"The women just die. We cannot get them anywhere."

After a crazy, wet speed boat ride to LaGonave from the mainland, I tumbled into the Episcopal Church where the lay leaders sat in scattered chairs waiting to meet.  I tasted like salt and was still dizzy from the ride.  I had not actually known they were really coming.  I had asked for the meeting but there they were.  The lay leaders are the ministers of small, distant villages who take care of the small churches and schools that are sponsored by the parish.   They are the leaders and had wanted to get  their support and advice in the starting of the mobile clinics.

I ask for their names and villages and what problems women faced in childbirth.  One by one they told me the same thing. Their village is hours from the hospital and mostly they do not try to get women to the hospital.  She simply dies.  It is too far.  Sometime, they said, they carry her on a bed down the mountain but even if they get to the hospital they might not see them.

There is no prenatal care.  Never.  World Vision use to supply some in some places but they left.

I explain that the clinic is sending a team out to work with their matrones and agent santes and that they will come once a month to provide some care.  In time, we hope to send a nurse or doctor who will also provide primary care.  I explain these things.  I tell them it will be free.  I explain that they can come to Bill Rice for free too.

Although the Bill Rice Clinic had been offering free prenatal care since I left, I could tell that no one had told them about that or about the birth center.  It is often too far, it is true, but they were not told.

As they talked about the many mothers who die each year in their villages, I felt  waves of such sorrow and injustice.  

I look at each village on the map and wee how far away they are and how difficult it is to get there.  I listen to what they tell me.  "The matornes have never been trained."    "We have no vehicles at all if something goes wrong."   "They bleed to death."   "They have eclampsia and never wake up."

The Hatien doctor, says each woman needs 3 sonograms in pregnancy.  I look at him in disbelief.  Is he listening?  They have no prenatal care and sometimes no matrone even and no transport in an emergency.  He is a sweet, charming man and he is the director of the program.  He had doubted this was possible but I hope by listening to the stories he feels a deeper commitment.

We have 10 days to set this in motion.   It is not too difficult but it is at the same time almost impossible.  They have to get to me or I have to get to them.  It is hours on bad roads.  The training takes time and yet their is not enough time to train people in skills often reserved for specialists.   We must prepare supplies and try to get a system of reporting and charting organized.

Kenel, who I met at Midwives for Haiti, is translating for me.  I am trying to help him with a farming internship in Oregon. He is starting a Fruit Trees for Haiti Project.  He does a good job and later we walk down to the small port and visit with the people who work there.  It is a warm, lazy evening in Haiti.  Tomorrow is a training with the matrons and agent santes.  I am hoping to build this sense of a health care team in the villages.  We review films and pictures and then I sleep until the church bells wake me at dawn.