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With few resources, Haiti's women and children at a disadvantage

By Theola Labbé-DeBose
Washington Post Staff Writer
Thursday, January 28, 2010; A13

PORT-AU-PRINCE, HAITI -- The labor pains started before dawn. Marie Delise sat up on the thin blanket she was sleeping on in the middle of a street and shook her husband awake. It was time.

For two hours, they walked through dark streets filled with people who, like them, had been made homeless by the earthquake. They paused each time she had a contraction.

At the main hospital gate, now guarded by U.S. troops, Delise held on to her husband, Gregory Presmy, as they walked into a courtyard filled with female patients lying on beds. Tarps fastened with rope and string shielded the women and their newborns from the elements. Handwritten notes taped to the edges of beds revealed each patient's name and vital signs. This was the maternity ward, post-earthquake.

Delise was soon taken inside the hospital, which had no electricity or running water, to give birth. Haitian American nurses -- volunteers from New York -- created a delivery room with donated supplies. Then the earth shook, one of the many aftershocks since the Jan. 12 temblor.

Greleyon Presmy was born shortly after 6 a.m. into devastation and desperation, a new life among thousands of dead.

"I hope that he becomes a good man, a great man who will grow up to help the country," said Delise, gazing at her son, swaddled in blankets and wearing a tiny knit cap.

Those high hopes face serious challenges as health and safety conditions in the capital city worsen, putting Haitian women and children at particular risk for disease and sexual exploitation.

Reports show that violence against women and girls was already common in Haiti before the earthquake. In a 2006 study by the Inter-American Development Bank, one-third of women and girls said they had suffered physical or sexual violence, and more than half of those were younger than 18.

"We have to keep in mind that disasters make existing inequalities even worse," said Marijke Velzeboer-Salcedo, an expert on gender issues for the Pan American Health Organization/World Health Organization. "Those who are stronger and more powerful, whether physically or psychosocially -- or both -- are going to have better access to scarce resources. But when women are deprived of resources, entire families are likely to be deprived, too."

About 37,000 pregnant women affected by the earthquake are in desperate need of food, clean drinking water and access to health care, said Franck Geneus, who directs health programs in Haiti for CARE, an Atlanta-based nonprofit group that helps women and children around the world. As many as 10,000 of the women could give birth in the next month.

Workers in the battered town of Leogane carefully planned the distribution of hygiene kits by first sending in an assessment team and coordinating with local leaders to ensure that the neediest women would be helped, officials said. The goal is to prevent the aid from ending up in the hands of people who try to sell it or force women to trade sexual favors for food and supplies.

Still, even with security, it has been difficult for most women and children to get help. At an aid point in downtown Port-au-Prince near the collapsed presidential palace, throngs of men crowded around a doorway and fought with one other while Haitian police beat them back with sticks and batons.

"Stand in line! Stop pushing!" officers yelled as others handed out bags of rice, corn, sardines, sausages and beans. There were separate lines for men and women. But only men were at the front, clawing for the food; women and children waited behind in longer lines that did not move.

Judline Merland, 25, was one of the few women who emerged with a bag. "I don't stay here," she said, pointing to the nearby sprawling tent camp in Champ de Mars park, across from the crumbled city government buildings. "I come down during the day, and at night I go sleep up in the hills."

* * *

Inside the park under a blue plastic tarp, Stefanie Senat looked like a doll as she lay on a dirty white blanket with flies hovering around her. She was 16 days old. Her father, Stefan Senat, 23, said she had an eye infection and was getting too sick to cry. Her mother, Rose Petithomme, 26, said she had stayed up all night trying to breast-feed but her daughter wouldn't latch. Even if she did, Petithomme said, "the milk is not enough for the baby because I feel weak myself."

Squatting next to them was Barbara Mondesir, 29, who was with two of her sisters; the family had lost seven members, including two children. Mondesir said a friend of hers had been raped walking back to the camp shortly after dusk. "I feel like it's not safe here," she said. "I don't go out at night."

Mireuse Jean-Felix, 18, and her husband, Jean Sanes, 31, awaited the arrival of their first child in a crowded tent camp across from the police station in Petionville, among trash, feces and urine.

Jean-Felix, who is six months pregnant, had carefully saved money from her job as a restaurant server and bought clothes, a bathtub and sheets for the baby. She left those supplies behind when she fled their home during the quake. Although their house is still standing, she is scared to go back because of aftershocks and because the house next door collapsed.

"The baby used to move a lot, but since the earthquake, nothing," Jean-Felix said.

* * *

The flow of patients into the outdoor maternity ward at the downtown hospital continued. Gina Pardo, an obstetrics and delivery nurse from New York City and originally from Haiti, said she has the bare minimum of supplies. Doctors and nurses are using string to tie off umbilical cords.

She has lost count of how many deliveries have come through. "Every time I think we're done, they bring in more," she said.

A woman in a thin blue nightgown walked around the courtyard, trying to speed labor. Another woman writhed and yelled out in pain on a mattress on the ground, her labor progressing quickly.

Marlene Garby, 26, sat up on a bed, her hand gingerly touching her lower stomach where doctors had made an incision to deliver her baby, Sonia, by Caesarean section hours earlier. She had received pain medication, but she said the incision still hurt. Her IV bag hung from a tree branch. Her sister Garby Naelle, 27, cradled her new niece and smiled. "I feel happy because the baby is alive," Naelle said. "God saved her."

Garby and her family lost their house and have been sleeping in the street. "I don't know what to do next," she said.

Nancy Gerdes, a volunteer nurse from New York's Long Island, encouraged Garby to try to breast-feed despite her pain. Most of the mothers are now homeless, and discharging them and their babies has been difficult, Gerdes said. But they cannot stay at the field hospital indefinitely.

"They need a place to go," Gerdes said, "or some of these babies will die when they leave here."

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