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.
Showing posts with label SE Asia. Show all posts
Showing posts with label SE Asia. Show all posts
Sunday, January 12, 2014
Agent Orange
Nhan takes me to the War Remnents Museum in Saigon. It is in a large building with a courtyard filled with US war planes and helicopters. Although Nhan lives in Ho Chi Minh and was a child during the war, she has never been in the museum. She reads each sign carefully and for a long time. She has these experiences but they were not connected to the greater political and historical context of the war. They were a family of 18 children running around trying to survive.
I can see that good fortune, for her, is based on hard work as well as paying respect to ones ancestors who can offer protection and good fortune. Even the most simple home establishes a place to honor the ancestors and most have an outdoor spirit house for a daily offering of fruit, flower and incense. Although I ask for more information about the spirit houses, I could see that they were such a part of their life that my questions seemed foolish. No one asked why. It just was. This was what would protect them.
If the last babies, born to Nhan's mother died, no one questioned why. The country was suffering from severe drought and famine and the country was recovering from war. There was very little healthcare and so a baby born too early and with birth defects would have slipped away without understanding the lingering effects of the war.
In the museum there are rooms full of pictures of children who suffered from birth defects caused by Agent Orange. Twenty-one million gallons were spread on southern and central Vietnam to defoliate the landscape where North Vietnam soldiers were hiding. 24% of South Vietnam, or an area the size of New Jersey was stripped of all crops and forests. Two million acres of forests remain without trees today.
The spray, manufactured in the United States, was spread by plane, helicopter and by hand. The barrels it cam in was later used for water barrels, showers, and barbecues. It was made of Dioxin, a chemical that was known to cause birth defects.
The Vietnamese Red Cross estimates that over 150,000 children were born withe birth defects. The chemical was also sprayed over Vietnam and Laos. As I look at the pictures I feel, along with everyone else, deep waves of nausea and grief. We walk quietly from room to room.
In Cambodia, I talked to a midwife and she told me about these births of conjoined twins and how they were her hardest births. I remember thinking that most people never see such a birth and I am amazed she delivered them at all. I think this but the I am in the museum and in the Agent Orange Exhibit, I see all these conjoined babies and think of how she seemed to have no idea of its cause.
Service men, who worked around Agent Orange or sprayed it also had babies with birth defects, though it would take make years, many law suits and may public health studies to get the government to take responsibility and provide care.
Aschengrau and Monson of the Harvard School of Public Health conducted a study published in 1990 in the American Journal of Public Health on paternal military service and the risk of late pregnancy outcomes. The scientists reported that Vietnam veterans’ risk of fathering an infant with one or more major malformations was increased at a statistically significant level.
Although the US government has paid $47 million dollars for the victims of unexploded bombs, it has refused to help the many people who need health care and support due to disabilities caused by Agent Orange. Somewhere in my country there are wealthy families who profited from their stock in Dow Chemical and other chemical companies who made Agent Orange. Perhaps that wealth has been passed down to children and grandchildren.
On the news, people range about unemployment benefits but no one talks about all the people who got a hand out from the US government by supplying chemicals that caused the death and disability of children in our country and SE Asia.
The war in SE Asia was not fought for democracy. If it was, we would have supported the elections called for by the treaty that divided North and South Vietnam. We would not have placed a dictator in the place of democracy. This belief in Democracy, even if some did not like the outcome, would have saved millions of lives. We fought the war, not for political freedom but for the freedom, for some companies, to make money, regardless of its impact on others or the environment.
The people in Vietnam, with disabilities caused by Agent Orange, are our spiritual children. They are the legacy of my country and we have to make amends, both here and there. The children of the people who owned the chemical companies enjoy fewer inheritance taxes than prior generations. The money exists but it is concentrated in the same hands that fought so hard to send young boys to spray a chemical they new nothing about. It is unlikely that the children of the chemical companies ever went to Vietnam.
Today, women struggle to get pregnant, supporting a billion dollar fertility industry. Babies are born premature and our schools struggle to care for an increasing number of children with learning disabilities. In our hearts, we know we are being sprayed, with today's version of Dow Chemical. We know but it is not easy to see and we do not know how to stop it. Coal Companies, oil companies and chemical companies spill and toss things not good for any baby into the air.
I sit at a table, in Vietnam, with mothers who gave birth during the war. "It was not birth who killed our children. It was other things. We were not afraid of birth."
Thursday, January 9, 2014
Floods in Vietnam; maternal health and global warming
Small islands in the floods of Vietnam
Two mothers, with their babies, sit and watch as the flood waters rise around their Central Vietnam home. They wave and call to us. Hundreds of people died and tens of thousands lost their homes. Was this just normal rainy season flooding or the effect of global warming?
Regional Vice President for South Asia Isabel
Guerrero discusses how an expected 2°C rise in the world’s average temperatures
in the next decades threatens South Asia’s dense urban populations with extreme
heat, flooding, and disease and could trap millions of people in poverty. Read
more at: http://climatechange.worldbank.org
Effects expected from projected rise in
temperature, worse effects if warming is bigger
When we get home, it is dark
and the rain has covered all but the top step.
We wade through warm water to the house and place our things in the dry
interior room. We have a simple meal of
rice and greens and then go to bed. I
sleep with Nhan on a hard surface covered with a bamboo mat. It is not possible to use the outhouse so I
arrange a bucket and throw the contents out into the storm.
There is no electricity. In the dark the monks still chant. I try to layer clothing and blankets for a
softer sleep and warmth. Nhan gives me
a massage and hopes this will help me sleep through the
storm. She asks me over and over if I am
worried and I say if they are not worried than I am not.
But somewhere in the dark,
the old aunt and uncle get up with loud voices and I can hear their
concern. They are moving things up to a
higher place; food, firewood, the chickens.
They work in the dark until dawn.
I can see that my biggest help is to stay in one place and not get in
the way. The puppy pulls on the woven
chicken baskets and lets them all out.
He is a mischievous puppy and entertains us as the water rises.
When it is light, they get
down their small boat; the one the uncle built himself from bamboo and put it
in the water. I can see they are excited
and happy to go out in their lovely, little boat. They go over to check on the monks at the
temple. The temple is under water, even
though it is built on a hill and the whole structure is well elevated. It is not high enough.
Small houses are islands in
swirling water. People call hello from
behind veils of beating rain. We sit
and watch. I can see a family across
the way in which the floods are about to enter the house but no one
leaves. I see cows being led through
the water by owners in boats.
There is no means of
communication with the outside world. No
one comes to check or help. It is a
flood in the time of flooding and some are worst than others.
In Cambodia, the houses are
built on stilts but in Vietnam they are houses built on small houses with
elevated decks and porches and a loft in case the flooding gets really
high. The families most precious things
are put in the one “dry” room and usually includes the family alter and old photos
of relatives who have died. The aunt and
uncle’s alter is in a small balcony and they say we can go up there if we have
to.
When the sun comes out, we
get in the boat to visit neighbors and see how everyone is. Whole
houses are under water. People are
living in small boats. Animals are stored in houses for safety. In my country, this would be a disaster. People would be evacuated and there would be
emergency money for shelters and re-building houses. Only neighbors offer help to one another and
even that seems undependable. Each
little island is expected to know how to survive the monsoons.
![]() |
| Nhan navigates a carefully crafted, homemade boat through the flood waters. |
They say it is normal but it
is the highest any of them can ever recall.
It is far above the last recorded highest levels in 1999. I can see that people have built their houses
high enough to avoid flooding and they are still flooded. Later the government estimates 80,000 people
lost their homes, 28 died and more were missing.
It is festive, going out in
the boat and visiting neighbors. A
couple sleeps in their boat, afraid if they leave their house it will be
robbed. It’s under water anyway. A man cried as a neighbor forces him to leave
with his cows. Many houses are simply
empty and covered in water. Nhan paddles
through all of this with ease. My shoes
float away.
They ask again if I am
worried and I say I am only worried that the floods here will get worst and
that it is caused by Global Warming. They
do not know what global warming is.
The rains do stop, during the
third night and by morning the flood levels have gone down. The aunt and uncle are busy throwing water
back into the house and sweeping vigorously with a bamboo broom. Everyone is doing this. It is all of a sudden time to clean as there
is so much water to clean with; never mind that it is dirty water. There will never be enough clean water for
washing floors. This is fresh rainwater
and it is now being used in a mass, village throwing of water and sweeping.
When we are finished at the house, we go and repeat the procedure at the
temple.
Nhan goes out in the boat to
see if we can leave and returns in a few hours to say we can. We walk for a few miles, through the water
while Nhan takes our bags in the boat.
When we get to the highway a van will take us o to Danang.
As I walk, people wave, give
the peace sign and join in. The damage
is unimaginable. Schools, temples,
farms, roads and houses are in disrepair.
Some are better built for floods than others. Everywhere people are throwing water in and
sweeping.
When we get to town, I can
see more damage and more people pitching in to clean schools, repair bridges
and fix roads. That night we sleep at a
cousin's house. The room has been
flooded and we walk through garbage filled pools to reach the door. There is no furniture or food. We sleep on the mud caked floors on our
mats.
I try to talk about global warming but no one knows what
I am talking about, even with a translator.
It is not just that I am speaking another language; it is beyond
cultural belief and understanding.
Floods are normal and sometimes they are worst than others. They cannot imagine that something done in
the western world is causing the floods to be more frequent and more
severe. They cannot believe this even
though we dropped millions of bombs on their small country. They cannot see the hidden war of economic
greed and global warning. I feel that I
should tell them but what can they do. The old aunt and uncle will wait for the
water to go down and tend their farm as they have their whole life. Their children live in Ho Chi Minh City and
have no plans to take over the farm. I
panic, not because I fear I will drown in the flood but because of the rice
fields and the small, perfect farms set in and around them; places of impeccable
beauty and grace. Places where people
call hello to each other on small islands in the midst of a flood.
I want to believe it is
normal and that it is not caused by global warming. I want to believe ah, yes it is normal but I
can see it is higher than usual. The privilege
and curse of my background means I can read and listen to the news.
When I return to the United States, I see
that we too live on islands surrounded by a different sort of storm. We go inside and shut
our doors and buy more things than we could ever use. We get in the car and roll up the
window. We turn on the heat or air
condition and shut the windows and pull the blinds. I want to call out from my island to the
next and say, “Here I am. Are you
okay? Should I get in my boat and come
over?"
The aunt and uncle on the small farm, in Vietnam, have almost no carbon foot print. They have no utilities, car or packaged food. They make a small fire each morning in their outdoor kitchen and save hot water in a thermos for the day at the same time they cook their rice. The pig and chickens live there beside them, eating whatever scraps they can find. They weave hats, sleeping mats and even their boat. They fish and gather greens for dinner. They help the monks who live next door and greet friends and neighbors with friendliness and respect. The aunt had all her babies in this house. If it was dry enoughshe went out into the rice fields and if it was flooded she stayed inside, continuing her daily tasks until she felt the baby coming out. Birth, death, rain, floods and the dry season come and go. They sit there together with the puppy chasing the chickens. They have been married since they were teenagers. In my country, in highly developed countries the world over, we can not imagine them as they can not imagine us.
In the Phillipines, thousands are effected by the typhoon that also brought flooding to Vietnam. In all such natural disasters, women and children suffer and die and long after the rains and winds stop, they must re-build again and again. In my country, people donate money and when the images are too much to bare, go out and buy more, drink more, eat more trying to build the walls of their islands to keep out the flood; to keep their children safe against harm.
"Hello, out there. How are you? Are you okay? Should I row over and help?"
What if the best way we could help the next generation of babies was to simply change the way we live so they could continue to live as they have for thousands of years?
The aunt and uncle on the small farm, in Vietnam, have almost no carbon foot print. They have no utilities, car or packaged food. They make a small fire each morning in their outdoor kitchen and save hot water in a thermos for the day at the same time they cook their rice. The pig and chickens live there beside them, eating whatever scraps they can find. They weave hats, sleeping mats and even their boat. They fish and gather greens for dinner. They help the monks who live next door and greet friends and neighbors with friendliness and respect. The aunt had all her babies in this house. If it was dry enough
What if the best way we could help the next generation of babies was to simply change the way we live so they could continue to live as they have for thousands of years?
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