Friday, April 25, 2014

Living in tents; in their village and in mine

Living in tents
Homeless in their villages and in mine……

When I ride from the airport to the ferry in Port Au Prince, I can see that there are still many tent communities.  It is not like it was in 2010, when I first traveled to Haiti as a midwife.  There are far fewer.  I have come to see that the world sees the presence of these tent communities as a sign of failure and a symbol of Haiti’s problems.  In this section, of my blog, I am attempting to look at my own community through these same lenses.  If it is a sign of failure that some families are homeless in Haiti, is it any less a sign of failure if families are homeless in my own community?  Are the causes more universal that we would like to think?

Tent Community in Haiti

Are more people homeless in Haiti or the United States?
Do the same international economic powers create housing insecurity in both places?
 From the truck, I watch as a woman leaves her tent with a plastic jug to go get water.  Her tent community is neatly laid out in rows.  I can see that the tents are too close together to offer the many functions of a Haitien yard where women cook, wash clothes, and do all their household tasks.  I can see that this is not possible but then the new housing projects also seem to have not realized the need for yards to work in.  They are brightly colored houses lined up in rows with very little yard or common area.  They remind me of the Malvina Reynolds song.  “Little Boxes” about post War World II housing in San Francisco.  They remind me of our own failed housing projects in all of the United States’ major cities; the ones they later called the “projects”.   These housing projects also ignored the need for common space and community and the work of the yard.

The newspapers report that 400,000 people in Haiti still do not have a permanent home.  It is usually presented as a part of an article on corruption, the failure of NGO’s or the fact that the aide that was promised never made it to the people it was promised to.  Well meaning people, stop me on the street, to tell me what they have read.  They shake their head and wonder why I go back.  I am not sure what I am supposed to say.  

It is morning in Oregon and it is pouring rain.  A family, who cannot find permanent housing, is sleeping in my yurt.   The yurt is also a tent.  They have two small children.   What was suppose to be a quick stay while they look for a house has turned into a soul searching look at what it means to be without a house in my own village. 

Tent community in the United States

The bright, beautiful little girl is not the only one living amidst what is called housing insecurity.  The Point In Time Count estimated that 474 other families were also camping in cars, sleeping on sofas, living in campers and saying in shelters in my community. At the same time they estimated that 2,869 people were sleeping on the street and another 6,400 were in shelters and getting assistance. 

The housing prices have soared in my village.  People flip house, rent basements, raise rents and create tighter and tighter standards.   Family homes become bed and breakfasts and there are fewer and fewer places for families to rent.  Affordable housing drifts out to the suburbs; far from traditional neighborhoods, work and public services.   I watch this brave mother, who came here for a new job, fill out housing application and be turned down over and over again.  At night, she puts on her shoes and takes her children out to the yurt.  It is not that we don’t love them or want them, but only that it is not a home. It is only that she can not find a home.

After the earthquake in Haiti, I watched landowners pack 4 families into what was once a one family house.  Rents for a room with no electricity, plumbing or kitchen were raised over and over again.  The floors and walls were mud and the ceilings leaked but it was all there was and that came with a price.  It is easy to see why people need to stay in Port-Au-Prince where the tent is larger and dryer than the room and where there may be jobs.

On the weekends the family I am hosting, drives to relatives some three hours away. They could, of course, stay there but her job is in the city.  Everywhere people face these choices; work with poor housing or go back to family and no job.  I can see people in both countries going back and forth as they try to find balance and stability.

There are people of considerable wealth in both Haiti and in my community.  In Port-Au-Prince there are beautiful, flower- covered villas with views of the Caribbean Sea and the mountains.   In my community, there are many people with room for other people and people who do not need to raise their rents.  There are laws, in my community, to protect the availability of low -income rentals.  There are laws to protect homeless children but they are ignored.  

I understand that there are many more resources for the homeless in my community.  There are numerous places to get a meal; there are food banks, and food stamps.  There are shelters and tent villages.   Mothers can get WIC and children are fed breakfast and lunch at school.  We have a safety net but often the safety net fails to move families beyond the metaphoric tent community.

In my community, a woman and her children may easily become homeless trying to escape domestic violence.  Our homeless are often veterans of wars fought in lands colonized and exploited and turned upside down in the 1800’s.  

And so, in my village and in theirs, families live in a state of hope that tomorrow things will look up and things will get better.  In their country and in mine, people live in tents with no permanent home.   In their country and in mine, children lack the security of home and live in a state of waiting. 

In their villages and in mine.

Woman is the first environment

“Woman is the first environment. In pregnancy our bodies sustain life. At the breast of women, the generations are nourished. From the bodies of women flows the relationship of those generations both to society and the natural world. In this way the earth is our mother, the old people said in this way we as women are earth.”

— Katsi Cook, Mohawk Midwife

Friday, April 18, 2014

Tending the fire

Tending the fire

midwife women children vietnam haiti furnace fire making travel
Women the world over start the morning by making a fire for their family.  

When I arrive home, the old gas furnace makes a terrible, growling noise and then stops working altogether.  There is no more heat.   It is not warm in Oregon.  Spring will linger for many weeks with a deep, damp mist that colors our world many shades of green.  Thinking of the women who tended the fires in the many places I lived this year, I do not call to get the furnace fixed.   I walk out into the yard and forest and collect pieces of kindling to dry and stack logs by my door.   I get up early and make fires but not without the help of fire starters and lots of paper advertisements I collect at the grocery store. 

By the time the children wake up the fire is going and the house is growing warm.  I think about the women who made fires.  I think of the small cookhouses where the morning fire is started in Vietnam, Cambodia and Haiti.  I find the women in warm, little houses where animals and early risers gather to keep warm or make a cup of morning coffee.  It is, of course, not so cold there but the cookhouses are cozy places with small stools to sit on and quiet conversations that bind night to day.   I too liked to find a stool and sit; begging water for tea. 

I was never asked to make a fire there.  I don’t think they thought me capable of the task and most likely I was more in the way than ever a help.   In Haiti, large bags of charcoal were leaned against the mud walls and in Vietnam the aunt collected piles of wood that floated into the rice paddies from the rivers.   Pots and pans and homemade brooms lined the walls.   I never saw a man start a fire though in my childhood home, my father always started the fire so we would be warm on rising. 

The fires in Haiti come from the charcoal makers who cut down the last of the great mango trees and spend many days in the work of charcoal making.   It is different than the aunt in Vietnam who goes out in her homemade boat and collects sticks that are floating by.  I can see she is very proud of the growing pile of wood that comes to her in the rainy season.

The gas that once heated my house and which I admit I miss comes in a great pipe from far away.  There are large tanks on the river to hold it before it makes its way underground to each home where it warms us without effort. It is no doubt, as destructive an ecological process as the charcoal but it is underground and we cannot see it.   We get a bill each month in the mail; exclaiming at the rising costs.

The clinic in Haiti has solar panels and there is no doubt that with a little effort the morning cook fire could come from solar power and not from the last large mango tree.   In the day, there is more than enough power but no one fixes the solar panels and there is no electric stove.   I bring an electric teapot which I plug in to the solar system when the sun is out.   This seems miraculous and when I leave there is much talk about who will get the teapot. I suggest sharing is the best idea but they seem to think it needs to belong to someone and not everyone.   I’ll bring another when I return.   It is hot in Haiti and everyone could have free power and mangoes but they do not. 

I also know that turning on the gas heater and plugging the teapot into solar power is not the same as the cook house of Vietnam and Haiti.   There were cookhouses in colonial America, as well.  Places for baking and boiling and preserving food for those who could afford to make one.  
Did my ancestors wander there on the way to the fields or barn to talk and get a warm drink?  

In my village, many people stop at coffee shops.  They have become my villages replacement for the warm fires of the cook house at dawn.   Perhaps they live alone or are in a hurry or simply like the companionship of a warm, coffee house with many other people on their way to work.  When people get to work there are places to make coffee or tea and microwaves to heat up food.  I can walk into countless small shops and get food and a drink.  I do not need to collect wood or make charcoal or do much of anything but pay and greet my neighborhood coffee maker when it is my turn.  I take it into my car and drive away.   They do not take their coffee and put it on the donkey on the way to the market or juggle a cup of hot water with the reins of a water buffalo.  If you go to the cook house and pester the woman making the fire for hot water, you linger and drink it there beside the chickens and small puppies who have joined you.

I begin my days with fire making. I am not very good at it but I am getting better. In the late afternoon, I gather wood and bring it in so it will be dry.  I look carefully for what will burn more easily and what will fit in the stove.   I can see it is more difficult that the charcoal and far more difficult than turning on the gas furnace.  If I am not home, in the afternoon, there will be not be an easy time making the fire.  The wood will be damp and not start easily.   I am not strong with the ax or hatchet.   

The potatoes are cut and waiting for a bit of dry sky for planting.  The little girls are making fairy hotels from things they find around the house.  They busy themselves with notes to the fairies and wonder if you can believe in things you cannot see.  I say that I have always believed in things I could not see.  I believe that if I put a piece of potato in the ground that it will grow many more potatoes, even though they are under the ground and I can not see them.  They sit close to the fire and work with paper and cloth unsure what potatoes have to do with fairies. 

I miss the cookhouses of Vietnam and Haiti; those places of early morning fires made by women who had been making fires for most of their lives.   This morning and every morning, millions of women begin the day with a fire.  

I listen to people in my country wonder about careers and making enough money and have meaning in their lives.   I say that perhaps in every home someone has to tend the fire and make the hearth a place to gather and grow warm.   We can turn on the furnace or the stove but that may not be enough to make us warm. Perhaps this work is the most important work.

In Haiti, a child runs to a neighbor with a metal cup to borrow an ember to start their fire.  The child carries it carefully home where their morning fire too is started. The smoke lifts up from each small house and yard; mixing with the fog lifting from the sea.  In my home the sky parts and divides the morning from night as the smoke climbs up out of my chimney and joins the clouds drifting out to sea.  

I see the work of the day set out before me but none more important than the work of the women who tend the fire that starts the day.

Thursday, April 17, 2014

In my village

I have come home to Portland. 

 I could see that I was pushing against the current and needed to re-think what was happening with maternal health and what useful role if any I could play.   Although 99.9% of all childbirths are attended by matrones, who are largely women, the health care system is paternalistic.  

The skilled midwives, trained at Midwives For Haiti, were suppose to work under doctors who had less training than themselves and their role was constantly undermined.   Nothing was based on what women wanted, World Health Organization standards or research.   It seemed to be based on a system of power stemming from Europe in the middle ages.  There were two worlds.  There was the village or hamlet life with well defined systems of agriculture, market and yard in which women garnished respect and order.  There was then a system of governance, churches, schools and clinics that had rules, regulations and a way of doing things I failed to understand.  The power seemed to come from the town where the boats connected it to Port-Au- Prince and the greater world.  I was told there was a system of status assigned to certain people; there were people who mattered and people who did not. 

Most people, I knew did not venture down the mountain to the town, let alone take the ferry to Port-Au-Prince or leave Haiti.  Migration to earn a wage, was most often the task of young men.  Some teenagers had the opportunity to go to high school in town.  If you were about to die, they might try taking you down the mountain side, across the bay and to a hospital in Port-Au-Prince. Things to sell in the market were brought over on the ferry, but by in large, the families lived in cycles connected to their daily needs, the elements and the comings and goings of birth and death and foods coming in and out of season.

There was not a clear recognition of the importance of prenatal care let alone a birth with a skilled birth attendant.  Women who did come for prenatal care were not routinely tested for STD’s and care was sporadic at best.  I wrestled with what mattered most and what I , an aging, white midwife might offer to people I cared about.   I struggled with the idea that we leave our responsibility for others at borders as well as the many problems with NGO backed health care in Haiti.

I loved my day to day life in the small village.   There were small tasks that took forever to accomplish, a lack of supplies, almost non- existant communication and a chain of consent that was hard to master.  Still I wondered about doing what good I could and settling down into a routine of children, midwives and mothers.   I had to remind myself that I was there to help establish a maternal/ child health system using the skills of these newly trained midwives.   

I decided that mobile prenatal clinics would make the greatest impact on women, children and their communities and to do this well I had to take a step back and try to figure out what it meant to do this well.   The cluster of villages needing mobile clinics had long term relationships with churches in the United States.  They worked in partnership with a large church system that branched off into smaller and smaller streams and ended up in small, rural churches with lay leaders in Haiti.   Somehow I had to swim back up those small streams to the source and gain consensus regarding the importance of this work.    We had to, I felt, start at the beginning and rethink what care is most critical.  Later I would talk with midwives and we would ask ourselves what we would choose, if we had to choose.   Often NGO’s dedicated the most money to hospitals and hospital systems for emergency care or in the hope that women would one day choose to give birth there.  This is where the money most often flowed but it was like putting a band aide on a wound that could have been prevented. Of course the whole maternal health package includes prenatal care, skilled birth attendants, emergency transport,  emergency ready hospitals and  post partum care.

High on the mountains of LaGonave it seemed that care had to begin in the villages, close to home and garden and yard in partnership with the matrones, agent santes and village leaders.   But the question was not just to do it but to do it really, really well.   So I went and visited other mobile clinics and tried to sort out what works and what does not.   I sit and sort this out everyday while living and working in my own village.  

Haiti is always in my heart. I see what is before me and yet there is another lens through which I see things and that lens is Haiti.   In the coming weeks, as I prepare to return and help launch the mobile clinics, I am want to write about maternal health care in my own village.   I can see that I have set a standard for Haiti but what about my own village and what is happening there.  

I can see that heartbreak is central to the human condition and that some of it is preventable and some is not.  I wonder a lot about democracy and all the work it takes to really trust in the process of equity and the courage it takes to enter the conversation.   If I have a fear it is the fear that the worlds I have chosen are not adequate for the task before me.   I am surrounded by power systems, inequities and the long term results of colonialism in my own village.  As I pack and prepare to return, I promised I would take a reflective look at my own village and ask myself if the same obstacles that existed in Haiti, indeed exist here.

Within days of returning several things happened in my village; a wonderful woman and mother had died too young.  Another very young mother with two children faced the dilemmas of housing insecurity or being homeless.   I sunk into despair.  George’s mother died of breast cancer and left him an orphan.  Three girls I loved lost their mother. One of my favorite students ever was facing many obstacles finding a school and home for her children.  I became hesitant to go out in the world.  I could not bare the unfairness of the world but slowly, slowly the garden called to me and I returned to the world; not the same ever but returned none the less to try again, to allow my hear to break, to make mistakes and to try again and again.

Sunday, April 6, 2014

Loaves and Fishes

This past week, I have found myself flooded with images of sorrow.  I have, over many years, developed ways to integrate sorrow into my landscape; to let the heartache rest and grow into something new and beautiful.  I buried them in my garden, sewed them into a quilt or stirred them into a cake but this week I was too busy and the images would not be silenced.  The images were raw and refused to be controlled or intellectualized away.   I had not tended them and so they grew wild within my heart. I tell myself that this is inevitable and cannot be prevented sometimes.  It is just how it is. 

I woke up this morning, thinking of Jesus and his many stories about there being enough for everyone.  I thought, quite unexpectedly about the  stories of people fearing their was not enough for everyone and Jesus making enough food for everyone.  I consider that the stories are really about us having faith that there will  be enough for everyone and that we do not have to worry so much or hurt others because we think we will not get enough.   I consider that the miracle was the miracle of a love that believes there will always be room for one more and that when we live as a community, we will always find a way to feed one more person. 

In Haiti and around the world, mothers let their young babies die or abort them late in their pregnancy rather than risk that the child will grow up and starve or not have an opportunity for a good life.   I saw a cardboard box full of babies whose mothers let them go rather than risk suffering later in life.  I watched that cardboard box, filled with babies, fall apart.  I watched the dead babies fall to the floor and be scooped back up and this is what I cannot forget.  I cannot forget that somewhere they had a mother or was walking home and starting over without her baby.  She did not believe that there was enough for her, her older children, her family and so this baby had to be let go. 

There is enough, of course.  The story of the bread and fish was not to show how powerful Jesus was but to show how powerful we can be if we believe there is enough for all.

I am pretty sure that every single act of injustice was based on the belief that to include everyone would mean not enough for others.  In these many acts of genocide and destruction, I am sure someone believed that there was not enough land, not enough money, not enough room for everyone and so someone had to be eliminated or kept out.  To accomplish this great act of exclusion borders were created, stories were told and retold.  Caste systems were created.  Reservations and camps and barbwire were put up.   We stopped being tribes who care for one another.   We became a patchwork of islands fighting one another. 

Through all of this, mothers had babies and struggled to give them every opportunity to survive and thrive.  In Haiti, mothers make hard decisions.   For all of time, mothers have been forced to let their babies go.   I close my eyes and I see babies tumbling out of a cardboard onto the floor and being scooped up again; small hands and bodies intertwined.    Many people have tried to analyze the history of Haiti. We have watched movies of slaves mothers on ships choosing death for their unborn rather than slavery.  We know that the United States and France drew a line around that small nation to punish them for wanting freedom.   The devastating result of those decisions is a box of dead babies tumbling to the floor. 

We cannot close doors, close border, close boundaries, close neighborhoods without devastating results for someone somewhere.  We may be afraid that there will not be enough but perhaps a balance will emerge and the one loaf of bread and one fish will become many.   Perhaps we are our own miracle.

If you know what equity means; if you believe in the civil rights of all people, when you are asked to be afraid that there is not enough room, not enough time, not enough things open your door wide and put your arms around the mother who stands before you with her baby born or unborn and whisper in her ear that you may not be sure what is in your cupboard but what ever is there is hers to share.  Do this as a neighbor, as a community and as a country. 

I can see that everyday the world offers me metaphoric opportunities to turn one loaf of bread and one fish into enough to feed the whole village.  I can live with this faith or fear.  I am crushed by the image of the babies and all the many pieces of history that went into that box.  What I do know is that someone somewhere has profited and is continuing to profit from the inequities that caused their dying.     Nations  and people are resource deprived because someone, somewhere has drawn a line around a group, a village, a nation, a religion an idea.  I have come to see that civil rights and human rights does not allow us time to weigh the economic benefits for ourselves.  There is only the long, slow, steady belief that with faith and love there will be enough for all.   “All Born In” unconditionally.