After witnessing the success of our home visit program at the rural Carrie Wortham Birth Center, we’ve wanted to do something similar in Hinche. About 200 mothers give birth at the local hospital here each month and although our Postnatal Care Program there has filled a critical gap in care, we knew many new mothers return home and run into problems. We also knew that many moms who came to our Mobile Prenatal Clinics in the villages outlying Hinche give birth with matwòns, or traditional birth attendants, at home. Unless these newly delivered moms came to a mobile clinic, they wouldn’t be receiving postnatal care. We knew the need for a skilled birth attendant to check on new moms and babies was strong, but starting a new program is always a challenge. Fortunately, we -and our volunteers- are always up for a good challenge.

The following words and images are from midwife volunteer Daisy Grochowski:

We decided to start a home visit program. Everyone was well aware of this need, and I happened to be here for a month, with time to adopt the challenge of trying to make it a reality. To see women and babies, in their homes, within the first week of life, can truly be life-changing. Something as simple as breastfeeding support or cord care can save a baby who may not have made it otherwise. A blood pressure check or a hemoglobin finger-stick can identify serious health concerns for a new mom. With a little time, a great moto-driver/local advocate, and a backpack, we’ve been able to reach some of them. In the month that I’ve been here doing this, I can honestly say that lives have been saved with this program. It’s humbling and upsetting how much can be accomplished with so little. It can be overwhelming to see the health disparities here. But the home-visit program allows us a clear-cut starting point: one family at a time.

One of our first visits was a low birth weight baby boy with a poor latch. The first time we saw him he was slightly lethargic, but vitals were stable. A hospital transfer would mean the end of breastfeeding, and the limited hospital resources meant that little could be done for him there anyway. We spent time helping with positioning and latch, reviewed danger signs of when to go to the hospital, and promised to return in the morning. It was hard to leave that night, as we weren’t sure what the next day might hold. Over the next few days, we returned daily; observing his daily weights, vitals, latch, activity and I&O’s. His weight stabilized, and he began gaining. Eventually we realized we didn’t need to come back anymore- our little one had made it past this stage that so many don’t. All because of a blue backpack filled with donated supplies and a scale made out of office rings and a blanket.

On a Friday visit for a 3 day post-partum cesarean couplet, the mother was so weak she didn’t rise at all. She felt so fatigued and dizzy upon standing that she hadn’t been out of bed since returning home from the hospital the day before. An instant hemoglobin check revealed a level of 6, and her vital signs were elevated. Her baby had diarrhea, and an infection of the umbilical cord. Both were in need of immediate medical attention, and we arranged for a truck to drive them to the hospital. She was in the hospital for over a week, receiving daily iron injections and awaiting a blood transfusion, as the hospital was out of blood. I would stop by to see her most days, just to see how they were coming along. Mom was still weak and exhausted, but the baby was breastfeeding wonderfully, and doing much better. A grandma was always near the bedside, caring for them dutifully, expressing her thanks whenever she saw us. Feeling helpless about what to do while waiting for blood to arrive, we gathered volunteers and all donated blood. Although it wouldn’t go directly to her, it hopefully will save someone else. And, it allowed us to feel useful while waiting days for something we’re used to being able to order STAT.

One week after her admission to the hospital, she finally received her blood transfusion. The next day she looked like a changed woman. There was color in her cheeks, and I saw her smile for the first time. Another reminder of how much we can catch with the backpack, but are still reliant upon necessary resources that aren’t always available. We do the best we can with what we have.

A newly expanded community-health focus is being taught to the midwifery students here; including the importance of a home visit program for improving maternal/infant morbidity and mortality. The midwifery preceptors each had an opportunity to conduct a home-visit with our blossoming program, so that they were familiar with the model and could train others. They are excited about this, and believe that it will positively impact outcomes here. Mothers and families are grateful for the extra care.

If you are volunteering in Haiti this year, we hope you get to help grow this program.