Jenice Armstrong: Miracle help for Mirlande

LAST MONTH, I wrote about a little Haitian girl born without an anus who traveled here with her father for surgery at Abington Memorial Hospital.

I'd been concerned about her condition since no one at Abington would say what was happening.

I finally got an update from her doctor yesterday and, thankfully, the news is good.

Mirlande is doing fine and even eating, which is no small thing considering what her tiny body has been through.

In July, I described how her father, Josue Felime, 46, had taken his daughter to a makeshift hospital set up inside a relief tent outside an airport near Port-au-Prince where a visiting doctor from Abington examined her and discovered that the little girl was passing stools through her vagina. Mirlande also had a mass that was the size of a small orange between her legs that needed to be removed. She needed an operation - or face certain death by the age of 5.

Abington officials agreed to perform the operations as a humanitarian gesture and arranged for Mirlande to be flown to the United States with her father. Before her plane even landed, Dr. Ala Stanford Frey was planning to perform at least three surgeries on the child. The first, July 21, was to have been mainly exploratory, but once Frey started examining Mirlande's insides, she knew she had to move faster.

"She had lots of foreign bodies in her colon like pebbles and hay and cement and plastic and insect carcasses," Frey told me yesterday.

This horror was evidence of just how hard life had been for little Mirlande, possibly even before the devastating hurricane. Frey said she has since learned that desperate caregivers will resort to feeding children indigestable objects like cement just so they can put something in their mouths.

It took me a second to digest that.

When I met Mirlande last month, she was happily sucking on a bright red lollipop. Even though she was malnourished, she was working that sucker as if she had one every day.

I could tell Frey was shaken by her discovery. She performed an immediate colostomy on the child.

The following week, Frey removed the tumor between Mirlande's legs. She also created an anus for the little girl and cleaned out the foreign matter that had collected in her colon. It was a seven-hour procedure.

"It was a lot for her," Frey recalled.

Afterwards, Frey decided to transport Mirlande from Abington, which doesn't have a pediatric intensive care unit, to St. Christopher's for Children, where Frey has operating privileges.

"She needed critical-care support. That's as much as I'll say. I was very appreciative to St. Christopher's because they assisted me in taking care of her. I wouldn't have been able to care for her without the care and support I got at St. Christopher's."

After spending a month at the children's hospital, Mirlande was taken back to Abington where "she's up with assistance. She's still in the hospital. We want to give her therapy to get stronger . . . she doesn't have much muscle mass on her legs."

When she came into the hospital, Mirlande weighed just 19 pounds but has gained 3. She's still way smaller than other children her age.

To ensure that she gets enough calories, she's being fed through a tube in her nose. She has developed some food aversion because of her digestive trouble. But she still manages to eat. In Haiti, the little girl existed mainly on a little breast milk and oatmeal when she could get it.

"She couldn't eat much with her bowels being so distended," Frey explained.

Hospital officials are being extra careful about what Mirlande is fed because they don't want her to become overly accustomed to American food since the plan is for her to eventually return home. But Mirlande has been allowed popsicles and yogurt and they hope to get her on authentic Haitian food that has been donated by a local church which has been providing her father with meals.

Therapists are working to improve her walking and speech. Mirlande is verbal but only "to people she wants to talk to," Frey said with a laugh.

"But when you ask dad, dad says she doesn't talk. She does smile and joke and laugh, which is nice to see."

There's still a long road ahead for Mirlande. Another surgery is planned for mid-October during which Frey will remove the colostomy and hopefully get her started on a normal life. Mirlande may be able to leave America by early next year.

But if eating cement and straw was part of her past, what will her future hold? It's a sobering thought.