In May, my friend delivered a healthy baby girl by c-section here in Haiti at one of the nicest hospitals that I’ve been to in Port au Prince. She was a lucky one...THIS time. She is 43 years old, has a history of high blood pressure, previous c/s and of a previous neonatal loss. Yes, she “lost” a baby boy the first day after birth, many years ago due to pre-eclampsia and lack of pediatric care where she delivered. This time, she had some health guidance, her own experiences, and a steady job that allowed her to go to a good doctor to follow her very high-risk pregnancy. We searched out the best hospital for her delivery and then had to find a “connection” for her to deliver there. She found one! She went in as soon as her blood pressure began to rise seriously at 35 weeks and stayed on the open bed unit under observation until it was time to deliver. I am SO thankful to God that she had no complications, her c/s went fine & she had a good peds MD for the baby this time...her greatest concern! She now has a gorgeous, thriving 2 month old daughter.
Although her delivery went well, I’m sure if you are from a first world country, like the US, Canada or Europe...there are still a few differences in her story that might be hard for you to imagine. I know that I was stunned to hear that my friend had lost her only son within a day after birth due to no pediatrician being available for newborn care.
Did you also catch the hint that she had to have a “connection” in order to be SURE that she could deliver there? There is a strange separation here between prenatal care and delivery. In Haiti, you might see an MD for your whole pregnancy, but they may not be associated to any specific hospital, or maybe only to a very expensive hospital in Petionville that few can afford. So when it comes time for delivery it is up to you to find a place that has “space” for you and that you'll be able to pay for. If you are in labor here and you go to a hospital that is “full” they will not look for another bed to squeeze you in, but turn you away in the streets to find another place to deliver. Let me just add to that picture the fact that many moms walk miles or ride on tap taps (basically the back of a truck) to get to each hospital...WHILE they are in labor. Let me ADD that if you don’t have the money to pay, they will also turn you away.
My co-worker, Shelley, shared the story of a young Haitian woman that delivered in a local clinic. Someone came running to her to explain that the clinic was “holding the baby hostage” until this woman could pay the bill. Shelley went down there & found the woman lying there in a pool of blood. The caregivers explained that they weren’t going to stitch her up until they knew she could pay the bill. They also didn’t have any sutures or supplies handy. Shelley explains that she had to run to a pharmacy and buy the supplies, pay a fee and THEN they repaired her...stopping before the last stitch to request another $5 to complete the job. Once done they stood her up, placed her baby in her arms and practically shoved her out the door... If Shelley hadn’t been there with a vehicle...she would have gotten on a hot, crowded & bouncy tap tap for her ride home within hours of giving birth.
Another thing that I found different here is the fact that even the very NICE hospital requires sharing an open ward. There were at least 5 beds lined up on a wall on each side of the very clean & efficient maternity unit. If a mom had delivered then there was a clear bassinet at the foot of her bed. If it was twins then there were two crowded in. Each bed had one chair next to it for a visitor/helper. There were no hanging curtains to pull for privacy & the visitor hours were from 10-12 and 3-5pm, strictly enforced except for the one helper. Patients had to bring their own towels/blankets, and if food wasn’t brought to them by family/friends then they didn’t eat. It was a whole new world for me...and THIS is a GREAT hospital here.
I have only heard unimaginable stories of the “free” hospital downtown, from the many communities of Haitian women that I interviewed last year.
Despite a rudimentary understanding of this country...there is one maternity care fact that I will never get used to...DEATH. For the year and a half that I have lived here, EVERY single week I’ve heard a new story about a mom and/or a baby who died in childbirth, after childbirth, or weeks later from an untreated childbirth related complication.
I worked 10 years, full time in a high risk Labor & Delivery unit in Northern California and only faced ONE maternal death on our unit - a situation that was unpreventable. Even then a brave MD delivered her by c/s once we knew she could not be revived and with the help of a NICU staff SAVED her baby boy. ONE mom died...out of thousands of deliveries over the years.
Death permeates the reality of ALL of my Haitian friends. According to a 2011 UNFPA report on the state of midwifery in Haiti, every Haitian woman that bears children has a 1 in 100 chance of dying in childbirth during her lifetime. Until I moved here those “stories” were merely the basis for a good period novel...in order to set up the plot and tension of a character’s life and explain a missing mother figure away. It is a “nonfiction” reality for me now too...I may lose a Haitian friend to childbirth or mourn alongside over her baby’s death.
The sad thing is...the life-altering, heart wrenching tragedy of the earthquake could not be prevented...BUT needless maternal death in Haiti CAN be stopped with adequate, available care!!!
Apparent Project’s basic mission statement is “to keep families together”...one way that they meet that goal is by addressing the needs of the “social” (poverty) orphan population. Through job creation Haitian moms and dads are able to raise their own children. That is AMAZING and beautiful to see first-hand, especially in a country littered with orphanages and abandoned children.
Pray with us as we seek to help families STAY TOGETHER through other types of prevention as well! In this case...by providing good preventative medical and maternity care and safe deliveries here. While my background of 24 years working in maternal/child health is a great start, this is a DAUNTING task that CANNOT be managed alone! In the short time that we have been on staff God has steadily been increasing His prompting on each of our hearts, that this is a forefront issue to be addressed. He has ALSO been opening doors. We are all excited to see how He will continue to provide and pave the way for this ministry!
For example, Tuesday, Ted & I went to pick up a couple of used twin beds for Tynan and Emma from another family ministering here. They also had an office desk and cupboard set available which we decided to get in faith, with hope that it would be purposed for either the employee health clinic or perhaps a maternity center one day soon. While loading it up I was talking with the seller about some other shelving that he will be selling next month and mentioned in passing that we were hoping to eventually open a maternity & preventative health center. He got very excited to hear about our plans and proceeded to explain that he was opening a preventative health medical clinic in an area outside of Port Au Prince as well. He went on to announce that they had been sent a 40 foot container of donated medical equipment & supplies in order to furnish it. Apparently he received 4-5 of each equipment item, but only has 3 exam rooms to fill. So he immediately offered to GIVE us everything that he has left to set our clinic up! Uhhhmazing PROVISION!!
As you keep us & the people of Haiti in your thoughts and prayers this week - please continue to lift this potential ministry up. With the door of supplies/equipment that just opened, we are compelled to move forward and meet with others for advice this week. They are already providing maternity care in another area, so their wisdom will be crucial. We will also start on a project proposal as we follow the Lord’s leading. Yesterday a medical team arrived, who will be helping with employee health check ups and hopefully help me make a dent in starting medical charts that I can follow up on.
If anyone knows of a midwife or OB/GYN that would be interested in serving here for a few months...that will be the NEXT door to be opened. Did I mention that we continue to need your prayers? Look HERE for our ministry team prayer & tangible needs update!
For a better understanding of maternity care and midwifery in Haiti...read these first hand stories:
United Nation’s Population Fund. 2011. State of the World’s Midwifery Report - Country Profiles: Haiti. Retrieved from: http://www.unfpa.org/sowmy/resources/docs/country_info/profile/en_Haiti_SoWMy_Profile.pdf