Maternal Health in Leogane

This week we started our maternal health project! A few months ago, the women’s group in Leogane had identified maternal mortality as one of the greatest concerns of the community. Therefore, Family Health Ministries has started a Safe Motherhood Initiative to make pregnancies safer in Leogane. This summer, Julie, Julia, and I, are looking to identify the most common causes of death of mothers during or right after pregnancy. Family Health Ministries can then use this information to work with the community in designing programs that will make pregnancies safer. The way we are identifying the most common causes of maternal mortality is through the World Health Organization’s verbal autopsy surveys. We are surveying family members of women who have died during pregnancy. These verbal autopsy surveys ask a series of questions about the death such as “Did the woman have a headache?” and “Did the woman have swelling?” The answers to the questions are then analyzed to determine what the cause of death of each woman was.

The way we are finding families of women who have died is basically by word of mouth. We are going around Leogane telling people about our project and asking whether they know anyone who died during pregnancy. At first it was frustrating because we would find family members willing to talk to us and we would tell them to come to the clinic the next day and then they would never show up. We soon realized that we have to be the ones to go to them and not expect them to come to us. So now we go around a tent city identifying people who are willing to talk with us and the tell them we will be back the next day to do the verbal autopsy. Another reason that our project has been making progress, which is really sad, is that maternal mortality is a much greater problem here than I imagined. I’d say about ¾ of the people we talk to have a relative who died during pregnancy. Its difficult to see grandmothers taking care of 4 or 5 children whose mother died during pregnancy.

This week we did 6 verbal autopsies, which is much more than I expected for the first week. Several things have surprised me so far. First is the willingness of people to tell the stories of women who have died. I think part of this reason is the desire to make known the frustration that many people have with the current state of healthcare in Leogane. Another part is the desire of the community to support a project that will make pregnancy safer for other women. Another thing that has really surprised me is the coexistence of belief in Voodoo and medicine. Many Haitians practice Voodoo, a religion that combines West African beliefs and practices and Catholicism. When we ask family members what they think caused the deceased to die, we often get the response of magic or a curse. According to Voodoo beliefs, sickness can be sent to someone by another. What is interesting though is that many Haitians have these beliefs and at the same time take Western medications for their illnesses. I am only starting to realize this coexistence and I am finding it fascinating.

Everthing else is good here. We have been eating a lot, but also doing some intense exercising in our down time thanks to Hannah’s exercise videos! Some of my favorite meals here have been tiaka…it’s a pumpkin soup with like 10 other ingredients and its delicious, mayi moule…a cornmeal dish eaten with legumes, beet and potato salad, and this really yummy type of scrambled eggs they make here with like onions and peppers and some kind of meat. Also, fruits here are delicious! Dr. Merisier showed me a couple days ago how to eat a mango Haitian-style. It involved no utensils, just ur mouth and hands. It was a mango from his tree and it was delicious! I also love the bananas, papayas, cherries, and coconuts we get here. Oh and almost every meal we get either passion fruit or lime juice!

Eating coconuts that McKenzie got for us after climbing the coconut tree.

One of the kids in the neighboring tent city with her coloring sheet :)