Midwives For Haiti: Then and Now

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  • 1. Then andNow
  • 2. Midwives For Haiti’s mission isthe reduction of maternal andneonatal mortality in Haiti.Haiti has the highest maternalmortality in the Westernhemisphere. This is largely dueto the lack of skilled birthattendants to assist women withtheir pregnancies and deliveries.95% of the poorest one-fifth ofwomen do not have skilled helpat their deliveries.Without skilled care pregnantwomen are at risk of dying frompostpartum hemorrhage,eclampsia, obstructed labor orinfection.Maternal Mortality 350 per 100,000 Births“Instead of comparing our lot with that of those who are more fortunate than we are, we should compare it with the lot ofthe great majority of our fellow men. It then appears that we are among the privileged.”Helen Keller
  • 3. Simeus’ first wife died duringchildbirth and his newborn sondied a few months later.Simeus’ second wife, Ismerelda,delivered her youngest daughterin 2012 with the help of aMidwives For Haiti graduate.The number of orphaned orabandoned children in Haiti canonly be guessed. Before theearthquake it was estimated tobe 380,000 and after the quakethe number at least doubled.The death of a woman inchildbirth puts the lives of all ofher children at risk.Ismerelda , Simeus and Children Outside Their Home“Your children are not your children. They are the sons and daughters of Lifes longing for itself. They camethrough you but not from you and though they are with you yet they belong not to you.”Khalil Gibran
  • 4. Midwives For Haiti had a verysimple and humble beginning. In2006 a few midwives led byNadene Brunk came to Hinche,Haiti to educate 9 Haitian womenas skilled birth attendants. Thesewomen were being trained towork in a birth center that wasunder construction.Those women would never workin that birth center but a greatervision was born. They became thefirst of many classes that wouldgo on to serve women all overHaiti.The way forward was not clearbut the need was seen with greatclarity. Women would continueto die needlessly until there weremore midwives in Haiti. Theessential question was “If wedon’t do this who will”?Midwives For Haiti’s First Classroom“For me, an area of moral clarity is: you’re in front of someone who’s suffering and you have the toolsat your disposal to alleviate that suffering or even eradicate it, and you act.” Paul Farmer
  • 5. Our first school was located in arural area. Homes were simpleand without running water orelectricity. The best structureshad tin roofs and concrete floors.The worst dirt floors and roofsopen to the sky. In the U. S.those structures would not beused to house animals.Getting to the hospital took a 1-2hour walk. Once there a womanwas unlikely to find anobstetrician or midwife to carefor her after 4pm or onweekends. The hospital waslittle used by women in labor.They did not feel safe there.The doctors and nurses at thehospital had the knowledge tocare for patients but not themeans.Rural HaitiThe first question which the priest and the Levite asked was: If I stop to help this man, what will happen to me?But... the good Samaritan reversed the question: If I do not stop to help this man, what will happen to him?Martin Luther King, Jr.
  • 6. The hospital in Hinche is governmentrun and free of charge but everythingwas in short supply in 2006. Thisincluded medications , electricity andwater.Conditions at the hospital haveimproved in 2013. The maternity wardsare better staffed because MFH pays thesalaries of 11 midwives and the hospitalis able to pay 5 more. Electricity andwater are now available most of thetime. Medications are usually found inadequate supply although there can stillbe isolated shortages. For instance,sometimes the hospital has no spinalanesthetic medication.That the hospital functions as well as itdoes is impressive given that the percapita health care expenditure in Haitiis just $79 per year. In the U.S. it is$8,233.St. Thérèse Hospital Hinche, Haiti“The poorest parts of the world are by and large the places in which one can best view the worst of medicineand not because doctors in these countries have different ideas about what constitutes modern medicine. Itsthe system and its limitations that are to blame.” Paul Farmer
  • 7. When the rainy season came it wasnecessary to find a place indoors tohold class. We were able to find spacein a small room in the laundry of thelocal hospital. In Haiti you make dowith what you have.Midwives For Haiti’s Second Classroom“Ignorance is the curse of God; knowledge is the wing wherewith we fly to heaven.”William Shakespeare
  • 8. In 2007 our small annual budgetwas reflected in the condition ofour transportation.This Toyota truck is 33 years old.It is held together by duct tape,wire and the ingenuity of ourdriver Ronel.One day the drive shaft fell onroad when the universal jointbroke. Ronel had the truck goingagain in 90 minutes.Making Do and Getting By“You must do the things you think you cannot do.”Eleanor Roosevelt
  • 9. Now
  • 10. MFH students learn to treat lifethreatening complications. Herestudents are starting an IV andgiving magnesium sulfate to awoman having eclampticseizures. This woman survived.Her baby did not.High blood pressure duringpregnancy (pre-eclampsia) is themost common complication ofpregnancy and its moreadvanced form, eclampsia, theleading cause of maternalmortality in Haiti.Eclampsia can only be preventedby making prenatal careavailable to all pregnant women.Emergency“Half a million women die each year around the world in pregnancy. Its not biology thatkills them so much as neglect.” Nicholas D. Kristof (author of Half the Sky: TurningOppression into Opportunity for Women Worldwide )
  • 11. Midwives treat burns apatient received from a“traditional medical therapy”commonly used after adelivery.Without a skilled birthattendant pregnant womenare cared for by familymembers or a traditionalbirth attendant (TBA). InHaiti TBA’s have no formaltraining and may resort totreatments that are ineffectualor harmful.First Do No Harm“If you can, help others; if you cannot do that, at least do not harm them.”Dalai Lama
  • 12. Prenatal care is vital to thehealth of women and babies.The pink jeep (a significantimprovement over Ronel’struck!) carries our midwives to16 rural villages each month toprovide this dependable servicefor woman who do not haveaccess to medical care.In the first 3 months of 2013 ourmidwives saw 897 women andmade 10 emergency transportsto the hospital.Mobile Prenatal Clinic“A little knowledge that acts is worth infinitely more than much knowledge that is idle.”Khalil Gibran
  • 13. The mobile prenatal clinicmidwives examine eachpatient, determine a duedate, screen for high riskproblems and provideeducation.Caring, Compassionate, Competent“The purpose of human life is to serve, and to show compassion and the will to help others.”Albert Schweitzer
  • 14. Every woman attending theprenatal clinic receivesvitamins, iron supplementsand treatment for intestinalworms. Women with chronichypertension, a commonproblem in Haiti, receive anti-hypertensive medication.Traveling Pharmacy“Gardeners know that you must nourish the soil if you want healthy plants. You must water the plants adequately, especiallywhen seeds are germinating and sprouting, and they should be planted in a nutrient-rich soil. Why should nutrition matter lessin the creation of young humans than it does in young plants? Im sure that it doesnt.”Ina May Gaskin
  • 15. Each patient is tested forHIV, syphilis, gonorrhea,chlamydia and malaria.Patients with HIV orsyphilis are referred to thehospital for further testingand treatment.Patients with gonorrhea,chlamydia or malaria aretreated by the midwives.Without the mobile prenatalclinic these infections wouldgo untreated risking thehealth and life of motherand baby.Rapid On-Site Lab Tests“I still believe in a place called Hope.”William J. Clinton
  • 16. At $10 an exam, the mobileprenatal clinic is our mostexpensive activity. Webelieve it is priceless becauseof the lives it has saved.Priceless“Be kind whenever possible. It is always possible.”Dalai Lama
  • 17. The hands that deliver ababy in Haiti are usuallythose of a matrone, Haiti’straditional birth attendant.75% of pregnant women inHaiti deliver without askilled birth attendant.Matrones do not have thetraining or medicationsneeded to treat eclampsiaor postpartum hemorrhage,the leading causes ofmaternal death in Haiti.Matrones do have the trustand respect of women intheir community and needto be part of the solution.Connecting With Tradition“God has given us two hands, one to receive with and the other to give with.”Billy Graham
  • 18. These matrones wereamong the 30 that attendedour first matrone trainingprogram. This 20 lessoncourse taught techniquesfor performing a clean birthand how to identify dangersigns in pregnancy. Thematrones are encouragedto bring their patients tothe hospital and they areallowed to stay with themwhile in labor.By reaching out to Haiti’straditional birth attendantswe bring them into themedical community andimprove the care thatwomen receive.Fort Resolu Matrone Class of 2012“You are never too old to set another goal or to dream a new dream.”C. S. Lewis
  • 19. These women are graduates ofthe Midwives For Haiti programwho now work at St. ThereseHospital in Hinche.47 graduates are now working in14 locations around Haiti.Midwives For Haiti graduateshave an employment rate of 85%.This is remarkable in a countrywith an unemployment rate of40%.Of course we are thankful for thecare these midwives give to theirHaitian sisters but we are equallygrateful for all of the otherbenefits that come from work. Asecure income for themselvesand their families is the obviousbenefit and cannot beoverestimated in a countrywithout an economic safety net.Yet it is the confidence, dignityand professional pride thatcomes from their work thatchanges their lives the most.Education Brings Employment“All labor that uplifts humanity has dignity and importance and should be undertaken withpainstaking excellence.” Martin Luther King, Jr.
  • 20. Few people that visit Haitiremain unchanged.Haitians endure hardshipsthat are unimaginable tomost Americans and they doso with grace. Materialthings mean less andpersonal relationships meanmore. Even in deprivationthere is a sense of beingprotected by the favor ofGod.The Spirit of Haiti“Spiritual relationship is far more precious than physical. Physical relationship divorcedfrom spiritual is body without soul.” Mahatma Gandhi
  • 21. We need midwives, labor and delivery nurses, obstetricians, pediatricians and nursepractitioners (family practice, pediatric, and women’s health) to work with us inHaiti. Volunteer online at www.MidwivesForHaiti.org.Most of our donations come from people like you. Our average donation is about$450 but any donation helps us train midwives and bring skilled care to women inHaiti.Please lend your support. Donate online.“A small body of determined spirits fired by an unquenchable faith in their mission can alter the course of history.”Mahatma Gandhi