Midwife Gitte Mathew volunteered for three weeks in Haiti as part of ‘Midwives for Haiti’, an American NGO formed after the earthquake of 2010 with the aim of improving the skills of Traditional Birth Attendants, encouraging safe practice and the establishment of midwifery training schemes for local people.
I was born in Denmark, came to England as a teenager and trained as a nurse and midwife in the UK. I now divide my time between Scotland and working in Central Australia for 6 months every year. The last 3 years I have worked some of that time in remote areas of Australia including Thursday Island in the Torres Straits.
I am hoping that my trip to Haiti was not the last!
This is a complete record of my time spent working with midwifery students in a regional hospital as well as a birth centre in the mountains.
Saturday 18 November
Arrived Port au Prince Airport, met by Ernst (contracted by MFH) as promised, later met more MFH administrator staff at local hotel (they had been in meetings in town in the morning and shopping for Thanksgiving dinner): huge frozen turkey wrapped in my fleece to prevent it from thawing out. I Picked up Rosie (a volunteer from Virginia) from the airport and we set off. It took three hours to drive the 60km to Hinche – over huge potholes and speed bumps on an otherwise good and straight road.
Cattle, people and broken down trucks are everywhere. Ricardo (main driver) was obviously used to it and very competent. However they always have a second driver in case of accidents or a break down.
The MFH house is very comfortable, but a bit cramped in the bedroom with four bunk beds where Rosie and I will be staying. We have our own bathroom, though, which is great (even if the shower is cold, and we have to collect clean drinking water to brush teeth, etc).
Sunday 19 November
Up early, going to be ready to go to church with Rosie and one of the translators (Stanley).
Three of us travel on motorbike to the Catholic Church in town: everyone in their Sunday best, lots of chanting, rock band music, greetings to newcomers (esp. the two white people), incense, shaking of hands with the priests and everyone else around us.
Afterwards, we went to the market; vegetables, un-identifiable bits of meat, second-hand shoes, and tablets in just blister packs and no boxes, etc. Had first of four Creole lessons with Stanley – it was just too hard.
Later we went for a walk on the ‘Common’ at the back of the MFH house with some of the admin people: large green areas with goats, pigs, chickens and people gathered various kids along the way, who just found white people interesting (no one asking for money), and young guys who wanted a quick English lesson (so many really trying hard to educate themselves).
Amazing views over the mountains around the ‘Central Plateau’, disguising the deforestation and poverty, especially of the people living on the mountains.
Monday 20 November
I was picked up by David (driver) and rode with Rosie the 15-minute journey on motorbike to the hospital. Very dusty on the road, potholes full of water from last night’s rain, but the children going off to school were immaculate in their uniforms and white socks and hair braids, walking within inches of the traffic going far too fast for the conditions.
Met by Vanessa (translator) at the hospital entrance (she is studying nursing and almost finished, so pretty clued up on medical terminology – really helpful).
Started on the postnatal ward checking mums and babies with charts written in Creole.
10am: I was called to labour ward to take PIH girl to theatre – baby 2.5kg [about 5lbs 6oz], and just fine.
Came back to the labour ward. There are four old-fashioned labour ward beds with just enough space to stand between them. No curtains, no ‘bottom of the bed’, so everyone has to have their legs in stirrups. No bed rest, and no pillow, so women have to lie flat on their backs and there is little room to stand or move around. One sheet is to cover the torn mattress, and one sheet is provided by relatives, which they have to take away and wash themselves.
If a mum wants a shower after birth, she has to walk to the other end of the hospital compound, (where no one wants to go after dark). It is very undignified, but the girls seem to accept that as being normal.
Four mums in now; one is waiting for C/S: ruptured uterus, baby has already died. No one appears to be particularly sympathetic. The second is a 13-year old girl post C/S for obstruction (baby dead) and now has wound infection and fistula, lying exposed with a dirty, bloody sheet under her.
A third woman has had a previous C/S for post-dates, now 40+2, so will be C/S without trial of labour. The fourth woman’s cervix is dilated by 9cm at 10am, and still 9cm at 11am, so ARM and up sitting on birth stool (wooden contraption, unlikely that it is properly cleaned between births), just managing to squeeze in between couches, and sitting next to the metal bucket used to wee in.
Flies are everywhere, only one sheet and a piece of paper to soak up blood and liquor. The forth baby was eventually delivered, and is taken straight away to be checked. No encouragement to do skin-to-skin.
Home visits in the afternoon. Tiny huts with no windows and no power, using candles to see (I didn’t think we needed to take torches in daylight). A couple of premature babies were jaundiced. Trying to persuade their mums to take them outside in the sun, but they seem to want to protect them by keeping them indoors in the dark.
Tuesday 21 November
Went to mobile clinic, a 2-hour drive north and gravel road all the way, badly eroded by rain; apparently it gets much worse in the wet season. The women at the clinic were as usual in their Sunday best, and even the babies dressed in party clothes.
Quite a few women with high blood pressures and tachycardia, maybe due to dehydration and walking hours to get to the clinic. The only medication available: Methyldopa. Their urine is checked for protein and glucose and Hb by bush lab, but everyone is given iron tablets as routine, (and worming treatment at first clinic visit).
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