A midwife in Jérémie, Grand’Anse, one of the worst-hit towns in Haiti during Hurricane Matthew, has told how she delivered six babies, two boys and four girls, in a blackout during the night of the storm.
Marie-Lyrette Casimir, a midwife at St Antoine hospital, worked by flashlight as the fiercest Caribbean storm in almost a decade ripped though the south-west tip of the country, killing more than 500 people and causing widespread devastation.
Casimir, who was trapped in the hospital with her patients for hours after the storm, due to rising floodwater, said: “During the deliveries, the mothers were saying: ‘Miss Casimir, please save us. You’re going to save us.’ I was worried a lot, but I tried to calm them down, to be reassuring. I said to them: ‘Even in this desperate situation, you have to play your role, in the interests of the baby.’”
In a town where 80% of the buildings have reportedly been destroyed, St Antoine’s maternity unit, housed in one of three buildings that make up the hospital, emerged relatively unscathed. One of the hospital’s adjacent buildings was flattened by winds of up to 145mph, the other suffered extensive damage.
Casimir, who works for the United Nations Population Fund (UNFPA), described how windows were shattered and doors wrenched off their hinges during the storm and, amid fears the building itself would collapse, mothers were screaming and crying. There were two nurses in the ward that night, but she was the only midwife, she told the Guardian.
“I was very sad and worried … At first, the wind wasn’t very strong but the hurricane became really strong around midnight.”
When a power cut plunged the hospital into total darkness, she carried on using a rechargeable lamp and a flashlight, she said. “I was afraid, there was a lot of noise and I was worried I could be injured. But I had to stay – my work was to help women give life.”
Casimir, 46, said that by dawn the floodwater in the hospital had reached her knees. At one point she had to raise the bed in the delivery room, which was becoming contaminated with floodwater.
But her fears that falling debris or, worse, the collapse of the building, could risk all their lives, went unrealised. “I’m very proud of what I achieved that night. There were no deaths. The deliveries went well and none of the babies needed to go to paediatric care. Everything was great.”
Casimir’s story emerged after an assessment by the UNFPA and Haiti’s ministry of women’s affairs revealed the scale of devastation in Grand’Anse and Nippes, two of the country’s hardest-hit departments. It found most of the population affected were living in appalling conditions, with 176,000 in temporary shelters. Almost 100% of crops were destroyed in what is one of this impoverished country’s most fertile areas.
Up to 1.4 million people, 40% of them children, are in need of humanitarian assistance, according to a report (pdf) by the Office for the Coordination of Humanitarian Affairs (Ocha), with 806,000 people being at what it described as at “extreme-impact level” of food security (near-famine conditions), mainly in Grand’Anse and Sud. A further million people were at a “very high” or “high” level, it said.
Maternal health facilities were badly hit, particularly St Antoine and the City Med hospital in Beaumont. All seven of the main health facilities in the area were flooded and remain without power, water, equipment and short of staff. The directorate of civil protection of the Haitian government has reported 11 of the 33 hospitals in Grand’Anse, Nippes and Sud were damaged.
Along with the unmet basic needs of food and shelter for thousands, an estimated 13,650 women – among the most affected people – are due to give birth in the next three months, according to Ocha.
Vavita Leblanc, reproductive health programme manager of UNFPA in Haiti, said the agency has sent two teams of six midwives into the affected areas.
“In Grand’Anse, we found none of the health facilities have power [or] water, and all are flooded,” said Leblanc. “They have problems with medical supplies. Human resources have also been affected as nurses and doctors are facing their own problems, with their houses and with food.”
Leblanc said the devastation caused by the hurricane would severely affect the country’s maternal mortality rate – it is already the worst in the Americas but had been falling due to more hospital births.
“People will now stay in their communities to give birth,” said Leblanc. “It will set us back a decade.”
Two-thirds of babies in Haiti are delivered without qualified help. The country’s maternal mortality rate stands at 359 per 100,000 births in 2105. Cuba has a maternal mortality rate of 39 per 100,000.
Amid warnings by aid agencies of the risk of a fresh cholera outbreak, the storm also damaged most of the cholera treatment centres of Grand’Anse, according to the Ocha report. The country’s cholera epidemic began in 2010, when UN peacekeepers unwittingly introduced the disease shortly after a devastating 7.0 magnitude earthquake. The disease, previously unknown in the country, went on to kill more than 9,000 people.
This week, a UN official said he was concerned the scale of the cholera outbreak may be under-reported because remote areas are cut off. He also warned that protests, by desperate people angry about the slow pace and uneven distribution of aid, were impeding progress.
A spokesman for the World Food Programme’s Haiti operation told the Guardian it had so far managed to get food assistance to just 10% of the 800,000 estimated to urgently need it. “Initially, the response took time,” the WFP spokesman said. “We started distributing on 8 October and so far, 80,000 people have received assistance.”
He said the damage to infrastructure and roads delayed trucks going to the peninsula until 7 October, four days after the hurricane. It is now sending out between two and four trucks a day to the hardest-hit areas, as well as helicopters, he said. They plan to use boats to get out to the coastal areas.
There have been a few security issues, he said, but they represent a small proportion of the response. “People are really suffering, they are desperate and hungry, but we expect safe passage so that we can get to the communities that need it.”
To support the government-led response, the humanitarian community in Haiti launched an appeal for $ 120m, only $ 15.1m of which, according to the latest Ocha report, has been raised.
Paul Brockman, MSF head of mission in Haiti, speaking from Baradères, around 50km from Jérémie, said that while cholera is not as bad as they feared, significant risks remain. Brockman said: “There is a great need for shelter and drinkable water everywhere. Cholera could be a very substantial risk. It’s important to remember, that, as a small country, Haiti was very affected by the rain in the hurricane, even in the areas where the wind did not devastate – and with cholera still present everywhere, it increases the risk when treatment centres [have been] flooded.
“In every coastal area we’ve been in, there has been partial or total destruction of the cholera treatment centres.”
Midwife in Haiti tells of delivering babies knee-deep in water by torchlight
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