It seems like a lifetime but we have only been here for a week…. but what a week!!
Our flights were fine if a few too many! We survived the dreaded transfer between airports despite being warned by an elderly American missionary Dr behind us in the immigration queue that it was utterly inadvisable due to the small risk of kidnap. It was a bit intimidating to say the least but we knew it was going to be and so braced ourselves. After having to extract our not inconsiderable amount of luggage from a pile – literally a pile with everyone swarming through it – it was like a sort of suitcase armageddon, we piled it all onto one trolley and attempted to push it out of the exit which was no mean feat considering the size of it! As soon as we got out of the airport it was absolute sweaty blinding chaos. about 10 men trying to earn their $1 by grabbing your bag and a million taxi drivers fighting over you. We chose a woman in uniform, standing and looking official- this is a relative term. She lead us to a taxi driver in the car park. He had an ID badge and seemed like a respectable older chap- so we got in the car after paying off the 15 porters, and negotiating the taxi fare, down to a judicious double what it should have been.
The journey was very very short and ended with another cluster of porters hauling our bags out of the taxi before we had a chance to even stop properly. There was quite a nasty fight between two guys over one bag. The domestic airport was not well equipped for our four hour wait. We had to (using a variety of French, sign language and desperation) send someone to buy us bottled water as the only beverage on sale was fruit brandy. Which retrospect would have been apt preparation for the coming flight. Several ranks of broken chairs and we were initially the only “blan” (all white people) there. But our stuff got onto the plane (probably because we were four hours early!!) and we sat and played cards and sweated quietly… We met a wonderful 65 yr old missionary called Carol-Ann Truelove – she had lived in Haiti since 1975 and had 24 children (mostly adopted Haitians). She was a midwife and a nurse and her only nod to old age was reducing the amount of long motorbike rides she would endure. She was pretty awesome.
The plane ride was in a word. Terrifying. The plane was so full of luggage at one point shortly before take off Nina didn’t have a seat, a short reshuffle later one was uncovered. It was late afternoon and stormy and even the locals were looking a little nervous – the 12 seater plane dropped clean out of the sky about every 5 minutes and we spent most of the journey in thick cloud which occasionally parted to reveal enormous mountains! Eeeep! Breathing a huge sigh of relief we landed in Cap Haitian airport – which was one not very big building with holes in the side for luggage to be posted through.
M’rive Ayiti nan!
Moses the taxi driver picked us up and we wove crazily through the streets of Cap Haitien. Its very much as we expected, concrete buildings crammed with people and signs and gutters overflowing with rubbish, crazy traffic and lots and lots of people and all under the broiling sun. The road almost unimaginably pot holed, with cars veering clear across to the other lane to avoid minor canyons in the road. It is a question of the smaller the faster with moto’s overtaking cars overtaking taxis overtaking school buses overtaking lorries- in two directions on both sides of the road. We arrived a little travel weary at MBH, sweaty and generally a bit frazzled. The place is big and is inside a compound with a big two storey building,housing clinic rooms downstairs and accommodation upstairs. There are shade houses (like the opposite of greenhouses 🙂 that Rachel and I have taken charge of ripping out and planting again), there are banana and mango trees and tonnes and tonnes of Basil that Dr Zeenia has planted. Things grow so vigourously here! One of the many basil plants is waist height (on Rachel) and almost as wide, the lemongrass could hide a small child within.
There is a family who live in another building. Dupliese is the cook and her husband Jason is the guard, their son Junior does the gardening and is generally handy – there seem to be lots of other relatives and occasional visiting neighbours but until our Kreyol improves we cant put the puzzle together. Rachel and I have a large dormitory style room to ourselves but sleep under nets out on the balcony where you have an amazing canopy of stars and it is marginally less sweaty!
Marie Charles the midwife lives here too and so does Santo the translator. His little 14 yr old cousin is staying at the moment too – she is very sweet, speaks good french and is generally fascinated by the “blan”. We make a welcome distraction from her homework.
Mamas and Babies (and Famn Saj’s)
Marie runs a clinic every day and MBH have got a translator called Elize to work with us which is really helpful. There are generally about 20 women waiting at the gate every morning to be seen so its a long day. She is also on call for any births (we had one during clinic the other day – just as you do. (Cannot imagine that happening in the UK). Marie speaks French so we spend our days speaking our cobbled together schoolgirl french with her and filling in the bits that we are learning in Kreyol (also sometimes in desperation just saying things in a French accent – worth a go and it sometimes works!). We have asked for some Kreyol lessons from Santo the translator as it will help us get up to speed. We are starting to understand more and more every day as we hear the same words over again in clinic- often the words we hear in English every day when in clinic.
It’s a big shock though. There is no referral system – we see several women each day who really, really urgently need to be in hospital (i.e. a community midwife in the UK would have put her in an ambulance – 2 + of protein and a BP of 240/130). The saddest so far was a 17 year old girl. She was a domestic servant and had no family. She also had quite severe learning difficulties. It sounded like she had been raped and was now about 35 weeks pregnant. She had something called Olighydramnios – where basically the placenta isn’t working well and there isn’t enough water around the baby – the baby was literally outlined clearly and when Rachel and Marie palpated her abdomen neither could feel any fluid. It was almost certainly linked to malnutrition and the prognosis isn’t good, there is simply no way she could afford to go to the hospital. Marie wrote a letter to the doctors there and we gave her vitamins and a bag of food supplements. It was unbelievably depressing- even if we help in the short term, in the long term it is hard to see how she ill feed her child when she cannot feed herself. Nearly all the women we see here are malnourished and about 90% are anaemic. When you ask them how many times they eat in a day they look embarrassed and say that when they find food they eat it.
We also had a girl collapse in the waiting room and she appeared to be fitting but we were relieved to find she was actually ‘only’ hyperventilating- and had been for a week. She quickly regained consciousness and we did all we could – i.e. Marie cannulated and got some fluids up but she had had chest pain for about a week and her respiration rate was ridiculous, near 100 breaths per minute (try it). She was scared and there was nothing really that we could do. We sent her to hospital on the back of a motorbike with a family member holding her bag of fluids up. That is the reality here.
Marie says that there is someone like this everyday and her heart so obviously breaks every day when she can do so little for them. A lady came at the end of clinic on thursday and Jason let her in thinking she was in labour and should be seen quickly. We quickly realised that she wasn’t contracting but was in severe constant abdominal pain with abnormal abdominal swelling that increased and a low-grade fever that rose as we sat with her, she had also been bleeding that morning. The baby sounded fine but for how long we couldn’t say. Everything closed down on Thursday because of the news of the coming cyclone and so when they tried to find a tap-tap (local transport – a pickup with a sort of hut welded onto the back) for her they couldn’t. Her young husband had apparently been to market to sell a cow and had to wash and change before coming to get her (!) we all sat with her as it got dark and her sister kept calling the husband and telling him to hurry. She eventually was propped up on a motorbike and we won’t know what happened to her unless she comes back and tells us.
But sending these women to the hospital isn’t really any sort of better option. The training of the Drs isn’t great here. It is extortionately expensive to be treated and you have to send your relative to the pharmacy to buy your drugs for you. It’s expensive so they often buy from people on the street. Needless to say there is no way of telling what they are getting in those grubby plastic bags. And if they can’t pay….well. But that is how it is and if you start to focus on all the bad stuff then that is all you see. It is important to remember that although MBH cannot save everyone, it saves many, giving women a place to birth their babies who would otherwise have nowhere but home to go.
But we are learning so much each day. We are already seeing that there are small things we can do to help in helping Marie access resources and discussing our ‘up to date’ breastfeeding skills. We are also going to one of the slum districts called Chada on this coming Thursday to meet a traditional birth attendant called Madame Bois. We are both very excited about that.
It is amazing that these women have access to Marie’s and soon another long-term American midwife volunteer here, and another Haitian midwife is rumoured to be on the horizon. It is obvious that it makes a big difference.
Thank you for continuing to support us!
The work of MBH is amazing. Please encourage your friends and family to read our blog and donate via their website! They rely on donations for every single thing here. Even the most basic things like prenatal vitamins and iron can make a huge difference to individual outcomes.
We are having some issues with photo uploading at the moment but hopefully in the next post! Watch this space.
Lots of love from beautiful Haiti.
Nina and Rachel