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Week of 1.29.10

Saving Haiti's Mothers

On the ground in Haiti, working to save the lives of mothers during childbirth.

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The Weekly Q

Haiti's catastrophic earthquake, in addition to leaving lives and institutions in ruin, also exacerbated a longtime lethal risk in Haiti: Dying during childbirth. Challenges in transportation, education, and quality health care contribute to Haiti having the highest maternal mortality rate in the Western Hemisphere, a national crisis even before the earthquake struck.

While great strides are being made with global health issues like HIV/AIDS, maternal mortality figures worldwide have seen virtually no improvement in 20 years. Worldwide, over 500,000 women die each year during pregnancy.

This week, a NOW team that had been working in Haiti during the earthquake reports on this deadly but correctable trend. They meet members of the Haitian Health Foundation (HHF), which operates a network of health agents in more than 100 villages, engaging in pre-natal visits, education, and emergency ambulance runs for pregnant women.

The United Nations Population Fund, which trains midwives to share life-saving birth techniques and serve in rural communities, says that with proper funding, public support, and wider application of simple but scarce innovations, such deaths could be reduced by nearly 70 percent.

As media attention on Haiti slowly fades, the issue of maternity mortality remains as imperative as ever. But with an estimated 200,000 women in Haiti currently pregnant--and a main midwife training school devastated by the earthquake--the mission of keeping mothers alive has never been more daunting.

This show is a co-production with the Bureau for International Reporting (BIR), a non-profit video news production company.

To learn more about organizations helping women in Haiti and in childbirth worldwide, consider:

United Nations Population Fund

The Haitian Health Foundation

Family Care International


Should Haiti restore its destroyed institutions or start from scratch, and what role should the international community play in rebuilding Haiti?

Viewer Comments

Commenter: A S TOMES
Help the injured from the quake and then come back home. We have enough problems of our own. Let,s take care of our problems first. I am tired of the bleeding hearts that want to solve the worlds problems and trying to gain friendship from countries that care nothing about us. All the want is to come here and live our life style while bringing nothing to add to the country. In fact they become another problem here. Help and leave...not help stay support so their politicians, like ours, can steal all of the good intentions and aid we give them...I can not afford to solve the worlds problems, I have enough trying to take care of me and my family


Commenter: Aaron
Hello, I am a huge fan of NOW programming. I was able to watch and learn from this episode, and I was struck by the compassion of organizations like the Haitian Health Foundation, as well as the United Nations Population Fund. Considering the previous shop-worn condition of much of Haiti's destroyed institutions, it would seem to make sense to start from scratch in rebuilding. Of course, that cannot be done without a major, appropriate, formulated role by the international community. Separately, while watching, I was appalled yet again by the total absence of the apparently dead-beat fathers in the story! Sadly, this is the case all too often, and everywhere else in the world! Women who allow themselves to be impregnated by dead-beat men are not helping their own situation! Thank God for the compassionate organizations and funds I learned about while viewing NOW!

PBS...PLEASE DO NOT CANCEL THIS VITAL, INFORMATIVE SHOW!!


Commenter: Meena
If anyone is interested, please check out the film "Life and Debt" by Stephanie Black. The film pretty much sums up why so many third world nations are in such poverty and poorly educated compared to the developed nations. I know there are numerous factors that contribute to Haiti's poverty (corrupted Haitian goverance, exploitation by European and US nations,etc.) but strangely enough, overpopulation isn't one of them.


Commenter: M
Please listen to Crawford as stated earlier - this was a 25-minute documentary. They could not include everything that HHF does. I've been to Jeremie and visited Haitian Health Foundation and observed one of their training sessions for community health workers. HHF DOES provide education for families/ work for social change regarding limiting the number of children / family planning as well as nutrition and other needs.
Do y'all want the mothers who are already pregnant, and their unborn children, to have high mortality rates? To "reduce" population and create more orphans?


Commenter: Candy
Do these women want to become pregnant and keep having multiple pregnancies and children? Children are a lot of work and strain under the best of circumstances.I get the feeling that men are laying with these women , getting them pregnant with little care for the woman's welfare or the baby's. These women need education and a future, not constant pregancies and birthing. Educate these women on how to use Birth Control, how to say no to the multiple pregnancies and gain control over their destinies.

Getting impreganated shouldn't be a compulsory part of their existence because they have sex.


Commenter: katherine g, CPM
I am shocked and disgusted by some of the comments posted. In the US I work at a free standing birth center and also did many homebirths, and I have also worked in Africa and am currently working in Haiti as a midwife with a well known NGO since January 19th. The midwives here are very highly skilled, and although conditions are not at "American standards" they do a very good job. Work very definitely needs to be done with hygiene and sanitation but the fact is that women delivering at home deliver in much worse conditions and with absolutely no means for even washing hands. So i applaud the efforts of the midwives to continue working in spite of the fact that many have lost immediate family members in the quake and that most are now homeless. Many are unpaid for the moment. Telling the Haitian women that they should not ask us for help because you think they got themselves into this situation by not using birth control when we think they should have is disgusting and wrong. We cannot blame victims. Seeing cultural changes from education efforts can take a long time to measure significant differences... And you must not forget that there are very big cultural differences factoring here - including preferences in birthing position. We monitor women and babies carefully at the hospital I am working at and if there are signs of fetal distress or ineffective pushing we get the mothers to change position. If you would research a little bit you would know that not only having a skilled birth attendant can save the lives of women during childbirth in Haiti. There is a very very high incidence of eclampsia and preeclamspia that need medications during the 3rd trimester, during labor and for the first few days postpartum and delivery in a hospital setting with capacity for other interventions if needed. The Traditional Birth Attendants here are not trained for appropriate use of these drugs, and overdosages can be deadly.
Personally I am an advocate for homebirth for LOW risk births - so I am not saying that every single woman should birth in the hospital - for the moment we do not have the capacity to handle all births. We do need to start training more TBA's to carefully screen women and send all women with complications to the hospitals that are still standing. For the moment they are coming on their own - they would NOT rather birth at home because they have no homes, and there are few TBA's left. TBA's also do not have the capacity to screen every woman for HIV, syphilis and hepatitis like we do - we have found more than a few positives and have begun appropriate treatment. And there are and have been movements for family planning methods here but the earthquake and associated trauma have taken the spotlight and focus away from birth control TEMPORARILY...
And it is not the developing world that is causing the most increases in greenhouse gasses and climate change - it is the US. And you should all look at the maternal and infant morbitidy and mortality rates in CALIFORNIA right now... Is our health care system functioning like you think it is???
God, i have to stop reading these comments, for the most part they make me sick and embarrassed that "my people" can be so selfish, ethnocentric and judgmental.


Commenter: Gail Johnson
I am a semi-retired Certified Midwife from Texas, now living and helping with birth education here in Belize As well as maintaing my Texas liciense I have also obtained my Belize Liciense.
I do a geat deal of world wide travel , delivering babies and also teahing as best I can.
A present I do not know the educational past system in Haiti, so do not know what I can say to help.
Perhaps whn the crisis stage of recovery is over I can contribute some houghts.
Videos are great teahing tools, DVD"s is the correst word I guess, and also WHO has many tools .
I could come and help tach someday if you need these skills.
I served as a proctor for USA scholls and served on the Texas Midwifery Board for Rules and Regualtion of Midwifery for 6 years.
I am free to travel ad willing to do so.
see my web site www.midwifewithoutborders.com
I am commited until Oct. 2010 alrady, but wish to help as soon as I can.

Gail Johnson CPM
e-mail { midwife@verizon.net


Commenter: Lisa Jones, Fresno CA
Start over ... nothing last forever ... new builldings with new technology is the way to go ... be green and solar!


Commenter: Dr Jemima Dennis-Antwi, Regional Advisor for Anglophone Africa, Intertional Confederation of midwiv
Haitian Institutions are required to ensure that the people get access to the services needed to maintain and sustain their lives. For example improvements in the current Maternal Health Services is of prime importance to save the lives of the over 200,000 expectant mothers. Starting from the scratch implies ignoring what existed before as not useful to their current situation. That can be dangerous now. I believe that restoration through an approach that builds on existing strengths is the key. The surviving maternal health system including the work of HHF and support by development partnenrs should be resourced and promoted to gradually develop the Haitian people to take charge. International midwives should be mobilised on short term basis to bring their expertise to support what is on hand now which is obviously overstretched.


Commenter: Carl Aaron, CA
I agree that overpopulation is the cause of most of Haiti's problems.

Haiti's population was 6 million in 1990 then almost 10 million in 2008. Dirt poor people gathering wood has denuded the nation, leaving it with less that 3 percent forest cover.

Waters from tropical storms and hurricanes cause great erosion. Orphanages were destitute and overcrowded even before the earthquake.

Provide birth control devices and instruction after this situation is stabilized. If they decline to use it tell them not to appeal to us after disasters.


Commenter: Judith
Looking at this program from a maternity nurse's perspective and seeing that at this births, it is midwives in charge, I am horrified to see these women flat on their backs, lying on cots instead of being up and walking and giving birth physiologically using gravity.No wonder that they would rather stay home.


Commenter: Sheila Malone
If you study the history of Haiti you will find the US is 100 % responsible at this point in time for the extreme poverty and lack of infrastructure that exists in this country so closely tied to our own. This earthquake only highlights to the world the the awful truth of the lives of the average Haitian. Even now when we could do so much good we are not helping out the people who have the most need, but the ones who have money and supported the terrible regime we put into place. I think it is time for the world community to step in and help the Haitian People start from scratch. It is not just the poverty and lack of services but the oppression and deliberate effort on our part to prevent the Haitian people from taking charge of their own lives. The world can and must step in now that the quake has done it damage.


Commenter: Amie
I don't think that bringing birth into hospitals is the answer for Haiti. I believe having well trained birth providers (midwives with the necessary equipment and medicines) would greatly improve maternal and fetal outcomes.

North American has the highest rates of maternal and fetal death in the developed world. Our system is obviously not working and will NOT improve things in Haiti (in the long term).

Keep birth at home attended by trained birth professional, THIS WILL save mom and baby!


Commenter: judy mc

I do not understand why they government does not allow their people to use birth control. It is outrageous that there were 250,000 orphans before the earth quake and now there is much more. I am sure the people realize that having more children creates more orphans. I really would like to know the answer and why birth control is tabu. If you cannot afford to have children--use BIRTH CONTROL. We also need to moniter all supplies that we drop off in Haiti and make sure the people actually get them and that everything is distributed fairly instead of just taking someone's word. Some one from our government that is very well qualified in the skill of taking inventory needs to make sure that what is dropped off is actually going to the poor people that are in need and not being sold for profit. We as americans want to help whoever needs the help but we wish to make sure this happens and to make sure all supplies or monies is not going to the government for their own corrupt use. Our tax dollars need to be spent wisely.


Commenter: Norma G
The best way to save women's lives,is to limit their number of pregnancies.
Provide education & change cultural values.


Commenter: Cathy Dorman
You should check out Bethlehem Ministry's new clinic Clinique Espérance et Vie, a healthcare clinic serving 30,000 residents in Northeast Haiti. http://www.bethlehemministry.org


Commenter: Norma
Limiting the number of pregnancies is the #1 way of saving women's lives.
Education & Family Planning is essential.
Cultural values need to be changed.


Commenter: Karen K.
Excellent program, I have visited Jeremie, Haiti over a dozen times in the last 22 years. The program is working and the Haitian women are cooperative, because their babies are living.


Commenter: Nadene Brunk
Midwives for Haiti is training skilled birth attendants in Central Haiti and mobilizing midwife volunteers from the U.S who want to go to Haiti to assist women. The need is great and we can help but we need medications and salaries for more Haitian midwife instructors.
www.midwivesforhaiti.org


Commenter: Crawford
Folks, this was a 25 minute broadcast. Family planning IS a part of these organizations, whether it's condoms, teaching sexual and reproductive health, and sexual rights and self-esteem to young women. There was a focus on maternal health, not on birth control, in this single 25-minute broadcast. Don't think that just because it wasn't mentioned, it isn't there. Malnutrition is another source of maternal condition; just because it wasn't mentioned doesn't mean that it doesn't exist in Haiti. Focus on the programs detailed *in this 25-minute documentary!*


Commenter: Pam Macke
I just watched this and wonder how we can help? I am an OB nurse. Do you have trainging for American nurses to become midwives. We are involved with Mission Possible who is in Haiti.Pam


Commenter: Victoria
For heaven's sakes, along with saving mothers and babies lives, why not also bring along oondoms and realistic birth control options.
Teach women how to limit the size of their families which is now obviously out of control. I saw one women(from another news network) after the quake that had 11 children!
If you cannot feed, clothe and educate your children, why are you continuing to have so many?
Women need to be in charge of family size.
Look at the end result when they are not.


Commenter: Norman
Not one single word in this program about birth control which would do more than anything else to ease maternity problems for the women of Haiti. Why? Haiti has the 47th highest birth rate in the world.


Commenter: Allen Jamieson
The Maternity program was excellent. Anything that can b e done to improve the situation is to be congratulated.

HOWEVER -- The real problem facing Haiti and most of the developing countries goes before motherhood. The real problem is controlling the devastating effects of over-population. OK, spend money on maternity problems. BUT spent as much as can possibly be poured into family planning -- education about the benefits of small families, both for the individual family and for the country as a whole. Haiti cannot afford housing, medical care, food supply, and general living space for the unlimited population explosion they have been creating for many years.


Commenter: Karen Hays
Thank you for airing programming on this important issues. Of all the Millennium Development Goals, maternal mortality has not improved at all. Why??? It's a complex problem that has a lot to do with midwifery and medical services, but also the status of women in this world.


Commenter: Nadene Brunk
I hope Midwives for Haiti is mentioned in there somewhere. We have been training skilled birth attendants in Haiti for three years and will continue to do so. There are more trained midwives in Haiti with no paying jobs. Who is going to hire them and pay them. We are trying to do both- train and hire.
We could use some international help.


Commenter: C, Ricard
My husband watched this program on TV ....he mentioned the fact that nothing even mentioned about family planning....it appears that this topic was being surpressed on this program....that is too bad....all of us know what is going on and wish someone could speak out. I did read the links made available here. Hopefully when the new program starts "Need to Know"...it will not continue to be afraid to say what everyone needs to know about family planning problems in Haiti. If the Catholic church is to blame then we need to talk about it....that is a crime against humanity.


Commenter: Gary Baker MD
Once again the subject of "population control" is the silent elephant in the room. This video production and the whole Haitian earthquake disaster cry out as examples of the ills of dysfunctional family size and associated overcrowding and poverty. Yet over the past 20 years, population control has become a taboo subject.

While I applaud the goals and efforts to improve maternal mortality as demonstrated on this program, as a human I have become desperate over the silence regarding the #1 human problem, too many humans for this earth.

Too many humans on earth are destroying the life-giving biosphere, making too much deadly pollution and CO2 and insuring widespread war, disease, poverty and starvation world-wide. Over-population overwhelms any of the solutions aimed at world-wide health or prosperity.

While fixing maternal mortality is only partly related to the issue of population control, it is clear that fewer birth events directly relates to fewer birthing deaths, mother and child. In fact, after accounting for higher risk for first birth and for early teen births, maternal/child birth mortality rate increases with increasing parity and maternal age. World-wide prosperity and education that is improved with fewer humans on earth also improves all manner of health issues, including birth mortality.

What with the over-concern on right-to-life and a re-energized religious right and with 3-5 of the world major religious sects competing in a poorly-concealed membership population race, open discussion on population control and family planning has become politically incorrect. Yet blooming populations of our species are increasingly associated with killings and starvation that are not addressable by all humanitarian efforts. Overpopulation lies at the root of almost every problem faced by the human race.

It was ironic that:
1] males were blamed for the lack of attention to birth mortality, but birth rate and population control depends 9/10th on female physiology (There is equal culpability of the genders for both birth mortality and population management, but one man can produce 100's of lifetime births and the male is not the statistically limiting gender in population control. Yes, we need fewer males, too, but fewer males doesn't equate to fewer births.)
2] the parting picture in this video production shows 3 or 4 cute pre-puberal girls in party dresses walking down a dirty jungle road as innocent targets deserving your concern for their future birthing mortality. Obvious in these same images, they are poster children for "too many new females likely to have too many future children".

If population is not managed, then lasting world health will never be achieved, whether the subject is birth mortality or starvation or sanitation or ecology. With existing and further overpopulation, war, disease, natural catastrophe (such as the Haitian quake) and even a growth in homosexual orientation become species survival strategies.

Bring population control out of the closet again!! When a program shows a problem example of it, talk about it. Survival of our species and others depends on human population management much more than any other current disease or health issue.


Commenter: meiling albert
The international community has a moral and financial responsibility to rebuild Haiti, because most of Haiti's poverty was caused by foreign exploitation, even more than the rulership of the Duvaliers which also was financed by international loans. From the time of it's revolution, Haiti has been continually paying debts to France and later the IMF, very large amounts of money it could ill afford to let go of. It has been a moral crime all along and now that we are beginning to realize our part in it, we should help Haiti in every way possible.


Commenter: Vivian D'Angio
Whatever institutions that were working for the people of Haiti should of course be restored. I believe the international community must continue to support Haiti financially and with whatever will enable the Haitian people to have an economy with good jobs and a government responsive to its people needs.


Commenter: Hildegard Letbetter
Rebuild Haiti according to modern city planning.


Commenter: maryAnn Preston
If an institution can be salvaged it should be and maybe improved at the same time and with many they will have to start from from scratch. The international community should first of all forgive Haiti's debts and money at this time should be given in the form of grants and not loans. We need to make sure the money goes to the Haitian government and that the Haitian people of all socioeconomic class benefits from the rebuilding of their country.


Commenter: miriam bisk
I was extremely impressed with the Haition Health Foundation's work, in particular knowing that their overhead is so low (less then 8%) and was encouraging to see and hear about their devotion and passion as we here in Ithaca, a group of DFW women just sent a large donation to this organization!
Thanks for confirming our investigative findings with your NOW program.

Miriam Bisk
Chapter Leader Ithaca NY
Dining For Women


Commenter: Karen, NJ
I think Haiti should rebuilt all the destroyed institutions from scratch. Just for a better and renewed service for everyone and also more updated technology that could help Doctors and Teachers offer a improve service to this mothers giving birth and the general public. The international community would also be a great help due to the fact that Haiti is a country that needs every single help that can be offered.


Commenter: jennifer
let me begin by saying that i see every child as a precious gift. that being said, i have deep feelings of frustration when i see programs like the one i just watched, 'saving haiti's mothers'. while i agree that there should be help given to the women of haiti and any other country that is poverty stricken and/or victims of a great disaster.....why does the media only focus on the birthing of the babies and not mention at all, any effort to help/encourage the women to learn of limiting the size of their families. doesn't it seem cruel to dismiss the fact that most of these children are being brought into a society that can only offer them (at this time) a childhood and life of little or no opportunity to be fed well and taken care of in a way that will see them grow happy and provided for? worldwide i think we the public are losing sight of the fact that over population will only cause more societal problems.

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