On the anniversdy of my grandosn's death

This is the time when much of North America grows dark and cold and celebrations become plentiful. It is a time of lights and candles and warm fires.

I grew up with an image that all people contain an inner light that needs only to be nurtured and tended to. I was taught by the great teachers of my childhood, to look for that light in every person and in that way life would never be too difficult. The goal, after all, was not great riches or accomplishments but the ability to good naturedly look for the that light in everyone without undo fear or intimidation.

This simple task turned out to be far more difficult than it was originally explained to me and now as the New Year begins, I sit in the dark early morning of Oregon lighting candles and trying to keep afloat.

You see, a year ago my fourteen year old grandson shot himself rather than return to school after winter break. I did not expect this anniversary to overwhelm me as much as it has. I am trying hard but nothing can keep the grief from rolling over me.

My beautiful daughter has moved into a new house and we buy small things for it at IKEA on his birthday. We try to start over while not wanting to loose him. We walk and wander and I count the moments before his death trying to relive the hours when I could have made a difference and can not make it turn out differently.

In Haiti, once a doctor said to me, "Do you think its okay for NGO's to come to Haiti and let health care workers learn here." I remember thinking in reply ( I did not say this ) "Do you think its okay for an old woman crazy with grief to come to your country because its the only place where loss is normal enough for her to bare it."

He went on to say that we were saving lives so it was better than nothing but not how it should be. I agreed and we talked. I hand him piles of papers to explain what we hope to accomplish in Haiti. I walk out into a sea of people crowding the streets and I think as I had thought many times. "I have run away from home. I am in Haiti, hoping to do some good, but mostly I am trying hard to believe in that inner light in all people and for some reason its proving easier in Haiti than it was in my own country.

How do I say that I feel more normal here than I do in a mall in the United States at Christmas. I have rarely met a person in Haiti who has not lost a child or a parent or a sister or a brother and so in that place and in that context, Nathan's death is woven into a the fabric of life. It is in everyone's eyes and so I feel okay and able to navigate.

Soon these anniversaries of his birthday, of Christmas and his death will pass. I will take down the tree and hug all the people who loved him close and walk out into the day. Morning will spread over the Cascade mountains as 2012 begins. We never know how a year will unfold; the joys, sorrows and challenges. I am crazy with missing Nathan this morning. They say that such pain can open us up and spin us around and help us to see the world through a new lens that we never had before. That when someone dies this is the gift they leave us; the gift to see the world as we never saw it before.

Its a tender earth we walk on no matter where we go or what we do. A friend, who also lost a child about Nathan's age wrote and said its like carrying a rock in your pocket. It is always there.
And so there can be no doubt that I carry the smooth, cool rock that is Nathan with me all the time in Haiti; reaching down to feel it when i am afraid or doubt myself.

It is possible that I would never have gone to Haiti if Nathan had not died; if I had not needed to grasp the world and understand her in new ways so that I could make sense of this loss and the things that would cause a young man to take his life on a winter evening.

I am thankful for Haiti; for holding me in her arms in a way that no one else could and letting me heal in the warmth of her women and children. I hope its okay and that I can also be of some use in return. I see that light I was taught to look for, shining there in the midst of so much loss.

Many people will have a New Years Resolution to hit the gym and get in shape and I will keep at trying to develop my strength and flexibility so as to to see that light in everyone and if possible, even grow it a little. I am not sure what that will look like. I am sure. like last year, it will have its unbarable surprises and turns in the road. I feel Nathan smiling at me and saying, "Oh Grandma, you can do it." and I think, yes, Nathan, what ever it is, I can.

Slideshow of babies at MamaBaby Haiti

Thoughts on leaving Haiti for Christams

On the morning I leave Haiti, it is raining and warm. I get up at 3:00 am ot have a shower and pack a few things for the trip to Portland. When a woman comes to the center, I do the exam and paperwork so the midwives could sleep a few more hours. I think of how what was once so new to me had become so familiar. I could not be sure if I was going home or leaving my home. For surely that small parcel of earth and buildings and plants and people had become my home.

I do the familiar things associated with preparing for a trip; making sure the chickens will be fed and the gardens cared for; cleaning my room so others could use it while I was gone and then there was a quiet time to talk with the Gardener's Daughter. She is better now and I tried to help her think about the rest of her life. She wanted to make sure I was indeed coming back and I assured her and everyone I was. I told her that although going to school is not easy now, she can write in a journal everyday and I gave her a beautiful blank book and asked that she write everyday that I was gone. By the time I left, she had already filled many pages with her thoughts and feelings.

Beautiful warm kisses and hugs; the opening of the gate and then the now familiar drive the back way to the airport. Past the market and the river where they wash their clothes, past the market women and the donkeys carrying charcoal for the cook fires. Past the school children so perfectly dressed with bows in their hair, past tap- taps crowded with passengers and trucks filled with produce. Past mountains and fields; the road so full of holes now filled withe mud from the rain.

On the runway we stand under the wing of the plane to keep dry as the pilot checks our tickets. Someone turns on the propelar and with a great wind all the tickets are blown from our hands and the pilots and strewn across the runway. With shrugs and smiles, I am walked from the wing to the door with an umbrella where I find my seat and soon watch Haiti slip from view but not from my heart.

I have not slept al whole night in four months. I know I am exhausted but sleep does not come easy. So many images drifting through my waking and sleeping thoughts. When I step down into Florida and I am out on the street, I begin to cry and have the start of a panic attack. I can not understand where I am and why things look so different. I breathe and keep walking and in time begin to acclimate. The streets seem so empty and the sidewalks bare. I can not grasp that the roads are so flat and there is so much pavement. There are no cows or horses or goats or pigs everywhere. In my mind, I am wondering if everyone is okay without these things and worry a little bit. I have to work to pull myself into the present time.

I have made a cute Haiti Baby Slide Show. I show it to the people on the plane, in the hotel, to my grand daughter; to anyone who will watch it. Perhaps in a few days, I will put it aside as I join in the festivities of Portland with my family and friends but at night my prayers are also with the people I love in Haiti.

In the coming days I will be given opportunities to talk about what i have learned and what is needed. I will try to explain that the goals of maternal and infant health are global and include our own communities as well as those far way. I, of course hope, that my being in Haiti has made life a little better for some women and children and that I perhaps can plant a seed about the global possibilities for maternal care during birth.

It is hard to know these things but I do know that I have become a student of Haiti. I have read every book I could find and have sat very near her heart. When I read her history I know I am reading my own as well. The history is deeply intertwined with the history of the world and of the United States. There are terrible, terrible stories but I do believe that civilization, despite how it looks day to day, is on a great upward journey towards compassion and a shared humanity. People of European descent have a long journey ahead of themselves as they struggle, as I do, with what white privlege has meant in the Americas since Columbus first landed in Haiti. To struggle with what we will do with this inheritance and increased understanding. To not be brought down by our collective guilt and shame but somehow to become the student of life that Walt Whitman asked us to be when he wrote Song of Myself so many years ago. When I first heard that poem, I thought this is who I want to be. I want to step outside and let it all in and let it become me.

So in this interval I will rest and hold my family close and let the places that Haiti became me settle into the nooks and crannies of my soul and blend her song somehow with my own. Thank you Haiti for the chorus that still plays in my ears even when I am far away. Thank you for the hard and painful look in the mirror that knowing you has offered me.

The Gardeners's Daughter

Here is a photo of The Gardener's Daughter.

I am happy to say that she has not had a fever for two days and is doing much better. Thank you for your thoughts and prayers for her and her family.

The season for malaria

The Gardener's Daughter has malaria. She lies under curtains of mosquito netting in the postpartum room with a night fever of 104. Her daughter, an eager child, breastfeeds even as her mother slips into a fever induced delirium.

They say here, " Ah yes. It is the time of malaria" It is the season for the big, black mosquitoes that cause malaria. The little ones of summer, however annoying have gone and now with the rainy season the malaria mosquito has come. They say when the mangoes ripen the cholera season will begin.

It is also the time for congo peas and okra cooked into a spicy sauce that is simmers for hours over a charcoal fire. It is also the season for grapefruit sold in piles on the road for only a few gouds.

And so it would seem that the seasons are marked not by changing leaves or snow storms but by the rains and the fresh fruit and by the tropical diseases that claim millions of lives each year around the world.

I had not prepared myself really for this season of malaria. I do sleep under a mosquito net and take my malaria pills, when I remember, but I was not prepared for it in the clinic. I was not prepared to test and treat and wait with it. I was not prepared for the way the women walk and sleep and the high fevers.

The Gardener's Daughter is the second case this week. She did not sleep with mosquito nets nor did we give her chloriquin and she suffered from severe malnutrition and so, in this season of malaria, perhaps I should not have been surprised.

I look it up when the internet is working. I read every book we have laying around. There are several kinds of malaria and Haiti has the worst and most damaging. We should be passing out a malaria net, a bar of soap and malaria pills to every pregnant woman but we are not. We give iron pills and pills to kill hookworms. We set priorities and make choices.

Her fever scares me but we give her clean water and food and vitamins and a place to bathe and the medicine and watch the fever spike and come down and take its course. I learn to adjust my fear and to replace it with faith and knowledge and a simple prayer.

I have a new understanding of seasons. It once meant the coming of fall leaves or spring flowers but now I know that people note the seasons by the diseases they bring.

The nights are beautiful here and the days have a breeze. It is a beautiful season here- a perfect season - if only it wasn't also the season for malaria. Mosquitoes breed quickly where there is standing water, where there is little clean water and few latrines.

Morning spreads over the mountains, a cow calls to be milked, roosters crow all around and downstairs the babies stir and a mother works her way through labor.

I think of all the songs about seasons and hear Pete Seeger gently sing "a time for every season under Heaven" So I will quiet these words for now and go down to feel her forehead and begin the day.

A little poem in Creole for the midiwves here

Here is a simple poem I wrote while practicing creole. I love the way the words sound and come together in Creole.


Isit la kantan kay

Anpil bon travay nan isit la

dousman, dousman

Bon reve

Pra ke, mwen zanmi

tann pou nouvo jou.


I was playing around with words as the day was ending and volunteers were tired and discouraged.

Here is a happy house
Much good work is in this place
Gently, gently
Good dreams.
Take heart, my friends
Wait for a new day.

Happy mom and baby photos - the pictures not shown

This happy mom enjoys breastfeeding and to smile for me

I have a few days where I go around taking happy breastfeeding pictures and tell myself I will make posters one day. But really I do this to make myself feel better.

My camera is full of pictures of very think and sick babies. I tell myself I take these photos because one day I will show them to a doctor and they will help me with diagnosis and treatment. I have so many though and I wonder at my desire to capture the pain and suffering of babies in pictures. Perhaps I take them to make it real; so that I don't think I am living in a nightmare. Mo

Most always malnutrition goes hand in hand with skin diseases. I study them on the internet but then they all look mingled together on a tiny or swollen body and I end up using my best thinking at the time ( as well as whatever soap I have at the time.) And taking their pictures for a future time.

I can not or do not post these photos; instead I send out into the web universe the most beautiful picture of breastfeeding I have. If I trick you, will you believe this is true of all mothers and babies in Haiti or have I failed to convince you, even as I fail to convince myself.

Remember Peter Pan when we were all suppose to say " I believe" and Tink would live. Perhaps it is like that. I think if you see this photo it will be like magic - everyone will believe the babies are fine and then it will be true. Perhaps I believe if the world sees this photo and not the others that there will be jobs and farms and manufacturing and Hatien rice and all the children in schools.

And so here is my photo- truth or deception or some of both.

The Gardeners Daughter

The Gardener’s Daughter

The Gardener’s Daughter has given birth. She has labored for many days and we have had several sleepless nights. But now the baby is at last born and they are resting in the soft misty light of an afternoon rain.

The cook says she will make a special squash soup tomorrow. The farmer has brought us a beautiful stripped squash that has sat on the counter for many days now. It is the custom to eat this soup on Independence Day but that is not until January 1^st and the squash will not keep. It seems a good day for a festive pumpkin soup.

I first met the Gardener, as everyone has come to know her, on a busy clinic day. I noticed a tall, thin mother with her pregnant daughter standing there trying to catch my eye. When the hall way, in time, became quiet and nearly everyone had left, the mother approached me.

There are many stories in Haiti and many people who need an extra hand. It is easy to become resistant to individual stories and need; to put up a wall that says I can not bare to hear anymore. Perhaps I was too tired to not listen or perhaps there was something about the strength and dignity in her face that caused me to stop and gather one more story into my heart.

The two of them and the one soon to be born, I was told, had no where to sleep that night and for the days to come. The daughter was 18 and they had not eaten all day and the day before. The daughter was eight months pregnant.

I am not aware of any women’s shelters or places where meals are served or clothes closets or food banks; all the things in my community that we maintain to offer a minimal standard of humanity and survival.

I was quiet for some time, waiting for some thought and then I looked out on the gardens that were in such need of care and then I suggested a plan.

She should go out and see what she could find in ways of housing and I would help her if she would help me with the much neglected gardens. If she would be my partner in reviving the gardens each morning for a few hours, I would pay the rent and she and her daughter could eat breakfast with us each morning.

She returned that evening after finding a small one room house with a dirt floor. It cost $37 for the whole year. “The whole year?” I asked in disbelief. “The whole year.” They had nothing to put in the little house so I gave them a bucket to carry water and a sheet to lay on the ground. It was so little to offer.

At 6:00 the next morning and every morning after, the two of them arrived at the birth center ready to weed, water, plant and clean the gardens. Cheerfully, they made their way through the yard; planting flowers and vegetables and herbs along all the borders and in the shade houses. They rested for a breakfast on the porch and then when the sun got hot, they walked down the road to their little house. It was their only meal of the day.

In time, I took my share of meat or eggs that I did not eat, and gave it to them. The daughter had lost 8 pounds and she was painfully thin. I poured vitamins and water into her as she leaned on a shovel or hoe. I sent her to birth classes over and over again just so she could sit and rest. The Gardener, like many women in Haiti has perfect posture, long strong arms and a beautiful piece of cloth tied around her head. She smiles easily and was happy to meet everyone here and make new friends. In time everyone came to call her, The Gardener and her daughter became “The Gardener’s Daughter.”

There were six other children, living with relatives. When the daughter became pregnant they could no longer live where they lived and everyone had to move out.

It was not until the second day of labor that I felt I had to ask about the baby’s father and then learned of the abuse of her daughter by the landlord, that drove the gardener from her home even if it meant having no where to live. I learned that the oldest son had killed himself and that shortly after the father had left them all. They had moved in with an uncle whose elderly friend had, through force, caused the gardener’s daughter to be pregnant.

Somewhere in the midst of this long labor, we talked of these things and how they happen the world over. We acknowledged their many sorrows and loses and how it would be understandable not to want to bring a baby into such a world. We also talked of how much hope and joy a baby can bring.

I thought of the Diary of Lewis and Clark and how they describe Sacajawea’s birth as particularly violent. I thought perhaps it was the same for The Gardner’s Daughter and that when we give birth after a great violence has been done to us, it takes a special form of courage to open up to the great love that mothering asks of us. I thought of Pomp, Sacajawea’s son and how much she loved him. I told myself that other women have survived unwilling conceptions and have gone on to love the children and to heal themselves.

After we talked to the Gardner and her daughter about all they had worked to overcome there was a change. Our sweet laboring mama, held us close and in time and with much work, opened up and pushed out a baby girl whose eyes found and held her mothers; a little girl with soft, black curls and a mouth that smiled even as she slept.

Perhaps I have a soft place in my heart, for young pregnant girls, barefoot in the garden or for strong determined women who hold their families together and their daughter in their arms no matter the hardships. I watched them; grandmother, daughter, grand daughter all nested one within the other.

Later they asked me to name this baby and I named her Maddie Mae because I always thought it was a name that had a cheerful way of rolling into the world and because it reminded me of the names they love and most of all because I know a Maddie Mae who is strong and wise and kind and I thought that might be a good name for the baby of the Gardner’s daughter.

And so as in all birth stories, as my tale ends it also is just beginning.

A star covered blanket

On Sunday, I am walking down the stairs to make tea. There is a soft breeze and the moms in the postpartum room are talking amongst themselves as they nurse their babies. It had been a busy night and I was set to enjoy some sweet quiet before the day got started.

But here, all this can change quickly as the world around us moves in the opposite direction we were going.

Jason motions to me and then brings in first one, then two, then three new moms. I walk to get charts and names and to start assessing each mother in turn. It is a familiar routine of listening to heartbeats, bringing glasses of water, making families feel welcome. My still bare feet move on the cool, orange tile. Slowly the other midwives rise and tumble downstairs; sleepy and wondering what commotion brings them from their beds.

Each birth room door has its own special creek or groan when you open it. I hear them in my sleep and count the comings and goings even when I am not the midwife.

I remember pushing the door open and thinking we have to fix this door.

I had already said hello to this Mother and brought her water and smiled at her sister who sat on the bed by her side.

But when I open the door, the mother was not on the bed. She is standing with her sister behind her. I am confused bu then I see her baby lying on the floor. There is no sign of life and he is very premature. There is blood everywhere. Time stands still as we stare at the baby for what seems like forever; unable to move even though I see that we are moving.

At times like these sometimes a person far away will come and stand beside us and whisper in our ear. "You know what to do. Pick up the baby and hold him." And I do. I wrap him in white sheet. My hands are beneath the mother. I am moving.

...and then the placenta followed and then the mother began to seize with eclampsia.

I put the baby down in a corner of the room. We moved through the steps of caring for the mother until the seizure had calmed and the IV was running. Watching as the blood pressure came down as she opened her eyes and spoke. Hands moved and opened sterile packages, drew up syringes and took vitals. We spoke without words.

We invited her husband in to hold her head in his lap,reassuring him that she was doing well.

Bu then I remembered the mother is doing better but the baby. His eyes followed my eyes to the bundle on the floor. I went over and saw a string of ants climbing on the baby and inside I was crazy hysterical. I was screaming, "You can not have this baby." but the helping voice reminded me that it was time to wash and dress the baby and to be calm. So I did not scream at the ants but brushed them away and washed the baby.

I went and got a new blanket that my sister had just sent. I picked one with stars I wrapped that little baby boy up as sweet as I could and gave him to the dad and I could tell they were appreciative of the helping voice who calmed me down and told me what to do.

Santo drove the father and baby to the grandfathers and they buried him at that time. Later Santo told me it was raining then but I had not known.

I helped clean up as is our way as midwives. I did not one single ant in the whole place. In a way it was like it never happened except we were all so tired from being so scarde and acting like it was nothing at all. It was still early in the day so we drove to a fishing village and looked at fossils and let the warm water splash the clothes that we had not changed since morning. I did this because everyone was so scared that they wanted to blame someone/ anyone. I thought it best no to think like that and that a few of us might get some fresh air.

There were so many things I could not control or change. It all happened so fast. But I was glad that we had cared for the baby with so much love and dignity. The person who came and helped me out that morning was Pat Schweibert. She lives in Portland and for years taught many of us to care for babies who die in childbirth. When people were afraid, she taught us to look into those tiny faces and cherish our grief.

Thank you Pat, for your words over many, many years that came back to me with quiet reassurance when I needed them most. There are so many things that I could not control that Sunday morning but with your reassurance I could pick up a baby and place him in a father's arms- a real little person with his own star covered blanket.


PS

Eclampsia is a leading cause of maternal and infant death in the world. In this disease, a mother develops high blood pressure to such a degree that she experiences siezurres and kidney failure. It has been called the silent killer and the disease of poverty as it is associated with malnutriton.
That the mother made it to us on time is a miracle and I thank God that we had the right medicine and were able to work so well together to administer them and care for her. She did not have prenatal care which might have picked it up but it can also come on quickly. Many women around the world do not have transportation to get help should they need it. We were fortunate to have a car and gas to drive her to the hospital. We were fortunate to have a hsopital in driving distance to go to. Everyday people devote their lives to researching the cause of eclampsia.












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Local Market on Thanksgiving Morning

On Thanksgiving morning we walked to the local market and got some fresh bananas for breakfast and that was a great treat for us as there are many different kinds. We know many of the market women now and also see many women we care for there so walking to the small. local markets is a joyful part of the day. You can also see a school child in the background dressed in her uniform with her hair in the customary bows.

The women have small market stalls that sell just a few things and there are many of them. It is a festive place with much joking and bargaining.

It is always a gentle reminder to be in another country for a holiday.

Days for Girls - Menstrual pads for Postpartum Women

http://daysforgirls.blogspot.com/

We are having lots of fun with the sewing projects at MBH. The pedal machine hums along and we enjoy helping mothers put on their new baby slings.

Another helpful sewing project is Days for Girls which provides flannel menstrual pads to women the world over. We have been lucky to have kits to give out to all our moms but we will soon be out. This is a great project for a group looking for a project or someone could send us flannel and a donation and we could pay women to sew them here. I believe on the web site it lists supportive fabric stores. If you are interested in making cloth pads, donating fabric or helping to pay a woman here.

After a birth, the women are ready to put an old rag between their legs and then we offer them a beautiful bag filled with soft, cotton mentrual pads and new underwear. After a bucket shower, they slip on these beautiful clean pads and snuggle down to nurse their babies. It feels very special; like after all their hard work they have this one new, clean speical thing all for them.

Please let any service group know about this oportunity. The kits or fabric can be easily sent through IBC Travel.

More on the sewing machine and baby slings

One thing that struck me when coming to Haiti, was that the mothers did not carry their babies in any form of sling or wrap or back pack. They came to see us carrying their babies flat in their arms with great difficulty. I asked many people why no one carried their babies with fabric and no one knew why. I also noticed all the problems with breastfeeding, respiratory problems and dust pollution.

Many of these things led to serious health problems for the babies and help to account for the high under five death rate.

I also noticed the many mothers who had no food and needed small ways to earn money.

In this way, I decided to help mothers with no income, make baby slings to give to our new mothers. I am very excited to try this out this week and see how the mother's enjoy using them. It was thrilling to watch the women using the pedal sewing machine and to meet a woman who is willing to embroider our slings.

I am hoping that the pedal sewing machine can lead to other sewing ventures such as cloth diapers and cloth sanitary pads and that, in this small way, we can help mothers to feed their children.

I love this brand new Singer, pedal sewing machine as well as the hope that it has given women in our community.

Our new pedal sewing machine makes baby slings 4 moms

A letter to my former students at Sunnyside

Dear fifth graders at Sunnyside Environmental Middle School,

I remember when many of you were in kindergarten and remember also the many new students who joined you along the way. It makes me happy to think of you as fifth graders; so strong and smart and thoughtful as you enjoy your last year of elementary school.

I have come to Haiti to fulfill a dream I have had since I was your age to work in far away places with children who might need my help. I almost did not go because I did not want to leave all of you and Sunnyside but then I knew that there were so many people to teach and care for you there and not very many people who wanted to run a birth center and clinic in Haiti.

Each day I take care of pregnant women and the sweetest little babies. I sleep outdoors where it is cool and watch the night sky. Often we do not have electricity or water but most people here have far less. Most people live in small villages in clearings of very small houses. The houses are often painted bright colors and are about as big as the work room next to the office. They might have a pump and a bucket shower. They cook outside on charcoal and love the fruit that grows on the trees.

Today is a very happy day in Haiti as the congress just passed a law that said all children can go to school for free. Until today, most children never went to school and almost every mother I meet can not even write her name.

I came to Haiti because more babies die each year in Haiti than almost any country in the world and I wanted to see why and what might be done. I see many sad things but also a happy, fun, strong people who love their country.

When I am sad and can not understand why things are as they are, I study history. I try to understand how things came to be and what I can learn about my own behavior and the world around me. And so I am writing to you because I miss you but also because I know you are studying or will be studying the very place that I am living.! I think hard on how those times changed a beautiful island forever.

When I was you age, I was told Christopher Columbus founded America but later I felt that the grown ups lied to me or maybe didn’t know either . Maybe I love history and reading because I am like a little kid still a little mad because so much of what I was told about history wasn’t the truth. What I know now, is that Columbus came, to an island we now know as Haiti. Haiti is a part of a beautiful mountain range that sits beneath the Caribean Sea. There are some 700 islands in these chains, including Cuba and Jamaica.

I came to know that the Taino people lived on these islands for thousands of years. I heard that they had all died but what I did not know was that their memory and some of their culture is alive here in Haiti. I did not know that some fled to the mountains when the Spanish and continued to live there for many years. I did not know that when the slaves, brought to Haiti by the French, escaped they found the Taino people living still in the mountains. The Taino helped them to survive and to become free.

I did not know that there exist beautiful cave paintings and artifacts and that the word hurricane and hammock are the words of the Tainio. On my table is a bread made from the cassava root that is made just as the Tainios did so many years ago. It is a flat bread with a layer of sugar and cocanut that I eat with peanut butter and is still cooked over a fire beside the road near the place where I live.

When Haiti became the first slave colony ever in the world to gain their independence, the founder of the revolution, said that he did it for all the people of the Americas; not just Haiti. I thought about this a great deal; how the slaves here with the help of the Indians fought for their freedom; not just for themselves but for enslaved people everywhere.

After that though, Haiti had many obstacles to overcome and many people believe it was because the world was so mad at a group of people for being so smart and strong. Many people say, “why can’t Haiti be a good country” but those same people most likely still celebrate Columbus Day and to do not understand the many ways the Tainos and the Africans were punished for being people of color who dared to be free. The slaves in Haiti declared their independence not long after the United States, but the newly formed US government did not believe that Africans, who had been salves, could be free and independent.

I found out that Columbus was put in prison for the crimes he committed against the people of Haiti but those crimes never really stopped as I have learned from reading about history.

I once heard the children of Sunnyside sing “We Are the World for the Children of Haiti” and last week I heard the people of Haiti sing their own version for themselves. It was a great day and I thought of all of you.

I know Cori and Monica will teach you a lot of history this year and I hope you will open your hearts to these stories because they are never about long ago but about us and the choices we make each and every day about how we treat each other.

Haiti is not better because I have studied her history and know about Columbus but it helps me to understand as I live and work in this country whose history is so closely tied to that of my own country.

The children near here, play soccer just as you do. They gather in an empty lot along with the cows and goats and make goals from anything they can find. They wear old soccer shirts from the United States and love it very much. I think of you when I see them.

It takes a long time to undo the cruel things of history but its good to know that each of us is making history all the time, in our own small ways and that children everywhere find joy and adventure and laughter in their everyday surroundings.

The sun is setting over the mountains here and I need to go. I had wanted to share the many ways that history helps us, as it shows us a world of stories and heroes better than any in our imagination.

It is good to know the children of Haiti will have schools for free and that children everywhere can sing “We are the World” and somehow all the versions are connected and all true.

I miss you and hope you have a great fifth grade year.

Sarah

We buy chickens at the market

Yesterday, on the way home from picking up a new midwife from the airport, we bought two new chickens and a rooster with hopes that they will start laying eggs. They are Hatien chickens and are very pretty and small. They handed me all three tied by their feet upside down. They rode in the back of the car as quiet as can be and are now happily digging in the garden.

We also bought two big white Domincan chickens who soon became Sunday's dinner.

Santo bargained hard with the woman selling the
chickens and we all laughed a great deal. There were also turkeys, so perhaps we will go back again and get one for Thanksgiving. It made me wonder how my chickens are doing in Portland. Anyone who knows me, knows that I always like to have some friendly chickens close by to watch and make friends with.

It was a Sunday of many births. I have always loved a Sunday morning birth followed by a good breakfast which is just what happened this morning.

Wnen Mama Said Good Bye Today

"Mama Said Good Bye Today"


I wrote this, for all the oldest daughters in the world who loose their mothers in preventable pregnancy related deaths; for those girls who loose their childhood as they take on the care of younger brothers and sisters and the household. I had hoped to capture the defiant independence of a young adolescence who could not possible know how quickly her world would change. It was written after a mother here in Haiti, died in the hospital of eclampsia related placenta abruption and hemorrage.

It is also written for all of us who never had an opportunity to say good-bye to those we loved and lost. For everyone who tries to remember the last moment they saw someone, what they wore and said and the look in their eyes when they said their final good-bye. For our desperate wish to re-write that final good-bye

When Mama Said Good Bye Today

When Mama said good bye today,

I did not answer back;

The porridge was cold and Jean-Paul cried;

There was wash to hang in the yard.

When Mama said good bye today

I did not answer back;

She turned to smile, opened the gate,

Walked slowly out of site.

When Mama said good bye today

I did not answer back;

Her dress was old and stained with blood,

I hurt to see her look that way.

When Mama said good bye today

I did not answer back;

Said she’d bring a baby home

"So please just all be good."

When Mama said good bye today,

I did not answer back;

Grandma screaming, aunties crying.

"Sweet Jesse, please come near."

When Mama said good bye today

I did not answer back;

Papa praying , the neighbors

Saying she died cause we were poor.

When Mama said good bye today

she took our baby too;

Bled and bled and bled they say

There was nothing they could do

When all the people left today,

I climbed my comfort tree

And there, amongst the wind and leaves

My mama whispered bye to me,

I felt her there alone with me

warm inside my heart.

And when she slipped away from me,

I could not answer her back.

The face of statistics

Haiti by the numbers

Les than 45% of the population has clean water – 74 babies die per 1000 births – 12% of all babies die before their first birthday – one third of all children die before their fifth birthday - one in 71 women will die in pregnancy or childbirth – half the population earns less than $60 a year –
5.6% of the population is infected with HIV including 19,000 children – the average life expectancy is 53 – 163,000 children are estimated to have been left orphaned by HIV

In Haiti these numbers have come to life in the faces and stories of the people I meet. It is no longer one in seventy one women who die but rather a woman I knew and touched and heard her family cry. It is no longer 74 babies in 1000 but a baby whose heart beat I looked for and could never find. It is no longer 12% of all children under one who die, but special babies I have weighed and fed and held as they sleep. It is no longer mothers with HIV but the mother who lies about her testing so I’ll do her birth. It is no longer 163,000 orphans but the many men and women I have met who grew up orphaned and alone.

In this way the statistics turned to stories and the facts became the faces. The percentages turned to possibility and the thousands turned to one.

The local Matwans come for a visit

Last Saturday, twenty-five local matwans came to spend the morning here at MamaBaby Haiti. I was nervous, that they would not come and worried that I would not be able to create the sense of welcome that was so important to me.

But at 9:30 the first two knocked on our gate and more kept arriving all morning. Here you can see them having good fun with a model of a baby and pelvis. They are demonstrating how to deliver a breech baby.

We enjoyed a wonderful morning of friendship and common interests; laughter and many stories as well as our concerns about access to care and supplies. They signed up for a class in "Helping Babies Breathe" and agreed to meet once a month. We explained that our hope was that it be their meeting with us providing the space, speakers and resources based on their needs. They talked long amongst themselves while we prepared sandwiches and clean birth kits for them to take home.

I am told that 78% of all babies are delivered by these strong women; many of whom came to be midwives through a powerful dream. They are smart, loving community leaders who work for almost no pay and with few resources.

They work without the ability to read and write because no one ever taught them. We have resource books everywhere here. We look in them night and day and use the internet for what we can not find in books. The literacy rate of any country can not help but be deeply tied to its healthcare. It is my hope that the next generation of Hatien midwives will retain the love of community these midwives have, with an ability to read, , study so that they can have access to the resources necessary for safe motherhood. I know these midwives are forever sad thar they can not read and write and I share their sadness with them.

One midwife told us she also helped farmers with a difficult delivery of a baby calf as I think midwives do the world over. I told her I would teach her what I know about birthing babies if she would teach me to birth a calf and we all had a good laugh.

We offered them an opportunity to spend a week here in a "mini residency" where we can easily share practices and get to know one another better.

They came in good dresses with hats; looking exactly as my grandmother would have thought ladies who come to visit other ladies should dress. We could not match them for style or grace but hope they felt our sincere desire to be partners with them in caring for Haiti's mothers and babies.

Sunflower Baby

When I first got to Haiti, I planted sunflowers by the front door of the clinic. Once, when I was growing a school, I planted sunflowers as a symbol of hope and potential and beauty and so I had wanted to do that here too. I wanted flowers by the front door. I watched and waited and they did not grow. I thought the rains were too hard but then one day, when I had quite forgotten them, there they were in bloom. We has fun taking this picture and the mothers thought it was very funny too. A sweet, little sunflower baby.

Esthere come morning

Mostly, in Haiti, I spend my days here at MamaBaby Haiti blending my daily routines and relationships into a preparation for the unexpected. I have come to expect soft beautiful sunrises and sunsets and the sounds of animals all around me. I have come to expect the comings and going on the road and the familiar rice and beans served every day at noon.

But I have also come to expect trajedy and hearbreak. I have come to expect that the unexpected and the unthinkable will come to our door and that we will take a deep breath and somehow work it out.

Yesterday we drove, at sunset, to closest ocean shore and stood and watched the young boys go out in their father's fishing boat. We watched their laughter and how much they enjoyed chewing on sugar cane. We noticed the abundance of trees with grapefruit and sour oranges and bananas and the papaya trees whose bark glowed in the waning light. A small girl was catching a crab as her father checked the traps for the next mornings work. On the way home, we waved as we passed from village to village where people of all ages walked the dirt roads, visiting with friends and neighbors, eating outside over fires and selling small things by the road. We watched the teen agers courting and the children playing soccer with a piece of fruit in a dirt worn yard. And we all thought, despite how different ti was from our own life that there was such a goodness to life.

And then a mother comes in with her 8 week old baby who weights 2.3 kg and is covered with red, raw skin and rash for head to toe. The baby is barely alive. She has fed the baby garlic and salt tea for days. We slowly try to hydrate the baby; searching for what some volunteer may have brought here before. We ask questions. The mother had a heart defect as an infant that was never repaired. Her own mother refused the trip to Florida necessary for he surgery or perhaps it was not possible. The mother was told she can not breastfeed because of her heart but nothing else was offered. We try to get her to try to breastfeed but she refuses. She says the baby will die if she breastfeeds it and she believes this very deeply. We get a hold of a pediatrician who is has worked in Haiti for a long time and she says its better to not send a severely malnourished infant to the hospital. We also know that they are given an IV and sent back to us withe no long term solution or food.

So we settle in. She and the baby and a young cousin, sleep and eat and stay her with us. We try to get an ounce in and then two ounces. We bathe her and treat her as the doctor told us while a woman labors in the next room. None of us are sure she will live till morning and each person offers their own silent prayers and hopes and tries to make it better. We have midwives and nurses and a doctor on a cell phone.

Once years ago, I had a foster son from Vietnam who had what this mother suffers from. He could not be operated on because of the war in his country. I can see it all again in the way she breathes and the way she moves and her skin and I think I have seen this untreated heart before. His name was Phouc and he died in our home. The doctors hear tell her there is nothing more to do. I remember when OHSU told me there was nothing to do for Phouc and I should just take him home to die.

And this mom says to us, "Just save my baby. You can not save me." And so we try. I am an hour and half plane ride from Miami. We have our little band here but we are also so alone.

It is morning now and I can see, in my mind, the fisherman pushing their boats out into the sea as they have for hundreds of years; catching fish for the women to sell in the market. Watching the mountains emerge from the dark, lit from behind with a sun still soft and gentle.

Here the baby cries and we have made it through the night.

This baby. Her name is Esthere. And now I will, with all the love I know whoever you are who reads this has for all of us, go down and wash her wounds and feed her. I had to tell someone about her. I have to make her life real. I have to make it important so if you read this perhaps you will say her name today - Esthere- and she will be real and important for however long she or her mother may live.

Born under the stars

I wake up at 3:00 am and notice how sweet the air; the soft breezes that cool the night. The sky is full of stars and I watch as some shoot across the universe on a journey of their own. I am thinking how lucky I am to watch this with so little effort from my mattress on the floor.

Then, a horn beeping in the night. It beeps and beeps all the way down our road and by the gate and we all run. We grab blankets and gloves and then there right on the road, right under all those shooting stars and a crescent moon a mother gives birth with family and friends and midwives and driver all looking up at the night and then at the baby and thinking how glorious it all is.

In time, she is moved inside and another baby is born and as I walk from place to place I touch and carry and give and feel all the gifts that so many people have given to make all this possible.

Sometimes our steps feel lonely and even frightening but we all know that somewhere out there there are people who are walking with us and offering the simple gift of a blanket that we, thousands of miles away, wrap around a baby born outside on a star filled night.

Perhaps that is what stars are for; to remind us that we are connected by an ever changing night sky that we all can look up at and share no matter where we are.

A friendly cow pauses by our gate

A neighboor grazes his cow in front of MamaBaby Haiti.

Jason buries the placentas in the garden

This is Jason but everyone says it like this "jaaaay - son"
He has lived in Cap Hatien for most of his life and lived here at the birth center when it was a half completed house.

He is the one who opens the gate for the women in labor and the one who buries the placentas in the garden after a birth.

Most days, he sits outside the gate with his best friend, "The Boss". The Boss has a cow and Jason has two goats so they watch them and keep an eye on the road, greeting everyone who passes by.

He has many children and grandchildren who come to visit and his girlfriend cooks for us on Sundays.

Here is Jason, with a perfect placenta ready to be buried in the garden!

In Hait we are use to angles and miracles.

As a midwife, there is the moment the baby is born; the relief and gratitude I feel when the baby cries or lifts their head, eyes wide open to find their mother's face. There are the small. clenched fists and mouths that quickly suckle, a sneeze or cough to clear their lungs.

And while these things, sweet and miraculous are taking place, the uterus, former home of the baby must quickly empty itself of the placenta and return to its almost pre-pregnant size. The uterus, stretched to capacity must shrink down to the size of a grapefruit. It must clamp off the blood vessels that nourished the baby and in this feet of anatomical engineering, it must be careful not to loose too much blood. To do this, it must be empty; nothing can remain.

Mostly this happens. We wait and watch. Here in Haiti, we draw up pitocin before the birth and give it to the mom seconds after the baby is born. As a home birth midwife for all those years, I trusted that this would all work well but here with transport difficult and the women dehydrated and malnourished, we do not. This shot of pitocin, now known as active management of third stage, works well and we all feel pretty confident. "There is so little blood" we comment as we clean up and help the mom to a bucket shower and a clean pad.

And then there is the baby. After so many resusitations, always a happy sigh of relief and then on Friday afternoon, a woman bleeds an hour after birth and no amount of IV"s or medicine stops it. I put my hand inside and pull out hand fulls of blood clots and then in again and again; emptying the utereus and then for a long time holding it in place; rubbing and holding it beneath my hand forcing it to stay hard and small. We offer more medications, the power of a nursing baby and finally hours later it stays hard and the bleeding stops. Piles of laundry, used gloves and blood stained clothes.

We stand and go out into the hall to drink water and feel the fresh air of the approaching night. Another Mom is pushing; she is moving quickly and then there it is ; a perfect baby boy who cries and rests slippery and wet on his mama's breast and then the shot and the quiet wait for the placenta. I am drying the baby, changing blankets, offering the mom water and then the student midwife looks up and says, " the cord broke". I quickly change places and when I pick up the cord it comes off in my hands and there is no other end to be found. I try to reason that the other end must be right there and I can find it but can not. I reason the placenta can come out without the cord. Calm and reason.

We get her up. We give meds, oreintal herbs, Oregon herbs, more meds. We have her stretch and stand and squat but the placenta does not come out and she begins to bleed. For the second time in the day, I reach in to take the placenta out and it falls apart in my hands. I can not imagine what is going on. I feel for the familiar and it is not there. I can not feel what should feel like a placenta.

The Dad carries her to the car and our little team , along with Dad and baby, make our way to the hospital in Cap. And all the way I am holding the mom's head in my lap and holding her uterus in my hand; not allowing it to go soft. Sharon, the nurse, holds the IV bag. The always present holes in the road, seem worst than ever. I am afraid beyond afraid.. Why are there so many cows in the middle of the road. Why is it taking so long? Where did all these dogs come from? Which way to turn? Its so dark. Surely this alley is not the way to the hospital.

And then we are there. People everywhere waiting to get in; people sleeping outside. The Dad carries her in and then I am faced with a Hatien labor ward. Screams, rats, dirt, blood, one doctor for everyone. Rows of women drapped in stirrups withe no support or privacy. Babies waiting on the counters. We tell the Dad to put her on a bed and the very young Hatien doctor removes a small, deterioriated placenta that is more like a broken and deflated balloon.

We can not believe the baby survived and determine that the cord broke off at the base, leaving a large gaping hole in the placenta. There was not enough surface to nourish a baby and yet it did.
The mother should have bled more and yet she did not.

The father says to me, "we are use to angels and to miracles here in Haiti."

While we wait to make sure she won't bleed, Sharon covers babies and we try to help the other women. We get the doctors number and promise to call her. And there are women everywhere screaming. No one listens to heart tones. It is beyond my reason. Another mouse; no running water, no sheets.

And yet a woman, takes me to a washing station and pours clorox water on my arms and washes off the blood that is caked on my arms. I think she is a nurse's aide perhaps. The clorox burns and I am moved by this small kindness in the midst of so much.

I move from anger at the cows in the road, anger at the state of the hospital, anger at the situation in Haiti and then to tears and relief and then gratitude that the mother and baby were alive with virtually no working placenta.

We gather her up and head back to the birth center. This time, she sits with her husband; Sharon and I in the back with the baby. She walks into the center, bathes and gets into bed to bed to nurse and snuggle at long last. I am taken back by her strength and her resiliancy.

In the morning, Jason is sweeping the walks and the air is clear and cool with a soft Hatien sunrise over the mountains. I go downstairs to check on them and the other moms and then the fear and relief and exhaustion overcome me and I cry and cry with gratitude.

Each year hundreds of thousands of women die the world over because there is no trained midwife at their births, because there is no way to transport them to a hospital and no medicine to stop the bleeding.

The women of Haiti understand this risk and travel far to come here.

I feel inadequate and tired but there is team of us here now and others will come and go and when I look out two more women have come in the gate and are walking towards the door in labor. It is Saturday and Delha makes pancakes for everyone and the kids come in to show me their new drawings and the women must be checked in and a minster brings me bags of cocanuts and bananas and a new day begins.

"I am tired of Haiti being called the poorest country"

Santo stands up and says,"I am tired of people saying Haiti is the poorest country. How do they even know we are poor? We are not that poor anyway. They just say that." I can tell he is hurt, confused and mad and I guess just tired of hearing this over and over again.

On this particular afternoon, I have asked the Hatien midwives what supplies they think we need and they tell me throw away blue chuck pads. Right now we use washable pads and a wide variety of folded up sheets, towels and blankets; all that are washed by hand and hung in the sun to dry.

I pause and ask where we would get such a thing and when they say the United States, I try to say it is too hard to get that many chucks here and besides there is not a good way to dispose of them. I think of the road sides and streams and beaches all covered with endless litter and sigh.

It is then that he says, "we are not poor."

And for days, I think about his face and how it would feel to have the world call you the poorest country in the western hemisphere, the one with the highest infant mortality, the lowest literacy rate and on and on.

I think how I worked with a woman once who use to say how bad it felt to grow up poor and I remember asking her how she knew she was poor. I said I supposed we were pretty poor but I thought I had everything in the world one could want. I was surrounded by creeks, fields,forests and friends. If there was something better I had no way of knowing. Later, when I could make a comparison I still thought of my childhood as rich with the best of so many things.

When I walk out into my Hatien neighborhood, I see the richness of Haiti. I try to see the world through the eyes of the children I meet. It is warm outside and they play games with friends who live close by in small village communities. They throw water from the pump on each other and laugh at dusk when its time for a bath. They cook and eat outdoors and enjoy an abundance of fruit from the trees around them. When it is dark, they go to sleep or turn on the soft glow of a kerosene lamp. The dirt roads are worn and familiar and everyone calls "bonjour" or "bonswa". On Sunday, everyone dresses up and walks to church and the mountains echo with their faith and their songs.

I see this world and I understand that it is hard to hear that this life; this life so rich with family, church and the sweetness of life is anything but rich.

I try to say that the world measures poverty by schools, health care and clean water; things they all deserve. But I say I also know that there is another way of viewing poverty; the ones of isolation, loneliness, fear and greed.

And I promise, Santo, when we measure wealth by love, generosity, resiliancy and faith you will never be called the poorest country. You may even be called one of the richest of all.

"My name is Shilou"

"My name is Shilou Oger. I am thirteen years old. I have two sisters and a brother at home. Now I have a new baby brother who we have not named yet. I was chosen to come to my mother's birth because I am the oldest. We took the tap - tap a long way to come here. I had fun helping the midwives and the other mothers.

I go to school. I like to read stories. I like to play hide and seek and jump rope.

Now we are taking the tap tap home again."

A father kissing his new daughter

I have loved encouraging fathers to be a part of their children's birth. Here, a loving Papa gives his newly born daughter a tender kiss.

A Celebration of Names In Haiti

Through Our Garden Gate

A Celebration of Names In Haiti

Juseline, Maria and Cleanta

Come through our garden gate

Hips swinging, skirts swirling

Sassy, smiling; with periods late.

Miouse, Madeline, and Molemine

Wait by our garden gate

Somber , stretching, silent

Waiting their due date.

Rosana, Rosleande, and Lumane

Knock at our garden gate

Moaning, crying, holding on

Fearful of their fate

Iveline, Denise and Milouse

Fall to their knees and pray

Holding, squatting, calling out

As night turns into day

Dady, Elini and Joudeshka

When despair was very near

Opened up their hearts:

Abandoned all their fear

Nadine, Nadie and Yderline

Nuzzeled, nursed and knew

The joy of newborn babies

Named Merille, Fred and Ginew

Rosemon, Eline and Nadle

Left through our garden gate

Walking, waving, wishing

babies born in Haiti

Would live a bright new fate.

A pink umbrella at dusk

Perhaps in a busy world, it is the last beautiful images of the day that matter most; that linger and help us to make sense fo our world.

Last night, mine was of three young girls huddled close together under a pink umbrella; a new baby in their arms, as a light rain began to fall. I like to walk out to the gate and watch until the new moms and babies are beyond my view; until they turn the corner on the way to their villages.

There were eight births yesterday with so many images throughout the long day; cutting up the plastic table cloth to put under women, cutting blankets up to cover newborns, the thunder, the sweet open eyes of the newly born, the placentas one after the other left at Jason's door to be dug into the garden. The calls to Junior to keep the water buckets full and piles of laundry that had to be brought in half dry from the rain. Labors were short and long; sweet and hard; demanding and full of grace. A kaleidoscope of smells and sounds and images.

The three young girls, under the pink umbrella, arrived with their friend already pushing. They did not come with any grown ups; no mothers or aunts or grandmothers; just three teenage girls. We asked, "where are your parents" and they simply said, " she doesn't have a Mom." We pulled off her jeans as the head was just making its way into the world.

After the birth, they looked with appropriate teenage disgust at the vernix and blood. I don' t think it had occured to them that they come out naked and wet. But in time, they dressed him and the young mom wiggled back into her jeans and was ready to go. We convinced them to stay awhile and nurse and rest. In time the postpartum room was full of new babies and lots of people to visit with. She refused to breastfeed and when we asked what she had planned on feeding the baby she finally took off her bra and brought the baby to her breast with the encouragement of all the other moms in the room.

Then one by one the families said their good byes, newborn heads were kissed and only the three teenage girls were left. Slowly they gathered their things and went outdoors; raising a single pink umbrella, moving closer together and walking down the road.


There are people missing in every family; spaces left that can never be filled. Moms that would have been there if they could. And friends to hold an umbrella when they can't be.

Braids

These beautiful young women came to their friends birth and decided to braid my hair while we waited for the baby to be born.

One last check before sleep

After the sixth baby is born and tucked in, beside their mother, I walk from room to room, one more time before taking a shower and lying down. Every bed has a few people in them. Two grandmothers from different families sleep on a single bed; their two great grandchildren born within minutes of each other in beds on either side. Their heads, sharing one pillow, are wrapped in a swirl of lace and cloth.

Two very young cousins snuggle into a bed with the new baby they both worked so hard together to help be born. They make a heart with their sweet, teen age bodies around this new tiny little girl.

Moms in bed and Dads beside them on blankets on the floor. The occasional sound of a baby crying and asking to be put back to the breast.

Relatives from different families, who never went to sleep, sit on the porch talking with one another and sharing food. Outside, there is the sounds of the sheets being washed by sisters or aunts, squatting over tubs of water as they talk of birth and the days to come. The roosters and cows and goats remind me that although my day is just ending, it is morning here.

The skies are a gentle pink behind the mountains they call Mourn Rogue or the Red Mountains. They are a gentle slope of an ancient volcanic mountain range that is mostly buried beneath the sea, leaving 700 islands here in the West Indies. I tell the TBA that Haiti was once a volcano and I can see that she thinks this is just another one of my tall tales like a cervix opening inside a mother. She smiles at me and shakes her head and does not believe a word of it.

The mountains are the background of all our days and seem to hold us tenderly in their long sloping arms. I look out at them and the sunrise and then find a little rest.

Disney princess on a cloud of mosquito netting

Yesterday this premature baby was sleeping on a cloud of mosquito netting in her tiny Disney princess dress. She was born here and her Mom comes back regularly to eat and nap and get support with breastfeeding.

Spahgetti in the cord clamps !

After a busy day of births, I hurry to sterilize the instruments and a new cord clamp. We only have three sets so I have to set my mind to it first thing after a birth. I wash them and then look for a source of heat - charcoal, propane or electric depending on the day. The other morning I set them to boiling and imagine my surprise when I came down and the breakfast spaghetti was in with the scissors and clamps. I fished the instruments out and wrapped them up, determining it was still boiling water so it is okay.

However, I did not eat the spaghetti served that morning for breakfast !

Big sister

I was busy delivering this baby when I happened to look over and see this little girl peeking through the door at her mother in labor. Here she is with her new baby brother.

Patience

We have three more births on Saturday. I wake up and by six there are three women in labor and all the families on the porch watching through the window as I scurry about setting up a third birth room and walk in a circle bringing water, charting and taking vitals. They are all in hard labor and we wait to see who will give birth first. I think to myself " this is hard but I have it under control. " I walk around again. I catch one baby and Marie another and it goes well.

There is pause and number three who is having her first baby does not push. I look at her chart. Her name is Rosealine. It is common to to have an aline at the end of names. I say, "Rosealine" and she opens her eyes. I then witness what I now know as the shaking method of medicine which is if you don't know what's wrong and why, just shake or smack it and it will all turn out. A wide variety of relatives come and yell at her and shake her hard, despite my protests. Then the TBA comes in and thinks a good yelling and shaking will also help and then I scream at all of them and get the baby out- slightly premature and covered in meconeum ( baby's poop) which is not good. I am trying to suction the baby and they decide a good shake of the baby is good for whatever ails it too. But the baby is little and slippery and I am trying to make sure it does not breathe it in. Shake, rub. I say "no". A word they understand. I put the suction back in my mouth and the TBA grabs the babys face and starts to push dimples into its tiny, green face and I become hysterical. I loose all patience. The mother is bleeding so they pounce on her. Rubbing and punching her stomach. I say it is not her utereus. You have to feel and watch- not just grab mothers and babies and utereus's and pound and rub and smack them into existence.

When the bleeding has stopped and the baby is nursing and no longer green, I pick up and walk outside. I think about how frustrated I was. How I just wanted to be alone and take care of the mother and baby without all this yelling and rough treatment. Later I think about how if you could not read and had no books or medicine you would develop customs that might help and if you thought someone might die, it might just help to shake and yell the life back into them and I suppose in the case of babies and moms and utereuses it might have sometimes worked. At least worked better than nothing at all. I feel ashamed and tired.

The TBA brings me warm tea and gives me a kiss. I am so sorry I was not more patient. I show them pictures and try to explain but they think I know some things but not everything and a good smack helps many things. I try to say a good smack doesn't help anything - not really and they look at me but do not believe me.

After all the washing of the laundry, by all the relatives in the back yard, they go home and it is quiet.

The cook has asked for money for some fish and I give her a few dollars and ask to see what the fish look like when she returns. There are six very little fishes. I look down at them and think how will they ever feed all these people. Six little fishes. I watch them eat every part- licking he inside of the heads with joy and satisfaction. I wonder who gets the head as it seems to be a treat.

It is dark by 6:30 and I go to bed.

The moon is a crescent again. I have been here one month; one full cycle of the moon.

the dreams of a midwife

There is a wave of births; first one and then another and another and another.   I dream I am swimming in  a warm blue sea with the mothers and babies and the baby takes my hand and says, '"we'll do this together" and we drift in a place of dreams and trust until we come ashore and they are born. I dream and then more and more come.  Eight  babies to scoop up before they reach the floor in a swish of warm water, to breathe life into, to wrap their mothers reluctant arms around, to bring to the breast, to weigh and dress, to wipe and clean and change the sheets and begin again as the one before smiles and waves good bye and walks down the dirt road to home and family and another comes.

When I close my eyes, I am standing on the beach and the waves carry all these babies to me.  They are  laughing and cooing and I am collecting them like beautiful seashells and with my arms full, I carry them to their mothers who are waiting.

These are the dreams of a midwife, even now as it grows quiet

A free public education for all the children!

I jumped for joy yesterday when I heard that the legislature had passed a bill providing a free education for each child in Haiti. This will lay the gound work for change in Haiti as nothing else can. I am just so happy that come October all the children will get up and walk to school and I can watch them pass by. I know we will all be smiling a very special smile. All the marines in the world can not bring about democratic change as well as an army of dedicated teachers who love their students.

This is me with a new baby. mom, dad and Udel who is a traditional midwife who came and stayed and worked with me  This is the postpartum room

Many people make up my home in Haiti

It is 9:30 am and two mamas and babies are resting in the postpartum room on clean sheets with plates of fruit and porridge. It is Sunday morning and I tell the new Haitian midwife we are training that birth is a way of knowing and thanking God, in our own private way; for the miracle of it and that so often it all goes so perfectly. For the hope and possibility of that sweet new life.

In the place I live, everyone who is here, works to make that possible. There is Jason and his son Junior who bury the placentas and answer the knocks on the gate or call for transport to the hospital. They live in very small, tidy rooms outside and are a constant presence. They help with the garden and our the security which often means sitting outside by the gate visiting with those who pass by. Santo, the community health worker lives here and Marie the Haitien midwife and then any volunteers. Everyday our numbers swell with moms and babies, visitors and guests. I live upstairs in a dorm like life with communal meals and beds here and here. We move from our "home" to work in an instant, never knowing what will come our way or what the next moment will bring. The cook and the person who cleans and washes the clothes and sheets come each morning and stay until late. They sing and laugh and I can hear them chopping vegetables during the day. Their children come to and play here as well.

We all dream big dreams for Haiti and her children. We try to learn to talk each other's language and to make birth for the babies in the surrounding villages a safer, sweeter part of life.
I am never alone even when I am sometimes lonely for friends and family and those things sweet and dear to me.