The Long Way Around

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.

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. 

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.

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.  

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.

Father Illrick ( beard) and Dr. Larry Hoffman (black shirt) of St. Thomas Aquinas

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. 

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 north once we reached Mirabilais where the road goes through a space between mountains.

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."

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. 

They are all worth taking the long way around.