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President & CEO, IMA World Health

Though Mother's Day is now behind us, some strong thoughts and feelings about motherhood are still lingering in my mind. So, in honor of mothers around the world, I want to express my deep concern for the poor conditions for maternal care around the world, which represents one of the greatest inequities of the 21st century.

As a father in Maryland, I am fortunate that my wife had access to great medical care and the critical health services needed before, during, and after the birth of our two children. This was particularly important as she suffered serious complications, following an emergency cesarean section with our first son. We were grateful for our fortunate circumstances because of the high level of training, expertise and available medicines to manage the situation. In a lower resourced setting, my wife could have easily become a statistic of maternal mortality.

In the developing world—in places like Haiti or South Sudan—even the most basic care and childbirth supplies like sterile gauze or a bar of soap are virtually unobtainable for most. While my wife and I pondered over options for prenatal vitamins, selecting a provider and choosing our pain management method, millions of women will not have the option of receiving care from a trained medical professional throughout pregnancy or delivery.

During a recent trip to Haiti, my staff and I met a woman name Brigitte who faced an impossible choice—she could feed her family that month, or she could buy the basic supplies needed to deliver her baby. (Many Haitian hospitals lack the resources to provide medical supplies to patients, who must provide their own.) These basic supplies would cost her about $35—the equivalent of her family's entire monthly income.

Fortunately, through one of IMA's programs, Brigitte received a Safe Motherhood Kit™, which contains the essential clean and sterile birthing supplies to prevent infection, education on safe birthing practices and a newborn layette. The kit contributes to safe deliveries for women with an uncomplicated delivery. For just $25, supplied by a kind donor, Brigitte's chances of infection and death decreased dramatically—and we later learned that she delivered a healthy baby boy, and that the family is doing well.

Unfortunately, in the time it took to write this, many women (3 women every 5 minutes) in the poorest countries of the world have needlessly died from preventable complications of pregnancy and childbirth, mostly from severe bleeding or infection. Almost a thousand women will die today. I can't bear the thought that one of these could've been my wife, my mother, my sister, when something could've been done.

These deaths are morally unacceptable, and I believe it's up to each of us to stand up for the human rights of women and call for government leadership to continue support for maternal mortality reduction and global improvements for women's health. This, however is not just a problem for governments to tackle—as individuals, we can speak out for women and support local, national and international organizations that are working every day to reduce unnecessary death and suffering.

In the words of Dr. Mahmoud Fathalla, author of the World Report on Women's Health and chairman of the WHO Advisory Committee on Health Research, "Women are not dying because of disease we cannot treat...they are dying because societies have yet to make the decision that their lives are worth saving."
In the wake of Mother's Day, please consider the joys and challenges of all mothers around the world and help make motherhood joyful every day of the year.

Rick Santos is the President and CEO of IMA World Health located in New Windsor, MD. Rick is a father of two, an International Aid and Development Worker and a survivor of the January 2010 Haiti earthquake.

By Rick Santos  
President & CEO, IMA World Health

I recently had the honor of speaking to the congregation at the First Christian Church in Portland, Oregon. My long-time friend and mentor Rev. Dr. Rodney Page had invited me out to Portland for a fundraising event and concert, and Rev. Mark Schlessman graciously invited me to speak at the church.

Though I am frequently asked to talk about my experience in Haiti during the 2010 earthquake, I usually try to keep the focus on the present and the future. We are working hard to help the Haitian people rebuild, and that’s what really matters most. Though there are challenges, there are so many great stories of hope being shaped in Haiti right now.

But it’s important to share our past experiences, because they shape who we are and how we approach the future. That’s why I shared the following sermon with the congregation in Portland, and why I want to share it with you.

***

Reflections for First Christian Church, Sunday, February 20^th, 2011

January 12^th—The Earthquake

On January 12^th of last year, I was in Haiti to attend a three day meeting on Neglected Tropical Diseases—or NTDs as we call them. For all of that day, the first day, we were sitting in meeting rooms on the second floor of the Hotel Montana. We were discussing our work, which is part of the Haitian Ministry of Health’s National program for the elimination of NTDs, and the Minster of Health himself was there to open the meeting. During a break, we had arranged for some Methodist colleagues to meet us at the hotel to have dinner—and to discuss how IMA could support their clinics and work. Ironically, neither we nor our Methodist colleagues were staying at the Montana—which is where US Government officials, businessmen and many foreigners often stay. As the meeting ended for the day, we made our way to the lobby to wait for our friends.

Sarla and Ann and I, all from IMA, met three colleagues—Sam, Clint and Jim from the United Methodist Committee on Relief (UMCOR)—and we were making our way through the lobby of the Montana at 4:53pm on that Tuesday, when the 7.2 magnitude earthquake struck. In less than five seconds, my colleagues and I were buried under two stories of concrete.

January 12^th—The Miracle

I don’t remember the earthquake stopping; all I remember is feeling the earth shake under my feet, being thrown to the ground, and a large rumble or blast sound. It may have been 30 seconds or a minute, but the next thing I remember is reaching out and calling for my friends—and touching Ann’s arm, and hearing her say she was OK. The next thing I remember is calling out to the others, and Ann pulling out a cell phone and using the light from the screen to see everyone, to better understand what our injuries were and to assess our situation. I was pretty clinical at that moment. I guess I had to be, because it was a very grim picture—five people trapped in one space about 8 feet long by 5 feet wide and 3 feet high. Sam and Clint were pinned down by rubble—Sam was in tremendous pain, with a large boulder of cement on his legs. Clint had wood, concrete and rubble from the ceiling pressed tightly on him, and he was also in tremendous pain. Jim and I had cuts on our heads, arms and back, and we were covered in dust. Ann had the least injuries, and Sarla had been thrown to a space on the other side of two feet of concrete. Her voice was difficult to hear and she was cut up and bruised, but she was OK. All six of us had survived one of the most catastrophic earthquakes ever recorded. Around us, in the Hotel Montana, more than 100 people lost their lives instantly, and in Port Au Prince, the devastation was unimaginable; over 250,000 people were killed, tens of thousands more were injured and over a million people were displaced. More than 20% of the city was destroyed or damaged.

In the moments that followed the initial shocks, there we were, buried alive, trapped with no means to free ourselves, and really no sense of hope of getting out. We knew that if the so-called best hotel in Haiti fell in less than 5 seconds, what did that mean for the city and the people of Haiti? Even now it is hard for me to tell you what I was thinking—my very first thoughts, after making sure my friends were alive, were dark. To myself, I thought—this was it. I was never going to see my wife and two small boys again. But in that moment another thought, a very powerful thought, struck me: it was simply, we survived. I was profoundly aware of the fact—at that moment—that I was alive, and that was enough to begin to hope. I don’t know if you have seen the pictures of the Hotel Montana, but it had a moonscape quality, rolling mounds of white rock with wood and rebar, tons of heavy dense rubble, all precariously perched on the side of a mountain, and I was under about two stories of it. From the pictures, it was clear no one should have survived.

Those initial hours were so overwhelming.  However, I gained both strength and solace from an unlikely place; our most injured colleague, Rev. Sam Dixon, in unbelievable pain with a massive boulder pinning his clearly broken legs, led our small group in prayer. His first words were, “Lord….Please help those of Port Au Prince and Haiti, as we know that many are suffering…” It was only at the end of the prayer did Sam ask for God’s help for us. 

My life was spared by two steps and two seconds, while others lost theirs in those same steps and seconds. Ultimately, these questions of What if I had done one thing differently? and Why did I survive and others did not? are on an infinite loop and are really beyond me. They are for scientists and theologians, but faith and hope are not beyond me. When I try to deconstruct that moment now, break it into smaller pieces, I see it in terms of hope in the face of a very precarious situation, one whose outcome was not clear. I see that hope is based on many things, including a positive approach to life. Hope can come out of life experiences. For me this includes having a wonderful family and friends, from theological training, living overseas and seeing people with incredible strength in the face of grinding poverty—all these have all been a big part of my life. But I think there is something more, because for me these explanations feel like the walls and roof of a house, but not the foundation. The foundation needs to be based on something greater than oneself; it needs to be based in a faith deep rooted in a sense that God’s love is present—and here is the important part for me, and what I learned from Sam—God’s love is here, regardless of the outcome.

I remember that first night, after Sam’s prayer, sitting in the darkness with my head leaning against a light fixture still attached to the ceiling, and feeling God’s presence—it was a God moment, and all I did was quiet myself so that I could feel how much I loved my wife and kids, and that gave me a very strong sense of calm. God’s love was there—regardless of the outcome—and that was OK.

I remember at about the 49 hour mark—49 hours spent without food or water, buried under all that heavy rubble—around 6 pm on Thursday, both my hope and faith started to dissolve. Even though we heard sounds like helicopters flying over the wreckage, none of them seemed anywhere near. I could feel very distinct thirst and hunger pangs, and the moments of calm were beginning to give way to fear. Weighing on me was Sam and Clint’s condition—both had been lucid and in continual pain for the preceding two days. However, this third night, they were clearly deteriorating and beginning to hallucinate, and both would probably not last until morning. I also gave myself about another 40 hours before dehydration would weaken me beyond rescue. It was at that moment that I began to think about my wife and two sons again—what their lives would be without me there, what I would miss. I realized very clearly that faith and awareness of God’s love is not linear, that it does not move progressively in one direction, but that it takes deep dives and u-turns. That the house of hope and faith can crumble when the foundation begins to shake. I was able to pull myself together after that moment—as I realized that my colleagues and friends were going to need me to be fully present for the hours ahead and that I needed to show my love and resolve to them, regardless of the outcome. 

An hour after my darkest moment, we heard the first signs of rescue—we heard voices on the other side of the concrete. We called out and they called back. “We are here to rescue you,” they said. An unbelievable moment. Fifty-five hours after being buried, Sarla, Ann, Jim and I were rescued; Sam and Clint’s rescue needed more time. Ultimately they did not make it, and God’s love was there, regardless of the outcome. 

My narrative is one story. What is important to me now is how we respond to the on-going aftermath of this natural disaster. Haitians and Haiti are truly remarkable—in some ways they are the most resilient people I have ever met.  Before the earthquake Haiti was the poorest country in the western Hemisphere and one of the poorest in the world. They have had decades of dysfunctional government, with a slew of dictators and strong men, and have suffered social strife and numerous devastating hurricanes. (That is why most of their homes have concrete roofs: they were built to withstand the winds and rains.) And on January 12^th, over 150 years after the last earthquake, they suffered the most devastating natural disaster, measured both by the number of dead and injured for one country as well as the level of destruction and number displaced. Haiti would have to rebuild.  In the face of tremendous loss, the Haitian people were helping each other, saving people who were buried, and sharing food, water and resources. They understood that they needed to pull to together—and they did, with tremendous initial support from many organizations, including my own. 

 I went back to Haiti last June, about five months after the earthquake, to observe our health programs, which had recently been restarted. I was surprised by two things. The first was how the people of Port Au Prince had adjusted to daily life…girls dressed in school uniforms and carrying book bags were navigating mounds of rubble on their way home from school, the street vendors and markets were active and many people were getting on with the “new normal” as best they could. The second thing that surprised me was how in the many tent cities, how the new normal was unsustainable for many, and how there was a vast amount of work still to be done.  I have committed myself and my organization to do as much of this work as we can, regardless of the outcome.

I am very blessed to just be here today, and to do the work that I do, and to be able to share it with you. 

(Lectionary Readings:  1 Corinthians 3: 10-11, 16-23; Psalms 119:-33-40)