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Home » Get Involved » Field Journal » Four years...and memories to last a lifetime

Four years...and memories to last a lifetime

Flight homeFour years seems like a long time in retrospect, but fifteen hours feel even longer as I restlessly sit on a flight from Dhaka, Bangladesh to Los Angeles.  This will be my last trip overseas with VSI, as I prepare to leave the organization to pursue my PhD.  This last long flight allows me plenty of time to reflect on these past few years and the impact of this work on women’s health.

I first joined VSI four years ago when the organization was a much smaller operation and only had a few country programs.  I am honored to have had the opportunity to help build and support many of VSI’s misoprostol programs from the ground up.  Ghana and Bangladesh were such programs.

The first half of this last trip I spent in Ghana, visiting rural health centers where misoprostol tablets are distributed to women during antenatal care (ANC).  The counseling and misoprostol women are receiving while pregnant ensure they will have protection against excessive bleeding if they cannot make it to a health facility in time to deliver. In Bangladesh I traveled with partners and visited similar safe motherhood programs in rural communities. Trips to the field often translate to long hours, remote locations off the communications grid, and lonely hotel rooms.  But often in the midst of these inconveniences come moments of inspiration.  In every program and every community there are amazing stories of community empowerment, determination and dedication that stick with me.

At one particular remote health compound in Ghana, the only nurse on duty has dodged snakes in her bedroom, made do with no running water, and is living away from her husband—all while pregnant with her first child.  Despite her personal distractions, she is determined to include counseling on misoprostol in every ANC session.  She knows that for rural women making it to the facility is no easy feat— transportation is unpredictable and unreliable. Her counseling and having this medicine in hand could be a matter of life and death for women in her community. 

Bangladeshi menIn rural Bangladesh, I visited the program sites of our partners ICDDR,B and RDRS Bangladesh.  In the world of maternal health, it is natural that women become the focus of programs, but in this community, men are taking a proactive role in the health of women in their village.  I sat on the floor of a men’s group in Sylhet District watching as each man in the room formally stood up and presented his report on findings from a village survey. The care and attention that these men took in talking about maternal mortality was poignant; that all women in the village were receiving ANC and no woman had died in childbirth since the program began showed their words were matched by action.

However, often the “best” stories in this line of work are the uneventful ones.  In the Brim South district of Ghana, I visited the village of Oforikrom where Augustina (pictured below) was given misoprostol during ANC, delivered her baby in the health compound, and suffered no complications.  Due in part to my long hours, both in California and in the field, women in this village, like Augustina, now have protection from a leading cause of death in childbirth.  Her story, although not filled with drama and page-turning suspense, gives me hope to think that one day all women can be afforded this same assurance.

Squatting on the floor surrounded by Bangladeshi men talking about Ghana motherfamily planning; perching next to Augustina in her family compound and cooing at her healthy newborn, still unnamed because he is only a few days old; standing outside a community health compound listening to a nurse talk with a woman clearly and compassionately about antenatal care and delivery--these are the moments that remind me of why I do this work.  I think about returning to my desk in Berkeley and see program plans, Excel spreadsheets and unanswered emails. And then I remember sitting on a wooden bench in rural Ghana, listening to an elderly traditional birth attendant explain perfectly how to use misoprostol to prevent excessive bleeding in a home delivery with such enthusiasm and confidence. A smile comes to my face. 

As I reflect on the changes happening in my life and wind down from the past four years, it’s these memories that stand out, that I will remember most about my time at VSI.  Not the long journeys to get to Africa or Asia, not the sleepless nights due to jetlag or the many parasites I’ve picked up during my travels.  Instead, it’s the dedicated colleagues I’ve worked with in Africa, Asia and California; the Ministry of Health officials who push forward new programs for the mothers and children in their countries; the heroic health care providers who are always adding more to their already burdensome workloads; and most of all, the women whose lives we have touched in our programs. 

Jennet Arcara worked with VSI for four years as a Country Programs Manager.  In July, she left the organization to pursue her life-long goal of obtaining a PhD in maternal and child health.  This month she begins her studies at the University of North Carolina, Chapel Hill.  We wish her all the luck and success as she begins this new chapter in her life.