birthing adventures

My friend Nicole brought to my attention this BBC article, Save the Children: No expert birth help for millions, which speaks to how the global shortage of midwives inhibits the health of women and babies worldwide.  It is a story I am all too familiar with: violence against women packaged in the form of lack of access to sexual and reproductive health care tied up with a big red bow.  It is a reality that infuriates me.  It also is the beginning of how I find myself working as a birth doula today.

Throughout my journey to supporting moms in birth, I had the pleasure of working in three different African countries.  In Malawi, I collected data on maternal and child healthcare and HIV in some of the world's poorest hospitals and clinics for the Millenium Cities Initiative.  In South Africa, I conducted an evaluation of an integrated conflict resolution and women's empowerment program in the townships outside of Cape Town . I also worked with a grassroots organization in rural Tanzania to foster awareness regarding what HIV is, how it is transmitted and how it can be prevented.  My desire to grasp the vast inequality among nations first brought me to these countries, coupled with a strong will, hell bent on figuring out what to do about it.

When I was in Malawi in 2007 it became clear to me that a more robust health infrastructure coupled with an investment in healthcare providers was badly needed - this is something that development organizations were not created to fund.  One day while at Queens Hospital in Blantyre, the biggest hospital in the country,  I witnessed a woman being carried to the hospital for care by her sister because they lacked the funds for transport   She had been hemmhoraging after giving birth (50% of women in Malawi are supported in labor by a traditional midwife who lacks the supplies to manage excessive bleeding) and need medical attention or she would likely die.   The head nurse for maternal health, Mrs. Matola, happened to be outside talking with me and rushed to make sure she received medical attention as quickly as possible.  This scene stuck with me, but it was just another day at work for Mrs. Matola.  The need far outweighs the capacity of the healthcare system in Malawi.  The public healthcare system is funded with foreign aid funds and is the only option for the vast majority of Malawians - an option dependent on the ability to physically get to a provider.

When women are able to seek and attain medical care they are  met by healthcare workers who are overworked and with overpacked facilities struggling to function.  Joanne Jorissen Chiwaula a U.S. trained midwife catching babies in Malawi demonstrates this reality on her blog. The data abounds relative to this issue, however the money and political will to train more healthcare providers and create a health infrastructure in "developing nations" does not.  Mothers and babies are not at the forefront of our leaders minds and until they are, folks will continue to die.  

I tried my hand at policy work.  I thought influencing U.S. foreign aid policy might be a worthy goal for an educated - white citizen of the United States who cares deeply about the vast inequality in the world.  So I climbed in the belly of the beast and learned how policy is made.  What I found were bugs buzzing in the ears of those worried about the next election cycle, who owe favors to those who have their back.  I left confident that I could never be that bug and fell.  I went with my gut this time - not that voice in my head that wants  so badly to all by herself and because it is right - make the world a different place - I went with the gut that said you need to take all that love and desire to help and support people that want to listen, who are in need of that kind of heart and that can benefit from it moment to moment.  Now I stand at a crossroads with folks at major turning points in their journeys and assure them that they are safe and loved and cared for.  The structure becomes the individual if you let it.  For me, right now I am able to, and that feels really good.  I feel blessed.