Hardest hit

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.

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.

As the group takes in new children, Bowie says they are taking great care to make sure children are truly orphaned: "We want to reunite wherever we have that opportunity." To that end, the organization-which doesn't normally facilitate adoptions-is working with the Red Cross and other agencies to register children and look for any remaining family. The group has also visited IBESR officials to ensure their work is properly done, especially in light of the negative publicity surrounding the Baptists from Idaho: "We're really being sticklers about it."

So are the workers at God's Littlest Angels (GLA). The orphanage located just outside of Port-au-Prince and founded by an American couple in 1995 has long cared for the most vulnerable of orphans. Board member Tom Vanderwell says John and Dixie Bickel "felt called to the tiniest of the tiny and the sickest of the sick." Vanderwell has seen that reality firsthand: He and his wife adopted two children from GLA nearly five years ago. At 20 months old, their adopted daughter weighed 12 pounds. She's much healthier today, and so are many of the other children at GLA.

The group regularly facilitated adoptions before Haitian authorities closed the process. Vanderwell says the organization is carefully following post-quake Haitian regulations: For now, GLA isn't accepting any new adoption applications, even to keep on file: "We're committed to doing things right because we're here for the long haul-long after Anderson Cooper leaves and long after people forget about the Baptists from Idaho."

When the Haitian government allowed children to leave the country if their adoptive parents were already far along in the adoption process, Vanderwell says 81 children at GLA were eligible to go: "We sent 81 kids home." Since then, GLA has taken in more than 30 children, many from an orphanage that collapsed. Three children, separated from family, came from the U.S. hospital ship, USNS Comfort. GLA located the birth parents for all three. In one case, a little girl recovering from serious injuries remembered where she went to church in the city. GLA workers took her photograph to the church and within three days her father called to claim her.

Since GLA sustained little damage in the quake, Vanderwell says, "We have the responsibility and obligation to help others." The group has facilitated nearly 1,000 tetanus shots for the surrounding community and provided help for Haitian staff members-70 percent of the local staff lost their homes. The group plans to help rebuild homes in the community and arrange sponsorships for orphans.

Bowie says the workers at Danita's Children orphanage are in it for the long haul too. Children like Jean, she says, are "probably going to be in our care for the rest of his life." As the workers offer spiritual nurture to the children with biblical teaching and gospel hope, Bowie says some of the greatest encouragement comes from the orphans themselves. She says the children who were in the orphanage pre-quake are helping the new orphans: "There's nothing more powerful than seeing an orphaned child pray for another orphan."

She hopes interest in Haiti's orphans won't fade with time, especially among Christians. "This isn't an option," she says. "This is a scriptural mandate. We have to care for these orphans."

Related coverage:

'Still in shock' | Haiti is hit by a massive earthquake followed by aftershocks, with an epicenter near the capital, Port-au-Prince | Mindy Belz and Jamie Dean | Jan. 12, 2010 Helping Haiti | WORLD provides a list of relief organizations accepting donations to assist earthquake victims in Haiti | The Editors | Jan. 13, 2010 Search and rescue | U.S. disaster experts, the U.S. military, and private relief groups head to earthquake-devastated Haiti | Mindy Belz | Jan. 13, 2010 In the dark | Haitian-Americans hope to contact loved ones and quickly send aid back home to family and friends | Alisa Harris | Jan. 13, 2010Weeping and waiting | Haitian earthquake victims await help, but obstacles slow relief efforts | Jamie Dean | Jan. 14, 2010Desperation | Too many Haitians are in a holding pattern awaiting aid, as relief organizations try to make progress | Jamie Dean | Jan. 15, 2010Long night | With tens of thousands of casualties, Haitians weep and wait for morning | Jamie Dean | Jan. 15, 2010Deliverance | A group of orphans arrive safely in Pittsburgh while relief organizations report progress in Haiti | Mindy Belz | Jan. 19, 2010Crying for help | Hard-pressed Haitians seek assistance as aid groups face logistical challenges | Jamie Dean | Jan. 21, 2010Leaving Port | Beyond the capital city are rural communities equally devastated by the quake and in need of help | Jamie Dean | Jan. 22, 2010The new normal | As life and death continue their morbid mingling, relief groups forge ahead to help | Jamie Dean | Jan. 22, 2010Finding home | Now that search-and-rescue efforts have been called off, attention turns to providing shelter for survivors | Jamie Dean | Jan. 23, 2010Chaotic aid | Relief groups attempt to help Haitians despite murky rules, government interference, and the lack of a cohesive plan | Jamie Dean | Jan. 28, 2010Aftershock | Caregivers predict a second wave of death, as Haitians find moments of deliverance amid days of devastation from one of the modern world's worst natural disasters | Jamie Dean | Jan. 29, 2010Homecoming | For Haitians orphaned before the quake, it means leaving home and starting over | Alisa Harris | Jan. 29, 2010Crisis giving | Instant need calls for long-term strategy | Rusty Leonard | Jan. 29, 2010An indecent grief | First lamentations, then comfort that strengthens more than soothes | Mindy Belz | Jan. 29, 2010Hope for Haiti? (audio file) | Hear WORLD news editor Jamie Dean discuss her visit to the earthquake-ravaged country | Nick Eicher | Feb. 1, 2010 Despair and salvation | While the UN grapples with unruly crowds, The Salvation Army peacefully distributes food | Jamie Dean | Feb. 2, 2010 Crossing lines | Failing to heed sound advice, 10 Americans now find themselves facing kidnapping charges in Haiti | Jamie Dean | Feb. 4, 2010 Haiti's plight (audio file) | A discussion of the country's days of devastation and moments of deliverance | Jamie Dean | Feb. 5, 2010 Stress management | Helping Haitians recover takes zeal-with wisdom | Jamie Dean | Feb. 12, 2010 Taking charge | In quake aftermath, build new cities, says Haitian ambassador (and Bible translator) Raymond Joseph | Mindy Belz | Feb. 12, 2010 Houses of God | Grand-Goave, Haiti | The Editors | Feb. 12, 2010 Living water | Water Missions International offers long-term solutions for clean, drinkable water | Angela Lu | Feb. 13, 2010 Building blocks | While Christian Aid Ministries provides for the immediate needs of quake victims, it looks ahead to helping the country rebuild | Angela Lu | Feb. 16, 2010 Close quarters | ActionAid helps homeless Haitians deal with sanitation and security issues at camps set up in Port-au-Prince | Angela Lu | Feb. 23, 2010 The search for miracles | Port-au-Prince is a city desperately seeking turnaround-and that's before the earthquake | Jamie Dean | March 12, 2010Hope in the darkness | World Hope International offers Haitians practical assistance and spiritual guidance | Angela Lu | March 24, 2010 Night crawlers | A new disaster threatens defenseless women and children in Haitian tent cities: rape | Jamie Dean | March 25, 2010Homecoming | Missionary Patrick Lataillade, who nearly died in the quake, returned to help Haitians this week | Angela Lu | March 27, 2010 Hashing out Haiti | As the UN makes recovery plans, Haitians struggle for the basic necessities for survival | Jamie Dean | March 31, 2010