By: Jenny Eaton Dyer, PhD
This past week, HTHH and CARE traveled to Haiti to see how vital U.S. investments and partnerships are improving health outcomes for women, their families, and their communities.
While there, we visited with women and children both in Port au Prince and in the more rural area of Central Plateau. We spoke with these women about their access to health care and education and how it has made a difference in their lives and the lives of their children. I had the opportunity to interview her in her home, with her mother and children and family and neighbors, while there.
Destine Ebony, 28, lives in Marmont on property her grandmother deeded to her mother and her mother then gave to her and her husband. There, she grows okra, beans, and corn as staple crops throughout the year. They have access to clean water a short walk away. Her husband harvests crops, and right now, she stays at home with her four children to take care of them. Her eldest is ten years old, a boy, then she has a girl, 8, and then two more boys, 3 and 1. She has her hands full.
Destine had her first child at eighteen years old. Initially, she and her husband only wanted two children. But the last two children were simply accidents. She was using contraceptives but sometimes, like all women sometimes, she forgot to keep up with it and she became pregnant. After this child though, she says she is very serious about no more children, and she and her husband work together to remember to take her Depo-Provera shot at the clinic every three months. If the opportunity presents itself, she wants to have a tubul ligation, or “have her tubes tied,” for permanent birth control.
Her first two children she had at a hospital but it was quite a distance. In the last three years, the Clinic Marmont Maternity Center was built by Project Medishare with USAID assistance that has five beds for labor and delivery. She was able to have her last two children there. She let us know that the center was extremely helpful for complications with her last pregnancy; they were able to see her frequently to provide medicine and counseling on nutrition to help her with enhanced prenatal care. But it was also invaluable to have a nearby birthing center for her delivery.
The clinic also provides a spectrum of services including education on breastfeeding and lactation She personally committed to breastfeeding each of her children for two years, and she argued she has noticed a difference in the physical and cognitive development of her children versus the other children in the community. Also, the clinic provides all vaccinations for her children. Pneumonia and diarrhea, for instance, are the leading causes of death for children ages 0-5 in the developing world. These two interventions, breastfeeding and vaccines, can be absolutely lifesaving for children in developing nations.
When I asked her how important it was for her to have access to contraceptives (in her case, injectable, right now), Destine offered a variety of responses. She knows given their situation, they simply cannot afford another child. In fact, as any mother might, she worries about them even now in terms of how she will feed, clothe, and keep them in schools. Her eldest boy, Marc H’ Ansley, she tells me wants to become a doctor. Her little girl wants to become a nurse. She knows she needs them both to work hard, stay in school, and go to a university. But she doesn’t know how she will pay for them when the time comes. And then, what of the other children?
I asked her what she wanted to do when the baby was finally in school. She let me know she really wanted to develop the skills to be a seamstress. She loved clothes, and she wanted to be able to make and sell them as a means to enhance their income for her and her family.
Destine, like millions of other mothers around the world who live in poverty, faces the daily challenges of seeking out clean water, nutritious food, and keeping her children in quality schools. In her case, if she can continue to have access to contraceptives to limit the size of her family, she has optimism for a more successful future for her children and her community.
Without the support of influencers across the nation advocating for enhanced U.S. governmental foreign assistance funding in international family planning, Destine might lose her access to contraceptives. She asked us at the end if we would please go back to the U.S. and tell them she and her community needs our continued support.
We promised to do so.