17 January 2012

.a working progress.

Today I had a scheduled meeting with the Health Environment Officer and an assortment of Health Extension Workers at 8am to pitch my work plan (again!).  I arrived at 8am only to find no one there, 8:30am still nothing, and finally at 9am he arrived. An hour wait now really doesn’t feel like much of anything – I actually use it to prepare for the meeting (this is NOT a good habit to have formed about only 2 months. Ekk.) I met with Richard (HEO), and realized that he thought I was going to start training the Health Extension Workers on GPS TODAY! Wow. Forget formalities, this guy is ready to WORK.  I explained to him that I feel it would be best to first present the project objectives to see if there was interest with the workers, but he assured me that if the DHO liked the idea then it was fine – they would be interested. My Peace Corps “bottom up” development ideas are screeching at this!! But ok so I ask him what is our next step…after several long pauses and a lot of silence he finally decides I should meet the Health Administration Officer. Who warmly welcomes me to Malawi and Machinga District(this is a common theme honestly I can’t remember one professional encounter that hasn’t included someone telling me “you are most welcome to Malawi”), he loves the idea of mapping the Maternal Health Services within the district and sends us to meet with the Reproductive Health Officer and the Prevention of Mother to Child Transmission Officer. Phew! It feels like a PR tour, but Richard (the Health Environment Officer) is a champ go-getter and so willing to introduce me to the key players in the district (this is going to be SO helpful).

The hospital feels like a maze with odd signs written in poor English, we head towards the Maternity Ward. Taking a left into a dark narrow hallway, on my left I peek into a room with only a bench and a gymnastic mat on the ground filled to the brim with VERY pregnant women. It’s very common for women from the villages to come weeks before their “due date” to wait. Due to many variables including laws, transport, lack of access to services, etc. the gov’t encourages women to come and WAIT. Can you imagine? We continue down the hall and I’m all of a sudden encompassed by 15 or so Malawian Mamas breastfeeding their BRAND new babies (I’m assuming these babes were born today!!), the Mamas are uniformed in nothing more than their chintenjis (2 yards of fabric) wrapped around them like a towel.

I’m overwhelmed, my body is reacting to all these things, I’m afraid – anxious – I actually thought for a second maybe I should just turn around! Much like the first time you attempt to do a back float in water, you can’t let go of the control and the fear of the water’s ability to hold you. You kick and flutter trying to “help” yourself while you’re sinking. It’s only when you let go and trust the water can you float with such ease you wonder what took you so long to figure this out. This was me today, kicking and splashing the water - drowning. I recognized these feelings. I had the very same rock in the pit of my stomach feeling this past October when I was blessed with the opportunity to do a 24-hour rotation at Maternidad La Luz Birth Center/Midwifery school. Late in the afternoon the Midwife pulled me into the birth room and there was Sarahi almost crowning and I for a second I wanted to run out of the room. Birth was too much. It was so all consuming I couldn’t handle it. I could’ve looked away but birth grabs you whether you are looking or not, it holds you tight until you surrender. I surrendered and witnessed the most beautiful miracle, Joshua’s birth.

Walking into meet the Reproductive Health Officer we found her in Cherokee purple scrubs and a plastic apron that looked like something you would see in a cafeteria. She was a quiet and guarded woman. I have found in my 2 months that the key to successful meetings lies in the awkward silences. I introduced myself and the project objectives – but Maureen (RHO) still didn’t seem very interested. So Richard asked her if she had any information to share, she said no. I add more to the project background to maybe spark something, but nothing. -silence- We asked if Women are still birthing at home with Traditional Birth Attendants and slowly she began to share that a few area still have working TBAs,- more silence- Actually most of the district has several working TBAs. -More silence- Then she told us that there was Maternal Health Support Groups that assisted Women with their Pre/Ante-Natal care as well as Birth or transportation to the Health Center – but those group are no longer meeting. Success!

Maybe this project idea is needed. Maybe there will be fruitful work for me in the next 7 months to come. Maybe I still have a lot of knowledge to gain. Maybe once again I will learn that listen will teach you more that speaking.

After all these feelings and flashes I realized that my journey to this point has been a winding (sometime uncertain feeling) road because I’ve been afraid and fearful. Birth has grabbed my life and I didn’t want to accept it – I want a 9-5 job, I want to plan a schedule, I want to have relaxing nights – but birth has chosen me. Today I began to accept my path, my calling, I’m surrendering.  

What a beautiful day! I’m grateful.
Much love to you and yours.

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