In Haiti — the poorest country in the Americas, according to the World Bank — women die from pregnancy- and childbirth-related causes at a rate more than three times that of women in neighboring Dominican Republic and 12 times that of women in the United States.
One factor: not enough skilled health care workers trained to treat preventable problems such as eclampsia, sepsis and postpartum hemorrhage, the main causes of maternal deaths.
Henrico County-based Midwives for Haiti, co-founded by nurse-midwife Nadene Brunk in 2006, is addressing the challenge.
The organization runs a 12-month program that trains Haitian nurses to be skilled birth attendants. It also runs a mobile clinic that provides prenatal care in rural areas; pays the salaries of more than a dozen skilled birth attendants who work in a Haitian hospital's maternity center; and works with traditional birth attendants, called matrons, who attend 75 percent of the births in Haiti, providing them with training and kits for clean deliveries.
During a typical year, about 200 nurse-midwives from across the United States and elsewhere travel to Haiti to help teach, mentor and provide prenatal care.
Their efforts are having an impact in multiple ways. One is by recognizing and shifting many of the high-risk births to the local hospital, where clinicians are available if there are emergencies.
Brunk said that when Midwives for Haiti started, the local hospital was handling about 2 percent of the births in its service area. That is now up to 28 percent.
Under Brunk's direction, the organization continues to expand. Midwives for Haiti’s next major project is a birthing center in a rural community in the mountains of Haiti, where the nearest hospital is an hour and a half away by car.
“This is going to be a really important source of health care for the women," Brunk said. "We are excited about being able to offer them ... something that is in their community.”
IN HER WORDS
A small moment in life with a big impact
When I was first taken to Haiti, I quickly realized that I had skills that, although they were useful for my work in the U.S., could literally save lives in Haiti. The impact of severe poverty and the impossibility of getting out of it for most people in this world made me very interested in learning how to help in ways that empowered the poor and made lasting change for their lives.
“Strength in What Remains.” It is the story of a man who escaped from the slaughter of Darfur and is now working back in his country of Burundi as a medical doctor. He went through some really bad times to get to where he is now.
Alternate profession or course of study
I would be a surgeon because they see such rapid results of their work and can do a lot of good for the poor if they will.
Kitty Ernst, the founder of the distance midwifery program I went to and the leader of the birth center movement here in the U.S. — and a very wise woman.
Something that might surprise others
I like to piece quilts.
Something you’d like to do
I would like to travel to other poor countries other than Haiti.
Being a mother to three wonderful children.
Favorite thing about Richmond region
The ability to be in the city and in parks and nature within 15 to 20 minutes.
Position: executive director, Midwives for Haiti
Born/hometown: Dec. 15, 1951; Fredericktown, Ohio
College: Eastern Mennonite University, University of Virginia, Frontier Nursing University
Family: three children, six grandchildren