Jhpiego's Blog

At the General Hospital: Jhpiego Team Finds Pregnant Women in Great Need

January 25, 2010 at 7:07 pm Leave a comment

When the Jhpiego team arrives at Haiti’s largest hospital, five women have already given birth—and it’s only 10:30 a.m. The team’s obstetricians, nurse-midwife and health care professionals are there to conduct a review of maternity services at General Hospital at the request of the Haitian Ministry of Health.

Since a massive earthquake hit Haiti last week, killing tens of thousands and injuring as many, international relief doctors and nurses have arrived to help, and the General Hospital’s primary focus is now treating crush and trauma victims. That shift has left pregnant women without the expertise and specialized care they need, according to the Jhpiego review, led by Country Director, Dr. Lucito Jeannis.

Although women are delivering babies there, the lack of obstetricians and other personnel trained in maternal and newborn health concerns Jeannis and the Jhpiego team members, who are accompanied to the hospital on Sunday morning by a representative of the Ministry of Public Health, Dr. Franz Montes. General Hospital is the hospital to which Haitian women with complications or special obstetrics needs would be referred.

“You’ve got to have those referral centers as one end of the household-to-hospital continuum. Specialized emergency obstetrical care doesn’t exist there now. We have to work with the Haitians to rebuild that capability,’’ says Rich Lamporte, a Jhpiego team member from Baltimore.

As Jeannis, Lamporte and other team members walk through the hospital, they meet two Haitian medical students who have recently returned from school in Cuba to help in the earthquake relief. They’ve been assigned to deliver babies.

One of the medical students is examining a pregnant woman and appears puzzled at a concave portion of the woman’s belly. Jhpiego’s Willy Shasha, an obstetrician, examines the woman and advises the student that the woman has a full bladder.

“A full bladder can slow the progress of labor,” he tells the Haitian medical student.

The earthquake has disrupted service at the hospital in other ways. Even though the U.S. military has deemed the hospital building safe and secure, people are fearful to be under its roof and many patients are being treated in tents on the hospital’s grounds, the team finds.

While touring the hospital tents, the team meets a man whose pregnant wife was injured during the earthquake and began hemorrhaging. She has been at the hospital for a day, and now doctors have decided to take her into surgery. The husband is alone and distraught.

In another case, the team approaches a woman who is complaining of pains in her stomach. The woman, who had recently undergone a C-section, vomits. The Jhpiego staff gives her water and tries to comfort her.

A woman who had recently delivered a baby shows clear signs of eclampsia, a high blood pressure disorder and a leading cause of maternal deaths in the developing world. Her ankles are severely swollen. Jhpiego’s Anne Pfitzer talks to the woman and learns the new mother has not yet breastfed her baby; Pfitzer encourages her and gives her some tips.

Pfitzer counts six other women in labor in one of the tents.

After their tour of the hospital, the team attends a United Nations-sponsored meeting of international aid organizations that are focused on health issues. The Jhpiego representatives share their commitment to work with Haitian groups and partners to help organize and reestablish maternal and newborn health services, and provide a continuum of care from home to hospital.

“After the international relief physicians complete their important task of stabilizing the trauma victims and the trauma care ends, this is when all the primary care is needed. It is maternal health, basic health and hygiene, and prevention,” says Lamporte, “and there are consequences of not addressing those issues. We work across the system to meet those needs.”

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