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.