I am happy to share that the front room of The Gardener ( Madame Clauden's) house is emerging as a small community reading room. It is a sweet house with old fruit trees, a garden and many flowers. Now, thanks to the work of so many, it also has a shelf of books in English, French and Creole. Life is still not secure for this wonderful family but it is my hope that this small library will bring them stability and much joy.
I know that good health goes hand in hand with education and literacy. I hope that these few books will offer comfort, inspiration and knowledge to the people in the community. I have forever been grateful for the book mobile that brought books to my rural community. I looked forward to the many hours of reading it would offer me and now as, an adult, books continue to be wise and good friends to me.
Everyone who comes to Haiti, is touched by the beauty, dignity and warmth of this family. I have seen them in such hard times and am watching them emerge as the joyful, close family they always were. Because of all the daughters they remind me of the book, Little Women. They sew, cook, go to school, garden and welcome many visitors to their home.
I am hoping this small library will be a natural extension of the warmth and wisdom they have offered me while here in Haiti.
And I am hoping, if you ever come to Haiti, that you too will wonder up their garden path and enjoy a book admist the hibiscus and papaya.
These are the stories of my work as a midwife throughout the world. These are the stories of midwives, mothers, babies and the communities they live in.
Wednesday, March 28, 2012
Monday, March 26, 2012
Working in the community
This week- end our our community volunteers reached loving hands out into the community to help the families we serve. Walking down familiar, dirt roads and paths, through fields and amongst the cactus fences they got to know many warm and wonderful people as they worked side by side with them to improve the community.
Phil worked with three young men to hang plastic on the ceiling of a roof that was leaking rain onto an elderly, crippled woman. We all enjoyed some time in the sun holding babies and catching chickens as they worked together. The house still feels fragile but for now her bed will be dry and she will sleep better each night.
Ray walked to the orphanage where he did physical exams on the sickest children; something they had asked for all year long. Later we walked the children back to MBH where they enjoyed a movie and sandwiches provided by volunteers.
Phil, Tai, Megan and Jackie all painted a new community library we are working on. By evening the first ten books of the new library were on the shelf. Dafka's Dad came by with a sick baby Dafka saw he left her with volunteers and painted with the other volunteers.
Megan worked hard to create a web site to raise money so that Dafka's Dad could start a little business to support his struggling family.
Ray saw elderly patients from the community all day Saturday. I had given coupons to all our Hatien staff so that they could give them to people who they thought most needed care. They seemed to appreciate being able to offer the much cherished doctor appointments to the people in their community and to a part of the clinic life. Ray is the husband of one of my closest friends, Coni, who I met so many years ago in junior high. It has meant so much to me that she and her family have come to see me here.
Today the young women will head off to the orphanage again to help teach while Phil builds benches for waiting patients.
It was a busy but happy week-end here in Haiti where I once again enjoyed watching people fall in love with a country so different than the one they learned about in school and in the media. There is much to learn through service and this week-end a small corps of young women and some loving parents used spring break to expand their hearts and minds.
Phil worked with three young men to hang plastic on the ceiling of a roof that was leaking rain onto an elderly, crippled woman. We all enjoyed some time in the sun holding babies and catching chickens as they worked together. The house still feels fragile but for now her bed will be dry and she will sleep better each night.
Ray walked to the orphanage where he did physical exams on the sickest children; something they had asked for all year long. Later we walked the children back to MBH where they enjoyed a movie and sandwiches provided by volunteers.
Phil, Tai, Megan and Jackie all painted a new community library we are working on. By evening the first ten books of the new library were on the shelf. Dafka's Dad came by with a sick baby Dafka saw he left her with volunteers and painted with the other volunteers.
Megan worked hard to create a web site to raise money so that Dafka's Dad could start a little business to support his struggling family.
Ray saw elderly patients from the community all day Saturday. I had given coupons to all our Hatien staff so that they could give them to people who they thought most needed care. They seemed to appreciate being able to offer the much cherished doctor appointments to the people in their community and to a part of the clinic life. Ray is the husband of one of my closest friends, Coni, who I met so many years ago in junior high. It has meant so much to me that she and her family have come to see me here.
Today the young women will head off to the orphanage again to help teach while Phil builds benches for waiting patients.
It was a busy but happy week-end here in Haiti where I once again enjoyed watching people fall in love with a country so different than the one they learned about in school and in the media. There is much to learn through service and this week-end a small corps of young women and some loving parents used spring break to expand their hearts and minds.
Thursday, March 22, 2012
When aliens invade the body
I am a person who for many, many years loved nothing more than going barefoot through the pastures of my childhood. I delighted in the cool grasses and would even walk through clover patches filled with bees or into a barn filled with decaying manure. I liked to feel the earth beneath my toes; to gather all there was to know through the senses of my feet.
I remember a college professor telling me that if I lived in the south, I would get hookworm. I was sitting in a large classroom and he told the whole class that if Sarah lived in a warm climate, she would have worms by now and everyone turned to look at me but I shrugged and kept going barefoot. The possibility of a worm entering my feet without me knowing seemed as impossible as a man, several years later, going to the moon. I was pretty sure he just didn't want me barefoot in his classroom and failed to pay close attention to the life cycle he was trying to illustrate through my bare feet.
But now, when I see a child barefoot in the dirt, I am alarmed. I see Milove, yesterday, her toes brightly painted with nail polish I had found, going barefoot. I know she does not have a latrine and has no water for over a mile. I know they all live in a very small, mud house and I know her two year old son has repeated infestations of hookworms. I want to see. "Milove, wear shoes' but I know too that they must be saved for going out somewhere and not around the yard.
I never go barefoot outside anymore and most often wear shoes inside as well.
I have come to carefully consider the life cycle of this parasite and its effect on the women and children here. I know now that the eggs leave the human body through a person's feces and become larvae in the warm damp soil of tropical climates. Once they enter a barefoot, they travel through the vascular system, into the lungs where they are coughed up and swallowed and begin to complete their life cycle in the guts of 600 million people world wide, by sucking their blood" voraciously" and laying 30,000 eggs per day.
When a woman is in labor, I see the trails and tunnels on her feet. Sometimes I take them in my hands and hold them there so that they can rest awhile.
I can not see the worms. What I see is a chronic cough, anemia, premature babies, small babies, swollen children and malnutrition leading to a host of other complications. I see children who already can not find enough food, unable to fully utilize the food they get because they are competing with hookworms who are devouring their stores of iron and protein.
I think of the worst, scariest science fiction movie in which aliens invade the body and grow inside an unsuspecting hero. The problem is that these real life aliens live in the soil and come back over and over and over again.
When Dafka's Dad, has to go to his brother's funeral she spends the night with us and her diaper is filled with worms. Dafka can barely put any weight on her tiny legs let alone walk barefoot but she can get them from care givers who do not wash their hands after going to the bathroom. Dafka is in the less than 0% for weight for a baby her age and that is with our volunteers bringing her formula. (Dafka's mother dies shortly after she was born so she can not be breastfed)
Our protocol is to give all pregnant women in the third trimester abendazol to kill potential worms and hopefully prevent the complications related to severe malnutrition and anemia. It costs about 10 cents a mother. The World Health Organization believes that of the millions of people who are infected with hookworm, only about 8% are ever treated.
I lie in bed and try to think about other things. I wonder what I use to think about but I cannot remember.
I remember a college professor telling me that if I lived in the south, I would get hookworm. I was sitting in a large classroom and he told the whole class that if Sarah lived in a warm climate, she would have worms by now and everyone turned to look at me but I shrugged and kept going barefoot. The possibility of a worm entering my feet without me knowing seemed as impossible as a man, several years later, going to the moon. I was pretty sure he just didn't want me barefoot in his classroom and failed to pay close attention to the life cycle he was trying to illustrate through my bare feet.
But now, when I see a child barefoot in the dirt, I am alarmed. I see Milove, yesterday, her toes brightly painted with nail polish I had found, going barefoot. I know she does not have a latrine and has no water for over a mile. I know they all live in a very small, mud house and I know her two year old son has repeated infestations of hookworms. I want to see. "Milove, wear shoes' but I know too that they must be saved for going out somewhere and not around the yard.
I never go barefoot outside anymore and most often wear shoes inside as well.
I have come to carefully consider the life cycle of this parasite and its effect on the women and children here. I know now that the eggs leave the human body through a person's feces and become larvae in the warm damp soil of tropical climates. Once they enter a barefoot, they travel through the vascular system, into the lungs where they are coughed up and swallowed and begin to complete their life cycle in the guts of 600 million people world wide, by sucking their blood" voraciously" and laying 30,000 eggs per day.
When a woman is in labor, I see the trails and tunnels on her feet. Sometimes I take them in my hands and hold them there so that they can rest awhile.
I can not see the worms. What I see is a chronic cough, anemia, premature babies, small babies, swollen children and malnutrition leading to a host of other complications. I see children who already can not find enough food, unable to fully utilize the food they get because they are competing with hookworms who are devouring their stores of iron and protein.
I think of the worst, scariest science fiction movie in which aliens invade the body and grow inside an unsuspecting hero. The problem is that these real life aliens live in the soil and come back over and over and over again.
When Dafka's Dad, has to go to his brother's funeral she spends the night with us and her diaper is filled with worms. Dafka can barely put any weight on her tiny legs let alone walk barefoot but she can get them from care givers who do not wash their hands after going to the bathroom. Dafka is in the less than 0% for weight for a baby her age and that is with our volunteers bringing her formula. (Dafka's mother dies shortly after she was born so she can not be breastfed)
Our protocol is to give all pregnant women in the third trimester abendazol to kill potential worms and hopefully prevent the complications related to severe malnutrition and anemia. It costs about 10 cents a mother. The World Health Organization believes that of the millions of people who are infected with hookworm, only about 8% are ever treated.
I lie in bed and try to think about other things. I wonder what I use to think about but I cannot remember.
Monday, March 19, 2012
A Conference for the Medical Community on Beastfeeding
I knew it was an important event because the women in the kitchen killed six chickens for the lunch and offered to iron my clothes. We moved all the beds and slowly turned the postpartum room into a conference room, set up every chair we could fine and then with a prayer and a song, began the conference on breastfeeding in North Haiti.
When I had first thought of working in Haiti, I had thought most of all about the births and did not understand how much I would be called to attend to the problem of under five deaths in Haiti and the world. You see, each year, nine million children under the age of five, die throughout the world. I have shared with you some of my experiences with malnutrition and the death of young children and I hope I have shared my optomism that this can be helped by the protection and promotion of breastfeeding.
The conference was attended by doctors, nurses, midwives and traditional birth attendents with no way to distinguish one from the other. I opened the conference by giving everyone a gold ribbon tied into a bow to wear. This is the symbol UNICEF and the World Health Organization chose to represent the call for increased breastfeeding world wide as a key strategy in reducing under five deaths.
One bow is for the mom and one for the baby. The knot represents the community/family/father whose support makes breastfeeding possible. One ribbon stands for six months of exclusive breastfeeding and two years with appropriate supplemental foods. The other ribbon stands for the spacing of children three years apart to ensure good nutrition and health for both the mother and children.
It had been my goal to host such a conference for the medical community and I set out to make sure I did this before my time in Haiti came to a close. It was little overwhelming and a bit scarey but days such as these unfold as they will. The presentations were professional and well thought out. The audience was appreciative and eager. The food was magnificent. People left smiling and hopeful.
In time, the beds returned to the postpartum room and the moms with their starving babies, infections, superstitions and fears fill them. And I, take a deep breath and begin again confident that this Monday morning there are many more voices in Haiti carrying this message forward. My thanks to everyone who came and presented and to all the wonderful women who fixed food with so much love and grace and for the medical community of Haiti who found their way to our gate. On many days, life is better than our wildest dreams and expectations.
We ended the day with a walk up the mountain to the place where people gather to sing and pray and watch the sunset over the bay. The young boys, of the village, give each other bucket showers and later use the buckets for drums. I walk back to the place that has been my home here in Haiti, tired but grateful
Saturday, March 10, 2012
Seasons
In Creole, the word for rain is "lapli."
Since I have been here in Haiti, we have had a rain shower almost every day. I had come to know the rhythms of the island's landscape and her people through the rain. "Lapli" I would say as the rains began each afternoon. "Lapli." The word seemed so perfect for the warm, nurturing rains that gave water to people and animals and crops.
I had known warm afternoon rains where children took off all their clothes and bathed in the yards; their young bodies covered with soap and their laughter echoing off the sides of the mountains. I had known house shaking thunder and lightning storms that lit up the room as a mother was giving birth. I had known floods and puddles and swollen rivers. I had known village pumps and bottles of water carried on a young girls head. I had known springs where women gathered to wash their laundry and wait for it to dry in the sweet morning sun; visiting with friends and neighbors while children played. I had known the fears of water not boiled and the fear of water too close to open latrines.
I had learned to bring in the birth laundry from the clothes line quickly so that it would be ready for the next birth. I had learned to grab things from the porch and to put things up high that might be damaged by a flood. I learned that if it was raining women were more likely to give birth at home. I had learned to live by her comings and goings; to manuever the car around large ruts and puddles in the road to avoid being stuck in the mud. I had accepted mud splattered legs and to look for places where mosquitoes could hatch. I had learned something of the rain.
But it has not rained in three weeks and I am thinking about when it will rain again. When the breezes come up at sunset, I am sure they will bring with them the rain but they have not.
The dirt roads, particularly the main ones, become dusty. The pale brown dust covers the trees and houses and the people. The open air, "tap- taps" are filled with dust. The babies who come to see me have noses and lungs filled with dust that turns into coughs and wheezing. Respiratory infections become a parents greatest fear and worry.
The farmers can not possibly carry water up to their mountainside crops and even the gardens in the villages have no irrigation. I watch to see if the beans are okay and understand why they do not/ can not grow water intensive crops.
On the mountain side and in the land next door, farmers make charcoal that also clogs the lungs and noses of everyone. But this is how everyone, including myself eats. It seems that everywhere there are the slow smoldering fires of the charcoal makers and the men burning field before planting crops. I see it when I am out for a walk and high up in the mountains. It must be a good season for charcoal making as the rains will not put the fires out.
I use to teach children that there were four seasons; winter, spring, summer and fall but now I see that there are two seasons; a rainy season and a dry season. In the United States, much has been done to minimize the effects of seasons on agriculture, food production and human comfort. We have big machinery and paved roads. We have irrigation and city water systems. We have heaters and air conditioners; refridgerators and food preserving factories. Not always, but mostly,inventors and engineers have planned for dry times, cold times, hot times and the rains.
I watch to see the many day to day ways that my neighbors adapt to and use this dry season.
I watch the children sweep the dirt yards neat and clean each morning and toss water on it to keep the dust down. I see that parents do not take their young children out too much on the tap- taps. I see that the farmers plant crops that need little water. I see that the small mountain paths that wind by the streams and connect villages are not dusty. I see that the warm dry, days make the corn ripen and are good for drying beans.
If I am quiet and watch I will learn about this season here in Haiti and come to know her through these times just as I came to know her through her rain.
I like many people, struggle to live in the present moment; leaping backwards and forwards with such speed that I fail to recognize the small movements, gifts and intricate beauty of the season I am in. Here in Haiti, where the day to day movements of people and animals are filled with grace and beauty and sometimes great heartbreak, I am anxious to change things and propel the mothers into a tomorrow I can not even begin to effect or change.
I meet a woman here who laments her inability to affect change in Haiti and I think quietly to myself that I was hoping Haiti would change me. I was hoping to live through her seasons and in that learn to live better within my own. I was hoping to quiet the internal fight against the seasons of my own life and to walk slowly with grace down whatever trail I am on and not look back quite so much.
Since I have been here in Haiti, we have had a rain shower almost every day. I had come to know the rhythms of the island's landscape and her people through the rain. "Lapli" I would say as the rains began each afternoon. "Lapli." The word seemed so perfect for the warm, nurturing rains that gave water to people and animals and crops.
I had known warm afternoon rains where children took off all their clothes and bathed in the yards; their young bodies covered with soap and their laughter echoing off the sides of the mountains. I had known house shaking thunder and lightning storms that lit up the room as a mother was giving birth. I had known floods and puddles and swollen rivers. I had known village pumps and bottles of water carried on a young girls head. I had known springs where women gathered to wash their laundry and wait for it to dry in the sweet morning sun; visiting with friends and neighbors while children played. I had known the fears of water not boiled and the fear of water too close to open latrines.
I had learned to bring in the birth laundry from the clothes line quickly so that it would be ready for the next birth. I had learned to grab things from the porch and to put things up high that might be damaged by a flood. I learned that if it was raining women were more likely to give birth at home. I had learned to live by her comings and goings; to manuever the car around large ruts and puddles in the road to avoid being stuck in the mud. I had accepted mud splattered legs and to look for places where mosquitoes could hatch. I had learned something of the rain.
But it has not rained in three weeks and I am thinking about when it will rain again. When the breezes come up at sunset, I am sure they will bring with them the rain but they have not.
The dirt roads, particularly the main ones, become dusty. The pale brown dust covers the trees and houses and the people. The open air, "tap- taps" are filled with dust. The babies who come to see me have noses and lungs filled with dust that turns into coughs and wheezing. Respiratory infections become a parents greatest fear and worry.
The farmers can not possibly carry water up to their mountainside crops and even the gardens in the villages have no irrigation. I watch to see if the beans are okay and understand why they do not/ can not grow water intensive crops.
On the mountain side and in the land next door, farmers make charcoal that also clogs the lungs and noses of everyone. But this is how everyone, including myself eats. It seems that everywhere there are the slow smoldering fires of the charcoal makers and the men burning field before planting crops. I see it when I am out for a walk and high up in the mountains. It must be a good season for charcoal making as the rains will not put the fires out.
I use to teach children that there were four seasons; winter, spring, summer and fall but now I see that there are two seasons; a rainy season and a dry season. In the United States, much has been done to minimize the effects of seasons on agriculture, food production and human comfort. We have big machinery and paved roads. We have irrigation and city water systems. We have heaters and air conditioners; refridgerators and food preserving factories. Not always, but mostly,inventors and engineers have planned for dry times, cold times, hot times and the rains.
I watch to see the many day to day ways that my neighbors adapt to and use this dry season.
I watch the children sweep the dirt yards neat and clean each morning and toss water on it to keep the dust down. I see that parents do not take their young children out too much on the tap- taps. I see that the farmers plant crops that need little water. I see that the small mountain paths that wind by the streams and connect villages are not dusty. I see that the warm dry, days make the corn ripen and are good for drying beans.
If I am quiet and watch I will learn about this season here in Haiti and come to know her through these times just as I came to know her through her rain.
I like many people, struggle to live in the present moment; leaping backwards and forwards with such speed that I fail to recognize the small movements, gifts and intricate beauty of the season I am in. Here in Haiti, where the day to day movements of people and animals are filled with grace and beauty and sometimes great heartbreak, I am anxious to change things and propel the mothers into a tomorrow I can not even begin to effect or change.
I meet a woman here who laments her inability to affect change in Haiti and I think quietly to myself that I was hoping Haiti would change me. I was hoping to live through her seasons and in that learn to live better within my own. I was hoping to quiet the internal fight against the seasons of my own life and to walk slowly with grace down whatever trail I am on and not look back quite so much.
Prayer for mothers in Haiti by Mia Yang
Prayer for mothers in Haiti and everywhere who are afraid to breastfeed
This was written by niece, Mia, and have been a sweet companion for me as I work here in Haiti
Holy Mary,
blessed and beloved,
merciful and kind,
hear this prayer
Give me strength
to nurse this innocent child
as you nursed the son of God.
Fill my breast
with your divine love
and make my milk
abundant,
pure and good.
Amen
This was written by niece, Mia, and have been a sweet companion for me as I work here in Haiti
Holy Mary,
blessed and beloved,
merciful and kind,
hear this prayer
Give me strength
to nurse this innocent child
as you nursed the son of God.
Fill my breast
with your divine love
and make my milk
abundant,
pure and good.
Amen
Saturday, March 3, 2012
Baby Dafka Is Growing Up
Baby Dafka, now 6 months old, had a sleep over at the clinic last week. Her Dad brought her in with a fever so we decided to keep an eye on her overnight. She was cared for by many loving Aunties and was watched, through the night, by Laura, a volunteer doctor. Dafka, whose mother died when she was an infant has been a special baby here at MBH. Her father, despite many obstacles, has decided to not put her up for adoption but to face an uncertain future with all his children by his side. His love for her is a great joy to all of us who have helped care for her since she first arrived as a severely malnourished baby.
We love you, Baby Dafka.
Bath time
Everyone enjoys watching Madem Clauden give her grand daughter a bath in a big, metal laundry bowl. This round, little baby is a great testament to exclusive breastfeeding and the reserves it builds in babies who may later face periods of hunger. Her hair is tied into tiny bunches so characteristic of the loving attention paid to a friend, sister or child during haircare.
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