slow and steady (wins the race)

Islande taking blood-pressure on a Prenatal day at Heartline Maternity Center

Time flies and memories fade (especially if you are age 40+, like me) -  that to say, maybe this is something that you've forgotten - I am here to remind you.

In late October a "Love Flash Mob" happened at the Momastery website. The Heartline Maternity Center was awarded a grant from the funds that came in during the love flash mob from the non-profit, Together Rising.  The grant is specifically funding a second floor on our current Maternity Center as well as other renovations and improvements to the building. The new upper floor will allow us to move our classroom space upstairs and use our original downstairs classroom space as a new much more lovely and spacious postpartum room.  These changes will also allow us the space to serve 65 pregnant women at one time.  

The construction is at the four and a half month mark.  We are getting antsy and anxious to be done with the dust and construction. It appears that we could be using the new upstairs space by May!  The bathroom upstairs will have TWO stalls - which is going to change everyones life and make us all happy.  There are too many pregnant bladders in the building to be sharing one bathroom on Thursdays. 

(History - We began with 20 women in 2008, slowly have increased over the years but have had to cap our numbers at 45 due to lack of space.)

Because we have always always been about very slow growth, we have managed to keep our staff to client ratio at a level that allows us (the staff) to know each woman by name and have a relationship with her by the time she delivers her little one. 

In September one more staff member will join us when she finishes her training to become a skilled birth attendant.  By October we will be expecting about 10 babies per month rather than the current 6 to 7 that are born now.  By October we will be a staff of three midwives, one skilled birth attendant, and three nurses with a ton of midwifery experience. 

All of this is uber exciting.  The hardest thing about growing a high touch, high quality, super relational program - is finding staff that will buy into the way we approach care at Heartline M.C.  

I recently wrote about how important compassion is to what we do.  

Any new staff member we hire must be a person of great compassion and integrity.  The medical system of this country doesn't necessarily encourage that sort of care - but we do.

Today I want to introduce you to Islande.  She is a new nurse on staff.  It has been such a joy to get to know her for the past several weeks.  Her skills are excellent. Better yet and even more important - she genuinely loves serving and caring for women.  She is tender and kind and compassionate.  

We welcome Islande to our staff and are excited to watch her learn more about midwifery which will only help round out her awesome nursing skills and loving bedside manner.  She joins Wini and Nirva, on staff six and three years respectively. 

Nursing Staff L to R - Nirva, Islande, Winifred - at a Birth Symposium this week

If you would like to join us in reducing orphans and strengthening families in Haiti, please visit our website and consider partnering with us at:

www.heartlineministries.org 

Compassion in Maternal Health

The three Heartline Midwives went to Tanzania for two weeks in February.  Once we were there and in the thick of the messy work of it, we looked at each other and said, "Who goes on vacation to do what they do every day in real life? What is wrong with us?"  Then we tried to determine which one of us was to blame for our decision to fly to the other hemisphere to do midwifery.

Maternal Health in Tanzania - HEAVY.

I wrote something about the time there - and threw it away. It was not something that I wanted to publish, it was negative and raw. It reviewed the babies that died unnecessarily and the Moms that were mistreated and it is probably wise for me to keep those details off the Internet. Even though much of what we saw was totally devastating and we were in situations that made us feel entirely uncomfortable, I am glad I went to Tanzania.

I now know that the model of care Heartline Maternity Center is offering is a beautiful, life-giving, respectful, and dignified model of caring for pregnant women. That is a gift. A gift to me. A gift to pregnant women.  Our work here in Haiti is small and it will never be huge when it comes to volume of women delivered, but it is sustainable because love lives at the Heartline Maternity Center.  

If the choice is to provide care for 500 women at a time and not know a single one of them but simply try to get them through their delivery alive - OR - to provide high quality care for 50 to 60 at a time and know their face, name, story, as well as their fears, hopes, and history, I will always choose the latter. 

 I knew that before   .... But I** KNOW **it now.

We learned that in Tanzania there are not enough midwives or skilled birth attendants, much the same as Haiti. We witnessed that critical supplies are lacking, much the same as Haiti.  BUT - Here is the big secret in my opinion:  Compassion is every bit as important in quality maternal health care as the supplies and tools and a "skilled attendant".  You can have all the drugs, fancy equipment, and sterile gloves in the universe and if you don't have a staff that lives to bring compassion to women that are laboring and afraid, you may just as well skip it.  

Trust matters and relationships matter and compassion is more valuable than IV fluid made of liquid gold.

When observing the care in hospital settings in the developing world, one can tend toward despair.  (One, being me. I tend toward despair.) Several of the hospitals in the city I live, as well as the hospital we visited in Tanzania and countless other hospitals and clinics working with the materially poor are lacking the most valuable resource.  

That resource is compassion. 

A midwife friend with 40 years of experience in both low and high-resource settings said this: "Nothing happens that is sustainable and life-affirming without warm, loving relationships among people at work. Although we don't often talk about 'love' in our professional work, it has been my career-long experience that only love (compassion)  changes critical situations. 

Perhaps all of us have areas of huge frustration and despair in our lives, things we really don't feel we have any power to change as we look around at the brokenness of our neighborhoods or our professions or our policies. 

I've decided that the only weapon I have is my individual ability to choose love and compassion even and especially when others around me do not. 

For the Maternal Health crisis world wide, we pray for abundant compassion to reign in the hearts of the men and women that are being drawn to the profession. We pray for excellence and integrity and kindness and love. We pray for women to be treated with dignity and respect and to feel loved and cared for in their most vulnerable moments. 

Sans Somnus Pontificating

Somnus was the God of sleep in Roman mythology.

In real today-this day-not Rome, life -  he is nowhere to be found. 

I suppose that is why it is called mythology.   

We laid awake last night.  We cried together in the darkness of our room. After Somnus mercifully came for Troy, I tried to pray and then talk myself into sleep. It failed. I finally got up and answered emails instead of lying there livid that my brain for refusing to turn down. 

(Turn down for what* - for sleep, that's what.)  (*That line is to impress my kids. If you don't get it, no worries, it's me being all pop culture knowledgeable like the youngsters.)

Yesterday Troy met with the first parents of our three precious Haitian children.  When he shared some of what they talked about and grieved with him, I sat dumbfounded at the unending challenge of their lives.

Our two daughter's first Momma recently received word that her young adult son (Phoebe and Hope's big brother) was shot and killed in California. She had placed him (and eventually several of her children) for adoption.  Poverty and a broken world and system took five kids in three years and put them in three separate homes. Troy and I are raising her two youngest baby girls.  I'm totally done trying to reconcile any of that shit. I can only say, I am not at peace with what has happened to this family. She had not seen her son in 13 years.  She won't see him again.  She thought he would go to America for a chance at a "better life".  

For a short time Troy was present with her in her grief and he got down in the pit and sat in the discomfort of not being able to fix it but knowing that simple presence (without words) is a holy thing.

I don't know why I am writing that out.  I suppose it feels important to me that someone knows that a Momma in Haiti lost a son she had been wanting to see for years and she is grieving two losses. She grieves her loss of 13 years ago, she is questioning herself and her decision.  She grieves his death that took place before her dream of a reunion was realized. If that touches a place of compassion in you, perhaps you want to pray by name for Beanne. (Pronounced Bee-Aahnn)

Our son's birth family is in-tact outside of the two children they placed for adoption.  So, not in-tact, really. Mom, Dad, all the other kids, welcomed "Mr, Troy" to sit and catch up yesterday. They have a son that has never spoken. Another son they tell us is "not right in the head". We have developed our hypothesis about their diagnoses, but for them it feels like and is called some sort of curse on their children.  We are right. They are right.

While we grieved with and for these families last night, and attempted to release some of the weight of several heavy circumstances with our tears, we listened to Andrew Petersen sing.  The lyrics are deeper than I am, so I won't try to outdo Andrew.  I will paste him in below.

God ... We are aching for the yield. Aching.

We need the Lord to plant justice, justice and praise.   

Help us to be led in peace, and go out with Joy.  

Abide in us Lord, let these branches bear fruit.




Oh God, I am furrowed like the field
Torn open like the dirt
And I know that to be healed
That I must be broken first
I am aching for the yield
That You will harvest from this hurt

Abide in me
Let these branches bear Your fruit
Abide in me, Lord
As I abide in You

So I kneel
At the bright edge of the garden
At the golden edge of dawn
At the glowing edge of spring
When the winter's edge is gone
And I can see the color green
I can hear the sower's song

Abide in me
Let these branches bear Your fruit
Abide in me, Lord
Let Your word take root
Remove in me
The branch that bears no fruit
And move in me, Lord
As I abide in You

As the rain and the snow fall
Down from the sky
And they don't return but they water the earth and bring they forth life
Giving seed to the sower, bread for the hunger
So shall the word of the Lord be with a sound like thunder
And it will not return, it will not return void
We shall be led in peace
And go out with joy
And the hills before us
Will raise their voices
And the trees of the field will clap their hands as the land rejoices
And instead of the thorn now
The cypress towers
And instead of the briar the myrtle blooms with a thousand flowers
And it will make a name
Make a name for our God
A sign everlasting that will never be cut off
As the earth brings forth sprouts from the seed
What is sown in the garden grows into a mighty tree
So the Lord plants justice, justice and praise
To rise before the nations till the end of days

As the rain and the snow fall
Down from the sky
And they don't return but they water the earth and they bring forth life
Giving seed to the sower, and bread for the hunger
So shall the word of the Lord be with a sound like thunder
And it will not return, it will not return void
It will not return, it will not return void
It will not return, it will not return void
We shall be led in peace
And go out with joy

And the sower leads us
And the sower leads us
And the sower leads us

Goodbye Despair ... Pursuing One Hope

In the years we have lived outside of the USA, I have chosen not to engage much in the political happenings of my passport country.  

That choice was two things: personal and intentional.  

When I shared that with friends, family, and strangers on the interwebs - it was met with two distinctly dissimilar responses. 

1.  "You're unAmerican and that's not cool of you, not.cool.at.all. Tara."  
2. "That's great, I totally get it."  

There were no middle-of-the-road responses offered.  Probably, those in the middle just did what we all do when we don't feel strongly -  they stayed quiet.  One lady even wrote to me to tell me that she had "always viewed me as a strong female Christian leader" but "not now".   DOH!  (I didn't need her endorsement or the removal of her endorsement - so all is well.) 

This year, something really really bad happened to me.  I got sucked into the vortex of despair again.  

I was so put -off and floored that the obnoxious guy on the Republican ticket was gaining favor that I began to follow politics and USA political news quite closely.  

This modus operandi was for disaster for me.  

I despaired.  And despaired. 

When I despair, Troy just looks at me -  like way too long he looks at me -- and his look says this,  "Lady, I really like you, I do.  BUT.  This is not okay.  Stop being dragged down by the things of our world. Stop seeing only the darkness.  QUIT reading the damn news, please."  I know what every look means. That is the look he gave me several days in a row last week.

I finally talked to Troy about the look.  

He confirmed he thought I was despairing mucheth. 

Which leads me to my recent conclusion. I'm extracting myself from the race.  I did that officially last Friday night and I'm doing better already.

HERE ARE THOUGHTS FROM BACK WHEN I REMEMBERED THAT POLITICS of ANY country ARE NOT WHERE I will FIND my JOY or my HOPE ... 



 ~               ~                ~

(republished today without edits)

We don't often write about current events or what is in the mainstream news. We're narrow and limited and what you see is what you get.  

Generally, we only write about two things:  1. Our tribe  &  2. Living, working, and everyday learning & growing in Haiti (Maternal Health in Haiti).

Once in a long while I'll get worked up about something. That usually happens because some news story has touched a deep nerve in my heart due to a personal connection. With only a few exceptions, we don't venture outside of the lines here. 

We're the experts of nothing and the masters of zilch. Half the time I have to google things people are talking about to figure out what the heck is going on in the outside world of grown-up big people. 

You'll never find a recipe or a political discussion posted here.  I would rather pop my eyeballs out and set them in a pot of boiling hot bean sauce (and not share the recipe) than talk about politics on the internet.  

(Ironic twist: I am talking about the politics that I refuse to talk about - right.now...After this, though - finished!)

Besides the fact that I generally distrust governments and systems and all people with power, and therefore don't choose to engage it much, this excerpt sort of sums up my reasons for attempting to stay far away from the political controversy and especially the conversations that happen online:

From Communication Across Borders:

"Dialogue is best done in relationship, over breaking bread, over coffee." 

"We both have strong convictions that could lead to ugly...  Human reactions, emotions and interactions are complex. I also know there are some things that I won't discuss online, not because I lack conviction but because the potential for misinterpretation is too high..." 

That's it!  That.is.it.
If forced to talk politics I'd want to talk at a table, looking eye to eye. (I mean after we dug my eyes out of the bean sauce, of course.)

I think we're all fairly poor listeners. Misinterpretation or not, we aren't really open to hearing in the first place. We're a lot better at stating what we think than we are at hearing.In part, that must be why we love the internet so much. Because we struggle to hear one another and be respectful listeners in a face to face conversation, I see no point in attempting to communicate this more contentious stuff outside of close relationships, and not on the stinkin' internet.

I have good friends that cross all political lines and can be categorized in dozens of ways.My opinions (or my apathy) are not as important to me as my relationships with my friends.I value greatly my friendships with people that are disillusioned and not even sure what they believe anymore because they are too deeply entrenched in unanswered questions. I value my friendship with my Libertarian friend in Virginia and I value my friendship with my Obama-loving friends in Minnesota.I value my friendships with my conservative friends and family. I have listened to how they arrived at their decision and I don't begrudge any of them for believing in "theirguy".I just don't believe much of it with them.  

I doubt I can articulate clearly what I'm trying to communicate today.Trust me, I don't want to be controversial, combative, confusing or any any host of other words that start with the letter C.

I just know that there is something that is true for me personally.I don't presuppose anyone needs to feel the way I feel about it. I assume that I arrived at this point as a result of being removed from the vortex of the system. Simply put, I believe that I need not become embroiled in the debate, nor need I engage the rhetoric of the political high-season.  I've been told this is un-American, and I disagree.

Here's the thing, in my mind it's all an earthy battle ultimately bound to fail. 

I'd rather battle for Kindgom things that I don't believe will fail.  I'm in a place where instead of engaging in the ideas and sentiments of the politicians battle, I'd rather focus on the real and tangible war right in front of me.  I don't need to battle over politics because I have a massive fight on my hands as it is. 

The battle to walk closely with Him day-by-day. 
The battle to be salt, to be light. 
The battle against my own sin and depravity. 
The battle to love my neighbor well. 
The battle to act justly; to love mercy. 

The Kingdom isn't so much about how I vote (or promote my vote on-line) - the Kingdom is more about the way I love and live and act toward the forgotten and hurting around me. 

I urge you: Walk as Jesus walked. 

Live a life that is worthy of the calling 
He has graciously extended to you. 

Be humble. Be gentle. Be patient. 

Tolerate one another in an atmosphere thick with love. 

Make every effort to preserve the unity 
the Spirit has already created, 

with peace binding you together.  

There is one body and one Spirit, 
just as you were all called to pursue one hope. 

from Ephesians 4

~  ~  ~  ~  ~

Photo: Jesus for President, Shane Claiborne

On Overcoming: Lessons by Marie-Ciane

Marie-Ciane and Baby Michael 2 days old - January 2016

And I've come to be untroubled in my seeking

And I've come to see that nothing is for naught

I've come to reach out blind

To reach forward and behind

For the more I seek the more I'm sought

Yeah, the more I seek the more I'm sought

Read more lyrics: Joe Pug - Hymn101 Lyrics | 

With Nurses Nirva and Wini and Husband Bernick in front of their home 

When I listen to that Joe Pug song that I love so much, I envision our friend Marie-Ciane. Her life has been an exercise in trust...In reaching out blind, reaching forward and behind. She daily reaches into the unknown  hoping and praying and believing that nothing is for naught. 

Watching her navigate her way to the Maternity Center each week for Prenatal class showed us all what true moxie (force of character, determination, or nerve) looks like in action.

Marie-Ciane delivered her son a few days before the midwives of Heartline Maternity Center headed to work in Tanzania for two weeks.  We were thrilled to still be here and knew it was important to her to deliver before we left for a while. She and her son Michael stayed at Heartline for postpartum care for several days after he was born.  

While she was in labor, she recalled many details of her life, often sharing with us through her tears. As we listened to her recall history and grieve what she had lost, I knew we were being allowed a tender and holy moment and that her vulnerability and her story itself are a miraculous thing. 

Yesterday I sat across from Marie-Ciane for a quick post-partum check-in time.  I told her that the day she shared her story with me meant a lot to me and that I have remembered much of what she said. I told her that the only way I can explain it to her is to say that her strength and courage and ability to overcome difficulties are incredibly inspirational. (I went to get a Kreyol expert for help to be sure I was saying that right and getting my important message across with the passion I intended.)

We talked a while and I asked Marie Ciane if she would be okay with it if I wanted to write about her on the internet.  I told her that obviously, her story is hers, and it would not be a problem if she did not want me writing anything.  

She said, "Yes, of course you can. I will want to read it too."  

We spent some time re-checking things she had shared and making sure I had the details correct. I scribbled some notes as we talked.  I asked her if there was something she wanted me to share specifically and she did have a few things to say.  You will read those things at the end of this post.

We first met Marie-Ciane  (MC) when a former client of 2012 named Edline hand delivered her on a Friday and refused to accept anything other than the words, "Yes, your friend can have a spot in the full prenatal program." Edline and Marie-Ciane both teach Braille and are employed by the same organization.  Edline came to visit during MC's labor and we laughed at how great it is to have a bossy and pushy friend on your side.  (Their bossy might drive us crazy - but we NEED those ladies!)


*        *          *



Marie-Ciane was the third born child to her mother and father in 1975.  She doesn't stay in close contact with her older brothers.  

Marie-Ciane was born without eyes. Her whole life she has been told that her father was involved in things that weren't good and that because of his choices and activities, she was born without eyes. (In her words, he was involved in 'bagay mystic'.) I asked MC if she thinks that is true and she shrugged and laughed at my question and said, "If I don't have eyes, I don't have eyes. The reason still does not give me eyes."  

Source of Photo:
http://www.cmmh.org/st-vincents-centre-for-handicapped-children/

She is not exactly sure on the dates, but Marie-Ciane has no memory of her Mother or Father. He left her life when she was an infant, her mother died before she turned four years old.  Her mom's mother, the maternal grandmother, took over raising her.  

Sometime before she turned six years old Marie-Ciane's Grandma took her to St. Vincent's, a education and medical care center started by Sister Joan decades earlier. (Photo and website >)

St Vincent's cares for visually impaired or blind, deaf or hearing impaired, physically and mentally challenged and disabled children. For decades before the earthquake destroyed their building, they offered both residential and non-residential options to many children. I am unclear about what has been rebuilt and what is still being done. The organization is still hard at work here in Haiti. 

As a child MC said she spent Monday to Friday living at St. Vincent's Home and each weekend she would get to go be with her Grandmother. 

When she was 13 years old Marie-Ciane lost her Grandmother. She cannot recall exactly what illness or situation caused the death but she recalls that once her Grandmother passed away she lived full time at St. Vincent's and when summer came and there was a three month break, she would go to the province (Gantye, Haiti) to spend time with extended family. Marie-Ciane feels the loss of her Grandmother as one of the most difficult times of her life.  Her Grandmother was her stability in life.

At St.Vincents she learned Braille and to play the Clarinet and came to love music and singing and her faith was formed and nurtured. 

At our annual Christmas party MC stood to sing for us all. She speaks with great affection of several of the teachers and administrators of her childhood. It was fun as she named people that taught her and raised her to hear how many of them Beth McHoul knew from her decades in Haiti. 

When she was in her late 20s or even the year she turned 30, she met a gentle and kind man named Bernick - he used crutches to walk and he was at St. Vincent's for school. They fell in love and married the year she turned 31.  

After the 2010 earthquake displaced them, they were given a house in Sou Piste in an area where several dozens of temporary wood houses were built and families with disabilities were placed. The house was meant to be a temporary solution. They still live there today.

Bernick and Marie-Ciane's first born son, Daniel, is living near St. Marc with Bernick's family because they feel that the area they live is too dangerous for a four year old. They hope to some day have their whole family under one roof.  For now they are busy meeting the needs of newborn Michael.

Photos are important to MC.  She wants her sons to know about her and her life and her love for them. While she was here in postpartum she told me that she really wants Daniel and Michael to know about her.  I asked her yesterday if she fears she will die before they are grown the way her mother and grandmother did.  She nervously laughed at my question but reminded me that Haiti is difficult and she does not know how long she will be here for her sons. We agreed that every photo we can find of her will be printed for her to take and save for them.  After so much loss, this is one thing she can do to prepare should the worst fears come to pass.  

MC is enjoying a three month break from work right now. Michael is six weeks old this week.

Heartline's original breastfeeding song lyrics in Braille 

singing at Christmas party in December

In early labor I said, "You look beautiful in purple!" MC said, "Well take a photo then!"

Telling us some of her story in January

With Co-worker and friend, Edline (Edline had a baby at HMC in 2012)

With staff members Wini and Andrema at a PostPartum visit yesterday

Nursing baby Michael before heading home

Marie-Ciane would like to ask for your prayers for a few specific needs she has in her life.  She asked that you pray:

• That Bernick might find a job. He has the ability to do computer, office, administrative work. If he had a job too, they might be able to start to think about moving to a different home.
• That going back to work after her maternity leave ends will go well and it won't be too hard to leave Michael.
• She asked for a pump to pump milk for him. (This is taken care of and not a need any longer.)
• She asked that we would pray for a safer house and location to live. She would eventually like her first born son Daniel to be with them but wants a more secure housing situation for him and feels he is better to be with Bernick's family right now.  They do not own any land therefore housing is a difficult issue. She simply asked that you pray.

MC said she believes that God has placed good people all throughout her life that have helped her overcome and deal with so much loss and difficulty.  She doesn't at all think she does life alone.  She said several have shown up to come along-side her in her 40 years.

In our current day and age -  where things seem so discouraging and people even seem unkind and selfish at times  -- I thought you all would love to hear a story of a woman that has found much kindness and love in her difficult life.  

I hope you'll pray for this family of four and if nothing else, I hope it inspires us all to love others with our whole selves, especially the marginalized, forgotten, and materially poor. We all have the ability to change the trajectory of our own lives and the lives of those around us for the better.

Will You Fix the Hole in My Roof?

I hope to find time and clarity to offer several updates about things in Haiti and the trip the Midwives just took to work in Tanzania. For now I am still deciding what I think and feel about some of it. 

In the meantime I wanted to share this excellent post. Please read it. -Tara 

~   ~   ~

Twenty years ago I was referred a seven-year old little Haitian boy from Ti Riviere de Nippes, a little village in southern Haiti. His name was Abdon and he was a blue baby who was born with four things wrong with his heart (Tetralogy of Fallot). He was not able to play normally with other kids in his village and spent much of his day squatted down watching other kids play. We were able to get Abdon accepted by a children’s medical center in the US for heart surgery.  Without surgery Abdon’s chances of surviving past his teen age years were small.

One afternoon shortly before Abdon and I were to get on the plane for the States,  I was sitting in a chair next to Abdon’s father in Port-au-Prince. He listened to me explain the risks and benefits of cardiac catheterization and heart surgery for Abdon.  I needed him to understand everything and to put his signature on the line if he agreed to let us operate his son. The father had no questions at all and scratched his harsh “X” on the medical center form.

After Abdon’s father “signed” I asked him again if he had ANY questions. He looked at me and asked, “Will you fix the hole in my roof?”

I was taken aback and a little frustrated with him. But he was obviously a practical man and figured if we could fix his son’s leaky heart, we surely should be able to fix his leaky roof. (We were able to help Abdon, but his roof never got fixed by me.)

——-

There are only three types of people in the world: downstreamers, upstreamers, and people who really don’t care.

Downstreamers are a grungy sort of people and we don’t always smell fresh because we sweat a lot. And we kind of resent academic upstreamers who accuse us of putting band aids on problems rather than asking key questions regarding causation.

Upstreamers are not grungy and as a rule don’t sweat. They ask big questions and rely on data.

And people who really don’t care are people who are indifferent.  And this is by far the biggest group of the three.

In Haiti downstream workers like myself see problems in front of them, are appalled,  and try to fix them.  Upstream workers see problems, are appalled, and ask why the problems exist in the first place.

And sometimes there is friction between these two groups. But there doesn’t need to be. (The third group of people who really don’t care are not involved in this friction because they really don’t care.)

The above story about Abdon and his father is a vignette which is defined as a “small literary sketch.”  My blog posts (as well as other downsteamer’s posts) are frequently based on vignettes. I also rely on anecdotes.  My posts are anything but academic but I do want to get people’s attention by the narrative of a person, or his family, and his thousand neighbors in Cite Soleil or Park Cadot or wherever.

However, vignettes and anecdotes don’t have the power the upstreamers want and need.

With Abdon’s father’s question about the hole in his roof, an upstreamer would have asked, “Gee whiz, I wonder why he has a hole in his roof? Rats, bad construction, heavy rains, no job for money to repair it,  or a dysfunctional government?”

In my defense, I was more concerned with Abdon’s dysfunctional physiology than with his leaky roof.  I was nervous. Would Abdon be ok on the plane ride back to the States? Flying at almost 40,000 feet altitude is not always a good thing for blue kids who barely have enough oxygen in their blood stream at sea level. Would Abdon die in flight? I was worried about Abdon’s immediate disposition and his surgery, not about his father’s leaky roof or what CAUSED the leaky roof. My hands were full.

Another example is a cholera patient who presents in shock and needs IV rehydration quickly. I can’t give the family a lecture on how cholera is caused by a bacteria, how it was introduced to Haiti, or get all upset with MINUSTAH right then. But someone needs to and I depend on them and am thankful for the upstreamers to do this.

During my recent stays in Park Cadot on the Haitian/Dominican border, using vignettes I describe the people and their deplorable conditions.  Occasionally I offer my common sense and simple solutions for their problems. But my analysis of the legalities behind the Dominican deportation of people and the legalities behind the non-response of Haitian authorities is lacking. I am not a Haitian Constitution expert and don’t want to be. But I do want upstreamers to do the research regarding the politics and the legalities behind this horrible massive deportation of innocent human beings from the Dominican to Haiti.  And I want them to suggest solutions to help these displaced people.

When the earthquake stuck Haiti in 2010, hundreds of thousands of people were killed and 1.5 million people were made homeless. The downstream people raced around Port-au-Prince in all sorts of fashion and many others flew in from all ends of the earth. And they did what they could to help injured people strewn all over Port.  And the upstreamers sat at home or in their university offices and determined that the earthquake DIDN’T really kill people and make them homeless. They determined that bad construction, faulty zoning, widespread corruption, and a feudal land owning system were the culprits.

And both groups were right. (The people who really don’t care didn’t know about the earthquake…)

The bottom line is that the upstreamers and downstreamers need to get along and respect each other. Sincere people from both groups are trying to better the lot of Haitians. Both groups are fallible. But we are not enemies. The real enemy is indifference.

John A. Carroll, MD

www.haitianhearts.org

Marie-Ciane, Tanzania, and Zika ... Some Things That Need Prayer

Since Thursday of this week Marie-Ciane has been at the Maternity Center. She is a 40 year old Momma awaiting the birth of her second child. We (the entire staff here) have soft spots and utter respect for her.  She's downright inspiring. 

Marie-Ciane doesn't want or need pity, her blindness has not held her back and she certainly doesn't want anyone to baby or "other" her. She is totally independent and prefers to do things for herself. I offered to help with bathing but she declined. Before she wants help bathing, she chooses to be shown to the bathroom and left alone to do it herself. (Photo: She took our breastfeeding song and wrote it in braille a couple of months ago.) 

We are starting to think that maybe Marie-Ciane is going to need to be transported but no decision has been officially made as I write this.  From our statistics of 2015, we have learned that 1 in 4 women we serve end up with Pre-E, this is exactly what Marie-Ciane is dealing with and so far our efforts at inducing labor have failed. Prayers for this amazing bad-ass lady and her second child (a little girl, already named Sarah) are so very appreciated today and this week.   

THIS coming Friday, Beth McHoul, (KJ) Beth Johnson, and I will all be getting on an airplane bound for Tanzania.  This trip has been about 13 months in the planning/making and I think we are all surprised the date to do this has arrived so quickly. We will be working at a high volume (maternity) hospital in Dodoma, Tanzania with a friend and Midwife extraordinaire from Omaha, NE.  Our hope is that we will be helpful there and also gain experiences that will help us as we continue to work with the women of Haiti. 

We are going with expectations that look like this:  

We expect it will be something. It could be good, it could be bad, it could be fun and it could be really hard. It could be busy or it could be relaxed.We will know when we know and not before then. 

I am the only one of us that has never been outside of the Western Hemisphere or to Africa.  I think that means I am the only one that feels really nervous.  I don't love the feeling of being so far from my family and I get all spun up worrying about how I would get home if somebody got really sick or hurt. I am afraid for the feeling of being so disconnected from my people.  (Do it afraid.) 

Two Midwives named Shelly and Ann (from Boston and Germany) will be coming to cover for us here in Haiti. Please keep them in your prayers and nurses Wini and Nirva as they work/serve extra hours too.  Most of the women due in late January and early February have delivered their babies, the visiting midwives might have a chance to rest and relax a little bit.

In the news here, the political situation is tenuous. I am sure you've read a bit about it. Today was to have been another round of the election, but it was called off on Friday.

In our line of work we have been dealt a serious kick to the face.  The Zika virus is here and we are very concerned for the women of Haiti. For the next year this will be playing itself out in ways we probably cannot prepare for or imagine.   Rather than fill you in with my worried words, I am sharing some information from the CDC below.  

If you are a frequent visitor to Haiti, and you are pregnant or considering becoming pregnant, I beg you to read this.

FROM THE CDC WEBSITE:

(Click for FULL article/FAQ)

I am pregnant. How will Zika virus affect me or my unborn baby?

CDC has issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions 
and certain countries where Zika virus transmission is ongoing: Brazil, Colombia, El Salvador, 

French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, 

Puerto Rico, Suriname, and Venezuela.

This alert follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of 

mothers who were infected with Zika virus while pregnant. However, additional studies are needed 

to further characterize this relationship. More studies are planned to learn more about the risks of Zika 

virus infection during pregnancy.

Until more is known, and out of an abundance of caution, CDC recommends special precautions for 

pregnant women and women trying to become pregnant:

• Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission 
• is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare 
• provider first and strictly follow steps to avoid mosquito bites during the trip.
• Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and 
• strictly follow steps to prevent mosquito bites during the trip.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, 

CDC will update this travel notice as information becomes available. Check the CDC travel website frequently for the 

most up-to-date recommendations.