Dear Anne,
Two weeks ago on February 5th, the pink Jeep took four midwives to do the monthly prenatal clinic at Saltadere. On the way they dropped off two CNM's, Diane Rousseau and Marion Alex, at the Birth Center at Thomassique. They were stopping there to do continuing education with the birth center staff on the difference between chronic hypertension and preeclampsia in pregnancy and the treatment protocols for both. Our three graduates there, Wilna, Founa, and Natacha, are always glad for the morale boost that volunteer midwives give them.
Thomassique is an hour's ride from Hinche and the road is very rough. Saltadere is another hour east of Thomassique and as you know, there is no birth center there. When the midwives, Magdala, Thelamaque, Marie Anise, and Merlinda, arrived, they set up their stations and proceeded to see 26 pregnant women and one who had a negative pregnancy test. One woman was treated with Aldomet for Chronic hypertension at 20 weeks gestation. Her blood pressure came down to normal one hour after taking her medication so she went home with a month's supply.
But there were five women who were very sick. They had very high blood pressures related to preeclampsia- the major killer of pregnant women in Haiti. (In 3 of the charts I saw records of 194/120, 208/128 and 154/100.) Two of them were in labor and vomiting. Three were term pregnancies and two were preterm.
So when the Jeep stopped in Thomassique at the end of the day to pick up Marion and Diane, the midwives told them to "Prese, prese" (hurry, hurry) because they had 5 high risk pregnant women in the Jeep to take to the hospital. Two were in labor and they hoped to get them to Ste. Therese before they delivered in the Jeep.
It was a harrowing ride. One of the risks of moving women with high blood pressures is that they will have seizures. Quiet, still, and laying on the left side would be the safest way to transport them. But there was no room in the Jeep for them to lay down and that Jeep ride over that bumpy road is anything but quiet and still.
Diane and Marion found bags for the 2 vomiting women and tried to make others comfortable sitting on the floor with their heads in the midwives' laps. By the time the ride was over everyone on the Jeep was nauseated. The midwives had started IV's on all the pregnant women so that they would be well-hydrated for whatever needed to be done at the hospital. It was the best they could do. They feared the two in labor would deliver on the way and that the others would have seizures from the bumpy ride. They have a birth kit in the Jeep but space and time for the others was limited.
All eventually safely arrived at Ste. Therese in Hinche and were turned over to the midwives (all MFH graduates) at the maternity unit. Before the night was over. 4 had delivered, 2 premie babies were transported to Cange, and 4 had been treated and were still on MgSO4 for severe preeclampsia. The next morning the 5th was being induced for being 2 weeks postdates and delivered later that day, still on MgSO4.
The good news that although we do not know the outcomes for the babies who went to Cange, we know that the other 3 babies and all the mothers did well and were eventually discharged. The following morning, two of the women, who were still in the same clothing from the day before, had no family to take them home to Saltadere and no clothing for their babies so Marion paid for their moto-taxi rides home and gave them cloth diapers, onsies, and receiving blankets from the MFH supply closet.
I know this is only one day and one story from Saltadere but I wanted you to let you and your parish know that their support of the mobile prenatal clinic's monthly trip to Saltadere saves the lives of mothers and babies. The Jeep's maintenance is costly but days like February 5th the ten lives saved make us grateful for its ability to provide reliable transportation for our midwives and their patients.
Thank you,
Nadene Brunk
Executive Director
Midwives For Haiti
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