Haiti 2015: Day 1 & 2

We arrived into Port-Au-Prince on Saturday afternoon and made the long, winding journey to Hinche by way of the Midwives for Haiti Land Cruiser. I will admit that I was a bit excited about the travel accomodations, as we have always received transportation in the classic, "Pink Jeep." The enclosed air conditioned vehicle was a welcome repreive from our 20 hours of travel from Alaska, and especially knowing how I get with motion sickness. We would, however, find out that the air conditioner isn't functional. Ha! We packed into the back of the Land Cruiser and within about 20 minutes the first passenger was feeling sick. Thankfully, it wasn't me (yet). I got out the peppermint oil from my purse and Glen got out a rag, which we wet and put on the back of the other volunteer's neck. The rest of us rubbed peppermint on the backs of our necks to help us cool down. The cooling sensation felt amazing in the dense heat we were sitting in. Of course not long after that, I was the next victim of the trecherous journey. The constant swerves, bumps, and horns ablaze from other vehicles flashing by was taxing on my senses and internal stamina. I quickly turned 'green,' earning myself a front seat accomodation, right alongside our driver. I laid back in my seat, splashed water on my face, closed my eyes, and let the wind blow in my face. 2 1/2 hours from that point, we had made it safely to Hinche, and I had made it without vomitting...as did Lea, my partner in sickness

Sunday was our first full day here, and the beginning of a night shift at St. Therese. A group of us rode on motos into town and attended church service.

Volunteers Lea and Shelly

After church Glen and Camille (our clinic RN back at home, who joined us this trip) took a tour of Hinche. I stayed behind to rest and gear up for night shift. Camille would return, slightly aghast, telling stories of the food she saw in the open market- fruits, meats, fish, all swarming with flies. She held serious concern for Glen, and made sure to report back that he had been eating these items, without concern for what might subsequently happen from ingesting flies and larvae. Glen assured us that it was delicious and he was fine. 20 minutes later I was downstairs eating a late lunch and Camille came flying into the dining area, wide-eyed, as if she had just seen a ghost. She said to me, very much an exclamation rather than a question (because she already knew the answer), "Tara! WHERE IS DR. ELROD!?" (It's funny to me that more times than not, she still refers to him as 'Doctor Elrod,' rather than Glen.)

Amusingly, I had already heard him from downstairs and knew exactly where he was. He is, afterall, the world's loudest puker. I responded with, "Oh, he's upstairs puking." Camille's eyes were as wide as saucers, and just like that, it pretty much validated Camille's hesitance to consume anything out of the ordinary. But don't worry about Glen...it was delicious...and he's fine. ;-)

Glen trying some dried herring in the marketplace.

We arrived to the hospital shortly after 7:00pm, and within minutes had assisted with two deliveries. The first baby the Haitian midwife delivered, Camille and I would assist, and Glen would subsequently suture the mom's laceration. Camille helped to stimulate the baby and I tied the cord with string. Camille would do the newborn exam and dress the baby, all while Glen and I pushed with the mom 5 feet in front of the first mom who delivered. As Camille was doing the newborn exam, she noticed that it was oozing and had to re-tie it, tighter than what I had tied. Good catch, Camille.

The postpartum mom would lay there on her own delivery table, legs sprawled and perineum torn, raw from just having given birth, quitely observing the other woman preparing to do the same. I stepped over to her and made sure she understood, "We don't want to start to suture you right now, so that we are prepared for this baby. As soon as this baby is born, we will get you sutured and dressed." She smiled and nodded, appreciating the explanation. Camille took her vitals and tended to the baby while Glen and I assisted the other mom. The Haitian midwife charted, and attended to the other packed room of laboring women.

Camille and a new Haitian life

A healthy baby girl

The mom who was pushing had fetal heart tones in the 60s, telling us that baby was not doing well. Glen ruptured the bag of water (and as amnihooks are a luxury, the tool that the Haitian's use to AROM (artificial rupture of membranes) is a needle or the back of the needle cap). The Haitian midwife, Carmelle, joined us in telling the patient to push as hard as she could. "PUSH HARD! KEEP PUSHING, GO ON, PUSH! YES, JUST LIKE THAT...KEEP GOING...GO, GO, GO...PUSH!" These were the sounds now coming from the Maternity Ward. A 2.9 kg baby boy was born, needing stimulation and a couple cuffs of PPV. Mom was expecting a girl and had only brought a girl outfit to put baby in. Not that it would have been the end of the world to dress him up in a pink outfit, but I thought it a better idea to use a baby gift pack. This particular mom had brought a cloth pad but did not have any underwear to put that pad in and keep it in place. I was wishing I had thought to bring a stash of underwear. I think that would be a great addition to our packs next time.

After these two deliveries, we realized that there were no more syringes for Pitocin or Lidocaine, as well as no more Vitamin K. We searched everywhere, and ended up having to resort to putting Pitocin in the 1mL syringes that are typically used for Vitamin K.

7 hours into our shift and it was a bit quiet, with 4 babies delivered and no one imminitently delivering. We all retreated to the storage room, which also doubles as a break room for the midwives and volunteers. We intermittently talked, rested, and checked on the women who remained in Labor & Delivery. Over the course of the night we participated in 4 deliveries, with the Haitian midwife doing another delivery as we rested.

As an outsider coming to Haiti, it is so easy to feel sadness, despair, frustration, and helplessness. Nights like tonight are a welcomed blessing, showing us the good, the life, the hope...A competent and compassionate skilled birth attendant that is the product of Midwives for Haiti. Healthy, term babies. Perhaps it was a smooth initiation to preserve Camille. Either way, it was good to see the good.

In my time here and life since my first trip to Haiti, it seems that the feelings of sadness, despair, frustration, and helplessness are necessary: they are catalysts for change, afterall. Can you imagine a world in which we turn a blind eye and guarded heart to the pain and suffering that exists? Just because it is not happening where we are, does not mean it is not happening. I type that from my laptop and you read that from your computer screen or iphone. Human pain and suffering can be mentally comprehended, but to really GET IT, and act on it...that's a different challenge. More on that later.

Until next time...

Tara