The Stranger in my Bed

I lie in my bed with him in my arms, his wide, wet eyes staring, guileless and unblinking, into mine as I feed him. He is 8 months old and weighs about 8 lbs, the average weight of a newborn. He cannot sit up or roll over. His cry is weak and raspy. But he reaches his long, thin fingers out towards my face and lays his hand on my cheek as he eats, and I am in love.
His name is Kenneth, and I have brought him home from the Nutritional Rehabilitation Unit (or NRU) to try to help him grow and gain weight-really to increase his chances of survival. Perhaps it is a bad omen that, my first week in the hospital on wards, I have managed to bring a baby home. Truthfully I am not even sure how it happened, but here he is, lying in my bed, greedily sucking down a formula bottle at two o'clock in the morning. He is a twin, and the last of six children. His mom died, it sounds as though it was from TB, on September 30th, and he was brought to the hospital by his aunt. I would visit him each day on rounds, and despite his profound cachexia, he would smile endearingly up at me when I talked to him, and giggle when I examined his swollen belly. His aunt, who is only 47 but looks as though she is in her sixties, told me the story of how he lost his mom, and explained that they are now caring for his 5 siblings, in addition to her own 8 kids. Somehow my half-joking offer to take him home with me became a serious conversation between his auntie and my translator, and it was made clear that she would be grateful for the help. My sweet, insane, wonderful husband was not only supportive, but enthusiastic about the idea. And so, last Sunday, I found myself driving with our family, Kenneth and his auntie, and Yvonne, the translator, to his village in the middle of nowhere to discuss with his family the matter of our fostering this fragile little person. We took directions as we drove, in order to be able to find our way home, which read "left at the mango tree", and "right at the giant dirt mound". And then, upon arriving at the village, we sat on a giant straw mat, surrounded by at least 20 kids and an equal number of adults (each of whose hands we all had to individually shake), and talked about this little boy. In the Central region it is customary for the maternal uncle to make decisions about the children's welfare, even when both parents are present. Kenneth's dad is alive, but is very ill, and had left to go back to his home village for care. The uncle agreed, both verbally and on paper, that caring properly for the baby was beyond their capacity, and that we should be his temporary guardians. An elderly woman with rheumy eyes and skeletal hands, who would apparently have been his primary caregiver, kept grasping my hands and thanking me in Chichewa. in fact, rather than resist our request to temporarily provide for Kenneth, we were asked several times if we could also take his twin brother. He looked fairly healthy, however, and I still had some semblance of sanity left, so I gently but firmly refused. We took pictures of the relatives, and one of the twins together. They reached out to each other, and it seemed obvious that they recognized each other. And then we left, and took this emaciated, developmentally delayed, delicate little person home and into our lives and our hearts.
Dave and I had forgotten what it is like to have a newborn, but that is essentially what he is. He eats every 2-3 hours, even through the night, and he is incapable of rolling over or sitting up. His wasted little body is both tragic and terrifying, and when we change his diaper (which is newborn size and floats on him) he cries so hard, and brings his spindly little fingers together to wring his hands in helpless desperation. His upper arm circumference is, without exaggeration, the size of Dave's index finger. We are treating him for TB, so we have to give him his medicine every morning, and he has a food supplement called chiponde, which is like peanut butter thickened with oil and milk powder and sugar, that he is required to eat every day in order to help him gain weight. He is not a fan. He much prefers the formula we make, which he sucks down in great quantity, and seems to excrete into his diaper at a remarkable pace.
Our lives have, predictably, descended into chaos. We are fortunate enough that hiring an extra nanny for him only costs about $125 per month, so he is cared for while we are at work without any additional strain on Laura or the kids. But he wakes at 4:30 am, and cannot really be put down for long, and frequently soils the few clothes we have for him. So we are sleep deprived and have more dishes and laundry to do, and we feel like we are neglecting our kids. And yet, when he is well fed and clean he smiles the most beautiful gummy smile, his ridiculously big brown eyes locked with mine and his tapered fingers reaching for my face, and all the sleeplessness and chaos is momentarily forgotten. The Fitzgerald children, who have been generous with both their love and that of their parents, do not forget the inconveniences as easily, and we are anxiously asked multiple times per day whether we plan to adopt him. The truth is, I do not know what the future holds. I am trying to take it day by day. I plan to go with our clinic social worker on Tuesday to the village, to see what his home situation would be like. I am truly conflicted about what is best, both for him and for our family. I know I absolutely cannot take care of 1 year old twins. Life here is challenging enough, even with the help of our housekeeper and nannies (Dave spent 7 hours on line yesterday waiting for petrol while I was home with the four kids. He was not successful.) Yet we know we could never take one baby out of poverty, into luxury, and leave his twin brother at home in the village. We have discussed the possibility of supporting the orphaned children, providing them with mosquito nets and fertilizer and school fees, in short "adopting" their family. But meanwhile, this sweet little boy is bonding with me and with our family as he grows stronger, sleeping in an air-conditioned room in soft clean clothes with a belly full of formula (which cannot be provided in the village without our help and a source of clean water), and it seems as though it is increasingly unfair to send him back home away from all that we are currently providing. I do not want him to bond with me and then lose me, as he lost his mother only a few short weeks ago.
I think I will know better once we go to the village on Tuesday. In the meantime, as I tell the kids whenever they ask, I am waiting for God to tell me what to do.