By Diane E. Palmeri (1976)
In September of 1973, my husband, Tom, and I along with our two year old son, Paul, went to Saigon , South Vietnam , to set up and run a nutrition center for malnourished babies and pre-schoolers, for a charitable foundation in the States. Tom would administer the program and I, a registered nurse, would be in charge of the medical care. Our goal was to treat malnourished children from the numerous orphanages in Saigon and to train orphanage staff, so that some of the causes of malnutrition and disease could be eliminated.
Several months before our decision to go to Vietnam , we had already made plans to adopt a Vietnamese orphan. We felt the child should be reasonably healthy, since we planned to return to Asia , where both of us had previously worked, and therefore might not have extensive medical help within our reach. Once we agreed to go to Vietnam , we decided to wait and find a child ourselves in the course of our work.
A few days after our arrival in Saigon , a government worker took us on a tour of four of Saigon ’s orphanages. What we saw was appalling. As a nurse I’ve seen many awful sights, the ravages of disease, the sometimes drastic medical and surgical treatments required to save lives, and the lives, young and old, that could not be saved even with modern medicine. And I had told myself I was used to it. I knew what I would see before I went to the orphanages. But “seeing is believing” and in this case believing was the sick dull feeling in the pit of my stomach and the lump in my throat.
Many of the orphanages lacked sufficient funds to feed the children adequately, let alone clothe them or provide medical care. And most of the staff had little or no training in elementary hygiene, nutrition or child care.
At one orphanage, which had over five hundred infants and pre-schoolers, a nun ushered us into a room where the smallest infants were. Then she called our attention to one of the newborns. She began undressing the baby and we soon saw why. The baby had only small stumps for arms and legs. The name on her crib was Marie.
Tom and I went back to our quiet apartment somewhat shaken. For the next couple of days we talked a lot about what we had seen, but we didn’t mention little Marie, though we were both thinking of her. Finally, on the third evening, Tom brought up the subject of adopting her. We talked about the possible reactions of our son Paul and decided that, if handled properly, it could be a good experience for him in terms of developing love and concern for others. We also talked about the problem of getting prostheses for her in Vietnam or in other Asian countries, where we expected to be living for some years. Our conclusion was that it was quite unlikely that some other couple who could provide the most up-to-date medical care would ever adopt her. At least we could give her a family.
Tom finally said, “There are too many good reasons not to adopt her, so lets go ahead”. And I agreed.
We went back to the orphanage to tell them of our interest in adopting Marie and to ask if she was available. They were quite sure she was. At that time there was a European medical team working at this orphanage and we told one of their staff we were interested in finding out more about her condition, since it was possible that she could have other defects which might be incompatible with life beyond a few months. This woman told us how to reach the doctor in charge.
After ten days of phone calls and messages to him, I finally reached him by phone. When I told him of our interest in adopting Marie, he immediately said it was “a very bad idea” and that we should try to get a normal child because this baby didn’t have much potential. I told him I didn’t agree and asked him to check her thoroughly for any other congenital defects which would lead to an early death. He finally agreed to do this.
While waiting for an answer from him, Tom and I went to see a European geneticist. We described Marie to him and he indicated her defects were probably developmental, the result of illness or drugs taken by her mother during pregnancy, and such defects would not necessarily involve mental retardation.
At the lend of one week of waiting, I again began trying to reach the doctor, but with no success. Finally, I called the orphanage and was told that Marie was seriously ill with bronchitis. I offered to take her to a hospital, but the sister said the doctor would decide if and when that was necessary.
After several more anxious days, I finally reached the doctor. He said he had been out of the country for three days and he was sorry but Marie had died. Tom and I were sad and angry. I still can’t help feeling the doctor let her die. But perhaps it was God’s way of preparing us.
In the following weeks, I came upon a normal though desperately ill new-born boy at another orphanage. We obtained permission from the Director to adopt him and managed to pull him through. We named him Christopher because we felt he would bear Christ to us in a special way. And, as of that time, we had no intention of adopting another child.
But six months later, when making one of my regular visits to the orphanage where Chris had been, they told me they had a new baby with no arms. I went to look and found a three and a half pound premature girl with a tiny stump on the left and a partial arm on the right that ended in one small finger. She had been born that very day, immediately abandoned at the maternity hospital, and brought to the orphanage. They were keeping her warm with bottles of hot water and they said she was drinking from a bottle. But I felt she should come to our nutrition center because I knew they wouldn’t be able to keep her alive. And I hoped we could find a family in the States who would want her. The orphanage readily agreed. Her name was Bach.
Two days later, they brought Bach to our center. When she arrived, we couldn’t get her to suck or even to swallow from a dropper, so we had to give her milk via a tube to the stomach. Even in Saigon ’s ninety degree heat, we had to keep her bundled with blankets to maintain her temperature. It took three days before we were able to feed her with a dropper and ten days before she was able to suck from a bottle.
The Vietnamese doctor who visited our center daily to examine the sick children took a very positive attitude toward Bach and said she knew of people who learned to drive cars and feed themselves with their feet.
I took her to a European doctor because her small stump seemed to have a piece of bone protruding from it, which I was afraid could become infected. He said it was only part of a fingernail. But he indicated he felt it unwise to try to save babies such as she, for they always ended up unhappy as teenagers. Then he listened to her heart and said she had a bad heart murmur. So I took her to an American heart specialist, who told me it was a patent ductus. This is an opening that exists during fetal life and normally closes within hours after birth. He said it was very unlikely to close later on but could easily be repaired in a few years.
A month later, Tom and I were called one evening at 11:30 PM by the night nurse, who told us Bach was having trouble breathing. When I checked on her, I found her in severe respiratory distress, with every breath a gasp. I asked Tom to call the doctor who had first detected her heart murmur to see if he could admit her to the hospital. He said he had no incubators free and also indicated he wouldn’t want to accept her anyway but would rather save space for normal infants. This was an understandable attitude in Vietnam where the available hospital care was totally inadequate to handle all the children in need. But Tom and I felt Bach had just as much right to life as a “whole” child, even if we had to do the fighting for her.
So we decided to head for another hospital, which wasn’t as good. When we got to the street, it was only five minutes till the midnight curfew and no taxis were in sight. We went to the police station two blocks away and asked if they could help us get to the hospital. They said they couldn’t take us to the hospital we wanted because it was out of their district, but they were willing to take us to another, even less acceptable, hospital. We decided to go.
The Vietnamese doctors at this hospital agreed to admit her, but they had no more empty cribs and so she was placed on a wheeled stretcher. A tube was placed in her nose for oxygen, but their smallest tube was too large for her tiny nose and her breathing became more distressed than before, so they removed it. After several minutes of difficult conversation, I finally convinced them to put her directly on the floor rather than take a chance on her falling from the high stretcher. By 2:00 AM there seemed to be nothing more we could do for her and so we reluctantly went home.
When I returned the next morning, I found Bach in a crib, given her by a family that had put their own child on three chairs. She had not yet had a chest X-ray because when the attendant started to take her for the X-ray, she turned blue and they were afraid she would stop breathing. She was on intravenous feeding but still no oxygen. Some of the parents of other kids had given her condensed milk and unboiled water from a teaspoon during the night “because she was crying”. But she shouldn’t have been receiving anything by mouth because of the danger of aspiration while her breathing was so labored.
I decided I had better try transferring her to the other hospital which we had tried to go to the night before. She really wasn’t getting much help in this place and the other one supplied total nursing care for orphans and did have oxygen tubes for preemies. So I removed the intravenous needle, which was no longer even in the vein, and went out with her to get a taxi. But all the drivers took one look at this tiny dying baby and asked double the usual fare. I finally took an open motorized pedicab. During the ten minute ride to the other hospital, Bach stopped breathing twice, only to start again when I rubbed her chest.
When I arrived at the emergency room, they sent me to the clinic where I was brought into the examining room of an American doctor. I told him Bach’s entire history and present problem. She was all bundled in blankets and he didn’t even look at her. He said he guessed he would have to admit her since he couldn’t treat her there in the office, and he then began making out the admission orders. I simply couldn’t believe he wasn’t going to examine her at all. Finally, I asked him if he would mind checking her heart to see if he could detect any murmur. (A few days previous, our Vietnamese doctor had said the murmur had disappeared.) He did then listen to her chest and said, “No, I don’t hear any murmur, but she has bad pneumonia. I’m sure she won’t live.”
As soon as he had written all the admission orders, I headed for the pediatric ward as fast as I could, both for Bach’s sake and to keep myself from exploding in anger. On the way, I glanced at the orders and noted that he had ordered penicillin intramuscularly and normal diet. I didn’t feel this was the best treatment, but I knew the regular pediatrician, a New Zealander, would take over her care and I hoped he would set things straight. Before I left, I waited to see them get her on oxygen and settled. The nurse had a tiny tube and was preparing to place it in Bach’s nose when I noticed it was uncleaned from previous use on another baby. I asked her to get a fresh tube, which she did with a somewhat puzzled look.
When I returned to see Bach the next day, my hopes were rewarded. She was receiving the penicillin intravenously and had been taken off oral feedings. She seemed slightly better. Three days later, I called the pediatrician and could hardly believe it when he told me she was fine and could be discharged. After that, Bach had no more serious illnesses and began to grow and develop normally. She gave us her first smile at seven weeks.
Tom and I were expecting to move on to the Philippines within the next year, after fully expanding the nutrition center to care for one hundred children and getting replacements to run it. We hadn’t planned on adopting another child at this time. But we decided that, if we wanted to be sure that Bach found a family, we should adopt her ourselves. With our future plans, we couldn’t promise her prostheses, but we could promise her a loving family and the challenge to become as independent as possible.
On the evening of our decision, we brought Bach into our bedroom and let Paul hold her. We asked him if he would like this baby to be his little sister, like Chris was his brother. He nodded with a shy smile. We told him that she would need special help from all of us since she had no hands. And that he could teach her to do things with her feet, as he often did himself. Finally, we told him that little Bach was to have a new name and it would be “Marie”.
It was several days before we were able to move Marie into the family quarters. During this time, she remained in a room with nine other babies. But Paul, who wasn’t normally allowed in this room, went in frequently to visit “my baby”. He knew exactly where her crib was and even recognized her cry. He wasted no time in telling all the staff that Marie was his baby now.
We left Saigon in early April, 1975, and now live in Cagayan de Oro City in the Philippines . Tom teaches at Xavier university and together we run a feeding center, on our front porch, for twenty-five malnourished children from the neighborhood. We found a doctor here who was able to design a simple prosthesis for Marie’s right arm. It has a clamp on the end to which we attach a spoon and she now feeds herself as well as most kids her age. At twenty-one months, she began walking alone. She turns the pages of books with her tiny finger and picks up toys with her feet and passes them to her finger. If anyone leaves their shoes around, she steps right into them and struts around the room. A favorite trick is to pull the nicely folded laundry off a chair with her feet. In other words, like most two-year olds, she’s into everything, only with her feet. Marie is a happy, active girl, with a mind of her own. In fact, she can be quite stubborn at times, but that’s good. She is going to need lots of determination in the future.
I don’t think she is really aware of her difference and its implications yet, but she will begin to understand in the coming year. I’m sure there will be many trying times for her and us in the future. All I can hope is that we will be able to give her the love and support to face her problems and find a way to overcome them. Will she be unhappy as a teenager? Who knows? We will live together and learn.
The American priest who baptized Marie in Saigon asked Tom a question afterwards that we often hear, “Well, what are you going to do with her?” It always sounds strange to us, as if Marie were an object, not a person. We will “do with her” as with all our children; love her, help her to know all the wondrous possibilities of life, and then let her decide for herself.