Lagonave
June 2014
The waiting area at the Fort
Lauderdale Airport is filled with Haitians who happily greet one another. They
form small, happy groups who visit until it is time to board the plane. I let the sounds of Kreyol spill over me and
drift back into my heart. I speak in my
awkward version of a language that is meant to be rhythmic and full of
life. My attempts are slow and labored
as my brain switches gears and looks for the right words.
The people, who wait with me,
have the means to travel back and forth and are a long, long way from the
mountains of LaGonave. They have money
and a visa. I wonder if they know what
it is like for so many Haitians. But then someone could say that in my country
too. Do they look at me and think- ah a
white missionary coming to save the souls of Haiti? I say I am not a missionary but a midwife and
they smile with a shrug.
I am never sure that the Haitien
people would put maternal and newborn health at the top of their wish
list. They are ranked the highest for
infant and maternal mortality in the western hemisphere but I suspect that data
means far more to those of us committed to global maternal health than to the
individual person in Haiti. I remember
the Haitien social year doctor telling me the statistics were all part of a
plot against Haiti and were not true.
But then US medical people also gave me articles saying that the
placement of the US alongside Cuba was also not true and a plot. The rankings are suppose to make a country want
to try to improve; not dig in their heels and defend what they are already
doing.
I doubt myself. I get sick and throw up in a planter in the
airport. Am I sick or is my body
rejecting another plane ride and the wear and tear on body and soul I am about
to put it through once again.
I had hesitated to come. I had said I would return if they ever
wanted to get mobile prenatal clinics up and going. It was an offer in the midst of hopelessness. Your island and your health care system are
so broken there is not much of anything I can do to help but if you ever want
to have mobile clinics I think it would help.
I also say that it should have village leadership. I picture small,
rural maternal/child health councils where women demand that they not be left to
die in childbirth. My mind drifts and I
see the women standing up to the powers to be; marching to Port-Au-Prince and
demanding healthcare and transport. I
say it must be a grassroots form of care with the matrons, agent santes and lay
leaders.
My last experiences in the
hospital in Henche had left me believing that the village system has to be
given the tools of education, diagnosis and transport. We use to debate, which comes first prenatal
care or emergency obstetrical care. Of
course we wanted both. But, we would
say, what if we had to choose. I am a midwife and an educator so I chose the
village and mobile clinics. But it is
jus tone part of the puzzle that includes prenatal care, a means of transport,
a skilled birth attendant and then good care should you need a hospital. In LaGonave I have offered to help with the
prenatal care and transport plans.
In the days, leading up to me
leaving I am not sure that the villages have even heard of the new prenatal
mobile clinic system, let alone be involved in the planning and
implementation. They cannot even tell
me what villages we will visit. They say
the ones on the list are too remote and we will all get tired visiting
them. I try to explain that this is the
exact reason why they were chosen. Emails fly and I feel caught. The premise for my returning was
establishing community based maternal health care and no one seems prepared for
this. I think of my gardens and
grandchildren and projects I am working on in Portland. I think how I might cancel my ticket to
Haiti. I do not want to go down and be
a white person arguing with the powers to be for the basic medical rights of
women in Haiti.
My piles of pictorial
teachings lie in folders. I make graphic plans of how it all could work. I look at my countless workshop plans. I have downloaded films. My approach was to include the lay leaders,
the matrons, the agent santes and the midwives. I was going to try and build teams that
solve problems and work together. I
know that I appear casual in my dress and in my manner but I am a person who
cannot live a moment without a notebook to write plans in. I am a planner and they are not. I have sent my training plan and they send me
back shrugs – we can talk about it when you get here. I sent the plans months ago and I do not
want to go without a plan. I have ten
days for this and want every minute to count.
I have not recovered from the eclampsia and
Cardboard box of dead babies
from the last trip. I need a plan. Was it too many years as an
administrator? Trainings have schedules,
start and stop times and plans. I cannot,
it seems, go in without a plan. I have
tried it before in Haiti but not again.
But I consider the woman with eclampsia in the
hospital bed; in a coma after a five-hour motorcycle ride down the mountainside.
They tied her between two men. She had four other children and after the birth
had a seizure. With good prenatal care
and a transport plan this did not need to happen. It is difficult, yes, but can be reduced. She is a real mother, being held in her
husband’s arms for days while she is in a coma. I felt powerless and I do not want to return
to the world of male decision makers who seem oblivious to these deaths and
disabilities. They say to me, “they will
never change.” Did this woman even
have a choice? They say “women in Haiti
like having their babies at home.” I
say but they can do that and still have prenatal care and be screened for
risk. We can do so much.
My sister takes me to the
airport at 6:00 am and I throw up in the planter. The suitcase is four pounds too heavy and I
have to repack on the airport floor. The
small gifts for children pour out and I scoop them into different piles. There are toothbrushes and crayons and handheld
lenses a school was disposing of. I
bring very few pieces of clothing. My
sister puts one suitcase in the other so I have one to leave for a family who
needs it for storage. This is a very good
idea but there are small things all over the floor; seeds and baby blankets and
old window shades to write on. I smooth
the dirt over my vomit and consider it is something I ate and not my hesitation
about the trip.
My body says – maybe this is
not such a good idea but I stand and smile; take my boarding pass and walk to
the gate where I wait for the plane to Haiti.
It is a short flight. It is only an hour and a half. As we fly over Haiti, I see the ring of turquois
water and white sands. It is a greyish
brown but as we get closer, I see a patchwork of fields and houses and
rivers. At a certain altitude it does
not look so different. We glide through
white clouds and then Haiti comes into focus; the now empty rice fields and
houses only half built, muddy rivers and broken roads. I begin to see what for one moment, flying at
a certain altitude I could almost pretend wasn’t there. There is music as you enter the terminal;
always music. Even after the earthquake there was music. And with this music I accept that despite my
resistance I have come home.
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