When I first met Guerda, she was seven months pregnant and living in a miserable makeshift shelter in Carrefour, one of the hardest-hit areas of the January 12 earthquake. It was February, a month after the earth had shook. Flimsy cotton sheets served as a shelter for Guerda’s family, wooden sticks held up the structure. Inside, some blankets were put on a pile of gravel to make a mattress. One of Guerda’s little boys showed me inside, he was wearing nothing more than a rag.

I still have the notes of that day: Guerda Griffon, 29 years old. Husband fisherman, already 4 kids. Hurt her back when escaping from a building that crumbled down. Scared about the birth. Message to the world: We need help.

Afterwards, I wrote a blog entry and called it „The end of questions“. It was one of these occasions where even someone whose job is communications simply runs out of words. Here she was, this young woman, barely two years older than me. But our lives could not be any more different, and this difference was outrageously unfair. There was no pre-natal bliss about Guerda’s situation, no happy expectations. Instead: Worries, fears and plain misery. But at least CARE’s health team was here to talk to expecting mothers and help out with advice and some relief goods. We handed out  so-called „clean delivery kits“, containing gloves, plastic sheets, razor blades and some other items to ensure a somewhat sterile birthing environment. Guerda also received a „newborn kit“ with tiny clothes and a blanket.

Eleven months later, sitting in my office, I recognize Guerda on a photo taken during another CARE distribution. She is holding a baby in her arms. This time, the emergency was cholera and the CARE team handed out soap and hygiene items for the camp population. I was about to return to Haiti and happy to see that Guerda had made it. Haiti’s maternal mortality rates are among the worst worldwide. Out of 100,000 births, 670 women do not survive. But Guerda did, and she even made it to the hospital, which is not a given in post-quake Haiti. „After the earthquake, there was no maternal health service available. Hospitals evacuated pregnant women because they were full of heavily traumatized people and lacked space. The risk of infection was too high for women in labor”, explains Dr. Franck Geneus, CARE’s health coordinator.

During the immediate emergency response, clean delivery and newborn kits were a first measure to protect mothers’ health. But there is still a long road ahead. With millions of people still living in camps, pregnant women need to know where to turn to for a safe delivery and maternal health care. CARE is now working with traditional midwifes and local hospitals to set up a referral system for prenatal care and birth services. But with many institutions destroyed and staff lost, this is no easy task.

When I meet Guerda again in Carrefour, she seems to have aged even more in these last months. Luckily, the birth went well, considering the circumstances: “I delivered in a hospital. First, I was able to take a tap-tap, a public transport, because the driver did not make me pay for this. Then, at the hospital, there were complications and an ambulance took me to another hospital. I spent four days there.”

Guerda’s husband is doing better, he can go fishing again. And their shelter is now made up of plastic sheets that offer a little more protection from the rain. There is a real mattress and a table. But now, cholera is a major scare and the whole family is trying hard to respect the hygiene rules. CARE has set up latrines and hand-washing stations in this camp and initiated a waste-removal program. I am glad to see these improvements. And at the end of the visit, I also see something else: Guerda’s first smile. She proudly presents the latest addition to her family, her son Josué Lalané. He is not very interested in the situation and keeps sleeping in his mother’s arms. May he soon wake up to find a home that is worthy of its name in a country on the firm road to recovery.

December 27th, 2010

Sabine Wilke, CARE Haiti

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