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Karen Ruby Brown CNM, MSN, a midwife working and living in San Diego, CA found her way to ASRI via the Osborne Foundation, which is dedicated to improving both environmental and maternal-child health and has been one of ASRI's most ardent supporters since 2007.
In the spirit of the Millennium Development Goals #4 "To reduce child mortality" and #5 "To improve maternal health," and in response to ASRI's local needs assessment, Health In Harmony and ASRI founder Dr. Kinari Webb searched for a midwife who would come to Sukadana and provide continuing education and emergency skills training to the regions midwives or "bidan." Karen, who received her midwifery education at Yale, and who has extensive experience in both low- and high-resource birth settings, accepted the challenge.
She has now been to Sukadana twice, in 2011 and again, with her 2 teenage kids, in 2013, to teach evidence-based clinical management and lifesaving skills in postpartum hemorrhage, neonatal resuscitation, kangaroo care, breech birth, and preeclampsia, topics requested by the midwives and the Health Department.
Conducting the trainings was no easy feat, and required hours upon hours of meetings between ASRI and the Department of Health in Sukadana before Karen ever arrived. Says Karen, "I was impressed not only by this ongoing collegial and collaborative process, but also with the 60 individual midwives, many of whom travelled far and wide to reach the trainings."
"I had the midwives sit in a circle, which in and of itself differs from the common teaching methods in Indonesia," says Karen. "For introductions, and as a way of creating empathy within the community, we went around the room and each midwife (myself included) said one word describing the last birth she attended. While there was a fair amount of "no problem" and "happy," the descriptions were disproportionately weighed toward words like "hemorrhage," "asphyxia," and "died."
Indonesian midwives are well trained through a national curriculum and system of education. They have some emergency equipment and medications. Furthermore, they have smarts, and they have spirit and they have grit, taking care of childbearing families in remote areas, far from any sort of emergency help beyond that which they can carry with them. But sometimes they need additional help, the kind only a hospital can offer, and they need it reasonably fast." On her second trip, Karen hand-carried and left with ASRI a "MamaNatalie" and "NeoNatalie," durable teaching tools engineered by Laerdal Global Health specifically for skills trainings in low-resource settings.
Just last week we shared a story from volunteer Dr. Krista Farey about a difficult birth in a setting without electricity. "When childbirth does get complicated," Karen concurs, "ready access to a hospital can be critical. An ASRI hospital to help serve the mothers and babies around Gunung Palung National Park would eliminate the two-hour drive to Ketapang and provide life-saving treatment closer to home. The benefits of such hospital," says Karen, "are a no-brainer."
Especially in the month of Mother’s Day, we are so grateful for Karen’s efforts to help make the world a safer place for moms and babies.
To better ensure outcomes for women and children, the Community Hospital and Training Center will have a Neonatal Intensive Care Unit (NICU). While this room is not yet sponsored, it is critical. Childbirth is a beautiful experience, and mother's should not lose their children due to preventable and treatable complications. If you are interested in sponsoring the NICU, email firstname.lastname@example.org or call 503.688.5579.