Health care for the youngest, hope for all

One of the hallmarks of great global health efforts are those that seek to build local capacity, employing and honing local expertise, and bolstering a self-sufficient, sustainable health infrastructure.

Katherine Bramhall, a midwife from my home town of Barre Vermont, helped do just that after the 2004 tsunami devastated Aceh, Indonesia. The Yayasan Bumi Sehat clinic (YBS), has locations in Bali and Aceh Indonesia, employing Indonesian midwives who provide free pre-natal care, midwifery-services, breast-feeding support, and clothing and caring items to keep newbies well swaddled.  Maternal mortality in Indonesia is 373 per 100,000, compared to just 13 in the US, with malnutrition-induced hemorrhage being a constant threat.

Noteworthy as those efforts are, they'd be yesterday's news if it weren't for their recent invitation by the Haitian government to duplicate their successful Indonesian efforts in Jacmel, Haiti. What is especially noteworthy is the shear speed and efficiency with which they have been able to get off the ground. Within their first 2 weeks in Haiti, YBS had secured necessary Haitian professional licenses to provide clinical services, been donated property to build a permanent clinic, set up a temporary clinic and provided nearly 500 episodes of care, including 7 births and 285 pediatric episodes. The Bumi Sehat Mother & Child Clinic is now open for business, and unlike many post-disaster relief efforts, will continue providing care indefinitely.

Funding their current efforts is of course a constant struggle, and donations can be made through their website and Facebook page. Bramhall notes the difficulty that fading press coverage presents to her fundraising efforts. After the 2004 tsunami, she asserts, it took only 9 days before the story faded from the media. This despite a death toll of nearly a quarter-million. Since media coverage motivates charitable giving, this leads to drastic declines in funding for NGOs. At the same time, post-disaster areas experience high rates of price inflation. The confluence of these factors leads to an environment where funding dries up at the precise moment that costs are greatest, and needs remain high. New-media venues such as Facebook may help by bypassing the media and taking stories such as that of YBS directly to potential donors, but it remains to be seen whether it can lead to sustained giving.

In the meantime, the staff of YBS continue dual duties of providing care to the women and children of Jacmel while simultaneously establishing their permanent presence in the community. In addition to providing the expected benefits of reducing mother and child mortality and improving community health, midwifery efforts provide a secondary, often overlooked benefit. Since birth is a joyous event that speaks of future hopes, providing a space that celebrates and supports birth fertilizes a sense of hope and enthusiasm about the future, even in communities recovering from recent trauma.  YBS is helping to build that hope one mother and one child at a time. Their efforts are very much worthy of our support.