The Fertility Crisis in Haiti
Following the 2010 earthquake, Haiti exploded onto the international aid scene and was inundated with NGOs, mission groups, and other non-profit organizations offering everything from music therapy for orphans to temporary surgical clinics. However, few of these efforts have been well coordinated or had a lasting effect. The world is starting to lose interest in Haiti, just when it needs help the most.
Areas of particular crisis include women's health, infant health, family planning, and childbirth services. The United Nations Population Fund reports that the birth rate has tripled since the earthquake. Women in Haiti give birth to an average of 3.9 children (compared to the US rate of 1.89 births per woman). The maternal mortality rate is 350 deaths/100,000 live births and infant mortality rate is 52.44 deaths/1,000 live births (compare to 28/100,000 and 6.1/1,000 for the US). The population is currently 10 million and is expected to reach 15.7 million by 2050"”a number that the country simply does not have the infrastructure to support, with many citizens lacking consistent access to clean water, electricity and trash services, to name a few. 32% of women who want access to contraception and other family planning services do not have it and, even among those that do, there is confusion surrounding how and when to use them. Couples in relationships (very few Haitians officially marry) do not generally use condoms, since these are seen as primarily for use in preventing STIs, not for birth control. 1.9% of Haitians have HIV/AIDS (the rate is <1% in the US). This situation has been called a "fertility crisis" and is in dire need of energy and resources. The Focus on Haiti Initiative out of George Washington University sees little promise in either government or NGO driven action, given the political climate in Haiti and the historical failure of NGOs to have a lasting impact.
Supporting midwife Ninotte Lubin offers a third way out of this crisis. She is an educated, native Haitian who understands the intricacies of the Haitian socio-cultural scene and who has experience as a teacher. She is well respected in the community of Jacmel for her work at Mother Health International and Olive Tree Projects. She also has a broad, forward-thinking vision of family education beyond the birth experience. She understands that in order for Haiti to solve the fertility crisis there need to be well-established, long term education programs put in place. To support Haiti, we need to support Haitians and Ninotte Lubin is someone worth supporting.
*The information in this section was taken from the following sources:
Ninotte with baby at post partum visit, Mother Health International, Jacmel 2011.
Ninotte will need funds to pursue her midwifery certification and degree. She will also need specific supplies to aid her learning and to facilitate her planned teaching activities. The following is an itemized budget for her education, supplies, living and travel expenses over the next three years. In order to ensure that Ninotte has the best possible chance to pass the NARM exam (particularly given that she is taking it in English which is her 3rd language after Haitian Creole and French), it has been determined in consultation with American and Canadian midwives that she should take part in the NARM exam preparation course being offered in Boise, ID Aug. 11-15, 2014. If all of the requested funds are not raised, priority will be given the exam fee, preparation course, wish list items and then tuition.
Tuition (online through the Midwive's College of Utah): $11,662.50 https://www.midwifery.edu/tuition/
External Hard Drive: $50
NARM Exam Preparation Course (Aug. 2014): $950 http://www.mercyinaction.com/narm-study-retreat/
NARM Exam Fees (Aug. 2014): $400
Travel (May to Sept., 2014): $500
Living Expense in Haiti While in School- housing, food and dependant costs ($400 per month for 3 years): $14,400
Printer/Scanner Combo: $150
Camera/Projector Combo: $100
Total: $29, 312.5
Click on the link provided to view the Amazon.com wish list. These items are included in the overall budget, but this itemized list allows donors to send specific items directly to Ninotte.
Ninotte teaching prenatal classes at Mother Health International, Jacmel 2011.
My name is Ninotte Lubin. I'm from Jacmel, in the south east of Haiti on the Island of Hispanola, which is an island divided into two countries with a population of more than 10 million. Haiti is the poorest country in the western hemisphere. I'm number five of six children, single, with no kids but financially responsible for a family of five people including my mother and my nephew.
My father passed when I was a child with lots of dreams in my mind. One of them was to become an obstetrician or pediatrician. I remember seeing my dreams fly away from me because I didn't see how my mom, having become a widow with no work, no family support, no social help could really make that happen. I was crushed but hoped that God had a plan.
My mother had one choice: either be with her children or be with a man. With a man she could get some help but would compromise her children's future education because she would have to listen to what her man wants. I remember her gathering the six of us together and saying: I'm 42 years old, if I chose a man it would definitely be good for me in many ways, but I'm afraid of not being a responsible mother. So, it will be hard, I know that, but I'm not going to get a man, and I will tighten my belt to keep my family united and educated. She did it with the help of a lot of good people and my oldest brother found a job three years later as a primary school teacher. I always thank my mom for her wisdom as an ordinary woman!
At 19 I got my high school diploma, but was still uncertain about my future because my brother, whom I was dependent on to go further moved to the United States. But, I was always stubborn. I followed my inner soul, not what people had planned for me. A couple month later, the same year, someone from my church got me a job as a cashier in a grocery store in Port au Prince. I was so happy to move forward and, with my savings, to get more education.
I went to the Haitian American English Institute to study English (1[phone redacted]), and at the same time attended the University of the State of Haiti, INAGHEI to get a degree in Business Management (1997- 2001). I did it but was not my dream. At this time, I also was in business with a good friend of mine (2[phone redacted]) but the business did not do well. I felt lost, was not able to find work, started to blame others for my mistakes. I thought I had been cursed by others and tried getting help from a vodoo priest; nothing good happened. I was still a church person, but prayers didn't help either. What should I do? I got help from some church authorities, but I was still needy spiritually and mentally. One day in 2001, 13 years ago, I cried and asked Jesus for real help.
From that question I experienced a shift. I felt that I was responsible for my mess and I was the only person who could change it. My mother's sacrifice had been great, but I had forgotten about it. There was no justification for that. I felt guided by Jesus, but not in a church context. I felt guided to break all of the beliefs that had kept me in a hole of despair. In understanding my problems and myself I found a great correlation between the problems of myself as an individual and the problems of Haiti. I started researching and reading the history of my country. It was really interesting! One of the greatest realities that I started to understand was just how children are born in Haiti. I felt the need for change, especially around women and childbirth. During this time I taught French, Spanish and Social Sciences in two different schools in Jacmel (or Port au Prince?) at the middle school and high school level (2[phone redacted]). I spent the next few years reading and writing about Haiti, and I tried other things like creating an association where a group of people gathered together to think about problems in Haiti and what could we do.
Through my knowledge of English, in 2009 I was able to start translating for foreigners at Friends of the Children of Haiti (FOTCOH), a medical clinic in Jacmel. This experience brought to the surface how I see myself as a person of color interacting with white privilege. Warranted or not I had so much confidence that I was responsible for changing my life. I did change my thoughts and actions, which have brought me a lot of good friends and blessings.
In January 2010, the earthquake happened. Five months later, I started translating for midwives at Mother Health International, a birth center in Jacmel. A few months later I decided to start studying midwifery there and I also became the live-in administrator of the birth center. I was there for 15 months. I loved my work of studying, teaching women about their bodies, nutrition, labor, birth and parenting. After that, in order to further my midwifery education, in Aug. 2011 I moved to Olive Tree Project, a non profit organization run by Sarah Wallace, CPM, still in Jacmel. I worked with Sarah for two years as a student midwife and administrator. I loved my work there but I left amicably in July 2013 in order to move forward with my own dream of opening a Haitian-run birth clinic.
The Midwives of MHI debrief after a morning of prenatal visits. Jacmel, 2011.
To paraphrase Ghandi, be the change you want to see in others. So, I'm the change that will bring change for children in Haiti. How? By helping women to make better choices for their children and families. By welcoming babies gently and lovingly in a country where they are left behind. By advocating for holistic midwifery care to become one of the options for pregnant women. By training midwives so they will serve their communities instead of waiting for others to come do it for them, and by working to bring families together. One example is the current situation with Haitian orphanages where many children have parents who have had little choice but to turn the children over to the orphanage because they do not have the resources to raise the children. I believe the health of a country starts in each family as they create a life for their children in the way they raise them to work, play, and be contributing members of society. This is where Haiti is failing. Without the strength and support that comes from a familial foundation, children go into the world lacking direction, belonging and moral conviction. This has resulted in a culture with unwanted pregnancies on the rise, as well as fatherless children. My dream is that parents will make better decisions about having children, and that all children will have a strong foundation with which to start their life.
In order to realize my dream of opening a Haitian-run birth and education clinic in Haiti, I need to obtain an official degree in midwifery from an accredited school and certification through the North American Registry of Midwives. I'm seeking to fund my tuition, materials and supplies, testing fees, living and travel expenses over the next three years. I have a vision, no one can stop me unless I stop myself, I believe. Besides my midwifery teacher, Melinda Mclaren I want to thank some other good midwives and friends that have helped me in my midwifery journey so far: Kathi Mulder, Yvette Blanchette, Bonnie Ruder, Amanda Pheeney, Nancy Cowans, Heather Maurer, Susan Odgers, Sarah Wallace, Tara Mulder.
As part of the process of supporting Ninotte and her future aspirations for Haiti, anyone who contributes to her fundraising effort will receive regular updates on Ninotte's progress towards her goals. We will keep you in the loop about Ninotte's work and about Haiti in general through a blog that we will be starting in association with the Ninotte Lubin's Midwifery Education campaign. In order to receive these updates and the information about the blog, please email your contact info to the address provided.
About the creator of this project:
Tara Mulder is PhD candidate in Classics at Brown University and strong supporter of mothers and babies around the world. She traveled to Haiti in 2011 as part of the post-earthquake NGO influx and made friends with Ninotte Lubin. As soon as she finishes her dissertation on childbirth in the Roman Empire, she would like to go back!
- Hannah Mulder
- Cliff Mulder
- Nadia and Sonja
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