Monday, August 30, 2010

Journal Entry: Aug 27-28, 2010

The women come and come. Very few moments in the labor ward at night are quiet and without a woman in labor. The women come into the delivery rooms when they think they are ready to deliver. They are checked by a midwife or student. If she’s 9 cm or more, she stays and waits to feel the urge to push. If she is less than 8cm, she is sent back walking. Tonite we arrive and there are no sterile instruments. The autoclave is packed and I press the button that turns it on (once we have electricity again, that is). I’m not sure if it’s really working though. The midwives are not sure how the autoclave functions.

We can’t find cord clamps either. I know we had a huge bag full the other day. Ami and I will need to go to the storage room tomorrow and restock. Of the delivery areas, room 5 has two delivery tables. We still need to teach the midwives to use a private room as long as one is open. They gravitate towards putting the women in the same room.
The first mom this evening is having her second child. She pushes out a strong, healthy boy. She doesn’t loot at the baby. I tell her congratulations and that she’s done a good job. The baby is big and beautiful and healthy. My Creole for birth is improving every day. I place the mother’s hands on the baby on her chest. She does not engage.

I am reminded of how harsh these conditions are. Can you really fall in love with your baby if it’s chance of surviving its first 5 years is questionable. Can you open up to your baby if there is another woman laboring 3 feet away from you?
I pull the Haitian midwife aside to scheme about how to get this mom to bond with her newborn. The midwife hasn’t been so nice to her, so I want to engage the midwife on a different level too. In a whisper, I tell the midwife that the mother isn’t bonding well with the baby. I suggest that if she talks to the mother, telling her that she did a good job, that her baby is so beautiful, that her baby is so smart, that the mother will bond with the baby. If the mother is happy, the baby will be happy. If the mother is sad, the baby will be sad. Not far from her years as a student, the midwife complies. She talks to the mother. The midwife is more animated and engaged in the joy of a live birth. I see her smile.
The mother begins to respond when we tell her the good news — she has a healthy baby. 
Baby number 2 is a 17 year old mother, having her first baby. She screams so loud on her final push that I have to walk away from her for a second. The screaming brings the baby and she has a healthy baby girl.

I can tell that this mom has a small tear. I ask Bieneme, the midwife, if she would like to sew or would she like me to do it. She says she knows how to sew and that I can do it.
I want Esther and Bieneme, the midwives, to watch the suturing. I am here to teach. I tell them that I have been a midwife for 24 years and I still watch other people suture. Esther is eager to watch, she was with me on the first night as well. She thanks me a lot for showing her. I get the feeling that they don’t suture often because few women actually tear. Bieneme says she practiced a lot in class on foam. I say that it is different on people and that we should always watch so that we can show each other new tricks.
The third baby of the night, a healthy baby girl, is born in the postpartum ward.
The postpartum ward is a large room with 10 beds. Every bed is full with at least one person and some women are sleeping on the floor. This is also where some of the women wait while they are in labor.
Adeline and Bieneme are chatting in Room 1 when we all hear the loud grunting of a baby coming from across the courtyard. Bieneme springs into action and is out in a flash. Before I even get up from where I am sitting, I hear the lusty cries of a fresh baby from the other room.
It’s a girl, big, strong, covered in vernix. The mom’s fifth girl. I can sense she is a little disappointed. She also has two boys at home. Being a 7th time mom, her labor had putzed and putzed, and she had been continually sent out of the labor ward, not ready. As oft will happen with grand multips, with one final wave of intensity, the baby was born.
A mouse scampers across the floor of the delivery ward. It is 1:30am and 3 babies have been born since we arrived at 8. Thankfully, they are all beautiful and healthy. The pace tonite is steady but manageable. The albino gecko is on the ceiling.

At 3:10am, the 7th time mom is brought in from the postpartum ward. She is having heavy bleeding. Bieneme does an exam and removes about 250cc of clots. The mother has already lost at least 500cc. The midwife is discussing cytotec in Creole. I wake SheLove to help me with the translation. I get 800 mg of cytotec from the Cabinet. I motion to hand the tablets to Bieneme. She says, “You do it.” I place the tablets rectally that are known to be the savior of mothers in the developing world. The husband comes in and brings the tubing and Lactated Ringers that he bought at the pharmacy. This means we can give her IV pitocin. The women are required to buy their own IV supplies because all the other patients in the hospital have to do it that way and they do not want the pregnant women to set a precedent. The injustice of this seems absurd to me. Are they really going to withhold a simple life-saving treatment because they are afraid of offending the other patients? Isn’t a maternal death from postpartum hemorrhage far more offensive?

Thankfully this woman had the resources. We give her the IV. Soon she is snoring and her vitals are very stable. We let her sleep. I tell Bieneme that since she is a grand multip and has lost more than the usual amount of blood, that we need to check her vitals and bleeding every 15 minutes for about an hour or so. Bieneme looks at me and simply says that she is going to sleep. Bieneme is not a student, she is one of the paid midwifery staff. Thus, I can’t really instruct her what to do. Instead, I model, “I’ll watch her then.” Thankfully, the mom’s vitals stay stable and the modeling may have worked. Sometime in the morning I see Bieneme go in to check in on the mom. I asked Ami, “Is she going to check her blood pressure?” As Ami nods her head, I say, “Bon.”

A fourth baby is born before the night is over, another girl. Around 4am, the electricity goes off in the hospital in anticipation of the light of day. We have to work by flashlight and headlamps until the sun comes up. By morning, with all the baby’s born and the 7th timer sleeping, the midwives congregate in Room 3, our usual charting station. We chat, take photos and relax now that all is quiet and the shift is almost over.

Ami and I walk home at around 6am. It is bright daylight and cooler than midday. There is a pick-up soccer game already in action across from the hospital. The field is also where the dirt runway is for the small, 6-seater planes that fly into Hinche.

Women are selling food along the side of the road — fried plantains, avocados, hard boiled eggs, sundries. As we pass the empty churches, the ethereal sound of the church choirs practicing seeps onto the street.

The mile and a half walk home is grounding and peaceful. We are happy to be here in Hinche.

Sunday, August 29, 2010

A Day in Hinche

Our second night shift in the Hinche hospital produced 4 healthy and alive babies. Three girls and one boy. What gratitude for a good night. I showed the midwives my suturing technique on a young 17 year old girl who had the only boy of the evening. Most women here do not tear, so I think the midwives don't get a lot of experience suturing. We also dealt with a grand multip (this was her 7th baby) who had a postpartum hemorrhage. This is my personal developing world nightmare. I placed the cytotec, which has been life-saving here and globally. I also helped the midwife set up the IV, placing the catheter for her and demonstrating an easier way than what she was attempting. This woman only received IV pitocin because her husband went to the pharmacy and purchased the tubing and fluids. Correcting the injustice that these women have to buy these life-saving medications before they will receive them is one of the personal missions that I am willing to take on.

All in all, we had a good night at the hospital. We walked home in the morning at about 6:30am, hearing the high voices of the church choirs practicing already.

Here are some photos from Hinche:
Esther was with us on our first night at the hospital as well. She is quickly becoming one of my favorite midwives. She is already asking us if we can stay longer.

A little girl that we met when we were walking home from the store
There was a soccer game at the orphanage complete with uniforms and a coach. Meanwhile some other boys played music on the sidelines throughtout the game. Mostly drumming, the leader was singing and using a ukelele as a percussive instrument.
These boys preferred watching the musicians to the soccer game!
Without electricity, this woman uses a match to find a Coke in her "cooler" at her corner store.

Saturday, August 28, 2010

Pa Pi Mal

Being in Haiti is full of highs and lows. From one day to the next, we view tragedy and then so much joy and life. The day after Day One, we rested. I finally cried when I got home and was retelling the story about how, after the mother had died, I requested that we all get together and talk. It was the 4 graduate midwives, the two students and the two American midwives. We were all now bonded through our grief. I told them the story about how I went to the Symposium for Midwives and the Women Deliver Conference. I told them that the whole world is trying to figure out this problem of maternal mortality. I told them that they are not alone. "You are the ones who will make this better." I told the students that this is why they need to study hard, get good grades and become full-fledged midwives. I told them all that we need to work harder, stay strong for the women. Globally, many women leave midwifery because it is too hard. The conditions are so intense. They burn out. I told them that they need to talk about the tragedies, about the stress of the job. We can help each other through by supporting each other. Cashmere, one of the graduate students, said that from my words, she could tell that we loved them and that as midwives, we are all the same. Yes. That is it. That is why I am here.

The children of Haiti are keeping me grounded. They are so open and happy. Taking pictures is actually opening doors for us to meet people and to be with them. They all know about digital photography, so you can show them their photo right after you've taken it. They all crowd around and want their picture taken.

Ami and Dina and I went for a walk to the store in Hinche. We are very safe here. The worst thing that seems to be happening is that Ami gets lots of men following her and asking for her number phone. Dina and I don't seem to be drawing the same attention.

We are having a good time, sinking in deeper and deeper to the reality of Haiti. As we walk home from the store, a woman asks me if I want to give her $2 to take her photo. In my broken Creole, I say, "No, I only take photos for happiness." She gets it and asks me to take her photo. She is sitting on the porch of her house with her friends, she is obviously the gregarious one who talks to strangers. She laughs easily and draws the community towards her. Soon, I am taking pictures of all the women and the children. I take a group photo. Many people in Haiti have email addresses and want us to send them the photos. One of the women on the porch runs inside to bring out a flash drive. Wow. So strange, but of course, we can put all the photos on the flash drive for her. She may not have electricty nor running water, but she has a flash drive. She walked with us a few blocks down to the orphanage and we gave her the flash drive and a CD full of the photos.

The orphanage is the most vibrant of all. The children play all day. Our house is located on the boys campus but across the street is where the girls are housed. We go over to visit them everyday. 53 orphaned girls stay there with two house mothers. When we arrive, they swarm over to us, testing out their English, asking us our names, holding our hands. Yesterday before dinner we taught them the bump. Dina and I would show them a move and then they would all take turns dancing with us. It's exhausting doing the bump with 25 little girls before dinner! They are the joy and the hope of Haiti.

There is a way that the Haitians greet each other. When you ask them how they are doing, they say, "Pa pi mal." The littlest 3 year olds, the women in labor, the elders. Pa pi mal means "It's not too bad," or "It's not worse." Living with so little, with such tragedy, with such poverty, they rise up and say, "It's not worse."

Friday, August 27, 2010

Day One in Hinche

WARNING: Graphic content. Read at your own discretion. This is the real Haiti.

It’s 1am in Hinche and there’s no one here in labor. It is a moment of peace and rest. A few of the midwives are chatting while the rest of them sleep in the front room on the hard floor. Four midwives who have graduated from Midwives for Haiti are working tonite, as well as the two students who are in training.

The Hinche Maternity ward of this public hospital consists of two rooms. The front room has a gyn table and hutch which stores the midwives’ equipment. The next room is newly “renovated” from just an empty room with rows of delivery beds to 4 partitioned areas for births. Each delivery bed is an old GYN table with stirrups. Some look like they were from the 1950s, others are a little newer. A square piece of plastic covers the bottom of some of the tables, cleaned and reused after each birth. Plastic shower curtains serve as mild privacy enhancers around each delivery area. This allows each woman to deliver in a somewhat contained area. The women labor by walking around the hospital and return to the delivery ward when they think they are close to the baby coming.

Ami, Dina and I arrived in Hinche this morning and were given the hospital tour by Reina, the American CPM who is employed by Midwives for Haiti. She showed us the postpartum ward which is a large room with 10 beds, each with a mother resting. There is an similar antepartum room where some of the women stay if they are laboring or live too far away to go home. There is no clean running water in this hospital and no bathrooms for the women. Each woman is required to bring her own bucket which she will use for elimination as well as catching any blood, amniotic fluid, the placenta and dirtied clothes or sheets that she has brought along to  have at the birth. The woman usually bring a small cloth or sheet to place on the table as well as clothes or a blanket for the baby and cloths to use for their bleeding postpartum. And their bucket. Some women are too poor to even have these few things. Then we deal.

As Reina is giving us the tour of the Maternity ward, she brings us through the front room where of the delivery area where there is a woman lying on the gyn table with her abdomen exposed. I later learned that she was post-op CSEC. In one of the back areas is a mother who is pre-eclamptic. She had already had 2 eclamptic seizures and was awaiting a CSEC. The midwives had already been waiting for 2 hours and didn’t know when the doctor would arrive. Before we left, she seized again. I saw her naked, slumped body shaking with the involuntary movements of eclampsia. The midwives are trying to hold her up, the woman had seized by the side of the bed and had slumped into a sitting position. I went over to them, asking how I could help. Reina was trying to access the woman’s IV in order to push Magnesium Sulfate and slow the eclampsia. I handed her a new angiocath and was looking for gloves. Where are they? Where is anything around here? Dina and Ami had walked out, not knowing what had occurred, but when they came back to find me, I said, “She’s seizing.” Dina looked pale and I tried to catch her eye to reassure her amongst the chaos. I made Dina run out to the pick up truck to grab our medical bag, if only to get gloves for myself and feel more of service.

The midwives hauled the woman, who was quiet now, with postictal foam on her face and chest, onto the bed. I ended up at the head of the bed, pressed into a corner. Reina inserted the new IV and “pushed the mag” while the other midwives tried to hold the woman down, her thrashing with contractions threatened to dislodge her poorly taped IV catheter. Poorly taped because resources are scarce. The IV was placed, Mag on board, and I squeezed my way passed the midwives in order to leave. When would the doctor arrive? If ever.

The Midwives for Haiti truck takes us back to Maison Fortune, the orphanage where we are staying. Lunch was small fried fish, white rice, white bean sauce and a beet salad. I am hungry and happy for the food- it seems a far cry from rice and beans.

In the afternoon, Ami and I go with Cara to the storage room that is a ride away. Cara is a CNM and Harvard trained-public health PhD who is personal friends with Paul Farmer, the legendary tuberculosis doctor who has changed the face of global public health. She is our “cruise director” for our time with Midwives for Haiti. Both Ami and I have hauled 50 pounds of donated medical supplies and baby supplies. We sort supplies and take back as much as we brought, vowing to stock the “cabinets” this evening.

Ami and I arrive at the hospital after dinner. There are already 5 laboring women in the delivery ward.

 Sandie is the woman in what I will call Room One. It is a three-sided area that has a long countertop below a bank of windows. The walls are painted green two-thirds of the way up the walls which off sets the rust on an old medicine cabinet that houses the “sterilized” instruments. A GYN table with rusted metal stirrups is where Sandie is lying. She is on her back, knees up. In labor. The student midwife, Lidemila is taking care of her but she is not with her now. Sandie is alone, legs open. This is her third baby.

Next to Sandie is Denise. She’s 23 and this is her second child. She is quiet but lying in the same position as Sandie, on her back, knees up and open. I can’t tell where her labor is because she is not making any noise. She is in Room 2.

Room 3 is a GYN table that is being used as our charting station. The midwives sit here and document each birth in the big maternity register.

Room 4 has a woman, Christiane — same position. There is a plastic sheet underneath her and a small piece of colorful cloth that she has brought to lie her bottom on. The GYN table is bare, thankfully all of them are cushioned. But that’s the extent of the amenity. Women are required to bring their own cloth or towel to lie on, a blanket for the baby, any clothes for the baby. Midwives for Haiti supplies most of the medical supplies, all from donations from the US. However, if you have a postpartum hemorrhage, you need to supply your own tubing and IV fluids — available at the pharmacy.

Christiane’s baby is dead and preterm at about 32 weeks. I didn’t know that when the head was crowning and noone was with her. Ami and I stepped closer to deliver the baby. The head was small and misshapen. Maybe that was when Ami told me it was a stillbirth. We delivered a small girl, stillborn. Our first official birth in Haiti. The rag-doll limp of preterm death mocked a perfectly formed baby girl. We rested her body on the table underneath the mother’s bent knee. The placenta soon followed. I wrapped the baby in a blue surgical cloth and we showed the mother the baby. She murmured quietly in Haitian Creole, showing no demonstrative grief, simply compassion for the “poor little one.”

Now what? What do they do here with the bodies, so many bodies. Quickly one of the midwives brought in a small cardboard box. Even at her 1.5 kilos, the baby girl needed to be folded up to fit. Her coffin and resting place. I was told to just put the box aside. Where? Just leave it there along the wall, they will throw it out in the morning.

From my knowing that things can be different, I insist that we treat this baby with dignity. From my knowing that change comes slowly, I leave the box by the wall, covering the baby completely with the blue towel. Later, when the room is emptied and another laboring woman assumes the position, I insist on moving the box into the front room, onto a metal table. This is her final resting place, quiet and away from other women’s travail.

No one was with Christiane because everyone’s attention is on Anise in Room 5. Even a young doctor named Carlos is here. Anise is receiving blood — a rarity here. Her hemoglobin is 4, she is dangerously anemic.

But Carlos is not staying. This is not his shift and he’s going home. Anise is not in labor but her baby is dead and she is sick. Her mother is with her, mopping Anise’s neck and face.

Back in Room 1, Sandie has a normal birth — a baby girl at 8:55pm. I witness the birth and am impressed with the student midwife’s skills. Bon travaille to both midwife and mother.

But Anise’s condition has worsened. She seems to be having a bad reaction to the blood transfusion. Her pupils are non-reactive, pulse 100, respirations 32 and very labored. Her lungs sound wet as she breathes heavily in and out. There is no oxygen here to give her. A doctor is listening to her lungs. Her mother is at her side — silent, mopping.

Anise is 26 years old and 26 weeks pregnant. This is her 6th pregnancy. She has 5 living children at home. At 9:10pm, I count her respirations to be 36, too fast. I am much more in EMT mode than midwife mode for the moment. The medications that the doctor prescribes are unavailable at the pharmacy. She is in critical condition.

I leave to check in on one of the women in one of the rooms. Christiane, who had the stillbirth, has gotten up and dressed and is walking out the door. I thought she was going home, but I was reassured that she was just going over to the postpartum ward.

Then I heard SheLove, our interpreter say, “She died.” I flew around to look at Anise and her labored breathing. She was still, eyes wide. I was drawn to her, incredulous. It is 9:20pm. We had only been in the hospital for 80 minutes and already we had delivered a stillborn, witnessed a live birth, and now a maternal death.

She died.

There was no chaos, no uproar, no kicking and screaming about this untimely death. Mothers die here trying to give birth. Women risk their lives by becoming pregnant.

Anise laid there on the table. Her mother was gone. Anise’s body was naked and alone. I moved closer to touch her foot — urgently feeling the need to honor her, give her some dignity in her passing. I was so inadequate. I moved to her side and began to cover her body with the blue surgical paper that was beneath her. Someone had moved to close her eyes. We crossed her arms over her body.

She was brought to the morgue by two men who came by with an army stretcher. I followed them out, through the hospital pavilion guided by the light of my headlamp. We passed people sleeping on benches and broken hospital beds. I followed them out, wanting to know what they would do with her body. I was the procession as we walked out back behind the hospital to the tomb-like morgue. As we turned the corner to get to the back of the hospital, the men carrying the stretcher began singing, low. The moon had been full the night before so the night light was indigo blue. A few other women were following too. As we watched them open the morgue and bring her in, they asked me questions about what happened. “M’ pas comprend Kreyol.” I don’t understand Creole. I guessed what they were asking and told them the baby was still inside. Anise’s mother’s keening had begun from somewhere in the hospital.

At 10:12pm, Denise had a big, healthy boy. He is alive.

At 4:00am, Melange is here. First baby. 33 weeks. Baby stopped moving a week ago. The baby is dead and she was given a drug to induce the labor at another hospital, then referred to Hinche. Now she is having trouble giving birth.

Melange says she is 20 years old, but since many Haitians do not have a birth certificate, this is just a rough estimate. She looks younger to me. She wants something for the pain, but of course we have none. She does not like any exams, so we let her labor on her own and wait.

At 5:50am, Melange’s baby is born having presented arm first.

This is Day One in Hinche.

Thursday, August 26, 2010

I'm in!!

The first day in Haiti was a whirlwind of cultural integration. We sailed through customs and the Port Au Prince airport with no problems. Sister Mary from Matthew house was waiting there to pick us up. Sister Mary is a small, tough woman who has been in Haiti for 5 years. She was formerly a professor of nursing at the University of Buffalo. She is 78.
Our first drive through downtown Port Au Prince was a dusty, trafficky ride, fighting our way through the crowded streets, sharing the roads with tap-taps, people, vendors and UN vehicles. The air is white-dusty, the humidity clinging. We passed piles of rubble, viewing a few buildings that had been destroyed by the earthquake. Sister Mary patiently answers our questions as we try to get up to speed about Haiti.
We arrive at Matthew House to find a virtual developing world oasis. There is filtered bottled water, electricity, fans, screens, clean beds and towels and a newly tiled bathroom. I love Haiti already.
We ask Sister Mary if we can interview some of the families that are living in the tent city. She knows exactly who can help us -- Tey. Tey is the President of the tent city community. Basically that means that he is the go-to-guy for everything. He took us on a tour of the water filtering system at Matthew House, then brought us over to the tent city. It is mid-day, so most of the adults are out working. The children are contained in a safe place and look after themselves. The tent city was constructed on a soccer field that belongs to Matthew House. 70 tents were donated by the Lions Club and maybe ten or twenty more have added on. It is estimated that 700 people live here now. That's down from the 5000 that were here after the earthquake. This is deemed temporary housing and will be taken down in December. 
The children are happy and that is the hope of Haiti. Within the walled-in perimeter of the tent city, the children play, jump rope, go to school. The above picture is of some of the girls waiting on line for milk. Matthew house offers milk to all of the children every morning. Tey mixes up the milk from powder at around 6am. The children wait on line with a cup in hand. They each get a glass of milk. 
The tent city also offers a special larger handicapped tent. 10 people stay there, all amputees from the quake. We talked with a beautiful 14 year old girl who lost her leg.
A young family found us and wanted to show me their baby. We worked our way through the tents to where they were. A beautiful, chubby 3 month old was sleeping. They woke him up and dressed him so that we could take a picture of him. So proud.

We saw so many smiles. We are learning Creole. We are experiencing Haiti. We're in!

Wednesday, August 25, 2010

Night shift at the hospital tonite. Will go to Internet Cafe tomorrow.
Efforting Internet access with Data card. Worked in Miami. Nothing yet here.
We had an amazing first day in Haiti. 700 people living in a tent city the size of a soccer field. We met the children. Woman in labor overnite. Today w
e fly to Hinche.

Monday, August 23, 2010

Thank you, Sharon!

Sharon Hamilton, former President of the Midwives Association of Florida, is the hostess with the mostest here in Miami. She took us to the beach, the giant Whole Foods for last minute provisions, the local Borders for a Haitian Creole dictionary (too heavy, we didn't buy it, don't they have a pocket-size?). Ami Burnam has joined us and a final 45-minute call to AT&T should put us in good Internet access while we're away. We leave first thing tomorrow morning and should be in Port Au Prince before noon. The heat and humidity here in Miami are breaking us in, one last night of air-conditioning though. Clothes are all sprayed, ready to go.
Check in tomorrow!
At JFK in NY. The big bags weighed exactly 50 pounds each. Dina's camera equipment weighed 33 pounds and my medical bag weighed 30.

Sunday, August 22, 2010

50 years!

Yesterday, we celebrated Dina's parents' 50th wedding anniversary with a big shindig in Port Jeff. My mom and dad came down from Rye with Viola and Mary. There were about 70 people there with music and food and a good time had by all. Dina's parents are in love after 50 years of marriage. They renewed their vows and Walter kissed his "gorgeous bride."
This was our last big event before we leave for Haiti. Today is being spent registering online with the State Department, packing up, making copies of passports and tying up loose ends. We can only bring 75 pounds of stuff each, so I hope we are not over limit. By tomorrow evening, we will be in Miami, hopefully drinking a cool one on the beach before our 12 days without easy water and air-conditioning.

Friday, August 20, 2010

The Launch

The last step of the launch has finally occurred: Tyler is away at college, in his dorm, out on his own, at the New School, in New York City. The day was a long one in NYC for us, starting from the 6:57am train on the LIRR. We arrived at Penn in time to reach B and H photo by 9:15am. I needed to return the "nifty fifty" that arrived broken to SF. The Nifty Fifty is a 50mm f/1.4 Canon lens that I purchased for the Haiti trip. I will be using an older Rebel body from Dina's sister (all this info is for the camera buffs).
Then we headed over to the UNFPA office to try to get copies of Adding It Up and Women are the Fabric. I had a feeling that somewhere in NYC there was a storehouse of UNFPA publications. Well, we found it!! And Jay filled my backpack with info for the MANA board. It was all very heavy, but I was delighted.
Grand Central is only a few blocks from the UNFPA office so we headed over there to meet Tyler and Mary. A quick cab ride got us all to The New School for THE TRANSITION. Tyler unpacked in his dorm room while we found the local pizzeria for meatball and chicken parm wedges. Tyler is going to see what REAL italian food is like!
We had various tours and orientations and I was pleased at how the school told us over and over again how they were going to keep our children safe. They sure know how to treat a gal. The school is so awesome. It is in a really clean, hip part of Greenwich Village. The buildings are spread out over a four or five block area so NYC is really their campus. Tyler was already finding his way around without us. I loved it! (I better, given the price tag!!)
But it truly felt like The Moment we had all been waiting for with trepidation, excitement, tears and relief. After meeting Tyler's godfather (my cousin Adam) and his partner, David, for a lovely Mexican dinner, Tyler finally left to be with the other students.
The cab ride and LIRR journey back finally allowed the empty feeling to settle in. When I get back to SF, he won't be there.
It has been quite a ride, but we have spiraled around and around, finally coming to rest at a place of mutual respect and admiration. He just texted back, "Love you too!"

Thursday, August 19, 2010


Jay at the United Nations Population Fund hooked me up with pounds of pamphlets!!

Sent from my iPhone

Grand Central

Waiting for Tyler and Mary. We're dropping Tyler off at The New School in Greenwich Village. College in NYC, what's not to like?

Sent from my iPhone

Tuesday, August 17, 2010

Coalition Kick-Off

So, the coalition is off and running. Thank you to Lorrie Kaplan, Executive Director of ACNM, for opening the meeting with hope and willingness to "Stand in the present, walk in the future." Representatives from MANA (Gera and I), NACPM (Mary Lawlor), ACNM (Lorrie, Tina, Eileen, Patrick, Monica), Childbirth Connections (Maureen Corry), AWHONN (Cathy Ruhl and Kerri Wade), Amnesty International (Nan Strauss and Christina Finch) and AABC (Karen Fennel) were at this historic meeting. The presidents of MANA, ACNM, and AWHONN were all present via phone.
We talked with guarded optimism about models of coalitions that have worked, using the MAMA campaign organizational structure as a working example. Patrick Cooney, ACNM lobbyist, gave an overview of possible scenarios that may unfold over the next 3 or 4 months in regards to the Roybal-Allard legislation.
The task for each organization is to go back to their respective organizations and discuss possible improvements or challenges with the bill. MANA and ACNM, as well as the other orgs, will try to find common ground as we discuss the specifics of the bill.

Side Trip

to Washington, DC. I am blogging from the Acela Express, the American version of a speed train that travels up and down the East Coast Corridor. I left Port Jefferson this morning at 5:40am in order to get into Penn Station by 8 for the Acela. I have to say, I like it! When I first sat down, I actually had to ask the woman next to me if I was in the right section because I couldn't tell if where I was was first class or not! Two electrical outlets and a good WiFi connection are making me very happy.
I am heading into the ACNM headquarters in DC for a coalition meeting. It would be ordinary, if it weren't so unusual. ACN
M has invited a core coalition to meet to discuss the Roybal-Allard bill regarding maternal health, "HR3740--"Moms 21"--and other emerging federal legislation focused on improving maternity care." The coalition will include: ACNM, MANA, NACPM, Amnesty International, AWHONN, Childbirth Connnections and ICTC. This will be an historic moment for us all to work together. I will blog after the meeting to tell you how it went.

Monday, August 16, 2010

Email Blogging?

Now let's check this out. I am emailing this blog post. Internet Access in Haiti seems sketchy at best. I am wanting to find as many ways as possible to access this blog.

Sunday, August 15, 2010

Waiting for the train in Stamford, CT. Will head to Bridgeport where we take the ferry to Port Jefferson. Almost all Haiti equipment in tow.

Saturday, August 14, 2010

I guess mobile posting is more like Tweeting. Arghhhhh !
Read last 4 posts from bottom up.
? glad you know this stuff?
? would need. They're like fancy walkie talkies which are called handy talkies (or HTs) if what you really have is a handheld mobile ham radio. Aren't you
? g out the ham radios and trying to figure out how they work BEFORE we get to Haiti. I think I understand a couple of simplex frequencies which is what we
? Sittin' on the stoop of the East Durham "reading room." It's a closet-sized library that offers free Internet service here in the Catskills. We're testin

Friday, August 13, 2010

Mobile posting?

This is a test to see if I can post from my iPhone. Did it work?

Thursday, August 12, 2010

Mountains Beyond Mountains

Mountains Beyond Mountains, by Tracy Kidder, is the story of Dr. Paul Farmer, who dares to dream that tuberculosis can be cured in the poorest regions of Haiti, Peru and Moscow. The man is incredibly smart, having been educated at Harvard, but more important is his passion for the poor. He is daring and resilient, driven and compassionate. He makes the case for Margaret Mead's famous quote that a small group of people can change the world. I am inspired by Farmer, if not riveted to the descriptions of Haiti. The landscape, the poverty, the illness. The title of the book reflects a Haitian proverb that implies that beyond every mountain, or obstacle, is another mountain - or obstacle. The work is never done.
My bags are packed for Haiti with donated supplies and medicines. Here is what I am bringing:
Baby blankets (a duffle bag full)
Baby clothes
8 Head Lamps
8 Wrist Watches with second hands
8 Rain Ponchos (there are 8 students in the most recent graduating class of midwives)
100 doses of Pitocin
2 Bottles of Misoprostol
Bulb Syringes
A used Doppler that still works
2 Ham radios
Mosquito Netting
DEET insect repellant

What else? I will be travelling down with 2 large bags and will be donating almost everything except the clothes that I need to wear home and my camera equipment. Thanks to Isaac, I have a global data card for the computer, now just need to find a SIM card in Haiti and I will have lots of Internet access. So, if you hear from me, I found the SIM card. If I'm sporadic, I'll tell you all about it when I get home!

Monday, August 9, 2010


Thank you so much to Laurel and Meggie and Sean from Texas for fundraising for Haiti. Laurel is 8 and the daughter of a midwife. Her little neighbor friends Meggie and Seam helped her raise this money that they sent on to me. I will use the donation to buy school supplies for the children at the orphanage in Hinche. I leave today for New York and then to Haiti on the 24th. I will try to blog from Haiti, so stay tuned!