Sunday, May 23, 2010

Open the door...

We woke up this Sunday morning to a group of Haitians singing a sweet melodic and cheerful song. It is four in the morning. The roosters have started to crow and the world is still dark. This morning we also wake up in the home of Haiti, in the home of the poorest of the poor, on the bed of the needy.

I'm still not sure if I am truly experiencing this or if it is all a dream. But at my side, a pregnant woman sleeps propped against the backside of a turned over chair with a few rags under her and a sheet I have given her for a blanket. I wonder how it is that I am curled up on a dirty bed that is probably made of more rags and a couple old and dirty sheets and the pregnant woman is on the hard concrete floor.

Yesterday, we created a mobile clinic at the Joseph Community, a village that is now five thousand strong after absorbing maybe two thousand after the earthquake. The exact number, I don't really remember, only that it was a lot. The three midwives who go home today, Aisha, and myself went. Brother Michael had asked me if I wanted to go Wednesday instead and work the Saturday night shift at the hospital and originally I had agreed. However, when I woke up Saturday morning at 5:30 I had a strong feeling that I needed to be there.

Because Aisha and I were up so early, like the rest of Haiti, we had plenty of time to organize supplies. Aisha put together the mama baby packs that I had collected-- hand knitted hats, baby blankets, salve and soap-- while I packed up vitamins and supplements, pain meds, my equipment, I hoped I had something for everyone.

The drive to Joseph's community is quick, but up a very narrow, steep road (makes Albright Avenue seem paved for those of you that know that road). There were a few moments I wasn't sure we would make it. All along the road were little shack houses some brown and some painted in pinks and blues. We drove by people waving and smiling behind their cactus fences. Eventually we arrived at the top of a hill where a decent sized building stood and to the right a long and narrow stick shelter. This was the communities church and school.

Joseph, a beautiful twenty-six year old man was there to greet us and give us a quick tour before we got started with clinic. The community is trying to be sustainable. They planted a garden that Aisha and I will go back to see on Wednesday--it was too far to walk to for yesterday's agenda. The soil here is terrible and I am amazed that anything can grow at all, but it sounds like the eggplant they planted has sprouted and flowered, if nothing else. I am hoping I have enough money from me to purchase supplies to build a chicken coop and get some chickens. They need compost and chicken manure is a great source of that!

Joseph is aware of the plight of his people and eager to do what he can. Twenty-six and still hasn't completed high school. He knows he should become a doctor in order to better help his village. Joseph is the most graceful, grateful, peaceful, and patient person I have encountered. His heart and dream have become precious to me. I want to do everything I can for his community. So, I am glad that I came with so many supplies and glad I listened to the voice inside, telling me to skip the evening hospital shift so that I could be at the mobile clinic.

The people in Hinche have nothing. Nothing. But these villagers have even less. The church was packed with mothers and children, elders, pregnant women, and a handful of men, who needed health care.

There must have been a couple hundred people and I was the only one of our four care providers who had supplies and I am grateful I had them and in that moment, and so grateful for the midwifery and herbal education I received.

The CNMs were able to diagnose better and write prescriptions for the people, but I am doubtful that many had the money to buy what they would need to get better. Most of the people I saw were victims of the earthquake, refugees from Port au Prince. They have no money. No food. No water. Nothing. Ten people live in a hut as big as a king sized bed. Nothing.

I treated people for fungal issues, skin rashes, fevers and coughs. I did have something for everyone. I taught the old woman with fibroids how to do Maya massage treatments on herself, using water in case she couldn't afford oil. She couldn't afford to return to the doctor and said she didn't have money to refill her medicine. I palpated pregnant bellies, gave herbs to help fight off nausea, and we handed out the mama/baby packs, pre-natals and iron. I was happy that I even had a supplement for aching joints to give the old woman who lived behind the church. She is eighty and we instantly had a love and sweetness for each other.

Almost everyone I saw had a headache, pains in the heart, and a loss of appetite. All of those people had been in he earthquake. Many were still afraid. Again I am glad for the remedies that were donated. I hope they were helpful in supporting these people through their grief, aches and pains, infections, and teething babies. I could not have provided all that care had I not gone to midwifery school, had Mindy Cash not been such a thorough and enthusiastic teacher, had she and Holy Zapf not given me so many herbal remedies, had you all not donated so much money to allow me to buy what supplies I was missing and pay for my travels here.

Yesterday, I felt like I was a true village midwife. For the reward of that feeling I am so grateful.

Somwhere towards the end of our visit one of the CNMs encountered Rosamine, the mama in labor. She thought she had ruptured her water, but when I did an exam later the bag felt intact. Rosamine isn't due for another month. This baby will be her seventh. She reported that all her babies were born in her eighth month of pregnancy. She could be as early as thirty-two weeks.

The CNM expressed concern about her condition and asked me what I thought about going and doing a homebirth-- I don't know how I could have refused. She was having good contractions every three minutes and because it is her seventh baby and the baby is so small we figured she would go fast. Of course that is not what happened.

Plans were quickly made with the mama and with Joseph. Joseph would come back to the orphanage with me, I would quickly pack up supplies--sheets and rags, a mama/ baby pack, pinard horn and Doppler, instruments, gloves etc. And then Joseph would escort Aisha and me back to his village and he would stay for the birth, in order to translate.

We took motorcycles to her house as our hired driver decided last minute that he didn't wish to drive back to the village for some outraging political "we weren't going to help his village people" reason. Unbelievable! But the motocycles were thrilling, fitting, and better able to get up and down the narrow pathway that is their road.

The entire experience still feels unreal. Surreal. Me crouching over a tiny, thin Haitian woman who has wedged herself in a small corner. Listening to heart tones with a pinard horn because I didn't think it was appropriate to use the loud, modern Doppler. The baby sounded perfect. "The baby is happy," I kept telling her.

When Rosamine's contractions slowed down she would go outside in the drizzling rain and walk. I walked with her, pausing to rub her shoulders or squeeze her hips when she paused stopped for a contraction.

Her little house had two single beds with blankets and rags and who knows what else for mattresses. Under the beds a few items like dirt-rich clothing and buckets were kept. There was probably less than a foot of space between each bed and each bed was pushed against a wall. In front of the beds is two feet of space where a chair and small side table were crammed on one side and another small nightstand sized table on the other. One table supported a small oil wick light and the other a few dishes. There was no water or food. No water for the birth and if there had been, there was no way to boil it.

In front of this little table is where we found the mama laboring, wedged between the door, the bed, and the table. Inside the room was the matrone, Felicia and four of Rosamine's children. The eldest, Wilnise, who is twenty-two and has two children of her own. I thought she was thirteen. A thirteen year old son, with the name Julmanise, who looked like he was eight or nine. Little Wilmanise, the eleven year old daughter who looks six and Betchi Love, the four year old, who was sleeping on the bed. I am not sure if they truly know how old they all are.

While there we gave the family some snacks and water to drink. And I gave the little girl a handmade doll--the perfect pink Waldorf doll like the one my mother made me, only with a black face. Wilmanise was beyond delighted. She was immediately in love in that perfect way that little girls can be--so intensely that the doll might be loved into life. It was such a sweet moment. The littlest Wilmanise spent the rest of the evening curled up at Aisha's side and I think Aisha is equally attached.

This is how we spent our night. Cramped in this tiny Haitian house, waiting the arrival of the baby. Joseph translating, Aisha taking photos, me laboring with the mother.

Around midnight Rosamine's contractions slowed way down and we all curled up to sleep. It was too late to get a motorcycle back to the orphanage. By this time we had moved one of the beds outside to make more room for a delivery on the floor, killed a tarantula (the size of a grapefruit), received and sent away the entire neighborhood, and conducted a pre-natal on the pregnant neighbor.

I am not sure how much we slept over those four hours before sunrise. I am still amazed that Aisha and I shared a bed with a Haitian child, (the older ones went to sleep with the neighbors) who peed all over the bed in the middle of the night. Thank god urine is sterile, even here.

Looking over at Joseph and Rosamine trying to rest my heart just aches. I want to stay here and become the village midwife. I want to teach the matrone, who until last night had never heard or listened to fetal heart tones, midwifery skills, so she can better serve her people. I want to build Joseph a chicken coop. I want to bring these little children home so they can have clean water and good food and an education.

Joseph says "the situation of my people is very bad, but this family it is..." and he just shakes his head. He tells me that the song the villagers are singing this morning is about God parting the waters of the red sea. He has faith that his prayers are being heard and his people will be helped.

The song says "Open the door. Open the door God, for I cannot see a way through."

I am dissapointed that I didn't have the opportunity to help this mama have a safe homebirth, but I am happy the baby will wait. It is too early yet. The door needs to stay closed a little while longer. The door to mine and Aisha's hearts however, have opened wide-- my heart wants to swallow this mama and her children, Joseph with his unbelievable wisdom and impossible dream. It wants to swallow his village.

This experience has my heart opening so wide that I can feel it breaking. I remember one of the midwives from Portland telling me that her heart belonged to Haiti. I now know what she means, my heart belongs here too.

"Open the door God, so that we can find our way through..."

p.s. Most photos taken by Aisha Harley

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