Dantan is a remote village in southern Haiti where Marie grew up, one of 12 children. Her mother was a homemaker, her father a minister. Against all odds, while living and raising a large family in the poorest country in our hemisphere, her parents instilled the importance of family, faith and education. All but the youngest child has completed secondary school or beyond. Marie traveled to Port-au-Prince, a city of 3 million, because it held more opportunity for education and jobs. She attended a vocational school for a secretarial certificate, got a job and continued her schooling to become an auxilliare (nurse’s assistant) to further her professional development and make a higher salary.
One day, her male boss offered her more money if she would be “one of his women”. Marie knew that many of the other female workers agreed to this proposition in order to get more money to feed their families, pay the bills, and survive. She refused. Because of her refusal, she was mistreated, ridiculed, given less money and denied raises. She stood firm, prayed every day she would find a job where she was respected and valued as a woman. She finally graduated as an auxilliare, and set out to find a new job.
While visiting her family in Dantan, she heard about a birthing clinic called Maison de Naissance opening up not far from her parents’ home. Marie applied and requested an interview. During her interview, she demonstrated the qualities MN was looking for: compassionate care for others, technical skills, and a local community member. Marie was hired and helped open MN on October 4, 2004.
This is where Marie entered my life. From its inception, I have been involved in the work of MN since it founding - first volunteering as a nurse and mentor to our Haitian staff, then as the Program Director full time.
Over my 5 years with MN, I had the privilege of observing Marie help mothers and babies make a safe journey from pregnancy to birth and beyond (Haiti has one of the highest pregnancy related mortality rates in the world). She had her first child at MN and carries her own “safe journey” with her in all her work.
In 2012 Marie enrolled in an auxiliary midwife course with Midwives for Haiti, an intensive one year program that required living away from her family. She graduated with honor from the program, and is now part of the midwifery staff at MN, having faithfully served for 10 years.
She treats every mother and baby as loved and valuable in a culture that historically has oppressed women in every way; physically, emotionally, economically and socially. She believes it is her responsibility to take care of the women in her community. She is bringing women hope. Marie is a role model for the women she cares for; one of their own is a living example that through perseverance, hard work, valuing oneself and striving to reach one’s innate potential, a better life is possible. If one of their own can do it, so can they.
The most unlikely people usually do the most extraordinary work in the world, Marie is one. That is what MN is all about, empowering women, one mother at a time.
Cindy Obenhaus, RN, MN Program Director 2004-2010
The word “care” can mean many things. At Maison de Naissance (MN), it means that women receive counseling, education, medicines, lab tests, and loving attention every day, from expertly trained and dedicated members of our staff. It means that these elements of caring are provided without charge, and without discrimination, to all women who come to us. This is particularly important for women infected with HIV, the virus which can cause AIDS if left untreated.
In Haiti, as is true all over the world, there is a stigma attached to having a HIV positive test, and it can be difficult for a woman to accept the news. The counseling that accompanies this testing, both before and after, sets the stage for our mothers to understand that there is hope - that they can receive medications to help keep the virus under control, and to prevent their baby from becoming infected. Collaboration with the PEPFAR program at MN helps provide medication and the staff necessary to expertly complete the record keeping that insures all of our patients are tested, and all of the HIV positive mothers are given medicine in labor to keep their babies safe.
This is just one element of the care received at MN, but it’s a vital part of Berneice’s story:
Berneice’s husband was HIV positive when they met and married, but he did not share this news with her. She was thrilled when she became pregnant right away, and went to Maison de Naissance for an early prenatal visit. HIV/AIDS testing is a routine part of every pregnancy's first prenatal consultation. Berneice was devastated to learn that she tested positive for the virus, having had no other partners besides her husband. She felt very alone, never having known anyone who survived with HIV. Her treatment, including nutrition counseling and a referral to the Mother's Club, began right away.
After several visits to MN, she overcame the stigma of testing positive, and began connecting with the MN Mothers’ Club, where she met other women living with HIV and their healthy babies. They told her of their own experiences, and how the treatment worked to prevent transmission of the virus to their children. Berneice was able to complete her course of daily medication, kept her nutrition up, pulled herself out of depression, and delivered a healthy baby boy with the help of MN's dedicated midwifery staff.
When Berneice brought her baby boy back for a well baby checkup, she proudly showed him off to the staff who turned her life around.
What follows is a recurring theme when working in an impoverished, rural Haitian community, where maternal health professionals are everyday heroes.
Four days before Madeleine took her baby boy home from the hospital, she didn’t know if either of them would be alive by morning. Madeleine was eight months pregnant when she came to Maison de Naissance feeling very sick. Her head hurt, her hands and feet were swollen, she was seeing spots, and she had pain by her rib cage. She had been previously warned by her midwife and her community health worker to watch out for these symptoms of preeclampsia, a severe complication which can cause seizures, bleeding from a torn placenta, and even death of the mother and baby.
Though this was her first baby and she had been seen at MN only once, Madeleine knew her due date was a month off, and she was sure it wasn't time for her baby to come. As she rode the back of her neighbor’s motorbike along the bumpy dirt roads to MN, she became extremely worried. She wasn’t feeling the baby move as much today, and her head was hurting worse. By the time she arrived at MN, her blood pressure was very high and she was bleeding. The midwife who was seeing her recognized the symptoms, and provided medication to keep Madeleine from having a seizure, while an IV was started.
Grabbing a pack of supplies for a cesarean section, she accompanied Madeleine in the MN ambulance for drive into Les Cayes to the General Hospital, where a cesarean section could be performed. Thanks to the education that Madeleine received at her prenatal appointment with an MN midwife, she recognized the warning signs of preeclampsia. The quick work of her midwife ensured that she made it to the hospital in time to save the mother and her baby. Just another day of midwifery in rural Haiti, providing life saving maternal health care services!
Late in 2013, we heard from our local partner, the Haitian Ministry of Health (MSPP), that they were completing the construction of a new deliver ward at the local public hospital in Les Cayes, the town closest to MN. This was excellent news, as we occasionally had to refer a laboring mother to that facility if the delivery required surgical intervention. The only problem, we were informed, was that they were unable to staff it. This was in fact the perfect opportunity for MN. For some time, we had been looking at ways to expand our patient capacity, but also needed to maintain costs. We have always worked closely with MSPP, and one of our goals has always been to strengthen the local public health system by working with them as closely as possible. As a result, we offered the services of our highly trained and experienced midwives to the public hospital, in return for salary sponsorships from MSPP.
The process is underway, and two of our midwives are already helping out in the new delivery ward, providing professional attended birthing services to a mostly new segment of the population that did not previously have ready access to them. Another double win for MN - healthy mothers and healthy babies!
Just this past August, there was a surge in the number of mothers coming to MN to deliver their babies. While there are always month to month fluctuations, and even seasonal highs and lows for new births, August was an unofficial record setter, with over 90 healthy babies brought into the world by our dedicated and hard working midwifery staff in that one month. It seems that the public hospital in the nearby town of Les Cayes had reinstated previously waived fees for deliveries, and MN's reputation for exceptional care and no fees, ever, drew a significant portion of their patients to our facility.
People often ask why we continue to offer free services, when it appears that at least some percentage of the population in our zone of service could afford to pay at least a minimal fee? The answer is twofold: there is no way to easily distinguish someone with a little extra money from someone who has none, and in many cases, the little bit they might pay for our services would be better spent on food, cooking fuel, a child's school tuition, or any number of other important expenses.
When you consider that our average cost for an uncomplicated delivery, US $115, is only one percent of the average cost of a hospital delivery in the USA, all of the babies born at MN in August were delivered for less than the cost of one in this country! This is not simply a reflection of the economic differences that exist between the USA and Haiti, but more importantly, the result of the efficiency, competence, and above all, dedication of our staff to our mission, to significantly reduce maternal and infant mortality rates in communities like the one that they live and work in.
Amidst the highest infant and maternal mortality rates in the western hemisphere, $115 is a small price to pay for the midwifery services to deliver a healthy baby to a healthy mother and potentially save a life!
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