These are the stories of my work as a midwife throughout the world. These are the stories of midwives, mothers, babies and the communities they live in.
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.
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