Concrete Improvements: Hope for Haiti

America is a wonderful place to live. I'm, just saying: oh, be thankful, folks. We have a lovely, clean, comfortable, prosperous place to live.
Now, I spend a lot of words in this blog talking about how rough it is in Haiti; it does astound me how close a neighboring country has such an enormous contrast to us; and I think Americans need to know (and care) about their neighbors.. And Haiti has had a couple centuries without any stable or beneficial government or investment in infrastructure. That makes that place so poor that it's really still in the 19th century.

But this blog entry is about hope for Haiti. I was there in March 09, and in December 09. There have been quite a few international initiatives implemented to help Haiti, and they are noticeable even over 9 months. The road to Hinche is almost done. In past years, our group only flew, never drove, from Port au Prince to Hinche, due to the crazy bad roads--- it took 4-6 hours, and cars break down,etc. Now, the road is graded, fairly even gravel, with drainage culverts in place, and paving will come soon. Our friend and translator Berry says that he can get on a bus ( "tap-tap", actually a truck with people sitting in the cargo area) in Hinche at 6 am, and be at class in PaP at 9am. Roads are key. Commerce can happen with roads. A farmer with extra mangoes on his tree can sell them, if there are roads. No roads; they rot. Women in labor can get help from a midwife with roads. No roads, moms and babies die. It's a big deal. Road work in Haiti was everywhere.

My favorite symbol of new hope for Haiti was right out of the "Narnia" series of children's books-(The Lion,the Witch, and the Wardrobe...rememer the lampost?) It's in the middle of the photo on this post...While driving out in very remote rural Haiti, several times, we came over a rise, and I thought I was seeing things, as in a tiny village crossroads, I saw a solitary lamppost and street light, with a solar panel on top. When dark has fallen in those villages, people are sitting under those new lights, reading the newspaper. Sewing, studying. Carving. Talking. Hoping. Let's Hold them in the Light.

Do You Want Spaghetti or Bananas for Lunch?...or, Freaky Friday, again.

On my first trip to Haiti, the final day of the trip, Friday, was a crazy adventure in understanding Haiti healthcare, by delivering a baby in a Haitian hospital (‘A Haitian Birthday” post). Well, it must be something about the Friday thing, as this Friday Dec 11 offered Stephen and me yet another Grand Finale of the trip experience.
One of my main tasks for the week was to go out with the CARITAS mobile clinic team, with our 2 newly graduated midwives who will be adding prenatal care to the services this charity provides on a monthly basis in several remote rural villages. We learned only 2 days in advance that it was a “go” to do this, but I got the message to Magdala and Thelamaque, and they showed up at the orphanage at 5 am Friday…our last full day in Haiti. Soon thereafter, the midwives, Stephen and I, with a big bag of supplies and prenatal charts, and piled into the Toyota Land Cruiser, with the CARITAS team, 2 Haitian nurses and a driver. Being a driver in Haiti is a REAL job, really a profession. The roads are so terrible- rutted, with blind curves, and the traffic on them so heavy and diversified that driving is more like a rally road race than a “ride in the country”. We were a little behind schedule after waiting for our tardy interpreter, so the driver put on the gas whenever he could. Random donkeys, other trucks, chickens, goats, and deep potholes of course interfered, but he was valiant. We rumbled along in our Land Cruiser as the sun came up and the road got rougher after we left the paved part in Los Cohobas. We stopped to pick up, or drop off items or messages on the way, and the journey lengthened into a 3 hour adventure that included both Magdala and me getting carsick from the crazy turbulence, dust, and heat.
THEN we arrived at our destination; the itsy bitsy village of Rosec, with its tiny church and parish house compound. As we parked in the dusty courtyard and folks began to bring pieces of broken furniture, benches, and tarps which would build our “clinic”, the driver asked us “Do you want bananas or spaghetti for lunch?”..It was 9am, 90 degrees, and I’d been vomiting. Gee Whiz….decisions, decisions! Neither Stephen nor I had any clue how to reply to such a random question, and not much interest in lunch at that point, though we did find it intriguing that it was going to be obtained from a “restaurant”…one of which I really hadn’t seen yet that day…but anyway. Based on the status of the village, I didn’t want to expect more than anybody else would be eating that day, and if the menu was bananas or spaghetti, I’d eat it and be grateful. I said whatever they wanted to get was fine and passed over some cash.
We set to work, opening our bags on an ancient table that once had 3 planks, but now had 2, the middle one missing. We also had a small table for our desk, a couple chairs, and they got a bench from the church for our patients to recline upon for exams. Tarps were stretched to define our space, and one for shade, as the sun was getting higher. Meanwhile our patients were filling the “waiting room”—a bunch of other benches out in the middle of the courtyard. I am proud of our new midwives. Magdala and Thelamque are new at midwifery, and I am pretty new to practicing in Haiti, but we made a good team. I provided an organizing element, monitoring and assisting the giving of meds, physical assessments and plans of care, using faithful Manno as interpreter. The Haitian midwives had good ideas about practical Haiti things, like putting the bench so that the head was “uphill”, and discarding the urine samples in a gravel pile nearby. They were diligent and competent, recording each pregnant woman’s history and not shocked at the standard answers, which often involved 6-10 pregnancies, histories of prematurity, hemorrhage, and infants who died of unknown causes. Most women had no idea what their diagnoses or problems had been—there is very little discussion, education, or explanation given during Haitian health care, when the people to receive it. The women we saw had no previous prenatal care, and ranged from 16-35 weeks gestation. This also involved a lot of guesswork, as most women also had no idea how far along they were. Hopefully the “new Haitian midwives” we’re training will be communicators and educators with Haiti’s women.
Stephen took great photos and film of all of this, and reported to me several times that ”they just keep waddling in!”, lining up on the benches. Well, sun got higher, the day got hotter, and lunch came from the restaurant in styro boxes. We paused to eat. It was fried chicken, a couple very scrawny but tasty wings, actually, and boiled plaintains—aha! that was the “bananas” part of the lunch order!! Apparently it was a “choose your starch” question; we could have had “spaghetti”!! Darn it. This was the Haitian equivalent of “fries or baked potato?” Oh well. It was something to eat, and it was brief, as we had a message from the CARITAS nurse, who was working across the courtyard, asking us to “move it along, the ladies are complaining about waiting." In Haiti?? Tired of waiting? It seems all these folks have to do is wait! Some of their friends even came to wait with them, for entertainment! Do they have other appointments? We’re doing our best, lady! But we tried to speed up.
In my USA practice, a “New OB” appointment is the longest one. Even with nurses to help, it takes a good 30 minutes to start a woman’s pregnancy care and have a handle on her situation. Our Midwives for Haiti mobile clinic was new to Rosec, and the women had never seen anybody for care, so we had nothing but “new OB”s” all day. But we saw 18 women, provided Prenatal vitamins, iron, and administered worm medicine to everyone. Some we treated for other problems, including a terrible case of pneumonia that I would have sent directly to the hospital if we had been in the States. As it was, I put her on oral Amoxicillin and Zithromax, with the advice to GO to the hospital if she felt worse or not better in 1 or 2 days. I hope she gets well—it’s a long, hard journey from there to “the hospital”, and not much reliable help even when she gets to one.
After lunch, Stephen had shot most of his film and battery. He disappeared for a while… Then he came around the tarp while I was working on my lab desk/broken table,…looking a little… disoriented?...astonished? and said “Mom, I just attended a Haitian funeral.” This stopped me in my tracks, just for a minute, as I was seeing the pneumonia lady and was also running out of vitamins…I looked at him, and said;”Yeah? I bet that was different?!”…Oh, you will never believe it, he said—and gave me some details, only a few, until later—but it included a procession singing and dancing,
Drumming on buckets and drums
Banging machetes
Drinking alcohol and spitting it on the coffin…
But then, the coffin did not fit in the mausoleum,
So they hacked it up with machetes until it fit.
The widow seemed to like Stephen’s presence, and stood with him a minute, then basically signaled that he should leave. Which he did….so he came back to the compound with that funny look, and a wild story to tell later.
By then I had run out of vitamins and iron, but the CARITAS nurse said I could send the ladies over to her nurse who would give them some, but I had to “write a prescription”. I asked Manno: how in the world I do that, in Creole? On what form? But we just punted…I pulled out my little notepad, and he helped me spell out “Name” (Nom), “date” (Dat) etc., and we wrote a Rx template in Creole. I had a dog wandering under my half a table as I wrote these, and I have no idea where these “documents’ will go… but I wrote Creole prescriptions and the ladies got vitamins. And iron. Oh, what a day. It only took 2 and a half hours back, and no one lost their lunch—the lunch of “bananas” and chicken. It was the Freaky Friday, final-day-in-Haiti, all over again.

NO Fast Food in Haiti

It is just too overwhelming—and possibly tedious, both to read, or write, a list of what we’ve been doing in Haiti this week (besides sweating heavily, giving away scrubs, riding around in the truck!) Sharon and I plan to sit together on the flight back to Miami, Saturday, and compose an email to the M4H Board with that kind of laundry list. So for now, here are just some descriptions of little pieces of the lovely, crazy quilt that make up this week in Haiti:
A bigger classroom in the Ministry of Health was open for us to use for our “Out of Hospital Birth” presentation. All of Class 2, (mostly graduated) and Class 3—(beginners) attended, and Sharon and I had a blast, sharing with them our philosophy of woman-centered midwifery and the concepts of risk assessment; what’s ok to do at home, what’s not, and tips on assisting a labor without much intervention. Stephen and Chris improvised a “Haitian boom” microphone --- ( mic duct-taped to a broomstick) and got good audio and video of the whole event. Stephen said he had a proud moment with me and Sharon role-playing, demonstrating back labor, side-lying, and hand-and-knees delivery, with me crawling around on the conference table, moaning loudly. Meanwhile, Sharon played the midwife role, showed how to do these labors and deliveries and validated that mobility in labor and different positions are not only normal but helpful.
We’ve been available to whatever pregnant women wanted any care, so that has meant a prenatal visit each day with somebody—our translator Theard’s wife, and then each of the 2 cooks, wanted to See the Midwife and made an “appointment” when we could check them out in our bedroom at the orphanage. It has been so sweet to sit with these women, give them information about what is normal, when their due date will be, discuss what their plan may be for birth. They have generally seen somebody at the local clinic, but it seems there is no teaching or sharing of information…nobody knows why they should take iron, or vitamins, whether their urine test, blood pressure, or size of their belly was normal, so they just wonder and worry. We will change that with more midwifery care!
The lunch each day on the porch at Maison du Fortune Orphanage has given me happiness. In past trips, we’ve often not been able to arrange to bring our staff- drivers, translators, etc, into the places where we ate our noon meal. They just fended for themselves, or even (we kind of figured out over time)… went hungry. There is no Fast Food in Hinche! Actually, nothing is fast. Not the traffic, the most of which is on foot or human or otherwise. Not the pace of business—“Maybe Tomorrow” is a motto these folks live by. I went to a Haitian bank, and while a mob waited forever in line for the teller, cell phones were plugged into the wall, charging, by the potted plants—free power!
On this trip, at this new “home”, however, all The Guys Eat with us, served by the cooks of this house of Xavieran Brothers who host us. Each day at noon, we come back here, and rest on the shady, tiled upper porch, pray, and share our meal—(Any blog reader already KNOWS the menu!) And it is so pleasant.
In Haiti, hunger is not an abstract concept or a growling stomach due to poor time managment. People struggle, worry, and exert great effort each day to find a way to make some money, grow some crops, make some deals, to find food. Then they find charcoal with which to cook it. They get water from a tap, often not a tap at their house, but down the street. They go to market on a donkey or a bike or walk, to buy the food, and then, finally, if all goes well…there is lunch. It is a happy time. A big plate of beans and rice, a little bit of meat cooked, with raw onions on top… makes a Haitian happy. It’s made me happy too—to share it..to provide work that makes someone able feed their family..to get to live this day, and eat lunch with my family and friends. Messi Bon Dieu—Thanks be to God.

Pressure Cooker: Which are Thicker: the Mosquitos or the Stars?

Food cooks faster when you cook it under pressure. I’m feeling about cooked myself, now, from the heat, humidity, combined with pressure of what I hope or need to accomplish vs.the obstacle-ridden chain of events that can make up a day in Haiti. We can make plans, but they will change daily, if not hourly.

Many joys in the past days, and many frustrations and griefs. Hugging my son Stephen at the airstrip this morning was a big one. It’s so great that he’s willing and able to share even a a part of this work, and experience this piece of global reality, and my heart. Frustration over the lack of internet: it’s broken at our host building, and not one cyber café open in the whole town due to the Feast Day. So blog posts go out very intermittently as the opportunity arises. This afternoon, a long, dusty, rugged ride in the back of Ronel’s truck to the Medical Missionaries clinic in Tomassique, where one of our star graduates, Merlinda, is working. Great scenery! Great to see her and her clinic. She and a partner midwife attend 30-40 births a month out there, using 3 labor beds all in one room, and a table and a sink at the end of the room, behind a screen. That was the joy….the more difficult part of the scenery is the many, many people on the road, who live in these rugged hills, scraping out the meagerest living on bare agriculture and random pieces of work they can find. As we rounded one bend in a massively rutted road, I looked up the big wooded bank above the road, and saw a man at a treadle sewing machine, in the front yard of a little wooden Haitian house. What’s he sewing up there? How far will he walk, or ride a donkey or a bike, to get some food or some money for it?
In Merlinda’s clinic, she had a lady who she had attended 2 hours prior to our arrival. It had been a long labor but all was well. The woman, Jacline, had had one prenatal visit, and had traveled 2 hours to get there and have safe midwifery care for her baby’s birth. I gave her a gift pack of onesies and diapers. I want to give her and her baby a better life, but this is for now, the best we can do.
Long after dark, we got “home” to the orphanage. I broke the shower nozzle when I took a shower. I’m wracked with painful guilt over breaking anything in Haiti—it’s so hard to fix! So much other stuff is broken. It’s not easy to live a day here, even when everything works. I prepared for tomorrow’s plan, only to get a cell phone call at 9 pm that scrambled the day and week….again. The mobile clinic truck is going out on Friday and I need to take our 2 newly-hired gradutes and go help them get oriented. So other planned activites have to be fit in some other day, but we’re running out of days…and oh yes, we’re trying to take film while we do all this. I’m worried I can’t fit it all in. I’m worried I’ll forget things I promised to do, or that I will drop the ball on these peole we are trying to help. I’m afraid to let them down. These are real people with real lives, and they try so hard, and they count on us to help them. It’s hot, the mosquitos are thick tonight, the humidity is high, and the pressure is on. I’ve got to get in my mosquito net before I’m eaten alive! But I look up from my porch, and, because there is no municipal electricity, there’s no light pollution, and the stars are spectacularly thick and brilliant. It’s the glass-half-empty-or-half-full riddle of Haiti: Which are thicker? The mosquitos or the stars?

A Day in Haiti Lasts Three Days

At 4pm today, I was hiking down a rugged dirt path, gazing at dry blue mountains rising above bright green sugar cane fields. We had just viewed a rural school that our interpreters started this year, partly with funding from US donors like us and volunteers from their own community.. The school consists of blackboard, benches, a latrine and a thatched roof. At the 4pm moment, I dodged a cow coming down a path, with a kid following her on a string, not exactly in charge, but hanging on…. I looked at my watch, turned to my travel partner midwife Sharon Ryan and said “We’ve almost been in Haiti 24 hours.” Her eyes widened; she sighed, and she agreed…in regular time, we have only been here one day. It feels like 3. Maybe 4. But they have been 3 really good days, and we should sleep great tonight.
Our arrival in Port au Prince was a brief, intense overnight stay. The short drive through the city was almost as disturbing as my first time; the gigantic potholes! The dusty, hot streets! The minimal sanitation! and lots of pedestrians trying to avoid motorbikes and trucks. Our hostess, BethMcHoul fed us a lovely dinner, and showed us her women’s center and birth center, which is saving the lives of the poorest women in Port au Prince. Her program teaches women sewing skills to foster financial independence, provides basic education (reading, writing, math), prenatal and classes on health care, breast feeding. They even feed these severely malnourished women high protein meals by raising their own tilapia! Then Beth and other volunteer midwives attend these women’s births with dignity and kindness in a place where very little of that exists. And as a bonus, they give Midwives for Haiti volunteers a safe overnight when we’re coming into the country. God Bless them!~ heartlineministries.org. We donated some baby clothes medical supplies salvaged from the US hospitals, meds that she can’t get in Haiti, and she gave us advice and wisdom on working with Haitian women and culture.
Today has been a day of gladness and pieces falling into place. I had such joy to reconnect with the friends I made last March…our interpreters, Theard and Manno, and Ronel, our driver., Danise, our Haitian nurse-midwife teacher. After the 20 minute lflight in a 4- seater plane, we landed with no plan at all, other than to start making phone cell phone calls to all the people that we need to meet with. But, then the sun, moon , and stars all lined up… Father Jacques , our primary Haitian contact and advisor, said “come on over, I will be happy to see you now!” Within an hour of landing, we were sitting on his balcony with our group and both the M4H teachers, Danise, and Marthone, talking over many of the issues we current issues for the program and goals for the week. Then things just kept moving—we got to the orphanage where we will stay in the guesthouse. Ate dinner (Beans! Rice! Goat stew! Surprise!) with all staff and Brother Harry and Mike. We visited the homes of Theard and Manno, saw their kids and wives…I am getting re-accustomed to kissing on both cheeks as a greeting. We examined a friends’ wife and will try to find the right meds to help her severe abdominal pain. (We think she has an ulcer.) We saw the rural school (ie, paragraph 1!) that Theard and Manno have built simply on believing that they should, and friends have funded in random and generous manners when they can. As a result, since this past October, 72 children in Naral are learning to read and write who have never been to school before.
We looked at the house that MH could consider renting to have a “permanent space” that’s ours. I don’t think that particular house will work, but it’s an idea. This little non-proft currently lives out of closets in about 4 builidngs and pays room and board for 2 Haitian teachers in 2 different places. A “home of our own” in Hinche could save money and logistical energy. But for now, we’re “home”—the Maison du Fortune Orphange. A soccer game of about 30 kids was going in the courtyard when we returned at dusk. The boys are sweet and shy, but love it when we speak English with them—or join in their games. We brought them shoes, clothes, and medicines. Wait ‘til they see we brought them a soccer ball and a basketball.
I think I’m in an emotional honeymoon phase…I do find that as a “second voyager”, I’m now less traumatized by the poverty, and can really cope better and feel more normal than the first time. (I have high hopes that I won’t wake up crying at all!—we’ll see.) The bigger and harder issues of the week have not yet even begun. We need to spend some special teaching time with our students, have some meetings about getting the new graduates jobs, travel out to see some former grads at their practice sites, and oh yeah, Stephen lands Tuesday and we’ll start to make a film! But tonight, I’m just happy.
Happy to be in Haiti. The mountains and fields are spectacular. The people are incredible. They just keep trying, and they show that it’s true—we should never, ever, give up. You never know when things will go exactly right. Like today…these 3 days that we just lived in one.

Embargo

"Embargo": possibly Latin for "Tear your Hair Out"!
I was on call for 5 of the 7 days before I left for Haiti. Full moon, lots of labors and births. I knew the schedule, and that this was coming, so I packed carefully in advance-- my friend Brett even came over, gave us dinner, and helped do the final pack. We had SO many generous donations of all sorts, but were sure I had all in order. Except-- the day before my departure, I learned from Sharon, my travel-partner midwife from Ohio, that between Thanksgiving and Christmas, the airline has an embargo on any luggage over 75 lbs, and NO third bag allowed....hence, "Tear your Hair out!!"

I attended 3 births on Wednesday, then between deliveries on Thursday, I raced home, said hi to Greg who had not seen me for a day or so, and frantically re-arranged, ruthlessly and rapidly prioritized the "Must Go Now Stuff" in 2 Bags vs. the "Stuff to Go in March". This time, medical supplies, meds, cell phones and laptop, scrubs for the students, some baby and kids' clothing, books, portable food. A lot of the baby stuff, diapers, and some kids clothes will go in March when I go back for trip #3.

When my plane took off from Dulles on Friday at 6 am, I had 2 bags that were exactly 75 lbs; (after I re-arranged them at the baggage counter again with the whole world looking on..!) It's all ok--only a reminder and a taste of third-world life that I'm headed for. In places like Haiti, plans are made, but every day is generally a series of emergencies, small, medium, or large, that folks navigate as best they can. So my crises in packing are exhausting but oh, so small.

On the map, Florida sticks its nose out into the Atlantic and Caribbean, and Miami sits on the tip of the nose. I write this in the Miami airport, with the sensation of bouncing on the end of the diving board, the jumping-off point of the USA and into the third world. We land in Port-au-Prince, and nothing is quite so simple after that; not internet, power, water. Not even birth is safe.

But Midwives for Haiti has a mission that is inching forward, trying to help. This trip, I will look at a house that the Board may consider renting, so that we have a "home" in Hinche and not just random rooms and closets in several different buildings. I'll meet with teachers, students, our Haiti friends and advisers, and help organize a new mobile clinic. I'll talk about a Durango SUV that is being donated to the cause from the US, and how to get it to Hinche (that should be interesting for sure: we can't even send a package UPS, let's see how we get a truck there!) And my son Stephen will arrive on Tuesday and work on filming for future PR projects.

I don't need to ask for prayers or good wishes. Gifts, notes, hugs, help, donations, and phone calls have convinced me many times over that I only do this with the love and support of a very large tribe. Thank you for reading this. Thank you for being part of it with me. OK.... jump off the diving board!!!

Short-term Memory Loss and Recovery

Wow! Part of the beauty of a blog is the dynamic, day-to-day ability to post new information, or to correct mistakes! I had forgotten since March that a 3rd bag can be taken on the airlines, for $100 extra. I am over 50 now, and boy, it shows in the short-term memory lapses. I use a small notebook, every day, as my portable memory of things to remember!
So, corrections to the Algebra Problem:
Wendy Can take three bags, #300 pounds, of stuff, as long as the extra $100 is available as well. I can't even compute the cubic inches-- let's not try!
Other tweaks to the wish list:
USED SCRUBS: The students were issued 1 set of scrubs, to wear when they are training at the hospital. They would greatly appreciate an extra set, each. Since laundry is done by hand in a washtub in one's back yard, and hung to dry on cactus bushes, the value of spare scrubs becomes obvious. See photos of students in scrubs, and of laundry being done in the alleyway. (These photos look much better when you click on them & enlarge them).
A Laptop computer is also needed for our new (second!) Haitian nurse-midiwfe teacher, if anyone has a "spare laptop"!.

Algebra Problem

Amazing friends, family and supporters, are now asking "What are the needs for the December trip to Haiti?" It's a tough answer, because I learned last time that, at best, I will be taking 2 maximum-size duffel bags, and one small carry-on. I pay an extra $100 each for each bag, each of which I pack to the 100 lbs capacity, and use my carry-on for my personal stuff. So it's like an algebra story probem: "Wendy can take #200 pounds of items to Haiti, packed into 6,750 cubic inches...items must be small, lightweight, and of high value to the Haitian mothers, midwives, and babies. What should she take?"

So here are the suggestions and wishlist so far. I also am trusting the astonishing power of concerned individuals to let their hearts lead them to the perfect act of kindness...over and over again, it happens, better than we can "plan" it.

*Financial donations are obviously the most liquid and portable of all. Checks written to "Midwives for Haiti" with "Dotson trip" in the memo line can be sent in through me, and used in multiple ways for needs as they arise.

* Medical supplies are coming in abundantly from salvage-concious nurses at both Prince William Hospital and Loudoun. Sterile, or ultra-clean, uncontaminated: gauze, gloves, cord clamps, suture, lidocaine, syringes, and suture.

* Baby supplies:
light receiving blankets
small soaps & shampoos
cloth diapers(nevermind the plastic pants-not used!)
Onesies of all sizes

*For the prenatal clinics:
Prenatal vitamins
Over the counter Iron supplements; ie, Slo-Fe,
Vitron -C

*For the students:
Lightweight White blouses, we could use 15-20 of them, varying sizes small-med-large, new or great condition
(The students wear a white blouse and dark skirt to class each day, getting an extra blouse would mean a lot to them.)
Gently Used Scrubs, various sizes
small pocket-size spiral notebooks
Baby doll and soft pelvis model, for teaching birth maneuvers(--any retired childbirth educators??)-could also be ordered from ChildbirthGraphics.com, Item # 53954, (costs $195).

For the orphanage where we will be staying:
Clean used children's shorts & t-shirts, dresses (It's always "summer" in Haiti!)
Small packages of crayons, chalk, small toys or school supplies.

Prayer. Any and all denominations and flavors! For our trip safety- health & security- wisdom. Success in our mission, that more mothers in the Central Plateau of Haiti will live to raise their families, through our help.

Thank You
Thank You
& Haiti thanks you

May –November 2009: Living with the Kid in the Back -Seat

As important and compelling as it is, my volunteer work with Midwives for Haiti takes a back seat to my regular American life. I have a (wonderful and) demanding “real”job, with Loudoun Community Midwives, so M4H has been sitting in the back seat since May 2009. But WHAT a passenger she is! M4H is the backseat driver (or child) you love dearly and who will not shut up. Always hungry: How to help obtain funds for all the growth of the program in Haiti? Always questioning: When are you coming back? And always talking: Emails keep me connected to the folks down there that I care about—interpreter Theard got married, and I sent him a digital camera, because he asked. I have a “Creole Made Easy” CD (Easy- HA!) in my car, and have learned to say
“Jacques can give her the peanut butter”
“How do you feel?,
“First or Second Baby?”
“Do You Have Pain?” and
“PUSH” in Creole. And I can sing the Creole blessing for my food, too.

In spite of the tension it creates, I love it. Working to train midwives in Haiti gives me a different arena where I can feel my work accomplishes so much. So, in time I carve out of my “real”(USA) life and spend on the Haiti work, I’ve attended M4H planning meetings, and worked on editing the exams that our students take after completing each of their chapters in their textbook. I wrote a preliminary grant proposal to a large charitable foundation that may become a supporter. Haitian Artwork is on sale at the checkout window of my office. And now…I’m going back for another week in Haiti! I’m so excited.

This trip, December 4-12, has several goals. I’ll be teaching students about out-of-hospital birth techniques and some clinical skills. I hope to visit some of the M4H graduates and help ensure they have what they need to help mothers and babies. This trip, my 25-year old son, Stephen, will come along! Stephen volunteered to come and take film, then edit it for a video to use in the US, and maybe on YouTube, to educate others about Midwives for Haiti. We plan to interview a number of Haitian people involved with the work, film our students, teachers, and M4H projects, and just clearly portray life in Haiti, and why we do this work.

My hope is that the initial shock of going to a 3rd-World Country will be less intense the second time, giving me more energy to focus on the tasks at hand. I never want to become immune to feeling the pain or the burdens that others carry. I just hope the shock will be less crazy and stressful. I now know that many Haitian kids will holler “Blanc, Blanc! Gimme dollah!” whenever they see my white face. And I will just wave, rather than create a riot by actually giving away a dollar. I hope to not be too surprised to see pigeons pecking at the scraps on the kitchen floor, or when a bat goes flapping through the living room of the rectory at nightfall. (Note to self: Wear hat to dinner. Always sleep in bednet.) I know now that the first intense sight in Haiti is about a hundred Haitians screaming over a concrete barrier at the airport exit door, shouting to get taxi business. And I know who my ride is. I know where to get clean water, and what little gifts will make a Haitian smile. Being in Haiti is the gift, for me. I hope this upcoming trip will be worthwhile and sweet.

Haiti Hangover...or Afterglow?

I've been back from Haiti just over a month, now. I think my dear husband hoped, briefly, that I had made the trip, and gotten it out of my system. Alas, this is not the case. Actually, I'm planning a sale of Hatiian crafts and a public talk at my Quaker Meeting that helped sponsor the trip. God Bless Greg Dotson; he is a man that takes my passions to heart and helps nurture them to fruition. Greg's helped me with Haiti-P.R. and blog ideas, and he didn't even roll his eyes or sigh when I mentioned going back to Hinche in December. This man is a mid-husband, which is the animal midwives are meant to marry, but often don't. We often marry normal men, who mind very much that we are absent at all hours of the night and day and are consumed with caring for families other than our own. Those normal ones don't like the true midwife answer to "When will you be back?"....which is: "I don't know...When the baby's out and no one else is laboring." But I married a midhusband, 28 years ago. Thank God.

When I was in Haiti, I did not sleep well, and about 3 am on one of the nights, I woke up crying about...?.. it seemed like a definite disturbing thing at time, but now I just remember the deep need, the lack of resources... and the fact that the people kept going. The perseverance. But often, now, l wake up in America, and think about Haiti and the M4H program. I'm not weeping about it but neither can I let it go. What was once a set of abstract facts about a foreign Caribbean country now has faces, names, and real people attached. Once Haiti was a place I was going to work for a non-profit. Now, Haiti is a place where I have friends that need a lot of help. And I'm going back.

The Catholic Sisters of Charity (Mother Teresa's order) have an orphanage and feeding center, "Azil", in Hinche, and on Wednesday of our trip, we visited. Most kids there actually have families, but needed to be admitted and fed at the center to overcome malnutrition and regain health. The children get so excited when they see visitors arrive: not because we bring them things,( we do, but the things are quickly stored in a supply closet for later) , but they get excited because visitors hold them. I had children crowd around to sit on my lap, to be embraced. They did not ask for anything else. I could not even read to them, which I'd love to do, since I don't speak Creole. No, they just wanted to be touched and held. The intense human needs that I encountered in Haiti stay with me daily now...the need to eat enough; the need for clean water, need for health care and light to read with at night. The need for midwives to safely help women survive birth and live to raise their families. I have so much, in my comfortable life here, that I continually wonder what I can do to pass some of that to my Haitian friends.

I sent an email a few weeks after my return, to our interpreters Theard and Manno. I asked them to contact some craftsmen and women, and prepare items for purchase when the next group of midwives came from the US. So, when Sheila an Amy came to Hinche around Easter, "the guys" had located many soapstone statues, carved and painted wooden bowls, notecards, and embroidered clothes for us to buy in Hinche and sell in the US. The artists were so thankful to have big purchases! Then the items were wrapped and carried back to the US, through Port-au-Prince, to Miami, to Buffalo, and then to Leesburg in a car of one of Margie's relatives. The US part of the sale will be done when I speak about Midwives for Haiti at Goose Creek Friends Meeting on Mother's Day, May 10. Many of the items are beautiful. Some are strange or goofy. How to tell a person in Haiti, by email, what kind of shirt an American would buy? The collection of things is colorful and fun and lovely, and reminds me a lot of Hinche..The stuff is all over my dining room table....kind of like the piles of gauze and gloves and diapers right before I left. Fortunately, for all of us, we are a family that eats in the kitchen.

You are Cordially Invited to a Free Community Event & Charity Benefit

Wendy Dotson, CNM

will present

"Midwives for Haiti:
Saving the Lives of Mothers and Babies"

Sunday, May 10, 2009
Mother's Day
11:15 am

Goose Creek Friends Meetinghouse
18204 Lincoln Rd.
Purcellville, Va 20132

*
Public Talk & Slideshow
*
Haitian Handicrafts Sale
*
Scenic and Historic Grounds of Goose Creek Meeting open for picnicking

Re-Entry

Getting off the plane in Miami, I stopped to use the ladies room before I got in the passport line. I was so distracted by washing my hands in a clean sink, with soap AND paper towels! all together!! that I walked away and forgot my bag of duty-free rum. I was admitted back in the US through the passport line, and into baggage claim, before I remembered. Eventually, a customs staff person did retrieve it for me.

My heart did a flip when I passed a barber shop in the Miami terminal. I could get my hair washed, NOW! In the twinkling of an eye and with a painless zip of a plastic credit card, I receved a manicure (goodbye, dirty fingernials!!) and a shampoo and trim of my hair. The hairdresser was Cuban and spoke mainly Spanish, but I explained I had been "doing doctor work in the mountains in Haiti" and did not have many showers. Afterwards she said "Yeah, I seen the dirt come out in the sink!!" It was such a relief to be clean. Cleaner, anyway. I had brought more from Haiti than I planned--- Haitian road dust, all the way from Hinche.

I had not eaten since peanut-butter-and-bread-breakfast that morning at Fr. Jacques' rectory, so I needed food. I found the elevator up to the main concourse, and then a directory of the shops. I stood in front of the glossy black map of the airport terminal, and glanced down the list of restaurant and food choices. And I started to cry. I looked over my shoulder at the folks in the terminal, a little embarrassed. I wanted to explain"...Sorry, you see, I've been in Haiti. And they do not have this much...this much food. Or this much choice. The leap between worlds is overwhelming." No one was bothered by my tears, however, so I wiped my eyes and found some lunch. My salad & 1/2 sandwich was served in a clear plastic box, and it was very hard to toss it away afterward. I thought: Someone in Haiti would use that box! And they would. But getting it back to Hinche would be tough. A lot of the poverty is linked to lack of transportation and roads. I hope Haiti can get better roads. I hope so many things for Haiti.

I hope that the Midwives for Haiti program will survive and grow , to become an established school that produces more and more trained practitioners that can save lives and reduce those catstrophic mortality rates. I hope that the many good people in the US know that one of their closest neighbors, in their own hemisphere, is one of the absolute poorest nations on earth. I hope the Haitians keep on trying. There is despair and anger in Haiti, but there are so many who keep doing their best, each day, not only to survive, but to succeed. There are people in Hinche, tonight, reading under every street light, working to learn and improve their lives. Danise is at home in the rectory, writing a qualifying exam to ensure that only the best, brightest students will be admitted to this program that she now teaches. She emailed and asked for a desk, so apparently she doesn't plan to leave soon. There are student midwives in a classroom, five days a week, learning how to care for women and babies with respect and kindness and skill. And Danise told me that every day, they pray for us, their friends in the U.S. And then they sing.

A Haitian Birth-day, or ,The 3 S's

Dear Nadene and Steve,

As I fly home to Dulles, I want to thank you (??!) for the casual encouragement you gave me that "it would be great if I could take some student's over to L&D and deliver a baby in Haiti" before my week was out. Well, my friends, I did that, and what an experience it was! I tend to believe God has a plan in all situations, so I guess I was meant to grasp in huge experiential detail what it's like to lack what I will now call the "3 S's ": STUFF, trained STAFF, and STABLE surroundings (like water and electricity...) The language barrier added a special thrill as well!

So, I chose the 2 students who had no birth experiences except their own. On Friday pm at 2, they dressed nicely in their pink scrubs and followed me over the the Salle Maternite. I saw no one in the delivery area, so I introduced myself to the nurse at the maternity desk as one of the "Saj Famn pou Ayiti" midwives from the US, and said I would be happy if I could help with a delivery. Of course this was thru the interpreter, so I hope that's what I said. But perhaps this meant to her " I am WonderWoman!!- Bring it ON!"...I don't know.

The nurse said that "OK they got somebody for you" and they got a laboring lady out of bed and walked her across the hall to the delivery area for me to examine. She got up on the table, I found some gloves, and examined her. Her cervix was 6 cm dilated and she was having strong contractions. She was having her second baby. While I was explaining this to my students, I was slightly disconcerted that more women were being brought in and helped onto more tables--- they kept coming!

The next one was 5 cm dilated, fully effaced, 1st baby. OK...but here comes #3. She's only 3 cm, but making lots of noise and obviously laboring actively. I was starting to feel confused...do they just hang around those tables until they deliver? What about the labor area? And the nurse who was leading the stampede was doing almost nothing to organize or help me! ( I later learned she was the only nurse for ALL the maternity patients.. including rooms full of postpartum women, including some receiving blood. Aha.) NO STAFF. So I found a doppler and started checking fetal heart rate on everybody-- let's see if all the babies are OK! They were. Praise God. Next, I figured, OK, They've already invented Group Prenatal Care: let's try Group Labor! So while lady #4 was climbing onto her table, I did a round of Blood Pressures; this was hard because it was so loud in there with all the laboring and hollering. As far as I could tell, nobody was over 140/90. The nurse asked did I want to give the one with the 140/90 BP some Aldomet? Well, No thanks, I said, but could we dip her urine? We could, and cup of urine and sticks were given to me which showed negative protein, so I decided to just watch her. I did manage to explain this to the students for minute, before lady #3 got off her table, pooped in the plastic bucket at the end of the table, and vomited on the floor...likely not 3 cm anymore!

I already understood that we had almost no help; there was nobody consistently nearby except me, my students, and our interpreter. But they were getting some labor and delivery experience, by golly!!
Now I was acutely aware of NO STUFF. NO gel for the doppler. NO Kleenex to wipe off the doppler. NO paper towels (or anything) handy to wipe up the floor. The water did work, so I did wash my hands as much as I could, but did not have towel to dry with. There were also flies around-- not quite #3, a "Stable situation". Each woman had brought some type of cloth from home to put under her on the plastic-covered table. Some had pieces of sheets, some had a night gown or a skirt spread out beneath them. Now, I understand that this is meant to get them through an entire birth, and goes home with them to be washed. The thought of a full bag of chux and a roll of paper towels ran through my mind and seemed like something I saw in another life!

Next, the infermiere brought me--WOW!--prenatal records on each of the laboring women! They had all visited the prenatal clinic at least once! Nobody had a hemoglobin under 10, and no one had tested positive for HIV, and they had all taken some vitamins at some point. No babies were coming breech, no twins; hey, It was my lucky day!

Danise came over about 3:30 and I felt like the cavalry came over the hill. I told her I was staying until Ronel came for me with the truck at 5pm, and she and the students all said they would stay with me and work. More trained STAFF! Hurray! Our lady on the third table had been getting more and more active labor...actually, at some points all the ladies were yelling and crying; quite the drama! Despite having locked away the medical boxes for the end of the week, I did have a small bag of STUFF that I'd carried with me "just in case", - I had some gloves, a gown, suture, Pitocin, Lidocaine, and syringes. I broke open a few of the diaper & onesies kits, and placed a new clean diaper under my patient who was ready to deliver. This move was greeted with disapproval by the Haitian staff, that I was using that nice clean cloth in this manner!

At this point I couldn't really communicate with anyone around me, because the birthing mom had her arms wrapped around the interpreter, screaming and pushing the baby out. God Bless her, Danise was there to help me, so we actually checked the baby's heart rate a few times, and she found me a few instruments that I can only hope were sterile; there were 2 clamps and a small scissors. Soon, we delivered a baby, a girl, and she cried right away. I had Camina stand by with a clean diaper (another one! I was tearing through the resources like a crazy person by Haitian standards) that we used to dry off the baby. We suctioned her, cut her cord, and wrapped her in a clean blanket. My heart was full of gratitude to the friends and moms who had donated all that STUFF. God bless them, too. We did active management of 3rd stage since I had the Pit, and bleeding was well controlled. Hooray for stuff and staff.

Next, the perineum needed a small repair. I was so happy that I could give this lady lidocaine for local anesthesia, as it is not routine there; I just happened to have some. HER lucky day! When I had the syringe loaded and went to inject the area for stitching, I realized I had no light but daylight. This lack, the third "S",I call STABLE Situation: the need for power & water. We angled the table so that afternoon sun gave me light. I asked for a stool to sit down on while I stitched...one was placed under my bottom, but oh dear, it was actually a seat not connected to the frame. So, with a loaded 10-cc syringe and and uncapped needle, I fell backward on my butt, onto the filthy floor...waving the syringe around and trying not to get hurt or puncture anyone! The girls caught me before I whacked my head or poked anyone,picked me up, got me on a chair. I went ahead and used the lidocaine as I felt it was still uncontaminated and that's what we had. I had the scissors and 1 small straight hemostat left, and Danise indicated that this is what I had to use to suture with. So nevermind, Steve, teaching the students the proper way to suture, with pickups! I did the repair with one hemostat and some Vicryl. The students were thrilled to observe hand ties and instrument ties, and were able to identify them as I did them!

In the end, we had caught a baby in Haiti, and I had to go home with my truck before the other ladies delivered. I was soaked in sweat and very tired! It was absolutely mind-boggling to me that this chaotic escapade, the craziest 3 hours in labor and delivery I ever spent, had actually been a big improvement over the usual birth scenario at this hospital. It's also astonishing that most of the women in Haiti do not get prenatal care, and do not deliver in any facility or with anyone with training, so that this story actually is a best-case scenario. My patient was attended by trained midwives, and had more care, more precautions against infection and hemorrhage, actual local anesthesia, and even some clean linen. Midwives for Haiti and the people supporting us can do so much better, if we keep going. I am grateful for the eye-opening adventure, and I am inspired to try to supply the 3 S's, and keep working for birth to be safer, and better, in Haiti.
Onward!

A New Baby is Born

During the weekend before the new Midwives for Haiti class started, there was a lot of concern over how things would work on Monday. Danise, the Haitian nurse-midwife who was hired to handle the main teaching, still had not received the key to our classroom from the hospital administrator. It was also a little uncertain how many students were accepted in the program, how many would show up, and whether we had enough books and school materials for them. We drove all over Hinche in the beat-up truck that is the Midwives for Haiti’s main transportation, with our driver, Ronel, locating supplies and equipment. There was medical equipment at the Whitney clinic, where a huge box of emergency OB drugs, supplies and a laptop were stored. There were notebooks, pens, gestational wheels, to pick up from the storage closet at the Bishop’s house. There were several huge boxes of books that came with Nadene on the plane, including the newly-printed version of “A Handbook for Midwives” in Creole. Nadene, Steve Eads, and I sat with Danise and talked about the week ahead and how to begin the teaching and introduction to the program. I had very little to add, being entirely new to this, but fascinated and excited just the same. So much energy and money and preparation was spent to “gestate” this “baby” the second class of Midwives for Haiti, and it was uncertain how the labor and delivery would unfold...

So, Monday morning we packed everything into Ronel’s truck, put on our nice skirts and makeup (except for Steve…for the record, he wore scrubs and no makeup!), and headed for the hospital. At the same time Kathie and Cindy and June headed for a big day of primary care at the Whitney Clinic. When we arrived at the hospital, the classroom was still locked, and Dr.Prince, the hospital administrator, was unreachable, out of town. Fortunately, the Ministry of Health building was open and had a room for us, with chairs, tables, and table cloths, all set up!! And gathered at the front of the building were 6 beautiful midwife students, with perfectly braidied hair, bright white blouses, dark skirts, and HUGE smiles. They were so excited it brought me to tears. Nadene and I were almost overwhelmed with excitement! We set up the table with places for each student, books, notebooks, pens, pencils, wheels, and tape measures. The students were invited in, and took places… Danise welcomed them in Creole, and then asked one of the students to open with a prayer , which she plans to do every day, as it is traditional here. Magdala, Pastor Jude’s wife, started the hymn “How Great Thou Art” , in Creole, and all the students joined in, loudly, and in harmony. With the acoustics echoing inside these cement walls, it was utterly angelic. Nadene and I both sang along (although we were so moved we were crying!) in English.

Danise then introduced the program, and asked each of us to introduce ourselves and speak about why we came here, and the background and philosophy of Midwives for Haiti. Dr.Eads told the students about how it took 2 years to train the first class, due to all the obstacles and changes that occurred during that time, but that it succeeded through great perseverance and commitment, on the part of all the volunteers, the students, and much support from friends in the US. He then explained that this second class is very important, because it will show that this process can be repeated, and become a truly viable established program . Nadene talked about saving the lives of mothers and babies in Haiti, and touched on how it is a primary value that the M4H midwives become famous for being highly skilled, and for their kindness and compassion. I spoke about my path from being a direct-entry home birth midwife, to having a large hospital practice, and how the work of a midwife in all settings, in all countries, is very hard work ,requires a love of mothers and babies, but has great rewards…”and I welcome you to this work.” Another new student arrived every 30 minutes through the morning, until there were 9, and 2 more expected for next Monday! We taught chapters 1 and 2 of the Handbook, and went to lunch in the truck, with HUGE rejoicing—the baby was not only out, it was robust and crying (or singing) loudly. Midwives for Haiti, Class #2, had begun.

Hinche-ing into the Project

Saturday March 7, 2009

We flew from PAP to Hinche by small airplane. The dry mountains spread out beneath us, then the river, and the one large reservoir and dam that supplies water and some power to Port au Prince. I only got nauseated at the end of the flight, with some bumps and jolts, but by then the spires of the Hinche cathedral were visible. We passed the airstrip once, circled around, and landed. Goats, donkeys, pigs, and horses graze on the airstrip when the planes are not landing.

Transportation in Hinche is bike, motorbike, donkey, horse, or truck. Our driver, Ronnel, drove us all around Hinche in a very old but sturdy pickup truck that has bench-seats welded onto the bed in back. We toured the hospital, the rectory, where they serve 3 meals a day for us, at 7, 12, and 7pm., and the Whitney clinic where the Nurse practitioners will see patients this week. The hospital tour was most dramatic...these people are making do with the most difficult conditions I’ve ever imagined. Family members mostly care for the patients. They bring their own sheets, linens, and food. The hospital care consists of a diagnosis, a plan, procedures as needed...they do have radiology, and a lab, and a pharmacy. But basically, each ward is a large room, without screens, and a concrete floor, and some beds. Water may or may not work in each sink, including in the delivery room. Each nurse checks on 10-20 patients, so the family does most of the care.

We checked into our motel, which is very, very nice for local standards. The huge courtyard is paved, landscaped and shaded with mango trees. The motel provides generator power from dark until 6 am, the rooms are screened with nice windows for a breeze, and each room has its own bathroom, although there is no hot water tank. There's security and a big iron gate that is locked all night. We settled in and I hung my bed-net, and filled my 5-gallon plastic sunshower, and set it out in the sun to warm up; this was a wonderful idea and I'm looking forward to a warm shower eventually! For even more luxury, we took a trip in the truck to th Ebenezer store, one of the largest shops (with actual glass doors!) and bought...ooooh! fairly cold beer!!!
Dinner at the rectory was Beans, Rice, goat stew, plaintains, bananas... thank GOD I love beans and rice!

The Hinche water supply is ok for washing, but not drinking. All drinking water is trucked in, or folks boil it before drinking. My water bottle, which I fill when we eat our 3 meals a day at Father Jacques’ rectory, has become the only thing I drink from. Hinche has no public electricity. Power is on only at night, and only in houses that have generators or large strings of car batteries. My little battery-operated booklight is another best friend. At night, candles and small fires, light some of the homes. Anywhere there is a streetlight, or any light on the street, there are small groups of people, reading, including adults with books and newspapers, and children with schoolbooks.
So we spent Saturday in travel and preparation mode, and on Sunday we'll go to Mass....then Monday, the real work begins. I hope I can do some good.

Welcome to Haiti!

Welcome to Haiti!
Friday, March 6, 2009

Miami, FL, connection to Port au Prince: Even in the airport terminal, it’s clear which gate is for Haiti. More people crowded and waiting, less luggage and more plastic bags, more body odor. It’s clear we are not flying to a tourist destination or a wealthy place. I sit down next to a Haitian –American lady and learn my first word in Creole: “Famn Saj “(midwife). I find Steve Eads, the OB-GYN from Richmond who serves as medical director, sitting on the floor talking on a cell phone to his wife one last time before leaving the country. Nadene Brunk, founder of Midwives for Haiti, and June, a peds RN and veteran of many trips, come along soon after. June functions as pharmacist and fills RX’s in the clinic. Cathy and Cindy, the 2 NP’s of this trip, are due on a later flight in the pm. We all have separate seats, as we booked separately, so don’t get to talk much on the flight.

We all meet up on the tarmac, happy to see 80 degree weather. The mountains surrounding Port au Prince are big and dry right now—reminding me of Las Vegas terrain. The airport scene is hectic but manageable but it’s great to be there with veterans: 2 different drivers were present to pick us up, so one is very disappointed. At the exit doors, over a barrier, a crowd of drivers are all shouting and haggling to get some work...welcome to Haiti! We have hundreds of pounds of baggage, but finally get it all into Nadar’s bus and start our ride through PAP to our guesthouse.

The Port au Prince streets look like a war zone, literally. Pot holes like bomb craters. A crazy jumble of compounds, schools, shops, street art, and street vendors. Goats, chickens, a few skinny dogs. Live chickens for sale. Cinderblocks and concrete, and lots of half-finished houses with only a curtain in the window; no screens, no glass. Finally, we rested at the Bensons’ guesthouse compound, a very simple but refreshing oasis that offers accommodations to missionary and medical missions. Shade, tile floors, a breeze, cold water, locked gates. Haitian art for sale in the front office. A great view from the roof of the surrounding city and mountains.

I get a good background story of the M4H program from Nadene and Steve. There’s discussion about the new class of midwives starting during this trip, that we’re coming to facilitate. On Steve’s laptop, we view the slide show of the graduation of the first class of midwives...So moving to see all these faces of new midwives, and to understand the work it took to train them. As it was the first class, and presented many organizational and logistical obstacles, it took 2 years to completely train 7 midwives. Now, with much more financial support and experience, and Haitian connections and alliances, the hope is that it may take 6-12 months. Just before dinner, we walk over to see “the Ravine”, a neighborhood just around the block from the guesthouse, and one of the most dense and impoverished sections of Port au Prince. This is an astounding experience. (see“Beans and Rice and Singing”)

Dinner is traditional Haitian food, served family-style; Beans, Rice, goat cooked with onions and carrots, fried plaintains, sweet potatos, salad, mango. A cold shower (hot water does not exist down here—but I have the SUNSHOWER along!!!!) ...exhaustion... and a deep night sleep.

Beans and Rice and Singing

The Ravine, outside Port au Prince, Haiti is a 40-acre ravine over a small river. Both sides of the steep ravine have been built up with concrete and cinder block and tin roofs, one on top of another, to house an estimated 70,000 people. There is no power and no clean water supply except what is carried in. My group of 7 health care providers stood at the edge of the Ravine on Friday night, my first night in Haiti, as dusk was falling. Adults and children filtered up and down the narrow winding path, to and from their homes, carrying water in jugs, small plastic bags of bread, rice, and charcoal. Candles flickered and charcoal fires were lit. As dusk fell and my brain and heart tried to grasp the reality of this many people subsisting in a space with this few resources, the smell of sewage mixed with the smell of beans and rice and smoke from cook fires. A church choir began singing a loud song of worship, a flute tune drifted up from a tiny concrete dwelling, and I had my first lesson on Haiti: the poverty in material things is profound; they survive on less "things" than I could have ever imagined. And their hearts are deeply spiritual. Most education is done through churches, and most events are begun and ended with prayer. And in the midst of this intense need, they sing.

MORE STUFF and LOVE too

Thursday Evening, 3/5/09--MORE STUFF!

Well, okay. My 2 large, carefully packed-full bags turned into 3 large bags when, on my last day seeing patients in the office, my first patient gave me $200 "for whatever will help those moms and babies"...and then the Citranatal drug reps walked in with a trolley and 3 enormous cases of prenatal vitamins!! So, a third bag was borrowed and packed, with EVEN MORE STUFF, and I'll use some of the money to pay the $100 extra-bag fee that the airlines charge. I feel so grateful for the the donations of baby supplies, salvaged medical supplies, baby items new and used, and of course, finances. I've received financial support from my midwifery practice (thanks, Margie...), Goose Creek Friends Meeting, and several patients and friends. Many of the Loudoun Community Midwives staff and patients, friends and neighbors have donated diapers, onesies, blankets, pins, medicine, soap, sheets, and more. The staff at Loudoun Hospital's Birthing Inn saved me many pairs of unused gloves, gauze, suture, cord clamps, IV catheters, and much more. I even have a fair amount of healthy snack food I was advised to bring, for taking breaks with the students...apparently the students have gotten very familiar with granola bars thru the American midwives!---how appropriate. There is a lot of STUFF but I really know there is a lot of love and goodwill in the bags. I couldn't begin to make this trip without the support, love, and prayer that I know goes with me.

I think I feel ready, or as ready as one can. I started taking my anti-malaria doxycycline today, made rounds at the hospital for the last time in a while, and wrapped up admin. work at the office. Everyone has been so kind and supportive, and wishes me luck. I'm on call until morning, theoretically, but Margie's additional gift to me is that I can call her early to take over call, in time to get myself to the airport for a 6 am flight. Fortunately...no one is laboring so far, and I can tie up loose ends. I hope to learn how to better use my son Stephen's camera, and also hope to get a bit of time to be with my husband, Greg, until I can fall asleep and get a nap..before the 3:15 wakeup call. He and I've never spent this many days (9) apart and that will also be different. I'll miss him, and my whole life here.

After several huge challenges in 2006-08, including losing my mom to ovarian cancer, personal health and family crises, and business stresses, I decided to focus on a point of view that I consider my mom's legacy: Do More Good/ Have More Fun!
I hope this trip will do some of that.

Midwives For Haiti--Let's Go!

Here begins a blog documenting my trip to Haiti to work with and train rural midwives in Hinche, Haiti, with the non-profit Midwives for Haiti. The M4H concept is that Certified Nurse-Midwives and other medical staff from the US make regular trips to Haiti, with the goal to help reduce the maternal and infant mortality rate there. Training Haitian people in midwifery skills and providing supplies and support for their training is at the heart of the program.

We'll be working with a Haitian certified nurse-midwife who is employed by M4H, and will be helping to start a new class with about 15 students. I'm travelling in a group with Nadene, the founder of the program, Steve, an OB-GYN physician who is one of the medical directors, and several Nurse practitioners who will run clinics while we start the midwifery class. Our classes will be taught in a classroom at the local hospital, and they tell me I may do some work with students at the hospital as well.

I expect an experience that will be entirely different from my daily, cushy life in Northern Virginia. I anticipate sleeping in a mosquito net, frequent power shut-offs, cold water showers, and more poverty and health needs in the population than I've ever seen. I also imagine I may enriched in ways I do not yet know. I do know my heart leads me to care for mothers and babies, with a passion. I'm grateful to have a husband that supports and encourages that mission...and a lot of friends and family do too.... So you're all invited to travel with me, via this blog! Here we go!!