The Story of Family to Family
Excerpts from the Quarterly Newsletters
1975 to 2007
(Click on the graphic to view the book or right-click to Save as a file)
The following are articles about Tom & Diane Palmeri:
Exploring the Dark Side of Paradise, An American Couple Takes Up Misery's Gauntlet (by Michelle Green)
What Two Can Do (by Anne Buckley)
The following writings describe various aspects of Family to Family's work over the years:
Marie I and Marie II
Faces Not Forgotten
Just Another Day
The Boy Who Could Not Wait
Rene (Paul G. Palmeri's writing as a college course assignment many years after he knew Rene)
Daddy at Easter
Note: To return to the top section of this page, click on "Back to List of Writings" (after each story) or the "Writings" link on the left side of this page.
It had been a fine dinner, with drinks before and after, and we had come to that moment in the evening when the many masks that preserve us in the glare of the day are sometimes put aside and a person reaches out to touch the truth about himself and others. The young Filipino who was sitting across the table from my wife, Diane, and myself looked at us and said, “Why do you do what you do?” Diane and I grinned at each other. Then, for whatever reason, the lateness of the hour or the difficulty of answering fully, I said, “What else is there to do?” I meant it to be amusing, but it also had its serious point that he could take with him and ponder if he wanted. In any case, I left it at that.
It has often occurred to me since then that I cheated myself, as well as my young friend, out of an answer that might have been worth hearing. And so when a former student of mine who is now on the faculty asked me to write an answer to the very same question for use in the Philosophy Department’s bulletin, I thought perhaps the time had come to find out whether or not I really had an answer. For whatever it is worth, that is what follows.
The first thing to be said is that in the remainder of this article I will be answering only for myself. Diane and I work very closely together and I will often refer to her. And undoubtedly many of our reasons are similar. But there are also differences, and she will have to define her own position herself if she ever so chooses.
Now when people ask, “Why do you do what you do?” just what are they referring to? I teach Literature and Philosophy at Xavier University (Cagayan de Oro City, Philippines ). And I don’t imagine there are many American ex-Jesuits who have returned to the Philippines to teach at a Jesuit Ateneo. I know that some of my American Jesuit friends who used to be here and are now in the States find a certain irony in my being here when they are not. But still, my teaching is not the main thing that people have in mind. They are thinking rather of the fact that we have formed an organization of our own, Family to Family, Inc., to support the work that we do, and they are thinking of the work itself, the feeding program that supplies two meals each day to fifty malnourished children in our neighborhood and the temporary foster care that we provide in our own home to five children at a time. Those children have either been abandoned or come from homes where there are grave social and economic problems. They are almost always deathly sick when they come to us and frequently at the point of starvation. If a few months old, they weigh less than they did at birth. If three or four years old, they are often unable to walk or even sit. We keep and care for them until they are well and happy and can either be returned to their own homes or to new ones that have been found for them. And of course, the many people who can never accept the fact that our four adopted children (two Vietnamese and two Filipinos) are every bit as much our own as the two to whom Diane has given birth also have these in mind. Diane and I never think or our four adopted children as part of our work, but perhaps for the purpose of this article it is not beyond the point to include them. We deliberately chose all four of them ourselves and we have cared for them since they were infants, and they were in every bit as bad shape as the children who are brought to us for foster care.
With regard to what we do for the eleven children who are in our home at any one time, Diane is a registered nurse who has often had to function as a doctor, and so she supervises all of their medical care. I handle most of the administrative matters that come up, but am also directly involved in the care of the children. And that is perhaps the point to be emphasized, that both of us are always directly involved in caring for the children.
I believe the above is what others have in mind when they ask about what we do. But it need not be entirely the same as what I understand myself to be doing. And so it is necessary to cover the same ground again. First, my teaching at Xavier is significant to me, but it is not the main thing I am about, and I think people generally recognize that when they focus their attention on the children. The caring for the children is the central thing in our lives. But something that is almost always overlooked is that we live by the sea. People don’t think of that as “something that we do,” but for me it is. We live not one or two blocks from th sea, but with a yard that ends right at the beach. I wouldn’t have it any other way.
And now we come to the important part. Why? What are my reasons? Nothing is clearer to me as I write this than the fact that I have no fully rational explanation. Probably no one ever does for such things. Matters like these are so personal and so charged with emotions that they defy all attempts to systematize them. And so I want to stress that what I am about to say is not a prescription for others. It is only an attempt to trace the motivating forces of my own conduct of life. Perhaps it is little more that the distillation of a mood.
What else is there to do? That is what I asked the young man and I intended something very serious by it. Unless one is contemplating suicide, one has to do something for whatever years remain. The question is what shall it be and how to determine it. At forty years old, as I look backwards and forwards, I am convinced that few things can be more pointless than to spend a life doing what is not interesting. There are, of course, a great many things that are interesting besides bringing children back from the edge of starvation. But few people do any of them. And that is the real point of the question. Few people even stop to think that they could do anything different with their lives. If they give any thought at all to what they will do with the years remaining to them, they assume that they have to do whatever everyone else does. And so they spend their lives doing what they themselves consider boring, going to an office or counter each day where they eagerly wait for the day to end so they can wait for the week to end until finally, after a thousand or more boring weeks, they can retire and sit at home to wait for everything to end. How utterly futile. If there are people for whom this is unavoidable, I pity them. And so this is the first thing to be said positively. I do what I do because I find it interesting, not boring.
On the negative side, there are certain reasons that should be explicitly set aside because they may commonly be attributed to me. I do not do what I do out of a sense of duty or resoponsibility for the conditions that I encounter. Let me try to clarify this by using Xavier as an example. I know the precise solutions for all of the University’s problems. And I have frequently made a great many of my views on that subject known. Yet five thousand administrators, teachers and students ignore my advice and continue to do as they themselves see fit. So how am I to be held responsible for what results? In any case, I refuse to be. It is the same with the children who are brought to us. There are a great many people at various levels of society who are respoonsible for the condition in which they come to us, but I reject any insinuation that I am one of them.
Nor is the situation with the world as a whole any better. The world is mad. I do not say that it has gone mad because that would imply that there was a time when it was sane, and I see no evidence to indicate that. In fact, the question of whether or not the world has made moral progress over the centuries or of whether or not there is any moral pattern discernible at all, be it for the better or for the worse, is one that has engaged a great deal of my intellectual life for the past twenty years, and I can see no answer to it at all. The United States finally did away with the legal institution of slavery and that was understandably progress. But I am not so sure that slavery would be economically advantageous any longer. And old forms of slavery have been replaced with new ones, such as the massive network of organized crime that extends almost everywhere and is happy to reap fruit from the pushing of drugs onto children who are too young even to realize what they are doing. Did Caesar’s legions do anything worse than Hitler’s slaughter of millions of Jews? And while you read this, the ”boat people” of Vietnam are bobbing up and down in their boats, waiting to be raped and robbed and murdered while an indifferent world watches. Has there been moral progress or regression? How would one even establish the criteria for an answer? Shall we consider merely the quantative factor of the number of people butchered in any given time frame as a percentage of the total population available? Or shall we also consider the qualitative element of the savagery and brutality with which the butchering is carried out? And how much weight shall we give it? How do you like your victim, fried on a spit for three hours or with a swift and merciful bullet through his head? No, it would take a wizard, not merely an intelligent man, to know where the world has been morally and where it is headed. All an intelligent man can tell is that it has always been mad and that no single individual can fundamentally alter the great structures of oppression and brutality. And so, for my own part, I have washed my hands of the world and ignore it as much as I can. Though a general knowledge of what goes on is of some value, the reading of a daily newspaper or a weekly news magazine can do little more than foul the mind with what is ugly, and I do not allow them in my home. I have a fairly good idea of where the world is headed over the next ten years, it is not a pretty picture, and the last thing I need is a blow by blow description of it as it happens.
Having mentioned the fouling of the mind with what is ugly, I must also mention the beautiful, and for that I return to the sea. We live right by the beach and we have a little nipa-covered rest house where the sand begins. There I spend hours every day, often accompanied by the children. I read, I hold the little ones on my lap, I stare out at the volcanic island of Camiguin , and contemplate the cloud-wrapped peaks of the mountains that rise on the other side of the bay. It is a panorama that is ever the same and yet ever changing with each shift in the angle of the sun and in the formation of the clouds. For someone not brought up in the tropics, the colors are so brilliant they seem unreal. And yet they are far more real than most of what goes on in the life of man. The contemplation of such beauty is so uncomplicated and so immediately valuable. In the moment of experience, it is independent of what any tyrant in one of the great capitals of the world can do to destroy it. Aristotle recognized that not all propositions can or should be proven. Some are simply evident to anyone who understands them. Otherwise there would be an infinite regress. The same is true of values. Not every value is to be justified in terms of its instrumentality toward some other value. Certain experiences bear an ultimate value within themselves that is simply evident to anyone who understands. The contemplation of the beauty of Macajalar Bay as it repeats its endless transformations each day is one of them.
If this seems a lengthy digression, let me assure you it is not. And if the emphasis I am giving to the experience of beauty seems shocking to some, I will perhaps be excused when it is remembered that stressing the value of the beautiful is one of the things that a teacher of literature is supposed to be about, even if it seldom happens. In fact, the ancient Greeks may be the only people who have taken beauty in all its forms quite seriously. In English literature, it is William Wordsworth who towers above all others in his understanding of the desperate need man has for the beauty of nature and of all the forces in modern life that work to separate him from it. In any event, I see no less worth in an hour spent watching clouds move across the bay than I do in an hour of teaching Philosophy to students who positively do not want to learn how to write a correct sentence.
Somerset Maughn is an English novelist much given to exploring the reasons why people do what they do. He has many candid things to say about why he himself is a writer. In The Moon and Sixpence he probes the motivation of an English businessman who leaves his family and affairs to go to Tahiti and paint. There is also a minor character in the same book who is much to my point. Captain Brunot is a Frenchman who had fallen on bad times in France . With borrowed money, he bought an island in the Paumotus, and in the course of twenty years, he and his wife transformed what was little more than a sandbar into a beautiful and productive garden. He had no regrets for a life so spent. Beauty of nature is for the most part a gift man passively receives. It is there for the taking, frequently at no more expense than the trouble of raising one’s eyes from the ground and beholding it. But there is also the active creation of beauty. It is something that every artist understands, and yet it extends far beyond what people ordinarily think of as art.
And here we arrive at a point where a picture would truly be worth a thousand words, or rather two pictures. One of a child when it is brought to us and another of that same child a year later. Some of them die, of course, but most survive. And our reward at the end of that year is a vision of beauty that we ourselves have brought about. A transformation of a shrivelled, apathetic, and sometimes terror-stricken human form into a healthy and happy toddler, tumbling in the grass and the sea, filled with laughter and joy. I know of no better material in which to create beauty. I know of no deeper satisfaction than the creation of it. The condition in which the children come to us is the world’s doing. What they become in our care is our own.
And if in the midst of the madness, in the late hours of the evening, someone pauses and asks the ultimate question about life, “Why do you do what you do?” then that too is a thing of beauty and perhaps just as precious. Some people have considered us martyrs. If we are, it is only in that ancient sense of “witness,” witnesses in a mad world to the sanity of creating and cherishing what is beautiful. As for the rest, we have it all.
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MARIE I AND MARIE II
Diane E. Palmeri
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.
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FACES NOT FORGOTTEN
Just twenty-two years ago, I came to the Philippines as a young Jesuit missionary whose first assignment was to spend three years studying philosophy on the island of Cebu . We studied hard, but I discovered life was not going to be all books and classrooms. We also got to go on weekly picnics to the beach. And of all things in the Philippines , the most beautiful are its endless miles of shoreline. I also discovered the faces of hungry children, for whenever we would take out our lunches to eat, we would be surrounded by a ring of children, mostly dressed in gray rags, seldom asking for anything, but always staring, with eyes that grew larger with every bite we ate.
As I look back on my life now, I can recognize that the three years I spent studying with the Jesuit community in Cebu were the most frugal years I have ever experienced in terms of food and living accommodations. The problem was not that we had too much. The problem was that those faces belonged to children who never had enough. At the end of six years in the Philippines , I returned to the United States and I left the Jesuits. But the faces I had seen did not leave me; they have been with me ever since. And so seven years ago I came back to see if they would still be here. This time I came armed with an American nurse for a wife and fresh from a year and a half’s experience in Saigon where we had established and operated a one hundred crib live-in nutrition center for severely malnourished children. Initially, I was coming to teach Philosophy at Xavier University in Cagayan de Oro City, but we already had other things in mind as well, and it did not take long for them to materialize.
We had assumed that conditions in the Philippines would be much better than they were in Vietnam simply because of what the war had done to that country. What we found was something very different. Apparently, we had underestimated the impact of the American aid that had poured into Vietnam . In any case, what we discovered was that there was far less infant abandonment here but that malnutrition was even more severe. When we arrived in Cagayan, we brought with us our oldest boy, who was barely three and a half, and two Vietnamese babies, one of whom was a little girl with no arms, that we had adopted while in Saigon . Now one afternoon, as some of the more scruffy kids from the neighborhood were in the house playing with ours, Diane and I looked at the kids and then at each other. I told her to get out a big jar of peanut butter and start making sandwiches. It was a very humble beginning, and in the long run it proved to be a very unsatisfactory approach, but at least we had started.
And then we discovered something that I had never realized before at all. The children on the beach who gather round and stare with their hungry eyes are not the worst cases. They’re still able to be up and about. The ones that are really sick are kept at home and you never see them unless you search them out. And that was just what Diane, who had worked before in Public Health, began to do. And what she found!
Joseph was a seven year old boy who was the same size as his two year old sister. He could neither walk nor talk, had a bowel movement once a month, and was mentally retarded. The cause was simple enough, a thyroid deficiency, and had it been diagnosed and treated within the first month of life, he could have been normal. We immediately began providing him with thyroid tablets daily.
Amelisa was eight years old and weighed only thirty pounds when she knocked over a kerosene lamp and set her dress on fire. We found her two months later with a badly infected burn down her side and under her arm, without even a dressing on it. We hospitalized her at first and then began changing the dressing each day.
Ten year old Heidi weighed only thirty-five pounds and had miliary tuberculosis, which means that it had spread into the glands of her chest. We put her on three drugs, including daily injections of Streptomycin. But when Diane described her case to the Head of Pediatrics at one of the local hospitals, the doctor simply said, “We’re never able to save one like that.”
As the magnitude of what we had stumbled into dawned upon us, we realized that we would have to organize ourselves more effectively. The small organization that we had worked for in Saigon had ceased to exist after the Communists had taken over. But as we wrote and told some of the people who had supported us before of what we had found, contributions began to come in. Finally, we formed a new organization of our own under the name Family to Family. Instead of random handouts, we established a feeding program that provided two hot nutritious meals each day to malnourished children in our neighborhood. The backbone of each meal was corn-soy-milk, a high protein food that the American government gives out freely in underdeveloped countries. To that we added vegetables and fruit in order to insure the needed vitamins. We treated all of the children for parasites and provided as much medical assistance as we could afford. And for the mothers, there were lectures on nutrition and hygiene.
When we had first arrived, we had told the government social workers that we were interested in adopting two Filipino babies and would be willing to provide foster care to any they had until it could be determined where they would go. It wasn’t long until we had the two we were going to keep. The first was a boy who weighed only nine pounds after four and a half months in a hospital nursery. The second was a one month old girl, with a bilateral hare lip and cleft palate, who weighed less than she had at birth. When we saw the condition the children were in and came to realize how many others there were who needed help, we told the social workers that we would take in additional children for temporary foster care until they could make better arrangements for them. Our goal was to treat the foster children just as if they were members of our own family, and so we finally came to set a limit of five to the number we would care for at any one time. Together with our own six (Diane gave birth to a baby girl just three years ago), that makes for eleven children in the house, and any more than that would turn our own home into an institution and destroy the very essence of the kind of care that we want to provide.
And what do we have to show for seven years of effort? At present, there are over a hundred children in the feeding program. Twenty-five children have come to us for foster care that has lasted anywhere from one week to four years. Ten of these children were able to be returned to their families, two were adopted by us, and eleven have been adopted by other families, either here or abroad. Last year we began a day care program for twenty children. They were all malnourished and came from families where there was a desperate need for the parent who was watching them to seek employment. The little boy who needed thryroid is still getting it from us. His height has doubled, he walks and talks, is toilet trained, and can do simple chores around the house. Unfortunately, he will always be retarded, but he is far less of a burden now to the family that loves him so dearly. Amelisa’s burn completely healed after three months of daily dressing changes, and three years later we arranged for surgery to release the contractures that were making it impossible for her to move her arm away from her side. And Heidi, the girl about whom the doctor said, “We’re never able to save one like that,” was pronounced completely cured two years after we started her on TB medication. And you can imagine her mother’s joy, for Heidi is one of seventeen children of whom only three have survived.
I wish I could say that we have solved some fundamental problem, but I honestly can not. At times we see a minor breakthrough in some limited area. For instance, local Filipino families seem to be becoming more disposed to adopt abandoned babies, and if our presence has in any way helped to promote that, we are very pleased. But the larger problem of malnutrition and neglect, due to both ignorance and poverty, seems to grow worse every day. Part of this is due to the migration into our area of people who expect to find jobs here and don’t, but much of it is also due simply to the growth of the population in general and to a deteriorating economic situation. Whatever the reason, it seems as if we are once again engaged in a struggle in which there is little hope of ever seeing any “light at the end of the tunnel”.
Seven years ago I returned to the Philippines , wondering if the hungry faces that had haunted me for so long from such a distance would still be there. I found they were, more of them than I had ever dreamed. But somehow, with the loss of distance, they have also lost their power to disturb. They are no longer there, they are here, and so am I.
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JUST ANOTHER DAY
Diane E. Palmeri, R.N.
As I was contemplating the last months of my senior year at the College of Saint Teresa fifteen years ago, my mind often wandered to the future. I wondered where I would be ten or fifteen years later and if I’d have married, have children and still be practicing nursing. I hoped to nurse overseas in a developing country for at least a year and was quite open to doing such work long term, if only I could find a man willing to share in such a life. Pediatric nursing had been my favorite and I remember telling all my friends that I wanted twelve children. But if someone had told me that in fifteen years I’d be working in public health and nutrition, I’d have said it was impossible. I had really struggled through my nutrition courses and far preferred hospital nursing to public health.
However, a year at work at a hospital in the Central Highlands of Vietnam changed my mind about a lot of things. I had thought I would be working at the hospital all the time, but I ended up being assigned to train and then supervise village medics at their small clinics in half a dozen different villages. Somewhere along the line, I fell in love with public health. And back at the hospital, facing the challenges of nursing a handful of severely malnourished patients, some of whom were too far gone to be saved, gave me a new interest in nutrition. And of course I met and fell in love with my future husband, Tom.
Tom has written about how we got started on our work here in the Philippines . I’d like to share what that work means on a daily basis. Today was a fairly typical day. The chorus of crowing roosters, the neighbor’s radio and the babble from the kids finally got through to me about 6:30 . By the time I got out to the porch, where we eat breakfast, Paul, Chris, Jay-Jay and Reynaldo had all gone off to school. The rest of the kids were almost dressed and so I got out the tray of medicines and began giving them out. I started Monica on a decongestant since her nose had been running a couple of days and seemed to be turning into a bad cold. Her colds frequently develop into a draining ear and then I have to put her on an antibiotic, but sometimes the decongestant will prevent the ear infection. Renato got his last tablet of antiox for the worms he had again. He also got his isoniazid for primary complex TB. He will finish one year of the isoniazid in a couple of weeks. It’s hard to believe he’s been with us almost a year and even harder to believe how gravely malnourished he was at first when I look at his round smiling face and those sturdy arms and legs that never stop.
The only really sick one today is Juanita. She developed diarrhea two days ago and Tom found amoeba when he did the stool exam; so she has been on Kitnos. She still had diarrhea six times yesterday but was drinking well. But this morning she wouldn’t drink any tea and took only four ounces of Orasol (oral hydration solution). So I know I’ll have to keep a close eye on her.
After breakfast, I recorded the three stool exams that Sr. Gini did yesterday afternoon. All three had amoeba and so I computed the doses of their medicines and gave them to Joy to take to their mothers when she went down to supervise the feeding later in the morning. At 8:30 Monica, Renato and Erlinda headed across the street to their nursery school and I went over to our Day Care house where Sr. Gini was getting ready for our morning clinic. Roy arrived for his ear cleaning which Gine started. Then Sheilalin arrived for her dressing change. She had had an open sore on her leg for several weeks before her mother brought it to our attention. After five days of one ointment it really hadn’t improved, so I sent her to the doctor. Next came Daisey, who had been coughing and running fever for four days. Her chest sounded crackly with lots of wheezes, so she too went off to the doctor with a referral note. Next was Jennifer, who had been running fever just since yesterday and coughing. Her chest was clear and her lthroat was OK. But she did have swollen gums and so I told her mother she was probably just teething. I asked her to give her extra liquids and come back in two days if she was still running a fever. Galvin was next, with another boil. He has really had a terrible time with them the past few months. This one was already quite soft and ready to rupture, so I went ahead and did an incision with a scalpel blade and drained out the pus. Then I gave his mother the antibiotic and told her to come back tomorrow for a dressing change. Meanwhile, Sr. Gini had done several more ear cleanings and sent a couple of kids to the doctor with referral notes. Then she told me about a couple of sick children in the Day Care. We decided she should take Efrin to the doctor this afternoon since his ear drainage had gotten worse again. The couple of other sick ones seemed to have a touch of the flu, so we will just watch them for now.
The clinic finished up a bit early and I was glad to get back and check on Juanita. Tom had taken the little ones, back from nursery school, into the sea and I was also hoping to get my usual thirty minute swim in before lunch. That swim is my treat for the day. It makes me feel great physically and mentally, and it is the one thing I do during which no one can come and interrupt me with a problem. But today it was not to be. Juanita had had five watery stools and had refused anything more to drink. I sat down in the rocking chair with her to try giving her something myself, but she promptly vomited, and so I knew we would have to go to intravenous fluids. I called the doctor and she said to bring her over and she would start the IV and give me the medicine orders. I took Nening, one of our workers, along and we came back in a taxi with Nening holding Juanita and me holding the IV bottle up out of the open window. By the time I got Juanita settled back in her crib and told Nening how to time the IV rate, everyone else was just sitting down for lunch. After lunch, Juanita was sleeping peacefully and no longer looked dehydrated. I told Nening that she or one of the other helpers would have to stay with Juanita at all times and call me immediately if there was any problem. Then most of the rest of us settled down for a little siesta. After siesta, I was talking to Joy about the results of a stool exam Tom had done on Ronald while I had been at the hospoital. I told her to check with his mother and have her come see me so I could find out how bad the diarrhea was and decide which amoeba medicine to use this time. This baby has had amoeba monthly for six months, ever since he had the measles. He just doesn’t seem to have any resistance. Just as I finished telling Joy this, Christopher’s mother brought him to our outdoor kitchen. He had a deep cut on his leg. It was a clean cut that definitely needed stitches, probably about four. I thought of doing the suturing myself, but Sr. Gini was gone to the doctor with Efrin and Tom was teaching his Philosophy classes at the university, so I had no one to assist me. And I figured I had my hands full enough with keeping tabs on Juanita. So I sent the mother off to the government hospital, telling her that Christopher did not need any tetanus shot since we had just finished giving him his three doses about six months ago.
By this time it was 4:00 and the kids started arriving from school. They all wanted to see how Juanita was doing and she was glad for their attention. I sat with them and listened to how things had been at school. Some of them wanted some help with their homework so I helped them get started. There were a few interruptions as the mothers we had sent to the doctor this morning came back so we could mix and record their medicines. Our two volunteer pediatricians give the mothers sample medicines whenever they have them, but when they run out, the mothers come back with prescriptions, which we then fill.
Now as I finish this, the kids are having their dinner. Tom and I will eat later when he gets home from class. Juanita will sleep in our room tonight, so that we can keep a close eye on her. And I will need to set the alarm to get up during the night and check her IV. She will probably need the IV for only two or three days and then should be able to go back to oral liquids. Sometimes with amoeba you just have to give the stomach a rest for a couple of days.
It’s been a busy day and it isn’t over yet, but it’s been a satisfying day as well. Somewhere back in the States is a hospital where I am not working, but the patients there are cared for. If Family to Family were not here, I doubt that many of the people we saw today would have received any care at all. And I shudder to think of where the foster children might be. It’s a busy life, but it’s a kind of being busy that makes a difference. And that may just be all I’ve ever really wanted.
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THE BOY WHO COULD NOT WAIT
In a remote barrio of a small island in the Philippines , Alex, a nine year old boy with a hugely swollen neck, cried out, in terrible pain, “Mam Diane, help me! Mam Diane, help me!” His mother held him to her and rocked him and said, “Yes, it will be alright, Mam Diane has already helped you and she will help you again soon.” But Mam Diane would do no more for Alex, for these were his last words.
Diane is my wife, a registered nurse from Iowa , in her mid-forties. We have worked together with children in the Philippines for the past fourteen years. And as I sit writing the story of a nine year old boy who died with her name on his lips, I am driven to wondering where it all really began. In real life, things happen continuously, events simply flow from one another, and we are hard put to know where anything begins. But there are certain moments in our lives that at least clarify for us who we are and what we are about. One such moment for Diane and myself came in Saigon in late 1973.
Some friends of ours had put together an organization to work with severely malnourished children. They wanted to build a center and also to help improve the conditions in orphanages. Diane and I had first met at a small hospital in the Central Highlands in 1969, so we knew our way around. We would set up the project and run it for one year until they found replacements for us. It all seemed so simple. We would find hungry children and feed them and make them well. We thought we knew our way around. Actually, we knew nothing. And it all turned out very horrible.
We were involved with the Ministry of Social Welfare, and soon after our arrival, they assigned a vehicle and one of their workers to take us and another woman around for a day to some of the orphanages. To this day I pity the person who took us. She was one of their staff, but she had obviously never done this before; she simply knew the names and addresses of the places. She was Vietnamese but by the end of the day she looked white; all the blood had drained out of her face. It was all of the shocking things one occasionally reads or hears about and forgets. In one place, teenagers who were crazy were chained and padlocked to their own beds to protect themselves and others. More commonly it was little children that we saw, babies and toddlers, enormous numbers of them, left in their own excrement, rhythmically rocking, sometimes even pounding their own heads against steel poles as workers for whom it had finally become too much stood there with mops in hand, staring off into space like zombies.
In one great place, some distance outside the city, that housed twelve hundred children of all ages, we were finally ushered into a nursery where there were a dozen small babies. The room was hot, but someone immediately flicked on an air conditioner. We moved up and down the rows of cribs. Then the nun drew our attention to one crib in particular and undressed the baby lying in it. She was a little girl who had neither arms nor legs; her back was slightly arched; everything else seemed normal. We asked her name and were told it was Marie, a name commonly given by the nuns to girl babies who were abandoned with no name. It was late in the day and our tour was nearly over. We drove back to Saigon in silence.
For two more days we busied ourselves with one thing and another but continued to have almost nothing to say about our tour. On the third evening, we were sitting on the tiny balcony ourside our second floor apartment with our feet up on the railing. It was a tiny street but crowded at this hour because it was a short cut between two main arteries. Across the street, in front of a small restaurant, an old woman spat red globs from the beetle nut she was chewing onto the same sidewalk where she was hacking apart a large block of ice. We sipped our scotch and were grateful that we made our own ice cubes. Finally, I broke the silence with a question, “Can you think of any good reason why we should not adopt Marie?” There it was, out in front of us, what had been eating away at both of us. The idea of adoption was not new to us. Diane had given birth to our Paul two years before and we had brought him with us to Saigon . Diane could have more babies, but it seemed more to the point to care for unwanted ones that already existed than to add new ones to the population. We were planning on adopting a baby when the right opportunity occurred. Because Diane was a nurse, we felt we could handle a child with a medical problem that someone else might not be able to deal with. But we also might remain in Asia for many years and live in places where sophisticated medical care would not be available. So there it was. What about Marie? For twenty minutes we ran through all the good sensible reasons for not adopting Marie. She would need such special care and attention and could benefit so much from being with people who could provide her with everything. She should be in the States, near a major city. She should have this, she should have that. And after we let it all play out, perhaps to prove to ourselves how sensible we were, we came to the bottom line, which we had known from the very beginning. No one else was going to do anything for Marie. If we did not take her, she would be left where she was to rot away for as long as she lasted. It was us or nothing. And it was decided just that quickly. We would take her. With a great sense of relief, we poured another stiff scotch.
As soon as possible, we went back to the orphanage where we had seen Marie. We were told that the nun who was in charge of the nursery, and who apparently guarded her charges very jealously, was not around. And none of the other babies in the nursery were available for adoption at all. But the little sister who spoke to us did say with wide eyes that she thought the baby Marie might very well be able to be released to us. We inquired about her medical situation and were told that there was an international medical team that visited the orphanage regularly and handled all of that. We went to see Marie again and finally left in great excitement.
When we got home, Diane began phoning the doctor who was the head of the medical team. When a child has one abnormality, there is always an increased risk that there are others. Marie could have internal problems that would not let her live more than a brief time. If that were the case, we saw little point in taking her. But if nothing more was wrong than what was visible, she was ours. After many calls, Diane finally reached the doctor. She told him of our interest in Marie and that we would like him to examine her as thoroughly as possible. Diane was on a long time, haggling back and forth. When she hung up, she said, “He agreed to examine her, but he thinks adopting her is a very bad idea.”
“Then lets not ask him to adopt her.”
“He says children like this are always unhappy as teenagers.”
I thought on that a moment and replied, “Have you ever known a happy teenager?”
A few days later we had still not heard from the doctor. Diane tried to reach him but couldn’t locate him anywhere. Finally, she called the orphanage. They said that Marie was doing poorly and seemed to have pneumonia. Diane offered to come out and take her to a hospital at our expense. They said they could not authorize that; the doctor would have to see her first. When would the doctor see her? They did not know. Filled with frustration, we didn’t know what more we could do except wait. After a few days, Diane finally reached the doctor. He had not examined Marie thoroughly. There was no need. She had died at the orphanage while he was our of the country on a three day vacation. He was very sorry.
Of course, we knew that he was not sorry at all. It was exactly what he had wanted. Now there would be no unhappy teenager to remind all of us of our common lot. At the time, we felt very bitter about what had happened. At a distance of fifteen years, I am sometimes tempted to think that the doctor was probably right. But one of the few things I have learned is that what passes for the wisdom of age is often only cowardice. I resist the temptation.
Bad as we felt, we also knew that in the moment of our decision we had clarified to ourselves what it was we were all about and had passed a turning point in our lives. We knew what the stakes were in the game we were playing, we knew what we were prepared to take on. Or so we thought. In any case, it was time to get on with our work.
And work we did. An ancient Canadian Redemptorist priest just about gave us the keys to one of his orphanages. We set about rearranging things; stopped the babies from getting baths at 5:00 am; broke open boxes of badly needed clothing that were stored away unused, awaiting some unknown crisis; hired and trained two new cooks. But in the end it was all futile. New babies poured in every month and they died nearly as fast as they came. It was impossible to deal with the volume, given the staff and the facilities. It was the first of many hard lessons we were to learn about the limits of what we could do. But it was during this time that we got our Christopher. The orphanage staff knew we were interested in adopting a baby and one day they brought us a four day old boy who seemed in fairly good shape. The old priest said we could have him, and he also wanted us to take home, just for awhile, a tiny baby girl, “so she would have a chance to survive.” Our Paul came with us to get Chris, even helped to pick him out, and then screamed all the way home in the front seat of the taxi. Our interpreter thought Paul was jealous, but we knew better. He stopped screaming once we got inside the apartment and gave him Christopher to hold. Christopher was soon deathly ill and was in and out of a hospital twice. But he finally recovered and remained healthy after that.
While we tried to supervise things at the orphanage, we also moved out on our own. We rented a lovely two story private home from a Vietnamese Army Colonel who had a wife and one child. We moved into it ourselves and within a few months were caring for fifty babies in it, cases from many orphanages that would simply not keep where they were. The U.S. Congress authorized some special funding for children, part of which became available to us. With the help of that, we rented a four and a half story apartment building, hired a British nurse, and put another fifty children in with her. We kept the youngest and worst cases for ourselves. The atmosphere can perhaps best be gotten from one incident. We had a large staff, working two twelve -hour shifts. Diane and I slept in an air-conditioned room on the second floor. If there was a problem at night, one of them came pounding on the door and we bolted out of bed. One night the pounding started and Diane got to the door just as I sat up. After speaking to the worker, she turned and said, “It’s for you, thank God, we’re being robbed again.” Then Diane stumbled back into bed as I bounded out the door and up the stairs with a club in my hand to chase some son of a bitch over the flat roof of the adjoining building. There were only two reasons why the staff ever woke us at night. Robberies were my department; a baby going critical was Diane’s.
So there we were, our own operation going at full blast and Christopher adopted. Then one day the orphanage we worked with brought us a two day old tiny premie that had just come to them and that they knew they could not handle. In the tropical heat of noon-time Saigon , she could not maintain her own temperature. She had been completely abandoned and was definitely available for adoption. Diane and I undressed her and looked at her. She was so incredibly tiny. Perhaps her smallness was exaggerated by the fact that she had no left arm at all and that her right arm ended in one finger just above where you would expect the elbow to be.
Our organization was not an adopotion agency but there was interest in it and we had finally agreed that our people back in the States could try to find homes for children who had special problems and who would be particularly hard to place. So we told them about the little girl with no arms and a dwarf and another one that was missing something or other, I can’t remember what, maybe his head. After some time had passed, the poor social worker in charge wrote and asked if we couldn’t give her something easier to start with. I wrote and told her that we were not an original manufacturing plant and could not produce defects to order. We were just middlemen and simply passed on the merchandise that became available to us. I was not surprised to have no reply, and she never did come up with anyone interested in any of the three children. After some time had passed, Diane and I looked at each other one day with that silly grin we use for all our big decisions. Stuff our social worker in the States. We would keep the little girl with no arms ourselves. And we would name her Marie. Just imagine how wonderful. She had legs. Someday she would be able to walk and run and dance, all the things that the other little one cound never have done. And so she has, far beyond our dreams. She is fourteen years old now, can play cards and wash dishes with her feet, writes with one foot (the best penmanship in the house) , rides a two-wheel bike, and can dive and swim. She is, of course, a teenager and has been doing some serious stocktaking of her situation, and I believe she is unhappy. Welcome to the club. But for us, taking care of her has always been a piece of cake. For we have always been just as much aware of the legs she has as of the arms she is missing. Something few people have ever known is that to us she has always been Marie II, and we have never forgotten our Marie I.
Our year and a half in Saigon ended with Diane, myself, Paul, Chris and Marie leaving on April 3, 1975, on one of Pan Am’s last commercial flights. Not heroism. We had finally found an American nurse to replace us and were leaving more or less on schedule. But things were crumbling far faster than anyone had expected. Within a few days after we left, the orphanages collected all of their babies from our centers so they would have them with them at the end. Our buildings briefly became refugee centers as people from all over the country poured into Saigon . The American nurse who took over from us ended up sleeping overnight on the runway at Tan Son Nhut as she awaited a military airlift flight out. And the organization that had sent us there was soon out of existence.
Our own flight was a short one, just three hours to Manila . The next day we watched the TV news report the crash of a cargo plane full of babies just after takeoff from Saigon . Our families, watching in the States, were wondering if we were on it. But we were headed south to the city of Cagayan de Oro on the big island of Mindanao . Of the ten years I had been a Jesuit, I had spent the last six teaching and studying in the Philippines . I wanted to come back and to bring Diane there. There was enormous poverty, and yet because of the very low value of the peso, I knew a great deal of good could be done with very few U.S. dollars. As it happened, very few dollars were exactly what we had.
I got a job teaching Philosophy with my Jesuit friends at Xavier University . It paid $1,000 per year, slightly less than the rent we were paying for a simple house right by the sea. But we had some savings and we decided to gamble them on whatever would come next. The Philippines has very few zoning regulations. Beside the mansions of the very rich often live the terribly poor, divided only by a high cement wall, topped with broken glass, and a security guard with shotgun in hand on the other side. We were living in no mansion, but the kids who came to play with ours certainly looked miserable enough. One day I looked at the kids and then at Diane and said, “Start making peanut butter sandwiches.” It was a humble beginning and not very practical, but soon it grew into a daily feeding program, eventually for one hundred children, with a free medical clinic and lectures on hygiene and nutrition for their mothers. I think we must have saved the lives of many children. Some of them have even now had babies of their own who are in the feeding program, which still goes on. It is very depressing. The number of people in that neighborhood has doubled. Things have not gotten better.
While I was teaching six courses of Philosophy at the University, Diane was visiting the city’s hospitals and prowling the neighborhoods, doing what she’s so very good at, turning over stones to see what will crawl out. Part of what she found was abandoned babies, not nearly so many as in Saigon but still in desperate need. We had vowed never again to run the kind of operation that we had in Saigon ; with our best efforts and a large (if poorly paid) staff, it was still an institutional zoo. But that didn’t mean we couldn’t help a few babies. We adopted two, our Jay and Monica, but then we knew that had to stop. We would simply provide temporary foster care to others in our own home. The Department of Social Welfare was delighted to have our help and we were licensed by them and presented with our own copy of License #0001. We set a limit of five foster children at a time, determined not to let the atmosphere become institutional. Together with our own Paul, Chris, Marie, Jay and Monica, that made ten. Some of the babies moved through quickly, but more often they stayed for up to two years. The record holder was a little boy who spent four years with us, supposedly because he had been turned down for adoption by several couples to whom he had been offered.
With Diane’s qualifications and the experience we already had, the Department of Social Welfare gleefully brought to us their very worst cases. One was Bobby, a boy who was ready-made to haunt your dreams. If he had been any worse, he would have been in a coffin. He looked like his skin was made of papiermache and would crumble at your touch. Almost all his hair had fallen out. No one knew his age for sure, probably four or even five years old. He was suffering from severe malnutrition (marasmus), all sorts of parasites and TB. Both of his eardrums were ruptured. His neck was swollen where the TB had attacked the glands. We are not camera people, but have felt compelled to take some pictures for the sake of publicity and fund-raising. We have an amazing slide of Bobby just after he came to us, sitting on a swing, naked except for a pair of white socks. We had unbundled Bobby from blankets just long enough to take the picture and didn’t want to waste time getting the socks off. None of the children usually wear socks. But in the mid-morning tropical heat, Bobby could not maintain his temperature. He also could no longer walk and would not smile. He had even lost his appetite, one of the worst signs. When a starving child no longer wants to eat, you know you are near the end. It was because of this that Bobby did me a wonderful favor. We had to carry him from one place to another and hold him on our laps to feed him. We looked for foods he might like and got some dried fish because he was from a coastal town. For years I had wondered how anyone could eat dried fish, but of course, I had never tried any. Then one day, as I held Bobby in my lap and put bits of food into his mouth, bored at how slowly it was going and getting hungry for my own lunch, I began to nibble on some of his dried fish and what a tasty discovery it was. Ever since we have had dried fish on cheese and crackers as hors d’oeuvres. But the hand feeding did not have to go on for long. Bobby was so severely anemic that our pediatrician finally decided to give him a blood transfusion in spite of the risks. Half-way through the transfusion, he sat up in the bed and ate the tray of food that was waiting beside him. The next day he smiled for the first time. The road to recovery was very long but he was on his way. He began gaining weight; his muscles gradually regained their strength though his first steps were like those of an old man; he developed an open draining TB fistula in his neck that required daily dressing changes for seven months, but it gradually grew smaller and finally closed. We have another slide that shows him after he had been with us for one year, as chubby as any boy his age would want to be and dribbling a basketball in our driveway. He was adopted by a family in Virginia . Both his eardrums were operated on and he now has hardly any hearing loss. His new family has sent us the last slide of Bobby that we are ever likely to need. He is at center court, in full basketball uniform, playing for his high school team. He also plays on baseball and soccer teams. He has become quite an athelete. There are some days that you don’t care if all of your programs are failures and everything simply gets worse. It’s enough to know that you’ve helped some individual to escape.
In addition to the feeding program, free clinic and foster care, we began kindergarten classes for eighty children from very poor families, something they would never have been able to afford themselves. Then, five years ago, we made a major move. As Cagayan de Oro continued to grow, it became more crowded and filthy. But there was a small volcanic island, named Camiguin, a four hour trip away. We had often vacationed there for a few days at a time. Camiguin was primitive and beautiful and clean. Its seventy thousand people relied almost entirely on coconut and were very poor. We decided to keep our programs in Cagayan de Oro going with the staff we had built up but to move our family and the foster babies to Camiguin.
On Camiguin, we have become very involved in education. School attendance in the Philippines is not compulsory and there are many children who do not go even to elementary school. Usually, the reason is poverty. The public schools are free, but the needed supplies are expensive. So we now provide sponsorship for over three hundred children in ten different schools, giving them all the supplies they need on a monthly basis. But even this we have come to realize is not enough for some. We are very strict about attendance for those whom we sponsor and we became very alarmed when we noticed one boy had been absent for three weeks in a row. We finally learned the reason. He had only one outfit of clothes; it was the rainy season and his clothes were sopping wet; he stayed at home without clothes on until the rains stopped. A teacher complained to us about another boy who was always coming to school filthy. We discovered he had been dumped with an old grandmother who hardly knew what she was doing. It wasn’t clear whether the poor old woman was taking care of him or he was taking care of her. Prompted by these and even worse situations, we are embarking on our largest project yet, an elementary level boarding school for children who are so destitute that they cannot go to school at all in their present circumstances.
Diane has not given up her medical work, however. For the past two years, she has been attempting to identify every child on the island of Camiguin with a physical handicap and every person with an eye problem. She has found hundreds of cases, some of them terrible ones about which nothing at all had been done. Some of the worst are the children whose spines have collapsed and been bent far out of shape by TB. Little can be done on Camiguin for any serious problem, and so we have been sending these children all over the country to major hospitals. It was while doing this work that Diane discovered Alex, the boy with whom I began. Alex had an enormous swelling in his neck. Diane arranged for him to come to the Camiguin Island Hospital . The doctors there started him on TB medications and wanted him to get a biopsey done in Cagayan de Oro. Diane was going to bring him with her, but his family failed to catch the boat. One of our pediatricians thought that if the swelling got smaller under medication we might assume the TB was the cause. And the swelling did begin to recede. But then Alex had to stop his streptomycin injections because he was developing symptoms of toxicity. Alex grew very thin and pale, and the swelling began to increase again. Diane advised his mother to take him to Cagayan de Oro for the biopsy, but his mother had to wait two weeks for someone to return who could watch her house. Finally, she took him. They had to wait a week for his stitches to be removed. A week after that Diane told his mother the results, fibrolipoma, and said she would arrange for him to go to a hospital in Cebu for surgery. His mother was to see a social worker the next day to get a letter of referral saying they were indigent. But Alex could wait no longer; he died that evening, calling for Diane.
Beginnings and endings occur in fiction. In real life, perhaps the only beginning is birth and the only ending death, at least for the one who dies. If so, the story of Alex has its ending for him. But for the rest of us, we remain where we have always been, caught somewhere in the middle. Robert Frost has a fine poem, “Out, out –“. About a young man who accidentally cut off his own hand with a buzz-saw late one afternoon. It ends as follows:
He lay and puffed his lips out with his breath.
And then – the watcher at his pulse took fright.
No one believed. They listened at his heart.
Little – less – nothing! – and that ended it.
No more to build on there. And they, since they
Were not the one dead, turned to their affairs.
So it is, so it must be. For Diane and myself, turning to our affairs means seeing that the next child with a swollen neck is gotten to in time.
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Gny. Sgt. Paul G. Palmeri, U.S.M.C.
There are over one billion disadvantaged children on the planet today. My neighbor Rene is one of them. Rene is a nine year old boy who lives with his mother, father, and five brothers and sisters in a one-room bamboo shack. The floor of this shack is dirt, the Earth. There is no bed. He sleeps on a palm leaf mat on the floor. It has bamboo walls and a palm leaf roof. There is no running water. Rene has to fetch water on foot in one-gallon jugs throughout the day from sunrise and into the evening from a faucet over a mile away. The shack that he lives in has no toilet or shower. The toilet is a bamboo shack two hundred meters away from the house with a hole in the ground. There is no shower. Rene bathes in the creek next to the shack he lives in or walks to the faucet he fetches water from over a mile away. There is no kitchen. They cook their food outside with wood using one pot balanced on top of three rocks positioned in a triangle. The bamboo shack has no electricity. At night, one dimly lit kerosene lamp is used to provide lighting for the entire shack.
One look at Rene and you might think that he came out of a war zone. He has no shoes or slippers. He has been barefoot for so long that the skin on his feet is cracked and calloused. He wears the only pair of clothes that he has. He wears a pair of shorts which are to big for him. They are held up by a rope, which he has made out of a banana tree trunk he has converted into a belt. His shirt is torn and so faded and stained that you cannot tell its original color. His hair looks uneven like it was cut with a knife instead of a pair of scissors.
With all of this poverty in his life and person, there is one thing you would not expect to see and that is a big smile. From the moment Rene wakes up in the morning until he goes to sleep at night, he is always smiling. Rene starts his day by fetching water for his mother so she can cook breakfast for his brothers and sisters. His father goes to work before they wake up and does not come home until the evening. Breakfast is normally rice with dried fish. If they are lucky, one of their wild chickens might have laid an egg which they can then cook and share. After breakfast Rene takes what little dishes they have down to the creek to wash them. When he returns to the house, he helps his mother watch the children. Around lunchtime, he takes the older ones and they go foraging around the area that they live in. Rene knows where every fruit tree is within a five-hundred-meter area of their home. They go to each fruit tree in the hopes of finding some ripe fruit. If they cannot find any fruit, there are always coconuts to eat. In the afternoon Rene goes down to the beach which is less than a mile away. He has no boat or fishing pole or spear to catch fish. He tries to find what he can to give to his mother to cook for dinner. He turns over rocks and digs in the sand hoping to find a crab, clam or some kind of crustacean. At the end of the day, he heads back home with his brothers and sisters. They stop by a tree to pick some leaves which they can put in hot water and salt to make soup. As soon as Rene gets home he takes his brothers and sister down to the creek to bathe and get cleaned up. Then he fetches more water for the rest of the night. Rene waits for his father to get home in the hopes that he might bring them some kind of special treat. Rene normally falls asleep before his father gets home. As you can imagine Rene does not go to school. His family cannot afford to send him to school.
A few years ago Rene met a girl from the same bario where he grew up and fell in love with her. They live in a small bamboo shack just like his parents less than fifty meters away from them. Today they are married and have two boys. One look at Rene's kids and you can see his resemblance in them. They are dressed just like he was and going through the same experiences and hardships that he went through. But once again an unexpected sight to see were big smiles on both of their faces.
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Daddy at Easter
(April 7, 2012)
Tom PalmeriHi Kids!
Cowards die many times before their deaths;
The valiant never taste of death but once.
Of all the wonders that I yet have heard,
It seems to me most strange that men should fear;
Seeing that death, a necessary end,
Will come when it will come.
(Julius Caesar Act II, Scene II).
It forms the fundamental backdrop against which the drama of life is played.
I never did anything real bad, but I think my family always felt I was doing crazy things, like joining the Jesuits right out of high school, going to the Philippines for six straight years, then leaving after I was in that long and then giving up a teaching job to go to the Central Highlands of South Vietnam at little pay while there was a war going on to do something for which I had no experience. The one thing I believe no on thought was crazy was my marrying your Mama. I never heard a down word on that. But they soon learned that your Mama and I would continue doing crazy things together, like taking in foster teenagers before we even had a baby and then taking that baby, Paul, off to Saigon before he was two. (They never should have had him if they were going to do that was the word I heard later.)
People often feel they have not gotten what they wanted out of life. Sometimes they want things they are just not capable of. Sometimes they want multiple things that are not compatible. When I got out of high school, I joined the Jesuits, but I also wanted to be a Marine fighter pilot. Not easy to put those two together; I had to choose. Sometimes people want things and get them only to discover that they are not what they expected and then they don't want them anymore. And sometimes the opposite happens. You get something you had never wanted only to discover you love it. I was thirty-four when we went to Saigon. I was interested in helping poor kids, but I had no special interest in babies and had done a poor job with Paul. If he had a load in his diaper and Diane would be home soon, I left it for her. I really knew nothing about babies. Diane knew all about taking care of babies but not the dreadfully sick kind that we were about to encounter. It was a fast learning curve for both of us. Within weeks of arriving in Saigon, we were buried under babies and I was doing everything from changing shitty diapers to giving injections. And I soon discovered that I loved doing it. Saigon itself became a kind of nightmare. We had rented a house in which a Viet. Army Colonel, his wife and one child had lived and into it we put 50 cribs. Many of the babies really belonged in a hospital, but if you had seen the hospitals there (three babies on one bed with all their IVs run dry), you would know why they were with us. We were there for a year and a half and I swore we would never do anything quite like that again.
When we got to the Philippines, we did many different things, but one of the first was to take in babies for foster care. We kept two of them, Jay and Monica, but we knew we could not keep on doing that. So we just kept taking in babies and toddlers for temporary foster care. In spite of the other things we were doing, the little ones soon became the centerpiece of our lives, which is why the book about our work has the title that it does. In Saigon, we had discovered who we were and what we were. Now it was just a matter of 24/7 implementation.
Our three year old "Baby" James is # 70 in the long line of foster kids. Some of them came to us in such dreadful shape that we once had visitors suggest that it might be better not to keep that one alive because of the brain damage he would probably have. We did not concur. Many years later, he was an outstanding athlete. And today he is married with three children and doing computer stuff in the land of milk and honey. Not all the foster kids ended up so well; some became junkies. But that is not because of anything that we failed to do when they were with us. Of the 70, three died, but not because of anything medical accountable to us. Sam was probably born with something wrong that could not have been fixed anywhere. He should never have been sent out of the hospital, and within a few days, we had him in Madonna Hospital and stayed there with him for a week until the hospital lost him. Lovelyn was perfectly healthy and died in a freak accident. And Paulo, who did have his medical problems, was sick with nothing and on no meds the night he just stopped breathing in his crib as if someone wanted to let us know that no matter what we did we were finally not in charge.
Of the other 67, we lost not a one. We always brought them to our pediatrician as soon as possible so she could have a base line on them and advise us about their care. After some years, she asked us how we did what we did, by which she meant made these little ones healthy when her hospital would probably not have been able to do so. The answer was fairly simple. Sensible and aggressive medical and nutritional care. (The hospitals were seldom aggressive enough when it came to nutrition.) And lots of love, something that you don't really expect in a hospital. Little ones know when they are genuinely loved and not just being held and they respond with a will to live. Working beside your Mother was like looking at the ceiling of the Sistine Chapel where the hand of the Father reaches out and he touches the finger of Adam with life. She held the babies and gently blew the breath of life into them. She worked miracles. And I worked beside her and learned to do it too. Make no mistake; life is all about power. Unfortunately, for many, power means impressing others with your fame or wealth or controlling and manipulating them, or in the final extreme, killing them. But the greatest power is the power to heal others, to release and liberate them, to bring them back to life. And it is very addictive. And I have lived off this high for decades and all because of your Mother. She found the little ones and brought them home. She was the source of the endless stream of life. We were right to call her Earth Mother. And me Sky Daddy, rumbling and grumbling, lightning and thunder, bah humbug.
Not long before I went to Duke Medical to get checked, your Mother and I were dancing down by the sea. (A pox on men who do not dance with their wives and scoff at my dance floor.) And I told her that she would never know how much I loved her because I myself did not know until I was given my diagnosis and forced to look back at my life as something more or less complete. I have done quite a few things on my own account and my years in the Jesuits put me in touch with many extraordinary people. But the most singular privilege and achievement of my life has been to work beside your Mother.
So when I speak of
gratitude for what I myself have done and even more for what has been given to
me, I am frankly overwhelmed that all of this could have happened to that sickly
little kid from Flatbush.
As for the future, I still have some tasks to accomplish and I can think of no better words to guide me than those of Hamlet toward the end:
There is special providence in the fall of a sparrow.
If it be now, 'tis not to come;
if it be not to come, it will be now;
if it be not now, yet it will come
The readiness is all.
With lots of love to all of you,
Great Grand Uncle (I like this one)
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Contributions should be payable to "Family to Family, Inc." and mailed to:
Family to Family, Inc.
c/o Availa Bank
126 W 6th St.
Carroll IA 51401-2341