Sunday, June 27, 2010

Tu Touche La Femme

Today I was once again moved by my experience in Haiti and this time in a positive way. It has been a blessing to continue to be inspired by my experiences with Haitian women.

After the earthquake, I joined with Midwives for Haiti and went to work in Hinche, at the chaotic, desperate, understaffed hospital. I spent two weeks in Haiti--enough time to see a few women birth beautiful babies and to hold space while other women gave birth to babies whose spirits were no longer with us. I am not sure how many births or babies I actually attended, but more of them were sick than healthy, and at least one in four did not survive.

For me, Haiti is a place where joy is elusive. Although I heard laughter and saw smiles, the Haitian people's joy seems to live under a thick layer of sorrow, grief, poverty, illness, and hunger. For the most part, I had to look behind the desperation in people's eyes, deep into their hearts and souls to discover their hidden joy.

As I reflect on a photograph of one of the births I attended, I feel surprised at the mama's obvious happiness. Most of the women seemed checked out and indifferent about their labor, birth, and even the new baby in their arms. This birth was one of a few that felt like a triumph--like the experience was led by the laboring mother and not by the doctors, society, fear, or tragedy. It was heart-warming to witness a birth where nothing went wrong. The mother had been told by the doctors that she would have to have a cesarean because she was at 41 weeks. She was frustrated about her options when I first saw her. The other midwife and I were able to reassure her that her baby was doing well and that she, herself was healthy. I was sure that we could get her into labor. The doctors had given her two rounds of cytotec to induce her labor, but she didn't think it was working. With some midwifery 'tricks of the trade,' we got her into labor, and she birthed beautifully and with such strength--a perfect chubby baby boy; 8lbs and healthy.

It has been wonderful to see the photos of that joy--to be reminded of that triumph. It was a triumph for more than just her, me, and the other midwife present. These healthy, empowered births, during which women got off their backs and moved into squats or other comfortable positions and during which they lead the way and used their voices; these are triumphs for Haiti.

After I returned home, I received an email from Reina, a longer-term volunteer with Midwives for Haiti. Reina said that a beautiful mama had come in looking for me. Reina said the mama was absolutely radiant. Radiance wasn't something I saw a lot of in the Haitian hospital. It makes me teary just to think about---here she was, weeks later, still happy, proud, and radiant. This mama is the reason I want to go back and do more work like this. Having someone listen to her, help her, and allow her to labor in her own way-- it made a difference! I believe we created a ripple effect with that birth--we felt empowered, she felt empowered, and she spread that message--about her happiness, her triumph, her strength. This Haitian mama has become a voice of change!

Today I read the following saying, "Tu touche la femme, tu touche la famille," when you touch women, you touch the family.

But I think it goes beyond that... Maybe it is possible to change the world, one birth at a time. Maybe when you touch a woman, when you help her find her radiance and power, that is when you change the world.

Saturday, June 26, 2010

Bringing Life into Haiti...An Article from the New York Times

I came across this article in the NY Times and wanted to share. It points again at the tragedy that is Haiti. Last night someone asked me if things were really as bad there as it seemed. I would have to say yes, but things were bad there before the earthquake. As the Haitian saying goes, "I am no worse than I ever was."

"Still, Haiti is a frightening nursery. Even before the quake, this small country had the highest rates of infant, of under-5 and of maternal mortality in the Western Hemisphere; on average, according to United Nations reports, 670 Haitian women out of every 100,000 die in childbirth, compared with 11 in the United States.

In another tent camp, on a soccer field of a school near the downtown, one meal a day was as much as Mirline Civil, 17, could hope for. Her baby, born Sunday, struggled, too. When she tried to breast-feed the little boy, named Maiderson, he failed to latch. She rocked him back and forth and asked, 'Why are you crying so much?'"


Tuesday, June 22, 2010

Photos of Haiti here

See some of Aisha's great photos!

We need YOUR help to go back to Haiti! VOTE FOR US at the Grant for Change...

So, to answer the last post, I am hoping that this is what we will be doing! We have applied for this grant, through an amazing outdoor clothing company, nau. ( The way it works: the public, by voting, will select 5 finalists, which get pooled with nau's five favorites, those ten proposals will be reviewed by the grant committee and one final project selected. We want to be that project! So please help by voting for us. It will take a minute to do, but is so worth it! WE CAN make a difference, with your help, in Haiti!!

Grant for Change

Friday, June 18, 2010

Looking towards the Future..

I have been thinking a lot about going back to Haiti. Joseph asked me to come back and work with the Traditional Birth Attendants in the village, about 15 women, and I am looking into ways to make that happen. I want to go with some other midwives and work on training the TBA's in basic midwifery care.

For those of you that do not know about TBA's: They deliver the majority of babies in developing countries and according to the WHO are equated with Doulas. Essentially, they provide labor support and may or may not have education in midwifery or healthcare. The WHO estimates that “60% of births in the developing world occur outside a health facility with 47% assisted by a traditional birth attendant, family members, or without any assistance at all." In Haiti, less than 25% of births are attended by a skilled practitioner and the infant mortality rate in 2008 was reported to be as high as 30%. To me, that says a lot about what is occurring at the births outside of health care facilities.

While Midwives for Haiti (M4H) is doing great work in Hinche--teaching local students obstetrical care--I wonder about villages such as the Joseph Community, and how to create better birth outcomes for them. Studies have shown that simple programs that work on advancing the knowledge of TBA's in small communities directly impact birth outcomes. Some of these teaching programs do not even last more than a few days and are designed like a intensive conference! It seems to me a simple way of creating positive change! I have been brainstorming about how to honor the invitation from Joseph and how I can make another trip to Haiti happen.

Women in villages like the Joseph Community may travel to a local hospital or clinic to receive prenatal care, but then return home to deliver their babies with a TBA. However, some women like Rosamine (a PAP refugee I wrote about in a previous post) cannot afford the trip to the hospital or clinic, let alone the cost of any prenatal care. That community is so dedicated to their own independence, growth, and empowerment, and it feels like a promising place to put time, energy, and funding. If we could create a teaching program for the TBA's in the community, then women like Rosamine would have higher chances of a positive outcome and a healthy birth. That possibility is pulling at my heart. I keep dreaming of the words I am supposed to use when writing grants and I keep dreaming about the support that I know is coming. It seems like this is meant to BE!

Wednesday, June 09, 2010

Soup Joumou and the Haitian flag

"In the 1700’s the French took control of Haiti from Spain and continued the barbaric tradition of slavery where they enlisted the slaves to cultivate sugarcane, cocoa as well as other staples. The French would eat the delicious pumpkin soup prepared by the slaves but the slaves themselves were not allowed to consume it. The slaves rose up against the French colonists and in 1804 overthrew them, creating the first Independent African-American nation in the new world. (That little fact was a surprise to me!). The slaves celebrated their independence that day by preparing, eating and sharing the forbidden pumpkin soup with each other as a symbol of what they could achieve when they worked together."

Or as Brother Mike would say it's a big "$&%&*#" to the French, and he holds up his middle finger (Brother Mike is a wonderful man--good humor, cheer, love, support etc). We happened to eat this soup twice, once each week. One of the days was on Haitian Flag day--a day where Independence is yet again acknowledged and celebrated.

On May 18, 1803, while Congress was being held in the midst of the fight for Independence, the flag was created as a symbol of the much sought after freedom. "By removing the middle white stripe of the French tricolor, symbolizing European domination, and stitching together the remaining red and blue stripes, representing Haiti’s black and interracial citizens, the flag came to embody the nation’s spirit of freedom, unity, and individual liberty."

"L'Union Fait La Force" (through Unity there is Strength) became the slogan for the flag and the people of Haiti.

On Flag day there was no school and Aisha and I spent a good deal of the day playing with the orphanage children and getting better acquainted with the hospital and students. The town of Hinche was sparsely decorated with strings of small Haitian flags and signs declaring a celebration. That evening while we helped two moms labor and another have a VBAC (something that rarely happens in Hinche and only occurred because the Dr. didn't make it in time to perform cesarean), the town of Hinche was celebrating this colorful flag and all it symbolizes. When we drove to the hospital that night the small square in the center of town was full of people drumming and dancing. It honestly was hard to not hop off the Midwives for Haiti truck and participate.

On the walk home the next morning evidence of the night before was scattered throughout the streets. The strings of flags hanging across them were torn, many flags missing. I still don't know why.

On Flag day, this speech was made in our own country.....

"In the aftermath of January’s devastating earthquake, it [the flag] took on new resonance. The world rallied around the Haitian flag in an unprecedented outpouring of generosity and support. And like the stitched-together stripes of the flag, the Haitian people joined in solidarity to confront the challenges facing your country.

Today’s celebrations across Haiti and the Diaspora community are a testament to your resilience and determination even during the most challenging time. As we commemorate Flag Day, we must pay special tribute to those Haitians who despite having lost so much continue to work to build a stronger, more prosperous nation and a better tomorrow.

As the flag inspired an earlier generation of Haitians in their struggle for freedom, may it now inspire all of us to work for Haiti’s future. The United States will continue to stand with you as a friend and partner. And we send you our warmest wishes on this special day."~ Hillary Clinton

With all those messages in mind, I invite you to make some Soup Joumou:

Recipe for Soup Joumou or Pumpkin Soup
1 lb.cubed beef stew meat
2 lb. pumpkin (winter squash)
1 lb. cabbage sliced, chopped
3 carrots peeled and sliced
2 stalks celery sliced and cut,
3 quarts water (more later if needed)
1 large onion cubed
6 medium potatoes
1 lb. malanga peeled and cubed or equivalent
3 medium sized turnips, peeled and cubed
2 limes cut in half and juiced
1/4 lb vermicelli, macaroni broken short
4 garlic cloves, 2 sliced scallions, chopped fine
1 teaspoon thyme, 2 teaspoon of salt, 1/4 teaspoon pepper, all ground
1 scotch bonnet pepper, whole with stem.(hot).

Tuesday, June 08, 2010

Starting to reflect....

I am home now, but still have many stories to tell--and I know that I need to get them out there before they are gone.

The last days of being in Haiti were intense. Another baby died in a similar way as the one that came transverse and I have been deeply impacted by that birth as well--still processing all that happened and didn't happen, and what my part is/was in all of that. I emailed with a midwife today, about a baby that she just lost in Haiti and have been thinking about how to respond to her. I am proud of her for being in Haiti and for her courage to bear witness to all that she does and will. It seems to me that in going to these places we have to be humble in so many different ways (maybe even more than our minds have previously defined) and I think that I am still figuring out how that all looks. Here is what I decided to write to the other midwife...I think these words that just flowed out of me have also been said to me by many of you. Thanks to all of you for your love and support...

"I also had this thought after reading your email--mom's and babies in
Haiti are so much more fragile than we are in the US. Not because
they are less strong, courageous etc, but because of the resources.
On the one hand, because the babies are malnourished, weaker etc,
maybe we should be quicker to act and send them for a c/s. But, I
think, if you do that, then you are putting the mother at risk, for
she is also less resilient--malnourished, at greater risk for
infection and a long recovery. There is no easy answer, as I am sure
that you know, but acting faster isn't necessarily the best thing for
the mom, and maybe in some cases not the best thing for the baby. I
think in Haiti, the picture is much larger than life and death, than
saving babies and creating beautiful births. I think that we have to
truly rely on the faith that the people have. And I just want to
remind you, that while you could have done things differently, while
we are human and we do make mistakes (I am saying this more to myself
than to you, as I am still thinking about that last birth), we are
also not God, Goddess, Universe. Babies die, and I think more there
than anywhere else that belief, that if the baby was meant to make it,
it would have, is important. We can't play God, not in an ego lead
way that makes us think we know better than anyone else what a
particular situation needs, and we can't play God and save babies that
for whatever reason, are not meant to be saved. Protecting birth
space, I think, in Haiti, means more than protecting a life, it also
means protecting the space of death. Protecting the space where a
spirit can choose to come down and touch us if only for a moment."

While I was in Haiti for two weeks, we had six or seven babies that didn't make it--all for varied reasons--infection, malnutrition, stillbirth, delayed cesareans, and the list goes on. Six babies. And for some reason, I cannot recall how many live births I attended or we attended. There were a lot of babies that came. Statistically I have heard that the percentage of deaths per live birth is around 20%, at about the same rate as the World average...
Reflecting on Haiti all week has been hard, I have been exhausted and numb. So much happened and I feel like I integrated very little of it, probably because once one thing was accomplished, once one person was treated, we were running to the next thing. Being there was a lot like being on a hamster wheel--round and round and round--and only in the last couple of days have I felt like I could process all that I ran past. I hope to do more of that processing here, so stay tuned....