Peace in the Midst of the Storm

In that moment of potential fear I felt incredible strength and peace. It was as if time stood still, people were moving in slow motion. My thoughts were clear. I kept praying. I had no idea what was going to happen, but I had a deep sense that it was going to be ok.

On our first night in Wewak, the PNG women who had travelled with us from Perth, met with some family members and shared a meal. They met just outside the gates to our accommodation near the Mangroves of Wewak town. There was so much food left over that they shared it with the security guards on the beat in the town. In a matter of minutes a number of guards were eating and laughing with the women, sharing stories and asking about Living Child. At the end of the meal the security guards told the women that they would look after the Living Child team and thanked them for coming to help the mothers and babies.

These personal encounters count. A lot. Who would have known that the next morning the Living Child team would be in an accident and who should be travelling along the same road shortly afterwards? One of the security guards. He recognised the PNG women on our team and stopped to offer assistance.

Through the wise actions of two women on our team, together with a convergence of ‘fate’ or what I rather term, ‘God incidences’, the angry men were calmed down enough for us all to get out of the vehicle and retreat to a nearby house situated above the scene.

Team members and vehicles from Samaritan Aviation and Living Child arrived and we left the scene to return to our base in Wewak once again. Just before getting in the car I looked at the place where the accident had occurred – a narrow bend in the road with a steep drop off on either side. I had a deep sense that God had protected us all from certain serious injury or death. The reality hit hard. My shoulders crumbled under the weight of the burden and I sobbed.

On our way back, Jim took us via the fuel station. He filled up the car and then bought us all an ice cream cone. What joy! I will never forget the taste sensation of that ice cream.

Once back at our accommodation we sat in the lounge sipping on cold drinks and sharing our experience. It was important for us all to debrief, shed some tears and hug one another. It was very powerful. At no time did anyone say that they wanted to go home. There was an incredible sense of gratitude that God had protected us.

I didn’t tell them then that I was secretly planning my escape home.  The burden of responsibility leading a team of women to remote PNG was weighing heavily on me. My confidence was waning. Voices in my head were undermining me. Was this a sign that we were not meant to go to Angoram and Yamen? Should I pull the pin?

We decided to go for a walk down to the beach and have a swim. It was very windy, but still quite warm and very muggy. We had such fun diving into the waves with the locals, eating freshly cut papaya and playing the fool in the wind. It was good for the soul. My spirits lifted and I felt secure in the strength of this amazing team of women. If they could all laugh and joke and enjoy life after such a confronting incident earlier that day, we’d be ok.

 

 

 

A False Start

The first challenge is actually getting to the small town of Wewak on the Northern coast of Papua New Guinea. There are no roads linking Wewak to the distant Capital of Port Moresby. Not even to it’s closest neighbouring towns of Madang, Lae or Vanimo. If the airstrip is out of action, then the only way to get there is by boat. Or foot. Often flights are cancelled or rescheduled, so actually arriving in Wewak on schedule is a major feat indeed.

We took an overnight flight from Perth to Brisbane, then on to Port Moresby, paying the massively high excess baggage bill (the rules keep changing and in exasperation I zipped my lips and just paid the account!). While waiting anxiously to be united with Karen who was travelling up from Melbourne, we got a message to say she was stuck in Brisbane. Her plane had stood stranded on the tarmac while her connection took off for PNG! A team member down. Sigh… onwards to Madang, then Wewak. Each leg of the journey becoming more aware of the distance, lack of infrastructure, humidity.

It was wonderful to be greeted by our on the ground volunteers, Jim and Robyn Nottingham. Seeing a friendly, familiar face after such a long trip was a true blessing. Linda Tano, a PNG midwife had flown down from Goroka to meet up with us and join our outreach. It was wonderful to finally meet her after many conversations. We quickly took our bags to our neat and clean accommodation in the middle of the town of Wewak and then set off for a swim and dinner at Talio’s bar, right on the beach. It was refreshing to plunge into the water and just float for a while, taking in the surrounds and what we had achieved: arriving safely and on time! We slept soundly that night.

Sunday is quiet in Wewak. We rested, did a bit of shopping at the local store, sorted through all our gear, then excitedly collected Karen from the airport. She had made it. It felt good to have the full team together now. All so different, but all committed to helping the women and babies in this remote part of PNG.

Finally the morning arrived when we’d be travelling by road to the riverside town of Angoram. Everyone was excited, but also a little apprehensive as we contemplated being that much further from the safety of the ‘bigger’ town of Wewak with all its luxuries such as power, running water, shopping centres, chemist… It was a bit of a messy morning because vehicle arrangements had changed a few times, messages about fuel and boats for the next journey out to the village had been coming in thick and fast, expectations were high. Personally, I felt a little overwhelmed. The weight of responsibility leading a team was playing on my mind. I closed my eyes and tried to take some deep breaths, praying quietly under my breath for peace.

At 8.30 am the first vehicle was on its way loaded with 8 Living Child team members. We waved the others goodbye and were off. We were in the Samaritan Aviation 10 seater ambulance vehicle being driven by one of their pilots. Their float planes were not flying at the time and so they offered to drive us out to Angoram.

The climb out of Wewak is quite beautiful. About 30 minutes into the journey, our driver called out to us that if we wanted to have a last look at Wewak, now was the time to do it. At that same time my phone beeped and I looked down to see a message came through from Jim to say that the fuel for the boat journey had been arranged. I sighed with relief and thought, “God is good”. I had hardly finished the sentence when there was an almighty bang, screams, shattering glass and the scraping of metal reverberated around me. All I could see was a big truck sliding along the length of our vehicle. I thought I was going to see the end of our vehicle ripped open and mangled bodies laying everywhere.

After the noise of the impacting vehicles died down, the screams rose high. I looked back and saw that everyone was there. No blood. No mangled bodies. No twisted metal. “Are you all ok?” I shouted above the cries. “Yes”. “No one injured?”, I checked again. “No. All ok”. Thank God.

Our driver slowly edged the vehicle forward and reversed into a driveway next to the bend in the road. We all peered out of the windows and could see that the PMV had come to a stop, there was no obvious damage to it and no injured people. But then we saw an alarming sight. The driver of the PMV, together with a few other men, were running towards our vehicle, shouting and with arms raised holding metal bars, rocks and wooden planks ready to attack our driver. The evil hung in the air. It was thick and heavy. Start praying I called.

 

 

In A Bit Of A Daze

I can’t begin to describe to you the challenges of providing maternal & newborn training in Papua New Guinea.

It’s hard. Really hard.

In fact, many times, I just want to turn away, return home and forget the whole crazy idea.

Over the next few weeks I’ll do my best to try and paint a picture for you of what the Living Child team has just completed over 2 weeks immersed in the lives and world of people living in remote villages of the East Sepik Province.

At the moment I think I’m feeling a bit stunned at what we did. Perhaps a bit traumatised at what we witnessed too. I haven’t ventured out of my home yet – not ready to face the world we live in here in Australia. So much stuff. Services. Superficiality.

When I was in the village of Yamen last week I turned to my team member and colleague, Karen, and said, “It’s not in my imagination how bad it is here is it?”

“No,” she answered softly. “It’s really bad.”

“I’m not going to gloss over the reality of the situation for women anymore and try to justify that it’s not that bad. I’m going to tell it how it really is,” I said sadly.

How do you find the words to really tell it as it is? The photos tell a story, but even they look lovely and don’t capture the dirt and grime, heat and humidity, cries of desperation that are around all the time. Soon after we said good bye to a mother taking her dead 22 year old daughter (she died from unknown causes) down the river to her village for burial, our host and leader in the community of Yamen said, “Sara, it is good you have experienced the death of this young woman. You will now appreciate what we face all day every day due to a lack of services. I believe this will help to tell our story.”

No health services for over 20 years. 76 health Aid Posts in the District, but 69 are closed. Women having no choice but to give birth at home in their village or if they make it to the District Hospital, allocated the disused laundry with a piece of cardboard covering the crumbling concrete floor as a ‘sheet’. Staff who have had no training or supervision in over 20 years, too afraid to look after pregnant women because so many of them die. No proper record of births or deaths. Few, if any, babies immunised. Leprosy. Measles and mumps sweeping through villages and killing babies and young children. A high rate of young teenagers getting pregnant.

There is a ray of sunshine and hope and that comes in the form of Living Child. At a community workshop we held on the first day in Yamen, representatives from different villages told us that in the 5 years since Living Child has been in the area, they are noticing that their mothers are happier and enjoying life because they have a contraceptive implant, rather than a toddler at their feet, a baby on their hip and another on the way. A number of villages reported no maternal deaths in the last 5 years since village birth attendants have been trained. Wow!

I have to say, I took a double take when I heard that. No maternal deaths in the village since Living Child has been giving training. Suddenly I was inspired to go on. Despite the overwhelming needs and problems, despite the slow pace at which we’ve been able to do anything, despite the challenges and frustrations, there had been no maternal deaths in Yamen since 2013. That gave me enough of a jolt to keep doing what we could, no matter how slow! It is making a difference.

So, we rolled up our sleeves, mopped our brows and got to work…

The Spaceship

 

This time last week I was preparing for my last full day in Wewak after what was an incredible visit to Papua New Guinea. I remember thinking that so much had happened, could there be anything else to happen that day. I woke up expectantly. I was gaining confidence to do this. When God is in something, expect great things to happen!

It all began at the end of last year while I was in Kenya providing a reproductive health training workshop to field workers with a humanitarian organisation called Medair. While spending time with these incredible people who were working in war zones in the toughest places on earth: South Sudan, Democratic Republic of Congo, Somalia, Iraq, Afghanistan (you get the picture), I had a real sense that I needed to return to PNG early in the year, on my own, to set up the program for 2016/7. I also felt that I needed to connect with the government and formally partner with them somehow.

So, I booked a plane ticket for a 2 week visit.

A week before I left I had a dream. God asked me to get into a space rocket with a man I did not know and fly out into space. I asked Him where I was going, but He said that I didn’t need to know the destination. I was then scrambling around trying to pack the right clothes and He said that He will provide for all my needs, all that I have to do is trust Him. So I said to Him, ‘you are sovereign father God and worthy of my trust’ and stepped into the spaceship…A bit weird, I know, but true.

On Feb 14 I flew out of Perth. The checkin lady made quite a few comments about how dangerous Port Moresby is. I reminded myself that I was meeting people I knew and wouldn’t be wandering around by myself.

Arriving in Port Moresby on my own was a little daunting, but the hotel pick up worked and I now knew exactly where to get my SIM card topped up and data connected so at least I could phone a friend. I went for a swim and noticed some women with bilums from the Sepik area so went up to them and had a chat. I was starting to relax.

In the morning I went down to breakfast and sat with the Sepik women. They were very interested in the work of Living Child and asked what I was planning to do when in Wewak. I mentioned that I was hoping to connect with the Angoram District Administrator to let them know what we’ve been doing for the past 3 years and find a way to work with them. One of the women turned to me and said, ‘the Angoram DA is here now’.

I looked at her in disbelief thinking I’d misheard her. ‘Here? At Comfort Inn?’.
‘Yes’, she said, ‘there he is over there in the red shirt’.
Her finger was pointing in the direction of the pool. She got up from the table and went over to him. The next minute I was sitting at the breakfast table with him sharing about the work of Living Child so far and our vision for the future!

‘Sara’, he said, ‘we are very interested to partner with you to bring health to our people in Angoram district. Can you come to Angoram for a meeting next week and we can discuss your plans further with the Member?’

I couldn’t believe what I was hearing. On my first morning in PNG the meetings that I was hoping would happen, but wondering how they’d come about, were being planned without me doing anything really!

I went back to my room literally jumping with joy. I had an incredible sense of God going before me. All I had to do was trust him.

The next morning I had a call from the DA requesting I come downstairs to meet the Member of Parliament for Angoram District. I couldn’t believe it! Finally I was meeting the man a friend of mine, Steve Combe (who died tragically in a helicopter crash exactly a year earlier) had advised me to meet. The member and the DA were very welcoming in a gentle way. They have a vision to get health and education back on track in their District and would like to partner with Living Child.

What a start to this spaceship ride. I knew I was serving and trusting an amazing Heavenly Father who was going before me and preparing the way…I also felt that it was significant that these events were happening over the first anniversary of Steve’s death. A man who had a vision to bring midwives into East Sepik Province to provide training to prevent deaths of mothers and babies, and who played a significant role in assisting Living Child become established and connected in PNG.

Midwifery Beyond Borders

 

P8250143.JPGI’m currently in Johannesburg waiting to travel home to Perth after spending a few days in Nairobi, Kenya providing Reproductive Health training to field workers from an emergency humanitarian relief organization. On my way to Kenya it suddenly dawned on me the significance of the name of my blog: Midwifery Beyond Borders. There is an incredible shortage of midwives with global experience who can support and encourage skilled birth attendants SBA in low to middle income countries where the maternal death rates are highest. I am certainly stepping beyond my borders and into areas I never thought I would, even could step into.

I’m also starting to see a pattern in the type of work I do. Throughout my life, even as a small child, there has always been a restlessness with the status quo: I can see how things can be done better or see a gap for a new program, new intervention, new idea, new way of doing something. I remember as a young adult struggling with this; as a woman in my thirties, wondering why I could never just be happy with how things were and accept them; and now in my forties starting to creatively accept that this just who I am. Inevitably my new way of thinking or doing something, rubs people the wrong way, especially people or authorities that are keen to maintain the status quo! I’ve always had a strong sense of social justice and speaking up for those who don’t have a voice, even when it means confronting those in authority. This has not been easy, and many times I have recoiled in fear and trembling! The driving force for me is the fact that God is sovereign, above rulers and authorities on Earth, and if He opens a door for me to move through, I know that I can trust Him to give me the courage and the boldness to speak truth and speak up for those vulnerable people. My favourite verse is Jeremiah 1:9, ‘Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you go.”

The training that I do is not for people who are in settings where there is good governance, well-structured health services and well qualified health workers. I’m finding that I’m in areas where there is very little: poor leadership, few to no properly skilled birth attendants, hardly any resources in terms of simple equipment to provide a health service, environmental challenges, social inequalities and injustice. Those in authority quote the standard World Health Organisation WHO guideline mantra: “1. All women should give birth with a skilled birth attendant SBA at a health facility. 2. There is little benefit in training traditional birth attendants.”

So what do you do when there are no skilled birth attendants in the area? What do you do when there are no functioning health centres? What happens when there is a natural disaster or war and women don’t have access to health care or a SBA? What about the fact that women are not getting an education, so are not able to be trained as skilled nurses, midwives and doctors? And so the number of qualified health professionals is very low to be able to serve the needs of the community. What about women who have experienced terrible sexual abuse and violence at the hands of men, and then their only option for birth with a SBA is a male attendant? Is that fair? And what about the women who are from minority groups, displaced from their homelands and expected to birth with a SBA who treats them badly…verbally and physically abuses them? These situations are not unique, not unusual, in fact they are the norm for many women in low to middle income countries (and I have to sadly add that this happens in high income countries too!).

Many organisations and governments take a hard line approach to the WHO recommendations and I’ve heard stories where countries ban giving out clean birth kits to traditional birth attendants in remote areas because they don’t want to encourage women to birth at home. And yet there are no other options for them. Is it right that we take a hardline approach to women in trying to get them to birth in a health facility when there are so many obstacles and such poor services? Is it right that we marginalize village birth attendants or lay women attending to pregnant women and blame them for maternal deaths?

I don’t think so. I believe this is a top down approach that violates the rights of women, disregards their concerns and fears, and punishes them for circumstances that in many ways, are out of their control. It also further isolates them and promotes suspicion of modern healthcare. At the heart is the fact that I don’t believe that women want to die in childbirth; they want to survive, they want their babies to survive and thrive. The fact they don’t get to a health facility says more about the poor quality of the service and the attendants than it does about the behavior of the women. There are also many men who don’t want to see their wives die in childbirth and who live with the consequences of losing the mother of their children. Generalised statements about men I don’t believe is helpful either.

In my experience in remote villages of Papua New Guinea, women are desperate for better care in pregnancy and birth. Many men too want to know more so that they can help the women in their villages. When they have travelled to a Health Centre they have been let down: verbally abused, demeaned, sent home, made to wait…sometimes as long as they are close to death and then die (yes, this is true and I have heard many stories of this nature). Now this is not to say that there aren’t any caring health staff out there. There are and I have met them, but I have to say they seem to be in the minority. And, there are not many trained staff either. Many have had little training and little to none continuing professional education or support. Their health facilities are rundown and lack basic necessities such as clean water, soap, even a simple Blood Pressure cuff. I think we need to hear the voices of the caring health staff more…sadly I think they’re silenced.

I heard from a field worker who was in the midst of the Ebola crises in Sierra Leone earlier this year, that when people were in quarantine due to exposure to someone who was ebola positive, not even pregnant women were given care or support during childbirth. They birthed alone in their homes. Not even clean birth kits were distributed and explained. Many pregnant women suffered terribly during this crisis and died.

Women cannot be denied services just because they choose to birth at home (or are forced to birth at home) because there is inadequate healthcare. I believe it is important to start somewhere and that somewhere is building the trust of the women and community in the home. As skilled birth attendants we need to show women care and kindness so that trust and respect in the information we provide grows. We have an obligation to improve the quality of our care and services by improving cleanliness, working hard to improve our knowledge and skills and provide more outreach programs. Getting out amongst the people to increase their education about simple health messages can make a difference. The people feel that you haven’t forgotten them and do care about the state of their health. Myths and untruths can be gently refuted. Key health facts need to be communicated regularly over time. As their knowledge grows about how their bodies work, what is important for a healthy pregnancy and safe birth, when and how to get help, I’ve noticed that their confidence grows and so does trust.

So, caring midwives out there. Who is going to join me to be the voice of the women who have no voice and bring quality care to women of childbearing age in desperate situations?

 

Pictures

This morning, as I do most mornings, I woke up with pictures of Papua New Guinea in my mind. Visions of the villages, the river, the people, different faces, Rhondy, travelling up the river, teaching in the classroom, all the faces peering up at me, images of a hard life, sick children, grieving families because of the loss of a mother… There have been 2 known deaths of women during childbirth this week in the East Sepik Province. This is just the ones that we know about. What about the others that we don’t know about. The ones who have silently slipped away in the jungle, only their immediate family aware because the distances are so great and they are a forgotten people?

mother and baby pngYesterday, I saw a post on facebook which broke my heart. A PNG man was commenting on a PNG site and he posted a photo he had taken of a woman who had just given birth in a remote swampy area of Western Province. The photo struck me because when I looked at the woman, I could see the faces of other women I have met in East Sepik Province. Those in the lower Keram River areas where it is swampy and treacherous. The women have told me stories about what it’s like to give birth in these areas, but it is hard to imagine because I just don’t know how they do it. This photo now gives me a picture of what it’s like for these women. And it is not a nice picture.

There is a loving heavenly Father who has not forgotten these people. He has heard the cries of His people and is nudging people to be involved in providing support and assistance for some of the most vulnerable people on the planet at the moment: women and babies in East Sepik Province. I know for sure that I have been prompted by Him to help. Rhondy is a local PNG midwife who I have connected with in the most amazing way. God has placed a burden on her heart for her people. Her and I are working together through Living Child to provide a sustainable program of education and training, practical help and assistance for villages in some of the remotest places in PNG. Are you feeling prompted to help? With your help we can make a difference…

This Season of Life

Last night I read a blog post by Erika Marie who is working with Samaritan Aviation in Wewak. Her post was about the desperate attempt to save the life of a boy in the remote village of Samban after being mauled by a wild pig. As I read her blog and looked at the photos she posted on her facebook page I was teary and felt deeply sad for the suffering of the people there. Every word she wrote moved me as I have been there and seen similar suffering. I scoured over the photos to see if there were familiar faces from the training I’ve been involved in over the past 2 years and yes, there were. Erika’s account and her open sharing of her feelings hit a cord with me because I have felt those same feelings, done similar things, prayed similar prayers in the face of situations that I’ve never had to deal with before, with limited resources and in a very different culture. I also felt a deep sense of envy that Erika was there and I am not. That Erika has the freedom to stay and do something, but I do not.

It reminded me of the time I heard a woman speak about the Birthing Hut project in PNG, many years ago when my children were very young. Matthew was about 3 and Ryan was in pre-primary. When I heard her speak, I felt instantly drawn to the work and felt a deep sense that I wanted to be involved in that kind of work, but was restricted by the season of my life – wrapped up in parenting 2 young sons. I even told the speaker this and said one day I hoped to be doing something like the work she was involved in, in PNG. I remember being reminded that I need to make the most of every season in my life and be thankful for the moment, not wish my life away. I find I can do that for a while, but then will be distracted by something and then feel discontent and disgruntled about the restrictions and compromises I have to make to be a wife and a Mum. But then I return to that place of thankfulness again and trust that as I am meant to be involved in things, God will reveal it and enable me. As I thought about this a flash of clarity beamed across my mind that I am in fact living that dream of being involved in some midwifery work in remote PNG. Maybe it’s not exactly how I’d like it to be (I’d really like to be there full time devoted to the midwives and people in remote areas), but it is what I can do within the season of parenting teenage boys right now, and being a wife!

As the year draws to a close (and may I add, it has been an incredible year of challenges, but also beautiful blessings) and I ponder the work of Living Child for next year I’m starting to see more clearly my place and role, bearing in mind my responsibilities as a wife and a mother! As I reflect over Erika’s blog today and come to terms with my feelings of envy last night, I think I’m starting to come to a place where I feel comfortable with what I can do from afar. I’m sure this is a balance that all people have to find through their journey of faith and life. I know that my husband has made sacrifices in his career for me and the children so that we as a family ALL feel stable and secure and most of all loved.

The needs of people in the world are GREAT and never ending. The needs of the people in the East Sepik Province of PNG are HUGE (bigger than what you or I could ever deal with on our own). I know and believe that God has heard the cries of the people in the East Sepik and He is mobilising people with different skills and talents to help. I know that He has asked me to help, but I also know that He will guide and equip me as needed, within this season of life.