Tuesday, May 28, 2013

Have you read a good book about Haiti?

I am talking with a woman who volunteers in Haiti.

There are, in Haiti, volunteers who come one time for a week or two and others who stay for longer periods of time and still others who come back over and over again.  There are houses, built by Europeans, on small islands or cliffs overlooking the sea that sit empty most of the year.  There are Hatien-Americans who come back and build homes as investments; homes far larger than most houses in the United States or Haiti that often serve as guest houses for various volunteer groups.

This woman, I am talking with, is a come back again and again volunteer.  I had been reading The Rainy Season and Farewell Fred Voodoo, by Amy Wilentz.   I was longing to discuss these books with someone.  In Good-bye Fred Voodoo, she explores the many themes of foreigners in Haiti and their relationship with the Hatien people.  I had just ridden a crowded bus for five hours in which I was the only white person. We are given a pit stop in which I, along with my bus mates, find a tree to pee under in full view of one another.  They find this to be of great amusement and I laugh along with them or smile simply at the joy of being out of the bus and not having a bursting bladder.

And so, I ask in the guest house where I eventually arrive, if she has read any good books about Haiti lately.  I understand that I want  to live in a perpetual book group in which people discuss books at any given moment as a point on a compass that is guiding our lives.

She smiles and replies,  "I bet I read a book you never read."  I am excited at the prospect of any new book.  It is called, she tells me,  How To Make Love To A Black Man.

She goes on to say that when she goes to the beach the Hatien men always ask her to marry them. It is so sweet, she says, but her Hatien translators, who she also takes to the beach, take good care of her. She laughs and says she hates to go back to the United States.   It is true that strangers to not ask us to marry them and that we do not have men who take us from place to place.   Many of us live in places with people  representing many different cultures, nationalities and languages. Our whiteness, thankfully, becoming less and less of an advantage.   Attractive black men, in our country, hopefully have no need to flirt with or compliment aging white women to get an education or a job.

When I get home I try to look up the book.  I can only find How To make Love To A Negro Without Getting Tired; a book written by Canadian, Dany La Feriere, in 1985.

I think about this title and consider many things.  I am grateful, in my own country, that young people fall in love and marry whoever they wish, regardless of skin color, religion or gender.   I shudder to think of a time when a young, black boy was murdered for even talking to a white girl in the United States.

But in post- earthquake Haiti, white women are, if they are open to it, courted and wooed and helped in ways they would never be in the United States.  It is, of course, the attraction to that which is different but it also the possibility of immigration and sponsorship; one of the only immigration paths open to a young, male Haitien at this time.  It is also a power dynamic of boss and employee and rich and poor.  it becomes a way for a white volunteer to feel that she has come to know the real Haiti through these relationships.

In the United States and Canada few of us have guards, gardeners, cooks, cleaners and a woman who washes our dirty clothes by hand.   Guest houses with these services, provide much needed jobs for people in Haiti.  They serve volunteers who are also providing training and services to the Hatien people.

I watched countless crushes between the translators and the volunteers.  I saw them end in tears and misunderstandings and one end in a marriage and a new life together in the United States.  I watched married women, women with boyfriends and live in partners create romances in a foreign place that were safe because they were after all going back home.  I tell myself that this is normal and fun but then each volunteer leaves and the translator must welcome a new, young pretty white volunteer who will also go home.

I watch the Hatien men, in some organizations, take on positions of leadership and power rather than their female peers.   The men become escorts, drivers and translators. They help white women navigate a country that our state department still has travel warnings on.

The line between power and sex and love and money and exploitation and genuine friendship are difficult to navigate everywhere. In Haiti, it seems particularly fragile.

Amy Wilntz in her book, Farewell Fred Voodoo, says that every Hatien has their white person and every white person has their Hatien.  I cringe when I read this.  I know what she is saying.  I have seen it in  myself and others.   The question becomes if a volunteer is coming to do the work they set out to do or to bask in the love, attention and care of a group of people who have for too long been taking care of, directly or indirectly, white women.

Friday, May 24, 2013

The road to need is never too long - Hatein Proverb

The road beside the house where I stay in Henche is a collage of people, animals, vehicles and items for market.  Even when I am lying in bed and it is still dark, the road begins to sing.  I listen for the men singing on their way to their farms or the women singing early morning hymns.  There are cows, horses, donkeys, mules, goats and dogs.  They call to one another; their songs encouraging me to get out of bed and out onto the road.  The children walk to school in matching uniforms.  Women ride horses piled high with plantain.  A man proudly leads three goats.  They come down from the mountains, over small trails and through streams.  They started out some time ago to be here in the market town by daylight.  All day long they pass by signing and shouting and calling to friends.

Within this parade of people, animals and vehicles are women walking to the hospital to get help or have a baby.  If labors are short and easy then they remain in their villages and pray all will go well.   The smallest of trails might not have access to a motorized vehicle in an emergency and so some women set out to walk.   I do a history on a woman who has walked all night with her sister because it was cool then and she would not need water.  They have not brought any money but later someone from the family will come.  She walked to the town so that she might have a tubal ligation after the birth.  Another walks because her labor is too long or she believes her water is broken.  Another has taken two little whits pills to abort her baby and she is bleeding and afraid.  If they are lucky there is money for a moto but mostly they walk blending in with the market women and school children and business of the day.

Haiti has 4,161 km of roads.  Of these 1,011 m are paved.  The rest, like the roads that pass before my house are hard packed dirt that washes out with the rain and leave large pot holes and gullies.  The road becomes paths that wind between cactus fences into small villages where there may also be a small school or church.   Like the United States, the roads emerged from the trails made thousands of years earlier by the first people of the Americas.

The World Health Organization maintains that the ability to transport, in an emergency, is a key strategy in preventing maternal deaths.  That villages need a plan for getting a woman to a road and to a hospital.  They need ways to carry a woman down a path, onto a boat and onto a truck for transport.  Roads save women's lives.  They also bring much needed food to their village, medical teams, schools and access to greater markets.

So vital were roads to the future of Haiti, that Canada alone pledged 132 million dollars in 2008.  At other times, the World Bank promised 50 million, Canada pledged 75 million and the United States pledged 31 million.  Taiwan donated 300 new buses.  Despite these pledges, the road construction moves slowly.  We drive and walk through streams on our way  to villages for mobile prenatal clinics.  Women walk miles to get to the clinics.  The tap taps that sing through the larger urban  centers are not available in rural areas and even motos must be called and do not provide regular transport.  When you tell a woman she can go to the hospital for birth control, she looks down the road as if to say and how would I get there.  I walked five miles just to get here.

The construction of roads has been plagued with hurricanes, coups, violence and earthquakes. It has also been stopped by a land law system in which there was no registration of land ownership.  This meant that when a road project was begun, someone could walk up and say that is my land and you can't build a road until you pay me.  They pay them and another person comes up and says it is theirs.  After some time of this the construction company is fed up or out of money and the road is not built.

The women on their way to market or the clinic or a husband trying to get his wife to a hospital, make their way past never finished road construction.   Where I live in the United States, a traffic jam can send people into a furry of insults and violence.  A pot hole is cause for a flurry of letters to the editors.   In Haiti, the large machines block the road and people learn to walk around.   A ten minute ride, even in a pick up truck, becomes two or three hours for a women in labor.

The people with the money for roads say they'll be back when the land is surveyed and the deeds secured.

In the hospital, baby in arms, women prepare themselves for the long walk home; often with no food or water and only a sister to walk along beside them.  If you are lucky there is a friend or relative in town but if not, it is best to get an early start before the sun gets too hot.

Tuesday, May 21, 2013

Three little girls

When I return to Morne Rogue, after being gone for a year, I wonder how I will find everyone and in particular the babies I had tended most carefully.   There were three babies, I helped with, who were born into families where death, lack of food and a place to sleep were present when they were born.  Each was nursed back to health, fed, encouraged and each parent was given a micro loans to jump start small businesses.   Throughout the year,  I had heard of the many problems people faced; more deaths, stolen merchandise,  jobs that did not work out even when offered.

I was hesitant and afraid.  I could not afford to fund another round of business ventures and not so sure it would work, even if I did.   I had been able, in the past, to pay the parents for jobs they did; painting a wall, gardening and the laundry.  I had traded food for help in the kitchen.   In these small ways, I fought to keep them alive until they reached six months and on into the first year of life.   A group of other volunteers also worked to support and care for these babies.  We had all watched them and their families teeter close to death.   We knew that if they could get to their first birthday  there chances were much better.

And so, in my few days there, we had a Baby Party to celebrate the good things of the past year, first steps and first words.  The babies came and played at the library.  We sang and danced and looked at books.  We put stickers on their tummies and bows in their hair.  They gave hugs and kisses as parents clapped and laughed.  They shared bon-bons and toys.

We each knew that we had come through a great deal together and that for these few hours it was good to be happy with these baby girls.  They had more than survived- they were bright, happy and curious.  Many people came by to say hello.

Later we packed up the library, loaded it in a tap tap and drove it down to a new library site at a school.  Although the library had not worked in that site, it was still alive and would set down roots in a welcoming environment under the care of a grateful director.

After the move, the babies and i played and ate  and played peek a boo on the porch.  I can not say what the next year will bring for  them or their families or their country.  Three little girls; Dafka, Shiele and Mia dancing on their strong little legs in Haiti.   I tried, as hard as I could, to live in that moment and to not go forward or backward; to not dwell on the failed businesses and the ways I wished I had the wisdom and power to make things different. Each considers me a God Mother ( of sorts ) and I wished I was the one of fairy tales and magic wands but for that moment all I could
do was hold them tight and celebrate the miracle that they were alive and we had all lived to be together once again.

Thursday, May 16, 2013

The Bath

The Bath

After I was born, my mother took a bath; pouring cups of cool water over her body that had worked so hard to bring me into the world.  I saw the drops of water on her dark brown skin and when at last she joined me in bed she smelled still of sweat and soap and new milk.   I was bathed in her sweetness; her skin was my skin and we were one.

I promise the children I will take them to swim in the waterfall that merges from the rocks  high up in the mountains.  It is warm and by the time church is over and we have enjoyed a lunch of Rose’s delicious pumpkin soup, it is the hottest time of the day.   Islor shares a yard and  a large, unfinished concrete house with her  many aunts and cousins.  Her mother died when she was young and her father has abandoned her.  Still, in this year, at thirteen, she holds on to her life with joy and skill.   Her girl cousin is also thirteen and they share this growing up time with the love of two close friends. 

There remains a large tree with a homemade swing and a small wall that makes a good place for sitting.  When I arrive, they decide its best for everyone to bathe before walking up the mountainside.   The water comes form a pump some distance down the road but this does not seem to deter the bathing as it might have for me as a child.   They begin with me.   They pour water into containers and pour it over my head.  They use a bar of soap for shampoo and  then rinse. The left over water is caught in a pan and use for my feet.  My bath finished, they proceed with their own.   I suspect it is an act of great hospitability to offer a guest some clean water on a hot day or perhaps I just needed a good washing.

They are no longer the children they were a year ago, but young girls reaching reluctantly into womanhood.   The two girls bathe in the yard  with no  worry about exposing their emerging breasts.   I want to tell them that perhaps public bathing with older, male cousins and neighbors is not such a good idea but there is not really anywhere else to bathe and the men most  also bathe naked in front of them.   I am both envious and worried.  I see Islor give dagger looks to the young men who look at her as we walk by; young men who would not have commented a year ago.   Her cousin is oblivious to anything but the joy of cool water on a warm afternoon.  Islor is not oblivious.  She wants all the men, cousins or not, to keep their distance.  She is not willing to meet their gaze in the hopes of a bob-bon or some other treat.   She feels vulnerable, both as a young girl, and as an orphan.  

When they bathe, they wash their underwear at the same time. In this way water is conserved and everything is washed at one time.  The underpants can serve as a washcloth and then are hung on a bush to dry.  They lather and rinse not once, not twice but three times.  No wonder they seem 100% cleaner than anyone else I ever knew.

They emerge from the house with skirts, purses and shoes that neither fit nor are good for walking.   It seems we are going to town more than to the mountain.  In this way they show me they are young ladies.  They have put on poorly fitting bras which when we come to the pools they discard.  The shoes are shed even sooner as they mange rocks and dirt with skill and ease; the golden shoes offered by some volunteer in their hands and not on their feet.

In the cool shade of the waterfalls, they dive and swim with their carefully picked out clothes tossed on the banks of the stream.   I breathe in the afternoon with its butterflies and frogs and children diving into crystal clear pools.  I too had once swum naked in the streams of my childhood but when the first signs of change began I cried and did not swim naked anymore.  I made up excuses and in the end our little gang dispersed, never to swim again; naked and free in the pools of our childhood.   My emerging breasts seemed more a betrayal than promise but I had never seen a woman breastfeed a baby or swim naked or take a shower in the yard. 

And so like so many things in Haiti, I stand at the crossroads, seeing the beauty and freedom of a young girl’s uninhibited ability to bathe outside in her yard amongst family and friends of all ages and genders.  But watching the young men, watching them. I feel protective.   I worry about the late night trips to use the “bathroom” in a corner of the yard, the one time they are alone and unprotected.  I worry about the innocent smile that is seen as an invitation.

The matrones say that when a baby girl is first bathed you must put sugar and salt in the bath water so the girl will grow up to taste good.   The cord is left long on a baby boys so he will have along penis.   I can see that sexuality is woven into life in ways both natural and desirable and yet I know women are deserted to raise children alone, are beaten and have few ways to support themselves without the care of a man.  Many of these things are true all over the world.  In my country, the young girls I watched growing up, pay thousands of dollars and do themselves great harm with breast implants and lifts and tucks; giving up breastfeeding to keep the breasts they believe will give them the advantage in the struggle for survival. 

Later we collapse on the wall and an auntie sings the only church songs she knows in English.  Soon we are singing.   “Jesus is our friend” as loud as we can.   Romanoff is swinging and the baby is clapping.  We sing it over and over again and people come out of the house to laugh or join in.  They get a Kreyol song book out and I try to sing along.    She repeats the words slowly for me so I can pronounce them before we begin to sing.   I am bathed in their joy , even as earlier I was bathed in the water they offered so generously.

The baby who is born, later that night is named Bien Amie or “Blessed”.    The midwives have helped with five births today.  The students who I brought to Cap Hatien for an internship at MamaBaby Haiti are asleep but Maudlene removes her scrubs slowly and sings a song of praise before slipping into the shower and pouring buckets  of water over her deserving body.  The city electric is on so I know there is water in the shower but she pours the water slowly, with a cup, as she did as a child in her own yard surrounded by cousins and sisters; the sun light creating crystals of promise on their warm, naturally sweet and salty skin. 

The women, who sleep now beside their babies, will return to the yards of their childhoods where their sisters and cousins and grandmothers will bathe them with herbs and warm water as they welcome each one into this new motherhood. They will bring water from the pump with  laughter and generosity; their voices singing as one as they pour cool water over her skin as the ancestors  of Haiti have done for postpartum mothers for thousands of years.

Wednesday, May 15, 2013

A visit with Melove


I am sitting in front of Melove’s house, visiting with her and her grandmother.  Her 18 month old daughter, born when I first arrived in Morne Rogue clings to her mother’s skirt and tries to reach for her breast.   The grandmother laughs and shoves the small, still baby hand away.  The little girl, is showing  signs of malnutrition.  Her hair has the familiar redish tint and does not grow long enough for even the smallest barret or bow.  Her skin, that shone a year ago, is dull and dusty instead of rich and dark.   There is no evidence of food anywhere; only the bottles of castor oil the grandmother sells by the side of the road. 

Melove’s son, who lost his twin last year to malnutrition has grown more responsive.  He clings to his great grandmother and appears healthy with clear skin and thick hair.  For the second time, he gains access to the family food pot over this new baby sister.  His twin, who did not win, in the struggle to gain enough food is gone.  I had sent Melove her picture but she removes it from the  photo book I made her and sends it to the Dominican Republic with her two sisters who live there now.  She shrugs and says she is dead. 

A young man in a neat shirt and trousers comes to take the grandmother to the church. “Adventist” she reminds me.   The young man pulls the wheelchair out from behind the house where it  hangs perilously over the gully.  He works to make minor repairs and moves it over the uneven ground to where the grandmother waits.    The grandmother puts on a clean t-shirt, laughing as breasts, stomach and arms emerge and slip away again.

A man approaches us and Melove quickly tells me to leave.  I do as she says. There is an urgency to her voice. I walk down the road, listening to her yell at the man.  The chair I had been sitting on is raised above her head and she is getting ready to strike a blow.  People stand in the road to stare  but I do not turn back again.    I have seen Melove stand and defend her home and family before.  

Melove has been going to sewing school but tells me she does not like school and wants to start a clothing business.  The small grocery business failed when everything was stolen.   She wants to start a clothing business this time.  So far, she has gone to baking school, high school and sewing school.  She has tried other businesses.

She tells me she has a new boyfriend who loves her and her family but does not have a job.   The yelling gets louder, even as I walk further away.

A few more steps and I turn right down another road.  The fields and small gardens are slowly being replaced with grand walls and even grander houses behind them; the people who lived and worked there forced to move on, even if their family had occupied that land for decades.   The yard of one new walled home would have fed and housed a multi family, multi generational family for many years to come.  Many of these grand houses are built as an investment and sit empty; too large and expensive for anyone.

Melove is saved because her family house sits between a gully of garbage and the road.   The whole thing is less than 20 feet wide; a thin strip of poles and dirt shaking beside a  seasonal stream filled with garbage.  The grandmother says she owns it but ownership is difficult to prove and valid only until someone else with more power wants it.  It seems more likely that a flood will claim her house than an absentee owner.   The house teeters on  less land than it did the year before. 
The grandmother, being pushed by the young man walks beside me or rather bumps along beside me.  The Adventist Church is not too far away and they make this effort to go and get her several times a week.  The road is flooded each rainy season and a new route memorized around the ruts and potholes.   There is no reason, to fix them, as next rainy season more will return.

Melove has grown large with the familiar stomach of the very poor who dine on white rice and spaghetti.  She looks seven months pregnant; weight that most likely came on when she stopped breastfeeding.   She has been to get a birth control shot so she is not pregnant but her baby daughter is clearly in a state of impending crisis.  

Her older daughter, in the waking time of puberty, is not safe there in the doorless house by the side of the road.  She looks at me  as if to say, “What good is school?  I have no food and no door to protect me.”    She does not have her mother’s keen sense of manipulation, defense or ability to attract suitors.  She braids her friends hair and wipes the baby’s nose with the hem of her dress.

The next day, the fight forgotten, I am on a moto heading up Melove’s road to a meeting with a school director. When Melove sees me, she hops on another moto and the two drivers race up the road to the school, Melove on one moto and me on the other with people waving.    She comes to the meeting, sitting proudly by my side as we talk to the director.  Later, as we walk down the road I say maybe a little less hitting people with chairs and she laughs.  We find a moto and ride back down the road together.

Friday, May 10, 2013

Help from new freinds

One thing I appreciate about  working in Haiti, is the community of health care workers and other volunteers that comes and goes but alway supports each other in whatever we have to do.  Many times this month, the doctors at Partners for Health have helped with a very sick baby or in this case, with the mother who had been raped and was in desperate need of care.

 I had gone to the Mother Terressa House to ask for help and then to the newly formed Child Abuse Office in the new government building.  Back and forth on the back of the moto trying to find a way to keep her safe.  When I was beginning to give up, the doctors said ,"but there is a mental health team and we can put her in internal medicine until she is evaluated..."   It was more than I could have hoped for and so in the morning she put her head on my shoulder and let me hold her.  Later we walked her down to a safe, clean bed.  We bought her and her sister some food and water and left her sleeping.

In my dreams, she finds a place to live where she can heal and one day be helpful; perhaps an orphanage or a feeding center.  I know it seems unlikely today but I believe she is still in there and with safety and time, will come out of the layers she buried herself in and smile once again.

Her baby died at five days of age from starvation and dehydration in a hospital with nurse feet away because they did not believe they could ask for help or where to ask for help, even though it was only a few feet away.  The acceptance of a baby's death to a crazy mother were hard to talk about with the students.  I cloud see that they had never had a discussion of the effect of abuse on women or mothers and all we can find out when we listen and ask beyond the stethoscope.

Thursday, May 9, 2013

Ruth Caroline - Without Her Consent

I am trying to teach the midwifery students to ask questions and discover each woman' story as an important part of collecting information important to her care. I tell that a stethoscope and lab can only tell us  part of the story and we must learn more if we are to help.

We go to a woman's bedside in the postpartum room. We can see there is no baby and she is very swollen.  She has no IV ad has a catheter in but the bag is not full.  She stares out into space and is breathing fast.   Her chart says she is anemic and is getting iron pills.  That is all it says.    I can see that there is much, much more to this story. For six days nurses and midwives had taken her bllod pressure, pulse and temperature.  There were no notes, in the chart, about a baby.

The sister tells us she has not spoken since she was fifteen.  Her mother died when she was young.  She tells us that when the father went to work, the men of the village came and raped her day after day for many years.  No one knew she was pregnant.  When the baby was born she refused to nurse and let the baby die.  She refused to eat and refused to go to the toilet.  She had not had any water in two days and has not had any food.  I can see that she is breathing very fast and her pule is racing.

The sister's one hope is that they will give her a tubal ligation.  I ask who will protect her from further abuse but I can see that this does not seem possible.  We get her water and a light broth.  The students give her a sponge bath and she smiles a soft, far away smile.

I ask the sister if it is possible that she stopped talking because of the rape but the sister seems to think she was raped because she was not talking.  She says the father knows that they are there but does not send anyone to help and does not send any money.  They have no way to get home.

I am going to try and see if the Mother Terressa House will take her but we know that beyond this one woman that taking away the causes of such brutal anger towards women is an essential element of any healthy society.

In the last United States election, a  candidate said that a woman could not get pregnant when she was raped and that if she got pregnant it wasn't really rape.   Most people were outraged at his statement and he was forced to re-design his statement.  I think of this as I sit beside a young woman, just nineteen, who has slipped into a world of mental illness rather than face her reality.  She does not seem to be aware that she had a baby, at all.

There is no plan for her.  She can not have a tubal because she is anemic.  Her sister has three children in a village hours from the hospital and needs to go home.

Market place abortion

There are no empty beds anywhere in the small hospital. We move across the open courtyard from antenatal to postpartum to labor and delivery, trying to assess women and provide care.  There are suppose to be three distinct rooms; one for each part of the birth process but they are all in all the rooms so it is hard to be predict what might happen in any given room.  Twins are just a likely to be born in the postpartum room as in labor and delivery with  a room full of aunties, grandmothers and sisters trying to help while someone runs for a midwife. 

The rooms are hot.  The smells of blood, urine and sweat can not escape and linger in the air. The cleaning woman is asleep on the counter in the delivery room.  She has prepared a clean and comfortable bed and I can not rouse her even when I desperately need a clean delivery room. 

It is about 2:00 am when a very young woman comes in to the delivery area.  She has been placed on a table but no one is tending to her.  I cannot find the translator so I begin on my own, asking the questions that might give some insight into why she has come to the hospital.  Her uterus is small but I can hear a heartbeat.  Her vital signs are all normal and she is not bleeding.  I can tell she is waiting for me to do something so I do a vaginal exam hoping still to uncover the reason for her visit.  

When I feel for her cervix. At first I think it is hard and closed but then, I can feel that there are feet or arms hanging down out of the cervix.  Pencil thin legs resting in my hand.  She is showing no signs of discomfort and no contractions and yet the baby is hanging out of the cervix.  There is a heartbeat. I slowly take my fingers out and consider what to do next.

She like, many women, in Haiti and around the world has decided that she can not provide a good life for this baby. She says she has another baby at home and the father has twenty other women who are also pregnant.  This seems extreme but I understand what she is saying.  This baby, she knows, has a one in three chance of living after being born and only a 50% chance at a primary school education.  She can watch this child slowly die of malnutrition or she can let it go tonight. She chose now.

 There are no corner drug store pregnancy tests and so she and other women in her situation wait until the baby kicks, go to the market and find three little white pills to swallow.  She lies there waiting for it to be over; waiting for us to do something so she can go on with her life without another baby.

At the same time, another mother has come in from the countryside because the clinic there said that her baby had no heartbeat.  A woman has given birth in the postpartum room and another woman is laboring across and next to her.  Of the four women in labor and delivery, three have come in with babies who have already or will shortly die.  A woman with pre-eclampis will deliver in some other room and they will bring in her 20 week baby who is still alive but can not survive.  They hand me an adult bag and mask and look at me as if I should save this tiny baby.  I try to explain I would need an infant ambu bag with a mask for premature babies but it does not really matter. He is too young.  I wrap the baby boy, all snug and warm, and sit with him while he sighs his last sweet breaths.

The mother with the baby who is still half born is given more medicine and the baby is teased gently out of her with small pushes.   She does not bleed and in a short time is dressed and ready to go home.  I want to believe she has good birth control options in the future and that her older child will have enough food and an education.  I hope she can flee the man she fears.  It is estimated by the Hatien health department that 10% of all women experience violence from intimate partners.  Rape is common and tolerated.  During the coup to oust Aristede, it is estimated that 19,000 out of every 100,000 women in Port Au Prince were raped.  It was used to punish women and families who favored democracy.

World wide, 45 million women each year seek an abortion.  In Haiti and many places it is illegal so women take their chances and many die.  24% of all deaths in women 15-19 are pregnancy related. 

 I believe abortions are an indicator species; a marker of society's commitment to women and children.  Most women who are well loved and know that their child faces a secure future and has good access to birth control do not need abortions.  Societies that protect women from rape and violence, fund schools and health care and protect local food production prevent abortion.  

I think of the  African women who let their babies slip away rather than birth them into slavery.  I can see that this mother does not see a future for her baby that is not full of pain, hunger and violence so she lets him slip away.

Three babies are not born alive.  One is 16 weeks old, one is twenty weeks old and one is full term.  We cannot tell why.  I wrap them in blankets and they are put in one box for the gardener to bury together.  I see the cardboard box in his wheelbarrow as I leave the hospital.

If you are reading this and are sad about her self induced abortion, as I am, reflect on pro life United States presidents who campaign on a right to life platform and then create policies that cause vast suffering to Haiti's women and children; policies that destroy food production, health care and schools for many generations to come.  If you knew your child had a 1 in 4 chance of  dying of starvation or malnutrition  what would you do and what will we do when we know the cause and we, who love women and children cannot find a song powerful enough to stop it.

It is impossible not to feel that, in part, those three babies died so that the richest of our world could enjoy larger than needed profits, tax breaks, and extreme wealth at other people's expense.  The young woman of our story does not know exactly why she is hungry or why she was first raped or why her partner beats her and cheats on her and she never got to go to school.  She does not know and yet she knows.

 The mother who lost her full tern baby sings for a long time after the birth. She lies on the table holding her baby and sings and sings until she gives her up.  The song goes on for a long time. It is so sweet and so full of love and faith. It fills the rooms of those around her. 

By morning, everyone is preparing to go home.  Each of us walks by the box with the babies that is sitting in the wheelbarrow.

The mangos that are turning yellow will be sweet to eat at the end of the day when everyone is tired and there is time to sit and talk on small wooden chairs with seats woven with plants that grow by the roadside.   The rain will wash the day away and prepare us for still another.

Friday, May 3, 2013

Yon Ayisyen, Yon Pye Bwe One Person, One Tree

Today is a national holiday.  Emanuel, who teaches with me, says we will not have class and no one will go to work.  In my bed, long before it is light, I hear the men singing as they walk to their farms.  It is a call and response song that is far away and then right beneath my window and then fades as it goes on down the road.  I am sorry when I can no longer hear it.

I know that many people work on holidays. The men, who sing, must take care of their crops and the midwives in the hospital, St Thereese and the midwives, far up into the mountains and the mothers washing school uniforms. They work on this holiday and remember workers rights; international efforts to increase minimum wage and make work places healthy and safe.

 In the United States, where I was born, it is a day when children hang small baskets of flowers on door knobs to surprise friends and neighbors.  It is also a time for May Pole dancing; a lost art of  weaving brightly covered ribbon aroudnd a pole in a dance on the schoolyards of one room school houses across the country.  May first is a day to celebrate the flowers of spring.

Emanuel tells me that it is a day to celebrate to celebrate farms and the crops and that people go outside to dance and eat and pick flowers.

 I can see  that people are walking about with small trees in black plastic wrappers.  People are playing   music  and hundreds of trees are being given away.   It was then that  I learned that the president had declared this the Year of the Environment for Haiti and that on this day they were going to plant 1.2 million trees. There are baby trees everywhere.

In the field where we walk, there are hundreds of holes dug beside the many paths.
When I look in the holes, the dirt is rich and black and moist; a perfect place for a tree.  Later the school teacher asks to take our photo by the tree project and we happily agree.

The next day, I travel by pink jeep to one of the sixteen mobile clinic sites, that are located far out into the countryside.  The land becomes increasingly bare, dry and void of all vegetation.  They say that 98% of Haiti was once  covered with multi-layered hardwood trees as well as fruits and nuts and medicinal plants.  We drive for a long time, the dust from the road choking us and filling our hair and eyes with what was left of this once great forested land. and the soil that gave it life. The women who walk the road with their babies, things to sell and water jugs are thin and struggling. We drive and they walk and meet at a small, deserted house that serves as the mobile clinic site.  I can not imagine how they farmed there or how they would ever get to a hospital in an emergency.  We pass two funeral processions.  There are rows of school children walking with their teachers in front of a casket carried by men who are followed by the women.  They said an old matrone had died.  I ask who will take her place and they shrug. I ask if they will then go to the hospital even as I know how foolish the question is.

I  talk about  how they might  prevent a postpartum haemorrage in the most basic ways I know - pee often, breast feed right away, don't push till you feel the urge, never pull on the placenta.  They listen but they are hungry and they live in a dry, waterless place far from town; a place that can not grow food because the tress were all cut down and there is not enough rain.

 They walk a long way to get to the once a month clinic.  They walk miles to get water from the pump.   They accept that women die and are carried down the road, in a procession led by school children.   A woman shrugs and laughs as a toddler reaches for a breast above her lap already full of a new baby growing inside her.

A small boy holds a tree from yesterday's tree planting holiday.   Thirty to forty million tress are cut each year for firewood.  The smoke of the charcoal maker drifts through the windows.  I watch the small boy and his tree.  I look out at his place in the world and wonder how this tree and this boy can  survive.  He is hungry and is not in school. He holds tightly to this tree before beginning his slow climb up the mountainside with his mother.

One tree, one person. Late that evening it rains and I think of the one small tree in the boy's arms. and his mother and the baby inside her and of all the 1.2 million trees planted  and how the rain is watering them.   Espwa  (hope)

The placenta is called  the tree of life. When you  lay it out and look at it you can  see the rich deep roots and branches that nourished the baby; connecting one life to another; one generation to the next. One person, one tree for Haiti.

Thursday, May 2, 2013

"poysanne" / birth certificates in Haiti

For many years, in Haiti, there were two types of birth certificates.  One that was stamped with the French word for peasant, "paysanne" and those that were not stamped.  They were also stamped, "moun ondeyo" or people from the outside.  The babies born on the outside were the babies of the rural  poor who were not born in Port-Au-Prince and were mostly the heart of Haiti's rural agricultural communities.

One of the first things, Aristede and his political party sought to do was to have one common birth certificate for all babies born in Haiti.

My Kreyol teacher says, in defense of Duvalier's policy, that "paysanne" simply meant where you
were born and I say "but peasant is not a place."   I am not sure what "peasant" meant in that context, but I sense that it was  not a complimentary word to have stamped on your birth certificate.  It is not quite a career choice like farming or fishing and we surely can not assign an occupation to one at birth.  Peasant was a social class and by putting it on your birth certificate it assumed life long membership in a group that was "outside" the rich elite of Haiti; a group that had significantly fewer opportunities and  rights.

This is a story from the past.  In time, Aristede's party did change the birth certificates and did try to make sure that no child was assigned, at birth, a class designation from which there were no choices.  Most people do not have birth certificates.  They are not filled out by the birth attendant who most likely was never given an education an dan opportunity to learn to read and write.

I tell the midwifery students that their parents story of their birth is a sort of birth certificate. From that story they can discover who was there, the weather, the time of day, who picked their name.  I ask them to find out this story and carry this precious story with them always.  On it is stamped the world "precious" no matter where you are born.

Wednesday, May 1, 2013

A house with a roof....... Jean Bertrand Aristede

A house with a roof
Clean water to drink
A good plate of rice and beans
A field to work in close to our families

From a sermon by Aristede on what he wanted for Haiti

Learning is the brain dancing in rhythm with the nested communities around you

I begin to write about my teaching of the midwives here in Haiti and find the right place to begin is not with their form of education but with my own; the education I was given regarding Haiti.  I want to write about this but to be at least a little honest have to begin with myself.

When I was first introduced to Haiti, no one used the word Haiti. It did not exist.  They said Christopher Columbus discovered the "new world"on an island named Santa Damingo.  No one ever mentioned the world Haiti or the people who were living there. He was a good man in my education who bravely set sail and because of him we are Americans. That was all there was until Junior High World Cultures. My teacher was a former CIA employee.  I had no idea what the CIA was or what he had done but we traveled the globe learning of their work.  He was very excited and I carefully took notes on what leaders were overthrown and when and how the CIA went about doing these amazing things.  Perhaps Haiti was one of these victories but after some time they all blurred together in my notebook.  This was the same junior high that singled out and made fun of Catholic students when John Kennedy ran for president.   After the making fun of Catholics scene, I doubted much of what they said but had nothing concrete to replace it with.  I left junior high with an uneasy feeling about those stories. I could have asked my mother but did not.  I was over whelmed with having to go to school in town, instead of the country, and was trying to find my way in a social system for which I had no compass.  When I got off the bus, I ran to the creek and buried my face in the ground and cried but I was never knew exactly why.  At school some kids teased the special education kids who served the food in the cafeteria line and I was trying to get my nerve up to say something mean back to them.  It was all too much- the special education kids, the rules, the CIA killing other people's leaders, the ultra Christian principal.  In ninth grade my English teacher became a mentor and told me to keep a journal and I began to write.  I still ran to the creek every day but I also wrote. She, like many teachers, saved my life.

In high school history classes, I learned to speak out. I was uneducated and foolish but I was not quiet. I did my best to speak out against the wars in southeast Asia.  The teachers made fun of me but by then I did not care at all what anyone thought of me.  I was wondering why someone could not tell me about their actual cultue instead of what my country was doing to undo their culture.  It was 1966. Haiti's textile industry had already been ruined by the exportation of our second hand clothes which they called Kennedy's because it was under his presidency the US started sending them to Haiti.  Most clothes shops in Haiti sell second hand clothes from the United States.

I have few memories of Haiti in the next decade of my life.  College campuses were focused on Vietnam, without, in my case, a intellectual understanding of how this policy was being played out wordwide. I did not understand that the increased wealth of middle class Americans was coming with a price for people all over the world; for the people of Haiti.

In time I finished school and became a HeadStart Director in Lambertvile, New Jersey.  One day a little girl named Rosa was in the house area going on and on about the Hatiens.  "You better get on back from where you came. We don't need any Hatiens around here."  I was so ignorant for a second I thought it was someone's name.  I stared to ask who the Hatiens were and then realized it was people from Haiti.  In retrospect I suspect she was Hatien and she was mimicking what people said to her family.  I was busy and made no effort to understand the immigrant issue of the community I was suppose to be serving.   If Hatiens were coming because their country was dangerous I simply gave the children a name tag, a cubby and a toothbrush and brought them in to the classroom with joy but never once asked why.

My formal education, regarding Haiti's history and culture began, like tit did for so many people with the earthquake and subsequent trips to Haiti.  I read every book I can find and last night sat and discussed history for hours with my Hatien house mates.

I tell the midwifery students you must be willing to learn your whole life long. "Look at me I say. I am old and am just now learning about your country. "

I look at my new friends when spaghetti came to Haiti.  I offer that they do not grow wheat so it was not always here.  They say, "Ah, Sarah we will ask the old people and try to answer the question."  I think about my CIA teacher and somehow wonder if it did come the marines or the CIA.  There is always more to learn. I am keen to learn about spaghetti, my own country's history and the politics of hunger.  I tell my students learning is like dancing - only its in your brain. They laugh and ask me to dance withe them instead.