BLOG: In Haiti, Giving Birth can be Life-Threatening

The Sacramento Bee
Monday, April 25, 2011 - 20:00
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Andrew MacCalla is emergency response manager for Direct Relief International, a nonprofit based in Santa Barbara. He lives in Sacramento.

Halfway through my trip to Haiti this month, my wife sent me an email saying that if our baby was born today, he would have a 90 percent chance of survival. I found that incredible given that Melissa literally just entered the third trimester. Obviously, we hope that the baby will cook for the full 40 weeks and we won't have to worry about an early delivery, but it is actually quite comforting to know that if he had to come out now for some reason, he'd probably be just fine.

The day she sent me that message I was visiting a hospital we're supporting in a town called Marchand Dessalines, named after one of Haiti's first leaders after independence, about 2½ hours north of Port au Prince in the mountains of the Artibonite. I learned from Dr. Johnny Fequirere, the young Haitian OB/GYN who works at the hospital, that if a child is born in Haiti at the start of the third trimester, there would be practically no chance of survival.

Haiti has the highest maternal and infant mortality rate in all of Latin America and the Caribbean. Pregnancy and its complications have become the leading cause of death and disabilities among women of childbearing age. Out of every 100,000 births, 630 women die giving birth. Roughly 77 percent of Haitian mothers give birth at home, and nearly 100 babies out of 1,000 – 10 percent – die during the first year after birth.

The thought of my wife giving birth inside what's become the typical home in Haiti, a battered tent or tarp help up by four sticks without any running water or sanitation, makes me queasy.

In the year after the earthquake, Direct Relief has been focusing on addressing the immediate medical needs of the population. We've supplied wound dressings, sutures and wheelchairs after the earthquake; IV solutions, oral rehydration and antibiotics after the cholera outbreak; and bleach, soap, shampoo and toothpaste to address the poor hygienic conditions in the camps.

However, now 15 months after the earthquake and seven months since the outbreak of cholera, we're taking a step back to look at the ongoing and ever-present medical issues facing the country. And the one that jumps out and takes your breath away is the number of women and babies who die unnecessarily every year in Haiti due to complications with childbirth.

The doctor at the hospital in Marchand Dessalines told me that day that they deliver about 80 babies a month, 10 of whom will die. While this hospital has five well-trained doctors, 18 nurses and an anesthesiologist, they lack the material resources to save these babies.

There is no blood bank in the hospital. Oftentimes they do not have the medications needed to treat the women. And they do not have any incubators, let alone a neonatal intensive care unit, to deal with premature deliveries. In fact, the doctor told me that they have to refer these pre-term labor cases to a hospital more than an hour away. The road between the hospitals is bumpy and winding, and the woman is transported in the back of a truck. Imagine your wife or mother or daughter or sister having to endure that journey.

Bringing life into the world should not be a death sentence. We have the technology and know-how to treat babies who are born three months early, or even earlier. The eight hospitals we've selected throughout the country – all have trained doctors, nurses and midwives – will ideally become "centers of excellence" in Haiti with new equipment and supplies we'll provide them to save more lives and encourage more women to come in for prenatal care.

My wife, Melissa, has now had nearly a dozen hospital visits and will double that by the time this baby is born, yet more 50 percent of women in Haiti don't ever see a doctor before they give birth – partly because of the state of the medical facilities.

Sometimes it takes a personal experience, or just the ability to place yourself in someone else's shoes, to relate to these issues that affect so many people on our planet. I remember when I broke my first major bone and couldn't walk for more than three months; I discovered a newfound respect for people with physical disabilities.

And now that I have a pregnant wife, a baby on the way, and know what we can do with complicated pregnancies in the United States, I'm shocked by what the majority of women in Haiti have to go through just to bring a new life into the world. But we're doing what we can to help change that for the nearly 1 million women in Haiti who receive care at these facilities.