To Disturb the Comfortable

“Lord, as we prepare to eat this meal, we remember that many in this country do not have food and will go to sleep hungry tonight.”

These words from our host send a shiver down my spine as we stand in a half circle, praying over the food laid out on the counter in front of us. I felt the same discomfort as we drove from the airport to our guesthouse, through crowded streets made of dust and trash. This discomfort, however, is quickly forgotten as we settle onto benches around an expansive table and begin the warm chatter of getting to know new faces.

Discomfort returns once again this morning as I being reading “The Uses of Haiti” by Paul Farmer, a collection of all the ways in which the United States, my country, has laid waste to the country of Haiti. In fact, the whole reading list for our trip makes me sit in a perpetually cringing posture. Looking at our country from the outside is uncomfortable.

We will be in Haiti for two weeks. With this in mind, I remember being told that any trip that is under a year in length is more for the benefit of the person going than it is for the people they are going to. Yes, our trip is different. Our group brings specialized skills and needed supplies. But I think there is another value to this journey.

Living in one of the richest countries in the world, it is all too easy to fall comfortably into a bubble of blissful ignorance and instant gratification. We forget the impact our government has on the world, we forget how our spending dictates the livelihoods of other people, we forget that we are inevitably tied into a community much bigger than any border could encompass.

This trip is important because it reminds us to be uncomfortable.

It reminds us that not everyone has full bellies. It reminds us that a child surviving past age five is not a given for some parents. It reminds us that the “land of the free” has at many times suppressed freedom.

Whether it is a book, or a trip, or a conversation with someone who walks on a different path, we must search for these ways to get out of our bubble of comfort. Not only this, but we must allow ourselves to feel the discomfort so deeply that it drives us to act.

Changing the way our world looks in the future requires being disturbed by how it looks right now. May we embrace the discomfort.

-Mariah

Arrival in Port Au Prince

Ann here – After a fairly long day of travel, we arrived safe and sound in Port Au Prince.  We are staying at Heartline Guesthouse, and later today Midwives for Haiti will pick us up for the long drive to Hinche. The guesthouse is lovely, and makes the transition to being in Haiti easy.  Last night for dinner we ate chicken chili with rice, green beans, carrots, and bread.  Breakfast looks plentiful as well.  Other guests we met last night were Jen (an OB/GYN) and her husband, and another couple who are in a years-long process to adopt a little Haitian boy.

Heartline is also associated with a clinic and birth center, run by 3 American midwives, which we were lucky enough to tour last night.  In the photos above, you’ll see our group, Beth and Beth (both CPMs), photos of the birth center, including the “birthing stool headboard”, and one of the clinic rooms.  Also a mural on the clinic wall.  We were all tucked into bed by 9p, ready for some rest under our mosquito nets and with fans running.

 

By the numbers

When this trip was being planned, it didn’t dawn on me that we would be leaving on the International Day of the Midwife, and arriving in Hinche on (American) Mother’s Day weekend.  Yet that is exactly how the dates have worked out.

I received my midwifery training and education through Frontier Nursing University in Kentucky, which was originally founded by Mary Breckinridge, and years later re-founded into one of the best midwifery programs in the nation by Kitty Ernst, CNM.   When the Frontier Nursing Service was founded in the early 1920’s, maternal mortality rates in the US ranged from 67-85/10,000 deliveries, and neonatal mortality rates were between 34-44/1000 live births.  Research conducted by nurses during that time found that those rates were significantly less for women who were attended at home by midwives, including African-American granny midwives and others with little formal training.  Significantly better than women attended by physicians in hospitals.  As a result, Mary Breckinridge set out to found the Frontier Nursing Service, which would send nurses and midwives on horseback into the deepest parts of Kentucky Appalachia to provide care for families.  Within just a few years of initiating this service, the maternal and neonatal mortality rates in Leslie County, Kentucky, were lower than the nationwide statistics for the US.

Today in the US, we have a maternal mortality rate of 6/100,000 and a neonatal mortality rate of 14/1000.  Those numbers aren’t actually very impressive; 33 nations do better than us at helping women and babies survive childbirth.  Yet it is rare enough to lose a mother in childbirth that those of us who work in the field react with disbelief and shock when it occurs.

Contrast that to Haiti.  In the present day, the maternal mortality rate in Haiti is 359/100,000 women.  This number has actually decreased from over 600/100,000 just 20 years ago, largely through the efforts of Midwives for Haiti.  The infant mortality rate, however, has remained fairly steady at 52/1000 babies.  20% of children in Haiti do not live to see their 5th birthday.  There’s still a long way to go, mostly in the provision of postpartum and ongoing pediatric care.  Surviving childbirth in Haiti is not a sure thing; children growing up is not a sure thing.   What does it do to a culture, and to communities, when having a family is so full of risk and uncertainty?

What does seem clear is that time and again, women, babies, and families do better when midwives are regular providers of their care.  That time, attention, and vigilance trumps technology, and that primary prevention has a far greater impact than treatment after the fact.  I’m so looking forward to seeing the midwives in action in Haiti, and hearing their stories.  Happy Mother’s Day everyone!

Packing and Preparing

For weeks, I haven’t been sleeping well.  My brain keeps waking me up, thinking about this or that related to this trip – so I started a “to-do” list. The list has been massive.  Just yesterday, even as I crossed items off each time they went into a bag, I added several more things that just have to get done before departure.  Interestingly, the character of the list has changed – from all the preparatory stages (email Valley Connectors; arrange transport to airport), to items to pack (gloves, medical tape, card games), and then yesterday, things that will keep life running smoothly here at home in my absence (water house plants, email friends and family links to this blog).

Yes, I can be a control freak.  And what’s highly ironic is that in just 2 days, I will be landing in a country where decisions about day to day life are much more straightforward and direct:  Can I feed everyone in my family today?  Will the rain wash out the road I need to travel?  Will I safely make it through childbirth, and if so, will this child live to adulthood?  I think it’s safe to say that for most people in Haiti, watering houseplants isn’t typically even on the radar.

So I am confronted with the fact that this anxiety I feel – and all the preparation I am doing, to try and control it – is both a sign and symptom of my privilege.  The biggest thing for me right now is watching over the well-being of 6 EMU students.  And while that is significant, it is hardly what most residents of Haiti live into on a daily basis.  I am arriving with 3 different kinds of antibiotics and malaria prophylaxis, and have at least a half-dozen over the counter medications as well.  And yet illness while traveling is one of my worries.  When we live with so many advantages and privileges, maybe we forget how to let go of our worry, because we have bought into the illusion that we are in control.

While I finish my preparations today and tomorrow, I will continue to frame my worries and anxiety as a natural outcome of having so much, and of being so blessed.  It’s worth remembering.

But I’m still going to water the houseplants before I leave. 🙂