This is Haiti

 On my third shift in the hospital, I worked with an American nurse-midwife named Cathy. I helped with a couple of deliveries as she labor-sat with a 9^th timer who was almost complete. It was unusual that she wasn’t just spitting her baby out. Her contractions were short and far apart. We had her up and walking but she became a spectacle in the labor ward. She has gray hair and thus, many people, waiting in the hospital for other loved ones, started staring at her and following her around. They wanted to see how this “gran moun” (old lady) would deliver. We finally gave her a private space in the maternité so that she wouldn’t be the object of such gawking. The labor (or non-labor) was going on for hours.

Finally, it was decided that her labor would be augmented with pitocin. I didn’t think that this was a bad idea, seeing that she was a hemorrhage risk and that the weak labor pattern would make that worse. Within an hour or so of receiving pitocin, she was screaming her baby out. Again, a little unusual. I would have expected a 9^th timer to be an old-pro. Anyway, the baby came. But, it didn’t breath. There was meconium staining and the student midwife on staff was slow and clunky with her aspiration of the baby’s nose and mouth. As I saw that the baby was not breathing, I asked for the ambu bag and began the resuscitation. The baby was still unresponsive and apneic (not breathing). Within a minute, we had also begun chest compressions because the baby’s heart rate was low. Cathy did the first shift of chest compressions as I bagged the baby. I began the mantra of neonatal resuscitation. One and two and three and breath and one and two and three and breathe and…… Over and over. The baby, a little boy, was not responding. He most likely had meconium in his lungs and the, ultimately, quick delivery did not allow for enough squeeze to get it all out. Most people believe now that meconium aspiration is the result of an in utero distress. In the U.S., we deal with it often in the NICU and the babies live.

This little guy, though, was not going to have that advantage. We resuscitated him for 30 minutes, which is a long time for that kind of thing. He was finally breathing on his own, but he never took a full cry and he had the rhythmic agonal gasping of one who is desperately trying to receive air. Miss Genette offered that we could try to find a pediatric doctor to help. I thought that was a great idea and so I carried him out of the maternity ward and across the courtyard to the largely, ill-equipped pediatric unit. The baby boy was breathing on his own, but was still limp and unresponsive. Cathy and I would continued ventilating him with the ambu bag which seemed to be offering him more support. Miraculously, the doctor somehow came up with an oxygen machine. So, we put a nasal cannula on the baby and observed.

He definitely seemed to be doing better with the oxygen, but I still felt that this baby needed more care. Could we transfer him to Paul Farmer’s hospital 45 minutes away in Cange? The doctor agreed that this was a good idea and said that he would make the arrangements. I left the hospital about an hour and a half after this birth, having stayed with the baby the whole time. I felt that he was doing a little better. He had a little better muscle tone, but he still hadn’t cried and most of the time, his eyes were closed. He was receiving the oxygen and was now under the care of the pediatrician. I was adamant with them that this baby needed to be watched carefully until he was transferred to Cange. Miss Genette left the hospital 3 hours later and the baby still had not left yet.

The next morning, back at the hospital for another shift in Labor and Delivery, I asked about the baby. Miss Genette did not know, but we finally found another midwife who had the news. The baby had died on route to Cange.

I felt numb. This baby would have lived in the U.S. But this is Haiti, and the hospital does not have a NICU, does not have good suctioning equipment, does not have endless supplies of oxygen. I don’t even know if the baby had medical support on the drive. All I know is that a family member accompanied him.

I saw the mother in the postpartum ward and told her how sorry I was. She was resolute and quiet. I also knew she was about to pick herself up and go on with life. There is no time in Haiti to mourn the loss of a baby when you have 8 other hungry mouths to feed. Death is sorrowful and yet, not unexpected. The town of Hinche has at least 3 or 4 coffin shops where the wood workers display their hand-made boxes along with school benches and tables. We saw a coffin being carried down a dusty, dirt road by a procession of pall-bearers and community members. Out in the middle of nowhere, obviously they were headed to a burial spot. Death. This is Haiti.

                                   *************************************************

Women waiting for prenatal care at the mobile clinic

                                  **************************************************

At the orphanage, we have been playing and hugging and getting to know the girls even better than before. We have been staying at their orphanage, which is now separate from the boys. It is nice this way. The girls can maintain their own little world, not having to worry about their safety or the taunting that comes with the sexual tension of teenagers.  Of course there are the occasional sibling spats: hitting, crying, hurt feelings. But it doesn’t seem to last long and for the most part, the girls are happy and peaceful. I wonder sometimes about how to give them things in the most appropriate manner. We brought a volleyball net, 12 balls, knee pads, team T-shirts. That all went pretty smoothly. But then I also had my special gifts – earrings, necklaces, shirts, all “extras” from home that I knew would be appreciated by the girls. It is hard to give one girl something. There is a strong need and feel for equity and justice amongst Haitians. But, inevitably, there are the girls who become our favorites. My favorites this year were Joska and Marlande. They are both about 9 or 10 years old. Marlande is confident, beautiful, a strong singer during the evening prayers. She was affectionate and fun with me. When I gave her a special beaded bracelet, she gave me a big hug around my waist. She is easy with her love. Joska is more reserved although when pushed for a photo, she strikes the pose with ease. She is thinner than the other girls and Dina says the house mother told her that she has a medical condition. I do not know what it is. But, I enjoyed her easy smile and feisty spirit.

Joska

On the last day, we were cleaning up and I had a leftover baguette. There were a few girls sitting on the porch outside our room, so I offered it to them, saying that they had to share it. As soon as I gave it to them, a near riot ensued. Like a pack of wolves, they pulled and shouted and fought over the bread until a house mother broke in. This is Haiti and although I only heard it mentioned twice, I know the girls are hungry. They eat plain spaghetti in the morning, beans and rice at noon, and cream of wheat at night. Always the same, except for one day a week, when they get a chicken leg.

With the final clean-up, I swept the front porch and scooped the trash into the garbage bag that we had been using all week. One of the girls offered to bring the trash to the garbage area for me. I was happy for the help but also wondered in the back of mind if she was going to go through our trash.

Of the many things that I had brought to Haiti, one of them was a stack of this year’s baby cards. My plan was to cut up all the little faces and create a matching game for the girls. Place all the faces face down, and see if you can find two little baby faces that would match. As it turned out, the weeks were full and I just never got around to it. On the second to last day, I threw away half of the cards, and on the last day, I let go of the rest, realizing that I just wasn’t going to get to it and that it was going to be too hard to explain – cutting out the faces, matching them up, sharing the sets. Everything seems to need a lot of set up and organization around who is going to keep everything together so that pieces don’t get lost, games are kept in order. In the same vein, by the time we left Hinche, we only had 4 out of 12 volleyballs left – some had popped, some were hidden away by the girls for soccer, others I just don’t know.

Later in the morning, I was reminded that this is Haiti. The girls started popping up with the little baby cards in hand. They were fascinated by the photos and the names on the back. It was so funny to hear them pronouncing the American names – “Maxine Danger,” “Emeline.” They even wanted me to put the postcard up on their empty dormitory walls. I obliged, humbled. No matter how many hair ribbons and bubbles and Uno games that we give out, they will always feel a desperation for more. Even though they truly appear happy, I need to remind myself that they lack the foundational elements that a family provides. They have had to re-create their family life with 52 girls and 4 house-mothers. Believe me, it is far better than many. But, they will still fight over bread and pick through the trash. 

This is Haiti.

 

Twins: Solen and Solange

 

Volleyball Camp and My new Goddaughter

All is well here in Haiti! The girls are doing volleyball camp every morning. That means they start at 7am at the latest. Some girls are ready at 6! By 8:30am, it is getting too hot to play and everyone takes a morning nap. Tomorrow is our last day in Hinche so they will try to do a small tournament.

Leika is the daughter of Genette's neice. She is my new god daughter. I will try to post a photo of her but Genette and her husband, Louinet, are here now and I must go. Mobile Clinic tomorrow, then off to Port Au Prince on Friday morning. I feel like we have been here for 3 months and yet Friday is coming up so quick. Will post again soon!

His Name is Jackson

 

Has a month gone by? So much has happened and my head is swimming with Creole. Was it just yesterday that a woman who gave birth at the hospital asked me to name her baby? She was one of our first timers, 20 years old. Pushing was hard for her and she was definitely not liking it. After helping with a 10^th timer and a stillbirth, I was ready to sit her birth out and let Ami have her day. Somehow, however, I found myself in the middle of things. Her name is Sylvan and the student assigned to her was definitely not one of our strongest. When Ami and I come up against a student who needs extra help, we double-team her on a birth. We let the student listen to heart tones, which she definitely needed practice with. I delivered the baby after about an hour and half of pushing. The mother finally smiled after the baby was born. This, in and of itself, is unusual. But, she was happy that her son was born, healthy and strong. I asked her what his name was and she said, “You name him.” I would normally protest in humility, and yet with her, I felt it as a request that honored that we had accomplished the birth together. Jack came to mind, and then, Jack-son. So many boys here are named Benson, Wilson, Gampson, Jameson. I figured she would like Jackson better than Jack. I wrote it on a piece of paper for her so that she wouldn’t forget.

These moments of connection arise as a surprise. I mostly feel somewhat detached in the labor ward; partly because of the stench and mess, partly because of the language, partly because of the overload of sensory stimulation. I might collapse under the weight of any one of these factors. Keeping myself detached helps me to survive the 6 hour shift. And yet, birth has an incredible power to force connection. I can’t help trying to reach deeper into the laboring woman, trying to find a place to see each other eye to eye. Sylvan saw me as someone who took the time to help her in her most desperate travail. She honored this connection by having me name her son. So, he is named Jackson.

Before I left my shift for the day, I threw together all my little sundries in a ziplock: 2 coconut almond bars, a pen, a packet of wipes, an opened travel pack of panty liners. I wanted to give something back to Sylvan, too, to honor her. I wanted to give her anything I had. She has nothing. She smiled when I gave her the gift and in Kreyol, I told her I was happy to meet her.

Yesterday we went to the Matron’s Graduation. You can see Dina’s new YouTube video about the Matron’s here. I was told by Genette that Nadene wanted me to speak at the graduation. Later, I was also told that the students had chosen me as their “Godmother.” This is an honorary title given to someone who will bless them with well wishes as they embark on their new lives. I felt honored and doubtful that it had anything to do with me particularly. I was curious how I had been chosen and I finally found out when we reached the graduation. They had simply said, “How about one of the volunteers?” Since I was already a speaker at the graduation, I was a shoe-in. During the ceremony, I got to sit next to the ex-Mayor of Hinche who was chosen as the Godfather. We were the dignitaries at the event along with a representative from the Ministry of Health.

It was a wonderful graduation, with lots of singing and short skits to represent the work of the matrons. The ceremony was very African in style: drumming, dress and presentation all reminded me of a time when I travelled to Cameroon and saw the officiating at the opening ceremony for a new road.

This graduation of the matrons is significant. This is the second class of traditional birth attendants who have gone through a 20-week course on birthing that includes cleanliness, safety and mostly, danger signs of pregnancy. They take their role very seriously. I couldn’t hold back the tears as they sang and danced their commitment to saving the lives of mothers and babies.

Today we went to Miss Genette’s mother’s house. Genette is the young, clinical director of the Midwives for Haiti program. She was inspired to become a midwife by watching her mother work as a matron. She started helping her mother at births at 17 years old. We visited where Genette grew up, saw her one-room school house and her church. She grew up andeyo, or in the countryside. It is so inspiring to see her humble beginnings and to realize how far she has come.

While we were there, Genette’s niece made me the godmother for her new baby, Leika. I was honored and welcomed into Genette’s family. I am grateful for community and family, here and at home.

Photos from First 5 days in Haiti

Girls at Maison Fortune

Mary Louise and Viola learning Creole

Moto is the way to go!

2 hours of electricity at night means FANS!!

Bringing School benches to..well...school

"Danse" with Joska

Ready for Soccer

Does this remind you of another photo?

Haiti hot!

Marlande and Neslande, sisters

Happy campers!

Haitian Friends

It is hot. Haiti hot.

My body is so tired, but I can’t sleep. So, I’m sitting in the moonlight, writing a blog post. I would rather sleep. But, I can’t.

Coming to Haiti this fourth time was as much about seeing my Haitian friends as volunteering for the program. Genette, Magdala, Filomen, Guerlie, Esther. I love that we have carved our niche into this program and that, not only do people remember us, but big hugs are to be had whenever we see our midwife friends. Today, even the cook at the Midwives for Haiti house remembered me saying, “Aren’t you the one who sang, “Kijan ou ye? Kijan ou ye?” I launched into a chorus of the song we had made up our very first year here. It is a simple, nonsense song of the few Haitian Creole phrases that we knew. How are you? I don’t know. Not now. People love that song!

I saw Genette yesterday for the first time. She is as strong and competent as ever. I kept trying to ask her if there were any specific trouble areas with the program that she wanted me to work on. She just said that everything was moving along fine. She later showed me her new house that she is renting with her husband, Louinet. It is a cement structure, two rooms — a living room and an adjoining room that contains their bed, their dining room table and a stove and fridge. This is a huge step up from her previous home that didn’t even have electricity. I am so happy for her! I see the framed Sapling Award that she received at the MANA conference last year. There is also a snowy TV turned on, practically the first that I’ve seen in Haiti. Her position as Clinical Director of Midwives for Haiti is helping her move up in the world. She deserves it.

Magdala, Filomen, Ibanez, Paulene, Marie Ange and Judeline are the midwives at the mobile clinic. There is one student that accompanies us as well. Ami and I are with them and I am skeptical that they are going to need 8 midwives to do the clinic day. Boy, was I wrong! We say 82 women in about 5 hours. I was exhausted and overwhelmed by the end. Not having eaten and coming down with a cold did not help my depleted energy level. Did I say that I haven’t been sleeping? It’s too hot.

But Magdala and the midwives were so happy to see us. I was reminded of how hard they work. Heck, they do those clinics 4 days a week. I was wiped out after just one and need to take tomorrow off. We saw mostly healthy mothers and babies which was a treat. We did, however, also identify one woman with extremely high blood pressure (200s over 100s), one woman with a prenatal breast abscess and yet another woman who appeared to be in labor and yet, not really. She kept complaining of pain, but I did not palpate a contraction when she said so. Maybe it was a UTI, false labor, some other mystery complication, but we drove her and her sister back to the hospital in Hinche at the end of the day.

In the meantime, Viola and Mary Louise are making fast friends with the girls at the orphanage. I finally returned around 5pm to see the girls playing soccer, Mary Louise getting her hair braided by Barbara, and Viola being loved on by Sofia and some of the younger girls. Barbara even wrote Viola a secret letter. She wrote, "Dear Princess Vayola, I am happy to see you. I want to be your friend..." This is a major victory. Go Viola!!

 

 

I am happy to announce that we are all happy and well here in Haiti, minus a few stomach upsets. Kenel, our Creole teacher and Haitian son, is going to Port Au Prince tomorrow with 11 other young men from Maison Fortune. They will all be taking the national college entrance exam that allows 100 lucky (or connected) (or rich) young Haitians to attend the State University for free. If I am understanding correctly, the boys have other opportunities lined up for them, if they don’t make this slim cut. Most likely Kenel will enter the Catholic University in the fall, sponsored by the Virginia parishes that support Maison Fortune.

Gladius is another one of our translators. He will be going to the US in 2 weeks to attend a community college in Virginia. This is huge!! We are so happy for all of our Haitian friends and their continued opportunities.

We feel blessed for friends and community, as we build relationships even here. Viola, as expected, is speaking Creole already!! M kontan wey ou — I am happy to see you!

Here in Hinche!

After two days of travel, we are here in Hinche once more.

We left San Francisco yesterday morning around 7am. Dina, Viola, Mary Louise and I and our 500 pounds worth of stuff. We had successfully acquired a bag full of sneakers and shoes, three bags worth of T-shirts, volleyball shorts, knee pads and clothes. When I say bag, I mean a 50-pound bag of luggage! 12 volleyballs were donated by SF Juniors and we even received a volleyball net from a parent at the SF Waldorf School. We had soccer balls, malaria pills, a few medical supplies and various and sundry gifts for our Haitian friends. We were ready for adventure!

We arrived in balmy Miami around dinnertime, settled in for a short stay and went out for a lovely, local seafood dinner. Air conditioning was a luxury we knew would not follow us to Haiti. In the morning, we woke up to catch our 10am flight to Port Au Prince. I am always touched to see the scores of volunteers on the plane. Happy people, just like us, giving of themselves. I was attempting to put Dina’s heavy camera backpack in the overhead bin, when the man behind me asked me if I needed help. I said, “Sure.” He said, “Happy to help.” I knew that he meant it on a deep level. Those who travel to Haiti do it because they love it. We receive a small sense of satisfaction to be helping someone in need. Haiti will benefit from our small acts of kindness for years to come. With compassion, we lend a hand, hoping to make a difference.

Ronel and the jeep (not the pink one this time) were waiting for us at the airport. Each year I notice the improvement in the airport infrastructure and feel confident that there is, indeed, movement happening in this country. We loaded the jeep high with all of our bags. 8 volunteers in all, each with their 2 fifty-pounders and two carry-ons. Ropes, bungee cords and years of experience transformed an overflowing truck to a moving tower of luggage with plenty of room for 10 of us to sit. Viola and Mary Louise rode in the back, seeing Haiti for the first time. Tap taps, donkeys, the green and brown countryside — they absorbed the sights with excitement and curiosity.

After 3 hours of driving, we arrived in Hinche. Our first stop was Maison Fortune where we were greeted by our young friends, Odey and WaWa. They didn’t know we were coming. A moment of hesitation turned into warm hugs as they recognized us. My own outpouring of Haitian Creole probably resembled jibberish as my feelings of excitement could not keep up with my rusty language skills.

The girls had been moved to a different campus. It is about a half a mile away  from the school and main campus of Maison Fortune. Even as we drove up, we saw Barbara walking down the road. I excitedly told Ronel to stop the jeep! Barbara is one of the oldest girls at the orphanage and she is definitely the alpha female. As such, she remains aloof at times, observing rather than joining in the younger girls’ ruckus. When she saw us, I saw a smile of recognition cross her face. She was happy to see us.

As soon as the younger girls saw us, the swarming began! We had told them the year prior that we would bring Viola to visit. One of their most common questions is if we have any children. So, we had talked about her and shown photos. Nearly as soon as Viola and Mary Louise got out of the Jeep, they surrounded them; a couple of them said, “Li belle.” She is so beautiful. They grabbed their hands, blurting questions in Creole that Viola and Mary Louise didn’t understand. The smile was understood though and there was general merriment and celebration.

Later that evening, we sat on the porch of our building, surrounded by girls. They hugged us, asked questions, sang to us, played hand clapping games. They are happy in this new compound. It is spacious, clean, safe. It’ll be a great place to teach volleyball, away from the boys who would steal the volleyballs to play soccer. It feels protected; the girls look healthy. Mishou has grown, as well as Manoushka and Islande. Well, they’ve all grown!

We are so happy to be here in Hinche once more — safe and satisfied.