Stories From the Field:

HAITI

Millennium Development Goal #5 in Haiti

Barbara Curtis, a Certified Nurse Midwife in the Department of Obstetrics and Gynecology at Mass General, was granted a Center for Global Health Travel Award to volunteer with Midwives for Haiti.

Millennium Development Goal #5, to reduce maternal mortality rates by 75% by 2015, is an important worldwide goal. While all regions have made progress toward this goal, with just over one year remaining until the deadline, reaching the target will require accelerated interventions. Increasing the number of skilled birth attendants has been proven to reduce maternal mortality so I once again returned to Haiti to lend my support and volunteer with Midwives for Haiti. In Haiti, 75% of women deliver without the assistance of a skilled birth attendant and women are 70% more likely to die in childbirth than in the United States. This means Haiti has the highest rate of maternal mortality in the Western Hemisphere. Midwives for Haiti aspires to reduce these rates through their mission that all Haitian women will have access to prenatal care and deliver with the assistance of a skilled birth attendant.

Midwives For Haiti is making progress toward their goal through the establishment of a school in Hinche that educates Haitian men and women in midwifery skills so that they can become skilled birth attendants. The ten-month program has 15 Haitian students per class and I supplemented the teaching as well as provided prenatal care in the mobile clinic and at St. Therese, the local hospital.

The bright, airy classroom at the Midwives for Haiti Guesthouse hosted our comprehensive and technical program, woven by the underlying theme of providing compassionate care. In contrast with the Haitian custom of offering women in labor little touch or emotional encouragement, we model massage and kindness while teaching labor support, normal and abnormal pregnancy and birthing skills. These skills are put to the test in any one of the 16 mobile clinics scattered throughout the Central Plateau where we treated women for their pregnancy related complaints such as indigestion, backaches, fatigue, cramping and dehydration.

Haiti has one of the highest rates of preeclampsia in the world and this greatly contributes to the overall high rates of maternal morbidity and mortality. Educating skilled birth attendants to identify, treat, or refer a patient is vital in reducing these rates.  As such, I attended a training session for matrones, or traditional birth attendants. These men and women play an important role in home deliveries and it is important to ensure they are properly trained. In this session, we taught them to recognize specific complications in pregnancy and birth in order to help them provide safe care at home or empower them to make the decision to transport to a medical facility if the conditions require.

My journey to Haiti was incredibly eye opening and fulfilling. The skilled birth attendant students are committed to their education and in providing quality care for pregnant and delivering mothers. Largely due to this important training program, births at St. Therese have increased from 50 babies in 2008 to 1,450 births in 2012. Midwives for Haiti has a sustainable model in which they are hiring and training men and women in their own community to provide care. Together, they are working toward meeting Millennium Development Goal #5 to reduce maternal mortality. 

I am very grateful to the Mass General Center for Global Health for their financial support. At Mass General, I have the pleasure of caring for pregnant women from all over the globe and it was wonderful to see our mission at work in Haiti.