Transport in our tap tap

March 11th, 2017


Today is Saturday. It’s a chill day at the clinic. There are no appointments on the weekend. People do still come for births though.
This morning we had a mama laboring with her first baby. She had a preeclampsia trend happening at the end of pregnancy. Her BP today was 148/110. Here’s the dilemma in Haiti. Eclampsia kills many women and babies. So based on her being a primip and having slow progress we transported at 5cm, -1, 75%. Her cervix was very swollen as well. So in the decision making process we had to think. Is she going to birth fast? The answer seemed to be no. We also have to think how far away is the hospital. It was an hour. If she began to seize and needed at cesarean how long would it take to get care? So we opted to transport.
Transport in our tap tap is quite a thing. We put a mattress in the back of the tap tap, packed family in, midwives and an emergency transport bag. Then we were on our way.
We drove through Cap Haitien which is busy busy and slow moving, cars, trucks, motorcycles and people everywhere. It’s such a busy crowded town. Then past Cap Haitien and past the airport we went into the country. We were transporting to the hospital in Milot. The drive was fast. At times terrifying for me and I screamed out. I am a nervous passenger and most of my nerves I am able to leave at home but today they were there. I said “oh my gosh we almost died”. Darren responded later by saying “almost dying is living”.
The drive was beautiful, lush and green but like I said fast. It was so fast.
We arrived at the Milot hospital and backed into the driveway. Armed guards met us and it felt very chaotic. I was standing at the back doors of the tap tap standing but it felt like guarding the mama from all the people and the guards. Aloude our midwife listened to heart tones and they were good. This was a non-emergent transport. As midwives we more often do those in comparison to big emergencies. Our goal here was to have this mom, in Haiti, where they have the highest maternal and infant mortality rates in the Western Hemisphere be able to access more advanced care if it was needed.
The guards let us through the gate. We walked her up to labor and delivery. There were people everywhere, seriously everywhere. Our midwife handed the records to the nurse. Then we were told to take the mama back to a room. As we walked back there was a mama laying there in stirrups alone, no baby with large clots everywhere. I started to have some PTSD kick in at that moment. I felt it rushing in on me. Then we put our mama up in stirrups on a delivery bed, full trash can between her legs, all alone and we left. We left her there because we could not stay. That is the way.
As I was leaving the room and heading down the hall I felt my self wailing up. I hit the air outside and tears started streaming down my face. I was trying to be stoic and get out of the hospital before crying.
I saw the family outside and took a breath, asked Alide to wait, found Darren and Emily and gave the family some money so that they could get back home or eat or pay for care or whatever.
Then we left the hospital grounds and I started to cry.
I looked at Emily and told her this is why we opened MamaBaby Haiti. We wanted better for mamas and babies. Now we serve hundreds of women a year.
At the conference we went to about birth centers in Haiti they said only 35% of women seek care in hospitals and birth centers and that the number one barrier is fear of poor treatment. They say we need over 100 more birth centers to make a real difference here. That’s a lot.
Today I revisited a time in my past working in a hospital in Haiti. I felt it all again today. It hit me hard and fast. This is why MamaBabyHaiti exists.
Regardless, we still need to reach our hand out to that model of care from time to time. It was hard.
Claudin stopped on the road home and got us all a coconut.
My hopes for the day is that mama and baby have no complications and are treated with care and kindness. We will likely see her here with her baby in a few days.
I had a mega tearful meltdown when we returned to MamaBaby. Each day brings new challenges.
At the airport the other day there was an old man saying he was hungry as we drove away. I was trying to find money but we were in the back of the tap tap. As we drove away Darren said you know you can’t help everyone right? I just looked at him and said but I really really want to. He’s an old man. So yes this is my struggle. I may not be the woman in the bed at that hospital but I feel for her. I wanted her to have something better. In some ways she did or will if those more extreme complications present in other ways she didn’t and won’t at all. I’m just sitting in it emotionally today.
Haiti just has my heart.
Here are some pictures of our team here working before transport. Here are also some pictures of our empty clinic today.
Thank you everyone for all of your support.


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