Sunday, November 13, 2011

And now we are seven...

Soooo.  Kenneth.  I am sorry that I have not written sooner.  It has been a confusing, emotional, exhausting month.  Kenneth stayed with us for almost three weeks, and he grew at a rapid pace.  Within a week he had cheeks you could pinch, and after two weeks he almost looked like he had buttocks.  He was a voracious and demanding consumer of formula, finishing a can every 2 days, and reluctantly finishing the sachets of high-calorie Chiponde we forced on him each day (he was not a fan). Within 14 days he gained 50% of his original body weight, going from 3.8 kg to 5.5 kg.  This is the equivalent of Dave gaining 100 lbs in two weeks.   He became stronger and more interactive, and eventually was able to put objects in his mouth and push his little head off the blanket when laid on his belly.  A favorite activity of his was grabbing the sides of my face with both hands and pulling me down to give me sloppy, open-mouthed kisses on the cheek or suck on my chin.
Unfortunately, his perpetual demand for nutrition was not limited to daytime, and Kenneth would wake to take a bottle every 45 minutes to 2 hours, sometimes drinking 20 ounces overnight.  Dave and I developed a system where one of us would sleep in bed with Kenneth and essentially pull an all-nighter, and the other would sleep in a different room and recover from the night before.  It felt like having a newborn at home, but without the maternity leave, while living in a developing country where NOTHING happens easily except sunburns.  We became sleep-deprived, bleary-eyed strangers to each other.  I became very emotionally labile, deciding one afternoon as I trudged home from work on foot in the searing late-afternoon sun, that I no longer wanted to save the world.  I wanted to shop at Target, and go to the movies, and play with my nephews, and take a bath in my beautiful two-person bathtub in North Carolina.  I wanted to run on a treadmill in an air-conditioned gym, and eat peanut butter frozen yogurt, and go for coffee with my mom.  Dave, who became increasingly befuddled but never complained, took the challenge in stride.  The children seemed mostly to enjoy having the baby around, and Malawi proved to be a motherly, doting, reliable little caregiver to him.  Aine would exclaim “Oh I just love him!”, then run off to play with the neighbors.  Eamonn was indifferent at best, and desperate with anxiety at worst, repeatedly begging us not to adopt him.
The backdrop to this dramatic change in our lives was life in Malawi. Grocery shopping literally requires visits to between 5 and 7 different stores in order to buy the routine necessary items, we are both working full-time jobs in busy  facilities with extremely ill patients and few resources, and there has been a severe petrol shortage for weeks.  You never realize how completely dependent you are on cars until someone tells you there will be no gas deliveries to your city for 3 weeks.  Lines at the stations begin with the rumor of fuel delivery, develop within minutes, and can last hours, often ending in disappointment and sometimes bloodshed (no deaths, but some arrests).  Fuel, where to find it, how much it costs on the black market, and how much is left in the tank are constant topics of conversation.  We have become the proud owners of 4-5 jerry cans, dispersed hopefully throughout the city with people who can possibly purchase gasoline for us.  Dave has become proficient at siphoning fuel into the tank.  At the same time that we have had to walk/run to work more frequently, it has become hotter.  By the time I arrive at Baylor each morning my back is soaked in sweat and my face is covered in a layer of perspiration and grime.  For the first time since we arrived, exhausted, hot, and overwhelmed, I wanted to go home.
The situation was not sustainable, and I began to search for a plan.  We had intended to go to the village about 10 days after Kenneth came to our house, but our empty gas tank forced us to put the visit off for another week.  We had finally procured enough petrol from our neighbor that we could drive the hour on dirt roads into the village with Mrs. Chisala, the wise social worker for the Baylor clinic.  Malawi insisted on coming, and Martha the nanny held the baby while I drove.  The directions I made fun of in the last post (left at papaya tree, right at the bigger dirt road) were now the ones I was using to find my way back to Kenneth’s home.  We made a few wrong turns, but eventually arrived at the small grouping of thatch and mud huts, and a large and rapidly-growing crowd of relatives.  Again, we assembled on the bamboo mat, and again I individually greeted each of the adults with a handshake as the family passed the baby around, admiring his weight gain.  I tried to discern if he recognized the people who surrounded him as he stared at them with wide eyes, but I could not.  Again, I was asked to take his twin brother Innocent, and this time I was quick to agree.  He looked terrible.  He was now smaller than Kenneth, and he was limp in the arms of an auntie, unable to lift his head, his cry weak.  Upon further questioning, we learned that the baby had been drinking cow’s milk, diluted with well-water and mixed with sugar.  He was being supervised by his 15 year-old sister and his ancient, kyphotic “go-go”.  As a group, and surrounded by a gaping mass of children,  the aunties, uncles, Mrs. Chisala, Martha, and agreed that the best thing for the boys would be to stay together.  It was also obvious that they could not stay in the village.  The boys’ extended family is able to raise some animals and grow enough food to sustain the adults and bigger kids, but there was no extra money for formula for these two motherless babies.    I explained that could clearly not care for both twins, and it was decided that they should be brought to the Crisis Nursery in Lilongwe, a volunteer-run faith-based home for malnourished children from impoverished families.  Together they would be fed and rehabilitated, then possibly given to foster or adoptive families.  Mrs. Chisala firmly explained to the village, as she had explained to me, that if I did not intend to adopt both boys, then they should not stay in my home at all.  It was obvious that we had developed a close bond with Kenneth in the few short weeks we had shared our home with him, and she warned that he was beginning to see me as “mama”, and that further time together would be lead to emotional devestation when the time came for him to leave our family.  She also felt that, were we to continue to foster him, he would become accustomed to living an “Azungu” lifestyle, with air-conditioning and mosquito nets, and a large variety of clothing and food.  He would go from being doted on and played with and passed around, to surviving.  When I asked Kenneth’ teenaged sister if she would miss her brothers, she said frankly and unapologetically that no, she would be happy to be able to go back to school.
So, decision made and papers signed, we climbed into the dusty truck with the two babies and set off for Lilongwe.   We had to stop at my house to get Kenneth’s formula, clothes, and toys, and to let the kids and Mary (our housekeeper, who had grown to love him) say goodbye.   I cried most of the 45-minute ride back, and Mrs. Chisala consoled me, reminding me that the babies needed to stay together, and that no one expected me to take on the challenge of having 5 (!!) children.   I called Dave, who was at work, and he sadly agreed that the Crisis Nursery was the best place for them.   We had come to be doctors here in Malawi, and our sleep-deprivation was keeping us from functioning well at work.   Plus, our children needed us.  We had just transplanted them to this hot, fuel-deficient city far from their home.  We certainly couldn’t thrust twins on them, even if we thought it was a good idea.
My children were sad saying goodbye to Kenneth, and kissed him on the forehead.   Eamonn asked if Kenneth would find a family to take care of him, and I said that I honestly didn’t know.  My housekeeper, who has something of a flair for the dramatic, collapsed on the ground and sobbed when I told her the baby was leaving.  This, of course, made me cry even more, which of course made the girls cry.   Mrs. Chisala gentled chastised Mary for her theatrics, and restated her belief that, unless we could take both boys, Kenneth and his brother needed to go to the Crisis Nursery.   Reluctantly and quietly hiccupping, Mary agreed with her, but could not say goodbye to the baby, and declined my invitation to come with us to drop him off   .
The Nursery is very pleasant and clean, with colorful murals and clean, well-cared for babies, about 6- 7 to a room with one caregiver, called a “mother”.  I watched as volunteers fed babies, and I told myself that the boys could be very happy here, and that they would obviously be better off than they were in the village.   Still, I was heartbroken as I sat in the rocker with him for the last time. He reached up to grab onto my cheeks and suck on my chin, and tears rolled down my face as I told him goodbye.  Martha sat across from me and inconspicuously wiped her eyes with her chitenge.  Mrs. Chisala spoke with the director, and we left.
 I was exhausted when I returned home, and yet Dave and I threw the bags that Laura had packed for us into the trunk, put the baskets of food that Laura had organized for us into the backseat, and set off for the beach, where we had been planning to go with Kenneth. 
The weekend was wonderful, although we certainly missed the baby.  We stayed in a cottage owned by a friend of a friend, which was right on the lake.   It is simple and basic, but clean, and has a kitchen and three bedrooms (with a/c!).  Two miles down the road is a fancy hotel on a soft, white-sand beach, with a giant swimming pool and paddle boats and kayaks available.  We pay dues to be able to use their facility ($25 per year), so we spent both days playing with the children and swimming in the clear, warm, shallow lake waters.  We relaxed and talked, built sand castles and did cannonballs into the pool.
Over the next week I sometimes thought I heard Kenneth downstairs, cooing or squealing, and I would occasionally ask the kids if they missed him.  The girls always said yes, but Eamonn was usually quiet.  “Don’t worry mom, he’ll be OK, “he would assure me when I was sad, “He’ll be adopted by someone.”  I’m not so sure, I would tell him.  But, honestly, I felt better than I had in weeks.  I was well-rested, and had reasonable personal hygiene once again.  I slept in the same bed as my husband every night.   I was able to do my job and enjoy it.
Wednesday morning when we woke up, there was no water in our house.  We came to learn that the recurrent power outages had led to pump failure at the water board, and the problem was not expected to be fixed until the end the weekend, at the soonest.  In Malawi, I have found that it is generally the rule that one should roughly double any estimates of time and price given by repairmen, so I was not hopeful.  It is amazing the smell that develops when a family of six (including Laura) cannot flush the toilet or wash dishes (or bodies) for 24 hours in the oppressive heat.   So, once again, we planned for a beach trip.  We decided to stop by the nursery to visit the babies before we left that Thursday.
When we arrived, the twins were in separate rooms, with different “mothers”.  No one appeared to be able to tell the difference between the two.  The supply of one of Kenneth’s TB medicines and the pill cutter we had left were gone completely, and he had been given several days worth of the second medication at 4 times its correct dose.  He seemed to have lost his chatty demeanor, and only began to smile after 30 minutes of holding him.  The record books where information about the children was written stated that “unknown baby” (Innocent) had been having continued fevers and had not gained any weight in the week he had been there.  He had been given Tylenol and a few days of antibiotics, but when we picked him up his skin was on fire.  Dave and I set off for Baylor to get malaria and TB medicine for Innocent, as it was very possible that he was suffering from the tuberculosis that had infected his brother and killed his mother.   Although the babies had clearly been getting fed and changed and attended to, it was obvious that they were not being loved by a family.  It is impossible for a woman in charge of 7 malnourished children for a 12-hour shift each day to provide the same quality of care that living with a family can.  As we mixed the medicines and demonstrated the dosing to the caregivers and wrote in the book clear instructions for their administration, I looked at Dave with tears in my eyes.  “What do we do?” I asked.  “I’ve already decided,” he replied.
The first day at the beach, where we were staying at a lodge with the families in our complex, all of whom were also without water, I talked with Dave.  He was right, and although the idea filled me with anxiety and I couldn’t believe I was considering it, we began to plan to take Kenneth and his brother home.  Two problems were paramount:  the big kids, and the sleep issue.  We carefully plotted how to tell Eamonn, and I fretted about hurting him and felt guilt that he might feel burdened and overwhelmed and unloved.  And we decided that we needed a night nanny.  There was absolutely no way that we could function as parents or employees if we didn’t sleep regularly.  We decided that, here in Malawi, we were the Jolie-Pitts, and we could have the full-time staff that the wealthy in our country do.  To hire a full-time caregiver/housekeeper in Lilongwe costs about $70/month, and we usually grossly “overpay” our helpers at $125/month, so the financial burden would not be so high.  We started making calls, and soon found a potential daytime nanny, and confirmed with Martha that she could take care of the twins at night.  We spoke with Mary, to be sure that she could cover during the first week, while we were waiting for reinforcements. She, of course, was happy to help make it possible to bring Kenneth home. 
We spoke to Laura first, and although she reiterated that we were functionally insane, she was on board.  We then pulled sweet Eamonn aside that Friday afternoon on the terrace restaurant at the hotel and told him of our plans.  We explained that it was truly unlikely that the babies would find a home, and that their future was bleak if they survived and returned to the village, where they would be two of a score of children being essentially cared for by other children.  We told him that his support was critical, and reminded him how his sisters were inclined to adopt his opinions, and would be as accepting or rejecting as they thought he was of the idea.  We admitted that he had us in the palm of his hand, and jokingly offered to buy him electronic in exchange for his endorsement.  And my good, kind little boy agreed that we should bring the twins home.   He was understandably worried about the details, ranging from their college educations (?!) to whether he’d have to change dirty diapers, and we tried to answer all of his questions honestly and openly.
Together we told the girls the next day, and they first looked at Eamonn to see his reaction.  When he said, “I think it will be fun!  Two more minions for the Fitzgerald army…now we REALLY outnumber the grown-ups!”  they smiled, and it became official.  We were going to be a family of seven.
We brought  Kennedy Adam (we weren’t fans of the name Kenneth) and Shane Peter (formerly Innocent- he would’ve been beat up with that name in the US) home a week ago today.  How has it gone?  Well, better than I would have thought.  My children are phenomenal little people, and have embraced these tiny boys with a love and acceptance that fills my heart with pride and gratitude.  They play with them, feed them, hold them, and coo over them.  The almost round-the-clock staff we have employed (3 nannies, a housekeeper, and a lawn person) are essential, and the night nanny in particular is the key to our survival.  It is definitely chaotic, and I spend much of my time covered in food and baby drool, never have a minute to myself, and frequently feel incompetent and guilty in all forums of my life, but that is really status quo.  Every day I am growing to love these babies more, and I see my family doing the same.  I love their sweet fuzzy heads, and kissing their little necks, and feeling their weight on my shoulder. I feel renewed love for my husband and his generous heart, and I am in awe of the Fitzgerald kids.  I am overwhelmed, for sure, but taking it day by day.  What else can you do?