Getting ready for the mobile clinics

 I returned in June of 2014 to LaGonave, Haiti and tried my hardest to begin a process of establishing mobile prenatal clinics in remote villages.  Four villages were chosen by The LaGonave Partnership; a group of US churches who support and maintain a relationship with a village on LaGonave.  All the villages are connected by the Episcopal Church that appears to act as the governing body.  Each village has a small church with a lay leader, a school, a school lunch program and an adult literacy program.  All have a community health worker who lives in the village and, in theory, provides day to day health care.  The villages are 1-3 hours from a hospital, over very poor roads. in the event of a matronal emergency, it is unlikely the mother can reach care.  It is uncertain that there is a means to get her to care or that mergence services will be able to care for her should she arrive in time.

Meeting with the midwives, akan santes and matrons to play the new mobile clinics

The goal of the mobile clinics are the following;

1. To prevent, through education, screening and treatment, maternal and newborn problems leading to death and disability.
2. To allow families to build local economies without the additional burden of health care costs, orphaned children and the death of a mother.
3. To identify women who should have their babies in town, closer to emergency services.
4. To provide prenatal vitamin, safe birth kits and other medications as needed.
5. To support the collaboration of the the midwives, ajan santes, lay leaders and matrons.
6. To provide transport in the event of an emergency.
7. To provide safe waiting homes for women presenting with high risk pregnancies.
8. To provide life saving measures and medications to women in remote villages.

Everyone has fun practicing skin to skin birth techniques at a training on preventing postpartum problems for matrons, midwives and ajan santes.

My schedule for the "launch" of matronal/ newborn mobile clinics was intended to be democratic, inclusive and involve the people it would impact most,  in the decision making.  Within hours, if not days, I was made aware that there were no medications, no complete charts, no educational materials, and that the midwives and not been paid in months.  The "ambulance" is the car for the church.   All decisions go through the Father and must wait his approval.  The doctor, who is the medical director, also must ask him for everything; copies, medicines, water.  There is no system of independent, creative problem solving.  While I have worked for over a year to empower these two midwives to be critical thinkers, independent, responsible and caring practitioners, they are part of a large, complicated system that stretches across seas and countries and moves very, very slowly.  Despite this, bags are packed and we go to the villages ties and hold the clinics.