24 February 2015

More Mama Maisha stories + photos

For the past week, my co-founder and dear friend, Dr. Reta Graham has been in Shirati with two other colleagues.  We've been going out to the villages where Mama Maisha is getting established, and it has been an extremely poignant time for us.
First we went for a meeting of women's group members in Roche Village.  Over 90 women came!  We've only been working with the village women for 3-1/2 months, and on one week's notice, our Maternal Health Advocates had mobilized over 90 women of child-bearing age to come hear a seminar on Healthy Pregnancy, Safe Delivery and Family Planning.  There were so many beautiful women with pregnant bellies and tiny babies, and it did our hearts so much good to sit with them and answer questions and hear stories.  The lady in the orange and black and white striped dress told me she's going to name her baby girl after me!  We'll see if it really happens, but it would be an incredible honor.

After several hours with those ladies, we went for a "short" walk (about 30-40 minutes each way in the blazing hot sun) to the home of a Traditional Birth Attendant and saw the dark, windowless room and the straw mat where she delivers babies.
The next day we went to Burere Village for another meeting with clients (below).  The program hasn't been so dramatically successful as quickly as in Roche, but we still had a great time with the ladies who came.
 On Friday we went to Nyambogo Village to do a facilitated discussion with a group of TBAs.  This village has no health services at all, so the women really rely on the TBAs.  They were so interesting and interested in anything we could share with them, and they looked lovely in their colorful dresses.
As we sat and drank sodas with them, we asked how they got started in this work, and several of them shared stories about how they had dreamed that Jesus called them to deliver babies.  I loved hearing how they see this health care service as a kind of spiritual service and ministry.  I'm sure the women they serve are grateful for the gentleness and maturity that the TBAs bring to the bedside.

After a fun, restful weekend showing my new friends around Shirati, we headed back to Roche this morning for a great meeting with the Maternal Health Advocates.  We heard a lot of their struggles and the obstacles that women in their village are facing; sometimes stories sad enough to nearly overwhelm.  One MHA shared about how a woman showed up at her door in the middle of the night, nearly ready to push, and the MHA scrambled to get her on a motorbike taxi, and they set out in the cold, dark night together.  Along the way, the baby started to come.  In the dirt and the dark on the side of the road, far from any house, one woman with no medical experience or birthing training delivered the baby of another woman.  Sadly, the baby was born not breathing, and they were not able to revive him.  Our friend was suffering so much guilt, feeling that she had done something wrong, because she'd never been on that end of the delivery process before.

In order to give the MHAs confidence of knowing what to do if they are ever faced with a similar situation again, Dr. Reta and Dr. Bre simulated the best practices for a less-than-ideal birth environment.  Reta may not have felt particularly dignified laying on the floor "delivering" a camera, with its strap representing the umbilical cord, but the MHAs and I (who have never been on the "catching" end of a birth either) learned a lot from their practical lesson.

After this simulation, a couple of clients came to join us and share their stories.  One was the woman whose story I shared here back in December.  Her baby is now nearly two months, and is fat and healthy and beautiful.  The other client was an 8-month pregnant woman with a lovely, pacific smile who never spoke a single word.  I pieced together her story: she is simple-minded (honestly the best label I can put on it, not knowing any more specifics than that) and mostly mute.  She is unmarried and lives with her parents, but her disadvantages have made her a target for some absolutely disgusting men.  This is her second pregnancy; her first child is only 18 months old.  Her parents have decided to get her a tubal ligation after this baby is born to prevent future pregnancies, but preventing future pregnancies is not the same as preventing future sexual assaults.  

As we drove home this afternoon, that girl's story weighed heavily on me, and I asked Reta to pray the Serenity Prayer with me.  "Lord, give me serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference."  I was also reminded of a verse from Isaiah 30: "Your ears will hear a word behind you, 'This is the way, walk in it,' whenever you turn to the right or to the left."  I prayed that over her, that as she walks through an environment fraught with peril, she will hear the Holy Spirit guiding her to the right or to the left, away from men who may harm her.  I asked the MHAs to call me when this girl comes to the hospital for her delivery and tubal ligation; I hope I will have the chance to pray with her and advocate for her in yet another environment that could prove frightening for her.

Like I said at the beginning, it has been a poignant week, with a lot of highs and a few lows, but overall Reta and I feel reassured once again that this is the work God has called us to do here, and that God is the one guiding our steps.  Please pray with us as we finish two more days of meetings and planning before the team leaves.  Their fellowship and like-spirited-ness has been incredibly refreshing to me, and I will really miss them when they go, but I am the blessed one who gets to keep on collecting the stories and navigating politics and personal agendas and inefficient and/or corrupt systems to provide the best services possible for my sisters who are pregnant and delivering.  It's a wonderful life!

12 February 2015

2 Mama Maisha Stories + Gretchen's 1st Birthday

Now that we've been back home for a week, we've had the chance to catch up with our co-workers, including the staff of Mama Maisha.  Ellen, our Adviser, has been so active advocating for the women who come from the villages to deliver at the hospital, many of them in emergency circumstances.  She told me about one visit to the hospital which showed vividly the impact that Ellen, a retired maternity nurse, is having on behalf of our clients.

One of our Maternal Health Advocates notified Ellen that she was bringing a client to the hospital because her labor did not seem to be progressing well.  It was late on a Friday evening, so Ellen met the client at the hospital, paid the motorcycle taxi, and helped her get admitted to maternity.  Leaving her in professional hands, Ellen went home for the night.  She checked in again on Saturday, carrying food and tea for the expectant mother, to find her still in labor.  On Sunday, Ellen returned again, thinking to find a newborn baby, but instead found the mother still in labor.  Ellen sought out the nurse on duty and demanded to know what the plan was for this woman who had been in labor for more than 48 hours.  The nurse dismissed Ellen's inquiries, saying that she didn't know what was happening with this patient.  Ellen demanded a consult with a doctor, and when a visiting Dutch doctor arrived, he sent the patient for a Cesarean section right away.  The baby was delivered safely and the mother returned home to recover.  

Across the ward in another bed was a young woman with her mother.  Ellen began to inquire what was happening with that patient, sensing something was wrong.  A nurse explained that the woman had had a stillbirth.  After additional probing, Ellen got the story, delivered somewhat defensively.  The young woman had not told the nurses that she was ready to push (second stage of labor, when the birth of the baby is imminent), and instead was squatting over a bedpan, trying to deliver alone.  The cord was wrapped around the baby's neck, and it seemed that the long period of pushing may have caused the baby distress and eventually claimed the baby's life.  Hearing this story from the nurse, Ellen spoke to the mother of the young patient.  "My daughter is mute, she doesn't speak," the mother explained.  "We told the nurses two times that she cannot speak, but they still are blaming her that she didn't tell them when she was ready to push.  They were sitting there chatting while my daughter was trying to deliver her baby alone."  The family ended up filing a complaint with hospital administration over the treatment of their daughter, but even in the unlikely case that there are repercussions for the nurses on duty at the time, a baby has lost its life and a young mother is bereaved.

For me, this story drives home the importance of the advocacy Mama Maisha is doing in the formal health sector.  On the one hand we're trying to tell women in the villages that the hospital is the best, safest place for them to deliver, but on the other hand, we see systemic neglect and disrespect in the way delivering women are treated by the hospital staff.  I'm so grateful that Ellen was there to speak for our client, and I pray that we will have wisdom in how to try to change the negative culture surrounding childbirth.

Speaking of babies we are grateful for, today was Gretchen's first birthday!  Many friends stopped by throughout the afternoon to wish her a happy birthday and get a slice of her birthday cake.  She is growing so fast, and we're so happy to have this joyful, friendly, adventurous little girl as part of our family!

07 February 2015

I knew I was back in Africa when these five things happened...

...I got unsolicited parenting advice.
On the flight from Dubai to Nairobi (honestly right around the time we flew into African airspace) a Kenyan woman coming from the bathroom stopped to advise me to adjust sleeping Gretchen because her head was at an awkward angle.  I cannot tell you how often I get advice on how to hold, feed, comfort and/or clothe my kids from complete strangers, and after 2.5 months away, all I could do was mildly protest that she was okay as the woman adjusted Gretchen's head herself.  It's all kindly meant, but feels a little condescending.  (My pride rebels!)

...immigration took longer for the Kenyans than for the Americans.
Logically, it should certainly be easier to allow Kenyans back into their own country than to process hand-written visas for foreigners.  In the past we've all gone through the Kenyan line because Fred and Wesley have Kenyan passports and I have a residence permit, so don't need a visa.  This time, because we don't have Gretchen's Kenyan passport yet, she and I went through the visa line, and were done a full ten minutes sooner than the guys were.  Why?  I honestly have no idea.  There were far more foreigners than nationals on our flight, and there are always a handful utterly unprepared to pay a visa fee, which takes time as they argue why they shouldn't have to or can't pay.  All I can think is that the Kenyan government puts such a high premium on tourism that they expedite the foreign visitors as much as possible.

...our lost luggage forms took about an hour.
Our flight from New York to Dubai had been delayed an hour, so we just barely made it to our Dubai to Nairobi flight in time for boarding and we had a feeling our bags might not have made it.  Sure enough, only two out of eight pieces made it on our plane, so we had to report our luggage as lost.  What we should have done is just find our when the next Dubai to Nairobi flight was (six hours behind ours) and come back then.  Instead we got sucked into the African bureaucracy, where the forms for our luggage had to be filled out by hand, complete with coded letter/number combinations to describe each bag.  It seemed to take forever, especially to our three very sleepy kids.

...the lost luggage people seemed a little disappointed to see Fred.
This being Kenya, and this not being our first rodeo, so to speak, Fred made sure he was there in plenty of time to get our bags off the carousel when the later flight came in.  He ran into the lost luggage guy who was also searching for our bags.  This should have been reassuring, except that our instincts (and our taxi driver) warned us that we should not leave our bags in the custody of the luggage people for any amount of time, because they're notorious for rifling through and taking stuff.

...our plans changed immediately upon arrival.
Since we had to wait around for our luggage, we couldn't make it to the overnight bus we were intending to take to the border.  Instead we rented a hotel room for the night. (Thanks to the friends and family who handed us cash on the last day so that this unplanned-for expense was not stressful!)  The kids revived enough to bounce off the walls until they crashed like dominoes, and Fred and I realized that this change of plans was really God's best plan for us.  We got a pretty good night's sleep after about 34 hours of travel and a really nice, hearty breakfast before setting out for our final 10-hours home.