Notes from the Field, Haiti Edition

Karen Nassi, Director of Programs

Midwifes for Haiti students work with preceptors to check blood pressure and for other complications. Skilled attendance at all births is considered to be the single most critical intervention for ensuring safe motherhood. By training skilled birth attendants in a country where trained healthcare workers are lacking, Midwives for Haiti is able to increase the quality of care and improve access to skilled delivery care. (Photo: Monique Jaques for Every Mother Counts)

One of the great responsibilities of my new job as Every Mother Counts’ Director of Programs is getting to visit our grantees (and others in the field) to see them in action. Officially what I’m doing is building relationships, offering technical support where needed, and monitoring progress to improve our grant-making. But to be honest, watching these dedicated women and men (mostly women) do what they do best, working in various ways to make pregnancy and childbirth safer for women wherever they may be, is just a real treat for me. A few weeks ago, I traveled to Haiti for my first site visits with two Every Mother Counts grantees.

In Haiti 75% of mothers give birth at home without a skilled birth attendant or access to emergency obstetric care. This is an alarming statistic as skilled attendance at all births is considered to be the single most critical intervention for ensuring safe motherhood. By training skilled birth attendants in a country where trained healthcare workers are lacking, Midwives for Haiti is able to increase the quality of care and improve access to skilled delivery care.

The morning session at the Midwives for Haiti school, taught by instructor, Cindy, who is demonstrating types of birth massages and other pain remedies. (Photo: Monique Jaques for Every Mother Counts)

Our longest running partner, Midwives for Haiti, is an all-around powerhouse of an organization located in the Central Plateau that trains health aides to become skilled birth attendants, provides midwifery care in the town hospital, and runs a rural birth center and mobile clinics throughout the region. Every Mother Counts has been working with Midwives for Haiti since 2012 and our support has gone toward training 69 midwives, who in turn each deliver about 200 babies each year in the most underserved areas of the country.

Over the years, we’ve shared a lot about the midwives and skilled birth attendants and trainees at Midwives for Haiti and I was happy to have the opportunity to put faces to the names I had heard so much about. Like Sheila Pasquet, a nursing aide that has applied repeatedly to the Midwives for Haiti training program, was finally accepted, and just started her training in January!

Sheila (left) is a Midwives for Haiti’s student. Prior to joining the class, Sheila provided Zika outreach and education for mothers in rural areas. Sheila says, “The reason why I want to go through Midwives for Haiti’s training is because I saw so many mothers and children die. Many people were suffering on Mount Michele and Woch Milat in Cabestor, and mothers did not have access to a birth center. The terrain is so difficult that they were often carried down to the birth center by stretcher. Now, thanks to Nadene and Midwives for Haiti for building a beautiful birth center in Cabestor, the mortality rate has decreased.”

The second is Maison de Naissance (MN), a birth center located on the southern coast, a region that was hit hard by Hurricane Matthew late in 2016; a small emergency grant from Every Mother Counts helped them deal with the immediate aftermath of the storm and continue to provide care to the nearly 16,000 residents in their catchment area. Arriving in Torbeck on the southern coast, I was happy to see that the Maison de Naissance birth center had been able to make a full recovery — workers there had replaced roofs on several buildings, rebuilt a wall, constructed more secure water cisterns, installed solar suitcases, and cleared the property of tons of debris (such as fallen trees, destroyed crops, and building remnants that still serve as evidence of hurricane damage throughout the surrounding areas). Recovery for the region as a whole is more slow moving; five months later, many of the center’s staff, for example, are still living with relatives or in temporary tents provided by aid agencies.

Staff at the Maison de Naissance birth center in Torbeck sing together to start each day. Two graduates from Midwives for Haiti work here. After the hurricane, Midwives for Haiti sent graduates here to provide relief so that center staff could deal with the damage at their home. Many of them are still living in tents or with relatives. An Every Mother Counts emergency grant helped the birth center repair damage.

Though difficult to reach, the far-flung locations of my hosts gave me the opportunity to visit two very different parts of Haiti. One, dominated by mountains and streams and dusty roads, the other lush and green, bordered by lovely beaches. Both, however, are places where the health services that many of us take for granted are a luxury available to only a lucky few. And, in both, I met Haitians (and others) who are diligently working at multiple levels to build up their country’s inadequate healthcare infrastructure — the result of centuries of colonial and post-colonial violence, thievery, and racism — all the while serving those mothers who need care right now. And I saw the mothers too, waiting patiently in droves, in the hallways, outside the clinic, under the trees; waiting for care from skilled providers that will help them have a healthy pregnancy and delivery.

That’s why one of our three targeted barriers is education, because there aren’t enough of these workers. There aren’t enough people with the necessary skills and expertise to care for the mothers and families who need it. In fact, the World Health Organization has identified investing in community health workers as critical to building stronger health delivery systems globally.

I am proud to have joined the team here at Every Mother Counts, where we are part of that solution. We work with the understanding that investing in women, not just as patients but as health workers and skilled care givers, is critical to reaching our maternal health goals.

Topics: Childbirth, Maternal Health, Pregnancy