2 posts for the price of one

07/24/2013

1 day later

(didn’t make it to the Midwives for Haiti house yesterday, meaning no WiFi so this is sent a day late)

Listening to the girls sing their nightly prayers as I write, in previous years these sounds were drowned out by the boys loud radios and raucous games that went late in to the night.  These sweet girls sing together and I sit freshly washed from my bucket bath with a few blissful hours of time in front of a fan as the generator runs.  Tonight is so far temperate, the sweat ran down my face and body all night last night and I couldn’t sleep with the heat and closeness of it, just tossed and turned under my mosquito netting. The thunderstorm this afternoon was particularly vigorous and dropped the temperature and humidity to a tolerable level.  We waited out the rain under an awning across from the Ebeneezer market with our moto-taxi drivers.  The water puddled and splashed in the muddy and trash strewn streets, as we looked upon the verdant lot of corn tucked between the market and a house. We were on our way to Miss Gennette’s house, she had invited us over for dinner.  We had a lovely time and I ate my first full meal in days, I’m finally hungry, it feels great.

Today was our first day in the hospital for this trip, and it was very busy.  In 4 hours we had 6 healthy babies! 2 born by cesarean, 4 vaginally, 5 boys and 1 girl.   One of the babies was even born in the bathtub outside of the hospital entrance. Mom had gone to wash because the labor ward was full and the baby slipped out in to the tub while she was there, a big, healthy boy! The students we worked with today were good and competent, we had a brief resuscitation for the final boy, he had a bit of a difficult birth and took a few minutes to decide that he wanted to be here, but it went relatively smoothly and was a good teaching moment.  One of my perpetual frustrations reared it’s head though, with the ambu bag not ready and available when we needed it.  Supposedly this happened because there were only two on the unit, I got back to the midwives for Haiti house and there was a box of at least 20 ambu bags gathering dust, frustrating…I am going to try to take on the task of inventory in that room tomorrow afternoon, at least a beginning.  I would love to see an inventory of that storeroom become a weekly task for a volunteer.  It is not as glamorous or exciting as catching babies but it is so incredibly necessary when we realize things are going to waste that are needed at the hospital.

One of the most exciting things that is happening at the hospital these days is that they are building a newborn special care nursery, my greatest hope for this place is being realized! University of Ohio in conjunction with Partners in Health has received a large grant to build these nurseries in Haiti and they have chosen Hinche and St Therese hospital as a place with great need.  It will be a small, 4 bed unit dedicated to babies who need a little bit of extra help.  Very sick babies will still be sent to a bigger hospital, namely Partners in Health’s new hospital, but it means that those babies who we see so often in Hinche, just a little too young to nurse well, just a little bit of respiratory trouble, will survive and thrive!  The woman from U of O who is spearheading the Haitian portion of the project, Monica, is lovely and we have had some great discussions about what I have seen here as far as neonatal needs and what I would love to see in this space.  Primarily I am encouraging them to incorporate breastfeeding teaching and pump and bottle feeding techniques as part of the project, so that moms are still making milk and able to feed their babies once they take them home from the hospital and they are not dependent on formula to feed them, which is an expensive and potential dangerous task here. 

7/25/13

ruminations on what it means to serve and be of service

Every year when I am in Haiti I find that I have some crisis of conscious experience. Last year it was over a very difficult birth and ultimate death.  This year it is over organization.  It seems like such a small thing in comparison, organization and preparedness, but in my opinion it can mean life and death during a birth. I went a bit crazy about it at the hospital during our shift this morning.  Granted Maria and I had just assisted with the birth of a still born baby, who was quite macerated and difficult to look at, so I was already feeling a bit sad and I had not eaten much so my blood sugar was low but when I get to the bed side of the 3rd delivery of the morning with a woman who had been in the room for a couple of hours only to find that there was no ambu bag at her delivery table (for those who don’t know, an ambu bag is a device that we use to help babies breath (the bag and mask device seen on any self respected ER episode) if they are having a hard time getting started after birth, we use it in place of mouth to mouth resuscitation, to inflate the babies lungs appropriately without risking infection or passing disease) When I asked why it was missing I was told that there was not one clean. What happens if this baby needs help, I asked. What are they going to do? The midwife and the student just looked at me blankly.  The maddening part of this all is that the first delivery of the day we had an ambu bag at the birth that we didn’t use and it never got dirty, so where was that one? And for that matter the translator and I went in to the storeroom across the hall and found 3 brand new ones wrapped up in plastic, sterile and ready for use! I was livid, how do you expect things to go smoothly when you are not prepared? I know so much of this is my own “American” sense of how things are “supposed” to go, but even writing about this makes my heart race.  Those minutes spent running around looking for a bag when one is not readily available are minutes that can mean life or death or permanent disability for a neonate.  It is not very often that a baby this kind of attention but you never know which one is going to be the one. As it turned out this baby did have a bit of a tough delivery, he was mildly directionally challenged must have had a headache when he came out based on the shape of his skull, in the end he only needed some vigorous stimulation and a little bit of suctioning and he was screaming

lustily. 

 

My dilemma is that this is an annual challenge. I bring this up with the midwives and students every year, and every year it is the same, they nod and smile and agree and nothing changes.  Even the storeroom at the Midwives for Haiti house is a mess of disorganization and it makes it impossible to know what is available and what is needed.  What should this week’s volunteers bring when they come? It all sounds so simple, but here it feels daunting.  I can’t judge, I don’t know what it is like to live and work here every day.  I can surmise lack of pride, but that is my own prejudice.  I can assume lack of time, lack of caring but they care so much and they work so hard! I cannot just ask what do I teach, how do I explain, but why do I even care? Does it even matter? Is it my place at all to even question?  Is there really just a better way or is it cultural?  Most likely it is much more complicated then this and I am trying to simplify things way too much, but it is cleanliness and knowing where your supplies are, is that really so complicated? Ah it is frustrating and I don’t know what systems can be put in place to change it, entropy is a way of life here.  Things decay and devolve in this hot, tropical land, why fight it?

 

I am going to stop my rant, thanks for processing with me J I am off to start on the inventory of the storage closet at the Midwives for Haiti house…