Wednesday, January 30, 2013

Day 3: Haiti

Day 3

This day was Saturday, a free day at the clinic. No prenatals or classes scheduled. I slept in a little but not too much as I knew I needed to go check in on Medaline and probably discharge her. Not being woken by Martha let me to believe that her contractions stopped and she had slept. I was right and after she had some breakfast, oatmeal, I sent her home with a prescription for a syphilis, and HIV test plus and ultrasound order with instructions to do them all on Monday and return for a prenatal on Tuesday unless the bleeding worsened or she was in labor again. She happily agreed. I ate breakfast and some Benadryl and Tylenol for the cold and promptly fell asleep on the couch in the family room where I slept for 90 minutes or so. I woke disappointed that the power was out again, but Mary invited me to go on a walk 1/2 a block away to the cemetery which had manicured lawns and huge shade trees. I agreed and here I am now.

I think I am going to take this time to describe MBH the best I can. It is a large concrete building painted a pale yellow and white. The yard is compound like everything else in the neighborhood, probably .5 of an acre. There are three doors on the front of the house. The one on the left leads into the kitchen which has a refrigerator, oven, back up propane powered cooking station and falling apart cupboards full of dishes and pots and pans all covered with clean cloths or mesh screen to attempt to keep out insects. A wall of 5 gallon water bottles for the water cooler lines one side. If you continue through the kitchen you enter the court yard where they have the outside kitchen to cook, do laundry and wash dishes. Dishes are washed in three large tubs. One for soaking and cleaning, one for rinsing, and one for disinfecting with bleach water. Through the second door on the front of the house you enter the teaching and post partum room. Four single beds line the walls. There is a baby care and weight station and pictures of teddy bears and nursing mothers on the walls. The room is separated by another little entry room by a navy blue drawstring curtain. Yesterday this room was full with Mama Baby class participants, Mamba baby families, and postpartum families, about 20 in all. Through the blue curtain is an entry room from the postpartum room, kitchen and reception area. It has one bed there for triage and treatment plus a child sling scale where the child sits in a special cloth that is suspended from the ceiling on a scale. There is a small cabinet with pregnancy tests, HIV tests, glucose tests, thermometers etc. When you enter through the third door on the front of the house you enter a screened porch. This is where the mothers sit to wait to be called in for appointments. You don't make exact appointments. You tell them to come in 4 weeks and they come back around then. The first to arrive gets the seat closest to the door and is the first called. So they begin to arrive around 8 am and by 9 am when it is devotional time we have 10-30 women there. That room leads into the small reception area with a desk and an armoire that holds medications and vitamins. To the immediate right is the garage which has been converted into a large store room for supplies. On the far end of a reception area there is another bed that is used for triage or as an extra prenatal space. To the left is the hallway to the kitchen and postpartum rooms as well as the stairs to the upstairs. Just past the storage under the stairs is a labor room with the MBH logo painted on the wall. Two beds and a bathroom plus a supply shelving area.  From reception to the right there is a single labor room decorated with birds. A bathroom. A double laboring room decorated with painted flowers. There is also a hall way that leads out the back of the house to the grounds keepers’ home. Up the stairs opens into a great room with a small desk and office supplies. There is a large family sized black table with benches and two love seats and a coffee table. Shelves along the walls hold books and food supplies and condiments that belong to the midwives and other house staff. There is a door that leads to a covered deck. I spend a lot of time out here and often nap there. Off the great room is another large room called the over flow room. It holds overflow baby supplies and medications that will get too hot in the garage plus 3 more bunk beds for over flow staff. I often sleep on the top bunk as a breeze from the deck on the end makes me feel less clausterphobic.  Off the great room are the midwives quarters with a bathroom and 4 sets of bunk beds. Mine is a bottom bunk in the far corner away from both windows. Thus the closterphobia.  Another midwife room off the great room leads to Mary’s room where the directors stay, there are two beds. There is a bathroom and a third bedroom which has four bunk beds where the site manager, Santo, who I have not met yet because he is out of town, sleeps. The yard has a huge empty swimming pool, a chicken coup, two green houses and plants everywhere including beans, peas, tomatoes, corn, egg plant, lettuce, greens and other plant foods. Trees of mango, papaya, banana and sugar cane are also around. The whole house is very clean. The cleaning woman wipes the walls and mops every floor with a bleach solution every day. Building materials are difficult to come by so paint is chipping, windows need caulking etc. but they keep things very clean and tidy and I feel very safe even with all of the insects around. I am hoping for a few labors to come in today.

Chicken Coop and Banana Trees

Green Houses and Mango Trees

Women Waiting for their Prenatal

Birth Room with MBH Logo

Sun Room Birth and Prenatal Room

Birth Room Birth and Prenatal Room

Flower Room Birth and Prenatal Room

 Laundry is almost always drying around the Clinic yard


Papaya Tree

Staff Family and Dinning Room


Swimming Pool- This made me laugh because there is almost a page in the volunteer handbook about how you need to dress modestly when you are using the swimming pool :)

Passion Fruit Vine

When we got back I spent several hours napping as did the other midwives. We then decided to go for a walk up to the rock quarry about half a mile away. We stopped by the MBH children’s library and met the family featured in the you tube video. We saw many different people, animals, and houses. When we got to the quarry rain water had collected to form little pods where people were bathing and animals were watering. We climbed a steep hill and we were able to see all around us up the mountains to the east and the ocean to the north. It was very beautiful.

When we got back a labor was there a first time mom named, Tetalley. She was very sweet. We had spaghetti for dinner and mom and her sister Nahnah walked around. We told them to come and get us when things got more intense. I crawled into a new bed under a mosquito net out on the porch and waited. Around 10 Martha came and got me and told me she was active. I went down and found her rolling in bed with the pain. We got her centered and I did an internal exam and found her to be 100% and 5 cm. Her mother had shown up by that point and kept pulling up her skirt and opening her legs wanting her to push out the baby. I finally got her to leave her alone and she labored with us holding her hands, rubbing her back, and putting water on her belly. Around midnight she said she had to poop and I checked her and found her ready to push. Martha went and got Mary and they were going to turn on the generator when a miracle happened and the power went on. She had a very tight hymeneal ring. I was worried about her tearing on the birth stool so she pushed a few contractions there and then we moved to the bed. She would not have torn except for a nuchal hand that popped out. Baby had great apgars and cried eagerly.They worked beautiful together and grandma was so happy.

 I ended up needing to suturing her up a bit. She showered and then we moved her to the postpartum room where we worked on breastfeeding. I crawled into bed at 2:30 but still didn't sleep well as the baby was up often during the night and I went down to help the mama. She was exhausted and a little shell shocked which is pretty normal for a first time mom no matter where you live.

Photos of individuals shared with permission that was obtained prior to taking photo.

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