Thursday, September 08, 2011
Tuesday, August 30, 2011
Why a Radio Program?
Why a radio program anyways?
When we were called into the small emergency room I was shocked to see the young, pregnant, woman seizing on the stretcher. Her husband had carried her by bike five hours to the nearest health post, where she was then transported by ambulance to Puerto Cabezas, arriving 12 hours later. He thought that when she complained of her headache and when her body began to shake that she was in labor. After convulsing for two to three hours he realized that something was wrong. I was overwhelmed by the gravity of the situation. How was it that this woman didn’t know she was sick earlier? Why did her husband think that seizing was a normal process of labor? I wanted to reach out to this family and to all of the other women, bellies round with pregnancy in the rural communities of the Autonomous Region of the North Atlantic (RAAN) Nicaragua. I wanted to teach community members plagued by high rates of maternal mortality, what danger signs to watch out for during pregnancy.
As a Certified Nurse-Midwife I knew it was possible to work together with other nurses in the community to develop a unique method to provide prenatal education. This was when Mairin Karnakira-Mujer Poderosa, “Strong Woman” was born. This bold initiative is a radio-education soap opera developed to improve maternal health education in the RAAN, which suffers the country’s highest rates of maternal mortality. We hope that by improving women’s knowledge of pregnancy danger signs through radio-education that women will be able to recognize, refer, and treat complications without delay. This radio program gets the message out, in Spanish and Miskito, on how to have a healthy pregnancy to women living in rural communities who may not know how to read and have difficulty accessing health services.
Right now we are conducting an investigation to see if it is true, that listening to Mairin Karnakira-Mujer Poderosa does increase what pregnant women know about danger signs during pregnancy. We believe that Mairin Karnakira-Mujer Poderosa is a great way to provide health education to the most women living in the RAAN! Coming soon: the Ministry of Health in the RAAN will be transmitting Mairin Karnakira-Mujer Poderosa on at least three radio stations in the region! Thank you MINSA!
Please link to the recordings above if you would like to listen in Spanish or Miskito!
¿Por qué un programa de radio?
Cuando nos llamaron a la pequeña sala de emergencia me sorprendí al ver a la embarazada, convulsionando en la camilla. Su marido la había llevado en bicicleta cinco horas al puesto de salud más cercano, donde fue transportado en ambulancia a Puerto Cabezas. Llegaron 12 horas después. El marido pensó que cuando ella se quejaba de dolor de cabeza y cuando su cuerpo empezó a temblar que ella estaba en trabajo de parto. Después de que convulsionó durante dos o tres horas se dió cuenta de que algo andaba mal. Me sentí abrumada por la gravedad de la situación. ¿Cómo fue que esta mujer no sabía que estaba enferma antes? ¿Por qué piensa su marido que las convulsiones era un proceso normal del trabajo de parto? Yo quería contactar a esta familia y de todas las otras mujeres, vientres redondos con el embarazo en las comunidades rurales de la Región Autónoma del Atlántico Norte (RAAN) de Nicaragua. Quería enseñar a los miembros de la comunidad afectado por altas tasas de mortalidad materna los signos de peligro del embarazo.
Como Enfermera-Obstetra, sabía que era posible trabajar en conjunto con otras enfermeras en la comunidad para desarrollar un método único para proporcionar la educación prenatal. Fue entonces cuando Mairin Karnakira-Mujer Poderosa nació. Esta ambiciosa iniciativa es una radio-novela educativa desarrollada para mejorar educación prenatal en la RAAN, el area del país que sufre las tasas más altas mortalidad materna. Esperamos que al mejorar el conocimiento de las mujeres de los signos de peligro del embarazo a través de la radio, que las mujeres sean capaces de reconocer, remitir y tratar complicaciones obstetras sin demora. Este programa de radio transmite el mensaje, en español y miskito, sobre cómo tener un embarazo saludable a las mujeres que viven en comunidades rurales que tal vez no saben leer y tienen dificultades para acceder a los servicios de salud.
En este momento estamos llevando a cabo una investigación para ver si es verdad, que escuchando el programa Mairin Karnakira-Mujer Poderosa se incrementa lo que las mujeres embarazadas conozcan acerca de los signos de peligro durante el embarazo. Creemos que Mairin Karnakira-Mujer Poderosa es una gran manera de proporcionar educación prenatal a las mujeres que viven en la RAAN!
Pronto: el Ministerio de Salud en la RAAN transmitira Mairin Karnakira-Mujer Poderosa en por lo menos tres emisoras en la region. Muchas Gracias MINSA!
Por favor haga clic en los links arriba para escuchar el programa de radio en Espanol o Miskito!
When we were called into the small emergency room I was shocked to see the young, pregnant, woman seizing on the stretcher. Her husband had carried her by bike five hours to the nearest health post, where she was then transported by ambulance to Puerto Cabezas, arriving 12 hours later. He thought that when she complained of her headache and when her body began to shake that she was in labor. After convulsing for two to three hours he realized that something was wrong. I was overwhelmed by the gravity of the situation. How was it that this woman didn’t know she was sick earlier? Why did her husband think that seizing was a normal process of labor? I wanted to reach out to this family and to all of the other women, bellies round with pregnancy in the rural communities of the Autonomous Region of the North Atlantic (RAAN) Nicaragua. I wanted to teach community members plagued by high rates of maternal mortality, what danger signs to watch out for during pregnancy.
As a Certified Nurse-Midwife I knew it was possible to work together with other nurses in the community to develop a unique method to provide prenatal education. This was when Mairin Karnakira-Mujer Poderosa, “Strong Woman” was born. This bold initiative is a radio-education soap opera developed to improve maternal health education in the RAAN, which suffers the country’s highest rates of maternal mortality. We hope that by improving women’s knowledge of pregnancy danger signs through radio-education that women will be able to recognize, refer, and treat complications without delay. This radio program gets the message out, in Spanish and Miskito, on how to have a healthy pregnancy to women living in rural communities who may not know how to read and have difficulty accessing health services.
Right now we are conducting an investigation to see if it is true, that listening to Mairin Karnakira-Mujer Poderosa does increase what pregnant women know about danger signs during pregnancy. We believe that Mairin Karnakira-Mujer Poderosa is a great way to provide health education to the most women living in the RAAN! Coming soon: the Ministry of Health in the RAAN will be transmitting Mairin Karnakira-Mujer Poderosa on at least three radio stations in the region! Thank you MINSA!
Please link to the recordings above if you would like to listen in Spanish or Miskito!
¿Por qué un programa de radio?
Cuando nos llamaron a la pequeña sala de emergencia me sorprendí al ver a la embarazada, convulsionando en la camilla. Su marido la había llevado en bicicleta cinco horas al puesto de salud más cercano, donde fue transportado en ambulancia a Puerto Cabezas. Llegaron 12 horas después. El marido pensó que cuando ella se quejaba de dolor de cabeza y cuando su cuerpo empezó a temblar que ella estaba en trabajo de parto. Después de que convulsionó durante dos o tres horas se dió cuenta de que algo andaba mal. Me sentí abrumada por la gravedad de la situación. ¿Cómo fue que esta mujer no sabía que estaba enferma antes? ¿Por qué piensa su marido que las convulsiones era un proceso normal del trabajo de parto? Yo quería contactar a esta familia y de todas las otras mujeres, vientres redondos con el embarazo en las comunidades rurales de la Región Autónoma del Atlántico Norte (RAAN) de Nicaragua. Quería enseñar a los miembros de la comunidad afectado por altas tasas de mortalidad materna los signos de peligro del embarazo.
Como Enfermera-Obstetra, sabía que era posible trabajar en conjunto con otras enfermeras en la comunidad para desarrollar un método único para proporcionar la educación prenatal. Fue entonces cuando Mairin Karnakira-Mujer Poderosa nació. Esta ambiciosa iniciativa es una radio-novela educativa desarrollada para mejorar educación prenatal en la RAAN, el area del país que sufre las tasas más altas mortalidad materna. Esperamos que al mejorar el conocimiento de las mujeres de los signos de peligro del embarazo a través de la radio, que las mujeres sean capaces de reconocer, remitir y tratar complicaciones obstetras sin demora. Este programa de radio transmite el mensaje, en español y miskito, sobre cómo tener un embarazo saludable a las mujeres que viven en comunidades rurales que tal vez no saben leer y tienen dificultades para acceder a los servicios de salud.
En este momento estamos llevando a cabo una investigación para ver si es verdad, que escuchando el programa Mairin Karnakira-Mujer Poderosa se incrementa lo que las mujeres embarazadas conozcan acerca de los signos de peligro durante el embarazo. Creemos que Mairin Karnakira-Mujer Poderosa es una gran manera de proporcionar educación prenatal a las mujeres que viven en la RAAN!
Pronto: el Ministerio de Salud en la RAAN transmitira Mairin Karnakira-Mujer Poderosa en por lo menos tres emisoras en la region. Muchas Gracias MINSA!
Por favor haga clic en los links arriba para escuchar el programa de radio en Espanol o Miskito!
Tuesday, May 10, 2011
Take One!
Try Outs!
Recording Workshop
In the Recording Studio...
SO recording has begun! I have been working with a team of "actors" from the local university URACCAN's Centro de Liderazgo, or center for leadership. It is basically a live in high school made up of students from surrounding Miskito communities who show traits of leadership. We have been in the studio recording four times now and have completed 8 out of 9 chapters in Spanish. Tomorrow we will finish our Spanish chapters and move into Miskito. I had decided to work with this group of students because they all speak Spanish and Miskito, though Spanish is certainly there second language! I've found myself taking on the role of whip-cracking radio show producer. Its fun, stressful, and as always, requires much more work than I ever imagined...its starting to look really easy to have a baby!!! Sunday when we recorded all day long the woman who owns the recording studio told me that our editor had commented that he is learning so much about pregnancy...my n=1 says that the radio soap-opera Mairin Karnakira just might work!
Recording Workshop
In the Recording Studio...
SO recording has begun! I have been working with a team of "actors" from the local university URACCAN's Centro de Liderazgo, or center for leadership. It is basically a live in high school made up of students from surrounding Miskito communities who show traits of leadership. We have been in the studio recording four times now and have completed 8 out of 9 chapters in Spanish. Tomorrow we will finish our Spanish chapters and move into Miskito. I had decided to work with this group of students because they all speak Spanish and Miskito, though Spanish is certainly there second language! I've found myself taking on the role of whip-cracking radio show producer. Its fun, stressful, and as always, requires much more work than I ever imagined...its starting to look really easy to have a baby!!! Sunday when we recorded all day long the woman who owns the recording studio told me that our editor had commented that he is learning so much about pregnancy...my n=1 says that the radio soap-opera Mairin Karnakira just might work!
Sunday, April 10, 2011
Friday, April 08, 2011
Betana
We set off in the late morning, later than hoped for but before I had expected we would actually depart. I climbed into the front seat of the white Land Cruiser, the kind that are famed for their ability to drive up, over, and through any river or swath of mud. Today we were heading for Betana, a community only 40 minutes drive south of Puerto Cabezas along the dirt highway to Managua. Over the past several months I started volunteering for an organization called CAIMCA. They provide health services to women with a special focus on women suffering from domestic violence. Under the same roof there are lawyers, psychologists, nurses, and a physician to support women by providing medical care and guidance through the legal system when filing a complaint against an abuser. My role at CAIMCA has been to perform Pap smears in the mornings, free of charge to any woman that wants to be tested. Our goal for this day was to head out to the community to provide the same service. One of the female leaders of the community had petitioned to have us come out to the women to perform Pap smears, rather than take the women to Puerto Cabezas; the 50 who had listed their names in a worn, yellowed notebook stating their desire for cervical cancer screening.
We arrived in Betana dusted by a thin layer of clay colored dirt. We pulled to the side of the road to ask a woman emerging from the tall grasses where the health center was. She turned her back towards us and pointed to a one story, pink, cement building just across the field. The health center sat squat upon a low rise in the plain, flanked by stilted wooden homes painted emerald green and Caribbean Sea blue. The Land Cruiser bowled up and over the ditch, through the grasses to park in front of the health center. It appear locked and dark. A passerby informed us that the nurse, along with the key to the health center, was in Waspan, a town 6 hours north of us.
We gathered our supplies and lugged them across a one plank bridge that guided us across a muddy ditch, passing through the chain link fence to the health center. The condoms, speculums, anti-parasite syrup, gloves, etc. were seated upon a wooden bench flush against the health center’s rose colored wall. As the four of us sat and chatted about what a speculum is, a thick legged woman in a hand stitched black tank and skirt with red flowers blooming across her chest ambled through the gate. This was the community leader who had organized the Pap smear event. She explained that she had expected us on Tuesday. All the women had arrived early and patiently waited for us; but we hadn’t arrived. Today was Thursday. She stated that we could make it work, but many of the women were out in the fields planting and would not return in time to receive the service. And she confirmed that the nurse was in Waspan so we would not be able to use the health center.
Ingenuity is a common quality amongst the people of the Miskito coast that have learned to reuse, recycle, and reinvent objects. When I think of the lifespan of an electronic device in the RAAN versus in the United States it has been rewired and reworked various times, buying it at least 10 more years. So when we knew that we couldn’t use the health center it was a simple transition to transform the school house into a clinic room with some simple equipment: one table, three sheets, two clothes pins, a flashlight, and a chair. I draped a yellow sheet edged with eyelet over the table and voila we had an area for examination. The clothes pins were used to hang a white sheet printed with climbing green vines dotted by delicate pink flowers to the side of the table creating a privacy curtain. I pulled an old-fashioned wooden school chair with built in writing plank to the side of the table and lined up the necessary supplies: lubricant, Pap smear kit, gloves. I dressed the flashlight in a latex glove to help me visualize the mysterious insides of the women that I would be examining. The bag of 40 sterilized speculums individually wrapped in torn white sheets held closed by masking tape sat to the side of my makeshift equipment table. Ready to begin.
Slowly but surely the women began to arrive, lining up outside the school house with curiosity. Elida would ask them their names, age, date of last menstrual period, and whether they had previously received a Pap smear in Miskito, and then pass them back to First Grade Classroom A for their exam. One woman after another came to receive her care, many for the first time in her life. I used my basic Miskito to ask them to climb onto the table, lie back and relax. The first few exams were quick and uneventful.
A woman, 68 years old, mother of twelve children came into the examination room. She wore a simple black polyester skirt, hemmed to hang at the knee, black cotton t-shirt, and hot pink bandana covering her long salt and pepper hair. She removed her undergarments and climbed nimbly onto the table. She didn’t complain of any pain or discomfort, she actually didn’t say anything to me, just got onto the table and lay back, knees bent and folded into each other in a shy, protective manner. I donned my gloves and prepared my field for the Pap smear, opening up the plastic case to reveal the glass slide, and inching out the wooden and plastic brushes that I would use to take the sample. I placed my hands gently across the woman’s knees and encouraged her to let her legs fall open. With a sigh of embarrassment she began to open her legs, and then shot her hand down between them to hide something. From between her fingers I could see the pale-peach color of something. It looked thick and muscular. I said some soothing words that I can’t quite remember because I was just as shocked as this woman was at what was hanging between her legs. As she lifted her hand it became clear that three-quarters of her uterus had fallen out from her vagina and sat between her legs. I slumped back into my wooden chair and let the image fully settle in. Now, I have seen uterine prolapses before. A bit of tissue protruding through the vagina, more so with a push referred to as the Valsalva maneuver. But, never in my life had I seen a prolapse like this. I could see cervix, discolored and dry, the upward curving of the upside-down pear shape of the uterus, and the thick muscular layers of the organ. I stood, removed my gloves, lowered the woman’s black skirt, and helped to lift her to a seated position.
“How long have you had this problem?”
“I noticed that it came down, and stayed down about two years ago when I was lifting a bucket of water. Before it would stay inside, but not now.”
Two years. Possibly longer.
“Does it hurt?”
“A little bit.”
I guided the woman outside to the community leader and had her explain in Miskito that she had a severe uterine prolapse and that she would need to be seen in the hospital in Puerto Cabezas. I imagine that the ObGyn will recommend a total hysterectomy. I can’t imagine that there is another remedy for a prolapse so severe.
I was shocked by the presence of this grave uterine prolapse, but by the time I lifted the skirt of the fifth woman whose uterus hung down between her legs it was less shocking and more disturbing. There was a pattern that I was noticing: older age, many, many babies, and a history of hard living with planting, hauling buckets of water, and hand washing. I imagine that in the history of these women there were also some prolonged labors with extended periods of pushing to get their babies out into the world. What began to stun me the most was how close these women were to the city, and yet completely isolated from general gynecological care. Two years? How does a woman cope with having her uterus bulging out from her vagina for two years? Why didn’t she seek care sooner? Is it the cost of bus fare to get to the city, the need to be at home to mind the house and children, or shame? Hopefully these five women will make the journey to Puerto Cabezas this Tuesday with the community leader to be seen at the hospital. Hopefully they will be treated with kindness and concern and not discrimination and ridicule for delaying treatment. Hopefully these women will receive the care that they need and live the rest of their days with more comfort and dignity.
We arrived in Betana dusted by a thin layer of clay colored dirt. We pulled to the side of the road to ask a woman emerging from the tall grasses where the health center was. She turned her back towards us and pointed to a one story, pink, cement building just across the field. The health center sat squat upon a low rise in the plain, flanked by stilted wooden homes painted emerald green and Caribbean Sea blue. The Land Cruiser bowled up and over the ditch, through the grasses to park in front of the health center. It appear locked and dark. A passerby informed us that the nurse, along with the key to the health center, was in Waspan, a town 6 hours north of us.
We gathered our supplies and lugged them across a one plank bridge that guided us across a muddy ditch, passing through the chain link fence to the health center. The condoms, speculums, anti-parasite syrup, gloves, etc. were seated upon a wooden bench flush against the health center’s rose colored wall. As the four of us sat and chatted about what a speculum is, a thick legged woman in a hand stitched black tank and skirt with red flowers blooming across her chest ambled through the gate. This was the community leader who had organized the Pap smear event. She explained that she had expected us on Tuesday. All the women had arrived early and patiently waited for us; but we hadn’t arrived. Today was Thursday. She stated that we could make it work, but many of the women were out in the fields planting and would not return in time to receive the service. And she confirmed that the nurse was in Waspan so we would not be able to use the health center.
Ingenuity is a common quality amongst the people of the Miskito coast that have learned to reuse, recycle, and reinvent objects. When I think of the lifespan of an electronic device in the RAAN versus in the United States it has been rewired and reworked various times, buying it at least 10 more years. So when we knew that we couldn’t use the health center it was a simple transition to transform the school house into a clinic room with some simple equipment: one table, three sheets, two clothes pins, a flashlight, and a chair. I draped a yellow sheet edged with eyelet over the table and voila we had an area for examination. The clothes pins were used to hang a white sheet printed with climbing green vines dotted by delicate pink flowers to the side of the table creating a privacy curtain. I pulled an old-fashioned wooden school chair with built in writing plank to the side of the table and lined up the necessary supplies: lubricant, Pap smear kit, gloves. I dressed the flashlight in a latex glove to help me visualize the mysterious insides of the women that I would be examining. The bag of 40 sterilized speculums individually wrapped in torn white sheets held closed by masking tape sat to the side of my makeshift equipment table. Ready to begin.
Slowly but surely the women began to arrive, lining up outside the school house with curiosity. Elida would ask them their names, age, date of last menstrual period, and whether they had previously received a Pap smear in Miskito, and then pass them back to First Grade Classroom A for their exam. One woman after another came to receive her care, many for the first time in her life. I used my basic Miskito to ask them to climb onto the table, lie back and relax. The first few exams were quick and uneventful.
A woman, 68 years old, mother of twelve children came into the examination room. She wore a simple black polyester skirt, hemmed to hang at the knee, black cotton t-shirt, and hot pink bandana covering her long salt and pepper hair. She removed her undergarments and climbed nimbly onto the table. She didn’t complain of any pain or discomfort, she actually didn’t say anything to me, just got onto the table and lay back, knees bent and folded into each other in a shy, protective manner. I donned my gloves and prepared my field for the Pap smear, opening up the plastic case to reveal the glass slide, and inching out the wooden and plastic brushes that I would use to take the sample. I placed my hands gently across the woman’s knees and encouraged her to let her legs fall open. With a sigh of embarrassment she began to open her legs, and then shot her hand down between them to hide something. From between her fingers I could see the pale-peach color of something. It looked thick and muscular. I said some soothing words that I can’t quite remember because I was just as shocked as this woman was at what was hanging between her legs. As she lifted her hand it became clear that three-quarters of her uterus had fallen out from her vagina and sat between her legs. I slumped back into my wooden chair and let the image fully settle in. Now, I have seen uterine prolapses before. A bit of tissue protruding through the vagina, more so with a push referred to as the Valsalva maneuver. But, never in my life had I seen a prolapse like this. I could see cervix, discolored and dry, the upward curving of the upside-down pear shape of the uterus, and the thick muscular layers of the organ. I stood, removed my gloves, lowered the woman’s black skirt, and helped to lift her to a seated position.
“How long have you had this problem?”
“I noticed that it came down, and stayed down about two years ago when I was lifting a bucket of water. Before it would stay inside, but not now.”
Two years. Possibly longer.
“Does it hurt?”
“A little bit.”
I guided the woman outside to the community leader and had her explain in Miskito that she had a severe uterine prolapse and that she would need to be seen in the hospital in Puerto Cabezas. I imagine that the ObGyn will recommend a total hysterectomy. I can’t imagine that there is another remedy for a prolapse so severe.
I was shocked by the presence of this grave uterine prolapse, but by the time I lifted the skirt of the fifth woman whose uterus hung down between her legs it was less shocking and more disturbing. There was a pattern that I was noticing: older age, many, many babies, and a history of hard living with planting, hauling buckets of water, and hand washing. I imagine that in the history of these women there were also some prolonged labors with extended periods of pushing to get their babies out into the world. What began to stun me the most was how close these women were to the city, and yet completely isolated from general gynecological care. Two years? How does a woman cope with having her uterus bulging out from her vagina for two years? Why didn’t she seek care sooner? Is it the cost of bus fare to get to the city, the need to be at home to mind the house and children, or shame? Hopefully these five women will make the journey to Puerto Cabezas this Tuesday with the community leader to be seen at the hospital. Hopefully they will be treated with kindness and concern and not discrimination and ridicule for delaying treatment. Hopefully these women will receive the care that they need and live the rest of their days with more comfort and dignity.
Sunday, March 20, 2011
Progress!
After many months of work on the radio program Mairin Karnakira-Mujer Poderosa there have finally been a couple of successes...Below you will find the first page of the first completed chapter! I didn't include the whole thing because each one is about 11 pages long. The first is page one of Chapter 1 of the nine chapter series completed and in Spanish, the second is page one of Chapter 1 completed and translated into Miskitu!!! It feels like such an accomplishment. I apologize to those readers who don't read Spanish or Miskitu, there are no English scripts!
RADIO NOVELA: MAIRIN KARNAKIRA (MUJER PODEROSA)
Capítulo 1: Atención prenatal
CONTROL: FADE IN SONIDO DE OLAS FADE OUT A FADE IN MÚSICA]
CONTROL: FADE IN DE MÚSICA A SONIDO DE RÍO DURANTE LA NARRACIÓN
LOC: Usted está escuchando: Mairin Karnakira (Mujer Poderosa), una historia que sigue los pasos de cuatro mujeres Miskitas embarazadas: Vilma, Carolina, Mari, y Jenny. Ellas viven en la comunidad de Li Prana, la que se encuentra ubicada la orilla del mar y por ella pasa un río de agua muy clara y fresca para bañarse.
CONTROL: SONIDO DEL MAR A FADE IN DE SONIDO DE MOTOR DE PANGA LUEGO ENTRA NARRACIÓN. ENTRA MÚSICA
LOC: A la comunidad de Li Prana no se puede llegar por tierra, está a tres horas en panga al norte de Bilwi, Puerto Cabezas, Nicaragua. Al llegar, se ven muchas casas de madera pintadas en colores brillantes como rosado, azul y celeste. En la comunidad también hay muchos árboles frutales como el mango, nancite, pejibay, corozo, y muchos manglares con muchos ríos que se deslizan como serpientes de agua hacia las barras del litoral y la gente se deleita con sus frutos, tanto de los árboles como los que les dan los ríos y el mar.
CONTROL: SONIDO DE VIENTO ENTRE ARBOLES FADE IN SONIDO DE OLAS A FADE IN MÚSICA
LOC: La mayoría de los hombres que viven en Li Prana trabajan en el mar, por eso casi toda de la gente come mucho pescado, otros mariscos y carne de tortuga. Pero también, los habitantes comen yuca, plátano y arroz que cosechan en la misma comunidad. Todos cultivos tradicionales para la subsistencia familiar.
LOC: En Li Prana, como ya dijimos, viven las cuatro mujeres embarazadas de nuestra historia: Vilma que está casada con José, quien es carpintero y están esperando su primer bebé. Jenny, una adolescente soltera, también esperando su primer bebé. Carolina que está casada con Mario, un pescador y tendrá su segundo bebé y Mari que está casada con Edgar quien trabaja en el mar como buzo, ella va a tener su quinto bebé. Acompáñenos para saber qué pasará con estas mujeres de Li Prana.
CONTROL: SONIDO DE OLAS A FADE IN VIENTO SUAVE
LOC: Es un hermoso día soleado y con viento fresco en Li Prana, es temprano y todavía no hace calor. Las cuatro mujeres de nuestra historia: Vilma, Mari, Carolina y Jenny están lavando su ropa a la orilla del río.
RADIO NOVELA: MAIRIN KARNAKIRA (MUJER PODEROSA) MISKITU
Capítulo 1: Atención prenatal
CONTROL: FADE IN SONIDO DE OLAS FADE OUT A FADE IN MÚSICA]
CONTROL: FADE IN DE MÚSICA A SONIDO DE RÍO DURANTE LA NARRACIÓN
LOC: Man walisma: Mairin karnira, miskitu mairin kwihra wahlwal nahki auyaba dahra: Vilma, Carolina, Mary an Jenny. Witi naniba, kabu un ra tawan lupia kum Li Prana wiba ra iwi bangwisa, an bak sin awala sangni kum luwisa, aihtabaia dukiara kahula.
CONTROL: SONIDO DEL MAR A FADE IN DE SONIDO DE MOTOR DE PANGA LUEGO ENTRA NARRACIÓN. ENTRA MÚSICA
LOC: Li Prana Tawanka lupiara, sip sauhkak waras, Bilwi Puerto Cabezas Nicaragua wina yahbra tanira awar yuhmpa pitka sa. Auma Taim kaiksma, tat watla pint dingkan mapla sat sat, paura sangni an sangni pihs baku. Baku sin tawanka lupiara dus ma nani manis sa: mangu, krabu, supa, suyat baku an laulu manis, awala ailal wal, piuta baku kabu tanira iswisa an arbar kat, baku wal upla nani ba ai lilia bangwisa, dusma nani aima saki ba wal, awala nani wina, kabu wina saki ba wal sin.
CONTROL: SONIDO DE VIENTO ENTRE ARBOLES FADE IN SONIDO DE OLAS A FADE IN MÚSICA
LOC: Li Pranara iwi waitnika nani ba aihkika kabu unra wark taki banghwisa, ba mita upla sut inska pisa, kum kum ba wasi an kusua wina. Bara, uplika nani ba sin pisa, yauhra, platu an rais. Silp tawan kat mangki sakisa patitara natka kat, ai pamalika raya brikaia dukiara.
LOC: Aisi kata baku, Li Pranara mairin kwihra wahlwal iwi ba dukiara, yawan aisisa. Vilma ba José wal aimaya, witin ba dus warkka daukisa.(carpintero wiba). Witin nani ba pas ai luhpia briaiaba, bila kaikisa. Jeny ba tiara kura mayas kum, witin sin, pas ai luhpia baikaia bila kaikisa. Inska mamiskra Mario maya, Carolina sin ai luhpia pas ba ninka briaisa. Mari lika Edgar, kabu ra wark tatakrika, buzu kum maya. Witin ba ai luhpia numba matsip ba baikaia bila kaikisa. Kaisa yula kahbaia, naha Li Prana mairka nani wal, dia takbia sapa.
CONTROL: SONIDO DE OLAS A FADE IN VIENTO SUAVE
LOC: Li Prana ra yua kum lapta ingsa, pasa kauhla an kau titan sa, an kau bitni apu. Wan aisanka tilara mairin wahlwal na: Vilma, Mari, Carolina an Jeny, awala un ra kuala subi bahgwisa.
[SONIDO DEL RÍO Y DE MUJERES RIÉNDOSE]
LOC: Witin nani ai kwihrka nahki paliba dukiara pana pana aisi banhgwisa. Nahki pil muniba, ai sibrinka kum kum an nahki ai dara waliba dukiara. Vilma aisiba walpi.
VILMA: Ay Mari, Na pyua nan na swapri pali aidaukisa kuala suban ai daukras, plun piakaia ra sin pas kata apia baku sna. Naha na pas kwihra tiwri. ¿Naku ai daukina, bakusa ki?
RADIO NOVELA: MAIRIN KARNAKIRA (MUJER PODEROSA)
Capítulo 1: Atención prenatal
CONTROL: FADE IN SONIDO DE OLAS FADE OUT A FADE IN MÚSICA]
CONTROL: FADE IN DE MÚSICA A SONIDO DE RÍO DURANTE LA NARRACIÓN
LOC: Usted está escuchando: Mairin Karnakira (Mujer Poderosa), una historia que sigue los pasos de cuatro mujeres Miskitas embarazadas: Vilma, Carolina, Mari, y Jenny. Ellas viven en la comunidad de Li Prana, la que se encuentra ubicada la orilla del mar y por ella pasa un río de agua muy clara y fresca para bañarse.
CONTROL: SONIDO DEL MAR A FADE IN DE SONIDO DE MOTOR DE PANGA LUEGO ENTRA NARRACIÓN. ENTRA MÚSICA
LOC: A la comunidad de Li Prana no se puede llegar por tierra, está a tres horas en panga al norte de Bilwi, Puerto Cabezas, Nicaragua. Al llegar, se ven muchas casas de madera pintadas en colores brillantes como rosado, azul y celeste. En la comunidad también hay muchos árboles frutales como el mango, nancite, pejibay, corozo, y muchos manglares con muchos ríos que se deslizan como serpientes de agua hacia las barras del litoral y la gente se deleita con sus frutos, tanto de los árboles como los que les dan los ríos y el mar.
CONTROL: SONIDO DE VIENTO ENTRE ARBOLES FADE IN SONIDO DE OLAS A FADE IN MÚSICA
LOC: La mayoría de los hombres que viven en Li Prana trabajan en el mar, por eso casi toda de la gente come mucho pescado, otros mariscos y carne de tortuga. Pero también, los habitantes comen yuca, plátano y arroz que cosechan en la misma comunidad. Todos cultivos tradicionales para la subsistencia familiar.
LOC: En Li Prana, como ya dijimos, viven las cuatro mujeres embarazadas de nuestra historia: Vilma que está casada con José, quien es carpintero y están esperando su primer bebé. Jenny, una adolescente soltera, también esperando su primer bebé. Carolina que está casada con Mario, un pescador y tendrá su segundo bebé y Mari que está casada con Edgar quien trabaja en el mar como buzo, ella va a tener su quinto bebé. Acompáñenos para saber qué pasará con estas mujeres de Li Prana.
CONTROL: SONIDO DE OLAS A FADE IN VIENTO SUAVE
LOC: Es un hermoso día soleado y con viento fresco en Li Prana, es temprano y todavía no hace calor. Las cuatro mujeres de nuestra historia: Vilma, Mari, Carolina y Jenny están lavando su ropa a la orilla del río.
RADIO NOVELA: MAIRIN KARNAKIRA (MUJER PODEROSA) MISKITU
Capítulo 1: Atención prenatal
CONTROL: FADE IN SONIDO DE OLAS FADE OUT A FADE IN MÚSICA]
CONTROL: FADE IN DE MÚSICA A SONIDO DE RÍO DURANTE LA NARRACIÓN
LOC: Man walisma: Mairin karnira, miskitu mairin kwihra wahlwal nahki auyaba dahra: Vilma, Carolina, Mary an Jenny. Witi naniba, kabu un ra tawan lupia kum Li Prana wiba ra iwi bangwisa, an bak sin awala sangni kum luwisa, aihtabaia dukiara kahula.
CONTROL: SONIDO DEL MAR A FADE IN DE SONIDO DE MOTOR DE PANGA LUEGO ENTRA NARRACIÓN. ENTRA MÚSICA
LOC: Li Prana Tawanka lupiara, sip sauhkak waras, Bilwi Puerto Cabezas Nicaragua wina yahbra tanira awar yuhmpa pitka sa. Auma Taim kaiksma, tat watla pint dingkan mapla sat sat, paura sangni an sangni pihs baku. Baku sin tawanka lupiara dus ma nani manis sa: mangu, krabu, supa, suyat baku an laulu manis, awala ailal wal, piuta baku kabu tanira iswisa an arbar kat, baku wal upla nani ba ai lilia bangwisa, dusma nani aima saki ba wal, awala nani wina, kabu wina saki ba wal sin.
CONTROL: SONIDO DE VIENTO ENTRE ARBOLES FADE IN SONIDO DE OLAS A FADE IN MÚSICA
LOC: Li Pranara iwi waitnika nani ba aihkika kabu unra wark taki banghwisa, ba mita upla sut inska pisa, kum kum ba wasi an kusua wina. Bara, uplika nani ba sin pisa, yauhra, platu an rais. Silp tawan kat mangki sakisa patitara natka kat, ai pamalika raya brikaia dukiara.
LOC: Aisi kata baku, Li Pranara mairin kwihra wahlwal iwi ba dukiara, yawan aisisa. Vilma ba José wal aimaya, witin ba dus warkka daukisa.(carpintero wiba). Witin nani ba pas ai luhpia briaiaba, bila kaikisa. Jeny ba tiara kura mayas kum, witin sin, pas ai luhpia baikaia bila kaikisa. Inska mamiskra Mario maya, Carolina sin ai luhpia pas ba ninka briaisa. Mari lika Edgar, kabu ra wark tatakrika, buzu kum maya. Witin ba ai luhpia numba matsip ba baikaia bila kaikisa. Kaisa yula kahbaia, naha Li Prana mairka nani wal, dia takbia sapa.
CONTROL: SONIDO DE OLAS A FADE IN VIENTO SUAVE
LOC: Li Prana ra yua kum lapta ingsa, pasa kauhla an kau titan sa, an kau bitni apu. Wan aisanka tilara mairin wahlwal na: Vilma, Mari, Carolina an Jeny, awala un ra kuala subi bahgwisa.
[SONIDO DEL RÍO Y DE MUJERES RIÉNDOSE]
LOC: Witin nani ai kwihrka nahki paliba dukiara pana pana aisi banhgwisa. Nahki pil muniba, ai sibrinka kum kum an nahki ai dara waliba dukiara. Vilma aisiba walpi.
VILMA: Ay Mari, Na pyua nan na swapri pali aidaukisa kuala suban ai daukras, plun piakaia ra sin pas kata apia baku sna. Naha na pas kwihra tiwri. ¿Naku ai daukina, bakusa ki?
Wednesday, March 02, 2011
Some images from the hospital...
RADIO + BIRTH CENSUS
FETAL MONITOR
THE "PIXIS"
THE FAMOUS HANDFOLDED GAUZE
From Daukura with Baby
It was about four years ago that I arrived in Daukura for the first time. The panga ride up the coast was more than harrowing as the drunken captain pumped his fist in the sky, weaving his way in wide circles through waves, his thick plated gold chains slapping against his chest. The driver’s precarious maneuvering left us without diesel sooner than what is the norm. He rocked clumsily along with the waves as he tried to switch the plastic tubing from one bright blue tank of fuel to the next. I can imagine him, one eye closed, trying to focus on where he was going to insert the tube when the large rouge wave came letting the panga slip onto its side, throwing me halfway into the Caribbean Sea. As the boat righted itself he was able to get the tubing in and the boat started again, at the same time that it was filling with water. There was not a pail, bucket, or water jug on board to bail out the sea water whose level was slowly rising. Many hands and a little innovation later threw the water overboard.
Soon after, as we pulled into a community different from my final destination, I gladly jumped ship, setting my feet in Daukura.
It was in Daukura that I met Anhet. A Miskito woman who speaks excellent Spanish due to working abroad in Guatemala and later in Panama. We created an instant friendship. As I have passed the years visiting Puerto Cabezas I always take the opportunity to visit my friend when she is in town.
When I first arrived in September there was a rumor about Anhet. I knew that she had been in Panama working, but everyone said she was back. They said she was pregnant. I eagerly sought her out in the house of her cousin. A stilted wooden home painted a rich lilac color. A house so large with a fence so famous that when giving the direction to a taxi driver you simply say “Kelvin’s house”. I saw my friend lounging on the terrace, seated at a wooden bench, an obvious belly protruding up from under her billowy red shirt. Her due date was set for March, and I would be here.
We discussed what she wanted for her birth. She told me of how her mother and her two aunts are both midwives. But her mother was afraid. She didn’t want Anhet to have a homebirth with her. We talked about having a home birth where I attended her, but in the end she felt that what she wanted was to birth in the hospital. I made Anhet a promise that day that I hoped I could keep: to give her tender loving care during her labor and attend her delivery in the hospital.
So the months wore on. Anhet’s belly grew and stretched with the new life growing within her. We talked of labor, love, and newborns. She went for an ultrasound. We smiled together, our eyes softened, as we read the report. She was expecting a baby girl. She pulled miniature dresses in pastel colors and tiny red socks ringed with tulle out from plastic bags to show me her preparations. The days ran together as Anhet’s time came closer and closer. I had a moment of panic as I realized I would be out of town for five days the second week of March. I crossed my fingers that I would be able to keep my promise to her. Dios primero, as people say here.
On Sunday I headed to the beach. I left my phone at home, as usual, where I knew it would be safe and out of the reach of thieves. I basked in the warm February sun, enjoying the light glinting off the white caps. My friend’s son ran circles around me, standing on his hands, attempting back flips. When I made it home later in the evening there were eight missed calls on my phone. Anhet.
“Estoy mal amiga. Desde la manana he tenido dolores.” (Friend, I’m bad. I’ve been having pains since the morning)
So I filled my bag with some sterile gloves and my stethoscope and headed off to
Loma Verde, a growing community on the outskirts of Port where Anhet lives. The taxi dropped me off in front of the lime green cement home wringed by a wood and chain fence. I opened the slated gate and walked inside. When I passed the threshold there was that quiet hush that accompanies the beginning of labor. It’s like a dense cloud of expectation of those around, the cousins and aunties holding back their breath through tight lipped smiles each time a contraction grabs someone they love; and also there is that shift in energy as the world prepares itself to greet another being. But Anhet was still smiling. I knew it was early, and she had a long road ahead of her.
After chatting at the large wooden table in the kitchen we moved into the bedroom. Anhet lay across the king size mattress shrouded by a light blue lace mosquito net. Her baby lay as a mound over her abdomen, her tiny limbs pushing and probing through her skin. I kicked off my shoes and curled my legs underneath me, adjusting myself at her side. I pulled my stethoscope from my purse, inserted the ear pieces, and then laid the rounded bell up against her belly. Transported through the tubing to my ears was that familiar fast paced tick-tick-tick of her baby’s heartbeat. One after another I passed the earpieces to expecting mother, cousin, expecting grandmother, and auntie while carefully holding the bell in place which later left a small circular impression on her skin. We counted her contractions: every five minutes, but short and light.
Two weeks earlier Anhet had an ultrasound. Her mother, the midwife, felt that the baby was in an unusual position, and the ultrasound showed Anhet’s little girl seated in the pelvis rather than head down. I wanted to assure myself that this little girl had flipped into a head down position to ensure a safer labor and delivery. I laid my hands upon her belly, grasping one side of the fetus as I palpated with the other hand.
“Feels like feet over here,” prodding against the upper right quadrant.
I moved my hand above the pubic bone and grasped a hard round globe. The baby’s head. The aunties and Anhet’s mother with their years of experience agreed that the baby had back flipped, nestling its head into Anhet’s pelvis. To double check what I really was feeling I recommended a vaginal exam. My fingers felt along the soft, fleshy cervix, and I was able to insert two fingers side-by-side through the cervix to feel the familiar round hardness of bone and skull.
So I went home, to try to sleep with my cell phone tucked up against my ear, waiting for the call. At 6:00 am when my alarm went off I still hadn’t heard from Anhet. I hopped under thee cold spray of water in my shower then donned my scrubs, downed a cup of earl grey tea, and finished off a bowl of fresh fruit. Off to the hospital.
When I arrived at the hospital I found Anhet in the maternity wing, a stuffy room hot from the midmorning sun streaming through the wall of windows. Mattresses line the perimeter of the room, each one filled with a woman awaiting her time. My friend sat at the edge of her bed, freshly bathed, her moist dark hair curling into rings. She wore a pastel floral house dress. She still smiled, but looked tired, and her contractions now caused her to pinch her breath off shortly. The matriarchs of her family surrounded her, each one advising and consoling her in lilting Miskito. Soon enough Anhet would be ushered back to Labor and Delivery where her contractions would mount in number and intensity.
A couple of hours later the double wooden doors clacked open, and in shuffled Anhet, eyes red and moist with recent tears. She was at that moment in labor when women realize that those early contractions were just the warm up and that things were just going to get heavier. I helped my friend to the bathroom where she scooped cool water from the fifty gallon barrel with a cut off plastic jug, rinsing her body. She changed into the hospital gown, opened to the front as is the custom, but which always gapes open precariously at the right breast.
I settled in for the next couple of hours to support my friend through her labor. The contractions swelled up inside of Anhet who found it most comfortable to stand, bracing her palms against the wall, fingers splayed open, her legs firmly planted underneath her hips. With each fresh wave I reminded Anhet to breath deeply, to let the pain drift out with her exhalation.
“Wind cum, respira profunda (breath deeply).”
During the break between contractions I found my mind drifting back to those days in Daukura when Anhet and I first met. I thought of the stilted house, painted white and trimmed in green, the rocking chairs lined up in rows on the terrace. Mostly, I thought of the night when I bathed in the kitchen. Anhet had brought a bucket of water with a plastic bowl into the wooden room, setting a cake of soap on the windowsill. She closed the door behind her telling me she would stand guard. I had stripped off my sea-salted cloths and began to throw water onto my head, letting it drip down my shoulders to my feet. The cool water cut through the thick heat of the night. Anhet and I whispered through the slats in the wooden planks of the wall. We discussed boys and birth control. Our friendship was solidified in those moments talking through the wall as the water formed a moist puddle at my feet, dripping through the cracks into the earth below.
The contractions came and went, coming closer and closer, like the tide riding the shore. The labor and delivery room was empty aside from the midwife, Anhet and I. I allowed her family to come in one at a time, the midwives eager to see Anhet’s progress and pass on words of wisdom. Her aunt’s arms embraced her during contractions, the fingers of her left hand open wide, browned and wrinkled, expertly cupping the uterine fundus as she must have done countless times to other laboring women. She asked whether we should give Anhet some herbs to speed her labor. I thought she was progressing fine, so better not to intervene.
I examined Anhet: 7 centimeters. I felt disappointed as she had been 7 centimeters two hours ago when I had examined her. This was the first labor and delivery of a friend that I had attended as a midwife. I wanted everything to go smoothly for her, but also knew how labors can stall and problems can arise. The baby’s head had dropped significantly into the birth canal though, giving me hope that she would make her appearance soon enough. Thirty minutes later Anhet complained of increasing pressure, saying she felt like something was going to fall out.
I donned a glove and examined my friend once again. She was completely dilated and my fingers braised up against her daughter’s head just millimeters from the mouth of her womb. With two courageous pushes her little girl’s head crowned and extended into the world. A tight cord around her neck held her back for an instant. I set two clamps and cut the pulsing cord that had transported oxygen and nutrients to this being for the last nine months. Her body came slipping out with the next push as I raised her up onto her mother’s abdomen. 4:13pm February 28th. She had arrived.
Soon after, as we pulled into a community different from my final destination, I gladly jumped ship, setting my feet in Daukura.
It was in Daukura that I met Anhet. A Miskito woman who speaks excellent Spanish due to working abroad in Guatemala and later in Panama. We created an instant friendship. As I have passed the years visiting Puerto Cabezas I always take the opportunity to visit my friend when she is in town.
When I first arrived in September there was a rumor about Anhet. I knew that she had been in Panama working, but everyone said she was back. They said she was pregnant. I eagerly sought her out in the house of her cousin. A stilted wooden home painted a rich lilac color. A house so large with a fence so famous that when giving the direction to a taxi driver you simply say “Kelvin’s house”. I saw my friend lounging on the terrace, seated at a wooden bench, an obvious belly protruding up from under her billowy red shirt. Her due date was set for March, and I would be here.
We discussed what she wanted for her birth. She told me of how her mother and her two aunts are both midwives. But her mother was afraid. She didn’t want Anhet to have a homebirth with her. We talked about having a home birth where I attended her, but in the end she felt that what she wanted was to birth in the hospital. I made Anhet a promise that day that I hoped I could keep: to give her tender loving care during her labor and attend her delivery in the hospital.
So the months wore on. Anhet’s belly grew and stretched with the new life growing within her. We talked of labor, love, and newborns. She went for an ultrasound. We smiled together, our eyes softened, as we read the report. She was expecting a baby girl. She pulled miniature dresses in pastel colors and tiny red socks ringed with tulle out from plastic bags to show me her preparations. The days ran together as Anhet’s time came closer and closer. I had a moment of panic as I realized I would be out of town for five days the second week of March. I crossed my fingers that I would be able to keep my promise to her. Dios primero, as people say here.
On Sunday I headed to the beach. I left my phone at home, as usual, where I knew it would be safe and out of the reach of thieves. I basked in the warm February sun, enjoying the light glinting off the white caps. My friend’s son ran circles around me, standing on his hands, attempting back flips. When I made it home later in the evening there were eight missed calls on my phone. Anhet.
“Estoy mal amiga. Desde la manana he tenido dolores.” (Friend, I’m bad. I’ve been having pains since the morning)
So I filled my bag with some sterile gloves and my stethoscope and headed off to
Loma Verde, a growing community on the outskirts of Port where Anhet lives. The taxi dropped me off in front of the lime green cement home wringed by a wood and chain fence. I opened the slated gate and walked inside. When I passed the threshold there was that quiet hush that accompanies the beginning of labor. It’s like a dense cloud of expectation of those around, the cousins and aunties holding back their breath through tight lipped smiles each time a contraction grabs someone they love; and also there is that shift in energy as the world prepares itself to greet another being. But Anhet was still smiling. I knew it was early, and she had a long road ahead of her.
After chatting at the large wooden table in the kitchen we moved into the bedroom. Anhet lay across the king size mattress shrouded by a light blue lace mosquito net. Her baby lay as a mound over her abdomen, her tiny limbs pushing and probing through her skin. I kicked off my shoes and curled my legs underneath me, adjusting myself at her side. I pulled my stethoscope from my purse, inserted the ear pieces, and then laid the rounded bell up against her belly. Transported through the tubing to my ears was that familiar fast paced tick-tick-tick of her baby’s heartbeat. One after another I passed the earpieces to expecting mother, cousin, expecting grandmother, and auntie while carefully holding the bell in place which later left a small circular impression on her skin. We counted her contractions: every five minutes, but short and light.
Two weeks earlier Anhet had an ultrasound. Her mother, the midwife, felt that the baby was in an unusual position, and the ultrasound showed Anhet’s little girl seated in the pelvis rather than head down. I wanted to assure myself that this little girl had flipped into a head down position to ensure a safer labor and delivery. I laid my hands upon her belly, grasping one side of the fetus as I palpated with the other hand.
“Feels like feet over here,” prodding against the upper right quadrant.
I moved my hand above the pubic bone and grasped a hard round globe. The baby’s head. The aunties and Anhet’s mother with their years of experience agreed that the baby had back flipped, nestling its head into Anhet’s pelvis. To double check what I really was feeling I recommended a vaginal exam. My fingers felt along the soft, fleshy cervix, and I was able to insert two fingers side-by-side through the cervix to feel the familiar round hardness of bone and skull.
So I went home, to try to sleep with my cell phone tucked up against my ear, waiting for the call. At 6:00 am when my alarm went off I still hadn’t heard from Anhet. I hopped under thee cold spray of water in my shower then donned my scrubs, downed a cup of earl grey tea, and finished off a bowl of fresh fruit. Off to the hospital.
When I arrived at the hospital I found Anhet in the maternity wing, a stuffy room hot from the midmorning sun streaming through the wall of windows. Mattresses line the perimeter of the room, each one filled with a woman awaiting her time. My friend sat at the edge of her bed, freshly bathed, her moist dark hair curling into rings. She wore a pastel floral house dress. She still smiled, but looked tired, and her contractions now caused her to pinch her breath off shortly. The matriarchs of her family surrounded her, each one advising and consoling her in lilting Miskito. Soon enough Anhet would be ushered back to Labor and Delivery where her contractions would mount in number and intensity.
A couple of hours later the double wooden doors clacked open, and in shuffled Anhet, eyes red and moist with recent tears. She was at that moment in labor when women realize that those early contractions were just the warm up and that things were just going to get heavier. I helped my friend to the bathroom where she scooped cool water from the fifty gallon barrel with a cut off plastic jug, rinsing her body. She changed into the hospital gown, opened to the front as is the custom, but which always gapes open precariously at the right breast.
I settled in for the next couple of hours to support my friend through her labor. The contractions swelled up inside of Anhet who found it most comfortable to stand, bracing her palms against the wall, fingers splayed open, her legs firmly planted underneath her hips. With each fresh wave I reminded Anhet to breath deeply, to let the pain drift out with her exhalation.
“Wind cum, respira profunda (breath deeply).”
During the break between contractions I found my mind drifting back to those days in Daukura when Anhet and I first met. I thought of the stilted house, painted white and trimmed in green, the rocking chairs lined up in rows on the terrace. Mostly, I thought of the night when I bathed in the kitchen. Anhet had brought a bucket of water with a plastic bowl into the wooden room, setting a cake of soap on the windowsill. She closed the door behind her telling me she would stand guard. I had stripped off my sea-salted cloths and began to throw water onto my head, letting it drip down my shoulders to my feet. The cool water cut through the thick heat of the night. Anhet and I whispered through the slats in the wooden planks of the wall. We discussed boys and birth control. Our friendship was solidified in those moments talking through the wall as the water formed a moist puddle at my feet, dripping through the cracks into the earth below.
The contractions came and went, coming closer and closer, like the tide riding the shore. The labor and delivery room was empty aside from the midwife, Anhet and I. I allowed her family to come in one at a time, the midwives eager to see Anhet’s progress and pass on words of wisdom. Her aunt’s arms embraced her during contractions, the fingers of her left hand open wide, browned and wrinkled, expertly cupping the uterine fundus as she must have done countless times to other laboring women. She asked whether we should give Anhet some herbs to speed her labor. I thought she was progressing fine, so better not to intervene.
I examined Anhet: 7 centimeters. I felt disappointed as she had been 7 centimeters two hours ago when I had examined her. This was the first labor and delivery of a friend that I had attended as a midwife. I wanted everything to go smoothly for her, but also knew how labors can stall and problems can arise. The baby’s head had dropped significantly into the birth canal though, giving me hope that she would make her appearance soon enough. Thirty minutes later Anhet complained of increasing pressure, saying she felt like something was going to fall out.
I donned a glove and examined my friend once again. She was completely dilated and my fingers braised up against her daughter’s head just millimeters from the mouth of her womb. With two courageous pushes her little girl’s head crowned and extended into the world. A tight cord around her neck held her back for an instant. I set two clamps and cut the pulsing cord that had transported oxygen and nutrients to this being for the last nine months. Her body came slipping out with the next push as I raised her up onto her mother’s abdomen. 4:13pm February 28th. She had arrived.
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