Wednesday, February 24, 2010

Jennifer's words on Haiti

Below are words that Jennifer wrote about the conditions of the hospital in Hinche (pronounched "inch). Women are not nursing their new babies because the earthquake "scared" their milk and made it turn bad. I wonder if any of the Maya Spiritual healing techniques I know are similar to the ones in Haiti? Can we spritz these women, do spiritual bathing and return their milk to it's original sweetness? I will have to do some research about that. The result is very sick babies--diarrhea from the rice milk they are being fed and general severe malnutrition--and the moms all seem to have horrific yeast infections.

And the picture of birthing mamas is not pretty...already a mama has died and this morning another woman lost a baby. I spoke with one of the women the started the Midwives for Haiti program last night, she said that there is no way to preppare for the things that we will see. That at least one baby dies every week and it is common to lose mamas as well. In Senegal it was almost impossible to get a woman to a doctor for a cesarean if needed. It sounds similar here. And the picture of birth is far from compassionate. Jennifer said that one of the midwives saw a fifteen year-old woman get brutalized by five "midwives" and a doctors-- slapped, held down, screamed at. It was described as rape. Raped while giving birth. I am amazed at what we are capable of doing to each other and what we are capable of surviving. The description reminds me of what I saw in Senegal--the worst of 1950's American obstetrics practices. The midwives currently in Hinche are talking about starting a birth center, so that maybe this can occur less, maybe women will get off their backs, remove their feet from the stirrups, and have more empowered birth experiences. We will see.

"We did the round and fed everyone in the trauma area (amputees, burns, etc.) Most injuries are from the earthquake. Patricia and I bought 10 loaves of bread and some peanut butter. We fed 50 people (the loaves here are so tiny). So many grateful people.

The hospital is full of hungry people because they are fed one meal per day–lunch.

My little patchwork quilt boy was happy for the dinner. He let me take his picture. He is beautiful and amazing. I told him through translator that I am so proud of him for surviving the quake. He was burned so badly in the quake that he would not have survived had it not been for operation smile coming two weeks ago to staple skin grafts all over his body. The skin grafts are white skin so he looks like a beautiful patchwork quilt of black and white. He has staples all over his body. He is so happy and smiles so sweetly to me as he says, “bonswa.”

Lots of moms in labor, including a mamma who came in with a fetal demise. She hadn’t felt the baby move for a few days. I kissed her on the forehead after telling her with my eyes that her baby died. I tried memorizing “your baby died, I am so sorry” in Creole on the airplane, as I knew I would have to say it to someone. When the moment came, I couldn’t remember the words. She understood and caressed her belly longingly. I had to walk out to cry.

No one birthing at the moment. Fifteen beds filled in the same large room of laboring women. Once one is pushing she will walk to the delivery room and climb on to the table and deliver on her back with her feet in stirrups. Then, she walks to a large postpartum room with many beds with moms and babies, usually grandma laying between the beds on the cement floor.

It’s not so bad at night when the doctors are gone and the midwives are willing to watch us catch the babies.

I don’t know how to get the moms off the tables, as the floor is filthy and the birth stool I ordered didn’t make it in time to bring to Haiti."

Friday, February 19, 2010

Reminders of Senegal...

I have been reading more about the needs of the hospital I am going to work at in Hinche. What I am learning sounds so familiar, like the clinics in Senegal--electricity is intermittent, running water scares and unsanitary. The staff has to work by flashlight once the sun goes down. The photos I have found look similar too--cracked walls, dirty walls (I remember thinking that the curtains in Senegal hadn't been cleaned in years and years and that touching them would be very unwise). I wonder if there is an autoclave to sterilize the rusty instruments (I heard there are few instruments anyways, and that the ones there are rusted) and if it is even used. The autoclave in Senegal was used for storage and not because it didn't work. It worked perfectly fine, but it took too much time--by the time it would have finished sterilizing the limited number of instruments too many women would have been in and out of the clinic.

There are now problems occurring with sanitation and the access to clean water is diminishing. I am uncertain how this is all impacting the hospital in Hinche and the St. Joseph's community. The board members of Midwives for Haiti are traveling there in March, so hopefully they will have more to report. This morning I read the statement "the stench of decomposing bodies [has been] replaced by that of excrement." The rain that has been falling on the Haiti is causing further problems. I wonder what the sanitation will be like when I arrive--at the peak of rainy season and malarial outbreaks. Already there are concerns about the rise of diarrheal related illnesses like typhoid and an expectation for cholera outbreaks.

I have been asked several times in the last 24 hours what it is that I am going to eat and where the food will come from. Right now the report is that we have access to rice and beans, provided by the monks who will be hosting us--but where are they getting the rice and beans? And if the market is open and we can purchase food--what will even be available and at what cost? I may be able to afford to buy a chicken from some local farmer (and apparently there are chickens to buy), but how will it feel to know that I am one of a few with the means to buy food. When I was in Senegal food wasn't an issue, there was plenty of fish (more fish than I care to remember) and plenty of millet, powdered yogurt, hard boiled eggs, and bitter root vegetables. If we were hungry in the middle of a shift it was easy for one of us to walk to the market and buy a watermelon--the perfect sweet, refreshing snack for the hot environment. It was a fun snack to share with the medical staff and they purchased plenty that they shared with us. The people in the small, poor village of M'boro for the most part seemed well fed. Granted there was malnutrition, but I know it will be nothing in comparison to the conditions of Haiti. I am not sure I am or can be prepared for that reality.

Wednesday, February 17, 2010

Items Needed for Trip to Haiti

Supplies Needed In Haiti include:

Suggestions of things the new mothers need:
Clean new or gently used sheets, flat.
Light cotton nightgowns - especially good for moms without a surviving baby
Cloth diapers
Diaper pins
Receiving blankets
Small bottles of baby wash or baby shampoo
Soap bars

Ongoing needs for the hospital: Funds to buy items will aslo be greatly appreciated
Cloth surgical towels
Bulb syringes
Anti-hemorrhagics (Pitocin, Methergine and Cytotec)-no expired meds, please!
Suture material
Prenatal or multi-vitamins (from your local healthfood store)
Gloves-sterile and non-sterile, size SM and MED range in price
New or gently used receiving blankets, onsies, newborn baby hats
Suturing instruments:
Tissue Forceps, Hemostats, Retractors, Needle Holders, Scissors
Pinard's horns
Newborn or Ped's stethescope
Cord tape and clamps
Cord bander
Needed yet for students:
Brown doll to practice birthing
5 fetoscopes
Inexpensive fish scales for weighing babies - 9 of them

Needed now:
A good used laptop so Theard can translate some tests while you are there
A power strip so you can plug in the printer and laptop.
#21 HP black inkjet cartridge
Paper for printer

Soccer balls (with needle to pump them up) would be much appreciated
Other balls and hula hoops would be good, if not too hard to transport.

Tuesday, February 16, 2010

Trying to Save Lives in PAP

Haiti Recovery

Letter about Haiti and report from UNICEF

Dear Friends & Family,

As many of you may know by now, I will be going to Haiti in May to volunteer in a midwifery training project, Midwives for Haiti! I am thrilled to have the opportunity to put my midwifery skills and training to good use and hope that you all can help support this experience!I will be teaching basic prenatal care skills and attending births along-side local student midwives.

The lack of skilled obstetrical workers makes Haiti the most dangerous place in the western hemisphere to have a baby. According to World Health Organization statistics 670 women die for every 100,000 births. That rate is 60 times higher than in the US.
In the rural areas of Haiti only 15% of births are attended by someone with the training and supplies needed to make birthing safe. Midwives for Haiti has been working since 2004 to train community midwives. The organization has received the support of the local population and the Ministry of Health.

I have attached the link to the organization’s website which provides a wealth of information about this inspiring and ambitious project.

As a midwife, I have more time and skill to offer than I do funds, so I am writing to ask you to become a part of the Midwives for Haiti team by providing a donation to help support this life-saving work. Since the earthquake, it has become even more challenging to get much needed supplies into Hinche and delivered to the midwives. Additionally, there are 150 refugees that are also in need of supplies and assistance. Donations will help cover the purchase of much needed medical supplies, a “medical” translator, and possibly food and other supplies for the clinic.

Any donation you make will be greatly appreciated and judiciously used. There are a few ways you can make a difference.

1. A check made out to me will allow me to purchase desperately needed supplies and non-prescription medicines to carry into Haiti in May. This will immediately impact the lives of the poorest mothers and mothers-to-be in our hemisphere. Donations may also be used to cover cost of a translator to help with teaching the local midwives and in-country travel. If you would prefer to gather/purchase supplies directly, please let me know and I will send you of list of items needed, also see the list below.

2. Or if you would prefer you can purchase medical supplies via Cascade medical supplies
at or (503) 595-1720 and have the supplies shipped to me. Currently no supplies are getting in to Haiti, so ordering and shipping to me or making a donation ensures that the clinic will receive what is needed. See the list below in an upcoming post....

Please send your donations to my home address (if you don't have it drop me an email). I will be leaving in mid-May but in order to have time to purchase supplies would need to have your donations by March 30th.
Thanks so much for your support. I will be keep you all updated as preparations continue.
Aerlyn Pfeil, CPM
Phone: 503.539.5733

UNICEF on Materntiy cases in Haiti:

"Since the earthquake, maternity wards have been overwhelmed with surgical cases, leaving only the most at-risk deliveries attended. But life, of course, goes on. Medicins Sans Frontieres, just one group of medical volunteers in the country, reports an average of 12 deliveries a day [at their location], 40 percent of which are by caeserean-section. Premature births are another common, but regrettable, result of the trauma inflicted on mothers by the quake.

Health workers on the ground are doing all they can to prevent more deaths—a second wave of fatalities that lurks in the debris of the ad hoc play-yards children run through barefoot, and in the bacteria that thrives in crowded encampments lacking basic sanitation. Skin ulcers, gastro-intestinal illnesses and dehydration are already a problem.

The vaccination campaign will last about two weeks and aim to reach 500,000 children. Of course, there are many children who will not benefit from the immunizations, due to lack of access or already weakened immune systems.

And then, again, there are the unborn—120,000 Haitian women are pregnant today. Half of them have been affected by the quake. Of the 7,000 mothers who are due this month, 1,000 are likely to miscarry, according to the United Nations Population Fund."