Monday, April 12, 2010

Additional Volunteers Join Medical Mission in Haiti

Four new Project HOPE volunteers hit the ground running on at the Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti, on Tuesday for a two-week rotation, joining volunteers Claude Hillel and Joy Williams. By the end of their first day, which began at 7:30 a.m. and didn't end until midnight, the team had not only had a hospital orientation tour, but had rounded on patients, delivered a baby and treated victims of a multi-fatality car crash.

During her tour of the maternity ward, Massachusetts General Hospital nurse midwife Angela Ferrari was handed a chart and asked to see a patient while the attending physician, Dr. Maria Small, dealt with an emergency. "It was nerve-wracking being thrown into a situation where I didn't know the chart system and then learned that the patient wasn't even pregnant," admits the petite Ferrari, sporting a t-shirt reading "Midwives. Helping People Out." Before she could even finish reading the chart she was whisked away to help deliver the retained placenta of a woman who was at risk of a life-threatening hemorrhage.

"You know what you're doing in your own setting," says Ferrari, who works with a large group of midwives at Mass General-- an unusual situation in a field that mostly comprised of small private practices. Ferrari was asked to come to HAS to help restart the hospital's midwife program, which was abandoned in 2008 when the hospital's sole midwife left the hospital for another job.

HAS runs six health centers and helps to support seven others in the region. While most mothers have traditionally given birth at home, the centers have made it possible for safer deliveries and thus have lowered the region's infant mortality rate. Mothers-to-be bring their midwives and have the benefit of medical help if a problem were to arise during the birth process.

"The problem is finding the midwives," says HAS medical director Rolf Maibach. "It's not a field where you get a certification-- the knowledge is passed on from mother to daughter. These days young women want a diploma so they are not as interested in these traditional things." Maibach hopes to be able to reignite interest in the field by staffing not only the main hospital but also the health centers with nurse midwives who might one day be able to provide training for women in the community.

Ferrari's third patient of the day arrived at the hospital from one of these clinics and without a midwife. The woman's screams were loud enough for staff to pull the woman out of line at the OBGYN clinic. In her second day of labor, sweat caused her thin white dress to cling to her swollen body. Her husband and mother-in-law supported her weight as she was moved to a bed in the maternity ward. Without a translator present, Ferrari held her hand. "I wish I could explain to her what I need her to do to make her more comfortable," said Ferrari, using a combination of pantomime and French to ask the patient to sit up, then take a short walk. Ferrari's face contorted in empathy with each of her patient's painful steps.

It wasn't until 11 p.m. that the baby boy-- Cemesier Renatho-- was delivered, with a vacuum delivery tool and a full head of hair. A rapidly dropping heartbeat necessitated the speedy delivery and he was immediately put on separate IV's for antibiotics, glucose and saline. Without the extra care, Dr. Small fears that the child may have had a much worse fate.

At the end of the day Ferrari finally changed into her scrubs. She was excited about her role at HAS. "I definitely now feel that I have a sense of how I could be useful. It's exciting to be able to be a part of such an important relationship between midwives and HAS." She added, "But before I come back next time, I'm going to learn some Creole!"

Story and photos by photojournalist and HOPE volunteer, Allison Shelley.

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