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?'"


Slideshow
Article

Photos of Haiti ...click 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. (nau.com). 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

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!

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).

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....

Pa gen problem

Today is thursday. Aisha and I were invited to Joseph's community for the day.  Our plans were to visit the school, Joseph's aunt who needed some health support, to check on a baby that had recently been born into the community, to visit the garden, and to see our little homebirth family. All of this would make for a long day, but as we learned to say in creole "pa gen problem," "it is not a problem."

Joseph picked us up on motorcycles and took us on a very bumpy ride to the church and school in his village of 5,000.  Aisha and I were on the same bike, sitting behind our driver, going up pot hole covered hills and coasting down the other side.  a couple times we had to get off and walk, but our driver kept telling us "pa gen problem." I heard and said that phrase a million times and I wonder what would be a problem?!

 The school is a long shack, probably the same length as many living rooms, that has been divided by chalk boards into four rooms. We handed out pencils and I talked to the head professor about the school, it's needs etc. The children learn math and writing, philosophy, Latin, reading etc. Culturally everyone is good at memorization, but seem to be less so with critical thinking.  And despite the access to education there are no jobs. So getting an education  doesn't help many people get ahead.  When I asked the head professor about music education, he had the children sing us a creole song. It was sweet and the children were thrilled about sharing. The song was about seeds blowing in the wind.

The grandmother that I saw last Saturday when we had the mobile clinic was there, which made me very happy. She is eighty and sweet with her missing teeth. We had a little printed photo of her as a gift and a dress.  There are people that we just connect to instantaneously in life and for me she was one of those souls. She called me her daughter and we kissed and kissed each other on the cheeks.

At the end of our day we went to Joseph's house and met some of his family. There was a baby there that he wanted me to see. While I was holding little baby Jennifer, Joseph told me brother Michael had been asked to be the child's godfather and that I was to be the little one's godmother.  It was very sweet and I didn't know what else to do but agree, which made Joseph very happy.

During that conversation I realized that the father of the baby was the son of the little grandmother I have fallen in live with. So she is sort of my grandmother now and I like the thought of that.  My first act as godmother was to give the little baby girl a doll, the second was to make sure her family will recieve the first brood of chickens (we donated a coup and chickens to the community.)

After we had toured the school Joseph took us to the garden. The community has purchased three acres of land down by the river. A group of Portland midwives that came in the early spring donated enough money that they were able to buy PVC pipes and a pump for an irrigation system as well as two oxen and a plow.

The garden is lovely, surrounded by mango trees, and seems to be thriving.  They are growing eggplant and corn, peppers, basil and fennel. I gave Joseph a bunch of seeds for squashes and spinach, basil, and some other herbs. I was pleased to see the promise of prosperity here because of the generosity of the Portland community!  There were maybe ten people out working the garden that morning, including Joseph's father, who was drivind the oxen and breaking the soil with the old plow. It is amazing what dedication can create. The hope with the  garden is to provide food for the community and to sell produce in the market so that more seeds etc can be purchased for future crops.

Aisha and I were both very moved by what we saw and what the goals of the community are. I had $250 left over in donated money and between that and what Aisha had to contribute we were able to help purchase a chicken coup and chickens for the community. We discussed with Joseph and brother Michael that our hope is that as the chickens breed they will be distributed throughout the community so that each family will eventually have chickens and eggs.  Who knows how the money will truly get used (although Joseph is giving receipts for everything to brother Michael and Joseph hopes to send us photos as the project progresses).  It feels rewarding to help a larger community help themselves.  It isn't any easy thing to accomplish.

One of our translators, Gladious, told a story about Haiti. He drew a little stick figure of a man and explained that the man was a representation of Haiti. Then he described a chain of hands creating a "rope" that extended to this man. He said that the role was all the help coming to Haiti, but "it is sad," he said "all these hands reach towards Haiti and Haiti stands with his arms crossed. Haiti does not help himself.  It is a sad image and yet it seems true. 

Aisha and I had a long talk with Joseph about the same thing. He talked about how difficult it is to get his people to see the bigger picture. Everyone is in a state of survival and that means it is everyman fir himself. To me that makes the Joseph community all the more special, for the association created to oversee the village truly has a grander dream and sustainable goals. When we get home Aisha and I hope we can find a way to support the community further, especially in the building of a school.

After the garden tour we were wisked off to the famous cursed waterfall, about a thirty minute bumpy motorcycle ride away. I couldn't get the full story on why the waterfall is cursed--but it sounded like multiple white people have died trying to swim in the pools and Joseph would not let us near them!  I am glad he kept us safe, but definately wished we could swim in cool water. It was clean and blue and I imagine it would have been refreshing. I am sure the water demons made it enticing for good reason!

As we walked towards the falls children seemed to appear out of nowhere to escort us.  Aisha and I had a little hand in each of ours and we were guided up a narrow and slippery path toward the top of the falls and the voodoo cave. The little boys waded throught the water telling us to step here and there to avoid falling in. It was sweet and everyone seemed to be enjoying the little adventure.

The cave was much larger than I was expecting. Full of bats and swallows; walls covered in names and carvings of faces and stick figures--a bit creepy actually. Joseph informed me that people in Hinche still come to make sacrifices and perform black magic. People still believe that siknesses and deaths occur because of spells--I had to demonstrate to one of the villagers that the salve I was giving her for her excema wasn't poison. It's a strange little world.

Overall it was a magical day--vacation from the hospital and deaths and people who seem to be missing their radiance. It was wonderful to be handed healhy babies to hold and examine. I don't know how everyone knew i was the femn-sage...

Joseph has asked me to come back and see his people again. And I hope that it will be possible. I know Aisha would also like to return and I am curious to talk to the traditional birth attendants in the area. We need to get a grant to build them a school and just help expand the resources of the Joseph community.

At the end of the day Joseph took us to see our little homebirth family. Only
Betchi Love and Rosamine were there. Julmanise, the little girl that Aisha fell in love with was off washing the laundry. So we waited and I played with Betchi Love and the little neighbor boy, and talked with Rosamine about her recent trip to the hospital. They told her that all was well and that hopefully she would wait to have her baby. Joseph has promised to send me an email when she does.

We left them more linens and food and one of the kick balls we brought along. I also checked in on the mama who live in the section of the house behind Rosamine. I gave her supplies for when she has her baby in three months and a three month supply of prenatals and iron. We felt like we were Santa Clause and I hope that the distribution of so many gifts causes no problems. Pa gen problem. I hope that baby Rosamine comes out strong and healthy and that Joseph looks after our little family.

The day ended with a long drive backto Maisson Fortune, the orphanage and a discussion with  the motorcycle drivers (one who looked like he was eleven) about how much we owed them.  The initial response is "however much you wish to give" and thus begins a sligtly disturbing cultual experience. We make an offer, they act insulted, we ask again how much and they refuse to say but make a drama that what they have done for us is so much. So we offer more, they throw up hands and pretend to drive off. Aisha and I get flustered and offer them ourfinal amount, shoving the money, which is more than generous, into one of the driver's hands. "Pa gen problem," I tell him. The other, older driver, leaves in a huff and Joseph gets teary, saying that it is a problem that we have just spent the day helping his people (and the motorcycle drivers are part of that village) and he is ashamed and embarrassed. I tell him that it is not his fault and that he is still in my heart. 

The days spent in that community made the biggest impact on our hearts. I feel like my soul truly opened up to the plight of Haiti. As Joseph said to me many times "you are now one of us. You are one of my village." I am not sure yet how to process that. What does it mean to be part of Haiti of it's sadness and bleakness, of it's tragedy and loss. There have been moments of joy each day--coming home to the girls at the orphanage who want to sing "shante, shante," they say, "song, song." And so we shower and sing with the girls, let them do our hair and fall asleep with the children playing and the dogs barking and the roosters crowing at 230 am and in the morning we step forward to face the unknown one more time, knowing that the day may be better than yesterday or it make be worse, but most likely the sunrise will bring with it another tragedy and little hope. 
 
Sent from my iPhone

A happy, healthy birth...finally...

It's Wednesday morning now. I got home about three hours ago from a night shift. I was greeted by a happy Brother Michael who was making fresh hot pancakes and fruit salad for breakfast. He wanted it ready for when we got home, which is really sweet. Normally we don't eat breakfast until 7pm and it is always oatmeal. The pancakes were a real treat!

Last night was a treat too. Three moms in labor and one birth. Rounds were relatively uncomplicated--aside from a postpartum mama who had come in with toxemia. She was feeling awful, but we were able to get her some medication from the pharmacist and it helped her feel better. Her baby is also sick, but I couldn't figure out with what. I hope the charge nurse will tell the pediatric doctor to see her as I requested. Getting help here means taking matters into your own hands. The women headed in this morning will also check him out. If no one comes up with a plan I will call home and ask for some advice. Rebecca, if you are reading this--be ready for a phone call!!

Around the time I was working with the toxemia mother one of the mothers who had been laboring all night started feeling pushy. We got her to the delivery room and with a little coaxing I was able to get her into a semi-squat. She pushed beautifully for a little over an hour and she had labored sweetly. She was 41 weeks and had been induced that morning for postdates. The doctor had told her that if she didn't have the baby that night he would do a cesarean. Poor thing. She knew she didn't want that.

When she told me about that it had been around 7 pm and she reported that she was really having contractions. I did an exam and found her to be 2 cm with a nice, soft cervix. Then I discussed stripping her membranes with her; told her it would be uncomfortable at least, but I thought it would work. It did. And probably fifteen minutes later her water broke. She seemed to hit active labor a couple hours later. The baby was born beautifully, supported in a squat by a CNM from KY and one of the translators!

I was thrilled to catch a healthy baby boy. Thrilled she wasn't in her back, that her birth was healthy. The little boy weighed 8lbs 2 oz. The biggest baby I have seen here. Cute, chubby, and healthy.

When the mama's aunt came to help, she rattled off in creole the whole story--me promising her she didn't need a cesarean, her having the baby in a position that was supported and more comfortable. It was so rewarding to hear her yell her story with such joy. I needed a good catch and a healthy birth experience. The joy of that mama makes so much of the hardship here worth it!



I thank her for allowing us to assist her in the way we know how!

Akal, akal, akal...

(Heads up readers: graphic, tragic entry. Please preview before sharing with children.)

Monday afternoon, I returned to the hospital to work the afternoon shift. It was around 2 pm. When I walked into the hospital courtyard Reina was there to greet me. She asked me if I could hurry into he delivery room with her, stating that a mom was in labor and had pushed out the baby's arm.

I gloved up as quickly as I could. The mom was on hands and knees and Reina had tried to rotate the baby. The new shift of midwives was on their way to teach class and came in to delivery with me. We quickly discussed what to do for the mama. The baby's hand and arm was completely blue with no reflexes and Reina said that she had been unable to get heart tones--the baby was dead; probably died en route to the hospital. Reina tried to reach for the baby's head to see if she could get it to rotate at all, but was unsuccessful.

I tried next. I had both hands inside the poor mama and was able to get the anterior shoulder to budge a little, but not enough to make any difference. I tried reaching for the posterior shoulder--nothing. We tried pushing against the side of the head from the outside while trying to rotate from the inside--nothing. No budging. And on top of that it seemed like the mama had also ruptured her uterus and the doctor wasn't around to do a cesarean. That meant that if we didn't get the baby out and if the doctor didn't show up soon we would probably have a dead mama and baby on our hands.

My little emergency guide to obstetric complications says to transport immediately for a cesarean for a transverse lie. And with the mentum anterior (face up, chin probably caught on the pubic bone) this made it all worse. The baby was completely compounded and position changes and reaching in to rotate the baby did not work.

Eventually, the doctor showed up and said that he would be ready to do the cesarean as soon as the anesthesiologist arrived. We explained to him our concerns about timing--she had now been with us for close to an hour--and he agreed that she had a ruptured uterus.

Feeling inside her was strange. Maybe because the baby was deceased. The students couldn't understand why Reina and I were trying to get the baby rotated--I feel like they don't understand that where we come from we keep trying even if it seems hopeless that for us sometimes it just feels better to do something.

The doctor put on gloves and tried just as we had. I doubt he was able to reach into the baby's mouth and try to move the baby that way. Reina and I had both tried that, but again nothing helped. Then the doctor suggested removing the baby's arm. I am not sure what he thought this would accomplish; I think he was feeling desperate like we were and he wasn't sure when the rest of his team would show up.

Again, I tried to get the baby up off the pubic bone and again my efforts were useless. Damn transverse lies. Was he really going to amputate this baby while it was still inside it's mother?! At some point in time the anesthesiologist showed up. He consulted with the doctor and I guess they agreed that cutting off the arm was the next step because now the generator wasn't working and without electricity they could section this mama.

I couldn't believe this was all happening. It was like being caught in some horror film. I watched as the doctor took a scalpel to the baby. He cut through the flesh so easily, right along the little shoulder. I silently prayed that the baby was truly dead--I know that he was, but I prayed anyway. As he cut the babies heart and liver and intestines--perfect, glossy, tiny and smooth spilled out through the cavity of the arm. It was horrible to watch and surreal. The smell isn't something I will forget. I still can't believe I know what the inside of a human being smells like.

The arm came off easily and just sat there on the delivery table next to all those little inside parts while the doctor reached back inside mama and tried again to rotate the baby. Again nothing.

We moved mama back to hands and knees and I tried. I reached my hands inside, carefully slid my hands up the baby's back and chest so as to not get poked my the tiny broken and exposed ribs. I had the dreadful thought that my anterior hand was actually inside the body of the baby. It might have been. It wasn't any easier to slip my hands inside now that the baby was armless.

I still couldn't get the chin up off the pubic bone and I still couldn't get the babe to rotate out of the transverse position. What more was there to do? It all felt grotesque and hopeless and completely heartbreaking.

I am uncertain how much time had passed by then. The doctor gave up and left he delivery room after I had tried one last time to change the baby's position. I guess we all kind of did. But in that moment of surrendering to the hopelessness the doctor came back and said he would go through with the cesarean I think regardless of the lack of electricity. He told Reina and I that we could assist.

So I went to the closet and pulled out a newborn onsie and a couple of receiving blankets. I took one and wrapped the arm and the fetal parts up. No one knew where to put them. A nurse said to put it on the floor and that after the baby was born we could put the bundle with the baby. I tucked the bundle of parts carefully under the delivery table. The. Reina and I helped transport the mama to surgery.

Before you can go into surgery it is required that you put on a clean scrub top and clean crocs. Sometimes the surgery ward rubs out and I wonder if they just wait for the clean ones to come or if the staff moves ahead regardless. The attention to protocol here is strange to me. Some things that seem so arbitrary to me seem life and death to the Haitian staff, and things that I wouldn't dream of being casual about are handled in a lackadaisical manner. Reina and I shared a comical moment once we donned our surgical outfits. We had on scrubs that were many sizes too big, pink crocs that were a men's size 11 and big blue hair nets.

Into surgery we went. Miraculously, while the mama was being prepped the generator kicked in and we had electricity. I stood by and watched, holding the receiving blankets in my hands, ready to hold the poor sweet baby. It seemed like it took forever, but eventually I was holding him and being directed by a nurse to place him in the box that was sitting on the floor.

When a baby dies here, it gets put in a box. Sometimes I think more than one baby gets put in the same box. In this baby's box was a blue paper gown, a couple used gloves and some gauze. I was very reluctant to put the baby with the trash, but it seemed I had little choice. So I plopped him in and closed the lid and refused to put the box back down. I watched the mama get sutured, watched her receive a tubal ligation, and held that box rocking it and patting the bottom of it as if it were a live baby I was holding.

The anger came up when the Haitian nurses started laughing. I know that our cultures are different, but it was and still is challenging to feel like this baby was being thrown out like trash. I just smiled and kept rocking the box. It was still very warm. Reina told them that in our culture we hold babies when they die--the nurses just sort of snickered and the doctor commented "this is good."

Eventually, I told Reina that I needed to go. I wanted to clean him off and wrap him up properly. The mama never saw her little son and that is probably for the best, but after nine months of carrying the baby I imagine it is very hard to have nothing. No memory of a peaceful and innocent little face.

Back in the delivery room, I did all of that. I was sad that someone had emptied all the trash bins and thrown away the bundle that was his little arm and other parts. But what could I do? I washed his cute little face and cooed over his sweet little pursed lips. I wrapped him snuggley in the receiving blankets and I just held him and rocked. I was vaguely aware of the midwifery staff and translators watching me.

And I chanted. Akal akal akal akal. Timeless. Deathless. The chant that I was taught in yoga teacher training to do when someone dies. Reina joined in. Then I put the little one back in his box, tucked the blue surgical cloth around him and closed the lid.

On the walk home last night, Reina and I were taunted, yelled at, followed, and harassed. The experience made me so mad. I had just helped deliver one of their own and I was one of two that seemed to celebrate that life, however short. I wanted to yell back at them. I was upset that Haiti and I do not understand one another.

I shared my anger and sadness over our dinner prayers. It felt good to get some emotions out. I know that what Reina and I did took a lot of courage. That it was a courageous thing for me to stand in the delivery room of this hellish hospital and chant akals, but I still feel turned off and numb-- like someone else is attending to the Haitians now, someone else is conducting rounds and getting mothers to nurse. It feels a bit lost over here, a bit defeated.

Tuesday morning, I asked someone where the babies are buried. The little box that I had left in the delivery room was gone. I walked behind the hospital wondering if I would find an area that looked like a little grave yard. Instead I found a pile of trash, remnants of surgical items, syringes, bottles of hospital waste. Among the trash was a lone box and blue surgical draping covered in blood and wrapped like a bundle. Touching it gingerly I realized there was no baby inside. The box and the bundle were empty. I had the horrific idea that a dog had carried it off for a snack.

I have no idea where the baby was buried, if it was buried at all.

“Normally there is no power in the human but the power of prayer. And to do prayer, you have to put your mind and body together and then pray from the soul."— Yogi Bhajan

Photo update

Aisha in the delivery room



Sterilized instruments