Ten Years and Three Minutes

Someone needs to write a book about Nadene Brunk and the story of Midwives for Haiti; maybe someone is me.  Ever since I saw the first email she sent out in 2006, inviting American midwives to come to Haiti to teach skills to Haitians, this effort has had a gripping hold on my heart.  TEN years

have gone by since the first group of 8 students in Hinche (now formally named "Class One") gathered in a courtyard under a mango tree to study maternity care with American volunteers and a couple ragged posters.  Now on Sunday, I serve as the marren, or "godmother" of Class Ten, 30 students.  The role is an interesting Haitian tradition, and seems to be kind of a cross between Maid of Honor at a wedding and an AA sponsor.  I give a little talk and give presents.  So. I will try to celebrate and commemorate 10 years in about 3 minutes, at the graduation ceremony.

 The talk, which I will give in Creole and English, is mostly just a laundry list of whom should be thanked and honored, kind of like an Oscars acceptance speech, and about as fascinating. It is, however, my job and the proper thing to do, according to Gladias, my closest Haitian friend and translator of all things Haitian.  I wrote it in English; he translated it in Creole, and I understand most of the words.  The things that really thrill me are not in the speech, due to the 3-minute goal. Plus, Historian is not my job for now.  If I write the book, it will be!

I am happiest that I truly believe women in Haiti are being helped, and lives saved, by the ever-growing group of Midwives for Haiti graduates, a number now well over 100,  and 94% of them employed.  I'm also thrilled that we no longer work out of 2 closets, one hospital classroom, and a church rectory, as we did when Nadene and Steve and I attended the start of Class Two.  Even better, our Jeep drives on a highway all the way to Hinche, instead of flying in a tiny plane and landing on the dirt airstrip after the goats were chased off.  And oh, the LandCruiser! MFH has 2 motor vehicles now, a Jeep and a LandCruiser, and sometimes, both of them are running ! Once, we got around in Ronel's 1984 Hilux truck with wooden benches in the bed for seats.  These are only a few of the near-miraculous accomplishments and blessings of Midwives for Haiti over 10 years that we are all celebrating. This ramble down memory lane is a bit over simplified, and reminds me of a dad that once told me " when they're little, they have little problems; When they get bigger, they have bigger problems."... It's true for non-profits, too, and makes me reflect on on how to help MFH. Find funds for solar power panels to energize the compound where the classroom, offices, volunteer housing, and supply depots now reside.

Nonetheless, something now exists, something that I think is good, and it has grown by close collaboration with Americans, Haitians, and the hard work of people with huge hearts, to the benefit of mothers and babies in Haiti. The conclusion of my 3 minutes is "With God's help, we have done this, together."  

This is Beautiful

This will be a Blog of Duality.
I will tell the story of today in a non-medical way, and then, since I happen to have a lot of OB/ Nurse/Midwife friends, a more technical way..  Please read whichever version suits you, neither, or both.  IT WAS A VERY FULL DAY.

Non-Medical Version:
Today was a terible and wonderful morning at St Therese Hospital.  Despite the tough conditions, I keep seeing progress.  I took a photo of the medication/midwife office and sleeproom, intending to label it "This is Beautiful".  Some would see banged-up antique cabinets and a rusty bed.  BUT It is clean, organized, (more all the time!) and has the medicines available to save lives, and even small lockers for all the midwives' purses.  6 Years ago I would have fainted in delight to have this tidiness and functionality.  Today I didn't faint, I just felt happy, and went into L&D.  A quiet morning turned into a busy one.  I worked with 2 new student-midwives.  We admitted and delivered a lady in premature labor.  Mama was in labor with  a 7 month pregnancy that turned out to be  (surprise!) twins, a girl,who survived, now in the Neonatal Intensive Care Unit,  and a boy who never took a breath on his own.  This was a huge morning of learning for my students.  While part of it feels so sad, I am proud and grateful that really good care and kindness was given in a bad situation.

Medical Version, copied from an email to an OB GYN friend of mine:
   This am, I spent 2 hrs at St Therese.  With 2 students, I delivered unexpected 28-30 wk twins.  A, girl, cephalic, followed by surprise baby B, boy, breech.  She was resuscitated ok and is in NICU, he never breathed on his own and mom never held him.  But Alice, this sounds horrendous, yet I can tell you so many good things.

The students were great.  They took vital signs and started the IV properly.
In spite of unskilled brand-new hands (each had 1 prior delivery), they knew what they were doing.  They got terrific learning through this case.  ( And I did a good job teaching them !! )
The med room was clean and full of meds and supplies.  The birth kits are all together and available.
We had all the clean things we needed for the birth and resuscitation-- including a NICU doc!
The boy who died was dressed and treated respectfully.  As is typical, Mom would not hold him nor name him, but she did see him.
The place still looks yucky; the water still barely runs in the sink, and blood and fluids do pool on the floor during the deliveries, and those tables are horrific.  BUT.  So much progress since my first crazy delivery there in 2009.  Things are much better.  We need to keep going, and keep circling in prayer the desires and dreams that God put on our hearts.

Bon Nuit from Haiti!

BON NUIT FROM HAITI, MY FRIENDS

Why Ask Why? It's About the Heart.

Port au Prince is NOT a lovely city.  Even with notable improvements in areas like the airport, goats climbing thru trash heaps, snail-paced traffic spewing carbon monoxide betwixt water-filled potholes, and a strong smell of human body odor and urine, don't add up to a tourist spot.

Even staying at the lovely home of my midwife friend Beth McHoul is a lesson in Haitian security.  A thief was robbing ladies coming to & from the maternity center of their cell phones and cash.  The Heartline Ministries guards seem to have fixed that for now:  A guard watches the street from a little tower, and as always, 2 mastiffs are on duty.

So, DEAR GOD,
Here we are in Haiti again, You, Greg and I, as well as lots of Haitian people and  some American missionaries, and others.  Even though (or maybe, because?)  I've done this trip enough times to stop counting, I am asking myself, and You, exactly why I keep doing it.  I know the first trip was kind of a humanitarian adventure/educational experiment in embracing the "third" =developing world.  It deepened my heart and broke it, too.  The first evening that I saw the small bags of bread, charcoal and bottles of drinking water carried into the Ravine in Petionville, and heard the church choir start up, my perspective of the world shifted forever.  Sometimes, after that, I woke up weeping.  Later, after the Port au Prince earthquake, I could not weep for months.   But Haiti has become an important part of my life.

   Haitian material poverty, maternal mortality, along with myriad other issues, are so huge and complex that it's absurd to think I am "fixing anything" by coming here a time or two per year and helping teach or support some midwives.  But I love to come back and visit, and do a little bit of work, in Haiti.  I know now that I'm coming here to reach deeper into my own heart.  I also know it's part of what You want for me, and a way to teach me and reach me.  Thanks for that. Lord, from my deepest center.

I love to hang with the Heartline Midwives, share our life stories, birth stories, and a few of their tasks.  I only visit, bring a few bottles or boxes of  medicine,  check a few mamas.  Still, the impact that prenatal care, family planning, or safe midwifery and birth makes in one life, or a family's life, and ripple effect in many hundreds of lives, gives me hope, in spite of it all.  It's evident that we humans can't "Fix" this.  But we also know that You ask us to do what we can, and You honor it when we do.  It means something anyway, to me, to You, and even to some Haitian people.  Do the numbers really matter?  Maybe not at all.

It will make my heart glad to see my Haitian friends and god-child, and see their lives unfolding, and to deliver the silly, small gifts that fit in our luggage.  This time, new t-shirts, a set of plastic dishes, medicine for the hospital.  Greg will build cabinets in the Flower of Hope School, and meet with the staff, as a new Board member.  I'll help teach some classes on managing blood pressure and pre-eclampsia in pregnancy.  I'll give blood at the Red Cross; after being in Haiti, I can't donate in the US.  We will do each task in full realization that these tasks are drops in the ocean.  But we will do it from the heart, and in doing so, You nourish us.  We can only do one thing at a time.  Why not make it something fundamentally helpful to just one human?

These trips have a humbling, infinitesimal but real, rational basis and a very large spiritual one; I just accept that.  Thank you again, Lord, for the clarity to keep it simple, and the gift of coming to Haiti.

What are the ODDS?

Haiti, and midwifery, are full of  surprising (or shocking...it just depends) experiences, but Monday morning was yet another one.  Just what are the odds this could happen--? On a once-a-month visit to Dos Palis,  the Mobile Prenatal Clinic arrives in the village, we set up tables and supplies in the empty concrete church, the benches fill with pregnant ladies,...then one of them walks in, to the head of the line, gives a loud shriek, and starts pushing her baby out?   She was moved to the "GYN corner" table, Magdala Jude (trained in Midwives for Haiti Class 2) gloved and performed a very straightforward delivery, and I received the newborn baby, a healthy 6-lb girl who came out yelling like her mom.  In this case, I really think the clinic may have saved the lady's life, since soon after the birth she had a big blood loss that required more than the usual medicines.  We had all the necessary stuff, however, including oxytocin and misoprostol, though how the midwives find them in those dusty suitcases is beyond me.   The new mom was quickly stable, then rested for most of the morning on a clean sheet.  Mostly she rested on the table, but a few times, we needed to examine someone on it,  at which time she sat on a nearby bench, nursing her baby.  I bought her a bottle of juice, and someone brought her clean clothes. So, what are the odds of giving birth at the clinic that comes in a Jeep one morning a month?  Did she labor all night, waiting for us?  Did she walk to the clinic that morning, stopping along the dusty path for contractions?  How far did she come?  The village "matwon" (traditional birth attendant), who attends the local births, said "not far", but it's far enough ....By the end of the morning, she walked out to the road with a little help, and got a motorcycle taxi to take her home, baby wrapped in her arms and a couple clean blankets.   I truly do think think it could have saved her life.  As we're fond of saying at my midwifery practice at home: You Could Not Make this Stuff Up!!

Spider-Man and the Cabinet-Makers

Spider-Man and the CabinetMakers

It's not easy to be married to a midwife, and even harder to last decades.  The reasons are obvious- the crazy hours, dinners or shopping or laundry abandoned, daytime sleeping (if you don't have little kids) and  childcare chaos ( if you do.)  The many times that the spouse gets the bottom of the barrel, emotionally, after draining labors and all the other stressors of this life.  Not only has my dear husband Greg hung in there with me, but in recent years, I've been able to convince him to come to Haiti, too!

Thus this trip has a couple Surviving Hero Mid-Husbands:  2 life- long, 30+ year partners, mine, and Jessica Jordan's husband, David.  Both experienced carpenters and re-modelers, Greg and David may have one of their most unique re-hab projects ever, as they are re-building and painting the broken, torn-up cabinets at St Therese Labor and Delivery Rooms.  Before today, I think neither of them had to measure space and evaluate wood structure literally 2-3 feet away from a laboring woman- much less one VERY vocal and with an urgent need to throw her dress off.   The guys were entirely unruffled...tape measures clicking.  That is what 30 years of having labor and birth conversations can do. I did stand by the lady and rub her belly and her back, mostly in order to keep her from kicking the guys or grabbing their arm as they walked by. 

Now the CabinetMakers are deep into their piles of tools and supplies, figuring out how to get those doors off, painted, the structure repaired, and then the doors back on, with new hardware, this week.  Clean, organized medical supplies- - a lofty goal, and also must be done while birth goes on!  They sure do deserve the cold beers at the end of the day that will also be supplied to them. 

My husband won the Hero award early, however-- he killed a huge Spider this morning that we'd been warned about last night.  I'm talking a 6 centimeter spider that moved fast, lurking in the corner of the ceiling.   Greg nailed it wth a towel, threw it on the floor and stomped it dead.  Herosim is not dead, this week in Haiti. 

Interview Day

The young woman wore dressy sandals on her feet with smudges of mud and dust on her ankles, but her top half was wearing a very cute green and orange flowered dress.  In the middle was a little round tummy smeared with ultrasound gel.  She is seventeen years old and pregnant...how far along, she has no idea.  When I put my hands on her belly, I had a pretty good idea that it was about 18 weeks along.  The ultrasound came up with 17.  She lives with her aunt and doesn't know where her mom or dad are, or if they are even alive.

It's "Interview" day at Heartline Ministries Maternity Center in Port au Prince, Haiti,  a day when pregnant applicants verify their pregnancy with a urine test, and hope to get into this program that will give them weekly pregnancy care and health services including their birth, all the way to 6 months postpartum.  There are only 50 slots in the program.   Today, 25+ showed up and sat for hours for a chance to be in this lucky club.  They waited a long time, as it was busy; this morning, the 6th mom of the week delivered at this little birth center.   6 new moms, none have gone home, and Heartline has beds for 2, officially.  The rest are cared for in office space and the birth room.  2 mamas nearly ready to go home both dressed and moved over to share one bed as a couch, where they ate breakfast and nursed their babies.  The new delivery got the clean, vacated bed and settled in with a sigh.  It's so nice when a birth is OVER, both for the mom and the midwives!

The midwives and staff didn't get a lot of time to sigh, however...Besides Interview day,  each Friday is also Family Planning day, and the covered porch was full.very full, of women who came for a  3 months of birth control.  We gave nearly 80 Depo injections and I inserted 2 IUD's that will give 5-10 years of contraception.  I also stitched the post-partum mom, took blood pressures, and examined the newborn who is a healthy 7-pound boy named "Reggie", but this was minor extra work.   Meanwhile the real Heartline staff midwives and doctor did ultrasounds, prenatal visits, treated a mama's high blood pressure, and conducted the interviews.  I really missed my nurse-"peeps" from home who came with me on a recent trip, (Jen and Alicia,) due to to the aforementioned hypertensive lady and a new mom with big breastfeeding difficulties!  

At the end of the day, two of the mothers were ready to go home.  I piled in along in the ambulance/SUV with the moms and their babies and their bags of donated baby supplies.   Midwife Tara almost ran over a pig deep in the muddy rut of one of the roads...yes, this is urban Port au Prince.  We escorted each mom to her house- both tiny affairs with concrete floors and corrugated metal walls and tarps for shade just outside.  One old Granny really lit up as her new great- grandbaby was brought home to her safe and clean and healthy. We prayed with the moms and babies, for their health,safety, protection.  That's not the afterthought-- it is the heartbeat of this amazing work in Port au Prince, that is so small, but so true, so poignant, thereby so powerful, and nourishes not only these Haitian women, but this American one, too.    Bon nuit from Heartline, Port au Prince, Haiti.   

This is Why

Greg and I leave early this morning on Trip Eleven to Haiti....and this is why we do it!
From the Blog of Nadene Brunk , founder of  Midwives for Haiti..."Ten Things I Learned in Haiti"

It will be great to see Haiti friends on this trip...I no ask for a lot of things for donation, as there is a whole part of my house full of donated items.  Also,thanks to sister-projects such as Christy Turlington-Burns' "Every Mother Counts",  MFH has have more resources to help this work. ( Money still needed.  Oh yes.)   Yet, today there was an urgent email from Haiti with a list of items needed...then I went to Costco for ink cartridges, batteries, and Trail Mix!  My wonderful hospital administrators came through with syringes and alcohol pads.  My husband, Greg, is exhausted from remodeling our house, and now he comes with me to Hinche, to fix up the supply cabinets in Labor & Delivery at St. Therese Hospital.  I thank anyone who cares to come along on this-- it keeps on going and I do love to work in Haiti.  Nadene's Blog tells why....see you soon, in Haiti.!