When it rains

Marie, the midwife from Hench, who left so quickly to go home when I arrived is suppose to return today but calls to say Monday instead. I worry that she might not return at all as she is so far from her family and young children. This would be, of course, understandable, but still we need more than one midwife here.

It rains though and when it rains they do not come to the center but have their babies under tin roofs with local midwives and come to see us in the morning. Or they do not come because they can not find or afford a motorcycle ride and it is too dark to walk. Yesterday morning a woman walked to see me only a few hours after the birth; the baby's cord bleeding quite badly. I have become accustomed to this and quickly re clamp and cut it and bathe it in alcohol; wrapping the baby back up and handing her to her strong mother. The baby was dressed in a very frilly pink dress and blanket and booties so I was quite surprised to remove the diaper and find a boy.

I try to teach, Audel, the traditional midwife who I have brought to stay with us about washing and boiling the scissors for a birth. I motion to boil them quick while the electricity is on and I find her standing with the scissors staring at the stove and I realize she has never seen one before and I am sorry for my assumptions. I show her how to turn the stove on and boil the scissors. I want her to do this when she leaves here to practice again in the poorest neighborhoods of Cap Hatien but I don't know how she can. She says she will bring many traditional birth attendents to study with me and I say yes but wonder where to begin. Haiti has the highest infant mortality rate in the western hemisphere and most babies are born with traditional birth attendents at home with no training. Adul says they cut the cord with rusty razor blades and I think, at least,w e should be able to give out clean razors and sterile clamps.

Paul Farmer's book the uses of Haiti is his best and quite a lesson in United States history as well.