Looking towards the Future
I have been thinking a lot about going back to Haiti. Joseph asked me to come back and work with the Traditional Birth Attendants in the village, about 15 women, and I am looking into ways to make that happen. I want to go with some other midwives and work on training the TBA's in basic midwifery care.
For those of you that do not know about TBA's: They deliver the majority of babies in developing countries and according to the WHO are equated with Doulas. Essentially, they provide labor support and may or may not have education in midwifery or healthcare. The WHO estimates that “60% of births in the developing world occur outside a health facility with 47% assisted by a traditional birth attendant, family members, or without any assistance at all." In Haiti, less than 25% of births are attended by a skilled practitioner and the infant mortality rate in 2008 was reported to be as high as 30%. To me, that says a lot about what is occurring at the births outside of health care facilities.
While Midwives for Haiti (M4H) is doing great work in Hinche--teaching local students obstetrical care--I wonder about villages such as the Joseph Community, and how to create better birth outcomes for them. Studies have shown that simple programs that work on advancing the knowledge of TBA's in small communities directly impact birth outcomes. Some of these teaching programs do not even last more than a few days and are designed like a intensive conference! It seems to me a simple way of creating positive change! I have been brainstorming about how to honor the invitation from Joseph and how I can make another trip to Haiti happen.
Women in villages like the Joseph Community may travel to a local hospital or clinic to receive prenatal care, but then return home to deliver their babies with a TBA. However, some women like Rosamine (a PAP refugee I wrote about in a previous post) cannot afford the trip to the hospital or clinic, let alone the cost of any prenatal care. That community is so dedicated to their own independence, growth, and empowerment, and it feels like a promising place to put time, energy, and funding. If we could create a teaching program for the TBA's in the community, then women like Rosamine would have higher chances of a positive outcome and a healthy birth. That possibility is pulling at my heart. I keep dreaming of the words I am supposed to use when writing grants and I keep dreaming about the support that I know is coming. It seems like this is meant to BE!