tag:blogger.com,1999:blog-55772741157398695212024-02-20T01:08:17.649-08:00My Life in HaitiThe musings of a nurse-midwife who is happy to work at increasing access to skilled maternity care for women in Haiti.Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.comBlogger26125tag:blogger.com,1999:blog-5577274115739869521.post-89497736449547666072021-03-09T14:17:00.001-08:002021-03-09T14:17:22.673-08:00Brother Harry<p><span style="font-family: arial;"><br /></span></p><p><span style="font-family: arial;"><br /></span></p><p><span style="font-family: arial;"><br /></span></p><p><span style="font-family: arial;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGTV8fZ4pLQ3Sdc51Dl4xJHhlbgUS-pYWqMFTDsPf-j4ERpRuz8VVsnZbhSatl0TleFeXqtDuQ1oblt-ETW-tUO1X2mKYPGfz4CnDv2294fLfedHUrCsERyArQAT_N-DOrvE9ZWYEkKaQ/s400/Brother+Harry.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="266" data-original-width="400" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGTV8fZ4pLQ3Sdc51Dl4xJHhlbgUS-pYWqMFTDsPf-j4ERpRuz8VVsnZbhSatl0TleFeXqtDuQ1oblt-ETW-tUO1X2mKYPGfz4CnDv2294fLfedHUrCsERyArQAT_N-DOrvE9ZWYEkKaQ/w400-h266/Brother+Harry.jpg" width="400" /></a></span></div><span style="font-family: arial;"><br />Someone wonderful died yesterday and vivid memories of him are flooding into my thoughts.</span><p></p><p><span style="font-family: arial;">How many people start a new career at age 60? Brother Harry arrived in Haiti in 1989 when he was 60 years old. He lived in a small house in Pondiassou, a small village about 3 miles west of the city of Hinche. I am not certain what his goals were but he was a member of the Catholic order of the Xavarian brothers who are dedicated to education so I guess he came to Haiti to educate. And educate he did. </span></p><p><span style="font-family: arial;">On my first couple of trips to Pondiassou and Hinche (2006 and 2007) I did not meet Harry, but some of the doctors who were with me met him as they were looking for Cokes and beer and found Harry had a supply just up the road a bit. Those first few visits our main translators were Manno and Theo who were from a village called Clory about a mile north of Pondiassou. We learned that they had walked from Clory to Pondiassou, where there was no school, and met with Brother Harry every day in order to learn English and to read and write in both Creole and English. (Later, with donations from midwives, a school was built in Clory.)</span></p><p><span style="font-family: arial;">Frankly, without translators Midwives For Haiti would never have happened. Therefore without Brother Harry Midwives For Haiti would not have happened. Our "school" for midwives started with 8 nurses and met under the mango tree in the courtyard of the Little Sisters of the Incarnation. Our teachers were American volunteers who came sporadically- whenever I could get them scheduled. Our curriculum was just "whatever we can teach them from A Book for Midwives". We figured if they knew what was in that book, they would save some lives of mothers and babies. That was our goal. </span></p><p><span style="font-family: arial;">Manno and Theo were our life lines while we were in Haiti. They managed our logistics and taught us about Hinche. Since our students did not know when we would be there, and it was pre-cell-phone time, Theo would go around to each of their homes to spread the news that the midwives were coming! They would drop their normal lives and all turn up at 8 am promptly on Monday mornings for a week of training. The midwives who happened to be there were frequently not the same from one week to the next and left notes for each other so that each would know what material had been covered and what they had learned from the students. </span></p><p><span style="font-family: arial;">Sometime in the late 90's, a group of Catholics from Richmond, Virginia had helped a Haitian man build an orphanage for boys in Hinche. Brother Harry started spending a lot of time educating boys there and when they built a guest house he left Pondiassou and moved into the guest house to be closer to his work. </span></p><p><span style="font-family: arial;">That is where I met Brother Harry. Since Midwives For Haiti had no headquarters or house, we rented space from either the rectory of the parish or the bishop's compound L'Eveche. When we learned there was a guest house available at the MFO (Maisson Fortune Orphanage) we started sending all of our volunteers there for their stay. I think we perhaps paid $35/night. We felt good that we were supporting the orphanage at the same time that we were working to educate midwives.</span></p><p><span style="font-family: arial;">Every morning at MFO guesthouse, Brother Harry would fix breakfast for his guests. It was usually coffee and oatmeal and he enjoyed the dried cranberries or raisins or nuts that we brought with us to add to the oatmeal. Supper was fixed by some cooks they hired and we all pitched in to do the dishes. </span></p><p><span style="font-family: arial;">Before supper each evening, Brother Harry would gather all guests on the beautiful stone porch overlooking the grounds of the orphanage. He would have a reading of something meaningful and then he would invite us to comment on the reading and on what we had learned from Haiti that day. More than one of us sobbed as we unloaded all of our feelings about what we were seeing and what we were learning about life in Haiti. No one who goes to Haiti does not struggle to see how a loving God can allow such suffering. </span></p><p><span style="font-family: arial;">Brother Harry could be seen during each day holding his lessons on the porch with 8-10 boys around him learning games and learning English and learning wisdom. Later he was joined by Brother Mike and Brother Bill. Each of their personalities and skills brought gifts to us and the boys. Brother Mike was always the one who brought us boys with medical issues. Brother Bill was the fix-it man and he never fixed a sink or toilet without some boys around him learning how to do the same.</span></p><p><span style="font-family: arial;">There were frequently new kittens on the porch. Between the kittens, the nourishing meals, and the spiritual insights, and the cushioned wooden benches, we loved our times on the porch with "the Brothers". We had so many wonderful conversations with these men and we admired their love and dedication to the orphans. After the 2010 earthquake a girl's orphanage was started next door and it gave the Brothers even more to do. Although all of the children went to school on the campus each day, late afternoons and evenings saw them seeking out the company of the gentle and loving Brothers. </span></p><p><span style="font-family: arial;">In 2011, Midwives For Haiti started renting their own house but that did not stop our visits to check on the Brothers. The following year we found an even bigger house that met many more of our needs and started renting it from Father Noel, a Haitian priest whose family owned the house. One of my favorite things to do was to invite "the Brothers" for dinner one night. I would put 3 tables together, 2 long and one short at the end to create a large rectangle table. I would get out our best tablecloths and it would usually take 3 to cover the table. The cooks would be notified how many guests were coming. I would bake bread and Steve would make homemade ice cream with our 2 gallon White Mountain ice cream maker. Sometimes we celebrated birthdays, like Pastor Jude, and have cake. </span></p><p><span style="font-family: arial;">When the Brothers were coming for dinner it was really special. We would greet them at the door with smiles and hugs and offers of drinks. Brother Mike did not want "adult Coke", a mixture of Coke and rum. He wanted just "the adult". They looked forward to these evenings of food and fellowship as much as we did and at the end of each evening we were all filled with love and gratitude. </span></p><p><span style="font-family: arial;">When Brother Harry was in his 80's he started having a lot of back pain from a progressive degeneration of his spine. He traveled back to the U.S. for therapy now and then but always came back to Haiti. He wanted to be live and die there and had his burial place picked out. One of his volunteers, a law student named Ryan Kenrick, who later joined the Midwives For Haiti Board of Directors, told us about Brother Harry showing him the spot he had chosen for his burial plot. </span></p><p><span style="font-family: arial;">Not all was well with the leadership of Maisson Fortune. The Brothers would advocate for the children, asking for toothbrushes and more food and books. They would be told that money was being sent but then would see no evidence of it being spent for the children. A delegation of Catholics from Richmond came down to investigate. Without knowing details of what transpired, we heard that the Brothers were being asked to leave. We were devastated for the children. </span></p><p><span style="font-family: arial;">So the Brothers all went back to the states. Brother Harry went to a nursing home in Kentucky. Brother Mike became a hospice worker, and Brother Bill ended up coming back to Haiti to work in another area. I remember when Brother Mike came to Haiti to clean out Brother Harry's house in Pondiassou. Getting rid of his bike, his pots and pans, his small personal bits was very hard. He came to our house to say goodbye to us. We reminisced about our wonderful times together. He mentioned how many wonderful midwives he had met over the years through our organization. When I learned he was going through training to be a hospice worker I said, "You're going to be a midwife to the dying!" He teared up and said being a midwife would be a huge honor. We hugged and said goodbye, each to go back to our missions richer for the friendships we had made.</span></p><p><span style="font-family: arial;">I am copying here the letter Steve Applegate wrote this morning regarding Brother Harry that includes Brother Harry's own words about his time in Haiti.</span></p><p><span style="background-color: white; font-size: 14px;"><span style="font-family: courier;">Harry Eccles passed away yesterday in Louisville, Kentucky. He was 92/93.</span><br /><br /><span style="font-family: courier;">Harry was one of the first Americans I met in Haiti. Hinche to be exact. He was a <a data-saferedirecturl="https://www.google.com/url?q=https://steveapplegate.us7.list-manage.com/track/click?u%3D66068de9042a44d0c610a2c32%26id%3Dfbf6ea26f3%26e%3D3c05475474&source=gmail&ust=1615395300370000&usg=AFQjCNEQaBYlHJk7D6bNlCs543gDjLhXdQ" href="https://steveapplegate.us7.list-manage.com/track/click?u=66068de9042a44d0c610a2c32&id=fbf6ea26f3&e=3c05475474" style="color: #336699;" target="_blank">Xaverian Brother</a> who served and lived at the <a data-saferedirecturl="https://www.google.com/url?q=https://steveapplegate.us7.list-manage.com/track/click?u%3D66068de9042a44d0c610a2c32%26id%3D26a7519a37%26e%3D3c05475474&source=gmail&ust=1615395300370000&usg=AFQjCNH-6wBGgh1HTr54awCs6sSFzU-2Zw" href="https://steveapplegate.us7.list-manage.com/track/click?u=66068de9042a44d0c610a2c32&id=26a7519a37&e=3c05475474" style="color: #336699;" target="_blank">Maison Fortunate Orphanage</a>. Whenever I would be walking in Hinche, young men would come up to me wanting to practice their English. I'd always remark how well they spoke English. When I asked where they learned to speak English so well, their reply was always the same, "Brother Harry."<br /><br />We became good friends. I treasure the moments we were able to sit on the MFO porch early in the morning, before others had awakened, chat while drinking coffee and eating Harry's infamous oatmeal.<br /><br />God bless you, Harry. You were an inspirational, spiritual, kind, soft spoken man, who was able to get dressed and show up everyday, in Haiti. That made all the difference.<br /><br /><strong>In Harry's own words:</strong></span></span><span style="font-family: courier;"><span style="background-color: white; color: #505050; font-size: 14px;"></span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">"After a few "exploratory" visits to Haiti in the '80s, I went in '89 with Brother John Mahoney to live in Pandyasou, Hench,with the Little Brothers of the Incarnation. Brother Cosmas Rubencamp, Haiti expert for the diocese of Richmond, was our guide then and for years to come. It was because of Cos that I met Jean-Louis Lefort.</span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">After about 15 years, I needed a break from the daily Pandyasou-Hench commute, and, with Nick McCann (a Xaverian volunteer) went to live in the just-finished guest house at Maison Fortune. We and other Xaverian volunteers had been making the trek to MFO even before the present campus opened. These young volunteers made great big brothers and sisters for the children, and I was the porch-sitting "grandfather." Actually, my morning coffee pot and oatmeal did get good reviews.</span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">My memory file is somewhat moth-eaten, but these volunteers are unforgettable: Chris Lecher, David Goy, Jonathan Dohanich, Chris Roberson, Mike Mcgeehin, Brian Goss, David Patterson, Jana and Ben Robbins, Greg Mason, Ryan Kenrick, Kevin McArdle, Nick McCann, Paddy Lynch, Peter Everest, and Caitlin Gordon. There were others (especially from Penn State) who spent "winter breaks" with us, including high school groups from Mt. St. Joseph, Bishop Sullivan, Good Counsel. The experience was growthful for volunteers and children.</span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">Most visitors at the guest house were drawn there by MFO, but even those with other priorities shared with us in activities and reflection. Paramount among them are Midwives for Haiti, marvelous women (and a few men) with world-wide experience, who worked to improve feminine health.</span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">Two memorable events of these years were weather-related. Although Hinch was not damaged by the 2010 earthquake, MFO's population was swelled by refugees from Port-au-Prince. Another year our campus was flooded, and the children were evacuated to St. Martin de Porres High School. I think they enjoyed the adventure. I stayed high and dry on the second floor; Louisville's 1937 flood was enough for me!</span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">The most significant event of my tenure was the opening of a home for girls; this later developed into a separate campus. Truly impressive!</span></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: courier;">My own experience was enhanced when Brothers McCarthy and Bill Griffin joined me. Their "youth," energy, and creativity complemented my grandfather's role, and I was happy to be escorted across the campus by helpful kids who carried my book bag to English class."</span></span></p><p style="background-color: white; color: #505050; font-family: Arial; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><br /></span></p><p style="background-color: white; color: #505050; font-size: 14px; line-height: 15.12px; margin-bottom: 0.11in;"><span style="color: black;"><span style="font-family: arial;">I think of Brother Harry when I think of all that can be done between the ages of 60 and 90. He was such an inspiration to me when I wanted to give up our mission in Haiti. I think of Brother Harry when I see pictures of Jesus with the children around his feet. I think of Brother Harry when I think of the hundreds of lives that were changed in Haiti because of the education he provided. Oh, Brother Harry, I miss you so much!</span></span></p><p><br /></p>Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-6493271104136077662019-10-21T15:31:00.001-07:002020-01-12T12:50:37.790-08:00A New Chapter for Midwives For Haiti<br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">It has been almost 2 years since I retired. It seems longer in many ways because we have done so much traveling with our RV. Because Steve and I are on the Board of Directors - sometimes via Zoom or Skype - we are able to keep up with the organization's major programs.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">In the early part of the year the Search committee had interviewed several really good candidates and had chosen Jane Drichta to be the new Executive Director. Jane came to us with multiple qualifications including experience in starting her own NGO, working in the Philippines, Iraq, and Uganda, and having graduate degrees in Global Health and Tropical Nursing. She is also a midwife! She has worked and lived in areas of political instability but she had never been to Haiti. The BOD decided I would be the best person to take her there to introduce her to our staff and acquaint her with all of our programs.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">I love taking people to Haiti who have never been before and watching them fall in love with the people and the tropical beauty. And it was especially wonderful for me to see dear </span><span style="font-family: "arial" , "helvetica" , sans-serif;">friends I had not seen for two years.</span></div>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">After the long but uneventful trip from Port-au-Prince to Hinche, we arrived at our headquarters in the early evening. The house looked so good! The downstairs rooms had all recently been painted in the pale mint green and everything looked so fresh and clean. Jane was thrilled with the house and with meeting all of the people who work for us there.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">Sunday afternoon food and staff arrived for the First Annual Staff Appreciation party. Speeches were made and included a reminder from the head of nursing at Ste. Therese hospital to Jane - without Midwives For Haiti there would be no maternity unit at that hospital and many lives would be lost. There was singing. My favorite part of every party in Haiti is the singing!</span></div>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">The new class, Class 11, began on Monday. It is always exciting to meet these nurses who have been chosen from over 180 applicants to begin to become midwives. I shed a few tears as they gathered and started their day with a hymn of gratitude and introductions to all of us and all of them.</span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Class 11 at the beginning of an 18 month program</span>. <span style="font-family: "arial" , "helvetica" , sans-serif;">Lead instructors are Limone Clerveau and Daisy Grochowski.</span></td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">Jane and I had other work to be done. We had a typically long wait at the bank to get the MFH account set up for Jane's use, a meeting with the staff, a review of volunteer handbooks that had somehow been lost since I had left, and went through supplies.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">In the past year we had transitioned from the mobile clinics going once a month to 22 villages to placing midwives in government owned clinics on a weekly basis in 8 of the villages we had visited before. This increased the quality of care we are able to give because we can follow women more closely who need vigilance on blood pressure medicine or in other high risk circumstances. It also was welcomed by the government and as they had only one nurse at each site who did not have the skills to do prenatal care and risk screening, they were thrilled to give us a room in each clinic for that purpose.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">I went to La Belone to see how the prenatal clinic works there. I enjoyed seeing the countryside on the way out. I also enjoyed talking to the pregnant women as they waited to be seen. They were all grateful for the midwives and some had walked 2-3 hours that morning to get there. They just wished there was a midwife there full-time so they could have skilled care during their deliveries. Sadly, until we get a midwife in every village, most women in Haiti still deliver at home without the skilled care they should have.</span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">The road to La Belone</span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">I borrowed Midwife tools for clinic.</span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">The clinic at La Belone</span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Beautiful Haiti countryside</span></td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">A walk to our praying hill, an evening of heavy rain, a visit to the grocery store, and lots of long talks over our cold beers on the porch rounded out Jane's first week in Haiti. One day I made bread and ice cream. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">Making ice cream is a team effort. </span><span style="font-family: "arial" , "helvetica" , sans-serif;">The 2 gallon recipe included the yolks of 15 eggs, expensive cream I had brought from Port-au-Prince, milk, raw sugar, and 7 bananas.</span><span style="font-family: "arial" , "helvetica" , sans-serif;"> Davide got a large rectangle piece of ice from the market. It's about 2 foot long and a foot square. Then he puts it in a bag and bangs it on the cement outside to get it into pieces small enough to fit in the White Mountain freezer around the canister of ice cream. Chunky rock salt is added to the ice and then Toro and Davide churned until it was too hard to churn. I told them how my dad would fold up a rug and put it on top for me to sit on so he could crank it harder without moving the churn. </span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Breaking up the ice block</span></td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">The cooks and the men got the first bread out of the oven and the first rounds of ice cream. They were very happy and I enjoyed my time working with them.</span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Cranking ice cream</span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Magdala and husband, Pastor Jude came to visit me</span></td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">At the beginning of the next week, the protests about Petro Caribe were starting again. I needed to get to PAP to catch a flight on Wednesday but left a day early hoping to miss some road blocks. But near Mirabilais our vehicle sat in a long, long line of vehicles- perhaps 2 miles long, and waited for an hour or more for the road to clear. Police had to come and get the protesters to move the barricades of trucks and tires. Only one lane could go through at a time so we were happy our lane got to go first.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">I never felt unsafe. However, the protests have become more violent since August. There seems to be no end in sight and I fear Haiti is headed to a huge humanitarian crisis. Without fuel and with unsafe roads, doctors are not going to work at the hospitals. Without fuel, trucks and cars cannot deliver food and goods. Our birth center manager was robbed. A student was hit in the face with a rock. At one NGO, that runs a birth center, a needed C-section did not happen when it should have and the baby died. People are starving and people will die in record numbers unless there is international intervention. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">We are no longer allowing volunteers to go to Haiti. That means the sutures, the IV tubing, the dressings, the gloves, the baby clothing and blankets, etc, are no longer coming down. It makes life very difficult in the hospital for our teachers and preceptors. MFH is going to try to use American Cargo to ship supplies that are being donated to our Richmond office via Amazon. The first shipment goes this Friday with a lot of prayers it is not stolen and that our staff stays safe while picking it up. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">People ask me since I am back, "How did it feel to be in Haiti and not be the Executive Director anymore?" My answer is "It was wonderful to feel the love and pride about the program's accomplishments without the burden of keeping up with all of the obstacles and problems that are inevitable working in Haiti. It was also good to see my dear friends in Haiti. But I am very thankful for Jane and to have capable staff and leadership to carry Midwives For Haiti forward to places I could not go." I am very happy to be retired. And again- grateful beyond measure for the people continuing to work to save the mothers and babies of Haiti!</span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Me with Mario Cleophat, Midwives For Haiti Program and Partnership Manager</span></td></tr>
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I end with this quote from Leila Janah:</div>
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At the end of our visit, I watched a woman deliver on a squalid table with a gruesome expression and thought about my friends giving birth back home in beautiful facilities. How is it that such a grave disparity persists in<i> 2019,</i> with all the wealth in the world? Why do we allow some women to suffer so needlessly because they happen to live in a country without the resources to care for them properly? This isn't a Ugandan problem, or an African problem or even a women's problem. It's <i>our </i>problem. Every woman that dies or loses her baby on a threadbare cot in the heart of Uganda, <i>in a shack in Haiti</i>, whi<i></i>le her sisters on the other side of the world enjoy first-class care, is a threat to our collective humanity. <i>Italics are my additions.</i></div>
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<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-34522253002667996122019-05-18T20:47:00.000-07:002019-05-22T03:18:20.828-07:00Abortion- What's Love Got to do with it?<!--[if gte mso 9]><xml>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
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<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
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<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
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<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
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<w:LsdException Locked="false" Priority="52"
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZnANkEdNA8t8NIdAeXW5h12wHYuKN4PFTejwpcmkuyghY5-8k3rd_UJyo9ZDAgI_fP90T6Yfi30UNRBjeF7OXtmi5gax4cea15QYOIXr3llYIIhyDVhkYsUzTSKL13QnEbal9Hk99xko/s1600/MWFH_011315.0216-Edit.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1077" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZnANkEdNA8t8NIdAeXW5h12wHYuKN4PFTejwpcmkuyghY5-8k3rd_UJyo9ZDAgI_fP90T6Yfi30UNRBjeF7OXtmi5gax4cea15QYOIXr3llYIIhyDVhkYsUzTSKL13QnEbal9Hk99xko/s640/MWFH_011315.0216-Edit.jpg" width="430" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo by B.D. Colen</td></tr>
</tbody></table>
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;"><br /></span>
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;"><br /></span>
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">I want to talk about abortion in Haiti. But first here are two true stories.</span></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">In my practice in Richmond, I saw the midwifery patients most of their pregnancy visits, referring them to and consulting with a physician for anything that was not normal or was concerning. Because of this, I got to know my patients quite well and could not help but deeply care about their lives and what the new baby and birth would mean for them.</span></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">One day one of my patients arrived for a routine visit and had an unusually high blood pressure and 4+ protein in her urine. Christy looked completely normal and had no other symptoms except perhaps a mild headache. But these are cardinal signs of preeclampsia, a killer of women all over the world as it can lead to kidney failure, brain swelling that leads to seizures, and death. No one knows what causes preeclampsia. There are some things that can be done to treat the symptoms but inevitably the only cure is to end the pregnancy. This is upsetting to the woman, frightening news to get, but in this case it was especially frightening because she was only 28 weeks pregnant and ending the pregnancy now meant her baby's life was at risk. The hospital where I worked did not have the necessary equipment and the experts to keep a baby alive who was less than 32 weeks gestation so she was sent to another hospital where the baby could get the necessary help if needed. </span></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">I went home that afternoon hoping that Christy would be able to get steroid injections over a 24 hour period that would help her baby's lungs mature and give it a better chance of survival. The next morning I learned that when Christy arrived at the hospital her lab worked showed that she was in critical condition, could have a stroke or seizure at any time, and her kidneys were barely putting out any urine. An emergency C-section was performed and the baby went to the Level 3 nursery immediately. Christy rapidly started to get better. Her baby received the very best of care possible for babies who are premature and even though she had not had time to get the steroid injections they were able to help her baby breathe until she was able to do it on her own weeks later. Christy and that baby are still alive today.</span></div>
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<span style="color: #505050; font-family: "pt sans" , sans-serif;"><span style="background-color: white; font-size: 18px;">Here is a similar story in Haiti. Josette was a midwife trained by Midwives For Haiti who worked full-time at the hospital in Hinche. I had barely arrived in Hinche on a Saturday afternoon when I was told that she wanted to see me. I went out onto the porch to meet her and found her barely recognizable. Her face and hands and feet were very swollen. She was obviously pregnant. </span></span></div>
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<span style="color: #505050; font-family: "pt sans" , sans-serif;"><span style="background-color: white; font-size: 18px;">Josette came with a note from one of the Haitian obstetricians saying that she needed to be on bedrest because her blood pressure was high and she had protein in her urine. She wanted me to know why she would not be at work the following week. When I saw the note, saw her lab results, and saw her, I was scared for her but when I heard that she was only 27-28 weeks along in her pregnancy, I was aghast. Nowhere in Haiti does a baby of that age have a good chance of making it if born that early. She assured me she would go on bedrest, drink plenty of water, and pay attention to signs of increasing problems like not urinating very much, headache or confusion. She also assured me that another midwife who lived near her would take her blood pressure twice a day.</span></span></div>
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<span style="color: #505050; font-family: "pt sans" , sans-serif;"><span style="background-color: white; font-size: 18px;">Josette knew she was in grave danger. Over the years of working at St. Therese she has seen a lot of death of both mothers and babies. She had fought for their lives. She knew she could die, too. Stupidly, </span></span><span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">I asked Josette if she knew that most likely the baby would need to be born soon. Of course, she knew. We hugged and prayed. I wanted to keep tabs on her so we made sure we had her phone number before she went home to bed. </span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">But the very next day, she was put in the hospital because her blood pressure was in stroke range. That was Sunday. We do have betamethasone in Haiti which can help mature the baby's lungs so Josette got 2 injections 12 hours apart as prescribed. We needed time. Every day that baby could stay in there the better its chances were at survival. She also started getting Labetalol, a drug that would help keep her blood pressure under control.</span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">Monday night we were so concerned that we were standing by her bedside and Dr. Eads was giving her boluses of Lebetalol in her IV, retaking her blood pressure, giving her more and more and the blood pressure would not come down. We were very fearful she would start having seizures or have a stroke. So late at night we left her in the the hands of another midwife with strict instructions on keeping her dosed throughout the night. We drove to where the Haitian doctor lived, got him out of bed and had a discussion outside beside our vehicle about what he planned to do about Josette. </span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">This doctor had worked with Josette for years and cared a great deal that she have a good outcome for her pregnancy. He was scared about what would happen to Josette if we did not end the pregnancy and he was scared about what would happen to the baby if we did end the pregnancy. The two doctors agreed to give her that night at least and confer in the morning about what to do. The next morning, Josette was sluggish and her blood pressure was 180/120 even with medications. She was in grave danger. The doctor was very busy and did not do the C-Section until late afternoon. Josette did fine with the C-section and immediately started to get better. </span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">But her baby did not have a Level 3 nursery and the staff did not have the equipment or training to save a baby that young and the baby died very soon after birth. We were all heartbroken. But we knew the C-section had saved Josette's life. Today, Josette is alive and well and takes good care of the one other child she had before this pregnancy.</span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">What do these two stories have to do with abortion? They point to the fact that every day doctors are making life and death decisions for their pregnant patients that have enormous consequences and that sometimes means they have to choose between one life or another. The choice is one life or two deaths.</span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 18px;">I think of these two stories when I think how ignorant most people are about pregnancy, birth, and why there is a mother dying every two minutes across the world from complications of pregnancy. Because of what I have witnessed in Haiti, I am keenly aware that birth control saves lives, that a lot of sex happens without consent, that in many places women's lives are cheap, that where you were born and who you have around you can determine whether you will live or die before, during, or after pregnancy.</span></div>
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<span style="background-color: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">Abortion is illegal in Haiti. I think it would
be hard to find any medical professional willing to perform the procedure. But
abortion happens frequently in Haiti- probably daily- because I know one
hospital that sees the aftermath several times a week. There is a medication
that people can buy on the black market (on the street) anywhere in Haiti that induces abortion
at any time during a pregnancy. Legally buying that drug in Haiti at a
drugstore is very difficult.</span></div>
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<i style="mso-bidi-font-style: normal;"><span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">(This causes problems for organizations like Midwives For
Haiti and other health care organizations who want to use it exclusively for
treatment of post-partum hemorrhage (PPH). Postpartum hemorrhage is the second
most frequent killer of pregnant women in Haiti and is number one in many
countries in Africa and Asia. It is no discriminator based on religion, race,
or wealth.)<o:p></o:p></span></i></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">I remember one 13 year-old brought in by her
father for pain and bleeding following an induced abortion by this medication. My student and I
found the dead baby, estimated to be about 18-20 weeks gestational age, between
her legs, still in the amniotic sac and still attached to its cord.<span style="mso-spacerun: yes;"> </span>I wondered if her father gave her the
medication or if he was the father of the baby. Within an hour after we had
removed the placenta he walked her home, refusing any birth control method. <o:p></o:p></span></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">I remember a mentally impaired woman brought in
by her sister. <span style="mso-spacerun: yes;"> </span>The midwives said she
comes in every year or so with an induced abortion because the men in her
village use her for sex all the time. We spent weeks trying to figure out a
place for her to go besides back to her village. Because of the lack of any
social services in Haiti we struggled to find a safe place for a grown woman
with mental impairment. Then one day she and her sister disappeared. With an
IUD in place she would not get pregnant again but I still think of the hell her
life must be.<o:p></o:p></span></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">For women in Haiti there are terrible things
that make them consider abortion.<span style="mso-spacerun: yes;"> </span>The
inability to feed themselves or the children they already have, the loss of
financial support from the father or from family, rape and abuse. They feel
there is no other option. And sometimes when we see the 80+ children in the
feeding center with their distended bellies and no energy to even feed
themselves we get a hint as to why women in Haiti choose abortion. Watching your child
die slowly from lack of food is a terrible thing. <o:p></o:p></span></div>
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<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">So what do women in Haiti need in order to stop
abortion from happening? It isn’t religion because faith is strong in
Haiti.<span style="mso-spacerun: yes;"> </span>Women call on Jesus daily for
food for their children, to be delivered from sexual abuse, to escape their
terrible lives. They are calling “Jesu, Jesu” as we deliver their babies, dead
or alive and we are trying to be Christ-like to them. What we are unable to
give them is food for their families, years of consistent birth control, and locks and security in
their homes. Living in a mud house or a house made of tarps is invitation to
sexual abuse. If we had all these things to give them, plus easy adoption to
loving homes (finding “loving” is part of why it is not “easy”) there would be no
abortions in Haiti. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">Unplanned and unwanted pregnancies occur even
with the best birth control. However, the abortion rate in the USA dropped 25% after the Affordable Care Act (CDC records), largely due to increased access to birth control. It dropped 40% in Colorado when birth control became totally free. Now we
are facing repeal of the Affordable Care Act in exchange for one that considers a pregnancy or a previous C-section a
pre-existing condition that insurance companies can choose not to cover.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">I have heard people say things like, “She
shouldn’t have more children until she can take care of the ones she’s got” and
“She shouldn’t have sex if she can’t afford birth control”.<span style="mso-spacerun: yes;"> </span>This ignores that sex often happens without
choice for a large number of women. And it ignores that even women who are in
loving supportive relationships have unplanned pregnancies. I am one of the
millions of women who had an unplanned pregnancy. But it was not unwanted
because I knew I could gladly care for and love another child. <b>And I had everything that
most Haitian women do not have. </b><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">Haiti proves that laws outlawing abortion do not end abortion. There IS logic
to giving women love, support, food, shelter, birth control, and medical
insurance. I love my granddaughters so much and hope they never feel so desperate they even think about an abortion. But if all abortions are outlawed they will be afraid to enter the hospital with life-threatening bleeding for miscarriages and ectopics and the doctors will be afraid to treat them for fear of being investigated for causing the bleeding. I fear for my granddaughters when or if they have a miscarriage (1 in 4 pregnancies end that way) or if they have an ectopic pregnancy that has to be removed to save their lives. Will they be put in jail, will their doctors be put in jail, will all their medical records get scrutinized by lawyers who do not even know what an ectopic pregnancy is or how to treat it? </span></div>
<div class="MsoNormal">
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;"><br /></span></div>
<div class="MsoNormal">
<span style="background: white; color: #505050; font-family: "pt sans" , sans-serif; font-size: 13.5pt;">I think pro-life and pro-choice Americans should sit together and figure out how to decrease abortions in this country. Because women and mothers are valuable. Because love has everything to do with it.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<!--EndFragment--><br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-87274380556233814222018-02-08T18:01:00.001-08:002018-02-08T19:14:23.632-08:00Maternal death hits homeA week ago tonight after we were in bed awhile, I heard the big metal door slide open and the Land Cruiser leave the compound. I remember thinking, "Who gave permission for someone to take the Land Cruiser- at this time of the night?" I forgot about it until maybe 30 minutes later when there was pounding on our door.<br />
<br />
It was Stecy, our volunteer coordinator. She said with urgency, "Dr. Steve, Perrine needs you at the hospital. Someone is seizing." Steve dressed quickly and hopped on the moto with Judnell to go to the hospital. I was thinking that Perrine knows what to do about seizures--MgSO4 injections and hydralazine--- so maybe it is worse than usual and the patient is not responding. But seizures themselves don't usually kill women. It is the organ failure from the excessively high blood pressure that kills them. The brain swells, the kidneys stop functioning, and the lungs fill up with fluid. I felt that Steve would have good suggestions about what steps to take to reverse these and fell back to sleep.<br />
<br />
Some time later, I woke and wondered why he was not back. I heard low voices in the kitchen so I opened my door and saw Steve and Phu sitting at the kitchen table. I walked out to see why they were still up in the middle of the night. Steve looked at me and said, "She died." I could see he was upset. I asked, "Who?! Why?"<br />
<br />
The story of the death of our student, Guerline Adeka started way before that day. She was pregnant through most of the last 9 months of the class and due two weeks after graduation. But for some reason, she spent about 4 days the week before this night in the hospital with ineffective labor pains-meaning she was not dilating. So a doctor did a C-section. All seemed well. She and the baby went home. A postpartum visit was done. All seemed ok.<br />
<br />
Monday and Tuesday were review days for the class. Guerline did not come but everyone understood. Major surgery 3 days before would not make sitting in class for hours very comfortable. But she did come for the exam Thursday morning at 8 am sharp. She was determined to put a lid on this year's work. Determined to graduate with the exam behind her. Perrine, our clinical director, asked her how she was doing. She told Perrine she felt short of breath the night before. Perrine said to call if she felt worse.<br />
<br />
So she did. She called Perrine about 10:30 pm. Perrine took the vehicle and went about 2 miles to pick her up. Guerline was in respiratory distress and kept saying she could not breathe. She was panicking and Perrine stopped on the way to the hospital to get some money because she knew oxygen would be needed and one has to pay for that. Within minutes of walking in the hospital, Guerline collapsed and was gone. Perrine started CPR, anesthesia intubated her so they could get good ventilation. When Steve arrived he could not find a pulse but he helped Perrine do CPR longer. Perrine had the desperation one feels when you know and love your patient and when you are saying, "This CANNOT happen! NO! It did not bring Guerline back.<br />
<br />
No one slept much the rest of that night. As medical people do, we discussed what happened to Guerline. Probably a Pulmonary Emboli happened. Its a risk of any surgery, thankfully rare. And here in the U.S. we also lose mothers after C-sections due to PE's. There was some discussion about heart failure from cardiomyopathy but that probably would not have taken her in an instant like a PE can. And was it a necessary C-Section?<br />
<br />
I woke in the morning to wailing. As the students started arriving to review the exam with Cindy, they learned that their friend and colleague had died. I have never heard such wailing by so many people at once. It was heartbreaking. It went on for hours. It was so so sad. We gave hugs, served coffee, held each other. Later in the morning, some students started singing. Mixed with the sobbing, it was sweet and comforting.<br />
<br />
I thought about how Haitians know how to grieve. There is no hiding how they feel, no burying their emotions. The grief is there for all to see and hear. I also wondered if the weeping encompassed all the sad things, all the losses, all the injustices they had ever experienced in their lives. Grieving is the only way to get to the other side. And we never quite arrive on the other side. We are never the same when we experience great loss. It marks us for life. It changes us.<br />
<br />
One of the most striking things about Haitians that anyone learns when they spend time with them is that they are some of the strongest people I know. They have an incredible ability to feel deeply, to express themselves vividly. They know how to live in joy regardless of their circumstances. They can dance and sing with grace and skill and beauty.<br />
<br />
That is why, later in the afternoon, the maestro led the students in practicing their singing for the graduation ceremony. It was a bit more subdued. He could tell it was not easy. But sing they did. Life must go on. They were graduating from a difficult course of study and work. They had spent hours in the hospitals and birth centers learning from women. They had sat through days and weeks and months of classes. Graduation would bring a new life for them and their families. The work they were called to do will save lives. They know that deeply. They will do it for Guerline.<br />
<br />
And they would sing. They deserved to sing. They needed to sing.<br />
<br />
This is why I love Haitians. They get me in the heart and soul every time.<br />
<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com2tag:blogger.com,1999:blog-5577274115739869521.post-25044905076782746632017-11-19T10:55:00.002-08:002021-03-13T10:19:41.639-08:00The costs of doing good<div class="MsoNormal">
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">Last evening I had my 2<sup>nd</sup> shower
in the 7 days we have been in Haiti. I am a pro at bucket baths by now and can
get really clean with very little water if I have soap and a washcloth. I do
not take showers for granted so I am thankful even for the cold ones. Last
evening the shower was really just cold water flowing out of a high faucet but
it felt so good.</span></div><div style="margin-bottom: .0001pt; margin: 0in;"><span style="color: black; font-family: "Times",serif; font-size: 13.5pt;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiCXh5AD1dGJbuqWKqCw6IL_rAaTtAw-S6-Gc0odeLe_Z6mRbAgjP14qW-AADr6B-UvtbpSnZMvG1VFHpLa_V791xMATz7Wtt5QMmGmNtnGyYhPOp-P5X9hZYmRFPdmWrbuldCw0bgQFc/s1600/staff+photo+for+nadene.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1091" data-original-width="1600" height="435" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiCXh5AD1dGJbuqWKqCw6IL_rAaTtAw-S6-Gc0odeLe_Z6mRbAgjP14qW-AADr6B-UvtbpSnZMvG1VFHpLa_V791xMATz7Wtt5QMmGmNtnGyYhPOp-P5X9hZYmRFPdmWrbuldCw0bgQFc/w640-h435/staff+photo+for+nadene.jpg" width="640" /></a></div>
<o:p></o:p><o:p></o:p><br />
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">As always when Steve and I come to Haiti
we are constantly problem-solving with our staff. Haiti is not an easy place to
work and probably the most difficult part is that we do not understand the many
ways Haitians think differently than we do. Things we take for granted that are
not ethical are not seen as unethical at all- “just the way we do things here
in Haiti”. We can knock our heads against it constantly or accept that we have
to have a lot of supervision and oversight over every detail. When we cannot
find the right persons to trust in a supervisory role or cannot afford them we
have to accept that frequently we will be “taken” financially and materially.<o:p></o:p></span><o:p></o:p></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">It is common for Haitians to recommend
someone for a job you want done and when they do, they always recommend a
relative or friend not necessarily the person who knows how to do the job best
or at the best price. So finding skilled workers is really hard. Added to the
finding of a friend or relative to do your job, you can bet the price will
include a kickback to the person who got them the job. We have some regulations
and laws against this in the U.S. but here it is an accepted way of life.<o:p></o:p></span><o:p></o:p></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">It is easy to slip into a skeptical mode
where you trust no one and that can be hard on one’s morale after a time. I
think that is why so many NGO’s and overseas relief workers burn out. They just
cannot get used to being “taken” and they feel their good will and generosity
begin to make the people they came to help develop “entitlement” and
“dependency” attitudes.<o:p></o:p></span><o:p></o:p></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">The problem is that administration and
oversight take money and no one wants to see a large portion of a budget going
to our administration and less to the actual work of saving lives. And yet all
larger and successful organizations have learned that oversight and data collection
and evaluation are necessary in order to use the rest of the funds responsibly.
Midwives For Haiti grew really fast in the direction of providing a lot of
direct care to patients in mobile clinics and the hospital in addition to our
training program. We know we have made the difference between life and death
for many. But we also hope our donors understand that administration of the
programs is necessary also. With the right administrative staff we can teach by
rewarding honesty and hard work and put in steps methods of terminating
employees that do not do their job or use funds wisely.<o:p></o:p></span><o:p></o:p></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">Mary Francis is just one of our
employees that takes very little supervision. She lives in Cabestor next to our
birth center. She fixes the best coffee in the world with a mixture she gets at
the market of star anise, cardamom, and cinnamon. And her plantain soup is so
delicious. I do not want to know how much sugar she puts in it. With her we
know where our money goes. She buys our food at the market and she cooks it.
And her life is so much better because we need to eat when we are visiting the
birth center. I wish managing all of our employees was as simple as Mary
Francis. But it is not that simple with most of them. Most of them we have to
trust to do their work when we are not around and to use our money wisely.<o:p></o:p></span><o:p></o:p></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: black; font-family: "Times",serif; font-size: 13.5pt;">Cold showers are the least of my worries
while here in Haiti. I would take a bucket bath every day the rest of my life
if I could know we will be able to expand our work, change more lives, and
solve the problem of maternal mortality in Haiti.<o:p></o:p></span></div>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/>
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Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-27279002353836742182017-04-13T10:20:00.002-07:002017-04-13T10:20:45.137-07:00A History Lesson about Lovie Shelton
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I recently read a book called “Lovie”- by Lisa Yarger, a story of a
nurse-midwife who delivered thousands of babies in eastern North Caroline in
the 50’s, 60’s, and 70’s, and 80’s - and 90’s! 50 years of being a
nurse-midwife! </div>
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I was delighted to read references to Frontier Nursing
Service and Frontier Midwifery School in the book. Lovie Shelton was a nurse
first – graduating from Norfolk General Hospital. Her first job was working
with a doctor who did home births and she loved going with him to support women
in labor and being in their homes. But she wanted to know more. So she went to
North Carolina University in Chapel Hill to get a degree in Public Health
nursing. But she was still interested in learning about birth and midwifery. The
faculty at North Caroline U. told her about FNU and Mary Breckinridge. So she
spent 3 months in the 40’s at Frontier with Mary Breckinridge and the midwives.
She was so impressed with not only their maternity skills but also that they
did so much primary care in the area completely without the aid or supervision
of a doctor. </div>
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She knew that midwifery was what she wanted to do so she
asked Mary Breckinbridge if she could get midwifery training at her school. Ms
Breckinbridge said she had every class filled up for the next four years. (I
had not known this happened!) But she told Lovie she could pull some strings
and get her into the Edinburg, Scotland school with a scholarship. So in 1949
Lovie went to Scotland for midwifery training and wouldn’t you know- Margaret
Myles –yes, the midwife who wrote the Myles Midwifery textbook was her teacher.
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You know that after World War 1 the maternal mortality rate
in the U.S was between 6 and 700 per 100,000 – like what it is in the Congo or
Central Africa right now. And you know that the medical community started
paying attention to nurse-midwives when Mary Breckinbridge’s statistics in
southeastern Kentucky showed marked improvement over the rest of the country. </div>
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Once Lovie Shelton finished her nurse-midwifery training she
came back to the U.S. and looked for a place where she was needed. She got a
job setting up the health department in Beaufort county in North Carolina. She put
out the word that she was a trained midwife and started doing deliveries on the
side.<span style="mso-spacerun: yes;"> </span>The doctors supported her because
they did not want to deliver black women and poor women- before Medicaid there
was no money in it. They put her in charge of the granny-midwives and she
taught them and supervised them and sometimes took away their privileges if she
felt they were incompetent. </div>
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Lovie started a maternity clinic at the public health
department so that the granny-midwives could bring their patients to that. But
even so, most women who came to her clinic were still being delivered by the
granny-midwives. But her fame grew and more and more women called her for
deliveries. Sadly, she got a lot of flack from her fellow nurses who saw
midwifery as a dirty, shameful thing that brought down the stature of nursing. </div>
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Over the years granny midwives were being phased out, and Lovie
became very busy. She was becoming well-loved because of her skill and because
she treated each woman with compassion. She quit her public health job and was
on call 24/7. Once she delivered 196 babies in one year. Sometimes she was paid
and sometimes she was not. </div>
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Lovie always struggled working in a state that had no
regulation for nurse-midwives and legally she could do no more than the
granny-midwives could do. So she developed a 2-bag system. One was her granny
midwife bag- all the clean birth stuff like soap, clean razor blade, gloves,
and clean newspapers—and a 2<sup>nd</sup> bag with her BP cuff, stethoscope and
gloves. The first bag is what she would show the doctors. She had respect and
support from doctors until Medicaid came along and then they were not happy
with her- she had to lay low and be extra careful to take only low-risk moms.
She never lost a mom. She did lose some babies, most because she was called too
late. </div>
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So how does Lovie’s story relate to what I do? </div>
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I spend about 4-5 months a year in Haiti in the Central
Plateau district where there are 2 hospitals for over 725,000 people.<span style="mso-spacerun: yes;"> </span>There are also only around 7 obstetricians
for that many people. Calculating birth rate for it comes out to about 18,000
women that are going to need maternity care in one year. I am not certain I
have current numbers but there are about 12 nurse-midwives are working in the
Central Plateau- these are the university educated nurse-midwives recognized by
the International Confederation of Midwives. So guess who is doing over 75% of
the deliveries in the central plateau—yes, the granny-midwives, known as
matrones, still do the bulk of deliveries in rural Haiti. Even in the towns and
cities, women still use matrones because 1) they have no transportation to a
facility, 2) they have no money to pay the facility, 3) it is culturally
acceptable to birth at home, and 4) they claim they are treated badly at the
hospitals and clinics. So the maternal mortality in Haiti is about 350-450 per
100,000 depending on whose stats you look at. And- Currently only 9% of the
need for midwives is met in Haiti.</div>
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If you look at the State of Midwifery Report from 2014, you
can see that the most progress in combating maternal mortality is being made in
the countries with several levels of midwives- what the WHO calls
task-shifting. What we had here in this country was task-shifting when in 1932,
the White House Conference on Child Health and Protection found that when
granny midwives were trained, their infant mortality was no worse and sometimes
better than the doctors. So, training for granny midwives became standard in
public health departments. </div>
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We also know that CNM’s, CPM’s and birth centers and the
regulation of them has had a rocky history in our country largely because of
the financial implications for doctors and sometimes because of genuine concern
for safety. </div>
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My point is that countries wanting to make progress on maternal
mortality need to go through the same process- of starting with training
the traditional birth attendants and then educating midwives to differing
levels of competence, regulating what each level can do legally, and gradually
getting more and more highly trained nurse-midwives. In the U.S. we went
through an evolution from the granny midwives- who delivered most of the babies
in this country before the 1950’s, to regulation of the granny midwives, to
regulation of nurse-midwives- and we are still working on that in some states. </div>
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So that is what we are trying to do in Haiti. There are
thousands of uneducated traditional birth attendants who need training on when
to refer and need a constant supply of clean birth kits. Midwives For Haiti has
educated around 200 of them from 6 areas and are being asked to do more. We
distribute hundreds of clean birth kits per month and are constantly
needing more. We also train nurses who have varying levels of education, to be
skilled birth attendants. This means they can do all that the WHO says are the
core abilities of a skilled birth attendant. We have trained 124 of them. Haiti
does not have a title for them yet. Their diplomas simply say they are nurses
with advanced obstetrical training. But the government is taking notice. Unlike
the university-trained nurse-midwives in Haiti who have an attrition rate of
over 60%, only 2 of our graduates have left the country. The rest are working
in birth centers and hospitals all over Haiti and delivering around 9000 babies
per year. We are in collaboration with the Ministry of Health who is still in
the process of deciding how to regulate them. The Ministry of Health is hiring
them because they either cannot afford the nurse-midwives, or they cannot find
any nurse-midwives willing to work in rural areas. </div>
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An example of how the government views us is that in our
current class we have 4 nurses who automatically have jobs in rural clinics
working for the government when they are finished. We are in conversation with
the government about how to regulate them and what tasks they can do legally. </div>
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Just as in this country- a variety of midwives are needed in
Haiti to meet the need. </div>
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With a rising maternal mortality rate here in the U.S. we
are in desperate need of connecting nurse-midwives to the women who need them
most. The coming years it is going to be a challenge for the poorest in this
country to access the care we are so good at providing.<span style="mso-spacerun: yes;"> </span>I challenge all the alumni of Frontier to be
pioneers for finding ways to enable the women in their communities to use them
for their maternity care from prenatal care to deliveries to postpartum and
family planning and their primary health care. Women in the U.S. need us. We
may need to rock the boat just like Mary Breckinbridge did and Lovie Shelton
did. Let’s not be afraid to do it to save the lives of mothers and babies-
whether it is in this country or another. Countries like Angola, Sudan, the Dominican Republic of Congo- they are
not on the ICM’s map because they do not have nurse-midwifery regulated. But
that should not stop us from trying to train whoever is doing the births- in any country. In
order to change lives we may need to do just what Lovie did in this country- <span style="mso-spacerun: yes;"> </span>carry two bags. One that is legal and one that
rocks the boat but changes the world.
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Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-5388198572011351482016-07-01T12:58:00.001-07:002016-07-01T13:22:09.885-07:00The Servant Heart of a Midwife<br />
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<br />
Kitty Ernst turns 90 this year. And this is the story she told to new and old midwives in Alberquerque last month.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-BPfLlgT-tbam7w3GF0VpEu2eC5eHa5rxm-b6nm8kOIlH5Gx6DGauykF-gbNaWOuFFSVmfQ_3f5rbvbGorCALIi0lQmw1nyqXP_u8Ua59N3NKN1QM9VvF20eCSMdx4Cq8fG66w71BbDQ/s1600/Kitty+ErnstJessicame_n.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-BPfLlgT-tbam7w3GF0VpEu2eC5eHa5rxm-b6nm8kOIlH5Gx6DGauykF-gbNaWOuFFSVmfQ_3f5rbvbGorCALIi0lQmw1nyqXP_u8Ua59N3NKN1QM9VvF20eCSMdx4Cq8fG66w71BbDQ/s320/Kitty+ErnstJessicame_n.jpg" width="320" /></a></div>
Kitty told of how when she first went to the Frontier School in Kentucky she had no intention of becoming a midwife. When she learned that the reason most students were there was to become a midwife she wanted nothing of it and planned to leave. The reason she did not want to become a midwife is because she had been exposed to "obstetrics". What she had seen up to that time of obstetrics left her with the image of doctors and nurses <i>standing over</i> suffering women and telling them what to do to get their baby out. She hated it. She was not going to do "obstetrics".<br />
<br />
But a wise teacher told Kitty that she should at least see one midwifery birth in a home before she left the school. So very soon she was taken to a home where a woman was in labor. There were sleeping children in the small room where the woman was sitting up in her bed so everyone was very quiet. Kitty was amazed to see the midwife at the feet of the woman looking up to her talking softly. The midwife rubbed her feet, asked her if she wanted water, told her she was strong, and held her when she was in pain.<br />
<br />
Kitty had lightbulbs go off in her head. THIS was MIDWIFERY????!!!!! This image of the midwife as a servant to the woman was something that clicked with her core values. She decided on the spot to stay at that school and become a midwife. And what a midwife she has been!<br />
<br />
I was not the only one in the room that night that teared up when Kitty told this story. Jessica Jordan and I looked at each other with our blurred-from-tears vision and acknowledged that the story was pretty much pinging on every string of our soul.<br />
<br />
One of the things we struggle with so much in Haiti is the culture of class that partly stems from their long history of slavery. In Haiti it is not uncommon to treat anyone who has not received as much education or make as much money as you as a lower-class citizen and worthy of your scorn. So one of the barriers to skilled care in pregnancy and birth is that Haitian women stay away from places where they are talked to and treated as if they are nothing.<br />
<br />
We constantly tell our students to treat patients as if they were their sister, their mother, their friend. We talk about compassion, caring, gentle touch, and the importance of listening to women.<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB7bGJFL6Abbo2n0CU8j5QwpA78EfFkZCs_bowE9oeRgvZzv8MpeHy2QODVt1kMqyNaZhXhaXBwQkNvV7nX-_4BJ8RFSzNoKTzL9BcrwTrJOL9sRY4hij0JC-0sZmSn973N1Hoc0mgxZY/s1600/Marie+Denise+with+a+patient.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>But the servant heart of the midwife is the hardest thing to teach. Especially if you have never experienced that kind of caring in your life.<br />
<br />
We tell our volunteers repeatedly that if they do nothing else but demonstrate compassion to patients, then they have made a dent in the hearts of the staff and students and demonstrated true midwifery. This year I am thinking of what we could do for our students that would make them feel the compassion and gentleness of unconditional love. How can they show what they may have never experienced?<br />
<br />
This picture is of one of our grads pouring water over her patient's head in an effort to cool her. She is being a servant midwife. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB7bGJFL6Abbo2n0CU8j5QwpA78EfFkZCs_bowE9oeRgvZzv8MpeHy2QODVt1kMqyNaZhXhaXBwQkNvV7nX-_4BJ8RFSzNoKTzL9BcrwTrJOL9sRY4hij0JC-0sZmSn973N1Hoc0mgxZY/s1600/Marie+Denise+with+a+patient.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB7bGJFL6Abbo2n0CU8j5QwpA78EfFkZCs_bowE9oeRgvZzv8MpeHy2QODVt1kMqyNaZhXhaXBwQkNvV7nX-_4BJ8RFSzNoKTzL9BcrwTrJOL9sRY4hij0JC-0sZmSn973N1Hoc0mgxZY/s320/Marie+Denise+with+a+patient.jpg" width="320" /></a><br />
<br />
Every woman on this earth has experienced suffering in some form. It may have been spiritual, physical, or mental pain. She may have suffered alone or been blessed by caring sisters of the heart who held her up when she was down. The time of birth always hurts. No one can take away all the pain - although in some cases we have the means to come pretty close to painless. But most women in this world birth without access to medications so they rely on their family, their mothers, sisters, and significant others to see them through the deep waters of childbirth.<br />
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I try to remember this when I am with strangers in any setting. Here before me is someone who has suffered, especially if she is a woman. The statistics of domestic violence, rape, and trafficking are sobering. Every midwife has heard the stories, cried the tears, screamed inside at the injustices that women endure all over the world. Childbirth is just one time when women suffer.<br />
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Whether you are a man or a woman, you need someone to be your servant when you are suffering. I am learning that a lot of midwives get into hospice care when they stop catching babies. Care at the end of life is another form of servant midwifery. Some of you remember Brother Mike McCarthy who was a Xaverian Brother at the Maisson Fortune in Hinche. He was a gentle and sweet soul who let a lot of midwives cry on his shoulder after hard things happened to them in Haiti. When he left Haiti he told me he was finishing three months of training to be a hospice worker. I said, "Brother Mike. you are going to be a midwife to the dying!" He gleamed. He could not think of a greater thing than to join the ranks of all of the "servant" midwives.<br />
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This is Beth McHoul and her patient who is in labor. A midwife at <b>Heartline Ministries</b> in Tabarre, Haiti. A servant midwife every day of her life. <br />
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This is Rebecca Barlow, student midwife, demonstrating servant midwifery at St. Damien Hospital in Haiti. She is a Frontier Midwifery student.<br />
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Being a servant midwife takes emotional and physical and mental energy. What midwives get in return for what they spend is the knowledge that there would be no soul in their work without servanthood. No matter who you are, if you helped someone who was suffering today, you are a servant midwife.<br />
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Let's all be a servant to each other. This world needs more servant hearts. Thanks for reminding us, Kitty!<br />
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Photo credits:<br />
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<b><u>Photo of Marie Denise by BD Colen, Photo of Beth McHoul by Tara Livesay, Photo of Rebecca Barlow by Maribeth Quinn.</u></b>Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-50906494951523357792016-04-24T17:45:00.003-07:002021-03-13T10:21:54.895-08:00To be or not to be? To be, of course, but how?This is a painful thing to write because change is painful and change is inevitable. But change can bring good things, right? Right???<br />
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Midwives For Haiti is currently running its annual campaign for the
Mobile Clinic Program that serves 600-700 women per month with prenatal
care. Other years we had matching funds to help us reach our goal, but
the organization that provided those funds has a limit of 3 years on
their funding in order to discourage dependency. We understand that but--- what will happen if we cannot support this program after this summer? <span id="goog_799029396"></span><span id="goog_799029397"></span><br />
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is a painful thing to have to give up something that has been really
good and saved a lot of lives because of a lack of funds. Without enough
money to run the mobile clinics, the BOD will have to consider the
options. We have thought of them before- everything from disbanding the
program all together to just reducing the number of villages we visit.
There is a lot of fear about any of the choices. Who will get lost in
the transitions? Will there be lives lost?<br />
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The church I attend meets in a 90+ year old building with a huge sanctuary, incredibly fine woodwork, stain-glass windows, an expansive organ that fills the front of the church, many rooms, and several annexes added through the years that make it a maze to newcomers. Everyone loves walking in those old historic doors knowing that hundreds went before them and everyone feels the responsibility to those who went before to carry on the work of the church.<br />
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But the congregation can no longer support the cost of the building, the upkeep, the maintenance, and the cost of heating and cooling such a massive structure. So they are facing some hard choices- namely leasing or renting out a large part of it or selling it and moving elsewhere. A lot of grief is happening and a lot of emotions with fears and hopes are being shared in the "town hall" meetings.<br />
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A question in everyone's mind is whether or not the church can remain the same church in a different space, in a different part of town, with different patterns to being together. Spiritual growth and support for it is one thing, but what happens to the projects the church has in the community like the weekend backpacks for the hungry children in the local school, the variety of services for the elderly in the two nearby retirement villages? Can the vision and mission of the church remain the same in a different way? And a big fear- who will get lost in the transitions? Will people we love leave us?<br />
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Same questions---If Midwives For Haiti has to stop the Mobile Clinic program can MFH maintain its vision and mission- to increase access to skilled care for pregnant women in Haiti? Can the wonderful midwives who have dedicated their lives to this work be put to work in a different setting? The problem is that anytime you limit a midwife in Haiti to one space you limit how many people she can reach because transportation is a huge obstacle for most women in Haiti. But can we perhaps do a better job and give more thorough care if we limit the care to a specific place? The vehicle costs are killing us.<br />
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What if we just have to bite the bullet and stop the salaries of midwives and drivers? There will be many family members that will go unfed and their children will have to stop school. And the many women they know need care will go without. Healthcare is just not sustainable work in Haiti.<br />
Or anywhere for that matter. Without insurance a visit to the hospital could bankrupt some of us. In Haiti there is no way most women could pay for the services needed to have thorough prenatal care and a safe delivery. So very few could come up with the money.<br />
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And do not tell me they should just not get pregnant. You be the one to issue the decree there should be no more sex. Good luck with that. And even here in the U.S. where birth control is pretty much accessible to everyone- depending on what our elected leaders do next- people still have unwanted pregnancies. And pregnancy can kill women. It does every two minutes in this world. EVERY TWO MINUTES, PEOPLE!!!<br />
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It breaks our heart to let Mobile Clinic go. Because we know it saved lives. But there are other lives to be saved. And we cannot save them all. What steps can we take that will bring the most life to the most people with the funds we DO have?<br />
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Just like the church at Ginter Park, Midwives For Haiti will jump into this unknown place called the future. But we will do it while holding hands with each other and total faith that we are supposed to DO THIS WORK!! Hold tight!<br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com2tag:blogger.com,1999:blog-5577274115739869521.post-68820396453099787552015-02-08T17:04:00.000-08:002015-02-12T06:17:39.746-08:00The Baby in the BagThe Baby in the Bag<br />
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Three weeks ago Rebecca Barlow and I wanted to recreate Frontier Nursing's "baby in the bag" photo in Haiti. For those of you unfamiliar with the story, in the 1920's to the 1960's Mary Breckinridge established the Frontier Nursing Service in south eastern Kentucky. Small clinics and nursing posts were built in areas where there were no roads. Eventually they were able to refer to a small hospital nearby rather than putting people on boats, mules, and horses to get to a train to take them to Lexington. The clinics were staffed by nurse-midwives who traveled by horseback, and in addition to catching babies, they stitched wounds, gave vaccinations, and brought healing to the sick in the region.<br />
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Because the nurse-midwives always carried their supplies in a leather saddlebag that contained their starched white aprons, clean sheets, sterile instruments, cord ties, and gloves, the children of the region came to believe that all babies arrived in these bags. Sometimes they wondered why the babies stayed in there so long after the midwife arrived. <br />
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FNU's Baby in the Saddlebag picture </div>
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Rebecca is a current Frontier Midwifery student and I am a graduate from Class 8. Right now in the house here in Hinche, Haiti we have midwives Kathleen Lutter and Susan Mitchell, from classes 84 and 85, respectively. Nurse-midwives frequently see how our mobile prenatal clinics operate here in rural Haiti and draw the lines of similarities- mostly in bringing skilled care to where the people live- between Midwives For Haiti and the work of the nurse-midwives in the mountains of rural Kentucky.<br />
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Last year, a colleague of mine from my nursing faculty days, Violet Horst, contacted me. She had found some old leather bags at the University of Virginia's nursing school that were probably used to carry supplies for public health nurses years ago. They needed to be cleaned up and the handles needed repaired. A kind harness-maker from Dayton, Virginia fixed them for her for no charge. Then she mailed them to Midwives For Haiti in Richmond, Virginia. She also fund-raised for BP cuffs, fetoscopes, and other midwifery equipment to put into them.<br />
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When they arrived in Haiti, they were given to our mobile clinic midwives. Four of them ride our aging pink Jeep to sixteen villages around the central, as far away as a 2 hour drive, delivering skilled midwifery care to over 500 women each month. They received 4 of the bags. The other two bags went to Illa and Juslene, the two midwives that Rebecca trained last summer to do thorough assessments of mothers and babies before they leave the hospital here in Hinche.<br />
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Putting the bags in the hands of midwives seemed to bring Mary Breckenridge's vision back to us and I really wanted to get a picture of a Haitan baby in one of those bags. We had a professional photographer here for just a few days and the morning before he left we asked him if he could help us get that photo. BD Colen said he would do it so we showed him the Frontier picture.<br />
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We decided that for various reasons, going to the hospital to take photos was not wise or practical and that bringing a woman and her baby to us was reasonable as we could provide the vehicle to bring them to the house. We called Illa and Juslene and asked if there was anyone ready to go home that would consent to coming here and having their baby's photo taken. They called back soon and said "Yes, come and get the mother and baby".<br />
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When they arrived at the house and Illa helped the very young mother out of the van, she said to us, "She's a little embarrassed to come because she has no clothes." The grandmother was carrying the baby while the mother climbed out of the van holding onto a brown towel wrapped around her body. She had a green blouse on and that towel, nothing else. And she was reluctant to sit because of course, having just had a baby, the back of the towel was bloody. <br />
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Haitian women frequently come to the hospital with the only nice outfit they have, get the dress or nightgown or skirt soiled during the birth process, put the soiled things in a bucket to take home and wait for family members to bring them something to wear home on the back of the motorcycle. They use multiple rags in their limited supply of underwear to keep themselves from soiling everything they lie on or sit on. These rags do not get tossed. No, they get taken home to get washed in a bucket to be cleaned and dried and reused over and over. This mama's skirt was in a bucket back at the hospital.<br />
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We have a house full of women and all of us swung into action. Kelah Hatcher, the daughter of a CPM volunteer, offered a pair of underwear, and in that we put a blue surgical towel for padding. I went upstairs to my still unpacked bags and found a blue and white shift I had bought, and because sending it back when it was too small seemed to be more bother than it was worth, had brought to give to someone. We sent her to the bathroom with the panties and dress. She walked out looking regal with a shy smile. <br />
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Because she also looked tired and uncomfortable, we hurried to get our photos. BD worked with lighting and settings in the house, Rebecca kept the baby wrapped well and the little boy just slept through it all. We got one photo with Illa and the baby and many of just the baby in the bag.<br />
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Although Emily said all the volunteer donated baby supplies had been depleted, we scrounged in all of our storage rooms and managed to find one cloth diaper, one onsie, a pink cotton receiving blanket, a blue sheet, a plastic bag for the dirty towel, another clean towel and a baby toy I had brought from my granddaughter. The grandmother is pictured here with the Hospital Albert Schweitzer bag we found to put it all in. It included a few goudes to pay for a mototaxi ride home when she was discharged.<br />
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In the end, the pictures were taken and the mother and her grandmother taken back to the hospital to get some last instructions and teaching by Illa before going home. In the end, I was left thinking more about this mother than I thought about the photo shoot. I thought of the home she was taking this baby to- its dirt floor, its lack of running water, electricity, its meager food supply. I thought about the baby's grandmother wanting to help so much but not having much but herself to offer. I thought about how much I love my grandchildren and want them to be happy and loved and safe.<br />
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I have also thought about Violet Horst who is a woman who is one of the 3% of people who survive a gleoblastoma, a dreadful brain tumor, for more than a year. I thought of all the love and grace she has brought to her students while teaching pediatric nursing and how her love reached all the way to midwives and mothers in Haiti while she wears electrodes attached all over her head to beat back the growth of the tumor.<br />
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In the beginning it was about a picture of a baby in a bag. In the end, it was about women loving and supporting each other through the treacherous roads we travel. In the end, there was so much love in the house it was spilling out and we would never be the same. In the end, we were more inspired than ever to carry on Mary Breckinridge's vision.<br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-37367697299171109092014-09-16T18:00:00.001-07:002014-09-17T21:19:28.881-07:00<div class="MsoNormal">
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<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">I have been working in Haiti to decrease maternal and infant
mortality by increasing the access women have to skilled maternity care. So I
have been amazed and dismayed to learn there are actually women in this country
who sometimes choose to have their births “unassisted”- without a skilled
midwife or doctor close by. It is true that most of the time, with a full-term
pregnancy, a woman’s body knows what to do and a healthy baby is born. And it
is true that sometimes medical interventions cause complications that would
otherwise not occur. </span></span></div>
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<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">In most cases women in this country who chose to have a
skilled birth attendant nearby will not need their expertise. They will
frequently just enjoy the reassuring and caring presence of someone who has
cared for them during their pregnancy and wants the very best for them and
their baby. I know a midwife who knits sitting next to her patients as they
labor. But I know she would have interventions ready in a flash if that mother
or baby started showing distress.</span></span></div>
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<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"> <img alt="Photo: "A woman, as long as she lives, will remember how she was made to feel at her birth." -Anna Verwaal" class="scaledImageFitHeight img" height="504" src="https://scontent-b-lga.xx.fbcdn.net/hphotos-xpf1/v/t1.0-9/p403x403/10704071_10152593938843463_2299949536830027249_n.jpg?oh=b8c7f38bd6738685b5b093c4e99856cc&oe=549B6C85" style="left: 0px;" width="379" /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">The reality is that occasionally even women and babies who
have had the very best of prenatal care and are in the very best of health have
bad things happen during labor and birth or soon after birth. Whether one
chooses to birth at home, at a birth center, or in a hospital, having a skilled
birth attendant has been proven to make the difference between life and death
for mothers and babies. In case you wonder what can go wrong here are just 10
of them:</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><b>10 things that can happen to any woman during birth
regardless of race, wealth, medical history, or location in this world.</b></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">1. The baby may not breathe on its own after birth. This
happens about one percent of the time and is more frequent if the baby is
premature or has been exposed to certain medications. But it can happen to
anyone. It kills about a million babies each year in this world.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">2. A piece of the placenta remains in the uterus. This only
happens about 4% of the time but can be a cause of heavy bleeding and can
happen to anyone.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">3. The uterus can bleed too much after birth by not
contracting well on its own. It is more common if a piece of the placenta
remained inside but it can happen to anyone even if the placenta was completely
expelled.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">4. Your baby’s shoulders can get stuck in your pelvic bones.
This is more common with big babies but can also happen to anyone.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">5. Your baby’s cord could prolapse or come out in front of
the head. It is more common when the bag of water is broken artificially but it
can happen to anyone.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">6. You can get an infection. In even the cleanest of
situations there are bacteria that you can be exposed to during birth.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">7. Your baby could be
stressed by the labor and not get enough oxygen.This is more common if the placenta is not healthy but can happen with even healthy placentas.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">8. Your baby could be
in a position that makes it difficult to exit the pelvis well and labor could
go very long.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">9. Your uterus could
invert- turn inside out while the baby is coming out. It is pretty rare but
sometimes happens to women who have had a lot of babies.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">10. Your placenta could be retained and not come out at all.
This may be because of conditions where it grows into the wall of the uterus or
just will not detach on its own for some reason.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">Here’s what can happen as a result of any one of these
complications and you are a woman in a rural village in 72 countries in this
world - or if you are one of the women who wants an “unassisted birth” in this
country.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">1. The baby could die.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">2. You could bleed to death.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">3. You could bleed to death.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">4. Your baby could
die.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">5. Your baby could die.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">6. You could die.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">7. Your baby could die.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">8. Your labor could be so long you and your baby could die.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">9. You could bleed to death.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">10. You could bleed to death.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">So every two minutes in this world a woman is dying from one
of these things or one of the things that can happen if they did not get
prenatal care such as seizures, placenta previa, and incomplete miscarriage.</span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">And the babies- more die on the first day of their life than
at any other time. At least 114 died in the hour I wrote this- the majority
from preventable causes that a skilled midwife could have prevented. </span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span></div>
<div class="MsoNormal" style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;">
<span style="color: black;">Christy Turlington Burns is a model, global maternal health
advocate, and founder of the maternal health organization, Every Mother Counts.
After a perfectly normal, natural birth, in a state of the art
birth center next to a hospital in New York, </span><span style="color: black;"> she
had a post-partum hemorrhage (PPH). Her situation required rapid intervention
by the midwife and doctor who were caring for her to keep her from bleeding to
death. Soon after, she educated herself on PPH and realized that if she
had not had immediate access to care,
she would have died. She became
passionate about helping more women to have access to skilled care in even the
most impoverished situations. She knows about those 10 things. She knows why we
do what we do and we are grateful for all of you who know.</span></span></span></div>
<div class="separator" style="clear: both; text-align: left;">
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<span style="font-size: large;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS3aL6d02M7UUUdSxKtaAXZOEnmNBdC0kT-LNu_iNY0wNwFJwiSHFccYhfSIBhqujaNPfRJM04rzxXEpwppYymQjUsl3MhJdHczvXBhhyphenhyphenudzxoHLHKcFkRR98zKqenD2NHk-9YvafdS94/s1600/Haiti+2006-057+copy.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS3aL6d02M7UUUdSxKtaAXZOEnmNBdC0kT-LNu_iNY0wNwFJwiSHFccYhfSIBhqujaNPfRJM04rzxXEpwppYymQjUsl3MhJdHczvXBhhyphenhyphenudzxoHLHKcFkRR98zKqenD2NHk-9YvafdS94/s1600/Haiti+2006-057+copy.jpg" height="240" width="320" /></a></span></span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;">
</span></span>Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-58126374625699635602014-05-30T08:57:00.000-07:002014-05-30T08:57:14.638-07:0010 Things I learned in Haiti
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<div class="MsoNormal">
<b>10 things I learned in Haiti-</b></div>
<div class="MsoNormal">
<br /></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">Life for women in developing countries
is incredibly hard</b>. Finding water, making a fire, cooking food and
washing laundry takes hours each day.<span style="mso-spacerun: yes;">
</span>Women who have no “time-saving devices” work hard just to keep
their families fed and clean. That means there is little time to read, to
create art or to do more than try to survive.</li>
</ol>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv2Q_rpXJFHe2QnGRbN0UOP556EwATLCxLU-lPxPrfKyItMHy3BiJOcHgvHqHB-A8LT54LeK0qGh5jimtFt_GF7p_iLjvbkqZ7XYypx8WqC-La0spvEIbndEs5HLOOp7TDnLWB1yRryx4/s1600/DSCN0141.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv2Q_rpXJFHe2QnGRbN0UOP556EwATLCxLU-lPxPrfKyItMHy3BiJOcHgvHqHB-A8LT54LeK0qGh5jimtFt_GF7p_iLjvbkqZ7XYypx8WqC-La0spvEIbndEs5HLOOp7TDnLWB1yRryx4/s1600/DSCN0141.JPG" height="240" width="320" /></a></div>
<ol start="2" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">In Haiti relationships are the source
of happiness</b>.<span style="mso-spacerun: yes;"> </span>Most Haitian
families have few material belongings.<span style="mso-spacerun: yes;">
</span>Conspicuous consumption is not possible in Haiti.<span style="mso-spacerun: yes;"> </span>Only a tiny fraction of Haitians could
find self-worth in what they possess. <span style="mso-spacerun: yes;"> </span>When you do not have things, cannot shop
when you are depressed, do not have more or less stuff than most of your
neighbors then it is your relationships that define the richness of life. </li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">Even the simplest of medical
procedures can be life-saving.<span style="mso-spacerun: yes;"> </span></b>Routine
procedures like taking a blood pressure or measuring the amount of protein
in urine can save a life.<span style="mso-spacerun: yes;"> </span>These are
things we do every day for our patients in the U.S. and I lost my sense of
their importance until I went to Haiti where most pregnant women are not
receiving prenatal care.<span style="mso-spacerun: yes;"> </span>Without
these simple tests women can develop life-threatening high blood
pressure.<span style="mso-spacerun: yes;"> </span>They will not know they
are desperately ill until it is often too late to save them and their
baby.</li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">Education is the most valuable
treasure a country can have</b>. In Haiti it is very prized by children
and adults and is seen as the only hope for change. At night you will see
children reading under the only street light in their neighborhood or in
the dim light that comes from a window at the back of a store. They walk
miles to school and have great pride in their uniforms and books. To get
their children into a school may be a parent’s greatest dream. </li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">Taxes and government are under
appreciated in the U.S</b>. If you don’t have a functioning government and
an adequate tax base you can’t have the public infrastructure that
supports private enterprise.<span style="mso-spacerun: yes;"> </span>You
don’t have paved roads, clean water, sewers, garbage collection, free
public education, trusted police protection or an honest justice
system.<span style="mso-spacerun: yes;"> </span>If you believe your taxes
are too high and that “government is the problem” go to Haiti and you may
decide that for all its flaws American government works pretty well.<span style="mso-spacerun: yes;"> </span></li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">When death is common your view of life
changes</b>. Here we live in denial of the inevitability of death. Because
death is a common experience in Haiti, Haitians have a stoicism,
resilience and an ability to carry on with life after a tragedy. They have
the same pain from the loss of a child as we do. They are just as sad and
grieve the same but they have accepted that death and life go hand-in-hand.<span style="mso-spacerun: yes;"> </span>I believe this attitude changes what
they value and how they treasure each other. </li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">In Haiti people still remember that they
are descended from slaves and they retain a proud connection to their past</b>.
Here in the U.S. we often have a sense we are living in a unique time of
our own making and have lost the realization that the world we live in is
a consequence of those who have gone before us, those who have worked for
hundreds of years to make our lives better.<span style="mso-spacerun: yes;"> </span>We owe a debt to our pioneer men and
women, a debt to be paid forward.</li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">For every task you want to accomplish
in Haiti there are unpredictable barriers</b>. To get anything done in
Haiti you have to have perseverance. For every organization that is
succeeding in making good changes for Haitians there are twenty that just
gave up. <span style="mso-spacerun: yes;"> </span>A friend once gave me very
valuable advice, “There are so many problems in Haiti that the only way
you will succeed in solving one of them is to put blinders on to all the
rest and concentrate on spending your life-time solving just one of them.”
The problem I chose to focus on was the lack of skilled care for pregnant
women. <span style="mso-spacerun: yes;"> </span>And I think even that has
been too broad at times.</li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">The midwives who come to Haiti to
volunteer believe midwifery is a calling</b>. They are not there for the
money, the fame, or the fun. They are there because they believe deeply
that midwifery is a special gift to women all over the world. They know
medical interventions can save lives but bringing compassionate care and
dignity to childbirth is equally important to them.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHSjPpHXjldCU0D9MP6OHWMf1iIT18QYeJSNpgbmu35IWxm07mcRu-zx1FKeeeul4MGvpre_Hdn_RWhMBlMBpM2dGa-spKWF5rTXvj-8D_jJ6fFAzNnBWMU9Zda9krXAu36ysDsREtfCk/s1600/DSCN0128.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHSjPpHXjldCU0D9MP6OHWMf1iIT18QYeJSNpgbmu35IWxm07mcRu-zx1FKeeeul4MGvpre_Hdn_RWhMBlMBpM2dGa-spKWF5rTXvj-8D_jJ6fFAzNnBWMU9Zda9krXAu36ysDsREtfCk/s1600/DSCN0128.JPG" height="240" width="320" /></a></div>
</li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><b style="mso-bidi-font-weight: normal;">Compassion is the universal language</b>.<span style="mso-spacerun: yes;"> </span>We may not understand the medical jargon
or barely grasp the detailed explanation the doctor is giving us but we
intuitively know when someone really cares about us.<span style="mso-spacerun: yes;"> </span>If they care then we trust.<span style="mso-spacerun: yes;"> </span>With unrushed attention and a caring
touch midwives speak a universal language of compassion to comfort their
patients, whether they be American or Haitian.<span style="mso-spacerun: yes;"> </span>Haitians recognize when someone is
genuinely interested in helping them get well, get the best care, get to
the bottom of the problem.<span style="mso-spacerun: yes;"> </span>They are
truly grateful for the compassionate care given to them. For some it is
their first taste of compassionate health care.<span style="mso-spacerun: yes;"> </span>I still get teary eyed when I think of
the story told by one of our volunteers about the 16 year old
soon-to-be-mother she help through a birth.<span style="mso-spacerun: yes;"> </span>That young woman told her she wished she
had something to give her in return but she had nothing to offer but her
thanks and the words, “you have been kinder to me than anyone has ever
been in my life.”<span style="mso-spacerun: yes;"> </span>Little did she
know how her words were treasured.<span style="mso-spacerun: yes;">
</span></li>
</ol>
Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-78116961403836929082014-04-08T08:21:00.000-07:002014-04-08T08:21:00.505-07:00"Thoughts on above, feet on the ground"April 8, 2014<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCnU67FS5YAnV5MLPE-snangHzZnMmTj5x2lnrDRpRMf0fNWfp0kE3C8pfHVMLkvistrm6o1WpieXq4Otn1XZZrS1pGC-nHKgeiT9aH8Kt5J_bcyAoteUInBqKIVYYZ36Aau00igK8HcA/s1600/16+Haiti+Calendar+2014+children+5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCnU67FS5YAnV5MLPE-snangHzZnMmTj5x2lnrDRpRMf0fNWfp0kE3C8pfHVMLkvistrm6o1WpieXq4Otn1XZZrS1pGC-nHKgeiT9aH8Kt5J_bcyAoteUInBqKIVYYZ36Aau00igK8HcA/s1600/16+Haiti+Calendar+2014+children+5.jpg" height="425" width="640" /></a></div>
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I was looking through Cheryl Hanna-Truscott's pictures from her recent trip to Haiti. My heart cried looking at this picture from both the simple joy on this girl's face as she sang a welcome to the "blans" visiting her school and from seeing that most of these children have that orange tinge to their hair that indicates long-term malnutrition and lack of protein (Kwashiorkor). I also fear for this girl's future - as many girls do not stay in school or have to move to the city to get further education. In the cities, these girls face unwanted pregnancy and rarely finish high school.<br /><br />
Recently, on a Sunday morning at the church I attend in Haiti, the young women's choir
was singing a song that included the chorus, "Thoughts on above, feet
on the ground.." I thought about the girls who were singing in much the same way I thought about this girl. What lies ahead for them? When they hope for the future what do they have to hope for?<br />
<br />
I wondered, as the Haitians sang, if they do not have a better understanding of "feet on the ground" than we Americans do. We manage to escape from the more difficult things of life like hunger, lack of clean water, washing clothing in the river, bucket baths, dirt floors, and no educational opportunities or hope for better times ahead. Instead we comfort ourselves with our food, our drink, our clean and lovely floors, our modern kitchens, our heated and cooled cars, workplaces and homes. We live in constant denial of our own death, the death of our loved ones, and the misery that most of the rest of the world deals with daily. We watch TV and read Facebook and constantly escape in computer-land so we can forget that life is fragile and precious. <br />
<br />
My work in Haiti is as necessary to my spiritual being as it is to the Haitians our program serves. It keeps my feet on the ground and better prepares me for facing the hard things in life. The fact that I was born in the U.S. instead of in Haiti is an undeserved gift. Those of us who can easily keep our thoughts on above because we are so physically comfortable owe it to the majority of the rest of the world to walk with them as they have their "feet on the ground" in a way we do not begin to comprehend.<br />
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This girl's feet will see much hardship. I hope someone's feet will walk with her and give her hope.Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-90158030965745069442014-03-12T18:37:00.001-07:002014-03-12T18:37:43.967-07:00The Long Way Around<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpa_d7pyx3esZd0l-Bay_skcr2mGf7pWXUfPoCV6Ok9YYK6Sd5q-mKxdqywEqtZGOTPT8-Xf2sO-dHv8WIjiWislxio39I6PbGCn16Ws-t0VF1lbw6J9KbBDXag9_K0ot3NwXU5Bhk0zc/s1600/Dirt+Road.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpa_d7pyx3esZd0l-Bay_skcr2mGf7pWXUfPoCV6Ok9YYK6Sd5q-mKxdqywEqtZGOTPT8-Xf2sO-dHv8WIjiWislxio39I6PbGCn16Ws-t0VF1lbw6J9KbBDXag9_K0ot3NwXU5Bhk0zc/s1600/Dirt+Road.jpg" height="179" width="320" /></a></div>
<span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUHE82IV6ukCbuQg28kkTP37tRDGH4TnKiOcRnkUnGqH4PtT9QYS-jFUIGhkMsg8Cd4exMd4gHX6NkVj6aFxYsolJBM7wmZGU6rCCHaWvat8wcLysfy475kUfJOWuhn4BiZWZXrxEG9Dg/s1600/Dirt+Road.jpg" style="margin-left: 1em; margin-right: 1em;"></a></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;">Saltadere is the name of a community 2 hours east of Hinche near the border of the Dominican Republic. The poverty is deeper there- evidenced by mud huts instead of brick and thatched roofs instead of tin. There are women there who have never had money pass through their hands and the majority of them have never had contact with any health personnel. Children are lucky to have one outfit to wear and their hair comes in orange from long-term malnutrition. </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">When our mobile clinic goes to Saltadere once a month 60-90 women come for prenatal care in one day. Some walk for hours to get there. Some are so sick with complications of pregnancy that we transport them to the hospital that very day. Severe anemia and preeclampsia are common. </span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">We have the funding for starting a birth center in Saltadere and the first year of its operation. Having a birth center there would mean that women would get prenatal screening much sooner and that instead of birthing alone or with an untrained matrone, they could have skilled care in a place that would have emergency medications and equipment. We could treat the anemia and the causes of it. We could educate the women about the foods they have that give the most nutrition, about family planning, and about breastfeeding exclusively for one year to increase the infant survival rate.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">We have never run a birth center- even though that is where most of our graduates end up working. So this past weekend we hosted a symposium on birth centers in Haiti to learn from the organizations that we know are operating these centers across Haiti. We addressed issues about level of care, level of training of employees, protocols for emergencies, and disposal of waste. Fourteen organizations were represented and we learned some valuable things. Some organizations charge a fee and some do not, believing a fee is sometimes a barrier for the people who need it the most. </span><span style="font-family: Arial, Helvetica, sans-serif;"> </span><br />
<br />
<span style="font-family: Arial, Helvetica, sans-serif;">Today we met with Father
Illrick to learn what needs to be done to the building before we put
equipment in it. Plumbing and electricity will need to be installed. The
community will need a survey to make sure they will use it. The
midwives will have to be interviewed and protocols reviewed and written.
We are short on committed money because of a security wall that will need to be built.</span><br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTpxefbsiiz9KqjjDBjJo2vKr8_xPiXsVmGXePCC6Xh0Q7KFFDuFOH05gSVU3Xx0dloTNE4qjIvBBkLcbsZhtbxW2G3rK18-WWH5B5Lc3GT_854fhtvcNIAOq72ftLMD9Aj2VQGTdAybo/s1600/Thomassique.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTpxefbsiiz9KqjjDBjJo2vKr8_xPiXsVmGXePCC6Xh0Q7KFFDuFOH05gSVU3Xx0dloTNE4qjIvBBkLcbsZhtbxW2G3rK18-WWH5B5Lc3GT_854fhtvcNIAOq72ftLMD9Aj2VQGTdAybo/s1600/Thomassique.png" height="213" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Father Illrick ( beard) and Dr. Larry Hoffman (black shirt) of St. Thomas Aquinas</td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
</tbody></table>
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<span style="font-family: Arial, Helvetica, sans-serif;">From my experiences in Haiti there will be no direct road to this birth center. Not only is the road to Saltadere a rough one for vehicles, we will go over many bumps in the road to open this birth center. If there is a long way around, we will need to be willing to take it. If I sound pessimistic it is caused by the seven years of working in Haiti. Nothing has been simple or cheap or easy or straightforward. </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">When we left Verettes, Haiti yesterday morning we could not drive "as the crow flies" to Hinche. Because of where the mountains are, we had to drive south to get around them and then</span> <span style="font-family: Arial, Helvetica, sans-serif;">north once we reached Mirabilais where the road goes through a space between mountains.</span><br />
<br />
<span style="font-family: Arial, Helvetica, sans-serif;">It is a metaphor for everything we try to do in Haiti. There is no straight line of tasks to get something done. There are twists and turns and obstacles at every turn and everything we do takes more than twice as long as we predicted. It seems that everything conspires to make sure we have to take "the long way around."</span><br />
<br />
<span style="font-family: Arial, Helvetica, sans-serif;">What is it that drives those of us who ride this road? It's the faces of the women we see who walk for miles to make sure their baby is ok, the women who are recovering from a seizure in the hospital (today one woke up from a two-day coma), and the sweet babies that ride home with their mothers on the back of a motorcycle. They will never have hot showers and a vacation at Disney. They will be lucky if they learn to read. Their mothers have no books to read to them at night. </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">They are all worth taking the long way around. </span><span style="font-family: Arial, Helvetica, sans-serif;"></span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUHE82IV6ukCbuQg28kkTP37tRDGH4TnKiOcRnkUnGqH4PtT9QYS-jFUIGhkMsg8Cd4exMd4gHX6NkVj6aFxYsolJBM7wmZGU6rCCHaWvat8wcLysfy475kUfJOWuhn4BiZWZXrxEG9Dg/s1600/Dirt+Road.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><br /></a></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiB_xYmw7E8oNX9VdG2F3t0M0dQqfHSQVG3wiE10J3VPmIsV8YwaShXWO_HOpzpZl61XurRK9IDY_FVbUey1PPDQMZn_ejhcKC10_ShO1KlhU1WdpME2cIG06i9WAlOxRsq8-_LPPu122o/s1600/Children+at+Saltadere.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiB_xYmw7E8oNX9VdG2F3t0M0dQqfHSQVG3wiE10J3VPmIsV8YwaShXWO_HOpzpZl61XurRK9IDY_FVbUey1PPDQMZn_ejhcKC10_ShO1KlhU1WdpME2cIG06i9WAlOxRsq8-_LPPu122o/s1600/Children+at+Saltadere.JPG" height="240" width="320" /></a></span></div>
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Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-14858226201141573102014-02-15T05:36:00.001-08:002014-02-16T09:19:45.898-08:00<div class="separator" style="clear: both; text-align: center;">
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Jenna and Brittany are holding the dossiers of the 16 students who will get the call that they have been admitted to our training program this year. Sometimes it is mind-boggling to think how this will change their lives and the lives of their families. The sad thing is that 109 applicants have to be turned down.<br />
<br />
Why do we continue training skilled birth attendants even after the government midwifery school reopened last fall? There were several things that helped us decide to continue to train. One is that we think it will be a long time
until there are enough graduates from the government program to meet the
need for around 1600 skilled birth attendants in the country.<br />
<br />
Another
is the history of brain-drain. Every nurse-midwife we have hired to teach has left the country
within one to two years. We do not think it is the nursing degree that
got them to Canada. It was the money. Anyone who makes enough money in
Haiti dreams of going to the U.S. or Canada. So the drain will continue
to happen.There are only about 100 obstetricians in Haiti. And around 100 nurse-midwives. More than two-thirds of the obstetricians and midwives have left the country. That leaves a
total of 200 skilled birth attendants left to deliver about 250,000
babies a year in Haiti. So most women do not ever see a doctor or midwife or even a nurse.<br />
<br />
Another is that we are uncertain of the willingness of others
to work in rural areas of great poverty for the same income that our
graduates work. Most will want to work in the urban areas where food is
less work to produce and entertainment and friends are nearby. Well,
wouldn't you chose a place with electricity over one without?<br />
<br />
The International Confederation of Midwives has decided that nursing is a necessary ingredient in the education of midwives. Because so many countries do not have a high quality nursing educational system they have recommended at least a three year program for students with no nursing background and 18 months for nurses.<br />
<br />
Because of the recommendations, although Midwives for Haiti is the name of our organization and we accept only auxiliares and infirmieres, we mostly use the terms "skilled birth attendant" when we talk about our educational program and training. The "Core Abilities of Skilled Birth Attendants" are defined by the World Health Organization and the International Confederation of Midwives and include both the abilities to care for normal pregnancies and skills to treat and care for complications and emergencies that can occur in the childbearing year. So even though we refer to our graduates informally as "midwives", the ICM would not approve of us using that term.<br />
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Currently our mobile clinic offers the same testing that is available at most government facilities for pregnant women. Plus education about signs of danger, breastfeeding, nutrition, dehydration, etc. And we will add Tetanus vaccinations this year. So far our graduates are working at 10 birth centers and two hospitals in Haiti.<br />
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So the most important reason we will continue our educational component one more year is that currently 49 graduates of our program are doing over 60,000 prenatal visits a year and over 11,000 births per year . Until there are enough skilled workers to take over their work with the poorest women in Haiti we will keep training. And who cares what they are called? Not the women who walk for miles to see them. Not at all.<br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-39731722687922681442014-01-19T14:52:00.002-08:002014-01-19T14:52:49.573-08:00End of the year reflections- written December 4, 2013<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_ttIQi2vED4rmi_lPOueIfnPUaassZbiNzSVeE0Lvg2Dfy7QEyhM6JBfB6Mh577rwNvRk8NWscmNy-ZNzc95vxP6d50lwWQkj9x91pt84BMnWdSjUGvsXKpZARq2D-JkEFvLfM0LPHWE/s1600/IMG_2807.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_ttIQi2vED4rmi_lPOueIfnPUaassZbiNzSVeE0Lvg2Dfy7QEyhM6JBfB6Mh577rwNvRk8NWscmNy-ZNzc95vxP6d50lwWQkj9x91pt84BMnWdSjUGvsXKpZARq2D-JkEFvLfM0LPHWE/s320/IMG_2807.JPG" height="213" width="320" /></a></div>
<span style="font-family: Arial,Helvetica,sans-serif;">I recently read that someone asked Mother Theresa how she could see all the poverty in the world and not get depressed. And she replied something to the effect that she just does the work she has in front of her each day. I have been thinking about the implications of that for our work here in Haiti. </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">I have been told that my face is an open book and I am very easy to "read". Sometimes this is aggravating because anyone can tell if I am sad or uninterested or happy, etc, and I would like to think I am more mysterious. I think everyone in the house had a awareness that I was having a "down" time last week, no matter how hard I tried to hide it. There were suggestions like, "You need to get out of the house and do something unrelated to work." </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">So I did. I went to the feeding center to play with starving children, I played a game of cards with everyone that had me laughing so hysterically I was crying, I had a lovely visit on the porch at the orphanage with the Brothers Harry and Bill. But the relief was temporary. This morning I received an email from a volunteer who saw through it all and wrote a note to me:</span><br />
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;">Nadene, Thank you for all you do! It is such a joy to be a small part of such a wonderful organization.</span></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;">There was a meditation that I read yesterday that seemed so fitting for you-</span></span></div>
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<span style="color: blue;"><i><span style="font-family: Arial,Helvetica,sans-serif;">Clearly, the apostolic mission exceeds our own
ability and the capacity of any human means. Therefore, we will not put
to one side, as if they </span></i></span></div>
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<span style="color: blue;"><i><span style="font-family: Arial,Helvetica,sans-serif;">were secondary, the
supernatural means. We have not placed our trust in our personal talents
and energy, or in any of the other means which support</span></i></span></div>
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<span style="color: blue;"><i><span style="font-family: Arial,Helvetica,sans-serif;">apostolic
enterprise. Our hope rests in Divine grace. We can rest assured that
God will perform incredible miracles with inadequate means. Let us
believe</span></i></span></div>
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<span style="color: blue;"><i><span style="font-family: Arial,Helvetica,sans-serif;">in the power of His grace and never become
daunted by the apparently insurmountable obstacles. Do not let the lack of <i>instruments</i> stop your work. Begin as well as you can. Let us ask Jesus to give us whatever we lack.</span></i></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;">I so often forget it is not me and that I need
help. Your are doing wonderful work. Just do not forget to get help from
the source! (KC Shinners, CNM)</span></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;">Volunteers KC and Bobbi, who have been here before and truly "get it" about the distance Midwives For Haiti has come in the last few years, were very perceptive. They know from their own life experiences that unless you have hope in "Divine grace" this load is too heavy to carry. I want to believe "that God will preform incredible miracles with inadequate means". Why shouldn't I, when God truly has shown that it is true with the Midwives For Haiti program? The mustard seed has grown into a tree!</span></span></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;">Last week Pastor Jude reminded me that the mobile prenatal clinic is the "heart" of Midwives For Haiti because it carries love and skilled care to so many women who need it so badly. Today the Jeep came rushing back from Fonbrun with a woman who has had prolonged and obstructed labor for several days. Without our midwives and Jeep, she would be just another statistic that no one even enters into the books to get counted in the data on Haiti's maternal mortality. Why can't I just find joy in that and not carry the weight of next year's budget and next year's problems on my shoulders? Why do I find it hard to "consider the lilies?"</span></span></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;">Bien Aime Guerlie is a graduate of our very first class and now one of our preceptors. She came to me last week with some advice. She is concerned about what will happen to Midwives For Haiti when I die. She suggested we have an advisory board here in Haiti in addition to the one we have in the U.S. She says there are many people who are interested and care about what we are doing and will do whatever they can to help us. </span></span></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;">This is something we have talked about before and is actually necessary if we are going to get official NGO status. So she inspired me to start a committee here. I think it will do two things: 1) We will not feel like we are carrying the load alone, and 2) it will give us some really good ideas and community support for some hard decisions that have to be made next year.</span></span></span></div>
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<span style="color: blue;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="color: black;">So here's to not carrying the load alone. You and me- we are all in this journey together and we have a Source to lean on. Without it we will fall.</span> </span></span></div>
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Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-44374725546713055612013-12-04T08:59:00.001-08:002013-12-04T08:59:16.610-08:00I<span style="font-family: Arial,Helvetica,sans-serif;">t is the Season of Joy (and Hopes) for Midwives For Haiti</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">Just 17 days ago I sat and watched as 23 very proud and very new midwives sashayed up the aisle of the room above the Ebenezer market to their honored seats for their graduation ceremony. The joy I felt was tinged with a sense of shock and grief because my brother had been killed in a tragic tree-cutting accident in Ohio 8 days before and I had just returned from his funeral. I sat and thought of the men who told me at his funeral that they would have never sat foot in Haiti if it was not for my brother recruiting them to come to help him with a construction project that needed their welding, electrician, or construction skills. I thought about all the people who are changed forever when they have contact and see with their own eyes the depth of the poverty and hunger in Haiti. I thought about all the good my brother had done for others in his life and what a senseless loss it was to lose him. It was really hard to get back into my life in Haiti that day.</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">But while the graduates sang and danced I was able to feel their joy and hope. We have hope they will find jobs - as did 95% of our past graduates - because to have a job means <b>the world shifts</b> for their families and <b>the empowerment they feel is worth the work of MFH by itself</b>. But with the additional high probability that each of these women will touch the lives of hundreds of women and babies each year for the rest of their lives- that is joy.</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">It was really a highlight of the weekend to have a team from Every Mother Counts and Christy Turlington Burns, the founder, present for the ceremony. They sponsored most of the costs of the education of these midwives this past year. They gave us the great news that they were going to continue their support for another year- such support allows us to expand our reach in other areas of our program and know the costs of training another class is a sure thing for our budget. </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">On Monday we gave the team a tour of the hospital. By the time Christy and her team arrived in the early afternoon all looked clean and orderly and every midwife looked totally in control. But what I did not know until later was t</span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-family: Arial,Helvetica,sans-serif;">hat that morning our
volunteers and students had arrived to find many women and babies on the
floor who had delivered during the night or were in labor. I loved
hearing the stories from Wendy and Jenn and Alica about the TLC our
students gave to the women as they cleaned them and organized all of
them into those that went home and those that needed beds</span>! You can see Wendy's interview with Christy here: <span style="color: blue;"> https://www.youtube.com/watch?v=y6BsXYVufnA</span></span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">There is much to be joyful about when we look at the number of women served by our mobile prenatal clinics- @600/month and those served in birth centers and hospitals all around Haiti- over 3000 per month in six of the 10 districts of Haiti.</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">There is also such promise of better things to come for the babies in the Central Plateau as Ohio State University is training 5 nurses to run a special care nursery and the equipment arrives for it mid-January. Monica Terez is leading the training, learning the language, learning how to get around in Hinche. OSU could not have chosen a more passionate nurse for this job. All those babies that have been lost in the past due to a lack of trained nurses and the ability to give them some support with respiration, feeding tubes, breastmilk, kangaroo care, warmth, etc. will now live and go home with their mothers. It will be a momentous day when that unit opens! This picture is of Monica assisting at a rural prenatal clinic.</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;"><b>And we bought another vehicle </b>the week</span><span style="font-family: Arial,Helvetica,sans-serif;"> after graduation! As everything is in Haiti - it was difficult beyond belief with multiple obstacles to overcome. So we feel a sense of accomplishment and deep gratitude to have finally done this. Every time I sat in another office and learned there was another fee, another certificate we needed, another hurdle to leap, I thought about all of our donors who gave so generously so that we can continue our mobile clinic program by having a substitute vehicle for our frequently crippled pink Jeep. As MFH still does not have official NGO status- a feat still in process- I am now the owner of the most expensive vehicle I have ever or will ever own- and will probably rarely drive it - have you seen the traffic in Port-au-Prince????!!!!!!</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">This next year holds such promise for good for Midwives For Haiti. I am thrilled to have a team in Hinche that includes Brittany, our house and volunteer coordinator- the title does not begin to describe all she does, and Emily Davis, our long-term volunteer from Brethren Volunteer Services who will head our data collection project, and Jenna Schmitz, CPM, a return volunteer who will stay for 7 months and has a proven track record of amazing feats every time she has worked with us. Each of these women gets a small stipend and lives with cold showers and the heat and the bugs and the dust- well, you get the idea- and their greatest joy is the chocolate our volunteers bring in every form imaginable. Brittany is becoming a great salsa dancer, Emily is learning the language, and Jenna is already changing things for the better for students and mobile clinics. These women give me JOY and if you met them you would know there is also HOPE for this world because of people like them!</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">Midwives For Haiti also faces many challenges for 2014. The outpouring of aid for Haiti is dwindling as the earthquake gets further into the past. As the board of directors struggles with what programs to cut in order to make the budget work, we are in pain when we realize some cuts may mean some Haitians losing their jobs. It is almost unthinkable. Most of our employees support extended families who will not eat or have a roof over their head without their relative's employment. We are short $80,000 and are busy thinking of ways to cut corners and still meet the needs of as many pregnant women as possible.</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">Life is fragile and precious. Midwives For Haiti programs are fragile and precious. In the past we have known both grief and joy. So we face the new year with hope and faith that together all of us can spread the joy.</span><br />
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<span class="text_exposed_show"><br /> </span>Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-63249592500140920522013-06-28T17:13:00.003-07:002013-06-28T17:26:54.782-07:00<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Arial,Helvetica,sans-serif;">It is 4:45 on Friday
afternoon in Hinche, Haiti, and downstairs there is lively music playing
as Brittany continues Carrie's tradition of taking dancing lessons.
Outside the volunteers are doing a lot of laughing as they take Kreyol
lessons from Kenel Pierre. I am trying to recuperate from the busy day
by setting on the porch in a rocker, enjoying a cool breeze, and looking
at the trees. </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">For the end of
June, the temperature has not been as hot as I expected and the late
afternoon rains cool the air - so sleeping is not a problem- along with
the fans, of course.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">My
Mac says that back in Richmond it is 91 degrees so sitting outside on
the deck at home right now would probably not be comfortable. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">We
are all over-the-moon jubilant because one of our dear translators
finally got his visa approved to come to the states with the goal of
becoming an OB/Gyn. I called Wendy Dotson, who with her husband, Greg,
will host him while he goes to school to give the good news. The meaning
of what this opportunity will make for his life is overwhelming and
brings me tears to think of it.</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">It is a time of enormous
activity for Midwives For Haiti in Hinche. Right now we have 23 students
and hard-working teachers and preceptors. Our mobile clinic midwives
care for around 250 women per month in surrounding remote villages. We
have an ongoing outreach program for the matrones in the Central
Plateau. We continue to support the midwives at the hospital here with
salaries continuing education and volunteer work support. They handle
around 150-180 births per month and their reputation is high in the
community. </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">Although
it is easy for me to just see the problems, I am continually inspired
by the stories of individual women who are blessed and saved by the care
they receive from our midwives. There is the baby that is too tiny to
eat but getting breastmilk because of a donated breast pump. There is
the mother of 6 who would have bled to death if her matrone would have
not seen her high number of pregnancies as a risk and insisted she
deliver at the hospital. After 4 units of blood she will go home to
mother children that would have otherwise had their own survival rate
decreased drastically if their mother would have died. </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">Ste.
Therese is going to have a NICU by the end of September! Ohio State
University faculty and staff will be training and supporting the staff
over the next few months. Babies who would have otherwise died or been
transported to Cange (which is closing their NICU to move the staff to
Mirabilais) will be able to be cared for here in Hinche. Monica Trexor,
the neonatal nurse clinical specialist, is here with us. </span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">I
started today with a problem-solving meeting with our mobile clinic
midwives. The to-do list at the end of it includes getting benches made
for the clinics where women wait with no chairs, finding a beach-type
tent for the clinics that are held outside, and getting a DVD player so
that patients can watch educational videos while they wait to be seen.
Figuring out snags in the record-keeping and medication orders (getting
Cefexime in this country is difficult) and how to pay the announcers in
each village were on the agenda also. With the help of Kathryn Kooistra
and her friend, Tracy, we are going to have a new way of getting data
from our records so that we can measure our effectiveness</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">The
direction of our program for next year weighs heavy on my mind. Our
training program needs continual evaluation of its effectiveness. We are
faced with probable loss of two teachers to Canada and the U.S.at the
end of the year. I think we have the strongest class we have ever had
but retaining good teachers remains a problem for us. (Indeed it is a
problem throughout the country. The most educated make the most money
and are the most likely to leave the country.)</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br />The
town of Hinche has been our center of activity for 7 years. But we are
asking ourselves if we should continue to teach midwives here at this
hospital where there are so many barriers to evidence-based care and in
this area where we have saturated the job market for our graduates. It
is exciting to have many of our graduates from sponsoring organizations.
They automatically have jobs when they finish. The thought of Vilana
and Soislia, Mariette and Vesline going to their rural communities and
working to bring skilled care where none has been before affirms that we
are doing the right thing, the needed thing in training. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">So
we ask: Should we teach in another region, should we teach in two other
regions if the opportunities are there? (We are exploring Hospital
Albert Schweitzer in Des Chappelles and Hospital Convention Baptiste in
Quartier Morin.) Should we take only students who are sponsored and have
jobs when they are finished? Should we begin to open and support more
birth centers? We really believe that the model of birth centers with
skilled attendants referring to more advanced medical care when needed
is a model that is the most life-saving and most cost effective for
every country in this world- including the U.S. How do we incorporate
more birth center experience into our students' clinical experience if
most of them will work in birth centers when they complete the program?</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">As always, the path for Midwives
For Haiti is never easy or clear. A favorite saying around here is that
the problems and questions we face this year will be gone next year but
next year we will have new ones. The really cool thing about our
volunteers is that they have such good ideas, help us problem-solve and
give us encouragement to keep climbing the mountain of obstacles. That's
because they are midwives and medical professionals who are
earth-shakers.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">I am reading "To Repair the
World" by Paul Farmer. In a speech he gave to a graduating class of
doctors he warned them of the "general anesthesia of the soul" that can
come from being among the privileged of this world. For anyone who is
experiencing "anesthesia of the soul", joining us in our work here in
Haiti will cure you.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">Nadene Brunk</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-43893708445620035512013-06-28T17:10:00.001-07:002013-06-28T17:10:12.909-07:00May 18, 2013<br />
<br />
It has been a different kind of week - but every week here in Haiti carries its own surprises, joys, and frustrations. Today I was cooking on the stove and listening to our cook sing a hymn while she peeled carrots on the back porch. The medical team was back from Bonabite and recuperating from seeing many patients in the country-side. Dr. Ken was draining a cyst from a midwife's arm that she had had for 27 years and she was happy she was finally going to be rid of it. Mirline, one of our teachers, was studying placenta previas and acretas at the classroom table. I thought about all the lovely souls in this place- from the laundry lady to the volunteer midwife from New Hampshire that puts her heart into teaching our students.<br />
<br />
The stories of the patients break our hearts sometimes. Both Sarah and Maribeth have worked hard to find a place for a 19 year old who birthed last week and has not talked since she was raped at age 14. Her sister says she has been raped repeatedly since then and that is why she also does not feed herself and is incontinent. Maribeth is being persistent in trying to find an alternative to her going home to a certain fate of more sexual abuse. There is actually a social service department here in Hinche but the resources for dealing with this woman are not here so there seems to be no solution to where to put her for care.<br />
<br />
Maribeth's persistence is what Jesus meant by caring for "the least of these". As women, we cannot fail to fight for our sisters who are oppressed or we will lose our very lives and souls.<br />
Sarah's continued return to Haiti to teach midwives and care for Haitian women with gentleness and love is another example of someone whose soul is rich and vibrant. Dr. Ken's listening ear and love for the Haitians who need medical care is legend here so they wait at the gate for him to see them.<br />
<br />
I am blessed to know these servants.<br />
<br />
Nadene BrunkNadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-41895827173260976502013-06-28T16:59:00.000-07:002013-06-28T16:59:21.755-07:00The cure for "anesthesia of the soul"<span style="font-family: Arial,Helvetica,sans-serif;">It is 4:45 on Friday afternoon in Hinche, Haiti, and downstairs there is lively music playing as Brittany continues Carrie's tradition of taking dancing lessons. Outside the volunteers are doing a lot of laughing as they take Kreyol lessons from Kenel Pierre. I am trying to recuperate from the busy day by setting on the porch in a rocker, enjoying a cool breeze, and looking at the trees. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">For the end of
June, the temperature has not been as hot as I expected and the late
afternoon rains cool the air - so sleeping is not a problem- along with
the fans, of course.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">My
Mac says that back in Richmond it is 91 degrees so sitting outside on
the deck at home right now would probably not be comfortable. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">We are all over-the-moon jubilant because one of our dear translators finally got his visa approved to come to the states with the goal of becoming an OB/Gyn. I called Wendy Dotson, who with her husband, Greg, will host him while he goes to school to give the good news. The meaning of what this opportunity will make for his life is overwhelming and brings me tears to think of it.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">It is a time of enormous activity for Midwives For Haiti in Hinche. Right now we have 23 students and hard-working teachers and preceptors. Our mobile clinic midwives care for around 250 women per month in surrounding remote villages. We have an ongoing outreach program for the matrones in the Central Plateau. We continue to support the midwives at the hospital here with salaries continuing education and volunteer work support. They handle around 150-180 births per month and their reputation is high in the community. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">Although it is easy for me to just see the problems, I am continually inspired by the stories of individual women who are blessed and saved by the care they receive from our midwives. There is the baby that is too tiny to eat but getting breastmilk because of a donated breast pump. There is the mother of 6 who would have bled to death if her matrone would have not seen her high number of pregnancies as a risk and insisted she deliver at the hospital. After 4 units of blood she will go home to mother children that would have otherwise had their own survival rate decreased drastically if their mother would have died. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">Ste. Therese is going to have a NICU by the end of September! Ohio State University faculty and staff will be training and supporting the staff over the next few months. Babies who would have otherwise died or been transported to Cange (which is closing their NICU to move the staff to Mirabilais) will be able to be cared for here in Hinche. Monica Trexor, the neonatal nurse clinical specialist, is here with us. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">I started today with a problem-solving meeting with our mobile clinic midwives. The to-do list at the end of it includes getting benches made for the clinics where women wait with no chairs, finding a beach-type tent for the clinics that are held outside, and getting a DVD player so that patients can watch educational videos while they wait to be seen. Figuring out snags in the record-keeping and medication orders (getting Cefexime in this country is difficult) and how to pay the announcers in each village were on the agenda also. With the help of Kathryn Kooistra and her friend, Tracy, we are going to have a new way of getting data from our records so that we can measure our effectiveness</span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">The direction of our program for next year weighs heavy on my mind. Our training program needs continual evaluation of its effectiveness. We are faced with probable loss of two teachers to Canada and the U.S.at the end of the year. I think we have the strongest class we have ever had but retaining good teachers remains a problem for us. (Indeed it is a problem throughout the country. The most educated make the most money and are the most likely to leave the country.)</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br />The town of Hinche has been our center of activity for 7 years. But we are asking ourselves if we should continue to teach midwives here at this hospital where there are so many barriers to evidence-based care and in this area where we have saturated the job market for our graduates. It is exciting to have many of our graduates from sponsoring organizations. They automatically have jobs when they finish. The thought of Vilana and Soislia, Mariette and Vesline going to their rural communities and working to bring skilled care where none has been before affirms that we are doing the right thing, the needed thing in training. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">So we ask: Should we teach in another region, should we teach in two other regions if the opportunities are there? (We are exploring Hospital Albert Schweitzer in Des Chappelles and Hospital Convention Baptiste in Quartier Morin.) Should we take only students who are sponsored and have jobs when they are finished? Should we begin to open and support more birth centers? We really believe that the model of birth centers with skilled attendants referring to more advanced medical care when needed is a model that is the most life-saving and most cost effective for every country in this world- including the U.S. How do we incorporate more birth center experience into our students' clinical experience if most of them will work in birth centers when they complete the program?</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">As always, the path for Midwives For Haiti is never easy or clear. A favorite saying around here is that the problems and questions we face this year will be gone next year but next year we will have new ones. The really cool thing about our volunteers is that they have such good ideas, help us problem-solve and give us encouragement to keep climbing the mountain of obstacles. That's because they are midwives and medical professionals who are earth-shakers.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">I am reading "To Repair the World" by Paul Farmer. In a speech he gave to a graduating class of doctors he warned them of the "general anesthesia of the soul" that can come from being among the privileged of this world. For anyone who is experiencing "anesthesia of the soul", joining us in our work here in Haiti will cure you.</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;">Nadene Brunk</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<span style="font-family: Arial,Helvetica,sans-serif;"><br /></span>
<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-69699748555664170302013-05-01T10:18:00.002-07:002013-05-01T16:55:18.624-07:00The Landing is ScaryMonday and today I rode a small 3-passenger plane to and from Jacmel. Three of us were in Jacmel to buy art for our art show this summer in Richmond. I am not overly fond of flyng - let alone in 3-passenger planes. But this morning we left Jacmel at 8:30 am and arrived in Hinche 30 minutes later and had the whole day to get some work done. Without the flight we would have had a 5-6 hour car ride and would have lost the day and been exhausted.<br />
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Landing in Hinche is always a bit nerve-racking because people, motocycles, goats, donkeys, cars, and children still use the runway to shorten their trip from the road on one side to the road on the other and there is no one to clear the strip before the plane lands. Barbed wire that was placed to create a barrier was gradually stolen. The pilot has to depend on people's ears working well and that they will hear the plane circle and get out of the way before it lands. I pray every time that no one gets killed. There are too many close calls.<br />
<br />
During the flight I thought about how lovely Haiti looks from the air. During the rainy season it is greener than usual. It was fun to see places we have been, including the new hospital in Miribilais with its 1800 solar panels on the roof. But the reality of living in Haiti is more like the landing in Hinche - it is risky and scary. It does not matter if they build a new hospital if you would have to walk an hour to get to it and there is no midwife in your village to tell you that your blood pressure is too high and your family has no transportation but a makeshift stretcher to take you there when you start seizures.<br />
<br />
Sometimes I feel the same way about our program. It looks good from the distance but in reality we have so many problems to solve before it is truly a model of a way to get skilled care to the women who do not live near hospitals. We have our mobile prenatal clinics but have no birth centers in those villages. Most women we see for prenatal care are still going to deliver without skilled care. We will prevent many seizures, preterm births, and post-partum hemorrhages by the preventive care and screening for risk that we do in these clinics. But the reality for pregnant women in rural Haiti is that the landing, the birth, is scary and risky. In rural Haiti 83% of women will not have skilled care for their delivery- even with a state of the art hospital one hour away.<br />
<br />
What good does it do to build a hospital with state of the art equipment and well-trained staff with an ambulance parked outside unless you have established rural clinics around it that screen for risks and teach danger signs? You can offer free care for HIV positive pregnant women but who is going to test the women just down the road and over the mountain unless they walk to the hospital for a half a day or two days for HIV testing?<br />
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Research has shown it takes 3 very important things to save the lives of mothers and babies: 1) a skilled birth attendant during pregnancy and birth, 2) transportation when things are not going well to 3) a well-staffed and equipped hospital that can deal with emergencies. Partners in Health and their many generous donors have built the hospital. Now we have to work on the first part- training skilled birth attendants and putting them to work in rural villages. This is where "the rubber hits the road". Without this mothers and babies will continue to die in rural Haiti. <br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-85570945739387681342013-04-27T10:22:00.001-07:002013-05-01T16:52:36.342-07:00A Fete in HaitiThe Surprise Fete-<br />
<br />
Yesterday around 25 graduates of Midwives For Haiti held a "fete" for me. This was supposed to be a surprise party but I got suspicious when a midwife who works in Port-au-Prince showed up dressed to the nines with no apparent agenda. I changed out of my scrubs into a blouse and skirt because clearly this was not going to be a casual event. Gradually between 3 and 4 pm, more and more midwives arrived and started filling the table downstairs with huge and colorful plates of food. Some of these midwives I see only once or twice a year at continuing education sessions so it was quite exciting to see them so pretty in their party dresses and some of them brought their small children along.<br />
<br />
After they rearranged the classroom so that the tables were in a large square, covered with tablecloths, and decked out with red napkins and bouquets of flowers, they invited me and the other volunteers to "chita" (sit down) in places of honor. Val Josette from class 3 was the mistress of ceremonies. There was singing- "How Great Thou Art", solos- some with improvised words to give gratitude to Midwives For Haiti, and speeches. Volunteers Cara Osborne, Zelda Collett-Paule, and Sarah Taylor were there to enjoy the music, the party, and food. <br />
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In one speech, a midwife described how women in her community seek her out for her midwifery skills and medical knowledge. She noted how empowering it is to be able to own property because of her midwifery job, and how empowering it is to not have to ask a man to buy her things. This inspired another graduate gave a recitation of a poem she had memorized for graduation last year. She apologized to the men in the group before she gave it- our faithful driver, Ronel, one of the male midwives, Frid, and our translator, Emmanuel. The poem was about the power of women, how capable they are, how they are not to be disrespected, how much in trouble a man is if he does not respect the women in his life. While she gave it there were hoots of approval and when she finished, there was great cheering and pounding on the tables. Clearly she had struck a nerve for all of them.<br />
<br />
There were gifts for me and Carrie and Steve. Carrie has been such a wonderful addition to our team at Hinche. The students and graduates know they can count on her to be an advocate for them, to problem- solve with them, to be a laison between here and the administration in the States. And they love that she has learned so much Creole so quickly.<br />
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I gave a short history of how Midwives For Haiti came to Hinche, the role my faith has played in the beginning and continuing work of Haiti and the obstacles we have overcome. I know they are some of the hardest working people in the world. Who in the U.S. works 8-10 hours a day in intense heat delivering loving care to mothers in clinics, in makeshift clinics under trees, in understaffed crowded hospitals and birth centers?<br />
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They recognized the sacrifices of volunteers, the hard work of our drivers and translators. They know it takes a team effort to make the supplies keep coming, the mobile clinic keep rolling, the patients delivered safely, the education of new midwives to go on for 6 and 1/2 years. <br />
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I was blessed by this "fete", the obvious care they had taken to prepare it, the love they brought to me and the rest of the MFH staff. I am so blessed to be a part of this thing that is bigger than me, bigger than each of us, and blesses both Haitians and volunteers each year.<br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com2tag:blogger.com,1999:blog-5577274115739869521.post-42998872789378871732013-04-23T09:42:00.002-07:002013-04-23T09:42:51.229-07:00Back in Haiti in April 2013This morning after coffee and oatmeal, I jumped on the back of a motorcycle to go to the hospital. It felt good to be back in Haiti to keep tabs on our program and see our students, friends, and teachers again. I wanted to check on Zelda, the CNM volunteer from Homer, Alaska, as it was her first day at the hospital and it can be a bit overwhelming, to put it mildly, with all the critical patients mixed up with the normal healthy patients and figuring out who are the students, the teachers, and the preceptors and who is the regular staff. Then there are auxiliare students and nursing students, too, and it can be overwhelming.<br />
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Zelda told me a baby had just been born with an emphalacele, which is an opening at the umbilicus that the intestines protrude out of. This baby will need surgery and that means going to PAP and there is a question whether or not the family can come up with the money for both transport and the surgery. The baby also appears to have some other chromosomal abnormalities. The hospital is fortunate to have a pediatric resident from Ireland helping out and she will do the follow-up.<br />
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Later in the day, Dr. Alice Hirata came back from mobile clinic with a patient who was 32 weeks pregnant, an unusually large abdomen for the dates, and a suspicious mass in her uterus. After getting a second opinion from Dr. Eads, they decided this woman has a baby with a neural tube abnormality, similar to hydraencephaly where the brain is displaced with an abnormal amount of fluid. So that baby will not live after birth.<br />
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One has to wonder if the poor nutrition in the impoverished areas of rural Haiti makes these kinds of abnormalities more frequent. It gives us more motivation to get education about nutrition, multi-vitamins, iron, and worm treatment to more women earlier in their pregnancies.<br />
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One thing that stands out to us is the stoic way these Haitian women accept the fact that they have a baby that will probably not survive. It is almost as if they have braced themselves for it ahead of time and they are not surprised. Not like we would be in the U.S. where we see abnormalities less frequently, expect a healthy baby every time, and ask for the answer to why if it does not happen.<br />
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It makes me think about the issue of control and how we live in the U.S. with the perception that we can control so much of our lives. Here in Haiti they to do not assume they have control. They are willing to think that curses, voodoo, and God controls their life and seem to have a lot less stress as a result. We worry about preventing cancer and preventing accidents, and want to know what we did wrong when things did not go as planned. They seem to accept that they are not in control. In some ways, I envy their ability to lay the blame anywhere but on themselves.<br />
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We also worry about the future much more than they do. They are grateful for food and life one day at a time. This makes problems for us when we think they should do long-term planning. But we could learn from them also that most of the things we worry about in the future we have little control over today. It would add to the joy of our days.<br />
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Today Sarah Taylor talked with the students and learned some more traditional postpartum practices that are common here. They believe that pinching a baby's cheeks frequently helps it get dimples, pulling on a baby's penis makes it get longer, and sitting over steaming water after birth helps the vagina heal tighter and smaller. The latter has been the cause of 3rd degree burns so there was some teaching to be done about the harm that some traditions have caused.<br />
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I am continually humbled by the fact that there is so much to learn about this culture, that I have so little understanding of their beliefs and world view. It is important for us to recognize that we have much to learn, to stay humble, to open ourselves to learn about how they view their problems. Otherwise, we will throw up our hands in frustration and give up. Lots of NGO's have come to Haiti and have done just that. We are saving lives of women and babies daily so we cannot afford to stop learning how we can be more effective in our work here.<br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com0tag:blogger.com,1999:blog-5577274115739869521.post-14615239704323555712013-03-08T09:08:00.002-08:002013-03-08T09:32:19.741-08:00International Women's Day <span style="font-family: Arial,Helvetica,sans-serif;">
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<span style="font-family: Arial,Helvetica,sans-serif;">It is March 8, 2013, International Women's Day. Here in Hinche we have a house full of women.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">There are the cooks, Diunny and
Salomon, who sing while they work, Elliot the housekeeper whose
service and smile encourage us everyday, and Monique who does piles
of laundry 2-3 days each week by hand in large plastic basins. I
think these women represent what most women in the world are doing
each day- trying to provide food and clothing and a clean home for
their family. Sadly, it means that the one thing that could bring
women empowerment and a way out of poverty for their families- an education-is not
available to most women in the world. (Thanks to a midwife donor, at least the 14 year old who babysits for the cook is going to school for the first year of her life and glows when she talks about it.)</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">Right now I can hear the students from
Leogane down in the classroom discussing malnutrition and sources of
good food for pregnant women. They watched 2 videos on Nutrition this
morning thanks to our projector and a donated laptop. There are two
teachers here who have a lot of experience and education behind them
who have decided that training other midwives for Haiti is the work
they most want to do.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">This new class of students are here
because we had no clinical site in Leogane, which would have been
closer to their homes. Since Monday night they have been sleeping on
mattresses on the floor and sharing a bathroom here at headquarters
until they can find a place to rent together in Hinche. I am amazed
how far they have traveled, how many comforts they have given up, how
they are willing to be away from family in order to reach this dream
of being a midwife.
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<span style="font-family: Arial,Helvetica,sans-serif;">It is being around these women that
gives me encouragement to continue this work when it all seems so
hard. They believe in Midwives For Haiti and its mission passionately
and are so proud to be students or graduates of the program. So when
I hear another impossible request from the medical director of the
hospital, wonder how the budget will get us through the year, and
feel exhausted from the constant decisions and responsibilities, I
just need to be with them, to hear them sing, to hear them thank
Jesus for Midwives For Haiti, and I feel so blessed to know them and
to be here.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">This afternoon the 16 Hinche students
will share case studies from their clinical experiences this past
week. The Leogane group will listen in and ask questions. Then for
the first time all 24 students will end the week together singing,
united in their mission to bring health and life to mothers and
babies in Haiti. On this International Women's Day, they know they can change the world.</span></div>
Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-33795631574305815952013-03-02T11:02:00.001-08:002013-03-02T18:04:21.021-08:00There are not enough hours to waste on worry<span style="font-family: "Trebuchet MS",sans-serif;"> </span><span style="font-family: "Trebuchet MS",sans-serif;">
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<span style="font-family: Arial,Helvetica,sans-serif;">March 2, 2013</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">I try not to fret in the middle of the
night but it was difficult to find a “letting go” point last
night. Tomorrow the teachers and 8 students arrive from Leogane. The
logistics of getting them a place to stay, getting mattresses for
them, starting classes and coordinating their clinical experiences
feels really big. I worry we are going to overstretch our budget and
our energy. Some of the restlessness was caused by the events of
yesterday when we just crammed too much into one day.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">It was one of those non-stop days that
left us all in a stupor this morning. The first Friday of the month
we always hold Continuing Education classes for all of our graduates
that can come. Twenty-seven came in the morning. I had Abby Merryman,
OBGyn MD from Dartmouth to help me review partogram use as they are
using it very poorly at the hospital even though the hospital
administration has done some education on its use.
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<span style="font-family: Arial,Helvetica,sans-serif;">The most frustrating thing for me about
that morning was the realization that although we go to great lengths
to have our students think critically about their practices, it is
still easier to just do what they are told instead of asking why. So
when I asked them why they kept women in bed who had ruptured
membranes they did not know except that they were told to do this.
Infuriating. Sometimes mornings like this make us feel like failures
as educators. I realize this is the challenge of educators everywhere
but it seems so much harder in Haiti where everything has been
learned by rote memorization and not by thinking through what the
research has shown to be best practice.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">While the midwives were still here in
the morning, seven men arrived from the Church of the Brethren's
Haiti Medical team. I had met Dr. Paul Minnich and Jeff Boshart in
the fall at a missions conference and they wanted to learn more about
what we were doing. They have 3 Haitian doctors that they pay to run
clinics in seven areas where they have churches and are looking to
expand the services they provide. They have no maternal health
component so far. Until I could get free to talk to them, Steve tried
to give them information and history on our project while they had
cold drinks on the upstairs veranda.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">Right after the Continuing Education
group left the current students arrived for case study day. Abby
stayed to help and observe this and Bobbie Curtis arrived back from
matrone training to help also. Students tell of cases they have seen
the past week and we all discuss what we can learn from them. This
week the cases included a woman who presented at prenatal clinic with
extreme fatigue and “poor health” who they sent for some lab
work. She had a hemoglobin of 4 (normal is 12-14) and a positive
malaria test (a major cause of anemia here.) Her baby measured for
small for her gestational age and she received 2 pints of blood and
chloroquine.
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<span style="font-family: Arial,Helvetica,sans-serif;">Another case involved a woman coming to
the mobile prenatal clinic in Roysec because she had been told by a
doctor near the border of the DR that her baby was too big and would
die. Because of her concern, the midwives brought her back to Dr.
Celestin at the end of the day for an ultrasound. He found a severely
hydrocephalic baby and recommended terminating the pregnancy before
the baby's head was too big to deliver vaginally. The baby will die
anyway because there is no available surgery for this here in Haiti.
(In countries where there are more medical resources these babies
would be delivered by C-section at full-term and have shunt put in
their head that would enable them to live normal lives.) The woman
refused the induction and was advised she must have a C-section if
she waits until the head is bigger. Sad stuff for the students to
learn.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">Once the case studies were over and the
students left at 2 pm, I finally had time to have lunch with the
Church of the Brethren team and enjoyed hearing about the growth of
interest in their project in the denomination that I have been a part
of for almost 40 years. They were especially interested in our
Matrone Outreach Program and we encouraged them to send someone to
our training the trainer program the week of March 18.
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<span style="font-family: Arial,Helvetica,sans-serif;">Before they left Karen Leichty, CNM
turned up to buy some HIV tests and some Albendazole as the medical
group from her church in Nebraska that she is working with this week
was running low on both. She and a family practice doc had gone to
Cabestor with our midwives on Tuesday and she was full of praise for
them and our work. She left a contribution for Midwives For Haiti and
a promise to come back to volunteer with us.
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<span style="font-family: Arial,Helvetica,sans-serif;">After the COB group left, multiple
graduates wanted to talk to me with various requests. This happens
every month. “Could you find a job for me closer to my children?”
“I need a new BP cuff.” “Last month I was not here to get the
fanny packs you gave out.”
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<span style="font-family: Arial,Helvetica,sans-serif;">The massive amount of food and drink
that goes in and out of our house on a day like yesterday is
incredible. Without Carrie and the cooks it would be impossible. By 4
pm I was so very tired when Carrie reminded me it was time for our
dance lesson. Let me tell you that living with a 23 year old puts my
energy in question. But learning to dance the batacha with our
handsome teacher, Fortuna, gave us some good hilarity at the end of a
busy day here at “grand central station”.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">This morning Gladius helped me with an
interview with one of our graduates for a position in the family
planning clinic at the hospital. We are receiving a donation of a
salary for her. There are still a lot of misconceptions about birth
control methods in Haiti – about whether they cause infertility or
cancer or make God unhappy. Add that to Haitian men thinking the more
babies they have proves their fertility and these poor- and I mean
really really poor- women have to be pregnant and risk their lives
too many times. Anyway, the graduate has some experience with placing
implants and other family planning methods and wants to be able to
stay in Hinche with her 2 small daughters so she is thrilled. She is
one of those colorful and powerful women who will make it her mission
to find every woman who wants birth control and get them to her
clinic. While we were waiting for Gladius to translate, I practiced
my Creole on her, which caused hearty laughing, and we shared
pictures of her girls and my grandchildren.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">The truth is that as women we have so
much in common no matter our age or nationality. We all want our
children to be healthy and happy, in that order. We all want to be
loved. We all want meaningful work and the empowerment of an
education. That is why we are in Haiti and that is why I did not stay
awake long to worry last night. There is peace about our purpose
here.</span></div>
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Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1tag:blogger.com,1999:blog-5577274115739869521.post-4839462553894657882013-02-17T13:59:00.001-08:002013-02-17T16:29:38.667-08:00The black holeFriday morning, after driving 3 hours from Hinche to PAP and enduring the stop and start traffic of the city, I was told for the second time at the immigration office that I did not have everything for my Haitian ID. I need a Haitian ID so we can buy a car because our Jeep breaks down too often and we are spending too much money renting other cars and drivers to take our midwives out to their mobile clinics.<br />
<br />
I was so angry. I was told that the translation of my birth certificate had to be certified that it was an accurate translation by an "official" translator, that Terrie's letter affirming I was an employee of Midwives For Haiti had to be translated, including the names of the positions of the board members on the letterhead. And written by hand on the list of 10 required documents was an addition for employees of NGO's (non-governmental organizations)- permission to work in the country from a government entity. We have a signed contract with MSPP in the Central Plateau so I can get that but the insanity of the translation stuff made me furious. I asked how a translation of the letter from my employer could possibly be deemed official because it would not be written or signed by Terrie. The immigration official just shrugged.<br />
<br />
Rita told me this morning that the two Haitian men who live at her house in Illinois had to pay someone to stand in line for them when they wanted to get their ID. Without the payment you would never progress in the line no matter how long you stood there. Then they had to pay someone to write their blood type on the document. This involved a ritual of putting some water on a piece of paper and having it "read" by the nurse and she wrote down any old blood type she felt like at the time. Later, when the men both became CNA's in the U.S. they realized what an absolute ridiculous farce this whole process had become because of greed.<br />
<br />
With so much anger inside of me, we stepped over the trash and debris in the road, dodged the motor bikes and cars who never stay in their lane and climbed in the dusty van with our driver. We were to meet Rick Martensen, the President of World Wide Village. While waiting on him at Servotel Hotel, Emmanuel, Steve, the driver, and I had a fairly decent cheeseburger and some fries. We are a bit beef-starved now and then. Servotel is a hotel near the airport built from shipping containers but you would not know it unless you looked very closely. <br />
<br />
When Rick arrived we told him a little about Midwives For Haiti and that we were on our way to Leogane to throw up the white flag of surrender to that project. He proceeded to tell us some amazing post-earthquake Leogane stories. About a donor that was going to build an $8 million dollar hospital at a damaged hospital site. A powerful Haitian priest wanted to skim 10% off the top for himself, as he had been doing for many years with other donations. So they looked elsewhere for land to start a new hospital. But that same priest stymied efforts to get permission from the government to build it because he was angry about their move away from the hospital where he was connected.<br />
<br />
The only maternity care available in Leogane is at the Medicins Sans Frontieres (Doctors Without Borders) hospital. They arrived after the earthquake and they currently deliver between 500 and 700 babies per month and have the only trauma care for miles and miles. They plan to leave the structure and pull out of Leogane in 2014. They have an excellent facility with staff and medicine in good supply. They charge nothing for their services so the businesses of local obstetricians who were charging for their services have been gravely harmed. Everyone knows that when MSF leaves, women without means will go back to delivering at home with unskilled matrones.<br />
<br />
Rick told us about the donation to WWV of a pre-fab hospital to Leogane after the quake that saved thousands of lives, delivered hundreds of babies, performed hundreds of surgeries. A year later it was to be turned over to a reputable Christian organization to run. But the community heard rumors that it would become a cholera center and vandalized and burned it to the ground. So Rick has a sour taste left from Leogane experiences and thought we were doing the right thing in ceasing our 2 year effort to start a school there. We learned about other World Wide Village work in Haiti with food and nutrition and talked about community health workers and skilled birth attendants and what each could contribute to rural communities.<br />
<br />
After several attempts at assisting another hospital to get their maternity services open last year, we realized it would never happen under the current administration. MSF became the only option for a clinical site for midwifery students so we met with the administrator of the MSF hospital. She agreed that training skilled midwives could be part of MSF's exit plan for the community. but she was reluctant to give permission without the consent of the District Director. For weeks we had tried to get an appointment with her. He advised that we let him and his friends in high places petition on our behalf. He wrote letters, submitted our documentation, our curriculum, talked to officials and we waited.<br />
<br />
So one main reason we were throwing in the towel in Leogane is that we had no agreement with a clinical site to train our students. We had hit a brick wall one too many times. That with the bad politics (to put it mildly) between persons in the U.S and persons who owned the land our classroom was on, we had decided to call it quits.<br />
<br />
I knew that going to Leogane to break the news to the students and teachers that the school was on hold indefinitely and that we could not ask them to put their lives on hold any longer would be difficult. I had no idea.<br />
<br />
After sharing pancake recipes with host and ex-Army medic Rick Hutchinson at Family Health Ministries Guesthouse after breakfast we drove to the campus to meet the students. Twelve beautiful students arrived (ten women and two men) with teachers, Mirline and Alcidas and sat under the pavilion near Dr. C's small clinic. Next to us was the locked building that held over $2800 worth of tables, chairs, fans, beds, and cabinets we had bought for our classroom. Inside in a locked depot was two large bags of supplies donated by Diane Rousseau. There were Childbirth Graphic posters, the student's Creole textbooks, BP cuff, book bags, and other teaching aid equipment waiting for classes to start.<br />
<br />
The students were stunned. If we thought they would just give up and walk away we were badly mistaken. They asked questions and ultimately said, "What if we all came to Hinche and you taught us there?" "I have a tent I could live in," said one of the guys. "Since we would be coming back to Leogane to live and work in the community, would the Leogane Rotary release the funds to us anyway?" "I have had my uniform ready for months and I want to go to midwifery school so badly." It was heartbreaking.<br />
<br />
Frankly the idea of bringing them all to Hinche had not occurred to us. And we doubted the Leogane Rotary would agree to give us funds to teach in Hinche even if it was Leogane midwives we were training. And how would we afford the teachers if we had no grant money?<br />
We took their phone numbers and email addresses with promises to let them know if we could change the situation in any way. <br />
<br />
When we finally stood up to leave, I was heavy-hearted. I had already fallen in love with their faces and the potential for good that the each represented. As we walked to the van, I suddenly became very light-headed and felt like I would pass out. The day before I had not had enough water to drink. Then during the night I was sick from something I ate, took migraine medicine for a migraine and had eaten very little breakfast. So now I was probably just too dehydrated. I remembered that Hilary Clinton fell because of dehydration and got a concussion so I allowed Steve to half-carry me to the van. Laying down seemed to help.<br />
<br />
Even though I drank a bunch of water, when we arrived at a local engineer's house to talk to him about the morning, I still could not get up without feeling I would pass out. I waited with Mido, our driver, in the shade while Steve and Emmanuel talked to the him. He was kind enough to come out to greet me and wish me well before we left.<br />
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On the way back to PAP and all the way to Hinche I hit a severe low in my spirit. Not being able to sit up without being light-headed or lay down without being nauseated did not help. I watched out the window as the endless dust and traffic moved with us. Most of the morning we spent standing still in the traffic and swirling dust. It took three hours to go a distance that should take 30 minutes in the U.S. Along the way the poverty and bleak lives of the Haitians is so evident. What must it be like to be so poor you cannot buy a new tarp to replace the holey, ripped one that serves as the roof to your family's dirt floored home?<br />
<br />
When I thought about all the greed and evil that has stopped good from coming to Haiti, I felt for the first time in all these years that maybe it was really too big and too powerful for us to continue our work. How much time and money we had spent getting signatures, having meetings, trying to placate the right people, and once we thought we were getting somewhere the officials changed jobs and we had to start all over. Our efforts to get officially registered as an NGO were getting nowhere and everyone who had tried it, grimly wished us luck. I felt I was in a black hole that would suck us dry financially and psychologically.<br />
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Meanwhile, in the back seat, Steve was having completely the opposite thoughts. He came up to talk to me over the back of my seat and to make sure I was still drinking water. He had been thinking about the idea of bringing the Leogane students to Hinche and really liked the idea of never going to Leogane again and having several classes running in one place to save us administrative time and money. He was playing with the budget in his head. He pointed out that students are in class 2 days a week and in clinical for the other 3 days and that we could stagger use of the classroom and use of the clinical sites for two groups. Why had we not thought of this before as a way to teach more students than 15 per year in Hinche?<br />
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Hope rose again in my usually optimistic self. When we finally arrived home to our house in Hinche where Carrie and her warmth and organization, sweet and energetic volunteers were waiting ready to be put to work, and nourishment and showers revived me, I was happy once again with the possibilities of our work.<br />
<br />
This morning at church I stood beside Rita Ledbetter as we sang along with the Haitians singing "I surrender all". The women's choir and the congregational singing held beautiful harmony and was healing and inspirational.<br />
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Still a little wobbly on my feet, I knew I needed to push fluids today. We stopped at the hospital because although Rita had volunteered with us after the earthquake she had been in Carrefour and not in Hinche. I wanted to give her a tour.<br />
<br />
Entering the maternity wing we found graduate and preceptor Magalie Gadet caring for the antepartum unit. In postpartum, graduate Edith Rose Gilles had a postpartum women on MgSO4, oxygen, and was giving Lasix to a newly delivered mother who was so severely ill with preeclampsia that she had pulmonary edema. In the labor and delivery unit, graduate Ysemonique had two laboring women on Pitocin and Mg SO4 for severe eclampsia. Another woman was getting IV antibiotics and being induced for prolonged rupture of membranes. Two more were walking the sidewalks in obvious labor.<br />
<br />
Ysemonique greeted us with her hands held stiffly away from her body and explained she was "dirty". She had no gloves! Again the hospital supply was inadequate and this happens often on weekends when "our" supply closet was locked up! So Rita and I climbed back on our motorcycle taxies, went back to our house, got sterile and unsterile gloves, returned with them and the key to the closet. Ysemonique wanted Apresoline, alcohol wipes, in addition to the gloves. We had them all. She assured us she had Misoprostel because we all know the MgSo4 makes these mothers at high risk for postpartum hemorrhage. She put on sterile gloves and checked the woman with ruptured membranes. She was 7 centimeters dilated. Ysemonique was pleased. The woman was in a lot of pain and she spoke to her softly, reassuring her.<br />
<br />
I left full of hope. Without our graduates at Ste. Therese these women would be left to the mercy of fate. Before we arrived, women just did not come to the hospital, especially on weekends, because there was no one to care for them. Now there are MFH graduates, many paid by a grant to the government and some paid by us, to care for women and save the lives of them and their babies.<br />
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I am not in the black hole anymore. I am baking bread today which makes everyone happy. Rita is emptying the large bags of supplies she brought to us. Including Hershey's chocolate bars. She and Micah will go help the nuns at Azil feed the starving children at 3 pm. Life is good here. Can you tell?<br />
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<br />Nadenehttp://www.blogger.com/profile/01789314850214138093noreply@blogger.com1