the door.

There was no mortician, and no paper or pen to indicate, per the standard procedure in the mortuary, who the baby in my arms was. I looked at the security guard and Bokang, and they looked back at me. I went out to the car, wrote Pulane's name and TTL's information on a piece of paper that I ripped from our vehicle log-book, and went back inside, slipping the edge of the note under the sheet Pulane was wrapped in. I had a strong desire to do more, but there wasn't anything else to be done.

As I turned to leave, I saw Bokang and the hospital guard looking into a large, walk-in freezer at the edge of the room. They were talking in low tones to each other, but I made out the word "bana" -- children.

I glanced through the open freezer door, and there on the floor lay the bodies of three boys in their underwear, varying in age but likely in their early teens. Their faces were obstructed, but the site was jarring. The soles of one boy's feet were stained in blood. I found myself staring.

"Are you ready?" I asked.

Ten minutes later I was back in my bed. Like I said, death here is never far away.

My high hopes for Pulane and her twin sister, Nthabiseng, now rest with Nthabiseng. I hope the amazing fight in her is enough.

S.P.@.T. -- V3

Sticking Points @ TTL, Volume 3:

1. Flashlight on a cell phone: the best app ever.

2. When you reach the point of preferring mutton to chicken at the local corrugated-metal lunch place, there is initial confusion. Do you really want mutton? Yes. Yes you do.

3. Twins are increasing in number. It's just a theory.

4. Little boys' homemade toy cars, with their frames and steering poles made of metal wire and their wheels made of aluminum cans, are awesome.

5. Fresh dried fruit is delicious. Pears are the best, followed closely by peaches. This is up for debate.

6. Where babies are concerned, high-fives are contagious.

7. Roadblocks are inherently flawed, because donkeys don't obey them. Nor do police.

8. Cold nights don't suck as much when the days in between them are sunny.

9. Sun hats on babies are hilarious and adorable.

10. Lambs have tails.

11. Little known fact: Candy isn't the best philanthropic gift for malnourished babies. I know, weird.

12. Days may start getting longer again, but it's still winter.

13. Moms make the best care packages.

14. Carrying something heavy (read: generator) with someone half your height (read: Nthabeleng) is made even more difficult and awkward when laughing uncontrollably.

15. Healthy babies are happy babies.

Familiarity

It's funny how things sneak up on you when you least expect it.

For instance, I suddenly feel a level of comfort, like I have finally settled into the rhythm of life here in Mokhotlong -- a sort of regular mix of the irregular.

Eric, the new TTLF Fellow, just arrived and moved into Kirsten's former rondaval. So far this week I've been trying to introduce him to all things TTL. It will be great having another person here to help again.

Eric's arrival makes me think back to my own arrival here more than five months ago, and how different everything seemed to me then. Now everything is far more familiar and I feel like I fit into it all. I'm more comfortable with my role here, with colleagues, with the babies, and with the people in town. It's a nice progression to have made and a nice feeling to have.

The feeling isn't hampered by the fact that the babies continue to do well. They are growing rapidly and are getting more and more rambunctious. They are all girls except little Mpho, and interact with each other in an endearing way.

I remember not too long ago when sickness was tearing through the safe-home and all the babies seemed threatened and the world felt like it was crumbling apart. There's nothing like the death of a little baby in your care to make you lose your level of comfort with your immediate surroundings and with the world as a whole.

At the other end of the spectrum, there's also nothing like the smiles of a handful of little girls, who have gotten to know you, who trust you and who run to you with big smiles whenever they see you, to instill that same comfort back again.

Baby Binging

Do you know what a premature baby eats?

Let's take Nthabiseng, one of the new twins who is eating well, as an example. It's really pretty amazing.

She's eating about 30 ml of formula every two hours or so. That means she eats about 360 ml of formula a day. That's more than a third of a liter.

She only weighs 1.5 kg -- a little over 3 pounds - and, for reference, is smaller than a regular 2-liter bottle of soda.

Imagine being that size, and drinking that much milk.

Trying to size it up in some comparable way for myself, all I can picture is a big recycling bin full of milk sitting there for me to drink each day. I don't think I could do it.

Premature babies have to fight constantly to stay alive, and so they need the nutrients of regular meals. Dr. Amy from the Baylor International Pediatric AIDS Initiative came by yesterday to check on all the babies here, and said the twins are right on track with their eating -- a great sign.

They were losing weight at home but have stopped since getting to the safe-home. That they are now suckling and eating well with no signs of vomiting or diarrhea should mean they will start growing quickly.

I have high hopes for these two. I know we have to get them nice and strong before they can go home, as they'll have to contend with 7 older siblings once back, but I think we'll get them there.

Even though I've seen so many babies transform here for the better, I still get excited every time I see the same promise peak out once more. It's intoxicating.

Cross your fingers

Imagine this:

You are a young mother in your late thirties. You have seven children. Your husband is working in another country. You are HIV-positive. You sell homemade beer for a living. You and all your kids live in the same, run-down, one-room rondaval. You are trying to make things work, but you're just barely hanging on. It's all too much. One child just got accidentally burned with hot water. Another one just got accidentally burned with fire. They are healing, but medical attention isn't exactly at your fingertips. You live in the middle of no where.

Then, in the midst of all this, you give birth to twin girls, bringing your total number of children to nine. They are premature. They are tiny. They are rapidly losing weight. What can you do?

Just last week, TTL was put in touch with a woman in that exact situation.

Her twins, Pulane and Nthabiseng, are now in the safe-home, bringing our total number here to ten.

The twins were born on May 11 at just over 3 pounds. They are adorable, especially when asleep and wrapped in blankets here at the safe-home, but are so tiny it is hard to imagine that they are real, living, breathing baby girls.

They still aren't eating very well, but I'm hoping that the more they get used to the formula, their surroundings and the care and attention of the bo'me, the more they will eat.

Their situation was so dire when we found them that a full recovery and a bit of a growth spurt here will be an amazing accomplishment, and another triumph for TTL.

These two have a long way to go, but they are in the right place for the journey.

Cross your fingers and wish us luck.

A Sixth Sense

It's official: I'm developing a sixth sense.

I noticed it today for the first time, and it made me happy. It's still developing, for sure, but it's there where it wasn't before. In a way, it's many senses combined into one. It's a sense of babies.

It's a sense of how to react to babies, a sense of when to leave them alone and when to get in their face. It's a sense of how to sway to make them close their eyes in your arms, and a sense of how to be firm without scaring them.

It's a sense of when they need to burp, and when they are about to spit a spoonful of vegetables right back out.

It's a sense of when to push them forward, and when to follow behind them just in case. It's a sense of when they want to stop playing and just sit in your lap for a while.

It's a sense of when they are wet, when they are currently wetting, and when it's just gas.

It's a sense of how they like each bite of dinner mixed on the feeding spoon, and how to trick them into eating when they don't want to.

It's funny how, when you work in an office that is part safe-home, you subconsciously get attuned to the various fluctuations of baby life. You start to sense those fluctuations from the other side of the building, just by picking up on the sounds that cut through the cement walls.

Today there were screams throughout the day, echoing through the office. Most of them were happy screams, with a ranging cadence only possible in early childhood, when screaming just to scream is fun. A few were sad screams, when a time-out imposed by the bo'me wasn't taken-to kindly.

Like I said, this sixth sense of mine is still developing -- and I'm far behind the babies themselves in developing it. They can already read me like a book from a mile away.

Selloane, for instance, has developed an obsession with a new game where she immediately walks up to me whenever I enter the playroom, giggling and grinning from ear to ear. I bend down, put my hands out in front of me, growl and essentially feign derangement, and she runs away screaming. Then we do it again.

But a few times today, when I went into the playroom to ask M'e Mamosa a quick question, Selloane somehow knew I was in work mode. Instead of running up to me grinning, she just walked up and clung to my pant leg nonchalantly, smiling up at me and wondering if the grown-up talk would end soon.

I looked down at her and smiled. Then I crossed my eyes and stuck out my tongue, and she screamed and ran away giggling.

Freedom and the Fourth

I woke up this morning to a quiet breakfast and a warm cup of coffee in the sun. The simple pleasures in life mean a lot here, and I felt at ease.

I let my mind wander and suddenly remembered that today is the Fourth of July.

While there certainly won't be any fireworks in Mokhotlong, there is something else, something far more relevant and important about this day for me here: the profound sense of appreciation for the United States I've gained.

I've appreciated my country before, but never so much as now.

I guess it takes a stint in a country like Lesotho to fully comprehend the luxury of living in the United States. I know there are people struggling with nothing in the U.S. also. And of course there are things about my home country that I would change.

But to such a vast extent, I realize more than ever that I am so lucky to have been raised in a country where the roads are maintained, where grocery stores brimming with food are everywhere, where hospitals are fully stocked with supplies, where the government is stable and where corruption is regularly confronted by a vast system of checks, balances and the fourth estate.

I appreciate more than ever the ease of transportation in the states, the ease of communication, the ease of entertainment, the ease of information.

I appreciate that, because of my loving family, I never had to worry about my next meal or where I would sleep or if I would be warm enough. I appreciate the great education I received, which has given me all the freedom in the world.

I appreciate the fact that, because of the stability I've been afforded in life, I was able to develop the network of friends who I now miss more than ever and appreciate more than ever.

This Fourth of July, I feel like I'm really celebrating in the right way, perhaps for the first time, just by appreciating the independence and freedom that life in the United States provides.

What I've seen firsthand here is that, when there is no food and no water and no medicine and no support and no transportation, freedom is a hard thing to come by.

Happy Fourth of July.