Thursday, February 4, 2010

Giving Life in a Land Overflowing With Pain

Found on the NY Times website
By DAMIEN CAVE
Published: January 29, 2010

PORT-AU-PRINCE, Haiti — Biology and the earthquake dictated that Roseline Antoine would give birth at 9:42 a.m. Thursday to a healthy baby girl who has no home but the street. The same irrevocable forces left Delva Venite naked a few feet away, in pain, waiting nearly a day for doctors to deal with the stillborn son inside her.

The women shared one of the better medical facilities here — a maternity tent outside General Hospital — but there were not enough beds or doctors. Flies were their roommates, bunching like crows on the intravenous drips, and as for the joy found in most maternity wards, that had been lost to the cracked earth.

“The street where I live, it’s so dirty; there isn’t enough food or water,” Ms. Antoine said. “I’m scared to bring a baby into this awful situation.”

Pulling down her blue dress after giving birth, she added, “I need to find a way to survive.”

The pregnant are an especially vulnerable subset of victims of the quake that has left so many Haitians homeless and desolate. The United Nations estimates that 15 percent of the 63,000 pregnant women in the earthquake-affected areas are likely to have potentially life-threatening complications. For the roughly 7,000 who will give birth in the next month, the risks are even greater.

Aid groups are doing what they can. CARE has been handing out hygienic birthing kits, and doctors from around the world have taken a special pride in delivering babies. Along with rescues, newborns have become beacons of uplift amid the darkness of death.

Still, Haiti is a frightening nursery. Even before the quake, this small country had the highest rates of infant, of under-5 and of maternal mortality in the Western Hemisphere; on average, according to United Nations reports, 670 Haitian women out of every 100,000 die in childbirth, compared with 11 in the United States.

The troubles are especially visible in the tent cities all over the capital. Earlier this week on the grounds of a former military airfield, Venold Joseph, 29, devoured a tin of spaghetti, her first meal since having her baby there four days earlier.

In another tent camp, on a soccer field of a school near the downtown, one meal a day was as much as Mirline Civil, 17, could hope for. Her baby, born Sunday, struggled, too. When she tried to breast-feed the little boy, named Maiderson, he failed to latch. She rocked him back and forth and asked, “Why are you crying so much?”

In three days of visits to General Hospital, which is operating mostly out of tents, mothers were desperate to avoid returning to their own patch of dirt.

The recovery tent, a short walk from the birthing tent, included 15 mattresses Thursday, on gravel, each with a mother and child.

Sandia Sulea, 24, leaning on her elbow, and Nativita Thomas, also 24, said they both had their babies three days earlier. Their homes were flattened. They were left to sleep in the street.

The medical tent, though hotter than 100 degrees in the afternoon sun, was a step up. Here, nurses bring crackers and juice. Here, if something goes wrong, a medical team will help.

“I know they need space for other people,” Ms. Sulea said. “But I don’t know what to do.”

Across the tent, an older woman nodded toward a quiet young mother in a men’s navy blue golf shirt, picking at her nails. While the other women had family or friends crowded around, she sat with her infant son, Mackendi.

“I’m from an orphanage,” said the new mother, Aristil Fabian, 18. “My mother and father are dead.”

Without family — her husband fled to the country — she said she had been roaming the street, bedding down in the closest camp when it was time to sleep. She made it to the hospital on Wednesday, when she had the baby, but by Thursday afternoon, she had no idea what was next.
“I don’t have anyone,” she said. “I’m alone.”

Inside two pediatric tents a few yards away, steel cribs with chipping paint sat crammed together. There were babies with broken arms, a boy with four amputated toes, and two abandoned children — one cross-eyed, the other, doctors believe, with cerebral palsy. No one seemed to know whether the parents died in the earthquake or just gave them up.

The most severe case, however, lay in another crib: the boy with no name. He was 13 months old, according to a man who was waving away flies, but he was so severely malnourished, his eye sockets looked like the cardboard tubes that hold toilet paper. His arms were thin enough to reveal separate bones and ligaments.

“We’re trying to do what we can,” said Dr. Carole Dubuché, a Haitian-American pediatrician who practices in Brooklyn, as she filled a bottle of formula.

Few of the doctors were local. Most of the Haitian obstetricians and pediatricians have still not returned to work full time. The young residents who are trying to fill the gap say a few show up for the morning or afternoon but do not stay long.

Ms. Venite’s husband, Gérard Joseph, said he understood why. “Everyone is looking for their family,” he said.

But not everyone sees it that way. “People here are getting a paycheck and they don’t come to work,” said Dr. Gerard Guy Prosper, a former head of pediatrics at General Hospital who now works in the Bronx. “And no one does anything about it.”

He nearly shook with anger.

The result, for now, seems to be a scramble to keep up. On Thursday, Ms. Venite’s pregnancy ended nine months after it started, with a small, still figure in a cardboard box on the dirty ground. It was only chance that kept someone from accidentally kicking it.

And on Friday by 3 p.m., two women had already had Caesarean sections; two others were waiting their turns. A resident said that all four women were at high risk for complications.

Inside the recovery tent, meanwhile, Ms. Fabian and Mackendi were gone. So was the malnourished little boy. He died Friday.

By comparison, the triumphs here are small. A group of doctors linked to a global health group out of Johns Hopkins in Baltimore opened three operating rooms this week inside the hospital, so some Caesareans no longer take place in the surgical tent where doctors are amputating gangrened limbs.

Ms. Antoine on Friday also found a place to live, in a neighbor’s yard. She had been sleeping in a sewage-drenched camp outside a flattened school in her neighborhood of Bel-Air. Now, she and her new daughter, Kimberly, live just behind it, under a thin white sheet near a mostly empty set of cages with a few chickens and a litter of puppies.

Her two older children, David, 12, and Osnort, 5, seem happier with their new quarters, but Ms. Antoine remains beleaguered. From her new dwelling, she can see the crushed house where she used to live — and where her husband died while she sold cookies from a pushcart downtown.

She lost everything that day, and she said she hated that she was suddenly dependent on the charity of others.

“I don’t think I can live like this, just waiting for someone to bring me food,” she said. She shook her head, and stared away, as her day-old daughter tried to suck her thumb.

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