I travel each week to a small fishing village where I teach a group of twenty traditional birth attendents. They are mostly an elderly group of women who arrive in their Sunday best clothes eager to learn and enjoy a day away from household chores. There are two male midwives,as well, which seems to be quite common and well accepted here in Haiti.
I have spent as many years in education, as I have being a midwife, and so I am excited to design and teach this curriculum. I research what has already been done and think about all my experiences this year working with the Matwans at the birth center. I think of everything I know about how people learn and am eager and excited.
I have taught Headstart and English As A Second Language and rebellious teenagers.
But I did not understand what it meant to live in a place where there is so little written language.
I did not understand what it meant to not know how to hold a pencil in your hand or to even look at a page of pictures. I knew they had been deprived of an education but I did not know what that really meant.
I had this idea that they could have a book with pictures of things related to birth and that they could share those drawings with others and use it as resource. It would not have words and so I thought it would work well. I copied drawings and then thought they would cut them out and glue them into the empty books. Soon I was faced with the clear reality that they had no idea how to look at pictures. They held them upside down and had no idea what glue was.
The next week there was no electricity to make drawings so I drew one big one on a sheet and had them copy the drawings. I could see that most had never held a pencil before. They tried so hard and seemed pleased to be given a pencil and a book to write in. They bring them in with such pride. I try to practice counting to 40 ( the number of weeks of pregnancy ) with them at the start of each class. I show them the way the baby grows as we count. They had never seen these pictures before and so the numbers are lost in the amazement of fetal anatomy.
I try to think what I am doing. I am there to give them a few tools so that they can save the lives of mothers and babies in impossible situations. If there is a complication they may have to carry a woman down the beach for 40 minutes to find a vehicle to make the 40 minute drive to the small hospital. We do role plays and act out what to do to keep birth safe. We sit in a circle and laugh and sing and even dance. I tell stories using drawings I have made. I try to illustrate cause and effect. I am swimming hard against the current.
I try to get them to show me the basics of a normal birth using role plays; simple steps of hand washing, setting up supplies, asking questions to determine risk, basic exams for position. Some try but I can see that I am asking so much.
I have never seen a home birth here but I have seen many homes. I try to picture a birth. I watch what they do when they come to the birth center. I try to put all this together in my head as I teach.
I have taught two classes so far and am preparing now for my third. I have had time to think it over. I can not give up on the counting or learning to use the pencils or how to read a picture.
Everyone deserves this small journey into literacy.
I have made a pictorial birth chart that is a simple guide towards safe practice and referral. My goal is that they can use this guide, record what they do and make the right referrals in time. It is my hope that by the end they can learn to use a bag and mask and help babies breathe when they do not. There is so much to teach.
But I also recognize that I do not know what they know. I can not swim out into the sea and catch an eel for dinner with a stick or make sails for a boat from sheets and blankets. I do not know all the right words in Creole to comfort and encourage in labor. I do not, even after these months, know just the right way to touch or move a woman to help a lingering baby. I do not know the right prayers and songs that drift from homes and churches; the one passed down when there were no pencils or paper.
I am lucky, as always, to be both teacher and student, and to spend some time with these elegant, graceful, funny, wise women and men who ask me to think as I have never had to think before. To move beyond what I thought was possible and to bend and sway with the breezes of time and place.