I've now been exposed to words and ideas I had never been exposed to or knew existed. This past week the Midwives for Haiti house was visited by a team from Ohio State University. It was from this group that I heard a subject I had never heard before- “Global Health.” The phrase and the subject of “Global Health” is now in my repertoire. It is now swirling in my mind and burning in my heart. I want to know more, understand more, and be more actively involved long term.
I've observed many things while being in Haiti, but there are three observations that are glaring:
- The chicken egg yolks.
- Gestational Hypertension and preeclampsia.
- Haitian poop. (At least the poop of birthing women)
Haitian egg yolks are lacking color. They are very pale and nearly white. In comparison to our fresh, free-range, Goldenrod Yellow-Orange yolked eggs we get back home, the difference is shocking. I find myself wondering what nutritional value the Haitian eggs contain in comparison to back home, as well as other places in the world.
Haitian food is delicious in it's own right, but it is far from a well-rounded diet. The Haitian diet is lacking in fresh, green, leafy vegetables, and fresh fruit. Most meals consist of a small portion of meat (here in Hinche, this has been goat meat for nearly every meal. On occasion we will have chicken. Beef is expensive.), white rice, and beans. If there is any vegetable present, it will likely be a root vegetable- carrots or potato. There are no fresh heads of lettuce or spinach for salad. Non-root veggies are either not available or just too expensive for most people to afford.
As any birth attendant knows, with birth, sometimes shit happens. Quite literally.
As a midwife, usually the presence of poop is welcoming. As the baby descends, it puts pressure on the rectum. In order to be born, babies have to maneuver through the pelvis and birth canal. Any available space is needed. If there is anything in the way, it will be expelled. This is a natural mechanism of birth.
The first time I saw a Haitian mom's poop, it caught my attention. I disregarded it as just that mom. Then I saw it again. And then again. It was lacking color and pale and soft- and forgive me for the detailed account of poop, but it looked like hummus. I wondered why this was.
If you have a diet that is lacking protein, iron, and so many essential minerals and vitamins, what do you think that means for women during pregnancy, and ultimately their babies? Poor diet is associated with a higher risk of poor outcomes- preterm labor, preterm delivery, small for gestational age babies, and possibly, complications such as preeclampsia.
What is the solution for this? It's not people from a rich, developed country donating prenatal vitamins and iron supplements. Short term, yes. But that's not the long term solution.
Isn't it interesting how every facet of the environment and country is intertwined? It's an agriculture problem. No, wait, it's a sanitation problem (you can't grow agriculture in polluted, unsanitary conditions, with unclean water). No, it's an infrastructure problem (what do we do when there is no water systems, no electricity?) No, it's an economic problem. (How can people grow when they don't even own land? When they have no money to start a business? How can the consumer even have access to a high(er) protein, fresh, well-balanced diet, when they have no job and therefore no money?
It's easy to come up with answers and solutions. Until you're here and you see that you can't have one without the other.
And that's where I'm at with that. Just recognizing the connection between everything, and that the solution is not easy. The wheels are turning in my mind and I want to know more though...
We learned in our first week what we should have honestly known already, based on the high maternal and infant death rate here in Haiti. Maybe we are slow learners, but we learned that a healthy, low-risk mom, with a healthy birth is the exception. Hypertension and preeclampsia is rampant here. And even with a seemingly healthy mom, I would not go as far to say that that is even low-risk, as nearly every baby we have “delivered” here has been preterm, IUGR, or SGA. I'm pretty sure my mouth would drop if I had a 7 pound baby come out.
Compound all that with the lack of skilled midwives and we're in a crap shoot.
Right now though, we (we as in me, you, everyone) have the ability to help. If you are a health care professional- a doctor, a midwife, a nurse, a sonographer, etc.- you have knowledge and skill to share and teach, which will ultimately improve outcomes. If you are not a health care professional, you can help by monetary donation, which can go to running programs such as Midwives for Haiti or even sponsoring a Haitian in going through the training to become a skilled birth attendant.
It's a start.