Wednesday, December 16, 2015

Trial in the Death of Oliver's Mother

There was a death but there is no trial, no coroner report, no peer review, no investigation, no law suit.

But in classrooms, across the United States, children are having mock trials of Christopher Columbus.  My grand daughters are in the midst of this study at their school.   They read Morning Girl about a Taino Indian girl and are now trying Christopher Columbus of the death of her people.

Christopher Columbus is greeted by the Taino Indians who he described as friendly and welcoming.  In less than 25 years, most were killed and others fled to the mountains and the outer islands.  

I say to my grand daughter, they are still dying.  It was not Espanola.  It was Ayiti; the word the Taino gave the land where Columbus landed and created his first settlement called LaNavidad.  

And so I accuse Christopher Columbus of the death of Oliver's mother.  I accuse him of creating "Colonality of Power"; a system in domination remains in continued notions of superiority.  I accuse him of taking an island free of gender discrimination and embedding it with attitudes that helped lead to Oliver's mothers death.  I accuse him of Hegemony; a system in which oppressive values an ideas permeate a society without being imposed.  

Christopher Columbus was taken back to Spain in 1500 where he stood trial for the genocide of the Taino people.
Today many people ask how Haiti is, without ever making a connection to long lasting effects of Columbus's legacy.

I accuse him of leaving an on going form of post colonial oppression that won't go away; that leads to a system where Oliver's mother was not able to make decisions to help herself and her children.  

Today I am going to talk to their class about the Taino in Haiti and the lasting legacy of Christopher Columbus.   I will tell them about the ways they escaped to the mountains and how they helped the slaves with their fight for freedom.  I will tell them about the beautiful ways the people love the land and care for one another.  I will tell them about the things that were taken but also of the things that could not be destroyed.

This story and others like it, make children really sad which is why I believe so strongly in service learning as a teaching methodology.  It allows the children to learn the truth about Christopher Columbus and his relationship to Haiti.  It allows them to understand that Haiti's challenges were created by colonialism and not just an earthquake.  But it also allows them to try to do some small things to help.    I'll make them a Santa list of things babies, like Oliver, might need in Cabestore. I'll tell them how hard it is to get to the market and how they might not have the most basic of things that could help a baby.

One day,  God willing ( as the Haitians say )  I will pack their gifts and make may way back to Canestore and offer them to the mothers there.   In this way, the circle of giving and receiving in cycles of healing and compassion.

And I will tell these children, over the holiday, when someone comes into your house.  Quickly offer them the best chair and sit with them and share a story.  Offer them whatever little you have.   Each time you do this, you honor the Taino's and the best of Haiti and show Christopher Columbus he did not win. There as something stronger than swords and it survived in the remote villages and hamlets of Haiti.

Sunday, December 13, 2015

Carrie Wortham Birth Center, Your Mom - Finding the Good Spirits

I had gone to Cabestore to help set up a new birth center.   Next to the church, it is the biggest building anywhere around and it is painted bright pink.   Women can go there for prenatal care and to give birth and for postpartum check ups.  There is trainings for the matrones and occasional medical clinics.   Its where Oliver's mom went for her check ups, when he was still inside her.  Tap, tap , tap went his little heart inside her.  Tap, tap, tap.

I tell Oliver that this is a sign that the "good spirits" are moving in to Cabestore ; that the bad spirits that took his Mama are getting smaller and weaker and the good ones are growing.   I tell him that sometimes when one good thing comes, many more follow.  

I tell him that each day, we get up and get to decide how we are going to live this life.   Sometimes we have to look, but the good spirits are all right there too.

I tell him the birth center is named after a woman I knew and she died too, right around the same time as his Mama.  Some "bad spirits" took her too.   I tell him that bad spirits come when people aren't paying attention to where they are going or who they may run over, as they plow through the world blind to other's well being.   I tell him, he can't walk yet but when he can to look where he is going and it will help a lot.  I tell him, even if he becomes rich and powerful, to watch where he is going and not run over anyone.  Slow down, I tell him and watch where people are going and help them out, if you can.  

This woman, Carrie; the one the birth center was named after, had a particularly good ability to create   good spirits.  She danced, ran, made brownies for everyone, took care of stray cats.  She was good at creating good spirits in the midst of some pretty, hard moments.   Its a talent but one anyone can practice this and get better at it.    

So, I tell Oliver, given that the birth center is named after a person talented in creating "good spirits" I believe its a good sign for his community.   I tell him good spirits are coming his way and he just needs to hold on.  

I tell him we are having a lot of trouble with "bad spirits"in our country too.  I tell him greed and not looking out for other people, is at an all time high.   But loving people and the fight for watching out for others, is also at an all time high.    I believe your Mama, was killed by centuries of greed.   I also believe there was a bacteria or a virus that we could have stopped but more important, she was killed by a deep division between those who have and those who do not.   Sometimes, in Haiti, I hear people blame the next door neighbor for these bad spirits but I suspect this only serves to keep you from understanding the source of the real "bad spirits."   I want you to know that your Mama loved you and most likely died of a water borne bacteria that caused severe dehydration that lead to her death.   The "bad spirits"; things like a lack of education, a lack of good farm land, a lack of food and too many children in too few years were all things that could have been prevented her death too.   Education, family planning and health care are human rights.  

In the future, the women indoor small hamlet, will get good prenatal care and access to a safe birth and easier access to family planning.   But most of all the birth center will stand as a beacon for our belief in good spirits.   Many volunteers will make their way to your small, rural community.  Haitian midwives will train there.  

There is nothing I can do to bring back your mother.  I can not change the events that led to Carrie's death.  All I can do is to work to understand the "bad spirits" that led to their deaths and try, each and every day to work hard to understand those things that bring "good spirits" as well.    I was raised a Quaker.  When I was little they said my only job, in life, was to walk around and try to look for the light in each human being.  To nurture that light and not be afraid to be a witness to the things that seek to put that light out.  To not be afraid.   Because of this, I  chose to interpret the "bad spirits" as the absence of light and not a specific curse.  I saw "bad spirits" is the absence of human rights, the absence of dignity and equity. And so, in this way, I believe your mother was killed by a "bad spirit" and that her death was preventable.  That "bad spirit"was greed.  This greed grows a big hole in people's hearts and it cannot be filled by things, or speed, or beauty or power.  The hole just keeps getting bigger and bigger and it feels like the "bad spirits" just want more and more and just keep taking more and more victims.  It feels that way sometimes.

I am a midwife, and I know that every baby is born with a "good spirit" growing in their heart.  The light inside each new born baby is so powerful and so sweet, it can nearly knock a midwife over.  I suspect that's why I'm a midwife.  I like to swim in that light.   I suspect the reason I like a nice, quiet, natural birth is so I can see that light a bit better and make sure the baby gets set straight in the world; knowing this goodness is his or her's birthright.  I like to keep a baby naked and on his Mama so that for a little bit all things are equal, with each baby and the world.   The inequities will come soon enough.

You were born into your Mama's arms.  You were bathed in this light.  They say your Mama thought of you, right before she died, and gave you to the women who is caring for you in your own village.  Sometimes, I am scared they will tell me you didn't make it.  I know the odds are against you.  

Hold on.  You were born in a sea of light.  There are "good spirits" all around you.  Hold on.

Keeping Oliver

Oliver's Dad stares at me with helpless grief.  He says, "The baby cries at night without his mother's milk."   His other children cling to his hands and pants and gather tight around him.

He is not the first father to hold out a motherless baby and plead for help.   He is not the only father, in Haiti, to consider adoption and then keep his baby.  Oliver's father hands the baby to the translator and then takes him back.  This goes on for several days.   The older women do not want him to go but he seems to lean towards letting him be adopted; to offering this one child a better chance.

One evening, he consults with the priest and the priest, who has shown no prior concern for the mother or baby or the community's well being, says the baby should remain in the small hamlet.  And in this way,the fate of baby Oliver is decided.  There is no plan for who will give him formula, watch him while his father farms or how he will go to school.   His chances of living in Haiti, are perhaps 1 in 10  but without a mother, they are far less.  

There is nothing more we can do.  I make lists of supplies for future volunteers to bring but even if they bring emergency formula or liquid vitamins, I am not sure they will make it up the trail to where he lives.   I amanita sure who is paying attention.

I tell the father "rice milk with Hatien rice - not white rice."  I tell him carrot juice at least once a week and many yams and sweet potatoes.   I say, "Not just white rice."   I give him vitamins to mash up into his food.

On the long way back to Portland, I am waiting at a hotel for a ride and meet a man who was adopted as a young child by an Australian family.  He came back to find his mother.  His adoption was not easy.   He has found his birth mother and is building her a new house and trying to help her village.   His children swim in the pool.   I listen to the Australian grandmother tell the story.  It was not easy for him to  know his Hatien mother gave him up for adoption.   He's struggled with his identity and felt he had to find her.  He was not a good argument for adoption.  Some would suggest structured sponsorships so that children can stay with their families but still attend school and get food at a school canteen.  There are other ways, they would argue but none of those existed in the Oliver's small hamlet.  It was adoption or stay where he was.    

I think of my adopted daughter from Cambodia.  Her older sister sent her to the refugee camps on the Thai border.  It was dangerous journey. There were land mines and no one knew what would become of such a small girl.  Most of her large, extended family was dead.  There were no parents and  her sister was just a teenager.  And so she made the journey from Pahl Pot to a refugee camp to my family.  Years later, when we return to Cambodia, I am harsh in my thinking.  I think, "You could have kept her.  What were you thinking sending her through land mines to a refugee camp.  " I do not say this but I think it.   I think she has mistreated my daughter but had she not sent her away, she would not be my daughter.  I believe this daughter dwelled in my heart for all my life; that she was placed in my arms as sure as any child I gave birth to.   She is a grown woman now and can return to Cambodia and see her sister.   Her sister says, "It all turned out" though now I am sure she wishes she had her sister full time in Cambodia.   Perhaps,as she observes, this woman who is too American, she has regrets.  There were years of separation; years with no contact.  Years she did not know if her sister was alive or dead.  

The translator only wants to take baby Oliver to Port-Au-Prince.  It is a few hours away and yet because the priest says no, the father says no and returns to his house with the baby.

When I go up to their house, the father offers me a chair and I sit in the sun. Baby Oliver melts into my arms.   He puts his small head agains my chest and breathes softly.  His hair is red now; the color of malnutrition but he is okay.  I tell him he is going to have to fight to live.  

I tell him, that although the world has some pretty bad "spirits" it also has more good spirits.  I tell him sure there is greed and some downright mean people, but there is more good.  The sun is filtered through the chestnut tree.  It is time to harvest the chestnuts and the men are busy getting them ready for market.   The light falls on his face.   His big, happy. Haitian family is standing around us and everyone's talking and laughing and out on the road farmers are singing as they return from work.

"Hold on" I whisper to Oliver.  "Hold on to all this goodness; to the songs and stories and the people who love you. Hold on."  

Friday, December 11, 2015

People only appreciate things if they pay for them

In Haiti, I am sitting somewhere and the topic of fees for services comes up.  In general the philosophy of the NGO is that:

1. People do not appreciate things they do not pay for.

2. It is the culture of Haiti to make people pay for school and healthcare.

3. The priest who is working with them, says they must charge.

4. Everyone can pay something.

5. Developed countries have taxes so in fact the people in our countries are paying for education and healthcare.

So, it follows, that if, the now deceased Rose, appreciated healthcare and her children's education more, she would have paid for it.   But given that she is dead, she must not have appreciated these things and thus did not pay for them and thus her children are without a mother.   It was not for a lack of resources but rather a lack of appreciation.

In my country; even in the poorest of neighborhoods, school is free for the children who walk in the door.  The children can never be expelled for lack of fees, books or improper clothing.   Their parents may or may not pay taxes, but the child walks in the school free of that burden.   There is no proof that children with expensive private school education, appreciate their education more than a dedicated public school student.

In my country, people all can get health care.  They are subsidized if they have less resources.  If they are considered disabled they get healthcare at no cost.   We give elderly people some form of subsidized healthcare.   Countries with far better health statistics than ours, have government sponsored healthcare.  No one in those countries says that they don't appreciate their healthcare.  It is simply considered a human right.  One does not have to appreciate it to obtain it.

In the United States, if you enter the emergency room, you must be treated.  Things go wrong. It doesn't always work but it is the law.   You can call 911 and someone will come and get you.  It is true you might get a huge bill, but you will be less likely to die.

Most all schools and clinics, in Haiti, are subsidized by foreign donors.  People like you and me who have it in our DNA to help others.   The donors can not possibly imagine Rose, dead, in a small house, her children stunned while the rain beats on the roof.  

Each year millions of dollars are collected for schools, books and healthcare in Haiti.   People say, "Where does the money go?"  

Rose could have gotten on a moto and gone to a hospital and they would  have seen her for free.  Someone would have taken her, I believe and I know the hospital would have seen her.  But she did not go because of a culture that has rejected the peasant woman as stupid and unclean and undeserving.  She lived in a culture of class distinction that did not allow her to believe that she would be welcomed and that they would really have seen her.

Rose and her community lacked faith and hope and a belief in charity beyond their own lakou.  The bad spirits of class distinction are rooted in her death.   It was better to stay home, with people who loved her, than risk the humiliation and rejection, that past experiences told them all, might await her.  

The problem with the fees, is that there is too much room for corruption and the true purpose is, not to fund anything, but to maintain a class division that is deeply rooted in Hatien culture. ( And US culture)  It sorts out the better off from the have nothing at all.

So today, as you go about your day, how many things are available to you and the people in your community regardless of their ability to pay for them or pay taxes?   Would you have it any other way?  Do you believe in a social system that guarantees people certain things such as education and healthcare.  If you or someone you love, gets these things for free, do they appreciate them less?

In my experience, people appreciate things when they are given a voice and are invited to contribute, in whatever way they can.  Parents can help with cleaning, repairs, and painting.  Children can learn to grow their own food for a school canteen.  Councils and democratic process can bring people into the community.   People appreciate things when they are valued and listened to.  We give children free school and healthcare, because they are children and what their parents do or have is not their responsibility.    

Rose died because she was, in our big world, a person of little value.   I did not really know her and Rose is not even her name.  I know that her family and her community, believe she died of bad spirits and so, in writing this, I am perhaps trying to do my own ceremony of driving these bad spirits from the world.
People from Haiti, risk their lives to seek work in other places.  A person who makes it to Florida may find work that will help pay school fees and fund medical emergencies.
In my world, the mountains collapse from over logging and the destruction of wetlands.  Homes are destroyed and people trapped in landslides.  They want to take farm land and forest to run oil lines through our state.  They demand this even as the world around us crumbles from too much destruction of the environment.  The poorest people of the world, ask us to use less so they can simply live.

Rose and her people did not know how to ask. They were denied an education.  The graveyard is full of their friends and family.  In the past, any decent, was met with death and the loss of land.   The bad spirits which came with a lack of voice and empowerment, took her away.

Wednesday, December 9, 2015

Rose's ecological footprint

I listen to reports from Paris about climate change.

Young girls walk to get water for their family each morning.   The water pump is also a place for friends to meet and visit with each other before heading back home.  

I think about Cabestore and Haiti and Rose's small hamlet.

Rose consumed very little in her short life.  She walked almost everywhere she went and used no electricity.   Her clothes were  second hand from the United States.  She ate whatever they could grow; the exception being the rice they were forced to buy from the Dominican Republic, when their rice fields were lost to them.

Her global footprint was very, very small.   She had almost no possessions;  her furniture was home made and she would be lucky to have a pot for cooking rice and beans.

But her life was not bad.  It was beautiful.   She woke up to beautiful mountains and clean, sweet, meandering streams and rivers.   The noises of dawn; of children and animals and friends were reassuring and happy.   She had sisters and cousins and friends; a good husband and beautiful children.

She believed in God and she believed that God dwelled in all things.

On the radio they say, "Are Americans willing to eat less meat, use less electricity, consume less?"   They say, "What if the developing world, used as much as Americans?"

Do we need to keep a certain part of the world, without, so we can have so much?

I add the factors leading to global warming to the reasons Rose died; the reasons why Oliver does not have a mother.  Poverty is a big business and Rose was one small casualty of the pursuit of wealth that has no bounds.

Yes, Rose, a bad spirit killed you, but perhaps not the one you thought.  It was not one that a Leaf Doctor could have rid you off.  It was he bad spirit of greed that surrounded you and enveloped you, even in that quiet, peaceful hamlet you called home.

They say that it was once an island of tropical birds and that whales and dolphins were always off shore.   They say there were giant hardwood trees and the rivers were full of fish.

I see you walking there, your baby indoor arms; a great woman with a very small, ecological footprint.   In a world full of environmental heroes, this morning I nominate the women of the world who walk so gently on this earth.

Sunday, December 6, 2015

When one mother dies.

Every Mother Counts

This is the name of a maternal health organization and indeed the one that is helping to make the new birth center possible.   It helps pay for the education of the midwives and the remodel of the building.  There are t-shirts and water bottles and other things with their logo floating around us as we set up.

It is based on the idea that if a mother dies, there is a terrible ripple effect in the community.   The baby has no milk, the children can't go to school, there is increased risk of sexual exploitation, there is starvation and of course the life time of grief and loneliness people feel when their mother dies so young.  Women work hard in Haiti.  They tend gardens, cook, wash clothes by hand, go to the market and bathe children.  All the work that they do must be done by someone else, if they die.  The oldest daughter loses her childhood.

There is some debate about how far this statement reaches.   Rose had prenatal care at the mobile clinic and delivered her baby safely at home with the help of a local matron.   The matron attended a matron training program.  But here we are four months away from the birth and the community is faced with life without this one important mother, her dazed husband and her children.   The newly installed midwives, are not so sure the nutrition of this four month old baby is their concern.  He was not born at the birth center and there is no formula.  What can be done?

In the USA, the father would get formula from WIC and food stamps.  He could go to a local food pantry or get an emergency box of food.  His children would get a free breakfast and lunch at a school that required no fees or uniform or books.   They would simply walk out of the house, dressed the best they could and go eat breakfast before school.  If they needed clothes, there would be a clothes closet for them to pick out new and gently used clothing.  If the baby or any of the children, needed temporary foster care, it would be provided.

In the USA, we have safety nets.  We all pay a portion of our income to assure some basic services for children who, for many reasons, are in danger.  Most of us, most of the time are thankful for this.

In Haiti, Oliver's Dad is trying to decide what to do with him.  He clearly loves and enjoys his children and does not want to give this baby away.   It has only been a few days, since his wife died.
He asks if he can get him back later or visit him or know how he is doing.  These would all be reasonable requests in the United States.   The translator shakes her head.  

A volunteer offers to help support the baby by sending money each month to the translator. The  baby would have food, clean clothes and above all a good education.   More than that; he would stand a chance at living.

The volunteer midwife and I, standing in the rain, know his chances of living are not good.   Many babies in Haiti never reach their fifth birthday.  In many places as many as 1 in 4 die in the early years.   Their bodies are weakened by malnutrition and the constant infestation of worms that destroy what nutrition they have.   There are all the mosquito born diseases of malaria and dengue.  There are all the kid infections that are easily remedied with antibiotics that are left untreated.   There is untreated water and latrines too inconvenient to use.  

The father is still considering the bad spirits that killed his wife and is not considering the possibilities of parasites and infections and malnutrition.   He is being told his wife's death was not preventable.  It was just fate.  The idea that they can prevent the baby's death is difficult to grasp.

A woman stands with the baby in her arms and insists she should take care of him; that Rose asked her and so he has to stay there in the family Lakou.   It feels unfair, to me, that he should have to choose.

We bring him formula and baby clothes.  But it is not easy to get formula week after week, after we have all gone home.  He comes at dusk, later in the week, and says the baby is crying. He is hungry and the children have no food.   We give him evaporated milk and some protein bars.   He says that on Friday,  he will bring the baby for the translator to take home.   He is sure.   The translator says she will make sure he knows how the baby is and that sometimes there can be a visit but the baby will be legally hers.

He nods and walks out into the darkness that surrounds us.   A woman is in labor.  We turn towards the birth room as he walks away.   The mist is settling in and there is a chill in the air, even thought the days are hot and still.

Saturday, December 5, 2015

Rose's Choice - "Send the children to school."

Oliver's mother and her large extended family grew up in Cabestore.  For as long as anyone could remember they had all lived and loved and given birth and died along those steep, mountain paths.

As a baby girl, Rose would have learned how to carry water, on her head, as she walked to the nearest spring to collect water.  Her cousins and sisters would join her as the mist rose from the countryside and the roosters crowed.  Perhaps her Mama would yell at her if she took too long but this was her time to meet girlfriends and share news from the other hamlets.   There were five other children and many cousins in her lakou, that sat half way up the mountain, with the corn fields forming a safe and comforting  blanket around them.

Rose was born into the dictatorship of Baby Doc Duvalier.  By the time she was five, Aristede had become the first democratically elected president.   In the years of violence and secret police; of hope and hope destroyed; they had lost land and family members.   They could not afford to loose anymore farm land and still feed their family.  Large, fruit and nut producing trees were cut and taken by the government police.  They stood by and watched; no longer knowing what a full stomach felt like.   She sat, under the tree, and braided her sister's hair and told stories.   When there was food to harvest, all the men would work together and sing and she would prepare a meal for them and bring it to the fields.   At the ned of the day, someone would come and take much of what they harvested but still it was food and she was happy.  

By the time, Rose was pregnant with Oliver, the best land had been taken and the fruit trees of her childhood were gone.  The land, like her body, were tired and over used.  You could only harvest so much without a rest; from a woman or a piece of land.  When there was more land, they could let pieces rest but no longer.  

Rose had never gone to school.  No one in their extended family could read or write.  For all the elections, dictatorships and occupations; no one had established public education.   When the Catholic Church established a school, she knew it was not for her.  She longed for a school uniform and matching ribbons for her hair but this was not for children like her.   She quickly learned to cook and care for babies and to help while her mother was working the gardens or gone to market.

Her older cousin had joined a small house church which followed the teachings of Liberian Theology.  He had returned home excited about the possibility for a new and equitable Haiti.   Soon, the government appointed clergy came and said they had no title to their land.   Her cousin argued that it had been in the family for hundreds of years; that the children would starve without it but the land was taken.  They could still farm it but a portion of every crop would go to the church.   The cousin was furious and said he would go,by boat, to the United States and earn money to buy land with a proper title.  He said all the children must go to school.  Even if it meant starving.  The children had to go to school.   He forbid everyone from the smallest pleasures; coffee and a piece of sugar cane; a little rum and betting on the roosters.  We had to send the children to school; one child at a time.   Rose knew this did not mean her as she was too old and was needed at home. She never drank coffee or drank rum or betted on roosters so none of these restrictions bothered her.  One older boy was chosen to go to school.   The older men argued that it would mean more work for them on the farm and that why was one son chosen and they all had to pay.  Her cousin argued "Someone has to know how to read."

The hope of Arrested died when he was overthrown.  Even out in her little hamlet, the news reached them.  Aristide had been overthrown and there was the return of military rule.   Her cousin sat under the last big tree and wept.   The next day, he left for the farms but never returned.   Some said he made his way to America and would return one day with money to buy land, with a title. Others said he was killed and his body thrown to the dogs.

Rose married a sweet man with enough land to feed a family.   Rose made him promise the children would go to school, even the girls.  He climbed a mango tree and threw down mangoes for each of them.  They sat there and talked about their life; how it would be different for them.   They would work hard and send the children to school.   They would be careful.   They would sacrifice everything for their children's education.

And so perhaps, when Rose had to choose the books for her children's school or the fees or the uniform or going to a doctor in town; she chose education.  

They say it was "Bad Spirits."   They say bad spirits have plagued that family for many years; starting with the cousin who joined the Liberation Theology Movement and down through the generations.  

The oldest daughter stares at me and wonders will become of her.  How can she ever finish school without a mother.

I wonder how it is that the United States occupied this country three times to assure democracy and never once in all that time, established a free education for everyone.

Let me explain, if a child goes to school without the proper clothes or books or fees; they risk public humiliation.  They can be shamed in front of classmates and neighbors as a poor child.   They are chased away and called names.

What would you have done if you were Rose?  As you sit there breastfeeding baby Oliver and the children say they must buy books or be turned out.  What would you do?   You know you have diarrhea and have vomited.  The clinic said you need to go to the hospital but you think- these things pass. Do you go or do you buy food for your children and pay the school fees?  

Later they call someone in to remove your bad spirits but all Rose is thinking is - take care of my children.  Make sure they go to school.  She hands her baby to an older woman and shuts her eyes.   His cry gets weaker and weaker as she sees her cousin waiting for her, there in the branches of the tree where she last saw him.

She calls his name.  She whispers, "I sent the children to school. "  

(  These things all happened in Haiti but perhaps not to this one woman or her family.  It is based on historical times but all can not be assigned  to this family or place. )

Wednesday, November 25, 2015

Where is Rose's Grave?

I wake up and offer my morning prayers to the day as it emerges over the Cascade Mountains.
In this quiet, my heart flies over the mountains and the sea to Cabestore and its trails of small hamlets and family farms.

And then, I write.  I am superstitious.  I think that if I tell this one mother's story, she will not have died in vain.  I believe that if I tell her story, her baby boy will miraculously live until the day I return. I believe that maybe the collective knowledge of her life will wrap her tiny house in goodness and light.

A traditional house surrounded by a family garden in which crops are interplanted - corn, millet, beans and squashes as well as fruit and nut trees.  When the lands are stolen for mon agriculture the results are often tragic.  

I close my eyes and pray hard - "Take care of that fragile family."

"For all the fragile families."

When I flew into Haiti, I looked out the plane window and I saw these tiny lights shining like diamonds in all of the mountains.  I looked again. They were everywhere; a land of diamonds just sitting there in the afternoon sun.  

Soon the plane, dipped down and I could see the rusty tin roofs of the many houses and they were no longer diamonds but rusted, leaking tin roofs.   But I knew that we can choose to see them as diamonds or we can choose to see the rust.   The diamonds, sparkling in the sun,stayed with me on my journey.  I began to look for them in everything I did.  I looked for those moments and places of blinding light amidst equally blinding poverty.

Rose, the mother in my sotry, died of poverty.  

She like all of us, comes form a long line of human beings who traveled and lived in small equalitarian bands of friends and family.   They followed the shoreline all over the world, fishing and gathering food amongst the rocks and meadows of the coast.   Archaeologists believe that these early bands of humans were free of class and were largely democratic.  They think this because of the graves.   Later, in the human story, graves would tell a different story but for thousands of years the final resting places of human beings were remarkably equal.   The other thing they noticed, was that there are virtually no skeletons with baby skeletons inside them. This leading them to consider that not many mothers died in childbirth.

Rose was buried in a poorly kept cemetery in Cabestore.  It sits on a bluff on the way to the "poor kids" school; on the way to the market.   Most people are buried in family graves; cement above ground, multi-layered places of rest similar to New Orleans.  They sit right beside them in their front yards.   I read that this was important because during slave times, there were no graves and so people wanted to keep their loved ones close by.  They can lovingly put things on them and walk by them every day.

The land of Rose's Lakou; her family yard, was lost and so she traveled down the trail to the community grave yard.   By the time, we arrived the burying was over and people were gathered, tied from an all too familiar journey.

The grave in the yard, was a sign of independence. self sufficiency and respect.

This was interwoven into a view of self sufficiency in which each family grew their own food and cared for one another on their own land.   The world could do as it would, but they would keep their land and their traditions.   This might have worked for some time, but in time people would come ( my country included ) and the rich and powerful of Haiti and they would want to consolidate the farms and turn to mono crops.  It was the same in the US farms.   'We can do better. Grow more. Make more money." The problem was that the families depended on the food grown on that land to live.    I watched huge trucks drive by piled high with plantains while the children's cooking pot sat empty.  

Despite a well crafted, ancient system of cooperation and taking care of each other; the land of Rose's family was sold or taken or coaxed away from her and she starved.   I believe her family grave is somewhere on the lost land.   Perhaps the men will  be hired to work the lost farm land and take home a few gouds to try to feed and educate their children.   Each day they will make hard decsions about the few resources they have.
The  baby is passed from arm to arm; from lap to lap no knowing where his mother has gone.

Tuesday, November 24, 2015

This Little Light of Mine

The mornings in Cabestore are veiled in mist; a cool mist that clings to the mountains. I sit on the porch of the birth center with my circle of solar lights.   I breathe in the morning and ask that I have the strength to be good and true and stay calm and kind.

I think about the many aspects of my own inner self.   They tumble out of me all day long and stay with me in my dreams.   I consider the power of these aspects and think that all the spirits of the Hatien Saints are all the many parts of us.   They do not have to enter us, as they say in Voodoo.  They are alway there.  The kindness and love and strength as well as the fear and sorrow.  They are all there; always.

I think they believe that these spirits come and go at will.  I think they think someone can enter your body and take over your sweet disposition with a rage that causes death and destruction.   I think it is all in there always.  We can choose what we nurture and what we try to calm.   We can use these many aspects and when we use them to hurt others, it can indeed feel like a bad spirit has attacked us.  

Sunrise in Cabestore 

This is a my Quaker interpretation of "spirits."   We were taught that each person has an inner light or spirit and that our only task in life was to walk cheerfully across the earth, looking for that light in other people.  Recognizing it and helping it to grow.  We sang "This Little Light of Mine" a lot.

"Ain't gonna let them blow it out !"

Can a whole country become convinced that the spirits blowing their light out are metaphysical and the work of friends and neighbors?

I was a religion major.  I consider how religion can be used to comfort and build community or how it can be used to control and grow fear and discrimination.

When Rose lay dying with her baby sucking the last bit of milk from her breasts; she believed that an evil spirit had entered her body.   She believed that this evil spirit was far greater than the good that was also in her and that no western medicine could take it away.

If the Agent Sante from PIH came to see her, he later agreed that it was "bad spirits" and would consider no other possibilities.

The priest did not walk up that muddy trail to see her or offer last rites.  I doubt they would have bothered to send for him.   They did not ask for a ride in his fancy SUV.  They did not have a mass in the church.   These things cost money and after all they did not have the money to go to the hospital or send their children to school.

The mountains are filled with the bones of mothers.

It is easy to doubt the presence of an inner light in all people.   When I emerge from the isolation of Cabestore, Paris has been attacked and hundreds of mothers will die as bombs are dropped and miss their target.   It is a battle, it seems between evil and good; righteous and evil.   People fighting over the right to God's teachings.

A volunteer asks. "What is the difference between Protestants and Catholics?"

I say well it was the Reformation.  The protestants believed that the common person could understand and have a personal relationship with God.  They believed they could read the Bible for themselves.  The Catholic Church at the time, believed kings and rulers were chosen by God and people needed to go through them to get to God.   They died for the right to pray directly to God.  They died for the separation of church and state.

I believe that good mother died of a bacteria or virus or amoebe and not the curse of a single neighbor. But I also believe that she was weakened by the spirit of greed that has infected her country for hundreds of years.

Sunday, November 22, 2015

Diagnosis - Bad Spirits

 I am standing toe to toe with the family and friends of a mother who had just died as the rain beats down on the tin roof and the yard begins to flood  There are two rooms in the house with only one window in each room.  One room contains the male domino players while most of the women and children and older men are squeezed together in the other empty room.   Small children peer down from an upstairs loft.

Children of the Lakou- always ready to greet us and offer a chair after a walk up the trail to do home visits Their mother is expecting a baby in January a the new birth center

The translator is busy negotiating the adoption of the baby.

I am wondering what type of diarrhea  she had and if it could spread to all these people living so closely together.  I try to remember what her husband had said.

No fever.
No blood.
Her mother had the same thing and died too
She had it for one week

"Does anyone think it might be cholera?" I try to say.

"Bad spirits.  She had bad spirits and they could not get rid of them."

Cholera or dysentary or something else?   They are both caused by crowded conditions and poor sanitation.   Our own country had many serious outbreaks with both diseases.  Cholera was the main cause of death on the Oregon Trail and dystentary killed more soldiers in the US Civil War, than battle.  It killed thousands of babies who were given cow's milk so their mothers could work in the sweat shops of New York City.

We all  remembered the cholera outbreak in Haiti; the one that was traced back to the United Nations Security Forces.  For many years, there were piles of rehydration salts with directions on how to mix it everywhere.   Soap and rehydration salts.

I gave her soap and rehydration fluids.  If we had beds that morning perhaps I might have let her lie down and given her an IV.  But we had just opened and we had no beds.  Later we would blow up an air mattress but that morning we had not yet gotten that far.   We did not yet have IV fluids.  
These things would come but not that day.

I ask the translator to take me to the supervisor for PIH's agent sane program and say again, Maybe cholera?" and he says no, "She had bad spirits."   I figure they should know what cholera looks like as so many people died from it but I am still unsettled and there is the issue of the baby and what he will eat.  I am also there to set up a new birth center.

But I worry that the "spirits" that killed this Mom would impact maternal and infant health.  I began to see those "spirits " as all those things that lead to death and disability hat are not necessarily see under a microscope or can be tested for.   I began to see the "spirits" that killed her while keeping my eyes open for outbreaks or other people with similar symptoms.

As I walked back to the birth center, after my visit, with the agent sante, I began to notice the large number of children not in school.  I  began to see the "spirits" as those things in any society that
any society that deny a mother the ability to feed or educate or get health care for her children.

They had called the "Leaf Doctor" after the woman had come to see me.  He could not save her either.  Dis he turn to him because she could not afford the moto ride to the hospital or because she believed it was spirits he could cast out.

I could have kept her lying in the grass and watched her ads I unpacked.  I could have given her an antibiotic or gently held her head and gave her fluids.  I tell myself I did not know then she would not go to the hospital and that she was going home to die.

The baby is given a container of formula and it is agreed that the baby will go which translator on the week-end.  There are conversations about potential visits and the birth certificate.   Its pins around me and I beignet think that at least the baby will be cared for and live but the spirits were at wow

Saturday, November 21, 2015

The road back home - Rose's Journey Into Death

I am not in Cabestore writing this.    I barely had any electricity in Cabestore and no internet.   I kept a journal and made cartoon sketches of the things going around me at four or five in the morning.   I would turn on solar lights and drink luke warm tea from a thermos.    The dogs often woke me up; the dogs and the roosters.

The place where I stayed was guarded by the priest's guard dogs.  The dogs were kept in crates all day.  People would poke them with sticks to make sure they stayed good and mean. The dogs  got in fights all  night long with the local dogs who were always having babies and in  a state of extreme starvation.  

When I first arrived, Frankie warned me that if I went downstairs to the birth rooms at night, the dogs would attack me and eat me.  

"What about the mothers in labor?  Will they eat the mother's in labor?"

I thought I would simply say we cannot have mother eating dogs at a birth center and they would be moved but they were not.   The priest said if I just used the secret code word, they would not eat me.   It was hard to remember and besides he said,  "Do not let any mothers know the secret dog code."

"How will they keep the dogs from eating them if they don't know the code?"   I am persistent.

Fortunately the mother eating dogs only tried to eat one volunteer whose aunt had died and had tried to go down the stairs before they were put in crates for the day.  I yelled the code world as loud as I could and the cooks called them in.   I considered that my accent was spoiling the use of the code word.   It is actually a sound.  Something like "Ta-tee-ta" but I never got it right.

Most nights, the dogs would start ripping a smaller dog apart and a great deal of crying and screaming of dogs would ensue and then the roosters got up and I could no longer sleep and got up too.

It was cold and damp.   The mist hung all around the mountains and  our clothes were wet.  I thought about the babies; the ones who would show up at the clinic with "Night fevers and grip."  

Was it malaria or simply the effects of sleeping on dirt floors on banana leaf mats.  It was so hot during the day but there by my little solar campfire on the upper porch, it was cold and my cartoons were drawn in the half dark.  

The four hour walk to healthcare 
After the roosters came the first people on the road.   The road was once a trail, like the one we take to Oliver's hamlet but now it was the market road and goes to LasCahobas and on to Merbela and Port-Au-Prince.  

The moto could take you out to the world beyond those small hamlets nestled in the side of mountains.  It could take you to healthcare beyond our capabilities.   It was possible.

 I had told Oliver's mother to go to the hospital; to follow that road but we all have been so sick we could barely manage to get to the bathroom and I was asking her to go all the way, on a moto, to town.   It was a forty-five minute ride to the closest small hospital and another hour to the larger one.  She would cross many streams and it was rocky and she had bad diarrhea and was throwing up.  Someone would have to go with her and who would watch all those kids.  

She nodded at me.  She was bent in half and throwing up the rehydration salts.  

Instead she made her way across the field and up the trail that turned into a creek when it rained and laid down in her small, dirt floor house, with all the children, and died.   I remember that her name was a form of Rose.  It was not exactly Rose but the word Rose was in it.  

Rose would have walked that trail.  Neighbors would have come out to say hello and a leaf doctor would be called.

There is a slight incline to get into her yard.  It is not so steep but if you were sick and walked all the way to the birth center and back sick, it would be one more hard hill to cross.  Her house was in a cleared yard.  There was a porch and all around fields of corn and millet with squash and beans tangled in between.   Her children would be naked, as they always were.   What did she see as she forced herself to climb the incline to her house and find a place to die.  

She would not make her way through the yard and down the incline or down the path that turned into a creek with rain or onto the moto or even back to us.  She could not nurse he baby or even hold him. She did not leave that yard on her own two feet again.  Back then I did not know the way to this hamlet or that she was laying there dying.  

I sat by my solar campfire and worried about the dogs attacking mothers and volunteers and how we would manage until the supplies came.  I made lists of things to do to get a birth center up and going. I made signs in Creole, looking up each word and making drawings to illustrate the danger signs of pregnancy.   I know these signs well, by now.

But I know I am also a placed- based midwife; a midwife who considers the geography of the roads, the condition of the soil, schools and the amount land one has to farm.  While I worried about the dogs and the lack of a bed to give birth on, Rose was dying.

Next - What did you say her diahreaa looked like?   Conversations at a funeral.

Thursday, November 19, 2015

The first time I met Mrs X - Oliver's mother

We had barely gotten the few things we brought to open the new birth center unpacked.    We arranged the birth room and prenatal room.   We knew where emergency kits were and had set up a birth bed and table but we were not yet officially opened.

We arrived Sunday afternoon and by Monday had a full day of prenatal care and machete wounds.   Machete wounds are neat and straight, if you get to them right away.  If you allow them to sit untreated they become an infected mass of puss and scaring.   I had not known this but came to see this but I was new there and this was the day of my first machete wound.  I poured betadine over the wound again and again and put triple antibiotic cream on it. It was too late for stitches and besides I was use to stitching vaginas; not machete wounds.  Later I would put in a few stitches.   Later when I saw how infected they could get and how the children starved if no one went to the farm.   Later when I could no longer see the lines between a birth outcome and the man's ability to farm.

But on that day, looking up from the machete wound, I saw a woman with her husband making her way towards us.  She could barely walk.

The new birth center in Cabestore at dawn with mist still clinging to the mountains

I finished the pouring of the water and tried to get the translator ( a different translator) to help me.   He was restless and did not hold still.  He was from the city and it soon became clear he did not have such a favorable opinion of the  "peasant" community.   It was not what a young, urban, English speaker aspired to.   But he knew the line was not so clearly drawn and the fear of dropping over the edge into such poverty was a day to day struggle of wit and will.

I got that she had diarrhea and it was bad. I rooted through a blue bag where I knew I had packed re-hydration salts.   We used them all the time but this was the first.  I found a bottle and clean water and had her drink some.  She threw up over and over again.  She was lying on the ground in front of the new pink birth center and was having fluids pour out of her.   I gave her anxious husband more packs of de-hydration fluids and told them to go to the hospital.  I said this through a translator who was not paying attention.   Later I would remember this.  Me trying to make sure they knew to go the the hospital, showing them the re-hydration mix and bottle.   The translator walking away and me hauling him back again.

"Are you sure she is going to the hospital? "

"Yes, yes."

But I am never sure.  In the weeks that follow he translates so many things without paying attention and so I am never sure.   It feels too cruel to ask, "Are you sure you told her to go the hospital?"  I ran upstairs and got her a diarrhea pill just to hold her till she got to LasCahabas.

We arrived Sunday and it was only Monday.

Later I would learn to walk upstairs and get 100 gouds and put the sick person on the moto - no going home- no nothing - just go now!

I never saw her again.   The next thing I knew we were walking up the path to her funeral and wondering what to do with the baby.

I had put together some emergency kits to prevent maternal and newborn deaths but there I was with a mother newly dead and a baby with slim chances of survival.

I walked that path many times and as I walked I asked, "Why did she die?"   She had gotten prenatal care at the mobile clinic.  She had not died in childbirth but she had died of an undiagnosed cause and the baby might die too.   In this way, I began to collect clues and conduct an investigation.

In the belief system of many people, a person can put a curse on you.  The translator says the person can send an actual virus or bacteria so it looks like an illness but it was sent by someone.   "Buy who? I ask.

"Sometimes you never know."   He does not have much patience for my questions.   It is just how it is.  He plays music all night long. Between his music and the dogs, it is hard to sleep.   The music keeps the bad spirits away.   I wonder out loud.  Maybe the bad spirit is things people worry about or a past argument or a loss of a good friend or fear.

"More than just that."    he does army calisthenics each morning with the midwives.   The young women at the water pump laugh so hard they can barely stand.  I take it all in - the baby without a mother, the calisthenics and the water pump.

Why did Mrs X Die? A medical mystery of Cabestore, Haiti

This is the story of Oliver; a baby living in Cabestore, Haiti.

His name is not actually Oliver but it is the name the translator gave him, when she wanted to adopt him and now it is the only name I can recall.

Why did your mama die little baby?   

It is the name he was given when his father, still in the deepest stages of grief, brought him to the newly opened birth center for us to care for him.   The translator, had offered to take him home and with the help of other volunteers, feed and love him and make sure he had an education.   When he handed him to her, she found soap and new clothes and washed his hair and put coconut oil over his soft, brown skin.

She took a moto to town, over many streams and rivers to buy formula and bottles.  It seemed a race against time for a baby, in Cabestore, who no longer had his mother's milk.   I have developed a way of looking at baby's skin and hair and development to assess if a baby is exclusively breastfed.  Exclusively breastfed babies in Haiti, are dark skinned with shiny black, soft curls. Despite all our teachings, an exclusively breast fed baby till six months is rare.  It takes constant encouragement.  I doubt Oliver had been given much breast milk during his mother's illness, on top of the cultural norm of broth and food at an early age.  He was already malnourished. He was chubby enough but the chubby of white rice, smashed with a few beans and coaxed into his small mouth.  His skin was too pale and  his hair stiff and dry. He already had signs of skin infections, coughs and wheezing lungs.

He melted into any set of arms that held him.

I first met Oliver at his mother's funeral.   The community health agent invited us and in this way I took my first walk up the trail to his house.    It was hot and sunny when we started out but soon we were standing in a crowded yard amidst a later afternoon downpour  We were invited into the house which was overflowing with children and young men playing dominoes.   It took many funerals for me to understand that young men are suppose to play dominoes at funerals.  How this tradition took root, I do not know but I do know that despite the pouring rain and numerous children, the domino players did not budge.

It grew darker but I could still see the mother's older children, staring at me.    Their mother was gone; buried in the family grave just an hour ago.   I watch the oldest girl, about ten, take her father's hand as the translator is busy offering to adopt the baby.   It does not seem the time to discuss the baby's possible adoption but then again, the baby would need care and food immediately.   There was no sign of food for any one of the many children.

The translator had adopted other children who all lived with her mother in a house in Port-Au-Prince.   It is near to impossible for a white or foreign person to adopt but a Hatien can simply say they are the mother and no one is the wiser.  She had two other children whose mother's had died in childbirth.

I ask the health agent, why the mother died.    He shrugs.  "It was bad spirits."   Later they say, "the grandmother died of bad spirits too."

One daughter and four little boys and a now a baby boy who is just four months old.

I am in Cabestore to help Midwives for Haiti, set up a new birth center.   We are here to help prevent mother's from dying but here she is newly dead and there is nothing anyone thinks could have been done to prevent it.

In the weeks, that lay ahead, I would walk that path many times.    I would ask myself over and over why Oliver had no mother. I mean really, I want to say.  Why did she die and how could it  have been prevented or treated?

I am haunted/inspired by two things.   The television show "House" and the film by the World Health Organization called,  "Why Did Mrs X Die?"

This is the story of Oliver and his young mother but it is also the story of Cabestore and of Haiti; a story of life and death  A slow story;  not a fast paced action story but a slow one in a hot climate with thunderstorms at dusk and market day every Wednesday and Saturday, despite the dyings and birthings that are sung and captured in the mountains.

I write because I too believe in magic.  I hope that if I write this down and send it out into the universe, I will be able to sleep at night.

Sunday, September 13, 2015

The Corn Mother at the Linnton Food Pantry

During the summer of 2015, I decide to help at the food pantry.  It seems an unlikely place for a food pantry but each morning I could see hundreds of people coming by bus or walking or crowding into old cars.  Volunteers picked up food at the regional food bank and brought it to this small, regional community center.  People came pinwheel chairs and with walkers; with children and grandparents.

They did not need anyone else to give out food so I  thought perhaps people would like a few health screenings.  I packed a bag and prepared to do  blood pressures, weights, pulse, blood glucose and oxygen levels.   These are very simple screenings that most people could get in a grocery store.  But it seemed that what they wanted, that the machine could not give them, was someone to listen to their story and I felt honor to listen to their journey; the journey that would bring them to this place of waiting for free food in a small, crowded center squeezed between the river and railroad tracks and highway.  The trains and trucks covered us with a layer of dust and noise.   In a city of lovely parks and old, tree filled neighborhoods, the food pantry sat on a sliver of land that thing hung on for dear life.  

It was a popular food pantry.  People came from far away because, I believe, there was considerable respect and dignity.   I listen to the stories of the homeless, the sick, the injured, the immigrant; people who found themselves without food and wondering why anyhow this happened.  

Almost everyone had high blood pressure and struggled with high blood sugar.  Their health was worn down by poverty and abuses beyond reason.  It was hard to hold their head up high but I could see that the poorest of our communities have a culture of their own.   They are bound together by survival.

This is one woman's story which brings with it the story of her birth.

A thin, anemic woman sits down and sighs.   Her strength shines through the fatigue.  She is still laughing and has grown tough and determined.  She is there with a friend.  They took tri-met to get there and smoke outside until their number is called.  She tells me her story; kids, grandkids, evicted, abused.

"I had to be tough" she explains.  "I was born in a cornfield." I listen carefully.

"It was summer and the corn needed picking so my mother went up into the corn field and I just slipped out before she could get back to the house. "

I ask if she and her mom were okay and she says she guesses so.

"Born in a corn field."   She shakes her head.   "They were poor too, like me."

I tell her that women all over the world gave and give birth in the midst of harvest.   I tell her, why I have met women who gave birth in rice paddies and gathering turmeric and ranching.   I had read Pearl Buck's Good Earth and was so surprised she had a baby in the rice field.  Now I can see that all over the world. women give birth during harvest.   They pick the baby up and head back to the house with the best harvest of all - the baby.   Later some one will go get the corn or rice or roots they were working on.   She will go to bed and be given tea and forever the baby will be told the story of birth in the midst of harvest.

 I thank her for the story.   I think of her mom with four other young children trying to get the corn in.  
Too busy to feel the contractions and the baby small and willing,:coming fast.  I think of the baby born with the sky blue above her and the birds calling and the corn singing to her.   It was a great morning to be born, I tell her.   I tell her that the mom was a Corn Mother and she says she never thought of it like that.

To the woman born in the corn fields of Oregon.  May she know how beautiful she is and how strong and mazing her mother was.

Mothers waiting for the Revolution

I wonder if mothers and babies need to wait for the revolution- or if creating a society where pregnant women and their young are cared for is the revolution?

The people I met in the mountains there in Southern Mindanao, are now my Facebook Friends and I watch them from time to time slip into view.  Sometimes they send me a message or greeting.  Sometimes they are involved in a political protest or an evacuation and other times there are photos of fun times with friends and family.  They fall in love and go to beautiful places amongst the outrage of injustice.

The people who connected me with them, have not yet met with me.   Times are set but never kept and the weeks slip by.    At first the people are so close to me, I can feel them all around.  I am desperate to do the simple things I promised.  I did not want to just go and then come back and forget them.  I pick very simple, very easy to accomplish tasks.   I make a pack of pictures to show people.   At first, I thrust the photos in visitors line of vision, and they look with some curiosity but I can tell it does not seem particularly real to them.   I quietly grieve the loss of these new friends.   I want to sing and be with them.

I had wanted to help them get Vitamin Angels.  It is so simple.  A short application but I need an organization.   My children say, "If you need an organization to help mothers and children in the Philippines, you should start your own."

I say, "But it already exists.  We just have to fill in the space on the application.  I'll do all the work."

But they never give me the information.   I call, email, text but it never happens.

They say there are more important issues than maternal and child health.   They say, "How can they worry about maternal and newborn health when they might be killed?"

I reply, "More are dying in childbirth and in the first five years of life.  "   No one ever answers.

I have a pile of things to send with the next visitor from Portland but they go without theses things and eventually I put them aside.

I look up the political situation.   The people are being manipulated by many foreign and local forces.   People in Europe fund "health care and schools" but it is all in the name of a revolutionary force.  They call the shots from afar, creating training camps and centers that are the face of the revolution.
They try to keep the communist revolution alive.   After this, they will tend to mothers who bleed to death or babies who die on political marches from the mountains.   Later.

I do not know enough about the political situation but I know that when mothers are safe to have babies when the choose and marry who they choose and are pretty sure their babies will live and grow up to get an education and will have food; that this will be revolutionary.

You can not simultaneously have forced child marriage,  a disregard for women's health and a revolution dedicated to equality and social justice.   Handing out prenatal vitamins and training health workers in basic life saving techniques, is not a Che moment.  It is too ordinary.  

But it is my revolution.  The one I have struggled and fought for all these years.   Tell me how you treat a woman who is pregnant . Tell me how you will treat her children and I will tell you the state of equity and social justice in your community or country or in the world.

The saying goes,  There is no way to peace.  Peace is the way.  There is no way to revolution.  Revolutions the way.

I only visited one small part of a vast network of islands.   Islands that were gathered  up and made into one country without understanding or consent.   My friends in the those communities wake up and have coffee over a fire and sweep the yard and begin their day, even as I drink tea and sweep and begin my day.

I wave the revolutionary flag of prenatal care and safe transport for all women.  I pack the weapons of clean birth kits and respect for women's reproductive health.   There are midwives in the revolution - women and men who support them, marching for this basic building block of social justice.  People who know that safe birth can not wait for political victories.  It is now.  One birth at a time.

Sunday, May 24, 2015

39,000 girls under 18 will marry today.

Child marriage is defined by the United Nations as any child who marries before the age of18.  It is estimated that 39,000 girls under 18 will marry today.

Between 2011 and 2020, it is estimated that 140 million children will be married and of those 50 million will be under the age of 15.

One half of all the girls in South Asia will be married before they reach their 18th birthday.

These women walked several hours to wait for a government midwife to immunize their children and get prenatal care.  They wait at a small store and if she does not come, walk home again and try the following month.   There is no care in their villages.  Mostly they come for immunizations.

When I am there, in a small community, I offer prenatal care and work with the community health workers and Gigi, the newly graduated midwife.   I ask a young woman who is only 14 if this is her first pregnancy.  "No" she answers.  "I had one other who died."    "When?"  I ask. She looks at me and says, "The day he was born.  That day."   I wonder why.  "Did he cry at birth?"  "Yes, she says."

I ask who the midwife was and she answers that her husband delivered the baby.   


She is fourteen, pregnant for the second time and has already lost one baby.  They tell me that the girls are frequently given in marriage for a dowry such as two horses or some other thing the family might need.  The  men are older and perhaps have other wives or children.   

The next day, I have a women's circle and we talk about birth and some things that might help in an emergency.   I suggest having a first baby after 18 but they laugh.  This is not possible.   They are married between 11 and 14.  

Wednesday, May 20, 2015

Mountains and Motherhood and Midwives

Childbirth in the mountains

Twenty-seven percent of the earth' s surface is mountains and these mountains are home to over 720 million people.   They are also some of the poorest people on earth and the place where far more women and babies die in childbirth.

In many countries that I have visited, the mountains were the places that people fled to when escaping slavery, state making and colonization.   The people down below in the valley land see them as living ancestors; carrying with them the traditions and knowledge of the past.  Most people originally lived closer to the coast where  trading, better soil and more opportunities for growing and hunting for food existed.

In Haiti and as in the Philippines, when the Spanish came some died of disease and were enslaved and some escaped to the mountains.  They were sometimes known as maroons; people who escaped from slavery and went to live in the mountains.   Brave and resourceful they came to make the unwanted land of the mountains their home.  They learned to farm, hunt and build communities high in the crevices of these places.

There were and are still are few roads.  Paths connect communities and are often a long way from the road.

In the Philippines, they ask what is to be done about our poor maternal health rating?

"It is" I say,  "A matter of mountains."


"Yes, mountains.   The women can not get down when they need help and no one wants to bring care to them so far up in the mountains.  It is matter of roads and people."

The governments hope that the women will come down.  They plan for waiting homes and birth homes but they are far from the mountain communities and difficult to get to.  They must leave farm and family.

But it is not just roads, it is that the mountains are fragile ecosystems and things like mining and deforestation destroy their source of food and cause severe starvation and malnutrition.  Streams are filled in by landslides destroying a source of water.

There is also war.   I think of the sandy roads of Cambodia that offered many,well staffed rural health centers.   The roads were flat and easy to use.   People road bikes and walked and healthcare was greatly improved in this landscape.  But even there, high in the mountains, on the border of Thailand and Cambodia, soldiers camped with their families and in that place- that place of on-going conflict, the women had no access to care and were far from help, should it be needed.

In the Philippines, a people fearful of the army and foreign mining companies, have difficulty worrying about birth.  The government says, "Come down out of the mountains and give birth down here."

They threaten them with fines; fines for the mothers and fines for the traditional midwives.  A woman at a small store says, "They just more further into the mountains where no on will bother them."

When I teach a workshop, usually for the traditional midwives, all the women, children and some men of the village come.  I can see from their stories that there, everyone is the midwife.  Anyone could find them self beside a woman giving birth; on the road, in a field or by the water.  They tell me that there in the mountain they all need to know.

On my way down the mountain, the motorcycle weaves around many new landslides and through mud from hard rains.  It is a long, hard ride and even when we get to the main road, it is a long way still to the nearest birth center and even there the midwife is gone and would not be there, even if the woman had made that long journey or could have afforded the motorcycle ride on a day when the road was not washed out.

I too, live on a mountainside.   I am 67 and people sometimes say, "I am afraid to come up there on that road to see you" and sometimes friends say "maybe it is time to move off that mountain."

Other times, I sit on a rooftop in LaGonave or sit by the school in Mindanao or sit on my little mountain and look out.  Buried in the mountains, we can see lights in the distance and know there is a life  out there.

A doctor says , "And how is America?  " I consider and say., "It is big place so its hard to say but I live on a dirt road on a little mountain and look out at the dusk creeping over the valley.  I have chickens and sheep and the children run and do not want to stop playing. "   She can see it is much the same.  But it is not.   The army has never once come up my mountain and if they are mining this mountain range it is not on my land and mostly never could be.  I can get in my car easily, and drive to town.  When my grandchildren are born on the side of this mountain, I can easily get down in an emergency.

I look at the group gathered to ask what I think about maternal health in the Philippines and I consider the question.  "Mountains.  You have to have a plan that considers the mountains and the people who live there; not one just for getting them down but one that respects their culture and their need to be near family and farm.  I think the midwives have to go to the mountains."

Monday, May 18, 2015

The Ladder System of Midwifery in the Philippines

The Ladder System in the Philippines - from Midwife to Doctor

This is my friend, Gigi, who lives and works and volunteers in the Philippines.  I spent my first week in Mindanao with her.  She has just finished her third year of midwifery school and was suppose to volunteer in the summer before she started a  year of nursing school in the fall.  

She and her other class mates are part of an amazing program, in which they complete three years of midwifery school and then can go on to complete a year of nursing school and then go on to medical school.  They can stop at any point in the program or just keep on going.   To qualify they must be chosen by their community or Baranga.   She was chosen for her obvious enthusiasm, intelligence and dedication.  

Her school is a large modern building. It is great, but what is amazing is the village of traditional houses across the field where all the students live, cook and study.   It is a remarkable model of improving healthcare in remote communities.   

Gigi and I had so much fun together.  We did prenatal care and taught classes and gave presentations as well as so much singing and riding motorcycles up to the communities and cooking and telling stories.  What was so impressive about her and the community health workers, was their true wish to help their communities and a sense of volunteerism.  She is becoming a doctor, via becoming a midwife and a nurse but her mission seemed so much larger.  It was to make her country a better place for everyone and most all of all those who have the least. She is eager to understand her country's history and the culture of the people she serves.  

There is much that can be said about maternal health in the Philippines but I want to start with this amazing woman and her path to becoming a doctor.   Her courage was as big as her heart and her smile.   

You may be surprised that it starts with 3 years of midwifery.  I think its inspiring  because its basically saying," let's start at the beginning of life and get that right."  A midwife also does many things including prenatal care, births, immunizations and family planning.  Each midwife there covers a large area that includes many remote villages.  There job is very hard, even with the help of community health workers from the World Health Organization.  There is no doubt that when Gigi graduates her community will be so happy to have her.  As part of the program, she made a commitment to stay in her country and return to her rural community.  

**** Just a note of caution, the Philippines did not meet the millennium goals in maternal and newborn health and the communities we visited had no prenatal care and no access for transport or even trained traditional birth attendants.  It is currently agains the law to have you baby at home with no ability to serve women in birth centers that they can have access to.   Gigi is part of the solution but in the mean time there ei much that can be done.

Tuesday, April 28, 2015

Prayers for Mary Jane Veloso

Mary Jane

Today we wait, with so much sadness as this young Filipino mother waits to be executed by firing squad.  She represents the many women and mothers, who each day, leave the Philippines to find work and support their families.  Although she was convicted of smuggling heroin into Indonesia, many supporters believe that she was a victim of human trafficking.  Like many mothers, poverty and a lack of education made domestic work in another country an inevitable solution for her and her children.  It is estimated that 100,000 women and children are part of the sex trade in the Philippines and that an estimated 4,000 people leave each day on temporary work visa's.  Still more, like Mary Jane, use any means they can to get a job and get caught in situations they could never have imagined as young girls in small villages.

I wait and pray, as so many are around the world with the hope that she will not be executed.  I do not believe in capitol punishment and support the United Nations efforts to make it an international human rights issue.  Only 21 out of 195 countries still have the death penalty and my country is one of them.

As midwives, we work hard to protect the life of mother and baby.  Nowhere is this more necessary than in the work to end human trafficking.  The impact, the violence, the fear are barriers to any move to healthy, sustainable societies.

I pray that they will not kill  her and she will get a fair trial.  I pray that we will one day have a world where a mother will never be forced to leave her children and risk her life to earn a living; that she will never have to leave her children so they can get an education and be safe.

I pray that there is work for everyone and a way for mothers to care for their children in  safe, secure way that causes no harm.  I pray for the end of the death penalty in my land and around the world.

Sometimes we know a person is convicted of a crime and when they are waiting for the firing squad, we know that society is to blame; poverty, war, greed, a lack of schools and a world that has too often turned their back on women.

I shut my eyes and wait and pray.  

Monday, April 27, 2015

Listening to the earth

I return from the Phillipines; from the southern most island of Mindanao.   I am here in Portland but my heart and mind are still there.  I know this is how it is.  I walk around and go through the motion of putting things away and getting settled back in but I am thinking of the people I met and loved in other places.

It is part of it.  When we go, we agree to get sick perhaps and to have our hearts ache.  The people I travel with there, call it an Exposure Trip.  They do not say it is necessarily a volunteer trip but an exposure trip.  Sure, I help as much as I can but mostly I am learning to see another part of the world in ways I had never thought of before.  I sit with mothers and midwives and community health workers and we teach each other.

Tomorrow I will begin to tell what I learned.  I have electricity and internet and an education.   I can put my laundry in the washer and walk away and sit here at the computer.   I can turn on a faucet.  I have the time and obligation to tell this story.

But just for today, I want to lie in the tall grass and let the wildflowers crawl over me.  I want to watch the bees on the thimble berry and the snakes lying beside me on a sun baked rock.  I let the sheep nibble my hair and toes and I listen to the earth; the layer that wraps itself around the world like skin to one living, breathing  planet.  If I lie there long enough I can feel the roots that grow and connect me to the places in the Philipines where I so recently walked and slept and enjoyed my morning tea.  I feel those roots spread out and climb the mountains of Haiti and the rice fields of Vietnam and Cambodia. I know this layer of dirt; the one I am sinking into; the one I am trying to be a part of, does not know the name of  the country or who has claimed its soil as their own.   I feel the feet dancing and the men walking from the fields and the mothers giving birth and holding their babies to their breast.  I put my ear to the ground, buried there, in the tall grasses and listen.

At the bottom of the small mountain where I am lying in the grasses, I can hear the boats and trains and the factories.  I can hear how they too stretch out and try to reach all around the world.  They move chemicals and oil and coal and propane.  They want to dig up the land of the first people of Canada and move it through the First Nations Land of North America and across the world to the first people; the ones I lived and sang and world with in the mountains of Mendanao.  There are other lines.  There was the slave triangle and the path of colonial ships and imperialist armies and political deals we did not learn of until it was to late.  Paths.

Inside each mother the veins of the placenta reach deep within her and connect her unborn baby to nutrients necessary to growth.  If the placenta is not strong or is disrupted, the baby can not survive. The mother and baby depend on this connection.  They depend on the earth.

We are connected by cycles of sun and moon and tides and seasons.  But we, in this modern age, are connected by mines and the minerals we take from the earth.  I am connected to all the minerals taken from the earth to offer me a life style so different from the people whose land it is taken from.  The typhoons and earth quakes are made worst by this disturbance, these large extractions, the coal trains that benefit the very rich and leave mothers walking on roads blocked by landslides, by soil destroyed by de-forestation.

Every minute a mother will die a pregnancy related death.  Most people will  never take notice.

Today, if you were to ask me, why mothers died,  I would look up and say "perhaps mining."  And you might say,"Mines,  you mean the mothers  are in the mines and they collapse."  I can see the shock in  your face. But I  reply, "No. Its  that the mines and deforestation took away her food source and her roads and her child's education and the riches made possible  from the mining took away her human rights.  That is why she died."  I would squint in the afternoon sun.  "It might look like something medical but in the end it was mining or plantations or de-forestation."

But I am alone just now.  I let the grass cover me and listen for the mothers' footsteps beneath the dirt.   I put my ear on the ground and listen for the music and the prayers. This is how it is when I return. Its best to be alone for a little while; to do the simple tasks of home and garden as I feel my heart so connected to another place and time; to stories that cannot seem possible and solutions too far from reach.