Supporting Safe Birth

Hello

We are in the process of planning a 2-week training trip to Guatemala, Oct 6-20, 2019, dates to be confirmed. We will be training and mentoring midwifery students and midwives in Helping Mothers Survive and Helping Babies Breathe programs.

Interested individuals need to attend our September 21-22, 2019 training weekend at UnityPoint Health-Meriter Hospital, 202 S. Park St., Madison, WI.

Sign up for this training under on this website under Programs. Please email Nancy at safebirthguatemala@gmail.com if you have questions, thanks

We had a great training day on April 6! HMS Preeclampsia & Essential Care for Labor & Birth:

Supporting Safe Birth is now a recognized charitable organization at AmazonSmile. When you use amazonsmile.com to shop at Amazon, .5% of your purchases are donated to your designated charity. Please consider adding Supporting Safe Birth as your AmazonSmile charity.  Remember, only purchases at smile.amazon.com (not the mobile app or http://www.amazon.com) support our work in Guatemala.

Thanks for making a difference! We’re helping save lives of mothers and babies in Guatemala.

Upon my return, one of my best friends said something wise and insightful to me.  She said it seemed like this trip was like running a marathon. We are excited in the lead-up, we struggle and feel pain during, and we describe it as the most amazing, transformative thing we’ve ever done in the aftermath.

We were up before dawn, before the roosters, in order to catch a flight home leaving just after sunrise. Shortly before sunrise, at 0415, the airline finally gave us the option of rerouting through Dallas rather than trying to plow through the Category 3 hurricane currently making landfall in northern Florida. While I’m beyond excited to be going home to my little family today, I know I’ll miss living the lessons that this trip has taught me.

Over the course of the last 10 days, I have realized that the girl who used to blithely gallivant around the world no longer exists. She has been replaced by a woman with roots.  Sometimes we perceive roots as holding us down, but they also give us stability. Stability to stretch even further beyond our comfort zone than we thought possible. Guatemala, a place I admit I knew next to nothing about prior to this undertaking, got under my skin and into my blood.  Looking forward to finding a way to go back.

Today was our second (and final) day of teaching at the midwifery school here in Guatemala City. It was also our last full day in Guatemala. On the last day or so we became aware of a strong hurricane working its way from Central America towards Florida. It was formed out of the storm we experienced down in Chiquimulilla, and the flooding it caused was so bad by today that they were evacuating the area where we had just been staying. It was set to make landfall north of Miami where we were due to fly into on Wednesday morning. We were pretty sure we could get into Miami, but we were also pretty sure we wouldn’t get out of Miami in a timely manner. The airlines, in their infinite wisdom, told us they were not planning on rerouting passengers until the day of our flight.

But today, we were teaching Helping Babies Breathe. The class started out on a somber note when some of the student midwives wanted to share their experiences with babies who were stillborn or who died shortly after birth. They talked about how those experiences motivated them to become midwives and why they felt like the training we provide, in particular, is so important to them. The class followed the usual rhythm….the students take pretests that assess their knowledge and confidence, we teach hands-on skills using the mannequins and role-playing, skills tests throughout the day to assess understanding of the material being taught, and ending with knowledge and confidence post-tests. All the students in my group were smart and learned quickly. The other trainers said the same thing about the students in their groups. Over lunch, we conducted a focus group and asked the student midwives the same questions we asked the midwives down in Chiquimulilla. They shared their hopes and dreams for their futures and for the future of the health of their communities. Like the midwives in Chiquimulilla, the students also talked about how the midwives in their communities need access to basic equipment so they can better care for their patients. They expressed a need for everything from gloves and gauze to blood pressure cuffs and cord clamps.

As in Xela, the session ended with a little ceremony to pass out certificates to the students, lots of laughter and photos and some happy tears. We definitely hope we will be invited back to teach at the school next year. After leaving the school, before dinner, we decided to take a quick run through the Mercado Central for some last-minute purchases. Nancy and I entered the market on one of the levels below the artisan level. It was a wild array of baptismal gowns, rhinestone jewelry, housewares, and produce.  Sadly, we had very limited time and we weren’t able to poke around at all. We ended up having dinner much later than we had intended, compliments of the Guatemala City traffic and finally made it back to our hotel around 10pm. It was the moment of truth…..would all my treasures fit in my suitcase without exceeding the 50lb weight limit??  Yes and no…..yes they all fit, but my bag weighed 50.4lbs…. Luckily for me, the airline person didn’t get her tail in a knot about 4 ounces. Tune in tomorrow for my final blog post to see if we got to fly through or around Hurricane Michael!

Day 8: Asociación Corazón del Agua, Guatemala City

Today we were up with the roosters for our first day teaching at the midwifery school.  The school was recently completed and it felt sunlit, fresh, and comfy. At any given time there are about 15 women enrolled in the school’s three-year midwifery program.  They come from all around Guatemala and their goals are to eventually return to their home communities to provide care for women and babies, as well as provide additional training to local comadronas. Teaching these women was very different from teaching the midwives in Xela because they had a high school education; therefore everyone was numerically literate and could read and write. This made our job much, much easier. They were also relatively young and you could just feel their energy, passion, and optimism. I definitely felt like I was in the presence of strong women who were dedicated to making the lives of mommas and babies in their communities better.

After a long day of teaching, we decided to get take-out for dinner and bring it back to our hotel. I think we were all sick of taking the time to eat in restaurants at this point. On this next thought I can’t speak for everyone, but I, for one, needed a shower.  Unfortunately, the showerhead gave me real pause. It was metal and had exposed wires running into it from the wall. Now, I’m not an electrician, but I see metal, wires, and water and I see a real problem. I texted Nancy, who was one room over, to ask about this. Totally normal, she said, it’s called a “widowmaker” and you have to be careful to not touch the shower head whilst in the shower. I sat with that for a minute….texted some people back home….seriously considered bucket baths.  But ultimately decided to face my fears and take a shower.  Which I did…..while standing in a low crouch. It was fine.

We left Chiquimulillaand headed north to Antigua. Our route took us through the Fuego eruption zone and the road we were traveling on had only recently been reopened. As it was prone to be reburied by mudslides if it rained, which it had the night before, we were a little apprehensive.  We were in luck, the road was open. The eruption zone was stark and strange.  The view out our windows was green and lush and alive and then, boom….black and dead. It was a haunting landscape maybe 2 miles wide where we were, but stretching out as far as the eye could see. Rows of palm trees coated in ash with their leaves limp and hanging. Houses half-buried. Melted pavement. A new gorge was torn into the earth by lava and pyroclastic flow. Eric told us that what made this eruption so deadly was because Fuegoerupted in a direction it never had before…like ever in the known history of the volcano, so there were villages in its path, whereas there are no villages on the other sides of the volcano. Driving through it felt a little bit like we were trespassing on hallowed ground.

By the time we reached Antigua, about 10 miles east of Fuego, it looked like nothing ever happened. Antigua is where you find all the language schools, ex-pats, and tourists. You also find some gorgeous examples of Spanish Baroque architecture, both intact and in ruins. This is also an excellent place to indulge your inner magpie, as there are lots of shops carrying shiny silver and jade jewelry. The outdoor artisan market is huge and set up as a series of square courtyards with a central fountain, each of them a little different from each other.  One of my favorite market purchases was a patchwork quilt…handmade from different squares cut from old traditional shirts worn by women called huipiles. I had no idea if that quilt was going to fit in my suitcase and on top of that it was pretty heavy, but I was going to try. (spoiler alert: it fit and my suitcase weighed in at 50.4lbs….whew!). My other favorite market treasure was a small drawing of midwives assisting a laboring woman. It was just sitting on a random shelf by itself, and, of course, it caught my attention. Turns out, Nancy bought the same drawing here last February and this was the last one like it. Shortly before we left for Guatemala I found out I got into grad school for midwifery and Nancy was absolutely certain this drawing was there for me and I was supposed to find it. I completely agreed and added it to my basket. 

We had dinner reservations at  Casa Santo Domingo, a restaurant built gently and beautifully among the ruins of a monastery that dates back to 1527. The ruins are meticulously preserved and exist as an indoor/outdoor museum that guests can walk through at their leisure.  At dusk, hundreds of candles are lit around the site The food was amazing, but the setting amid the candlelit ruins was what really made it magical.  After dinner, we headed back to Guatemala City. Our first-day teaching at the midwifery school was the next day and we had to be up early….again. 

Montericco is a beach town along the Pacific coast near the Guatemala-El Salvador border.  It’s a popular getaway spot for local Guatemalans. It can only reasonably be reached by traveling by boat along the Canal de Chiquimulilla which runs from La Avellana to Montericco. The canal is a busy waterway and looks and feels a lot you’re going up the Nung river in Apocalypse Now (only without the violence). There are many little waterways off the main canal and it looks like you could very easily get lost….either on purpose or by accident. Our boat was an open, flat bottom wood boat with a small outboard motor.  Other boats were larger versions of this; some large enough to transport cars and trucks along with people. The other boats we passed were extremely crowded and there was definitely a festive air to them. Our little boat generated a lot of attention because we were probably the only white people for miles around. We were safe because we were with Denis and Sari who are well known and well-liked in the community, but even Nancy said she wouldn’t have done this trip without a local Guatemalan along.  I admit I would have felt very foolish and unsafe had we done this alone.

The southern part of the country is more impoverished than the rest of Guatemala and, honestly, it was a kind of heart-breaking abject poverty that I have never been exposed to before.  Of course, there are reasons for this. Guatemala endured a civil war that lasted from 1960-1996.  In a nutshell, democratically held elections brought a leftist, pro-worker government into power. The US had big economic interests in the country and a leftist government just wouldn’t do. A coup was staged and the first of many military dictators was installed.  Many Mayan villages were burned and people were displaced from their land during this period and when the peace accords were signed in 1996, they went back to reclaim their land only to find they were “owned” by someone else.  All these refugees had to be relocated somewhere and down south was one place with land available….likely because it’s so difficult to cultivate among other reasons.  The terrible poverty we see here today is a legacy of a 30-year war.

But I digress.  We stayed a couple hours at the beach watching the waves and the people and then trekked back through town to the boat landing.  Back in La Avellana, there was a place where you could buy fresh coconut and drink the water inside. Since I had never done this before, my traveling companions decided that I MUST.  So I got a coconut,

Dennis hacked off the top part with a machete that was standing around and popped a straw in it for me.  After being out all day in the heat and humidity, the cold, sweet coconut water was amazing!  Before I knew it, we were back at Denis’s compound having dinner and then tucking into bed. That’s when the storm hit. It came out of nowhere…an absolute deluge of rain that was deafening when it hit the metal roof. It was so cool! I stood outside my room and just watched and listened. Almost every time it would thunder and lightning the power would go off….then the generator would kick in and the power would come back on…..then go off….then on…..it was wild. I think this storm was the tail of Hurricane Michael.

For all my love of wild places, I’ve never been in an equatorial jungle…until today. As we drove south to Chiquimulilla from Guatemala City, the temperature and humidity crept up and we shed jackets, cardigans, long pants and socks. With the change in climate came a change in vegetation. Sugar cane, coffee plants, and banana trees replaced the pines and corn that are so prevalent in the north. Spices like cardamom thrive down here, and I bought a bag of the most wild looking fruit I had ever seen from a young boy on the road. The air is damp, heavy and smells of plants and soil; everyone has a “sheen” to them, and you move a little slower. I started to wilt until I was reminded to drink a lot more water than usual which helped immensely.

We stayed with long-time friends of Nancy’s, Dennis and Sari. They live in a compound that they open up to a variety of groups from health care professionals, like ourselves, to more traditional missionary groups. For me, to stay in a place like this was like a dream….the dream had some scary bits, but a dream nonetheless.  The main gathering spaces of the compound were open to air….three walls and a corrugated metal roof and one side open to the outdoors. Our individual rooms were typical 4-walled rooms with a door, but all the other spaces were an indoor/outdoor combo.  For example, to get to a bathroom you had to walk outside (under a roofed corridor) to either another building or another part of the compound. And they had THE BEST shower ever here. There is no hot running water, which initially freaked me out,  but when its 90+ degrees with 90%+ humidity, you don’t exactly miss it.  The shower here is sufficiently indoor/outdoor enough that you feel like you are showering out in the open in the jungle but really you have a decent amount of privacy. The jungle tucks you in on one side,  and painted murals on the low walls create an air of whimsy on the others, and it is heavenly. It was also here in Chiquimulilla that I first tasted hibiscus tea.  It is a deep jewel red and can be served hot or cold. The taste is hard to describe, but a sweeter, planty version of cranberry juice sort of maybe gets close. Bottom line, its delicious.

Our purpose for going to Chiquimulilla was to conduct a focus group with as many local midwives as would come talk to us and answer our questions. It was possible no one would show up.  Instead, 8 midwives took a day off work, traveled many miles in the heat and humidity and very likely had to pay for transportation…all to sit down and share their experiences, their needs and their wants with us. After the focus group, we met with a local nurse from the Ministry of Health. Both these meetings resulted in a wealth of information that will help us tailor our future trainings to the unique needs of this community.

Our meetings ended mid-afternoon. Knowing my love of the ocean, Nancy planned a brief trip to the beach to round out our day.  It’s about a 15 minute drive from Chiqui to where you catch the boat to Monterrico.  It’s another 15 minute walk through Montericco until you get to the black sand beach where the waves crashing ashore last made landfall on some of the most remote South Pacific islands in the world.

This was my favorite part of our trip, so I have a lot to say about it. Tune in tomorrow for Day 6 Part 2: Boats in the Jungle

This morning we had to be back in Guatemala City for Nancy and Karen to attend a noon meeting which meant we had to leave Xela really, really early….like before the roosters could wake us up early.  I’d like to think that maybe we were up early enough to wake some roosters and I feel a certain warped sense of satisfaction in that. While Nancy and Karen attended their meeting, I was left to get lunch with the menfolk. The menfolk wanted McDonald’s. I said “absolutely not” in my full-on Mom Voice.  We had a nice, healthy lunch at a cute little café in the 4 Degrees North district. This district is a hip new mixed-use development designed to be walkable and lively with high-quality streetscapes and architecture.  Back in the day, I was a landscape architect working for a firm that designed similar urban spaces and it was fun to talk urban design again even if it was to a captive audience who mostly just nodded and smiled.

Before coming on this trip Nancy warned me about how these trips involve a million moving parts and that plans are always changing at the last minute. I mostly nodded and smiled but thought to myself, “the hotels are booked, the classes are scheduled, how much can really change?” Well, she was right…..I guess you learn a thing or two after 26 trips to a place. Today, Eric, our driver, informed us that the hotel we were planning to stay at tonight was safe, but getting in and out of the neighborhood it was located in was decidedly not safe. Pick another place, he said. So that was a scramble. We ended up with some of us at Jeanette’s (a friend of Nancy and Dave’s) and some of us across the street in an Air BnB. I was at Jeanette’s and not only was I crashing in their home, but I was crashing the party they were hosting that night. Nonetheless, they graciously welcomed me, a total stranger, into their home. I just tried to keep a low profile and stay out of the way.

Today marked the halfway point in my trip and that along with being in a kind stranger’s house with her little family and lots of her friends left me feeling incredibly sad and homesick. I connected with my little family and the one friend who was still up to text me back and made the best of it…..had a little Walmart Wine and went to bed. We had to be up with the roosters again in the morning so we could start heading south to Chiquimulilla.  Our adventures in Chiqui ended up being my favorite part of the entire trip.