On a mountain trail

When I first came to Haiti, I would look up at the mountains and ask, "but how do I get there?" and "what is up there in the mountains?' But people would shrug and say that there were only farms there.

The mountains frame our lives here in Haiti. They surround us like a protective circle of soft, strong arms stretching out in every direction. They start our days with soft sunrises and are there when the world grows dark and the moon hangs low in the sky.

For all their beauty, comfort and encouragement I had not found my way up into the mountains. Our walks have, over time, taken us further and further down the soft, dusty roads that connect one village to the next. But always dusk would come or the need to be on call at the birth center and I would turn back.

But Joclyn, a volunteer who has been here for many months now, kept walking. She would return after many hours and tell us of the places she went and the things she discovered and so before she left to go home, I wanted to join her on her mountain trail.

We walked, as we always do, down the road past the new house of Madame Clauden's, past the quarry where people bathe, past the place where people wash their laundry along with an occasional truck to another small road to the left.

The road is lined with the neat yards and the houses of the people we greet. Children stop their play, to follow along and off we go. The road becomes more of a path and the houses become further apart. We pass a church preparing for a wedding and a small school house. We pass women braiding each others's hair and children in wash bowls. It is late afternoon and people are sitting by the road resting after many hours of work.

The yards are watered to keep down the dust and swept very clean. Most people have large fruit trees and a piece of lace or cloth hanging in the door way. Like all places, the countryside is very different than the city and reflects a nature sometimes lost in a crowded place. There are small cook houses and hedges made of cactus to hang the wash on. There is beauty in the soft order of yard and home and the passing of the day.

Slowly the road turns into a path and we begin to climb up into the mountains. Along the way. there are cows tied to a tree with a calf close by. There are small garden plots and fruit trees. many of the tress have been removed for charcoal making or farming. I am surrounded by pasture and I think that it looks more like my own childhood pastures than I could have ever imagined from my window back at the clinic.

We continue to follow the path as it wanders pass more cows and more gardens until we reach a clean, clear mountain stream that cascades into waterfalls. The small boys playing in the stream join us on our walk and we become a small band making our way up the mountain to the place where we can rest in a field of wildflowers and butterflies and look out at the sea.

From there, we can see so many paths crisscrossing their way across the mountains; the paths of the many farmers who stake out a cow or plant a small crop of food for family or to sell. These are small plots of lands lovingly cared for with hoes and shovels and machetes by farmers who watch the rhythm of the day high from these mountains before returning down the path as we do to their families and friend who wait for them down in the village.

The children, who followed us, slowly join their families again. A mother who had her baby at the center calls to Joclyn and we stop to admire her baby who has grown so much.

The road grows wider and more familiar. Someone offers a piece of casaba bread with peanut butter to the last remaining child. Dusk settles around us as we make our way home.

The mountains. like Haiti, are nothing like I imagined. From my window I could only see a sillouette and it was in my imagination something altogether different than what I had expected.
I could not have imagined the beautifully laid out plots of crops or the many kinds of cows with their baby calves; the clear streams or children with the freedom to grow up in and explore these hills and secret places.

Islar, a girl, who comes with us, knows all the names of the plants and can tell me of their many uses. She picks off branch after branch and tries to teach me their names and asks me to smell and touch and know this plant that is so dear and familiar to her.

I think of all the beauty I saw on my mountain walk and how difficult it is to know a place from the view outside ones window. I hope if you read this, I have painted a new picture of Haiti for you and I hope that wherever you are there is a friend that will lead you up into the mountains to follow a trail that will change your view forever.

Thank you Joclyn for helping me find my way into the mountains and for all you gave to the mothers and babies of Haiti while volunteering here in Haiti.

I talk about breastfeeding at local churches.

This morning I was invited to speak in several local churches about breastfeeding. I had the idea that if the ministers talked about how perfect breast milk was for Haiti's babies that they would reach many women and make a difference. I was surprised that they decided that I would be the best person to deliver the message.

I felt I was too busy with births Sunday morning to go, but Yotar ( a translator and minister ) insisted and soon we were driving down small dirt roads and into little villages to share this message. Melove came along as she, of course, knew where all the churches were.

The churches were in small lots, crowded corners and open fields. I watched as people gathered, sang, prayed and greeted us. I loved how the churches were all decorated with cut out decorations and streamers, They were cut from colorful pieces of shelf paper and were so intricately cut and lovingly hung. I was nervous to stand in front of everyone but with Yotar's urging and the knowledge that breastmilk can save so many lives, I stood up and shared with them that only a God, so loving and so intelligent, could have made such a perfect food for their babies and that only a loving God would have made sure that it was free and available to even the poorest baby in the world. And I thanked them for being a guest in their beautiful country and getting to hold their sweet babies.

I looked out and saw Melove standing outside listening. She does not have church clothes so she could not come in but she heard and was I think, happy to have helped.

I agreed that I would continue to visit the local churches for all the Sunday's I am here in Haiti and in that small way to empower mothers and their families to see the many ways they can help their own children to be healthy.

I am also planning a medical conference on lactation on March 17th. It seems like a bit of a risk but I am going to give these two things a try.

Thank you to Yotar for setting this up for me and not letting me be too busy to go.

The birth of Melove revealed

I found out today that Melove is a triplet. Her mother was walking many, many miles from the countryside to go to the hospital. This was some years ago and there were no motos to give her a ride. Just when she got to the crossroads, where she possibly could have caught a tap tap, three little babies slid right out there on the side of the road. Her mother named them Melove, Mylove and MeReganold.

And that is the story of how Melove came into this world.

A mother dog gives birth to a pig!

On a lazy afternoon after a busy clinic day and a late lunch, a few of us were sitting and talking when Mylove rushes in and tells us that a dog has given birth to four puppies and a pig. She has run all the way over from the house where they were born to tell us.

Given that it is picture perfect Haiti afternoon of sunshine and breezes, we all agree to follow her. She leads us down dirt roads and grass paths lined with walls covered with bright purple flowers to a clearing where many people have gathered. We can see that this is an event of considerable importance by the size of the crowd.

They announce that no one else can see them but Mylove shoves her way to the front of the crowd and makes sure we get in. We peer into a closet at four little black puppies and one little pig who is the exact same size and coloring. Only he has hoofs and a curly tail. There is no sign of a mother dog anywhere but there are many old shoes thrown in for them to chew on when they get teeth.

Many photos are taken to document this remarkable birth. Then we head back down the grassy path all covered with purple and orange flowers, down to the dirt road and back home where supper is waiting.

It is truly an amazing event and we are all appreciative that Mylove came all that way to make sure we got to see it. We leave her on the road where we are sure that if there is anymore exciting things happening, she will be the first to know and that she will be sure to let us know as well.

And that's how we passed a beautiful afternoon at MamaBaby Haiti.

Mylove

I was raised with the many stories that comprise what we know collectively as the "American Dream." We grew up watching Cinderella go from washing pots and pans to marrying the prince. We watched transformations after transformation as Beast turned into a prince, pumpkins turned into coaches and mice into coachmen. We were shown the power of love with kisses that could awaken sleeping princesses. We believed that one could move, transform, have dream and have those dreams come true. In the Bible, we were taught that babies left in baskets could be kings and a carpenter could inspire a new religion. We knew the story of the Good Samaritan and of the brother who came home and was forgiven. We knew that people could make mistakes, bad mistakes and find love and redemption. These were the stories we were raised on.

We read Dickens and other English authors and clenched our fists as we hoped they would find their true family and be saved from a life of poverty and get enough food and school. In modern cinema we cheered on a host of female actresses who overcame poverty and oppression. These films won Academy Awards and became a part of our collective conciousness.

Somewhere, inside us, we believed that Cinderella was possible. People without legs could run marathons and the blind could read and the deaf could communicate with beauty and grace.

My country, flawed and imperfect, taught me to believe and even when this basic premise of American society failed, someone would come along and make it right and we would in time see our mistakes even if it was very, very hard and took considerable effort.

Here in Haiti, I believed that Mylove could be that story. She is smart and tough and full of passion. In the few months I have lived here, she had a baby and two weeks later lost her husband to cholera. She lived withe her mother who has not walked in 12 years and her older children. She gets up in the morning tend her garden plot, looks for castor beans to make castor oil and then begins her daily hustle to support her family. In the midst of this, she did not see that her two year old daughter was starving to death. If she left her in the hospital, she had to stay with her,and no one could care for her mother or the children. We could have helped but the grandparents came and took her to the countryside and she died.

Still, Mylove has other children and she can not give up. My friend who volunteers here, decided that she could teach her to pull the files in the morning. We would ourselves pay her a small salary and teach her skill and keep her form doing something not safe and she could bring the baby. She came dressed up ready for work and did the job perfectly. She shone.

After two days, I was told that I had brought great shame to the clinic by having her train there. I was told you have to go to school to learn to pull files one hour a day. I was told that I had disrupted the entire order of Hatien society and that the clinic could be closed because of my actions. What would people think if they someone like Mylove collecting names and pulling charts.

I was told that this was the American Way and not the Hatien Way. We do not do on the job training for clerks ever.

Mylove's body became hard and tense, as it was at the funeral, when we told her she could not train here. Hard and tense and ready for the next blow.

Who stood beside me in her defense as rocks were thrown against a woman who perhaps had done the unthinkable to feed her children ( and perhaps had not ) ? No one but me and the friend who was training her.

I have not recovered from this blow but what I know is that opportunity for everyone is not a fairytale or simply The American Dream. It is a universal right embedded in the dignity of the human spirit. All people can better themselves and all people can lend a helping hand, whenever they possibly can.

And so I hear the words of the little red haired orphan, Annie, singing "Tomorrow, Tomorrow" and I know that I have not given up on Mylove and will think of something, somehow.

Oh and these are the people in my neighborhood

Sometimes I walk outside, after a busy day in the clinic. I breathe deeply as I walk onto our front porch or into our yard or onto the road and in those places I feel the richness of my life in Haiti. So many different people gather there to work and talk; to play and pass some time with us.

It is Jason's job to keep people out but more and more the circle of who comes in the gate grows into the beat and rhythms of our day to day life

On this Saturday afternoon, the Gardner's son plays soccer with the other boys in the neighborhood, shooting balls into the chicken yard causing them to run and shriek and fly over the bamboo and wire fence. Then Mylove and her daughter come to show me her new school uniform because she is starting school on Monday. So then everyone must run and chase the chickens and get them pack in the pen. The soccer ball ( a gift from a former student ) lands in the chicken yard again and so the chase begins all over again.

A woman in labor walks by moaning softly. leaning on her sister and a friend. Relatives bring food to a mother who has already given birth and another mother prepares to go home with her baby in her arms.

In the back yard they are telling stories as they wash clothes and stir beans for dinner. I say that if you come and help withe the work, you can always join us for a meal and most often the Gardener and her daughter are there and the baby who sits in a wash tub and peers out into her world.

Next door, a strong man with a limp tends his land. Most often there is a cow grazing there and new crops to plant or harvest but these days he is making charcoal under large wooden piles of branches. It fills our lungs with smoke and we complain but know he is working so hard for his bag of charcoal to cook his own meals or sell in the market. He guards his land with piles of prickly plants. He comes early and I enjoy watching him out my window as the seasons and their crops pass before my eyes.

Dafka, the baby who was so hungry and who lost her mother, comes in the arms of her father to be weighed and to get new formula. I fill the older children with fresh fruit and piles of art supplies. A volunteer changes her and puts her in new clothes as we photograph her progress and talk to the Dad about a micro loan so he can keep his family together.

I have carried a great deal of grief with me this week as I thought about the death of MyLove's little girl. I know it was only last Saturday and that it is normal that I should still and perhaps forever feel the sad aftershocks of this preventable loss. Inside I am all tender and raw and so it is good to go outside and to watch all the people I have met and to celebrate the goodness of my neighborhood; how they help one another and enjoy their life.

I know everyone well enough to know the burdens and sorrows each one carries but here we all are with the gate opened just enough to let a good measure of love and friendship in even when it would be just as easy to keep it shut. Or to build it too high for a ball to make its way over.

The Gardner Is Madame Clauden

Life has changed for the "Gardener" and her daughter and actually her whole family. Now we all call her Madame Clauden; a name she carries with dignity and grace. Yesterday it was raining and we both incidently wore bandannas on our heads- hers was red and mine was blue. People said we were twins. She laughed and I was pleased to be the twin of such a fine woman.

We have worked to move her and ll her children into a half completed cement house down the road. It was a great day when we collected her belongings from the one room she was staying in withe her daughter and baby and moved her down the road. It was quite an event and soon her other children were gathered up and they were all safely together again, sleeping on the floor by candle light and celebrating.

My idea is to make it a Hatien guest house and people can stay with her as a home stay to help support the project. She would cook and help the guests to learn Creole and experience Hatien culture. This is common in other countries and so perhaps Haiti. It is a sweet house with nice porches and a lovely garden. The guest room is large with its own door and bathroom ( nice and modern but operates via pump water ) Perhaps one day you will know someone who wishes ot stay in a guest house in Haiti. They would walk down our simple dirt road and be greeted warmly by animals and people and mostly sunny days.

Madam Clauden has also been taught the art of chair massage and offers massages to volunteers which I believe is paying for her and her family's food. All the children are in school except the daughter with the baby.

The baby is chubby from breast milk and so although there are many challenges still facing them, it is a bit brighter and I wanted to share this good story.

I would send a photo of them in front of the new house but it is not always possible.

PS.

Jason's goat has had two tiny baby goats that are much loved here at MBH.

The Funeral of Valencia

I ride on the back of the motorcycle, holding onto the driver who is young and smells of junior high cologne. Behind me is a mother from a small village near the clinic. She is twenty four and we are part of a small funeral procession for her two year old daughter who died the day before. Another volunteer sits behind her. On the next moto, her baby daughter rides in a small wooden coffin covered with grey flannel. She is squeezed between two cousins and another moto driver. These two motos make up the entire funeral procession that makes its way from the end of a long dirt road to the public cemetery located in a larger village some distance away.

I have been to other funerals in Haiti; ones with church services and bands and a procession to the graveyard. I have seen whole schools, in uniform, follow behind coffins and so I am aware of how small we seem. The men taking the cow down the road and the children with sugar cane in their mouths stare at such a small coffin but I can tell it is not so strange a site for a Saturday morning. These things happen.

We weave in and around the large, muddy ruts and holes of the dirt road; getting out to walk when the holes get too deep for the moto to manage with all of us and the coffin.

We have been at the house of the baby’s father. He himself had died in July, leaving his wife pregnant and with three other children to care for. I first met her when she came into the center and gave birth minutes after arriving. She said the father was run over by a bus in the Dominican Republic but really I am not very sure as she also said he died of cholera one afternoon after work. I had paid her a small amount of money to clean the center on Sundays. Her mother, who has not walked in twelve years makes castor oil from the beans she collects. She has a garden plot for the family and some say she sells sex to buy her kids food but she has never told me this but only comes for a regular supply of condoms that she says she is getting for her sisiter.

The father’s family, when they found out the little girl was sick, had come and taken her and so for some weeks we had not seen or cared for her.

This house, which was her last home, is made of woven branches, stucco and is covered with a metal roof. When I get there, the baby is lying on a mattress and the neighbors are peering in the shuttered window. The baby girl is dressed in an old white, too big, fluffy dress and wrapped in a curtain. After some time, they try to put her in the small box but it is difficult and requires many adjustments. A rock and rusty nails are brought to hammer down the lid. The women and young girl cousins begin to cry and scream while the men play dominos on a table outside the house. I remember the sound of the dominoes being thrown mixed with the sound of the women crying and screaming and the pulling at their hair. These sounds and motions, one on top of the other.

The coffin rests on a table in a small room. There is a dirt floor that is in need of sweeping. The mother sits outside and stares straight ahead. She does not cry. Nor does she touch her daughter or kiss her but holds onto her red phone and talks quietly to the men from time to time. Her body, stiff and hard.

I sit with the baby girl and cry until I can not cry anymore. I ask Nathan, my grandson who has died, to take care of her. He was nice to young children and I trust her care to him. I call on all my ancestors and the people who have gone before me to catch her as her tiny soul floats their way.

I watch the grandmother, her hair tied in a blue head scarf. Her face tells me that she has buried many babies, children and a son. An old man with a machete and big yellow boots comes in from the fields and shakes his head and then goes back out to his work. In time, they carry her out to the waiting motos and we move down the road; the sounds of the crying following us into the morning.

I lean into the moto driver, afraid of the ride but too exhausted to care if I too die here in Haiti. I am worn down.

We stop at a graveyard that is locked. They yell for the grave digger and when no one comes climb over the wall and at last a man comes out and lets us in. The mother stays behind but I crawl over old tombs and weeds and human bones to the hole they have dug for her. It is clear that I am peering into a common grave and that many people have also been buried in that space. There are pieces of coffins, bones, cloth and garbage. I am weak with my inability to change what I am a part of. They toss her little box in the hole. I collapse and watch as her little body is covered with whole human bones, cloth and old rotting coffins. I make a small effort to pick wildflowers and throw them in the grave. It is too much for me and in my mind I lash out silently at all the architects of her death.

She has died of malnutrition and starvation. Some children here only die of malnutrition but she has died of both. When I met her, which was long after I had been her mother’s midwife, she was close to death. Her mother brought her late one afternoon and we quickly took her to the hospital.

I remember that she was wearing a too big green velvet dress that covered her swollen legs and I remember being confused at her splitting skin. I remember that she was in so much pain. Here when people want to comfort me, they remind me of how much she suffered and how much pain she was in. I remember but I am not comforted. I am a mixture of fury and exhausted grief.

Come night, I dream I am Peter Pan. She has on the green velvet dress and we are flying over the blue sea and I am showing her great pods of whales and dolphins. More children join us as we fly to an island where we rest and eat and are all-safe together.

There is no marker for her grave so I will record her life and death here. Her name was Valenda Juliene. Her father was Vernel and her mother was Melove Pieerre. Valencia died at 3:00 pm on February 9, 2012. She laid down in a patch of sunshine in the dirt and just died. She is survived by a twin brother, an older sister and a baby.sister. When asked why her daughter died, she said that some people say it was bad breast milk and some say a person was mad at her and the doctors say she had malnutrition.

She is here at 6:30 am to clean. We feed her and her children warm bowls of pumpkin soup and keep them close. When asked why she did not cry at the funeral, she says, “everyone is sad in their own way and I did not want to faint.” She has been on her won since she had her first baby at 14. She is beautiful, smart, tough and tragic and we can not help but love her.

The hsitory of the world on a baby's head

There could be many reasons why I am not still sleeping. It could be the full moon that has lit up my room and made me think it is morning. But no, it is not the same golden pinks of a Haiti morning; the light that emerges from the mountains. It is the cool, white light that weaves itself into dreams.

It could be the garden next door where a cow tied to a tree cries. Or a farmer burning their fields or a dog setting off a chain of crowing roosters long before it is time for their daily chorus. Or maybe it is the few hours of electricity that only come on in the wee hours of the morning or the touch of the mosquito netting as I toss and turn; the way it comes loose and wraps around my body.

It could be any of these things but it is my dreams that wake me; the dreams that connect my daily work with the places deep inside me that do battle with the lessons offered to me here in Haiti. It is my dream that wake me; the dreams of a baby's hair.

A newborn baby's hair here in Haiti is the softest and most wonderful thing one could ever imagine. It is black and rich and curls around your fingers when you feel the bones of the head when you do a newborn exam. It melts in your fingers. Each week, when the mothers and babies return, I gently check the openings of the baby's skull. It is second nature for a midwife or doctor; this sweep of the hands over the baby's head. We measure the head circumference, record it and graph it as we look for patterns of health or disease.

As the baby's I have cared for here, grow older, I notice far more about their tiny heads. I notice their hair. I come to suspect that I can tell what the baby is eating based on the texture of the hair. I notice when it begins to fall out and become thin and coarse. I notice the sores on the scalp that start as spots and move to open wounds.

I come to know when they are no longer just breastfeeding by the texture of their hair and the health of their skin. I see that healthy start slip through my fingers.

In my dreams, the babies and I are in a box surrounded by the sea and fish of Haiti's waters. There are all the fresh fruits of Haiti and rice fields filled with Hatien rice and yet we can not get to it. The box is made of thick plexiglass and we can see the food but we can not touch or eat it. I keep banging on the plexiglass as I try to tell someone to let us out so the baby's can eat.

In the clinic, I pass out bars of soap and squeeze ointments into small bags and offer shampoos and advice about good food and sunshine to sterilize bedding. I do this many times a day.

But at night, when I am alone, the images erupt in the grief and anger of dreams. When I wake, bathed in moonlight and stuck in the mosquito netting, they stay with me until i must get up and write them down and be free of them.

In five hours, another line of mothers and babies will walk in our door and I will try to get us out of the plexiglass box that I feel trapped in with them. I think to myself that I can read the history of Haiti in a baby''s head; the exploitation of natural resources and people that rob that baby of nutrients. I can read that story on a baby's head. I see the sores and scars and fallen hair like a map of the world. I rub oils and ointments and lotions into that map and try to erase the way it was written but I can not.

I, like millions of people who have woken up in Haiti, am healed by her mountains and the colors at the start of day. Night will pass and the dreams will only be lingering reminder of those things I struggle to say come daylight.

An English Class for Girls

When my sister, Beth, offered to come to Haiti and help out, I tried to think what she could do in a short time that would have the greatest impact. I thought of the many girls I met who were not in school and who often seemed eager to spend time at the clinic. I decided a girls class that combined health, art and English would be empowering and fun. Although I had planned for a small group of fifteen girls, the numbers often swelled to 60, as they packed into the postpartum room for songs, poems and lessons in English. The youngest was five and the oldest seventeen. They lingered long after the class was over and cried when she left to return home to the United States. Our Hatien midwives joined her each day for the advanced English class with the older girls. It was wonderful to have a sister here with me in Haiti and to watch her work with such skill and love with the young women of our community. After she left and the familiar solitary space grew around me again, I realized that most of the children I have met who were severely malnourished or not in school were girls.

Each day, at the start of clinic, I tell the women that they are the most valuable resource in Haiti because they will grow and care for its next generation. They look amused but also surprised to think of it in this way. In the girls English class, my sister and our friend, Maxa, showed the young women how important and valuable they were.

The international plan for lowering infant and maternal mortality is embedded in the need to empower, educate and protect young women. These last three weeks, with Beth and Maxa's help, MamaBaby Haiti helped build that strength in a beautiful, smart group of young Hatien women.

Thank you. Your songs and laughter still echo in our hearts.

The Baby Shower Script

In rural Oregon, a group of Job Corps students in Jill Howdyshell's ESL class celebrated MLK Jr Day of Service with the Baby Shower script crafted by some middle school students in Portland, Oregon. The activity, designed after Oxfam's Hunger Banquet helps participants understand global issues of maternal and infant mortality through a very unusual "baby shower." Perhaps you or a group you know would be interested in hosting such an event. My good friend, Jan Zuckerman, collaborated with me on this with her in Oregon and me in Haiti. If you are interested in this script, please e- mail me and I'll send you the script.