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Wait, if you are on a journey to create a land of healing in Israel, what are you doing in Africa?

August 17, 2017

Is it really only a week since I left my house in Jaffa and went on this journey to create a feminine village of healing?  The first word I learn in Amharic is tzelot  I learned it while looking for the prayer room at the airport after a flight delay kept me over-night at the airport in Addis Abba. Me and my Post Trauma go out traveling the world. Me and my post trauma who doesn't like changes of plans, delays and anything unexpected. We land at the birth center in Uganda, on the border with Sudan on a full moon night. Straight into a thunder storm and four births back to back. The first word I learn in Acholi is yawayamo

Tzelot is to pray, yawamayo, to breath deep. Are any other words really necessary?

How can it be that the moon is full again? Exactly a month ago, on the night of the full moon, after five days of walking in the mountains near St. Katerina, I climbed up to Mount Sinai to see he sunrise. At the top I found a choir of tourists from somewhere in Asia, singing praises to Jesus: Jesus, hey hey Hallelujah, and thousands of youth from all over the world with their selfie sticks trying to capture the rising sun above the plain where the Israelites may have stood when God spoke to them.

Only on the plane, after we crossed the Sahara Desert, and green Africa appeared beyond the clouds, my heart began to shine, to shed its layers and understand why a journey aiming to found a village of healing in Israel, a fundraiser journey in Europe and the US, starts here, in this continent at a birth center on the border of Uganda and the Sudan.

One night in the mountains in Sinai, Saalem, our guide, woke up from a dream. In his dream he saw a flood and the flood erased his village, I told him my father once composed a song about a camel with wings, after he served his reserve duty in the Sinai desert. Saalem too dreams about flying camels sometimes. Dreams, after all, are made of things we actually see. Like Maimonides said, the faculty that can imagine something as absurd as an iron ship in the sky, can do that as a result of knowing a ship that sails the sea and bird's wings.

I walk around the birth center, this feminine village, emerged from of the trauma of child soldiers and sex slaves who served the rebels. From the dream of two American midwives. I walk between the kitchen and the staff's mud huts, the clinic rooms and the main enclosure with the hammocks, the fire where the families boil water for tea and bath for the new mothers and babies. To the well where the women draw the water.

I walk around and see how my dream already exists, it just has to be brought into the material world. As one of my dear students told me: it will obviously happen, the only question remains is who would have the privilege to take part in it.

On my first day at the clinic I meet a sweet baby, born the night before I arrived. Since she was born she was not able to pee. She has a kind of a swelling blocking her vagina. Me and Christine, the local midwife, trained by the organization I work for have never seen this before. I send a picture to some midwives in Israel and in the US. They don't know this condition as well. Eventually a doctor from Brazil and another one from Israel tell me the same diagnosis - an impenetrable hymen. The hymen filled with normal excretions from the cervix and created a swelling that blocks the urethra and the vagina. The doctor manages to explain through broken messages on messenger that if I won't do a minor operation now, this condition will not improve on its own, and that anyway she will have to go through this operation once she reaches puberty and it is better now than later. I wait until morning so that there will be some light in the mud hut from the window.

 

 

I'm trying to understand the cultural repercussions for the baby whose hymen I am about to cut. The only way to explain is through talking about the myth of bleeding on the first night. I am searching for words to explain what I am talking about without reinforcing the myth. 'Do you know about that membrane that they mistakenly say it gets torn on the wedding night and then it bleeds and there is an expectation that it will hurt and there will be blood on our first time? While Christine is translating, I try to read the looks on the women's faces, I ask each of the women in the room if this myth exists in her tribe and if it happened this way in their case. Only one of them bled on the first time, but that was during the war…

I tell them about the custom of the blood stained sheet, still practiced in some communities in my country and Christine says that it was customary that the bridegroom's sister checks the bed sheet but that today it is hardly followed.

 

Anyway, I say, it is more of a myth. Some babies are born with the membrane open, in some it opens during childhood and in some it remains closed even after they have sex... And some are even like this baby who was born with a completely blocked membrane and it has to be opened now… I follow the instructions the doctor sent on Facebook and it goes according to his instructions. I put my hand two cm from her tiny vagina and pray that she will not bleed and that it won't hurt and that her first time and all the times after that will be with love and enjoyment.

On the eve of Shabbat my home sickness surges for a moment and I remember that I am homeless this year, but there is no time to dwell on it because the clinic is filing up with seven laboring women.

In the early hours of the morning, while attending to a birth with Christine I realize I am witnessing a miracle. I don't mean the birth itself, I mean Christine the midwife. Then it occurs to me that the woman giving birth should turn over from her back to her knees, before I have the chance to say anything, Christine already guides the women in Acholi  explaining that it will be easier for her and for the baby if she changes her position. When I was here seven years ago, Christine was a beautiful, shy, youth, she barely greeted me with a hello.

The war prevented her from going to school, now she is the head midwife at a busy birthing center, and not just a a midwife, but one that was trained according to the midwifery model. A midwife who is proficient in giving continuous care- to both the mother and the newborn, a midwife who always asks for permission before touching or checking dilation, equally skilled in compassion and kindness as in life saving skills. She knows how to trust the body, trust the labor, ready to interfere when needed.

Eradicating mothers, fetuses and newborn deaths in developing countries was prioritized by the UN and World Health Organization as one of the millennium goals. According to the WHO the required solution is training midwives, as many as possible. But what kind of midwives? As much as the medicalization of birth is complicated in countries like Israel and the US, it is much more complicated in developing countries.

 

Seven years ago when I traveled around Uganda between hospitals and birth centers, I saw the extent to which labor medicalization policy can be destructive in a developing country. Imagine a government hospital where no staff member received his salary since last winter. Where there are no surgical gloves, and the sterilization container has been empty since last month, with routine unnecessary interventions like episiotomy when one knife is moved from one vagina to the other, four women bleed on the same bed and infect each other with AIDS.  Obstetric violence to such degree that a women pushing as much as she can is beaten, pinched and reproached. Her legs are tied spread-eagle and whoever passes by sees her and comments: 'why aren't you pushing? Don't you love your baby? Do you want to kill him?'

Whoever is familiar with the political and historical interventions of whites in Africa, as well as with the political complexity of transferring childbirth to hospitals can see that Christine represents the best of all these worlds. A real miracle. The shy youth I met seven years ago, whose plans were set back by the war for a while, is now the head midwife in an independent birth center. She works in full cooperation with traditional midwives of the Acholi tribe who study life sustaining skills here and with nurse-midwives who were trained in a medical and violent environment and learn here about physiological birth, and a continuous, holistic and feminist care model.

The birth center serves as a bridge and a center for information exchange of knowledge and wisdom between traditional and modern midwifery.

I am still short for words to express all the insights asking to emerge from me regarding the connection between obstetric violence and psychiatric violence against women who were once considered hysterical and are now considered post traumatic. So much of what I know about healing rape I understand through the thousands of childbirths I witnessed. I know that women know: To give birth and to mourn, to give back to the earth, to breath, to sigh, to tremble. They can tie us to the bed, drug us and silence us but they can no longer call it medicine.

 

The night brings death and a birth. I work with Peace, a young midwife who was trained here too. A woman comes in by foot from a distant place with strong  contractions, twins' pregnancy and no pulse. I wash my hands and see in the water-bucket a butterfly the size of a palm breathing its last. In the early morning a woman comes in whose last birth was a silent one. The fetus’s pulse is strong and steady. It is morning and peace's child woke up in the nearby hut and couldn't find her, he comes into the labor room  and puts a sleepy head on his mom. When it is time to dress him for school peace leaves for a moment. The woman sits on the birth stool and I receive into my hands a healthy and very lively baby. For a moment the bleeding increases. A tincture of shepherd's purse does the work.

When the baby breastfeeds, the mother is clean and the womb has shrunk. I entrust her to the good hands of the traditional midwife and go out to the community kitchen where a thermo-cup with hot ginger tea is waiting for me. Zila  the cook bends to stir a pot on the fire with a toddler on her back. Her child is on the ground near her following the cats and the hens and laughing. This week, a friend of mine who suffers from post trauma had to separate from her daughter in order to receive treatment. I see a feminine land of healing where the strong connection of love in nature is not betrayed. A place where women can stay and work, therapists and patients, teachers, midwifes, witches, mothers and students can be there with all their parts.

 

 

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