Day 4: This morning began like most here. Waking up hot, not sure if you got much sleep but ready to start the day. Motos were waiting for us to head to the hospital. I walked in to a birth quite quickly. The woman in labor had been sent out walking and came back making the primal sounds that signal it's time to put your gloves on. She barely had time to get on the table as her babe was ready to come earth side. The healthy baby boy came with great effort by his incredibly strong mother and I place him on her chest and began active management of her placenta to decrease her risk of hemorrhage. At home I do not actively manage the placenta unless medically indicated but in third world countries where women are at high risk for hemorrhage and resources are limited it saves lives.
Another birth quickly followed that Shamarie delivered. It was her first birth in 12 years as she is an OB/GYN but specialized in uro-GYN which is an incredible specialty that repairs pelvic floor damage including fistulas. Amazingly there was a woman with a fistula who had been sitting in the postpartum unit for a couple of weeks and the doctor had agreed to let Shamarie teach him how to repair it if they could get the OR time. Shamarie loved on the bay and mother while I finished up the placenta. Then Shamarie did the repair. It was a beautiful birth and great team work.
The students got situated in the unit and Sarah assisted a student in her first birth and Heather got to step in as labor and nursing support. She was officially bitten by the birth bug and was glowing from that moment forward. She was moved by the power of women and the beauty of birth.
As the labor unit quieted down I headed to the post surgical unit to precept more midwifery students. Our first momma had come in seven months pregnant with an abruption and had a cesarean section but her baby had died. She had a hemoglobin of 7.9 before the surgery and the next day it had dropped to 3.2 but there was no blood in the blood bank. We asked if we could go donate blood but we were told all the blood donated at the Red Cross next tot the hospital had to be sent for testing in Port at Prince as they did not have the capabilities to test it in Hinche. I was happy to hear that they tested all the blood products but frustrated that they were regularly out of blood. This poor woman was so frail and weak. She had lost so much blood and needed a transfusion of multiple units of blood. I was told it was coming that day but she had not received it when I left the hospital that day.
Another woman that stood out today was a second time mother who had a cesarean section. I was able to have the student provide teaching on everything from breastfeeding to bleeding and infection. As I reviewed it all with the mother and student, the mother would tell my translator that she didn't have any questions but that she wanted me to know that everything I was telling her was correct. I loved it. She was an experienced mother and guided the student through her teaching.
At the end of our shift we headed back to the house on Motos and shared our meal together. Then it was time to head back on Motos to help the Sisters of Mercy at Azil House. This is the place that every year brings me to my knees. Families bring their severely malnourished children her to be fed and hopefully saved. The cribs are lined up wall to wall. The children sit lethargically, some too weak to eat. We hold them, love them and try to help with their afternoon feed. This place embodies the senseless disparities in our world. How is it possible that my car costs enough money to feed and save every child in this place for many years. It is incomprehensible. How in 2016 do we allow for such human suffering.
After the feelings were done and the babies and toddlers were cleaned up and placed back in their cribs we went out to the patio with the other kids ages 3-6 and played. We sang songs and danced and played with their broken toys. As we were leaving the head nun stopped to chat with us. She has been at Azil for five years. She was in Russia for 16 years prior. She shared stories about Mother Theresa and brought me to tears discussing the impact of service to the poor. She reflected on how we may not feel like one person can do much but just by coming and loving on one poor sick child we have made a difference to that one child. The ocean is made up of many drops of water and you might not think the ocean would miss one drop of water but what if all the drops of water didn't show up?