There's no easy fix

Volunteers ask me how I learned Haitian Creole. I tell them that I minored in French in college. But, after Thursday's meeting with Haitian Department of Health and its partners, I think I am going to leave that part out now.

Making introductions at the training. 

Because it was a state-sponsored meeting, the presentations had to be in French, which is the official language of Haiti but not that of the people I might add. I struggled understanding but was able to read the Power Points. Luckily, my interpreter translated general key points during the meeting for me - the Haitian Ministry of Health will be implementing a ten year National Health Policy strategy that will focus on improving community health. The government will fund the training of health agents who will staff community health clinics around the country. The goal is to improve access to health care in Haiti. MFH was invited because we are a partner of the Ministry of Health. There's going to be another meeting in three months, at which we hope to make a presentation about one of our projects. There may be funding involved!

New location - MFH Guesthouse.

Being silly at dinner (my camera's flash doesn't do the
darkness justice).

I'm including some pictures from this week's Matròn Training for Trainers. I described it already in my last post, so you can return to that to learn more about the purpose of the course. The training was supposed to be held in a building at the hospital but the "reservations" that I had for one of the rooms weren't good. So, we had to move everyone to the MFH Guesthouse in the middle of the course. I was a little frustrated about that, but what can you do? On top of that, the head instructor had not informed me about the stack of papers that had to be prepared and copied for the participants. But, we had a solid group of sixteen, who are now certified to train matròns anywhere in the country. 

What a fine group - participants and instructors together.

I almost forgot to mention - we had no power for two days at the house. A part in our generator (which charges 24 large batteries that supplies the electricity for the house) had to be replaced, and so we sent one of our security guards to Port-au-Prince (3 hrs away) to buy the part, return the same day, and then have a mechanic replace it. Talk about an easy fix. 

Little by little

My sister Katie and I outside the disco in town.

I was just about to sit down and write up this blog when a group from the Eastern Virginia Medical School stopped by to check on the program. I went over the program background and mission with them and handed off a few scalpels for their clinic. The group said they had some members interested in learning more about our work. We are always open to having guests in our class or on our mobile clinic, so I am hoping I will be seeing their faces this coming week.

A few of the students posing by our Pink Jeep.

I had two very productive and informative Skype calls this week - one about data collection and the other about our social media tools.

The first conversation was with a young woman who is focusing her Master's thesis on improving our data collection methods. She has a brilliant idea in using a camera. Her suggestion is that we take pictures of a scantron-type form that lists our data collection questions. For example, we might want to know how many times a mother has come to our mobile clinic for prenatal care. After taking a snapshot of the form, the picture can be uploaded into a program that reads the scantron. This way, no one has to sit at the computer punching in numbers. We will see what happens with this!

Students coming back from the hospital - outside of the
MFH Guesthouse.

My second conversation was with a woman who spent two weeks reviewing our social media tools - Facebook, Twitter, and our website. Though she has never been to Haiti to see our program, she heard about it through a friend and decided to volunteer her time to help us improve our monthly donations through our media services. She has some excellent suggestions (some of which I am already trying to execute) and will hopefully be helping us with our Spring Fundraiser. Very exciting!

A good portion of my week was also devoted to planning for the MFH sponsored "Training for Matròn Trainers." MFH is partnering with MSPP (the Haitian Ministry of Health) in offering a week course in training nurses and midwives in matròn training. Matròns are Haiti's home birth attendants. They do approximately 80-85% of Haiti's births because most women prefer to birth at home. This training will allow someone to lead the 20-week supplementary course that we are now offering to matròns in the area. Since graduating one class of matròns, we have found that more women are coming to the hospital because the matròn ESCORTS them to the hospital. So, these people are a critical part of our program because they are increasing the referrals to the hospital and saving lives. They also challenge the cultural beliefs with their increased knowledge in maternal health care and work to improve the lives of the women in their community. We are extremely grateful and indebted to the work they do.

Giving our busy mom Ina May a break!

Not a moment to waste! We have two sections of our sixth class of midwives running simultaneously and are already planning for a two-day HIV training to be held in April. I also have a day-long meeting to go to on Thursday with the Central Plateau's Department of Health. Thanks for keeping in the loop!

Spring Break Service

Our preceptors and teachers: Genette, Mirline, Marie Eleine, Guerlie, and Merline.

I am thankful that I pay taxes. 

When you walk through the streets of Hinche, you catch wafts of burning trash, mouthfuls of dust, and the exhaust from the moto taxis that zoom by. Why is it like this? The Haitian government does not collect taxes and, therefore, has limited funding in keeping the streets clean and safe (as in building sidewalks). Next time you file for your taxes, be thankful! (I do realize that I don't have a paid job and, therefore, have little to complain about. I am mindful nonetheless.)

Katie translating student letters with Gladias.

My sister Katie Gill came and visited me last week. I thoroughly enjoyed spending time with her and introducing her to Haiti. We went to the feeding center for malnourished children, attended the Sunday service and health class at the orphanage, and sat in on the matròn training in Rivage. We had a few other volunteers with us for part of the week, so Katie was also able to learn about what the experience was like from a healthcare professional’s point of view - coming to offer any and all services in a clinical environment. Though I did not intend on it, I also had Katie pick up a lot of my “end-of-the-list” items, or rather everything that I didn’t want to do. She was a real trooper and seemed to take in her first experience with failed-state poverty well.

A transformer going up in our front yard.
(He is strapped to the pole.)

On top of the American visitors, the MFH Guesthouse has been hosting six students from Leogane and two new teachers for the class. After about a year or so of trying to open a new school 45 min west of Port-au-Prince, the school has finally opened here in Hinche. I won’t go into detail, but MFH was forced to take on unexpected funding and salaries because a promised grant never went through. So, we are starting a new school with eight students but in the same location as the first one. The students living with us finally found a place of their own, and so they should all be moving out today. Every mouth and body takes up resources and space so fast! We are thankful that lodging was found in due time.

Our second class of midwifery students
that started last Wednesday. 

I’ll be getting a break from visitors for the next week or so. I hope to have more time to work with our cook on different dinner recipes. I introduced her to chicken salad (with a Haitian twist, of course), which I thought turned out very well.
Stay tuned for more soon!

March "Money" Madness

Walking into the hospital on a slow day.

 When I was trying to come up with a theme for the MFH monthly newsletter, I was debating whether or not to mention March Madness and all of the money thrown at the tournament. Though I decided on something else, I was reminded of America's seemingly careless ways of spending money. Let me just touch on a few things to prove my point.

Ina Mae and her second batch of kittens.

 I have helped start a monthly health class for the young ladies at the local orphanage. I am working with one of our midwives on preparing topics ranging from basic anatomy and female systems, healthy behaviors, and spiritual well-being. Though I am not doing any of the teaching, I do enjoy sitting in on the two classes (one for teenagers and the other for the younger girls ages 5-10). The girls are well-taken care of there, but they have no solid mentorship or female adult to turn to for counseling or direction. I am hoping that our midwife will grow in the role as such while we are working on getting basic questions about bodies and life answered! And, how much will this cost? $30/month.

Along with working on the website and general items for the class, I have also continued to gather statistics at the hospital and from our mobile clinics. At the hospital, we realized that the midwives do not record any details about major complications during or after birth. On top of that, there is nothing recorded about reasons for fetal deaths. So, our next project is creating another record sheet for the midwives to fill out for their patients. BUT, we are going to have to find a way to incentivize filling out this additional form. That's where we think a little extra money will do some good. How much? 50 cents per form.

Magdala teaching on stages of pregnancy at the matròn training.

We had some busy days this week with lots of guests coming and going. A visiting group joined our mobile clinic on Tuesday for the day. We had a dinner on Thursday for some young women who work for Partners in Health. On Friday we had a group of seven come by to learn about the program. Friday was also overwhelming with our monthly continued education class, the training for the matròns, class for the students, and meetings with many of the midwives all happening at once. Not to mention dance lessons! How much? A day's worth of time and energy.

These are just a few of the items that only take a little bit of time and money to change and save lives. With the hype of March Madness soon to stir America, I fear that my wishful thinking for the U.S. to redirect its pocket change will just go to waste. Maybe next year we can convince the NCAA to add a twist to the tournament: March Madness Haiti Fundraiser. Wishful thinking, huh?

Sending off some volunteers. 

THE RIDE FROM SALTADERE

Nadene posted this on Facebook the other week - I wanted to feature it in this week's post. It's a great story!

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

Carnaval

A look onto Fort Picolet, Cap Haïtien.

Driving up to Cap Haïtien was no easy task. It took a damn good driver, a few pit stops (to relieve my stomach), and a dollar or two to pacify the boys behind masks and doused in car oil (Mardi Gras here prompts road blocks). Despite the rough ride, we made it safely to the northern shore of Haiti where we were to join in on the Carnaval 2013 festivities. I traveled with two recent college grads from a partner clinic. They had the connections and the driver already set. Though I had invited myself along (I won't pass up an opportunity to explore more of the country), they were more than willing to include me on their excursion!

Imagine this street packed with people shoulder to shoulder.

We decided to tour the sites during the day and then stop by the parades and dancing downtown in the evening. The first one on the list was the Citadel. Built in the early 19th century, the castle-like fortress was meant to defend Haiti from the French. Though I don't think they ever did, an earthquake hit not too long after it was built and marked it as a World Heritage site. After a steep climb on motorcycles and a 30 min upward climb, the views were amazing.

Making our way up to the Citadel.

The first evening of experiencing Carnaval was a bit interesting. We really didn't know what we were getting ourselves into. Tons of people filled the streets as soon as the music started. Big trucks equipped with tall speakers and open tops carried the bands and other dancing guests. We made the mistake of trying to cross the street and paid for it. When I say that, I literally meant that we paid with our wallets (we got rushed and pickpocketed). Live and learn...

A view from within the Citadel.

Coming onto Fort Picolet.

Next on the list was to explore the city and the coast. A cold cup of chocolate ice cream (real ice cream) got us off to a good start. We made our way through where we had walked the night before until we decided to take a taxi to a site called Fort Picolet. There, we walked along a path that the guidebook had warned not to take at high tide until we reached the ruins of yet another fort built to protect Haiti from the French. Had some great views there and a brief interaction with a Voodoo man. Very casual.

Haiti's local beer advertised on the Boulevard.

To sum up the trip, on the last day in "Okap" I had my first cheeseburger in Haiti, viewed Carnaval from a much safer spot in the stands above the crowds, and had my ears blasted with some very loud Haitian and Dominican Republican music. Everyone back in Hinche asked if I danced. I said no because I didn't know how to dance like a Haitian... dance lessons are underway so maybe next time!

The travelers posing at the Citadel.

Posing at the Palace, a stop below the Citadel.

The story must be heard

Credited to Cheryl Hanna-Truscott

Waiting to be seen at the hospital.

Happy Valentine's Week! Haiti doesn't celebrate the day of love, but it does celebrate Carnival (translated as "Meat Farewell" in Creole), which is the Holy Month kick-off for the country. It's in Cap Haïtien on the northern coast of Haiti. I'm heading up there tomorrow afternoon and will include that trip in my next post!

I've been learning the ins and outs of a web designer program called Joumla. It's been a true test of my patience, but it has to be done. I have taught myself how to edit, create, and format articles and menus to put onto the Midwives For Haiti Website. I recently added the "Matròn Outreach Program." Check it out!

 I can't tell you how much of this program relies on social media. Volunteers have told us that all they did was do a quick Facebook or Google search to learn about the program. I'll get over my frustrations for monthly donations and new volunteers any day.

Newborn getting weighed in our labor and delivery room.

 Speaking of social media, I wrote the February E-Newsletter that goes out to all donors, volunteers, and the like. You can sign up to receive this on the MFH website.

As I mentioned in my last email, I am taking over the volunteer communication and planning process. This week has involved a lot of computer work, updating document after document after document.

Group photo with my housemates.

Aside from the general upkeep and public relations, I have been becoming a bit of a baker. This past week, I took our "off-the-street" hand ground peanut butter and baked some Haitian-style peanut butter cookies. They weren't too bad (at least to anyone with a sweet tooth). I have homemade brownies and dump cake in my repertory as well. I've been thinking about adding that to my "Skills" list of my CV. What do you think?

At the Women's Co-op checking out their embroidered work.

If you haven't been following us on Facebook or Twitter, you missed out on some great news the other day. We had 95 women come to our mobile clinic for pre- and post-natal care. That's a record high. The word is getting out, and more and more women are getting care.