We’re going to backtrack and update you all on our busy last week, but I need to post this update of the last few days first. You see, we’ve been noting the ebb and flow, the day to day feeling of how much we “get it” here. That is to say, some days something will happen and we’ll think, “Aha, I get it,” until two days later something happens to remind us, “No, we are still outsiders. We still don’t get this place at all.” It’s a pendulous existence between really great days and really less than great days, which isn’t too different from normal life except that all of our senses are heightened, so it’s great and really less than great on steriods. Anyway, here’s my story.

We’ve been out of site a lot, as we went to Antigua for Semana Santa (and the post on that is coming, so anticipate…). We got super lucky, as our boss scheduled to visit our remote work site, Quixabaj, this past Tuesday. For him, it’s a days drive to get all the way up here, which meant he had to leave on Monday, which also meant he drove us home. YAY! We got a late start, and arrived in the village even later, at about 9pm (but the computer center is now underway! More on Fletch’s wall). We had time to unpack from the days past and repack for the annual department-wide security meeting, which we’d be leaving to attend right after our little jaunt to Quixabaj. That required us to leave town on the 6:15 micro the next morning.

We definitely feel like we’ve been out of site too much, but we try to keep checking in with the family always. I hollered through the window right outside our house into Reina’s room to say we’d come home and that we were off again until Thursday early tomorrow morning. She and I always keep in touch. I like her a lot; in fact, I’d say she’s probably the closest Guatemalan friend I’ve got. She hollered back, and we all went to bed.

We’ve been working on getting this other village, even farther out in the middle of nowhere and even poorer than where we live, its own volunteers. It was apparent in our first visit there that we’d be unable to give this community the attention and support it deserves, and since then we’ve been petitioning our boss to place volunteers from the incoming group in this site. Our boss is a good sport, and since we wouldn’t shut up about this village, he made the effort to come see it and bring our security director with him to see if they could approve the site for future volunteers. We were really excited about this. Our health technician, who is our local supervisor, and Manuel, our village health comittee president, and Don Tomas, another local leader, all came with us. We were in the middle of what was a pretty productive meeting between our posse and the community leaders when I received a text message from Reina.

She said, “Hey, where are you? I wanted to let you know I have a new baby.” At first I thought, what? Then I thought, haha, she’s joking, but what is she actually talking about? And then I was just really confused. I sent her a joking message asking her where she got her new baby and what she did with her old one, haha. She sent me this message: “I was pregnant, and the baby was born today, and it’s boy.” Reina is really sarcastic, and really good at carrying on dead-pan jokes like this, so I just sent her a message asking, “Are you serious?” And I was confused some more while we waited for the next message to come in.

You see, a few days before we left for our Semana Santa vacation I was hanging out with Reina at the pila, washing clothes. For some reason she hadn’t gone to work in like 2 weeks, which was very unlike her, but she just said it was because no one was around to take care of her daughter. She’s between care-takers, but that doesn’t usually stop her since she has 4 sisters at home that take care of Delmy for her any time she needs it. I was washing clothes and looking at her and something about her posture struck me. I thought she looked a little pregnant. I told Fletch as much, but when I say a little I mean like 4 or 5 months. I’ve seen a lot of pregnant bellies in my life. My first thought was, “Hey, maybe I can be there for the birth? I’ve never seen one, and that would be cool.” But I figured I was probably just imagining it, or she’d tell me if she was pregnant when she felt she should.

As you might imagine this added greatly to my confusion. Was this real, or an April fools joke with Guatemalan timing? It didn’t help that Reina never answered my last text message to confirm. The road back to town from the village is a 2 hour ride which gave me lots of time to mull over my thoughts: We’ve lived here for almost 9 months exactly, so providing this supposed baby wasn’t early, she’s been pregnant the whole time! Why wouldn’t she have told me; I thought we were friends? I know that the Q’anjob’al word for a pregnant woman is yob’ ix but I never heard anyone in the family use it? This is SO Guatemalan of the family to not tell us this very obvious thing, that a baby is coming. Is it a Mayan cultural thing that they don’t talk about the baby at all until it’s here? I sleep ten feet from this woman, how could I not have known she was pregnant at all!? Is this for real, seriously? If she really was pregnant and really did have the baby, then I missed my opportunity to see the birth. Bummer.

I really wanted to go all the way home and check it out, you know, see if there was a baby, but we had to go on to the state capital for the all-day meeting the following day, and the meeting was to run too late for us to make it back that night. Thus I was left to wonder some more. In spite of meeting up with and hanging out with lots of fun volunteers, every once in a while I would wonder about this situation. Though I was becoming more and more convinced that it was not a joke, I needed to see it to believe it. I sent her a text message with the plans of our arrival home and asked her if the baby had a name yet. She wrote back saying they were thinking they’d call him Nas, like her Dad. That would make him the 4th Nas, as two of his other grandchildren (Galindo and Chalio are nicknames for the other Nases) are named after him as well. It was sounding pretty real to me.

So this morning we got on the bus to come home, and I was anxious to solve the mystery. I began cataloging my questions for Reina, figuring out the proper words and order for asking them. We arrived in town and caught the bus to our village directly. On the way I started a conversation with the woman next to me, who I didn’t remember ever seeing before. She didn’t know who we were either, which was definitely strange. We talked for awhile, and as we got closer to home she leaned over and said, “A woman in town died today from child birth.” Suddenly I was really afraid, and Fletch hadn’t heard the name the woman said so we asked her again. The woman’s name was Maria.

We pulled up to our stop, the last one on the bus route, and hauled our things up to the house. Naturally, I dropped my bags and went in search of a baby. And sure enough, Reina was resting over at the other house with her new little boy. She let me hold him and we started talking.

The first thing I asked was, “We’ve lived here for nine months next week, that means you were pregnant this whole time?” I said sort of laughing in surprise. The answer was kind of obvious, but she shook her head yes and smiled, embarrassed. So I asked why she didn’t say anything about it advance. This is where things got interesting. She didn’t tell ANYONE in the family she was expecting a baby, NO ONE. She shares a bed with her 17 year old sister, and her sister didn’t even know. So this is not a Mayan cultural thing. She’s a single mom, pregnant with her second child, and she was afraid of what her parents would say. She couldn’t do anything about being pregnant, nor could they, so she just didn’t tell them. “They might have guessed, but they never said anything to me either,” she said, “I thought about telling you a few times, but then I was always too embarrassed to say anything.” I told her not to worry about that in the future; I’m alright at keeping secrets. She laughed. Then I said, “So we left here at 6:15 in the morning, and you told me you had a baby around 12, when did you go into labor?” Her labor started early in the morning, but it wasn’t too bad. She didn’t get out of bed until 8, which is normal for her on days she doesn’t work. Her parents were leaving to go a family wedding, and she thought about telling them she was in labor (mind you they didn’t officially know she was pregnant), but decided not to. They left, and she told her sister Masha, who was the only one at home to help her, that she was in labor. The midwife was at the family wedding as well (maybe she should have mentioned something to her parents beforehand, after all). So Masha, who’s given birth to 5 children and is raising the only one who made it through birth alive, ran to get their neighbor/cousin Petrona, who is a mother of 8. Together Masha and Petrona delivered Reina’s baby. She said her water broke a little around 8:30 and Nas was born about 20 minutes later. Her parents came home from the wedding to a new grandchild–no use getting really mad then! Though I think their feelings are a little hurt, based on our exchanges today. That would be understandable. She told me she wasn’t sure if she should have sent the text message when she did, but I told her I was glad she did. I told her that I’d mentioned to Fletch I thought she looked pregnant, but not full term, and that in thinking back I realized she wore a lot of bulky sweaters. She laughed.

I have a lot of mixed feelings about this. It sounds so irresponsible that she didn’t tell anyone! But she is a nurse’s assistant. She went to the doctor for regular check-ups, which much more than most people here do, and even knew she was having a boy because she had an ultrasound done. She laughed that Nas was wearing Delmy’s old baby clothes because she couldn’t buy boy baby clothes or someone would have found out. I also think her situation is a testament to the necessity of teaching EVERYONE about birth and warning signs, because with only 1 or 2 midwives in town sometimes they aren’t around when they’re needed. Completely untrained people, who lack knowledge of basic hygiene practices like hand washing, are DELIVERING BABIES! I also felt sad for Reina that she went through the whole pregnancy pretty much alone. She told me her babies have the same father, and I’ve known for months they weren’t together anymore. However, she did tell the local nurse who ran into her at a check up once, and the local nurse is one of our favorite people, and herself a single mom. I’m glad she at least had that support. I just kept thinking, all of these complicated social issues on top of the fact that she had her baby with absolutely no medicine or medical attention save her own, in an adobe house with dirt floors. It was one of those moments I thought, “Oh my god, we Americans are such wimps.” Deliveries bring to mind moaning women, sometimes screaming. She shared a bed with her little sister for hours while she was in labor and didn’t mention to anyone she was having a baby until just before her water broke.

In my mind I have a picture of what happened at the birth. In it, Reina is stoically working her way through contractions and telling Masha and Petrona what they need to do to get ready, doing everything short of reaching down and catching the baby herself. Knowing her, it seems probable.

Just as we were winding down our conversation she received a call. She told me the call was pertaining to a woman who had died today in childbirth. I told her we heard in the microbus, but then she told me the woman was a cousin of the family. Everyone was getting ready to go to the wake. We said our goodbyes. Just as I got home, was looking out the window, and a truck with a casket in the back drove up the road with three full micro-buses following behind. They stopped in front of our house, and everyone told us to come along with them. We made up some excuses to not have to get in a crowded bus again today, assuring them we’d be along soon. As they loaded up and left for the house we talked about whether or not we should show up, whether it would be appropriate. Thinking back on the Galindo experience, we decided that since their illness and death customs here are community centered it would probably be appropriate for us to go. We didn’t particularly want to, but thought it best to show our support for an extended member of our host-family here, thus we took off up the road on foot.

We knew which house was hers because all the vehicles were parked outside. We walked up to the back door where half our health talk attendees had fires going all around them, huge pots of boiling water atop them, and a table with an enormous mound of tortilla masa being scooped out and shaped by 20 some hands, wrapped in leaves for tamales and carted around the house to another fire where there was the biggest of all pots for cooking the tamales. The women seemed generally happy to see us. I spoke to them in as much as I could without a translator. They laughed awhile until the lady we buy eggs from ushered us in to the house to find us a seat. There is no end to their being respectful to us, making sure we’re some of the most comfortable people in town. We told the women carrying babies not to worry about giving up their seats, as we’d been sitting all day. They looked relieved as they sat down again.

The room was an L shaped, adobe, dirt floor room with a low wooden ceiling. The casket sat open at one end of the room, but the body was covered with a sheet and adorned with flowers. Since pictures are a pretty rare thing here, we have no idea what she looked like or how familiar her face was. I had to wonder if she was the hugely pregnant woman who left last week’s talk early. I remember thinking, “You should stick around, you might need this information!” But we don’t know if it was her. We saw Nas and Manuel against one wall and went to talk to them. Nas said it was a tragedy as she was a very good woman. I asked her what he looked like, “Short and fat,” which could describe any number of people here. I don’t think the woman from the charla was fat at all, she just had a huge belly. Nas gave us other details; Maria was actually taken to the hospital and died during the c-section. This was her 14th child, and the little boy survived. He had me go visit the baby, and the women (more charla attendees) tearfully handed me the baby to hold. These situations are so awkward. What am I supposed to do? How long should I hold him? I guessed, and handed him back when the time seemed right.

Nas asked us about how funerals in the states work. He’d heard some bodies are put in an oven and made into dust. We told him that was true in some cases, but in other cases the funerals were similar to this one. He said, “The only thing we don’t do very well here is find words of support for the family. This is hard; we just don’t know how to do it.” As he was talking, a man came in and hung a sheet in the corner where the crying women sat. I asked him what it was for, “So people don’t enter,” but kids and adults kept coming and going. It didn’t look that effective. It seemed just to try and hide the women who were most upset and crying. Very strange. We stayed long enough for atol, and donated 10 quetzales to the family, as all the other families in the community were doing. Once Nas, Manuel, and families moved to leave we went with them. Lina, his wife, had stayed home with Reina and the baby, but she berated everyone’s coming back so early rather than helping out at the house. “We’ll go back tomorrow afternoon,” he told me. I think we’ll attend our first Q’anjob’al funeral on Saturday morning.

As my boss and counterpart had been discussing on our long road trip, our municipio, which is more or less equivalent to a County in the U.S., has already topped the maternal death toll from last year (we already had the highest rate in all of Guatemala, might I remind you) as of last week. Maria is just an add-on to an exceptionally bad year; we aren’t even half way through yet. Unfortunately the woman who died last week, before Maria, died in the exact same way, taken to the hospital too late. On one hand it’s great that the women are actually GETTING to the hospital, but it’s such a set back that the women are taken so late they die anyway. I am afraid that will begin to discourage the families from taking the women in for help in the future. Even worse in Maria’s case, she went in for an examination in Santa the day before her death, and was either sent home or the family decided to bring her home, so when she really needed help she was far from it again. This same thing also happened to Galindo. Why does this keep happening? Is it more the doctor being too hesitant to recommend that the families get to a hospital, or the families being too insistent on things being done at home? We should probably investigate that a little more. In general this has made us evaluate how we’ve handled getting to know the town and the midwives, which is to say, we’ve got a long way to go. I feel like we’re working all the time here, but perhaps we need to come up with a more comprehensive plan to get to know the midwives, and, if they’ll let us, maybe the expectant mothers as well. We’ll see. We have been trying to work with the community, but I think we need to come up with multiple approaches.

You see, this is all particularly bitter in regards to my post Despairing a Little and Baking Cookies for Peace. That was the dreadful time I tried to begin a dialogue on pregnancy and problems women have had here, and I ended up crying a little during the charla as I was trying not to break down completely because of their irresponsiveness. So last week we did a health talk on how to handle the uncomfortable aspects of pregnancy; nausea, heartburn, backaches, constipation, swollen legs etc. I thought this would be a good way to get them to come out and talk about problems that all women have before I tried to get back into talking specifics and details which might lead them to think I, or anyone else, was judging them. And I was thrilled when this approach actually worked. I’d planned to make next week’s charla about high risk pregnancy and recognizing danger signs. The health center has been working on these things with the midwives for a while now, but the families don’t have the information. Unfortunately for this family the information is coming too late. She died at one thirty this afternoon, and the charla will be next Tuesday at 2pm. Now I need to figure out a way to broach the subject with a mountain of sensitivity that will leave it clear to all I’m not judging this family or the way things were handled. That’ll be interesting, possibly tricky.

And if anyone out there thinks they might be interested, or know someone who is interested in donating to our Midwife Kit Project, there’s no better time than now. This problem is real and very severe here.