Apr 26, 2015

Our Tourist afternoon


 A trip to Hinche is not complete without a trip to Bassin Zim, which the Haitians are making into a National Park. The local children and young men still come to help you up the steep path, even though it is a stone walkway now. Their helping hands are appreciated in the slippery cave above the waterfall.

Kirby was our guide, and Greg even played his trombone for us. It is a magical place.












The Mobile Clinic


 Lociana measures the fundal height and uses a Doppler to listen to the baby.

Magdala sets up the tests they will do: Rapid HIV testing, malaria, and Hemoglobin. Some sites with more privacy also do gonorrhea and chlamydia testing. This clinic does not have any privacy. The women collect urine in a cup behind the building, for a urine pregnancy test, at their first visit. She is interviewing this woman, and asking about any problems she is having.
This is one of twenty villages served by the mobile clinics of Midwives for Haiti.  We drive down a narrow dirt track for 40 minutes to get to Los Mamounes. (I think that is the spelling!) The clinic was in the school before, but it was too noisy, so they moved to the church. The pregnant women see us arrive and they start coming. A woman comes with a brush broom to sweep down the dirt floor, and a man tosses water on the dirt to control the dust. All the four midwives wait in the Land Cruiser. Some men bring over benches for the women to sit on while they wait, a small table for writing, and plastic chairs for the midwives. The midwives bring in three large suitcases full of supplies, and a massage table.


 Marie Ange handing out medications.
 The last two women waiting to be seen. We saw about 21 women this afternoon. This is one of the smaller clinics.
With the help of an interpreter, I get vital signs (blood pressure, temperature, and pulse) on all the women that are waiting, after they get their teaching. The midwives have two laminated posters. One teaches about nutrition during pregnancy. The other one has pictures of danger signs in pregnancy. The midwife teaches until the women can tell her the danger signs in pregnancy. She warns them to go to the hospital if they have any of these problems.

Magdala and Philomene get the history from each woman, and do tests. Marie Ange hands out vitamins, iron, and folic acid to each woman. Today she also gives them some sanitary napkins for their postpartum period. The fourth midwife examines each woman on the massage table. Today they tell one woman that she needs to have her baby at the hospital. Her baby is very large, measuring 41 centimeters. They explain that she could have a shoulder dystocia, that the baby could be stuck. The woman has had all her five children at home, and she has never been to Hinche. They speak to her strongly, but we wonder if she will follow their advice. She would have to take a motorcycle taxi to the hospital.

There are eight new patients today. They collect 25 gouds for the first visit, and 10 gouds for subsequent visits.  (This is about 75 cents, and 25 cents.) The midwives are our graduates. They are sponsored by donors outside of Haiti. Once again, I am amazed at the efficiency of the clinic, and the competent  caring of the midwives. It makes me feel good about the work we are doing.


After the clinic, we went to a casabe bakery near by. this is an unleavened flat bread made from the yucca root. It was quite amazing to see how they mashed the yucca root, compressed, dried, sieved, and then made it into large flat cakes, about 2 feet across, and baked it on a large piece of metal.



Packed up to go to the market

The Postnatal midwives

 Our  postnatal  midwife,  Gerta, saw a woman six days after her delivery at Ste. Therese Hospital. This woman had a cesarean section, and she is here at the postnatal clinic for her 6 day visit. When the woman first came in, the baby was hungry, so Gerta helped the woman with positioning the baby at the breast, and did her teaching before examining them. As you can see from the pictures, the baby got very fussy when Gerta tried to examine her, so the baby went back to the breast, and Gerta listened to her breathing and heart rate while the mother kept her happy at the breast.


 These midwives are graduates of our program. It was very gratifying to see how competent and thorough they are, and how much they teach the women, They also treat the women with respect and kindness. They listen carefully to the women, and answer their questions to reassure them.



Our postnatal midwives have a registry of every woman who had a baby at the hospital, and they try to see the woman and her baby at 6 hours postpartum, 6 days postpartum, and six weeks postpartum. Because we now have three postnatal midwives, there is someone in the hospital every day to see the women before discharge. Most women are discharged about 6 or 7 hours after the delivery if it was a normal vaginal delivery without complications. The midwives make an appointment to see the women at the postnatal outpatient clinic on the hospital grounds.



Two postnatal midwives share the office, and see two mother-baby dyads at a time. The picture shows Gerta and Illa finishing up newborn exams. You can see from the size that one baby is six weeks old, and the other baby is only 6 days old. They weigh the babies, see if they are growing properly, and advise the mother on a healthy diet.

Handy Husbands

HANDY HUSBANDS

This was the title the men had during their week in Haiti. They painted and repaired cabinets at the hospital. We called them when labor and delivery was empty, so they could come in to remove the cabinet doors and paint the cabinet fronts. Invariably, they ended up being near some women in labor. Fortunately, the women seemed to be very busy and did not notice them. Now we have some place to store the delivery bowls with instruments and supplies for a delivery, each wrapped in a twin bedsheet. The sheets were donated by my co-workers at the Richmond City Health Department.

 These are the cabinets before repairs.



















 The workshop was on the front porch of the Midwives for Haiti house.





The cabinets are almost finished, but then they found out they needed locks.


A Trip to Haiti


GETTING THERE

We were in Hinche, in Haiti, for a week, arriving on Saturday, April 11th. I have now been at work a week since our return, but I have been processing the experience that whole time.  I have been a little depressed, and it is hard to put a finger on the problem. Is it post-vacation blahs? I think it is more than that. I think my problems in the States seem so petty after seeing the problems in Haiti. I think there is more important work I should be doing. I think I am worrying about how Midwives for Haiti can do even more than they are doing. And my work here in the States seems insignificant compared to the work I could be doing in Haiti.

A RECAP:
April  11, 2015  Our flight was late arriving, but our guide, Ernst, from Midwives for Haiti , was waiting for us outside customs. We walked through customs easily, even with our 4 duffel bags full of supplies and tools. We had three extra duffel bags that were filled up at the Midwives for Haiti (M4H) office, donations from other volunteers. Ernst led us to the M4H vehicle, where we met up with our friends, Wendy and Greg Dotson, a new volunteer from New Zealand, Pippa Lloyd, and our faithful driver, Ronel. Ronel has been with M4H since the early days, when he drove his old Toyota pickup, and we rode in the back. The Land Cruiser seems luxurious by comparison, with bench seats in the back, air conditioning, and a large rack on top suitable for carrying all the bags of supplies from the States.





We also carried in a few bags of tools. Wendy and I cooked up the idea of having our husbands accompany us, and finding a building project for them. Nadene and Steve found the project before we left, so the guys knew what to bring to accomplish their task of painting and repairing cabinets in Labor & Delivery in the hospital. It was David’s first trip to Haiti, and he wanted to make sure he was useful.


Nine of us filled up the van pretty tightly, and we headed out of Port-au-Prince immediately. Th,e trip took about 3 hours, as expected, even though we encountered a heavy rain in the mountains, which made new creeks appear, as the rain ran down the hillsides, and rocks tumbled down with the water. The new paved road from Port-au-Prince that they built after the earthquake is very impressive, but the rains and tumbling rocks made us remember that we were in the eroding hills of Haiti, and it was a little scary. Ronel is a good driver, and he got us home safely, with our piles of baggage.

David and I sat in the front seat, and David saw the sights along the road leaving Port-au-Prince.