By Emily Tinsley, RN, MSNed
As an experienced international educator of nurses in the developing world, I began my journey with Midwives for Haiti for the first time 2 weeks ago. Though I am not a midwife and my experience with mothers and infants is narrow, my abiding passion remains deeply in the provision of meticulous, basic nursing care and education in ambiguous environments. Midwives for Haiti spoke to my passion and gave me the courage to offer my humble support. My extensive experience in such environments was enough to keep me from having any expectations or personal agendas for this trip. I was only certain that I would observe, learn, and position myself wherever and in whatever fashion that I be most helpful.
To my delight, I was offered the opportunity to join efforts with Cindy Seigel, an experienced practitioner and educator of Midwifery. Though our paths had only recently crossed in brief circumstances, it quickly became apparent that our connection was bound by respect and camaraderie.
Each and every day was filled with an abundance of memorable moments, sites and personal connections. Our anticipated first day of acclimation and cultural integration transformed as rapidly as one can change out of church clothes and into scrubs. A rapid shift in plans came with news that several nurses had not shown up for work at the hospital. Without question or debate, we were headed to work. Within minutes of waving farewell and thank you to our taxi drivers, we were directed to the postpartum ward where an eclamptic mother lay unconscious with her limp newborn boy. Mother and baby were surrounded by several worried family members earnestly waiting for anything to alter the bleak reality before them. My mind instantly focused on the clinical tasks at hand and potential outcomes. We did not have oxygen, suction, IV’S, or a NICU doctor readily available, if at all. We did however, have our eyes, ears, hands and instincts to maneuver through the rawness of a family’s devastation. “Skin to skin”, Cindy gently advised. Upon bringing this infant to his mother’s bare breast, I searched for breath, movement, and even just a dribble of colostrum. I remembered the family asking for all that could be done to save the two lives before them.
In respect of their wishes, yet in personal conflict with possible unfavorable outcome from resuscitating a 28 week-old infant in this environment, I began chest compressions. The perceived hours blurred in the minutes it took for a heart rate to go from 30 to 120. Wrapped in a shirt, the baby was then carried away to a newly available bed in the pediatric ward where 8 other children were under the care of one nurse. The mother steadily improved with fluids, medication and diligent nursing care. Each day, Cindy and I observed this mother’s progression from being unresponsive to drinking, eating, sitting up and to smiling. Each day, Cindy and I noted this infant’s progression from near death to stability, feedings, and most recently his discharge home with mom.
Each day, we admired the rooted strength and perseverance of Haiti’s people. The midwives and nurses methodically maneuvered with grace and integrity through all the daily trials. As we were witness to so many similar clinical circumstances, I marveled at the artistry of shared human interactions, learning experiences, and improvisational execution of care in its’ purest sense. Recognizing such engagement each day, I was filled with an incredible feeling of hope for a sustainable presence and future of Midwives for Haiti.