Wednesday, April 15, 2015

What are the ODDS?

Haiti, and midwifery, are full of  surprising (or just depends) experiences, but Monday morning was yet another one.  Just what are the odds this could happen--? On a once-a-month visit to Dos Palis,  the Mobile Prenatal Clinic arrives in the village, we set up tables and supplies in the empty concrete church, the benches fill with pregnant ladies,...then one of them walks in, to the head of the line, gives a loud shriek, and starts pushing her baby out?   She was moved to the "GYN corner" table, Magdala Jude (trained in Midwives for Haiti Class 2) gloved and performed a very straightforward delivery, and I received the newborn baby, a healthy 6-lb girl who came out yelling like her mom.  In this case, I really think the clinic may have saved the lady's life, since soon after the birth she had a big blood loss that required more than the usual medicines.  We had all the necessary stuff, however, including oxytocin and misoprostol, though how the midwives find them in those dusty suitcases is beyond me.   The new mom was quickly stable, then rested for most of the morning on a clean sheet.  Mostly she rested on the table, but a few times, we needed to examine someone on it,  at which time she sat on a nearby bench, nursing her baby.  I bought her a bottle of juice, and someone brought her clean clothes. So, what are the odds of giving birth at the clinic that comes in a Jeep one morning a month?  Did she labor all night, waiting for us?  Did she walk to the clinic that morning, stopping along the dusty path for contractions?  How far did she come?  The village "matwon" (traditional birth attendant), who attends the local births, said "not far", but it's far enough ....By the end of the morning, she walked out to the road with a little help, and got a motorcycle taxi to take her home, baby wrapped in her arms and a couple clean blankets.   I truly do think think it could have saved her life.  As we're fond of saying at my midwifery practice at home: You Could Not Make this Stuff Up!!

Sunday, April 12, 2015

Spider-Man and the Cabinet-Makers

Spider-Man and the CabinetMakers

It's not easy to be married to a midwife, and even harder to last decades.  The reasons are obvious- the crazy hours, dinners or shopping or laundry abandoned, daytime sleeping (if you don't have little kids) and  childcare chaos ( if you do.)  The many times that the spouse gets the bottom of the barrel, emotionally, after draining labors and all the other stressors of this life.  Not only has my dear husband Greg hung in there with me, but in recent years, I've been able to convince him to come to Haiti, too!

Thus this trip has a couple Surviving Hero Mid-Husbands:  2 life- long, 30+ year partners, mine, and Jessica Jordan's husband, David.  Both experienced carpenters and re-modelers, Greg and David may have one of their most unique re-hab projects ever, as they are re-building and painting the broken, torn-up cabinets at St Therese Labor and Delivery Rooms.  Before today, I think neither of them had to measure space and evaluate wood structure literally 2-3 feet away from a laboring woman- much less one VERY vocal and with an urgent need to throw her dress off.   The guys were entirely unruffled...tape measures clicking.  That is what 30 years of having labor and birth conversations can do. I did stand by the lady and rub her belly and her back, mostly in order to keep her from kicking the guys or grabbing their arm as they walked by. 

Now the CabinetMakers are deep into their piles of tools and supplies, figuring out how to get those doors off, painted, the structure repaired, and then the doors back on, with new hardware, this week.  Clean, organized medical supplies- - a lofty goal, and also must be done while birth goes on!  They sure do deserve the cold beers at the end of the day that will also be supplied to them. 

My husband won the Hero award early, however-- he killed a huge Spider this morning that we'd been warned about last night.  I'm talking a 6 centimeter spider that moved fast, lurking in the corner of the ceiling.   Greg nailed it wth a towel, threw it on the floor and stomped it dead.  Herosim is not dead, this week in Haiti. 

Friday, April 10, 2015

Interview Day

The young woman wore dressy sandals on her feet with smudges of mud and dust on her ankles, but her top half was wearing a very cute green and orange flowered dress.  In the middle was a little round tummy smeared with ultrasound gel.  She is seventeen years old and far along, she has no idea.  When I put my hands on her belly, I had a pretty good idea that it was about 18 weeks along.  The ultrasound came up with 17.  She lives with her aunt and doesn't know where her mom or dad are, or if they are even alive.

It's "Interview" day at Heartline Ministries Maternity Center in Port au Prince, Haiti,  a day when pregnant applicants verify their pregnancy with a urine test, and hope to get into this program that will give them weekly pregnancy care and health services including their birth, all the way to 6 months postpartum.  There are only 50 slots in the program.   Today, 25+ showed up and sat for hours for a chance to be in this lucky club.  They waited a long time, as it was busy; this morning, the 6th mom of the week delivered at this little birth center.   6 new moms, none have gone home, and Heartline has beds for 2, officially.  The rest are cared for in office space and the birth room.  2 mamas nearly ready to go home both dressed and moved over to share one bed as a couch, where they ate breakfast and nursed their babies.  The new delivery got the clean, vacated bed and settled in with a sigh.  It's so nice when a birth is OVER, both for the mom and the midwives!

The midwives and staff didn't get a lot of time to sigh, however...Besides Interview day,  each Friday is also Family Planning day, and the covered porch was full.very full, of women who came for a  3 months of birth control.  We gave nearly 80 Depo injections and I inserted 2 IUD's that will give 5-10 years of contraception.  I also stitched the post-partum mom, took blood pressures, and examined the newborn who is a healthy 7-pound boy named "Reggie", but this was minor extra work.   Meanwhile the real Heartline staff midwives and doctor did ultrasounds, prenatal visits, treated a mama's high blood pressure, and conducted the interviews.  I really missed my nurse-"peeps" from home who came with me on a recent trip, (Jen and Alicia,) due to to the aforementioned hypertensive lady and a new mom with big breastfeeding difficulties!  

At the end of the day, two of the mothers were ready to go home.  I piled in along in the ambulance/SUV with the moms and their babies and their bags of donated baby supplies.   Midwife Tara almost ran over a pig deep in the muddy rut of one of the roads...yes, this is urban Port au Prince.  We escorted each mom to her house- both tiny affairs with concrete floors and corrugated metal walls and tarps for shade just outside.  One old Granny really lit up as her new great- grandbaby was brought home to her safe and clean and healthy. We prayed with the moms and babies, for their health,safety, protection.  That's not the afterthought-- it is the heartbeat of this amazing work in Port au Prince, that is so small, but so true, so poignant, thereby so powerful, and nourishes not only these Haitian women, but this American one, too.    Bon nuit from Heartline, Port au Prince, Haiti.   

Wednesday, April 8, 2015

This is Why

Greg and I leave early this morning on Trip Eleven to Haiti....and this is why we do it!
From the Blog of Nadene Brunk , founder of  Midwives for Haiti..."Ten Things I Learned in Haiti"

It will be great to see Haiti friends on this trip...I no ask for a lot of things for donation, as there is a whole part of my house full of donated items.  Also,thanks to sister-projects such as Christy Turlington-Burns' "Every Mother Counts",  MFH has have more resources to help this work. ( Money still needed.  Oh yes.)   Yet, today there was an urgent email from Haiti with a list of items needed...then I went to Costco for ink cartridges, batteries, and Trail Mix!  My wonderful hospital administrators came through with syringes and alcohol pads.  My husband, Greg, is exhausted from remodeling our house, and now he comes with me to Hinche, to fix up the supply cabinets in Labor & Delivery at St. Therese Hospital.  I thank anyone who cares to come along on this-- it keeps on going and I do love to work in Haiti.  Nadene's Blog tells why....see you soon, in Haiti.!

Sunday, March 23, 2014

Shirley's Baby & Haitian Heroism

Working in Haiti,  I'm often praised for doing good work, or told how thankful Haitian people must be for the program I work with.  The longer I work here and get to know Haitian people, though, I find myself profoundly humbled by their everyday heroism.  I am  inspired by them, and the tremendous courage it takes to live each day here, doing your best.    
One of our translators, Shirley, is a single mom who learned great  English while living in the US as a kid.  When her parents died, she was deported back to Haiti-- may never have been legal, it seems.  She works hard to support her children: a boy who is 8, a daughter who is 4, and now, an unexpected new daughter.
Shirley found this baby girl in the garbage lot, outside her apartment in Port au Prince last fall.   She tells it very matter-of-factly, that one night she went out to empty her trash, and heard a baby crying in the dark.   Knowing the sound of a newborn cry quite well  (she sees babies born every work day with us in maternity),  she located this little baby in the debris  and took her home.    The infant` was only hours old, and still attached to the placenta.  She cleaned her up, cut her cord, dressed her, got her some formula, and adopted her.   The baby is now 7 months old and walking!  She will eventually go to a good school, just like her siblings.  
Most Sunday nights, Shirley rides a tap-tap, (an open bus or truck with people sitting on benches) from Port-au-Prince to Hinche,  2.5 hour ride, to do this job translating Creole/English for volunteers who are teaching at the hospital.  During the work week, she stays in Hinche with a friend, and others look after her kids,  so she can earn a living.   She arrives on time, pays attention, and helps Midwives for Haiti in any way she can, all day long.  Last week she found my forgotten water bottle at the hospital and saved it in a cabinet for me.   On  Friday evening she takes the tap-tap home.   For Haitian economics, this is a pretty decent gig; it enables her kids to have food, clothes, and go to school.  Quite often she also goes back with cute clothes and shoes for her kids, formula for the baby, and some extra money...we love Shirley and try to help her.   She's one of my heroes.

Thursday, March 20, 2014

You Might Be in Haiti If.....

You Might Be in Haiti If:

You Make a mental note to not go anywhere, ever, without Kleenex or toilet paper in your pocket.

The colors are so clear and intense that the entire day feels like being stuck in an issue of National Geographic.

You wear a size 10 and are the fattest woman in town.  You are also the hottest woman in town and all women wish they were as fat as you.

You are exposed to TB and Hepatitis in less than five minutes.

You see a truck going down the road with seven bleating goats tied upside down!

You start a mental list entitled "Things I Have Seen On a Motorcycle in Haiti" and it includes A Family of Four, a live pig,  and a goat.

If you are cuddling a little kid at a feeding center whom you realize is soaked in pee....and then you realize that's okay.

Your favorite perfume is "Eau de DEET".

"You order "rum and coke " and you get a bottle of rum and a bottle of coke.
Compiled by many of the Volunteers for Midwives for Haiti!
You Might Be Working for Midwives for Haiti IF:

A set of clean "sea foam green" scrubs, size small, is not only a Hot Commodity that you can trade for beers or favors at the house, but Very Nice Business Attire for the day.  Every day.

You get a blood pressure of 220/130 on a clinic patient who thinks you are crazy for being VERY concerned. She also tells you that taking her diuretic is not convenient because it makes her pee all the time when she rides the Tap Tap. 

Everyone is reminded to start their day with 1000mcg of misoprostol in their pocket.

You have to step over a stray brown dog in the doorway of Labor and Delivery.
All of the dogs look the same and you think they must have come from the original Adam and Eve of dogs.

Colleagues come in from the hospital  night shift report a set of twins (one breech),  and one eclamptic mama, with the comment " but a lot of the night was quiet" ....

Tuesday, March 18, 2014

Opening Talk, Midwives for Haiti, Class 7

Tonight, the easiest blog I ever posted, because I wrote it a week ago.  I have spoken to the students at the opening of several classes, but tisone was special, as I delivered it in Creole, thanks to the translation help of Gladias, our Haitian college student who lives with us.  I believe so deeply in the potential of these Haitian students to help their country-- it was a joy to welcome them to this program.

am so happy to talk to you today on the first day of your class.

I have been coming to Hinche since March of 2009.  

I feel very fortunate to have been able to join Nadene and Steve with the

beginning of Class 2, and Class 3, and maybe some others.  

This is my tenth visit to Haiti, so I forget some things. 

Over these 5 years, I have seen this Midwives for Haiti Program grow and

develop very much.

As you probably know, originally it was just a group of students under a mango

tree at Pandiassou, with Nadene and some other midwives that she recruited! 

Now you have books in Creole, and Haitian teachers, and a beautiful compound,

and good teaching tools, to make a great learning environment.

We are very happy to see all this progress!   

I was thinking of this progress, and I asked myself, is it really still helpful for the

Americans to visit here?  

We have so many good Haitian midwives now, and Nadene and Dr. Steve have

selected some of the best ones, to be your instructors and teachers.  

I wondered  " Maybe it is not important for me to come here, it would be better to

 send the travel money to the Midwives for Haiti organization?" 

But I want to share with you the answer that I found to this question.

First, it is very important for me to come to Haiti, and work with you student

midwives, because this work nourishes my heart.  

I come here because I hope for this project to become a true collaboration

between Haitian people and Americans.  

We bring medical knowledge and supplies, financial support, and administrative


But you teach me many things too.

 I learn from the Haitian people about patience, and endurance, and about relying

always on God and each other, for help.  

So I come here not only to teach, but also to learn.

I also come here because I believe that being a midwife is a spiritual calling.

When we take this job, it is a responsibility to care for women and babies at their

most delicate time.

And if we have this responsibility, it is not only toward the women in our own

towns and countries.

We are responsible to help care for all women, and to help protect them as best

we can through their childbearing time. 

So even though I am an American midwife, I am a midwife first.  

And the women of Haiti need more midwives.  

So I come here to help you fill that need.

This week we begin with the most basic things about being a midwife.  

The things we discuss will be very simple, but they are also the most important.  

Just like the stones that we put down to build a house, these ides are the

foundation that will support everything else that you learn in the program.

You will learn many skills, and have a lot of knowledge about pregnancy and

birth and health care when you graduate.  

But if you fail to learn these first principles, you will not be a true midwife.

Love.  This is the guide that you must have in your heart when you do this

work.  You must have love guide you as you care for women and their babies.  

Love will cause you to speak kindly to all women, rich or poor, a pastor’s wife or

a prostitute..

When you are very tired and want to sleep, love will help you stay awake to help

a woman who is afraid and in pain. 

Love will help you get out of bed and report to  work on time, to help your sister

midwife, when she is done her work and needs to go home.

If you act out of love, you will not fail as a midwife.

Respect is the little sister of Love, and it is the other side of the coin that  you

must carry in your pocket always.

Respect will cause you to not only to speak kindly to a woman, but to guard her

health information, to protect the private things that you learn about her.  

Respect. will remind you clean your hands each time you touch  a

patient, even a baby, even when no one is looking.

Respect will have you tell your name to each woman when you begin to care for


Respect will remind you that even the poorest, the most beaten down women,

 are not donkeys, or goats, but human beings, created in God's image.

If you act out of Love and Respect, you will succeed as a midwife, and make all

of us very proud.

I hope to see you again, and wish you God's blessing on all your work.

Welcome to the Sisterhood of Midwives!