Today we visited Maison de Naissance for the first time.
We left the Brenda Hospital compound out a heavy red metal gate, scrunched in an MN Land Rover to drive through Les Cayes. We passed trees and street signs painted green and white for Carnival, middle aged women vendors selling piles of green mangos, and clothes lines of western hand-me-downs. Moving out of town motos sped past us as we drove over the bridge of a river headed for the ocean a few miles away, where brown bodies bathed and scrubbed rags over sharp rocks. Turning off the paved highway we jostled north on the bumpy gravel and rock main road to the clinic through smoke from burning trash, waving at little kids walking to school in their pressed uniforms and farmers hacking rice stalks with rusted machetes, all not too curious about the truck full of blons rumbling by.
Finally we got our fist view of the clinic, rolling under the carved metal gate with the mom and baby insignia. The whole place is much smaller than I expected; clean, white-washed walls, a thatched gazeebo waiting area, and a clear serene stream running through the back of the property. It's a weekend so there aren't many people there- only a few women in labor walking around, waiting for the right time to push.
We walk up the blindingly white steps and get a fast tour of the clinic, formally meet our three translators and the community health promoters, and jump right in- reading over the most up-to-date version of the community maternal health survey we hope to give. Translation is slow going, particularly because simply comprehending and explaining statistical methods and their goals is complicated enough in english (why do we need to take every left fork? Is surveying every tenth house enough to get a good idea of the population?) It's hard to tell when a CHW understands a procedure or idea fully or if they are just trying to be agreeable. But facial expressions tell al lot; frustration, incredulity, a joke. Often there will be a heated creole debate among the Haitians and one of the older, sassy health promoters will speak up to be translated, asking essential questions of us in her wise yet spunky tone: "Is it ethical to only offer aqua tabs in compensation for taking the survey?" or "People will expect you to do something about their lack of food if you ask them how many times a month they are hungry." Once someone brings up a cultural concept that it's possible for a women to be pregnant for four or five years and how will we deal with that when asking about number of pregnancies? Things that we think will be a huge deal like asking about infant mortality turn out not to be taboo because it happens so often here.
It's strange and challenging and so wonderful actually being here and trying to leverage cultural values, norms, and understandings. It's obvious these health promoters really care about the community and that they truly value their work even though it's rainy and muggy and so hot and the crazy Americans are making them trek all over the zone through the muddy rice fields all day. The CHW's, nurses, administration, and a lot of the community really see the clinic as a grassroots effort to bring health, connecting with and preserving the well being of their neighbors and extended families. As I sit at MN and every day that I'm out walking amongst the gut-wrenching rural poverty of the MN zone of service, I'm feeling blessed that I get to witness and be a part of this local solidarity and compassion.
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