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Hardest hit

Haiti | With nearly half a million orphaned children before the quake, Haiti's challenge to parent them just got bigger

Issue: "Fighting poverty," March 13, 2010

PORT-AU-PRINCE-When doctors first hunched over 6-year-old Jean in a crowded medical clinic supply closet, I braced myself for a horrifying sight: the painful death of a child.

All the signs were there: The severely malnourished and dehydrated boy with cerebral palsy took shallow breaths. His twig-like arms and legs shook. His weak eyes rolled back into his head. During a series of wrenching medical procedures without anesthesia, he barely whimpered. I left the makeshift clinic near Port-au-Prince that afternoon thinking Jean's first day at Presbyterian Mission in Haiti (PMH) might be his last (see "Aftershock," Feb. 13).

Less than two weeks later, unexpected news arrived: Jean was alive and well. A volunteer pediatrician with Flying Doctors of America had saved his life, and Haitian women from the mission's local congregation had cared for his daily needs-feeding him, bathing him, clothing him, holding him.

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Sadly, Jean's impoverished mother never returned for her son. When workers from Danita's Children, a well-established orphanage near the northern city of Cap-Haitien, visited PMH during quake-relief work, they offered Jean a home, airlifting him and another orphaned child to their facility in the northeast corner of the country. When I called the orphanage's U.S. office to ask about Jean, Sheree Bowie knew whom I was seeking before I mentioned his name: "Oh, you must mean Jean."

Bowie reported more good news: Jean was recovering strength daily. A volunteer specialist flew in from the United States to attend to his needs, and those of other children. Doctors were helping orphanage workers develop a plan for Jean's rehabilitation and daily care. The other kids love him. "Our children have been doting on him, and our volunteers adore him," said Bowie. "And we really believe he is going to thrive and do as best as he can."

It was a sweet note in a bitter score for the thousands of newly orphaned or abandoned children in Haiti. The UN estimates that Haiti was home to 380,000 orphans before the Jan. 12 earthquake that destroyed much of Port-au-Prince and surrounding areas. The post-quake estimates report thousands more children are orphaned, abandoned, or separated from family.

Many of those children have substantial medical needs: amputated arms and legs, severely broken bones, debilitating wounds. Other children suffered physical calamity before the earthquake: malnourishment, a high rate of HIV infection, and serious illness from treatable diseases.

While headlines have been dominated by news of the 10 Idaho Baptists arrested for attempting to transport 33 Haitian children into the Dominican Republic on Jan. 29-and the subsequent release of eight of the Americans-the serious work of caring for orphans in Haiti has gone forward with little fanfare. And with the Haitian government closing the process of new adoptions for the foreseeable future, many orphanages are preparing for children who may be in their care indefinitely.

Though it's difficult to pinpoint the number of orphanages in Haiti, last year the country's department of social services, or IBESR, reported 100 licensed orphanages and 67 creches-orphanages licensed to facilitate adoptions. Many more informal operations exist, with some overcrowded and undersupplied in the best of times.

Authorities worry that the country's longstanding problem with child trafficking may grow worse in the post-quake surge of orphans: UNICEF warns that children newly orphaned or separated from family are vulnerable to child predators. Haitian authorities say they want to attempt to reunite children with any living family before moving forward with new adoptions to avoid potential trafficking problems.

That means orphanages like Danita's Children will care for children like Jean and many new orphans. Bowie says the orphanage's population has nearly doubled. Before the quake it cared for 77 children. (The Christian ministry also has a church for 500 community members and a school for 600 children.) Since, the orphanage had taken in at least 53 children and another 22 adults in need.

Some of those children have serious injuries: A volunteer surgeon mended a severe wound for a girl with an amputated arm and exposed nerve. A prosthetics specialist assessed other children with amputated limbs. While most children at the orphanage are healthy, the workers also cared for special needs before the quake: a boy with a tumor in his mouth, children with slight mental retardation, a girl severely burned in voodoo rituals.

To care for children with old and new needs, the orphanage is bringing in volunteer doctors and building a medical facility to offer modern care in a country with severely limited medical attention. Bowie says in the past the workers have driven three hours to Santiago to obtain advanced care for children. Now they're attempting to accelerate plans for their own hospital already two years in the making.

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