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Visiting Remote Ethnic Villages in Laos with Clean Birth Kits
As we visited the clinics in Tahoy District, I got a sense of the grinding poverty of the area. People live on $1 per day. The life expectancy of women is short, either due to childbirth (8-12 births) or disease. Most will lose several babies, as the under 5 death rate is very high.
What do you see when you walk into the villages? Naked kids with runny noses. Mother with babies in slings. Bamboo and wood one-room dwellings on stilts. No electricity, not a single store. The people are still living as they have for centuries. They are forest people and foraging is still part of how they survive: rodents and roots supplement subsistence rice farming, which was introduced in the past decade.
The outside world is creeping in, however, due to a road connecting Thailand and Vietnam. Until 5 years ago the Tahoy people were completely isolated with little exposure to the outside world (except for the bombs the US rained on the area during the war with Vietnam)[1] The trip from the town of Salavan, 4 hours from the Thai border in southern Laos, took us 2-3 hours this week on the new road. It used to take 8-10 on treacherous, often impassable dirt terrain. Change is not all good: issues of human trafficking, HIV, and environmental degradation have already emerged. However, it is hoped that the road will also enable increased access to medicine and education.
Education and healthcare, in the case of birth, go hand in hand. Birthing is steeped in religious tradition, often with fatal consequences. Due to animist religious beliefs, women and girls give birth alone in the forest. However, if they give birth at the clinic, they can have the support of the nurses. Knowing that not all women can reach the clinic, the nurses and I agreed to initiate a “Safe Birth Outreach”. They will educate women and families: in the villages close to the clinic they will encourage birthing at the clinic; in the far away villages they will encourage women to get help.
The clinics will use the Clean Birth Kits to reinforce the message of the “Safe Birth Outreach”. The picture instructions show that the mother has a helper, who washes hands, uses the kit supplies, wraps the baby and immediately facilitates breastfeeding. The nurses have suggested adding receiving blankets, so I will begin accepting donations of gently used blankets to be used at the moment of birth.
CleanBirth.org will also develop illustrated posters to be hung in villages that caution against harmful behaviors in pregnancy (e.g. smoking), explain the warning signs of possible problems (e.g. pre-eclampsia) and show hygienic birthing practices using the Clean Birth Kits.
I learned so much from OV staff and the nurses. They told me what they need and we developed a plan to begin lowering maternal mortality in their villages.
A wonderful, productive trip. Now on to fundraising to make this happen…
[1] www.uxolao.org Laos is the most heavily bombed country in the world. During the Vietnam War, the US conducted a “Silent War” against Laos along the Ho Chi Minh Trail (HCMT). Tahoy was an important post on the HCMT. Unexploded ordinance continues to claim lives decades later. People blinded by Agent Orange inhabit the villages, carrying the physical and mental scars of war.
Training Lao Health Workers to Use Clean Birth Kits
“Off to Laos! I am really doing this!” I enthused in a text to a friend en route to JFK for my around-the-world flight. I was headed to a remote province of Laos to provide local women with Clean Birth Kits (essential birthing supplies: picture instructions, absorbent sheet, soap, cord clamp, sterile blade that prevent infection) and training on safe, hygienic birthing practices.
It took me 48 hours to get to Thailand, due to a delayed flight, and I was worse for the wear on arrival. En route from Thailand to Laos, my stomach hurt from travel-induced anxiety, malaria pills were causing another kind of digestive distress and I was sleep-deprived. Plus, I didn’t really know where I was going: a cell phone number from my Lao partner organization, OVC, was my only information. Arriving in the Thai-Lao border town, Pakse, I obsessively dialed my contact for hours until she answered. Much to my relief, she picked me up and drove me from Pakse to Salavan, where OVC is based.
My first day in Salavan, I knew that the stress and discomfort of travel were well worth it. I saw immediately, that the directors of OVC, Nong and Nyai, were women that I could work with. They are efficient, hard-working, committed and generous. For more than 10 years, they have been providing medical, educational and agricultural support to ethnic minorities in this remote region. They believe in empowering the local people: seven of OVC’s staff of twelve live in the communities and are ethnic minorities themselves.
The morning after I arrived, we kicked off the Clean Birth Kits training. Nong and Nyai had decided that the Clean Birth Kits Pilot Project should initially target four community clinics in Tahoy District, home to the Tahoy people. The Tahoy live deep in the forest and their religious beliefs lead women to give birth alone. OV hopes that in addition to providing life-saving supplies, women and families will be educated about the need to assist laboring mothers.
Four nurses, a District Health official, and OVC staff members traveled for hours on motorbike to attend the training. They were all-business and ready to learn. There was none of the giggling or unquestioning nods that I experienced working with Burmese or Khmer health workers. During the 8 hours we worked together, they asked questions, challenged ideas, and helped adapt the program to match needs on the ground. I was impressed with their professionalism and commitment to introducing Clean Birth Kits, which they agreed “the mothers would be happy to use.
In the days after the training, we visited the nurses’ at their clinics. They are in dire need of supplies. These clinics have little to offer in terms of medicines, equipment consists of wood slat beds, and refrigeration was not available.
The Clean Birth Kits Project will enable nurses to provide women with birthing supplies to be used at the clinic or at home. CleanBirth.org also funds the nurses’ travel to the most remote villages, 5-8 hours by motorcycle. They will bring birth kits and provide educational sessions to people who have never stepped inside a clinic.
Having the support of the nurses, the government (District Health official) and OV staffers, who will oversee the pilot project is crucial and I have it. I trust that they will execute the program.
CleanBirth.org has committed 1,200 birth kits and community outreach support to these clinics. Each kit costs $5. Please consider a donation: www.cleanbirth.org/donation. All of your money goes directly to the communities. CleanBirth.org has no salaried employees.
In the next installment, we head into the villages to see mothers and children. Stay tuned.
Long Road Ahead to Salavan, Laos
The road ahead of me is long. I leave home Friday at 10am and arrive in Bangkok at 2am on Sunday morning (2pm Saturday EST). Monday, I fly to Pakse, Laos and then take a 3-4 hour bus to Salavan. Long road literally.
In the figurative sense as well, I have a ways to go. My goals for this trip: conduct the Clean Birth Kits training and kick-off the Clean Birth Kits Field Trial. More broadly, I want to understand the local maternal and infant health needs, build trust with local staff, and develop a plan for meeting their needs.
I am taking off my fundraising hat for a couple of weeks (though I do plan to send emails that tug on heart and purse strings) and putting on my program coordinator hat. Though my primary job at CleanBirth.org is to raise money, this trip is my time to build relationships and develop a hands-on understanding of what can/needs to be done.
Wish me luck on the long road ahead…
Reflections and “What’s Next?”
The past few months have been fruitful. Instead of my usual “What’s next?,” I’m going to take a moment before I leave for Laos, to think about what’s been accomplished (Caution: I am pretty much tooting my own horn here)
First off, with the help of my wonderful intern, I have raised enough money to fully fund the Clean Birth Kits Pilot Project! People have been so generous. The number of people (70+) that have responded convinces me that the issue resonates with many people. One person that it resonated with is Sarah Cody at FoxCT who will be profiling CleanBirth.org on December 3rd. So excited! I hope that we will reach more potential donors…and that I don’t look too jet-lagged since I fly in the day before filming!
The fact that I don’t have to twist arms for people to pull out their wallets is crucial. If it was a tough sell, my job would be awful. Because when you get right down I need to 1. to listen to the leadership in Laos about what they need to improve maternal and infant mortality 2. get them money/training.
Despite my initial aversion to fundraising, reading “Fundraising for Social Change” has convinced me that people want to give. Thanks to this book, I am actually looking forward to developing a comprehensive fundraising policy, which will include becoming a 501c3 (in the works) and creating an effective Board of Directors.
I will certainly have my eye out for potential board members at an event I am hosting for YaleWomen CT on February 10. I will get a chance to talk about CleanBirth.org and then connect with these impressive women. Here’s hoping I capture someone’s interest.
Another way I am using my Yale connection, is to team up with students interested in global health at Yale Nursing School and the School of Public Health. In December, I will give a presentation to these students in the hope that one or two will secure a grant to come to Laos in summer 2013 and provide training to local staff.
I am so grateful to several women who have approached me about supporting CleanBirth.org: Susan Clinard an amazing artist and friend who is helping me plan a fundraiser in New Haven; Jacki at http://hjunderway.com/13-for-13/ who is running a 1/2 marathon in Tanzania to bring awareness to 13 non-profits; Valerie Baumal, founder of http://www.anakijo.com/, who has offered to donate her lovely handmade children’s products/a portion of her proceeds to raise money. Their generosity empowers me to think that we can indeed make an impact and reduce the number of mothers and babies dying needlessly.
I feel like I am ready for this trip and the training of 10 staff members. In the past week, I have used PATH’s fantastic resource about conducting a Clean Birth Kits training. I modified it and sent it along to a new Lao friend at Cornell who translated it. I need to print 10 copies, slide into 10 green (lucky Lao color) folders, insert into 10 purple (CleanBirth.org’s color) bags, add chocolate bars from IKEA (chocolate = universal) and I am mostly ready to go.
So… “What’s next?”
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