Adventures In Madagascar

A Madagascar Birth

 Mbôlatsara!

Here's a story about Anna Christine, a midwifery student from Denmark who was working with a Red Cross midwife here in Diego at the dispensary. From her stories it's a very different world. The medical equipment and the mindset are from the 1950's. Sanitation doesn't exist; well O.K. it does
but...here's an example. Anna Christine's first day at the dispensary: she walks into the side door and it's dark because electricity only is on from 10p.m. to 4a.m., it's 8 p.m. and all the doctors have left for the day (emergencies are sent to the "Big Hospital" --'sent' =walk). The big hospital is 1½ miles away over roads that are little more than dry dirt with rocks thrown in the numerous holes.). There are 2 midwives and one kinda' janitor guy. The hallways are filthy with trash and the smell of old urine. She is greeted by one of the  midwives with a candle, they talk (in French) in the very small triage room which doubles as a broom closet /  pharmacy. A very obviously laboring 15 year old girl comes into the "waiting room" accompanied by her sister or possibly her mom (Anna Christine was not sure because she doesn't speak Malagasy and the midwife speaks broken French).
The midwife brings the laboring mom into the triage room weighs her on a scale that is older than everyone in the room added together, the weight is wrong so the midwife guesses, takes her temp., BP, pulse, and sends her down one of the dark hallways to a dark room. The 15 year-old must bring all of her own supplies, candle, matches, alcohol, gloves, bar of soap, needles, string, scissors, rags or towels, everything, and oh yes $7.50 fee for the delivery (the average Malagasy makes a little under $1 per day if they have a good job). Then the midwife tells the girl to get up on the table (which
is a wooden board with a thin foam pad covered with plastic), and says to call her when she feels like pushing.

That's not the end of Anna Christine's story. In a couple of hours the lights come on and the walls are covered with mosquitoes and flies resting until there's something to eat. She also sees why the air smells like urine. At this point Anna Christine said she wanted to go home. Moments later the girl's sister comes walking down the hall to tell them she is ready to push. They arrive in the room and the young mom-to-be is still on the table knees up and lying on her back, in front of the table is a puddle of blood about a meter in diameter, the midwife hollers down the hall for the janitor, he comes in and takes an already blood soaked rag from his collection and smears the blood around on the floor (remember the mom is nearly naked on the table ready to push, she is crying because the midwife is scolding her for groaning too loud), after about an hour of pushing the mom is exhausted but has a boy. One hour later she and all of her stuff must be gone, little to no clean up is done afterwards by anyone, if the next mom wants it cleaned up she or her sister will have to do it. Anna Christine said that there are so many blood circles on the floors it's almost awash with it.

Oh, by the way, there are no toilets. Outside there is a hole in the ground surrounded by some dry brown grass. Water comes into the building-- they have it from about 9a.m. to about 3p.m., it varies. There is no hot water at all, the only disinfectant is what the mom brings and that is a bar of soap and, if she can afford it, some alcohol. Usually delivery is the first time that the mom has ever been seen. The mom labors somewhere else; could be home, at the market if she is a vendor, in the field if she  works in the rice field or...use your imagination. It is "fady" for a woman to make any noise while in labor. "Fady" are man-made taboos, very effective in controlling behavior.

Madagascar Hospital and Midwives
 

Well that's just one of Anna Christine's stories. She says she works 3 nights a week and 4 days a week, she gets no time off. She said she thought that the international Red Cross was supposed to keep and eye on all their clinics. It turns out that one of the inspectors came and stood outside the building and then left. She was even introduced to him but he didn't go in.
You know after reading this back to myself I think it sounds more like a horror story. You may be asking, "Why doesn't the mom just stay at home?" Well I'll tell you, because the houses are made of narrow planks of wood or split bamboo with openings in between and the floors are covered with dust blown from the wind; flies, mosquitoes, cockroaches, all kinds of diseases. But it's also a status symbol to have your baby at the hospital or dispensary because it costs money. If you have that kind of money to "blow" on a baby you're rich like the vahaza (white foreigner). In my eyes there is no difference between the two places, but that is coming from a vahaza point of view.

Have a very Merry Christmas and Happy New Year
In Malagasy: Ka! zaho tsy manintsy mandeha. Tratry ny Nôely sy Tratry ny taoñon-baovao.

Response to the Malagasy is: Samby tratry ny ho avy!
 (Same happiness to come, or the same to you.)

God's Peace,
Deborah

Tidbits from EBONY

My dear Charis brothers and sisters,

It is so fun to connect with you in this way! I can’t wait to meet you face to face. This week I am truly just going to offer some “tidbits” about things I have been learning and thinking about lately. A couple of these are excerpts from my prayer newsletters and a couple are written especially for you!

Tidbit Number 1: I have experienced the Christmas season in a communist environment, completely secular environments and even a different Cousin environment many miles from here. But, this Christmas season I am in a “modern” Arabic country and, let me tell you, the experience is just ... odd! I walked into an eerily empty movie theater tonight in this land where the “Bin Laden Group’s presence is common place, only to find “It’s Beginning to Look A Lot Like Christmas” blaring over the theater speakers. The next song was one I had never heard, but that mentioned the birth of Christ specifically. I wonder what the full veiled Arabic women around me are thinking as they hear those songs. Do they even listen to the words? They believe Jesus was a great prophet, but not God incarnate, Immanuel, come to redeem a people for Himself. May this Christmas season find open ears and open hearts in this land!

Tidbit Number 2: During this adventure of serving as a doula for the first time, I have a developing conviction about checking the copyright dates on any sources of information we are using for medical advice. There is a very popular pregnancy book out there, which I will not name, that has several different editions. If you pick up a $1 copy at a yard sale, you may be getting a book with medical information and advice that is over 15 years old. That’s a lot of elapsed time where science is concerned. For example, the 1991 edition of the book I am referring to equates a C-section with a tonsillectomy. I’ve had an adult tonsillectomy and I just witnessed as much as possible of a C-section without being a doctor and they are NOT the same. I already knew this, however, because of reading material, studies and scientific articles that had been developed and published SINCE 1991. Some things never change, it’s true! But, as limited, mortal beings, our knowledge, understanding and experience are constantly changing and developing. And that’s my two cent about that. :-)

Tidbit Number 3: “We Need to Be What We Want to See” is kind of a motto among some of my co-workers in the region of Central Asia. Derek Webb also mentions this concept in his song, “Take To The World” (which I HIGHLY recommend downloading and listening to, by the way!). We need to be examples of what we long for others to have the opportunity to become. Many parents realize this sometime in their lives—whether early enough to make a difference or maybe just in time to ask forgiveness from the children they’ve impacted. The workers in Ebony really want to learn and embrace this idea early enough to make a difference on the people they work with, teach, and share their lives with. One of the ways overseas workers “become what they want to see” is by working together with other people on teams rather than as lone rangers. There are a lot of examples of team work in the Word, but the story of the church is the greatest example, I think. Although much more than just what we would consider a “team,” the New Testament Body exhibits working together, submitted to their Leader, keeping in focus one common goal to which all other goals and activities contribute. I believe that one common goal of the early church is summed up in what has become common phraseology among my friends, “to know Him and make Him known.” Teams all over the world bind together with this goal in mind. Some even commit to each other and establish an order together that essentially makes them an organized local body of believers—just like what they want to see locals have the opportunity to do. Please pray for more teams to be formed in the hard to reach places of Ebony.

Tidbit Number 4: Reflecting on serving as a doula for the first time: It’s so interesting to learn this “servant-ness” (doula literally means servant) which does NOT come naturally to me. No matter what my actions may look like on the outside, I would not describe myself as servant-hearted. And I’m not being humble or something else that is noble. I’m the worst servant ever. I think I would get an “F” in it if I had to take the course! I’m just so grateful that God doesn’t just leave us “the way we are,” but He changes and grows and stretches us. It’s when I realize how that growth impacts others that I am really spurred on to keep being stretched and to die to myself. We can really change and bless people’s lives by serving them! That’s an awesome thing.

Thanks for reading my tidbits!! :-)

Merry Christmas,
Elizabeth Carmichael