Then and Now

Midwives For Haiti’s mission is the reduction of maternal and neonatal mortality in Haiti.

Haiti has the highest maternal mortality in the Western hemisphere. This is largely due to the lack of skilled birth attendants to assist women with their pregnancies and deliveries.

95% of the poorest one-fifth of women do not have skilled help at their deliveries.

Without skilled care pregnant women are at risk of dying from postpartum hemorrhage, eclampsia, obstructed labor or infection.

Maternal Mortality 350 per 100,000 Births

“Instead of comparing our lot with that of those who are more fortunate than we are, we should compare it with the lot of

the great majority of our fellow men. It then appears that we are among the privileged.”

Helen Keller

Simeus’ first wife died during childbirth and his newborn son died a few months later.

Simeus’ second wife, Ismerelda, delivered her youngest daughter in 2012 with the help of a Midwives For Haiti graduate.

The number of orphaned or abandoned children in Haiti can only be guessed. Before the earthquake it was estimated to be 380,000 and after the quake the number at least doubled.

The death of a woman in childbirth puts the lives of all of her children at risk.

Ismerelda , Simeus and Children Outside Their Home

“Your children are not your children. They are the sons and daughters of Life's longing for itself. They came

through you but not from you and though they are with you yet they belong not to you.”

Khalil Gibran

Midwives For Haiti had a very simple and humble beginning. In 2006 a few midwives led by Nadene Brunk came to Hinche, Haiti to educate 9 Haitian women as skilled birth attendants. These women were being trained to work in a birth center that was under construction.

Those women would never work in that birth center but a greater vision was born. They became the first of many classes that would go on to serve women all over Haiti.

The way forward was not clear but the need was seen with great clarity. Women would continue to die needlessly until there were more midwives in Haiti. The essential question was “If we don’t do this who will”?

Midwives For Haiti’s First Classroom

“For me, an area of moral clarity is: you’re in front of someone who’s suffering and you have the tools

at your disposal to alleviate that suffering or even eradicate it, and you act.” Paul Farmer

Our first school was located in a rural area. Homes were simple and without running water or electricity. The best structures had tin roofs and concrete floors. The worst dirt floors and roofs open to the sky. In the U. S. those structures would not be used to house animals.

Getting to the hospital took a 1-2 hour walk. Once there a woman was unlikely to find an obstetrician or midwife to care for her after 4pm or on weekends. The hospital was little used by women in labor. They did not feel safe there.

The doctors and nurses at the hospital had the knowledge to care for patients but not the means.

Rural Haiti

The first question which the priest and the Levite asked was: 'If I stop to help this man, what will happen to me?'

But... the good Samaritan reversed the question: 'If I do not stop to help this man, what will happen to him?'

Martin Luther King, Jr.

The hospital in Hinche is government run and free of charge but everything was in short supply in 2006. This included medications , electricity and water.

Conditions at the hospital have improved in 2013. The maternity wards are better staffed because MFH pays the salaries of 11 midwives and the hospital is able to pay 5 more. Electricity and water are now available most of the time. Medications are usually found in adequate supply although there can still be isolated shortages. For instance, sometimes the hospital has no spinal anesthetic medication.

That the hospital functions as well as it does is impressive given that the per capita health care expenditure in Haiti is just $79 per year. In the U.S. it is $8,233.

St. Thérèse Hospital Hinche, Haiti

“The poorest parts of the world are by and large the places in which one can best view the worst of medicine

and not because doctors in these countries have different ideas about what constitutes modern medicine. It's

the system and its limitations that are to blame.” Paul Farmer

When the rainy season came it was necessary to find a place indoors to hold class. We were able to find space in a small room in the laundry of the local hospital. In Haiti you make do with what you have.

Midwives For Haiti’s Second Classroom

“Ignorance is the curse of God; knowledge is the wing wherewith we fly to heaven.”

William Shakespeare

In 2007 our small annual budget was reflected in the condition of our transportation.

This Toyota truck is 33 years old. It is held together by duct tape, wire and the ingenuity of our driver Ronel.

One day the drive shaft fell on road when the universal joint broke. Ronel had the truck going again in 90 minutes.

Making Do and Getting By

“You must do the things you think you cannot do.”

Eleanor Roosevelt

Now

MFH students learn to treat life threatening complications. Here students are starting an IV and giving magnesium sulfate to a woman having eclamptic seizures. This woman survived. Her baby did not.

High blood pressure during pregnancy (pre-eclampsia) is the most common complication of pregnancy and its more advanced form, eclampsia, the leading cause of maternal mortality in Haiti.

Eclampsia can only be prevented by making prenatal care available to all pregnant women.

Emergency

“Half a million women die each year around the world in pregnancy. It's not biology that

kills them so much as neglect.” Nicholas D. Kristof (author of Half the Sky: Turning

Oppression into Opportunity for Women Worldwide )

Midwives treat burns a patient received from a “traditional medical therapy” commonly used after a delivery.

Without a skilled birth attendant pregnant women are cared for by family members or a traditional birth attendant (TBA). In Haiti TBA’s have no formal training and may resort to treatments that are ineffectual or harmful.

First Do No Harm

“If you can, help others; if you cannot do that, at least do not harm them.”

Dalai Lama

Prenatal care is vital to the health of women and babies.

The pink jeep (a significant improvement over Ronel’struck!) carries our midwives to 16 rural villages each month to provide this dependable service for woman who do not have access to medical care.

In the first 3 months of 2013 our midwives saw 897 women and made 10 emergency transports to the hospital.

Mobile Prenatal Clinic

“A little knowledge that acts is worth infinitely more than much knowledge that is idle.”

Khalil Gibran

The mobile prenatal clinic midwives examine each patient, determine a due date, screen for high risk problems and provide education.

Caring, Compassionate, Competent

“The purpose of human life is to serve, and to show compassion and the will to help others.”

Albert Schweitzer

Every woman attending the prenatal clinic receives vitamins, iron supplements and treatment for intestinal worms. Women with chronic hypertension, a common problem in Haiti, receive anti-hypertensive medication.

Traveling Pharmacy

“Gardeners know that you must nourish the soil if you want healthy plants. You must water the plants adequately, especially

when seeds are germinating and sprouting, and they should be planted in a nutrient-rich soil. Why should nutrition matter less

in the creation of young humans than it does in young plants? I'm sure that it doesn't.”

Ina May Gaskin

Each patient is tested for HIV, syphilis, gonorrhea, chlamydia and malaria.

Patients with HIV or syphilis are referred to the hospital for further testing and treatment.

Patients with gonorrhea, chlamydia or malaria are treated by the midwives.

Without the mobile prenatal clinic these infections would go untreated risking the health and life of mother and baby.

Rapid On-Site Lab Tests

“I still believe in a place called Hope.”

William J. Clinton

At $10 an exam, the mobile prenatal clinic is our most expensive activity. We believe it is priceless because of the lives it has saved.

Priceless

“Be kind whenever possible. It is always possible.”

Dalai Lama

The hands that deliver a baby in Haiti are usually those of a matrone, Haiti’s traditional birth attendant.

75% of pregnant women in Haiti deliver without a skilled birth attendant. Matrones do not have the training or medications needed to treat eclampsia or postpartum hemorrhage, the leading causes of maternal death in Haiti.

Matrones do have the trust and respect of women in their community and need to be part of the solution.

Connecting With Tradition

“God has given us two hands, one to receive with and the other to give with.”

Billy Graham

These matrones were among the 30 that attended our first matrone training program. This 20 lesson course taught techniques for performing a clean birth and how to identify danger signs in pregnancy. The matrones are encouraged to bring their patients to the hospital and they are allowed to stay with them while in labor.

By reaching out to Haiti’s traditional birth attendants we bring them into the medical community and improve the care that women receive.

Fort Resolu Matrone Class of 2012

“You are never too old to set another goal or to dream a new dream.”

C. S. Lewis

These women are graduates of the Midwives For Haiti program who now work at St. Therese Hospital in Hinche.

47 graduates are now working in 14 locations around Haiti. Midwives For Haiti graduates have an employment rate of 85%. This is remarkable in a country with an unemployment rate of 40%.

Of course we are thankful for the care these midwives give to their Haitian sisters but we are equally grateful for all of the other benefits that come from work. A secure income for themselves and their families is the obvious benefit and cannot be overestimated in a country without an economic safety net. Yet it is the confidence, dignity and professional pride that comes from their work that changes their lives the most.

Education Brings Employment

“All labor that uplifts humanity has dignity and importance and should be undertaken with

painstaking excellence.” Martin Luther King, Jr.

Few people that visit Haiti remain unchanged. Haitians endure hardships that are unimaginable to most Americans and they do so with grace. Material things mean less and personal relationships mean more. Even in deprivation there is a sense of being protected by the favor of God.

The Spirit of Haiti

“Spiritual relationship is far more precious than physical. Physical relationship divorced

from spiritual is body without soul.” Mahatma Gandhi

We need midwives, labor and delivery nurses, obstetricians, pediatricians and nursepractitioners (family practice, pediatric, and women’s health) to work with us inHaiti. Volunteer online at www.MidwivesForHaiti.org.

Most of our donations come from people like you. Our average donation is about$450 but any donation helps us train midwives and bring skilled care to women inHaiti.

Please lend your support. Donate online.

“A small body of determined spirits fired by an unquenchable faith in their mission can alter the course of history.”

Mahatma Gandhi