Cayman Islands Hospital midwives Mairead Campbell and Sue Doak spent their vacation time in Haiti teaching midwives in the impoverished country safe delivery techniques.
The two nurses travelled to Hinche in central Haiti last month for two weeks with the American organisation Midwives for Haiti and carried with them six suitcases of medical supplies donated by doctors in the Cayman Islands.
They volunteered to work with the group on their time off and fundraised in Cayman beforehand to raise money for the trip and take supplies with them.
“The conditions in the hospital were horrific. When women have babies here, they don’t realise how much they actually have compared to the women in Haiti. They literally have nothing,” Ms Campbell said.
“They come to the hospital with nothing and they have nothing to give them. They put us in a labour room the first day we got there and basically said ‘Get on with it’, which is fine – we’re both experienced midwives, but there was nothing there. They have no equipment, no pads or packs. We had a blade and a pair of gloves and that was it,” Ms Doak said.
“And they have no pain relief, no epidurals or pethidine, zero drugs,” Ms Campbell said. Ms Doak added: “There’s no options. They come in knowing that they’re just going to have their babies and that’s it. There’s no sheets for the beds, there are no cots for the babies.”
The babies sleep in the bare beds with their mothers and both usually leave the hospital within 24 hours.
After delivery, there are no showers or even hot water to wash with. The hospital has one cold-water tap in the delivery room. There is no air-conditioning or toilets.
The women bring their buckets with them to use as toilets and the waste from the delivery also ends up in the bucket, the nurses explained.
“The sanitation is just dire,” Ms Campbell said.
Open sewers run along the sides of the streets and the smell permeates everything, they said.
“It’s hard to believe this is just an hour or so away,” Ms Campbell said. “You cross a road and you’re in the Dominican Republic where the golf is $150 a round and the hotels are four and five star.”
They liken the work of Midwives for Haiti as teaching a person to fish. Volunteers with the organisation teach the local women and men to delivery babies safely. “That knowledge stays with them,” said Ms Campbell.
They were surprised to see elderly men show up for the birthing courses. They are traditional birth attendants. “They’re in their 60s or 70s, they’re like the village gurus, but they were willing to come and listen,” Ms Doak said.
Midwives for Haiti was set up in 2006 with the aim of teaching Haitian women who are already nurses or nurse assistants to become midwives and help reduce the high maternal and neonatal mortality and morbidity rates.
In Haiti, six in every 100 infants do not live to their first birthday. According to the World Health Organisation, Haiti is the poorest country in the western hemisphere and two-thirds of the population live on less than US$2 a day, so most mothers cannot afford antenatal care. Most give birth at home and 76 per cent of deliveries are carried out by unskilled helpers.
One in 17 women die from childbirth complications, 15 per cent of infants have low birth weight, one in four infants are constantly hungry or malnourished.
“It’s often too late once the women get to the hospital. They live in rural areas and might travel to the hospital on foot or on the back of a motorbike. They might be pregnant with twins, in labour, and have to come on a dirt road for two or three hours, by the time they arrive at the hospital, it could be too late,” Ms Campbell said.
However, by travelling out to the rural areas, medical professionals who work with Midwives for Haiti find the women who could be at risk, such as those with diabetes or high blood pressure, and warn them that they need to go to the hospital and not to attempt to have their babies at home. They give them medication for free as the women could not otherwise afford it.
“Before that, they had no antenatal care at all,” Ms Doak said.
The duo travelled from the Haitian capital of Port-au-Prince to Hinche and then around the surrounding area on a pink Wrangler jeep to visit clinics.
Ms Campbell explained when they arrived at the clinics – mostly half-completed buildings without floors or ceilings – there were usually no pregnant women in sight when they first showed up, but the women in the area were called to the clinics via a loudspeaker on the jeep that announced the nurses’ arrival in the village.
While there, they also visited a Mother Teresa home for malnourished children, which provided nutrition and health care for babies and children who would otherwise have died.
On a visit to a maternity hospital, they found a woman with a haemoglobin level so low that she was nearly dead. “We said, let’s give her a blood transfusion and they said there was no blood,” Ms Doak said. “There was a Red Cross right next door with a blood bank but they didn’t have any blood. We asked what blood type she was and I’m A positive and Mairead’s O positive so we donated a pint of blood each and she felt a lot better the next day.”
They also had to deal with local superstitions, such as that pre-eclampsia – a condition in which a pregnant woman develops high blood pressure and protein in the urine after the 20th week of pregnancy – is possession by a devil. “We know it’s just simple seizures and we try to teach them that it’s a medical condition. They would call in a voodoo priestess for someone who is having pre-eclamptic seizures, so we explained it could be treated by medication,” Ms Doak said.
The organisation works with local government hospitals and the local communities and provides a nine-month programme with about 16 men and women and teaches preventative pre-, intra- and post-delivery care, dealing with complications of birth and care of newborns, including nutrition and sanitation, which is especially important considering many infectious diseases, including cholera, are commonplace in Haiti.
Sitting in a bright, airy room at the Cayman Islands Hospital maternity ward, where parents learn to bathe their newborns and where mothers breast-feed their babies in comfortable rocking chairs, the nurses flicked through an album of photographs they took at Hinche. In one photograph, blood flows across the floor of the delivery room, with the sheetless bed with stirrups where the women deliver their babies in the background. One of the buckets the nurses mentions sits under the bed.
It’s a jarring image that lies in stark contrast to the clean and cheerful room they sit in and it takes them back to the scene of the hospital. “I can still smell the smell of it. There are flies everywhere, you’re just brushing them off,” Ms Doak said.
During their trip, Ms Doak and Ms Campbell volunteered as teachers in the classroom and in the hospital and also volunteered in mobile antenatal clinics and taught the traditional birth attendants at a local church. They both plan to return to Haiti and work with the Midwives for Haiti again.
“We wanted to highlight some of the fantastic work that is being done in Haiti by these organisations as we hope to travel there again next year. We’d like to thank our work colleagues and some of Cayman individuals and businesses for some very generous donations,” Ms Campbell said.