Saturday, February 22, 2014

Mentoring two new midwives in LaGonave


 With this, I begin a story of the mothers, babies, midwives and communities in the mountains of LaGonave, Haiti.   As in all my writings about maternal health, I try to bring a historical and geographic perspective to health care.    I try to come as a citizen of one world community but know I am forever “American” and with that comes the burden of commiting to know and understand the colonial and imperial impact on the women and young children of this community.

There exists, the lingering questions of how I can try to care for people, regardless of borders, knowing my country’s collective wealth was and is at the expense of others.  If we grew up, as I did, with John Lennon’s Imagine or Michael Jackson’s Heal the World is it possible to sing those songs with all our hearts; our hands and feet in motion with acts that cause no harm?   I was raised a Quaker where it was suggested that the happiest task of life was heading out into the world “cheerfully looking for that of God in everyone.”  As a midwife I have enjoyed seeing that light in the newly born.  I have also been committed to understanding the how it might be that all babies can be born into healthy, sustainable communities that assure them an equal opportunity for a meaningful life.     

My blog, thanks to Kayla, is divided into chapters.  The last one was SE Asia and there are other trips to Haiti where I also tried to write about history and culture. These stories reflect the people of LaGonave;  Haiti’s largest off shore island.  It is not large; about 30 miles by 5 miles but it is covered in rocky mountains with very few roads, electricity or water.   The island is rich in stories of Haiti’s last Taino queen, heroic Africans who escaped French slavery, pirates, and an ever-important mermaid. There were women led agricultural societies known as Congo Societies, a white marine who was made king and then the deforestation and long term effects of US occupation, dictatorships and natural disasters. 

Within these stories, are the women whose families have lived here for many generations and who know every winding path and all the people along the way.  I am tucked in a cluster of support structures, paid for by people of my country; a school, a church, a clinic, solar power, a well, an orphanage and a dairy goat program.  This hub branches out into smaller villages with more small schools and churches and wells and a cadre of community health workers live.  There are visiting medical teams who stay in the harbor town but I am up here in the clinic, living with the nurses and midwives who make this their home. 

When I agreed to come, it was because I had met two new midwifery students, at the school in Henche, run by Midwives for Haiti.  I have come to offer them support and help get the structures in place that might make their work easier.   When I talked to the NGO, they said again and again “There is nothing there.  There is no maternal health program.  There is nothing but mothers and babies dying.”  

Haiti, as most people know, has the highest rate of maternal and under 5 death in the western hemisphere while being a 45-minute plane ride from Florida.  I come wondering how to use what I have learned from other maternal health programs in Haiti to help grow this one. Is there a simple path that can be easily duplicated and repeated?  Despite the mountains, dirt roads and lack of infrastructure can all the maternal health programs create a network of support and shared resources? Can communities of mothers and midwives throughout North America find effective and meaningful ways to help mothers and babies thrive in this one small island at the tip of our very own wealthy continent?   How do we as parents deal with such disparity?   Do we allow our fear of failure to discourage and numb us? Do we say we cannot take one more painful story or photo or begin to conceive a sustainable way of building communities that begins with the long-term well being of each baby born? 

As a midwife, I fully believe that there exists within the midwifery model of care the essential elements of education, support and care that are nested into each village and each family.  Midwifery is an ancient tradition that flourishes in the mountain village around me.  This is their story as well as the story of the newly graduated midwives. 

Writing has been a good and dependable friend to me. I am thankful for the teacher, who in 8th grade first who encouraged me to write and all the writers who have offered me their stories.   At night here, they sit under the warm stars and share stories long after the last baby has stopped crying and even the roosters have grown quiet.  In this time, you along with them, become my zanmi under the tree; my friends to share a story with.


  1. Sarah, we are so appreciative of your courage and creativity. As I warned you...there is not much there...but we do have pregnant women who are responsive and appreciative. A lovely portrait of the joy and heartbreak of La Gonave. I look forward to seeing you this week.

  2. Sarah --

    I have seen you in action! You are making such an important contribution to the women of LaGonave. Mesi anpil!! Lee