6pm in the ICU

Libya. Wednesday, 5:57 pm. ICU.

We’ve dimmed most of the lights, so the patients can sleep more easily. Sleep is valuable medicine.

Rouana’s mom sits beside her, gently cleaning tape scum off of her face with a damp piece of gauze, then feeding her a bottle. She talks in a soft voice, tipping her head back and forth making smiley faces. Rouana mostly just looks back at her mom, sometimes kicking her sock-clad feet. Her mom is quietly active in taking over her daughter’s care as she gets well. Bottles, diapers, cleaning—she goes about the business of loving her daughter in practical ways.

Hunaida is tucked in the far corner, unofficially designated for “resting and growing”. Hunaida seems to have only two speeds…sleeping and HUNGRY! But now she is swaddled, laying in her mother’s arms, content after a bottle. Even though her mother is completely covered in black clothes from head-to-toe, a baby knows her mother—and she is so happy to be in her arms.

Mayar is sleeping, after a big day of drinking a little juice and trying to cough. She was the most compliant child in the ward: patiently waiting for her surgery, doing little errands for her mom like putting stray hairs from the comb into the trash. She was quiet and without complaint. But Mayar has found her voice here in the ICU. She is resolute—she will not cough. It hurts to cough after surgery—she’s old enough to know that! But she needs to cough in order to get well. And so we work every angle we have to make coughing seem like a great idea.

Awad takes his place in a bed in the middle of the ward, fresh from surgery. Dr. Novick and part of the surgical team stopped in to see how he’s doing before they start the next surgery. His heart didn’t want to stay stable, but for now he’s sleeping, and the ICU team are carefully monitoring his systems.

‘The baby with no name’ is having an awesome day. She is so young, the aunties and grannies in her community have yet to name her. She is showing slow, but steady improvement after a day of instability. Lots of rest is in order now. The doctors at her bedside compare her progress over the last few hours, with the previous 24 hours.

The x-ray technicians have already been through. The biomedical engineer comes in to check pumps and cords. Critical care doctors and nurses from our medical team attend each bed, teaching local nurses the intricacies of care.

There is just one empty bed in the room, freshly made up with clean sheets and stocked with supplies. Another child will lay in this bed as soon as their surgery is over in a few hours.

The room is full and busy, calm and efficient, and the most honest picture of hope. Hope isn’t tidy. Hope isn’t passive. Hope requires investment and leaning hard into the most difficult places.