Life's Not Fair with HIV

* Names and details were changed...but the story is true

When I first saw Khalia, she was sitting with her mom on the hard wooden benches outside.  Her mother made me promise to take care of her girl.  There were tears in her eyes as she pleaded with me.  Mom's aren't allowed past the heavy, paint chipped door of the labor and delivery ward.  I told her I would be her daughter's "watch mama." 

The nurses took Khalia back to take a cold bucket bath in the filthy shower stall.  Her mother then pulled a very used Coca Cola bottle full of water out of her colorful string bag.  She whispered to me that I needed to take this to her daughter to drink.  It was from Khalia's village where she had grown up.  All the women had "outed" their "heavies" (issues, grudges ect.) and blessed the water.  Now if the laboring mother drinks it, it shows that they are all at peace.  They believed it would make the labor go quickly and easily.  The wrinkled little mother was thrilled that I understood and was familiar with the beliefs from my years in the bush.  I gave it to Khalia, explained what her mom had said, and Khalia drank it up quickly.

Khalia is 17 years old.  Last year her husband bought her for about $3000.  She then went to live in his village as his fourth wife.  She spends her days tending the large gardens and cooking food.  Probably caring for the kids of the older wives too.  Her new husband  gave her HIV on her wedding night.  She is now HIV positive and has TB and herpes to go with it.

Now, here she was delivering her first baby.  The medical staff was standoffish about her medical conditions. (The herpes had done some awful looking things to her) They warned me not to be around her.  I did consider just helping the other 8 ladies in labor but I felt that God would have me to love on Khalia.  It was the right thing to do.  It is what Jesus would do.  I spent the next 8 hours with her. (and I did take precautions with fluids)   She is a sweet and beautiful girl who labored very well.  

She begged me not to leave, even for a minute.  I held her, massaged her, prayed with her, and encouraged her. 

Once she was ready to push, she pushed for almost 4 hours.  They never checked the babies heart tones. 

She got so exhausted.  Her babies head had been slightly in view for two hours.  No amount of squatting or position change was helping.  I finally was able to convince someone to come help us.  I was shocked at how she "helped."   She grabbed a razor blade and cut Khalia four times. Four large episiotomies on her herpes enveloped skin.  A beautiful baby girl emerged over the HIV infected blood. 

Khalia had more love in her eyes as she looked at her new daughter than most of the mom's I see here.  The baby latched on a nursed just fine.  It was hard to say goodbye to her.  I am privileged to have been able to be with her on that day. 
                                                                             

A Breech Nightmare

This story is one I've hesitated to write about. 

It has been a couple of weeks and the images are still haunting me...beware.  If you are pregnant, please don't read this.

My heart in sharing this is to open your eyes to state maternal care around the world.

I walked into the labor and delivery ward one morning to find a teenage mom surrounded by midwives and nurses.  Something was dangling between her legs.  I attended to some ladies who were asking for tea.

After a few minutes a midwife stopped yelling at the girl and explained to me: "Her baby was breech, and she was not fully dilated when she pushed the baby out. We kept telling her not to push, but she did anyway and the baby got stuck at the head.  Now the baby is dead and it is all her fault.  It's dead and stuck there."

That is when my brain made sense of the baby's grey body that hung there.  I asked if  I could talk to the girl.  They said sure.

I held her hand. I prayed with her. She asked me if it was a boy or a girl.  I had to lift the dead baby's leg to check. No one had told her that it was a baby girl.  At this point the medical staff were mad at her and just leaving her alone with her baby half born.  She asked me to get the baby out.  I explained that I could not do that.

Finally they hooked her up to pitocin and started yanking on the baby...and yanking and yanking and yelling at the poor girl.  All the while I stroked her head, trying to be the presence of kindness in a horrific situation.

After about ten minutes of this, another midwife walked over and showed them how to hook the babies mouth with her finger and tilt the chin down while putting the other hand on the mom's belly.  The dead baby popped right out.

This poor girl was terribly damaged "down there."  While they stitched her up they gave her a lecture. It went something like..."This happened to you because you got pregnant out of wedlock, you deserve it and this is all your fault."

I came behind and tried to undo the damage.  It was just awful.  She wrapped up her dead baby, got dressed, and hobbled home a few hours later.

This has not been the "norm" here, sometimes I see a lot of kindness and skill.  But this was downright awful and disturbing  I wish that all women could be treated kindly and that all births ended happily.  But, they don't. 

A Little Girl in Labor

She was twelve years old.  She had been in labor for two days and was HIV positive.  As I held her and rubbed her back through the contractons, it was hard for me to wrap my mind around the fact that this girl was only two years older than my son.

A smaller clinic 3 hours away had sent her to this larger hospital because they felt her labor was taking too long.  None of her family came with her.  She was so scared, and very much alone.  She kept calling out for her mom.

I encouraged her to walk if she could, and she did. She walked and walked and walked.  Eventually she had a baby boy.  When he started to nurse for the first time, the look on her face made me want to cry.  Her expression was that of  joy and amazement and love for this new little miracle that had been inside her only moments ago. 

I don't know her whole story, and I don't know what life will look like for her as she heads home. I doubt it is pretty.  All I can do is pray for her.



Left: you can see a woman walking away with a bag of firewood.  Right: the next generation of little women

They Are More that Just Statistics

This is a true story from when I lived a two day hike from any roads or maternity care. Warning: this is graphic; it may not be suitable for everyone to read.

Limaka and I sat together on the dirt, our machetes by our sides.  I twirled a piece of grass in my fingers and watched as my sons climbed trees and cut trails in the jungle.  We had been clearing the weeds around my house to keep the snakes away. 

 “My husband is dead and I had nine kids, but only one is still alive, I want you to meet her.  I’m so excited, she is pregnant and I am going to be a grandma!”   Limaka was bursting with pride as she spoke of her only living daughter, who had recently married and moved to a village 2 hours away.

I told her I would love to meet Lisi, her daughter.  But I never got the chance.

A few days later I heard that Lisi died.

This is what I gathered as to what had happened:

~ She went into pre-term labor (it seemed she was around 30 weeks)

~ The baby was a footling breech who slipped part way out.  It was stuck that way due to the cervix which was not completely dilated.

~ She tried to push for days, and she bled.  They offered to cut the baby.  She refused to let them hurt her half born child.

~They left Lisi and her baby under the house to die.  And they did.

I attended the funeral.  I sat in the smoky hut for hours with her dead body, and joined in the death wail. 

I found out the next day that I was pregnant with my fourth child.  I went to the USA where I had a doula, a midwife, a hospital that stopped my pre term labor, newborn photography, and a baby shower.

Here are some links to World Health Organization on infant and maternal mortality.

http://www.who.int/mediacentre/factsheets/fs333/en/ - infant

http://www.who.int/mediacentre/factsheets/fs348/en/index.html -maternal