I've clearly been busy, and as you can infer from the post title, things have been both good and bad, back and forth. Let me explain.
Last week, Nadene came. Nadene is the Founder and Executive Director of Midwives for Haiti. She is so inspirational, enthusiastic, and compassionate. She takes the burdens of our students and staff upon herself -- for example, not only does she work day and night to fundraise for our midwifery school and mobile clinic and future birth centers, etc., etc., but she takes it upon herself to find people jobs, give people loans, and deal with the small concerns people have. When she's in Haiti, I am her personal secretary and her listener, I am her follow-upper and her minion -- and it's great, really! She has all the answers, and if she can't come up with one immediately, she will silently ponder it and come to a logical, sound decision once she's talked it over and really thought it through. She speaks her mind and thinks aloud all day long. Oh, and she makes incredible homemade bread. It's truly a pleasure to have her around, because although her daily meetings and frequent transportation/translators keep me really busy, I really do feel much more confident while she's here. But Nadene didn't come alone -- she came the same week as a group from Ohio State who is beginning a NICU. What a huge project!! It's so exciting, but wow is it going to be a ton of work. They came with 2 adult representatives, and 2 recent high school graduates who were beyond cool. I'll add more about their project in another post. The same week they were here, a volunteer named Nicole was here, working on a research project regarding neonatal resuscitation simulation. A group called Haiti's Kidz came, 5 women from the Virginia area, to provide primary care from a set of their own supplies that they ship down and store here. Count it: eleven people. Oh, and then this incredible woman named Stefanie came for the night to see what we do. Turns out, her organization, CIDA, the Canadian version of USAid, funds 7 of our midwives at the hospital. Wow.
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| Liz came with Haiti's Kidz and this was her first moto ride! |
Everyone left on either Wednesday or Friday, except for Nicole, who did her experiment on Friday and Saturday. The first Friday of each month brings a few exceptions to the average week. Not only do we have our usual matron class and case study, but there is a continued education class for our 5 past classes of midwives. Usually volunteers or Nadene run the continued education, and they talk about whatever they feel confident in. Nicole planned to talk about nutrition (she is a naturopathic doctor and a midwife student), but as soon as the students heard about her research project (and the monetary compensation), they insisted upon doing that first. This required us to physically run to get photocopies made, speed home, find 30 pens, move the case study elsewhere, and give a 2-hour exam to a bunch of chatty midwives. It was crazy, but Nicole was so happy she had tons of participants, and with Gladias's help, it all went really well. That afternoon was full of meetings and then my usual Friday dance lesson. I'm proud to say that I know the Cha cha cha. Tura, my teacher, filmed us dancing and it's pretty comical. I'm not half bad for having no prior dance experience, but I definitely wouldn't know which direction to go if he weren't physically pushing me the right way. Saturday was great, because Nicole took the whole upstairs to do her simulations. I took nothing but my computer downstairs and answered emails all day long. It sounds like a horrible day to most, but I felt so much better after!
Saturday, a volunteer named Shauna came. She is a CNM, a Certified Nurse Midwife, which is exactly what we like to see! She and Nicole have been switching off between mobile clinic and the hospital all week, and working as quite a team when they're together in the L&D (labor and delivery) room. This week was full of great stories from them, meanwhile I ran around trying to find the hospital Medical Director. I never found him.
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| The hospital at Mirebalais is decorated with tons of metal work done entirely by Haitians. Though the patterns repeat somewhat, every disk like this is unique. There are 300 of them. |
Yesterday was a huge day for me. I spent the morning running errands, as usual, and then went to the hospital to find some people (the Medical Director...again). Right as I started to leave, Nicole called to me from the L&D room. 2 women were about to give birth, and she wanted me to see them. Davide said he would wait, so I walked in and gingerly sat on the edge of a desk in the middle of the L&D area. There are 4 rooms, one for storage or something, 2 with one bed each, and one room with 2 beds. Two poor women have to watch each other labor and deliver -- you work with what you've got. Shirly is our translator for the L&D room -- they don't like men -- and she's great. She is sassy and sarcastic, secretly love L&D, and apparently "rules the roost," as Nicole says. She shows the midwife students what to do, is constantly grabbing supplies for people, and is not technically medical personnel! We all think she should be in our next class of midwives, because she would be incredible. Anyway, Miss Anise, the head nurse, shooed some family members of the laboring women out, looked at me, and then left -- so apparently it's okay that I was in there! Philomène, a mobile clinic midwife working at the hospital because the jeep couldn't cross a river to get to mobile clinic that day, pulled out a chair for me. I waited a long time for some babies, and Nicole kept giving me updates. During a sort of lull, while we were waiting for some cervixes to dilate (this stuff is probably less casual in the real world, but I hear this stuff 24/7 so here it is), Nicole showed me a patient I'd heard about a few days ago.
Philogène (not Philomène) had come into the hospital last week and had undergone a Cesarean for premature twins who were at 34 weeks. The mother had then gone into respiratory distress, was given some blood and some drugs, and was basically left in post partum with her preemie twins. Because our hospital lacks a NICU, these otherwise healthy preemies were pretty much left on a bed beside their unconscious mother. The midwives had finished their work with her, the Obstetricians didn't know what to do with her respiratory issues, no one had diagnosed her, and no one knew where to refer her. She is technically an Ob patient, because she was a Cesarean post-op patient, but her problem was not in the realm of Obstetrics or midwifery. Thanks to Nicole and Shauna, she was transferred to the ICU, where, unfortunately, no one knew what to do with her. What our volunteers deduced is that after her C-section, her body had too much fluid (common in pregnant women, which is why their feet swell and they urinate a lot right after pregnancy), but her heart had been working so hard from the other 9 children she'd birthed, plus the pregnancy with these twins, that it could no longer work. Her lungs began to fill with fluid, i.e. she began to drown. When I saw her, she'd been knocked out by morphine and was hooked up to a nasal cannula with oxygen -- even though she clearly needed a mask. Nobody was attending to her. Her tiny baby girls were laying unattended on a bed next to her. The patient's husband was holding their toddler near the patient's bed, but not dealing with the twins. They hadn't been fed that day. Nicole and I each picked one up and found some milk, but the babies were too lethargic to really eat. The mother wasn't able to breast feed (obviously), nobody was pumping her milk, and although her 16-year-old daughter had recently given birth and was still breastfeeding, the hospital didn't want her to help out her little sisters. So the twins didn't eat until the Americans fed them. Although it was a really sad situation, it was absolutely incredible holding such tiny babies. I'll add another picture as soon as Nicole sends me one!
In the evening, we drove out to Mirebalais, where Partners in Health/Zanmi Lasante (PIH/ZL) just built a brand new, beautiful, top-of-the-line (for Haiti) hospital. It's called HUM for Hôpital Université Mirébalais. We met a young woman named Regan, an American in charge of the ER who played a major role in planning the hospital and stuff. She seemed pretty important. 25 million dollars of grant money built an incredible hospital by Haitian standards, with the majority of supplies having been donated by major companies such as GE. Let the pictures speak for themselves -- and keep in mind that Haiti is the poorest country in our hemisphere.
The biggest part of this trip was talking about our patient, Philogène, and what we could do with not only her case, but future cases like hers, where our hospital lacks sufficient staff, knowledge, and equipment to treat well. We came up with a protocol and will be sharing that information with our hospital staff. Unfortunately, the permission and protocol came on Friday, but poor Philogène didn't make it through the night. I don't know what will happen with her twins but maybe I'll just go take them.......... (I'm kidding, chill, Mom). I personally don't think they will make it, and I don't know what her 11 children will do without her.
The last bit of exciting news is that one of our best translators and probably my best friend here got his Visa and is going to college in the US! Gladias has been translating for MFH for several years now, at our mobile clinics, in the hospital, in the classroom, etc. He's also a great friend to not only me (and Carrie, of course), but to all of the volunteers, as well. He loves getting to know new people and is always up for the disco, the market, etc. He's such a window into Haitian culture, because he understands American culture pretty well and can tell us what is and isn't appropriate. At this point, my Creole is decent enough that I can pretty much get around on my own, but I take him along on errands and to meetings for moral support. He's great. Anyway, he's been accepted to NOVA, a community college in Virginia, where he's hoping to be a Pre-Med. He wants to become an Obstetrician and then come back to Haiti to practice. I have no doubt that he will make it -- he already knows everything about midwifery and pregnancy/birth anyway. It's a huge deal for a Haitian to get a Visa to study in the US, and he's got tons of people rooting for him. Best of luck to you, Gladias! MFH and I will miss you to pieces.
More pictures to come soon! Internet struggles....
Philogène (not Philomène) had come into the hospital last week and had undergone a Cesarean for premature twins who were at 34 weeks. The mother had then gone into respiratory distress, was given some blood and some drugs, and was basically left in post partum with her preemie twins. Because our hospital lacks a NICU, these otherwise healthy preemies were pretty much left on a bed beside their unconscious mother. The midwives had finished their work with her, the Obstetricians didn't know what to do with her respiratory issues, no one had diagnosed her, and no one knew where to refer her. She is technically an Ob patient, because she was a Cesarean post-op patient, but her problem was not in the realm of Obstetrics or midwifery. Thanks to Nicole and Shauna, she was transferred to the ICU, where, unfortunately, no one knew what to do with her. What our volunteers deduced is that after her C-section, her body had too much fluid (common in pregnant women, which is why their feet swell and they urinate a lot right after pregnancy), but her heart had been working so hard from the other 9 children she'd birthed, plus the pregnancy with these twins, that it could no longer work. Her lungs began to fill with fluid, i.e. she began to drown. When I saw her, she'd been knocked out by morphine and was hooked up to a nasal cannula with oxygen -- even though she clearly needed a mask. Nobody was attending to her. Her tiny baby girls were laying unattended on a bed next to her. The patient's husband was holding their toddler near the patient's bed, but not dealing with the twins. They hadn't been fed that day. Nicole and I each picked one up and found some milk, but the babies were too lethargic to really eat. The mother wasn't able to breast feed (obviously), nobody was pumping her milk, and although her 16-year-old daughter had recently given birth and was still breastfeeding, the hospital didn't want her to help out her little sisters. So the twins didn't eat until the Americans fed them. Although it was a really sad situation, it was absolutely incredible holding such tiny babies. I'll add another picture as soon as Nicole sends me one!
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| This is one of the preemie twins. How precious! |
When things got a bit more exciting in the L&D room, I went back. In one room, a woman was waiting to get a C-section. Though nothing was really wrong with her or her baby, she was moving along slowly. The bed had been brought in, but we were waiting on something (who knows what), and she went into labor before anyone could pay any attention to her. It came really suddenly, so Nicole and Shauna jumped right in. Our midwife students didn't even have their gloves on, but Nicole yelled to me and Philomène pulled me right into the room with them! The baby got just a tiny bit stuck, so he was flat-out blue when he came out. There was some resuscitation done on the part of our volunteers, but otherwise things seemed to go pretty smoothly. How cool it was to watch my first birth!!
In the evening, we drove out to Mirebalais, where Partners in Health/Zanmi Lasante (PIH/ZL) just built a brand new, beautiful, top-of-the-line (for Haiti) hospital. It's called HUM for Hôpital Université Mirébalais. We met a young woman named Regan, an American in charge of the ER who played a major role in planning the hospital and stuff. She seemed pretty important. 25 million dollars of grant money built an incredible hospital by Haitian standards, with the majority of supplies having been donated by major companies such as GE. Let the pictures speak for themselves -- and keep in mind that Haiti is the poorest country in our hemisphere.
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| We brought Gladias along for fun, and Ronel is our jeep driver |
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| "Corn on the cob" Haitian style. It's cooked so much that it's more like chewy popcorn. It's good, though! |
The biggest part of this trip was talking about our patient, Philogène, and what we could do with not only her case, but future cases like hers, where our hospital lacks sufficient staff, knowledge, and equipment to treat well. We came up with a protocol and will be sharing that information with our hospital staff. Unfortunately, the permission and protocol came on Friday, but poor Philogène didn't make it through the night. I don't know what will happen with her twins but maybe I'll just go take them.......... (I'm kidding, chill, Mom). I personally don't think they will make it, and I don't know what her 11 children will do without her.
The last bit of exciting news is that one of our best translators and probably my best friend here got his Visa and is going to college in the US! Gladias has been translating for MFH for several years now, at our mobile clinics, in the hospital, in the classroom, etc. He's also a great friend to not only me (and Carrie, of course), but to all of the volunteers, as well. He loves getting to know new people and is always up for the disco, the market, etc. He's such a window into Haitian culture, because he understands American culture pretty well and can tell us what is and isn't appropriate. At this point, my Creole is decent enough that I can pretty much get around on my own, but I take him along on errands and to meetings for moral support. He's great. Anyway, he's been accepted to NOVA, a community college in Virginia, where he's hoping to be a Pre-Med. He wants to become an Obstetrician and then come back to Haiti to practice. I have no doubt that he will make it -- he already knows everything about midwifery and pregnancy/birth anyway. It's a huge deal for a Haitian to get a Visa to study in the US, and he's got tons of people rooting for him. Best of luck to you, Gladias! MFH and I will miss you to pieces.
More pictures to come soon! Internet struggles....
