Introduction / or Getting Out of Bed When our Dreams Call Us

An Introduction

In 1980, my family grew to include children who had fled the conflict in Southeast Asia.   They made their way to refugee camps in Thailand and Indonesia by foot and by boat and then as, orphans and unaccompanied minors, they arrived aour house in Portland, Oregon.  I was thirty-two years old, pregnant and already a mother to two young boys.  My husband was in medical school.  We felt that love could accomplish all things and were children ourselves of the idealism of our generation.  Our old wooden house would burst to overflowing as we faced, unprepared, the joys and challenges of bringing young people into our community who were sick, frightened, homesick and lonely.  

Thirty-three years later, I made a trip to Vietnam and Cambodia with two of those now grown children. I had been to Cambodia twice before with my daughter but it was my first visit to Vietnam.  I had volunteered as a midwife in Haiti and Gahanna and wanted to spend some part of my trip with midwives.  They had grown up with a midwife- mother and knew this to be my particular and peculiar passion. 

I was interested in how Vietnam and Cambodia’s midwives had managed through bombs, famine, genocide and years of conflict.  I wanted to know how they became midwives and who helped them along the way.  I wanted to know how their new governments had made the transition from war to peace while improving the maternal and newborn mortality rates of women and children.   I wanted to know the situations in which my own children were born; of the practices and women who helped them take their first breath and survive.

I had wanted to offer the midwives of my children’s countries some small gift and so

before leaving, I had decided to offer training in newborn resuscitation through Helping Babies Breathe.  I packed training materials and 40 ambubags to give to local birth centers.  My children helped me to make contact with many local clinics and others I found through NGO’s working in the countries.   Through them I gave many workshops, observed birth in a variety of settings and had an opportunity to meet many midwives. 

I had become a midwife in the post  Vietnam war years, when many of us struggled to create a way of life that would eliminate the causes of war.  During this time, we formed food co-ops, schools, community gardens, and some of us were drawn to birth.  I was working in Head Start and saw the harm of drug and alcohol use on the unborn child.  I saw the need for parenting to begin long before my four- year old classroom.   A co-worker asked if I would go to her teen age daughters birth classes and birth.  It was my very first birth and I sensed then that in that place I could find, for myself, the moment where heaven and earth touched.   After so much conflict from war, the civil rights movement and protest I felt a possibility of healing and peace.

I began my journey, as a midwife, slowly but without hesitation.   In Cambodia, a midwife told me she was woken by a dream that told her to go and help a neighbor in labor.  We are all perhaps, offered these dreams but it is often hard to get out of bed and follow them.

This is how it was for me, both as a midwife and as a mother.  Once I knew that children from the refugee camps needed homes and families there was really never any turning back.   Once I began to listen to the story of birth there was no choice but to listen.

While women in my country were making connections between war and corporate control over every part of our lives, the women in Vietnam and Cambodia were struggling to heal their communities and their families.   Over and over again the women and the midwives told me that it was not birth that killed them or their children but war and famine.  Most women had many children during this time and all, that I spoke with, lost several to starvation and a lack of basic medical care.  I was reminded over and over again how deeply war impacts women and children and their ability to survive and protect one another. 

In these stories, I try to capture the impact of war but also the resiliency and courage with which women preserved their families and their communities.   As the guide in My Lai said, “It is hard for your generation of Americans to come to Vietnam.”  It was often very painful and full of heartbreaking memories.  Coming face to face with the lasting harm of Agent Orange on newborns left me sobbing with embarrassed, powerless, pent up tears.

Years ago, I had stood in silent vigils  asking for the war to end.  It felt right, no matter how difficult, that I make this vigil and stand beside the women and midwives of Cambodia and Vietnam.  I tried to feel peace and to let my heart, so broken by the actions of my own much loved country, heal. 

I am forever thankful to my children’s families who fed me, introduced me to older midwives and helped me find my way from place to place.   For all the cups of tea, laughter and nights spent sleeping together I am grateful.  To all the midwives of the world who deliver each and every baby with a silent prayer for peace in their hearts.  For all women who deserve to give birth in peace and to raise their children with enough food, a free education, health care and a clean environment.  

A photo of my children who came from Cambodia and Vietnam as adults.

Blessings

Blessings

A much loved baby rests in Cambodia.  A knife is placed near the baby for good-luck.  When my grandsons were born in Los Angeles their Cambodian grandmother was sure to carry on this tradition when the twin boys came home from the hospital. 

The world over, communities create rituals, and prayers as well as taboos to protect the newborn.  This rose out of the low rate of survival for under five children ,world wide.   In my travels, most midwives and mothers reported that the baby usually survived birth but did not always survive the first days, weeks or months of life.  

My adopted son’s s mother had 14 children. They all were born alive and well but four did not live to be five years old.  In the absence of scientific understanding all cultures explained these deaths as a part of life, as a result of war and poverty or as the work of an evil force. 

Unable to control poverty and war or even sanitation and food supply it is understandable that most cultures turned to small things to assure the well being of the baby.

The Catholic Church, for many years, taught that newborns had to be christened quickly in case they died and would not be allowed in heaven.   

In Cambodia, special  branches are hung by the doors and windows.  Often a knife or pair of scissors are placed by the newborn.   Red strings, blessed by the monks are tied to the baby’s wrist.   They reflect the love the community and parents have for their newborn and are wonderful traditions within the community.  

This week old baby receives a loving kiss from his big brother.  The father is blind and cannot work but lovingly placed the traditional plants by all the doors and windows to protect his newborn son.   This also lets those passing by know that a new baby has been born.

All communities can continue the many small blessings and rituals for the newborn while gaining a deeper understanding of germs and human physiology.   They can be taught that mosquito nets and breastfeeding and the proper immunizations can prevent many deaths. 

They can bury the placenta by a special tree or spring to assure the baby’s love of the earth and bring the baby to the temple for a special blessing.   They can do all this while still coming to understand the dangers of dirty water and having too many babies too close together.  

Like all of us, are fears are caused by real events and by stories we hear from others.  We pass them down and create small rituals to keep us safe.  We hope that if we follow a specific path and do the exact right thing, we can be free of these unfortunate events that take our children prematurely and cause us great sorrow.  

Parents have prayed for thousands of years that their child be spared.   In time, we have learned that by protecting all children everywhere we best protect our own children.   We learn that when we plant a tree, we bless future generations of children for many years to come.  We learn that when we make huge profits at the expense of the environment that we put all children in danger, including those closest to us.  We learn that excessive wealth and privledge for our own children causes war and death and  mental illness which may come back to harm those we love.

I do not believe that there is an invisible evil force taking the lives of children but rather the everyday power of too much greed  in our life causes war, violence, floods and hunger.   I love the beautiful branches of flowers tucked into the walls of the houses in Cambodia and hope they never ever give that tradition up, even as we who can, offer blessings to the worlds babies through the thoughtful examination of our own life style and its impact on others.

Birth on the border

Nhan motions for me to get off the bus.  No one else is getting off,  The driver pulls my suitcase out and leaves it in the dirt.   Nhan pulls me and the suitcase to a bench.  I look around for anyone who might speak English to find out why I am here and where I am going.  

A van pulls up that has "Luxury Resort" painted on the side.  I am pulled and urged inside for a short ride to a hotel.  The van and the hotel do not quite match.  We walk up a set of stairs and pass open doors where young girls in sports t-shirts sit with older men.

My room looks out on an aging Casino.  A woman comes and sit son the bed.  She smiles, an excited toothless giggle.  She knows some English, she explains because she worked at the US Embassy in Saigo and was there when the helicopters took everyone.  They wanted to take her but she didn't go.

"Tomorrow you go to Vietnam.  Tonight Casino. "  Her English is limited but I am thankful."  Nhan hangs her clothes, takes a shower and put son a dress.  I consider that this is my new home.

The embassy woman leaves to go cook and Kim, a distant cousin arrives.  She is from Virginia and is to be my translator.

She takes me out on the road to a night market that sits amongst towers of large, modern Casinos.  The Cssinos are everywhere.   "Las Vegas."  she sweep her hand over the landscape with excitement.

I watch young women dressed for Casino work, fed their children at the market before going to work.

I sit near her, eating some fred bread with chilli sauce amongst the blinking lights of generators and motorcycles.

She had come to Cambodia from Vietnam with her sister.  They had walked on a path that a friedn had described to them; a way to cross the border without papers.  They were told there was work to do there. Their family could not feed them any longer and there were no marriage proposals in their poor hamlet.   They had hoped ot earn money and start a small business that would help their family to prosper.   Soon, after they arrived they began to ash the sheets and make beds.   They slept in a plastic tent with the other girls and saved their money in a pocket they sewed to their clothes.   Once in a while they snuck back across the border to give the money to their family.   Their mother as to save it for them.  One day when they had saved enough to start a business, they went home but when they got there the house was empty and no one knew where they had gone.  All their savings and their only family were gone.  They slept in the empty house but when the hunger was too much they walked back over the border and tried to get the old job back.  The boss said he needed a person to give massages and let them watch the other girls who did massage.   It was not hard.  Their grandmother had massaged them as children as they lay on the floor beside her fighting sleep.    The men were mostly Korean or japanese or Chinese and went to sleep.

In time the one sister went back to washing sheets and the other became a sought after massage worker.  Her boss said he loved her and in time she found herself with a baby growing inside her.  She tried many ways ot end this pregancy but they did not work.  The Mother of Buddh, visited her and told her to have the baby so she did.   She ate very little so she would not show but in time her boyfriend found out and beat her.   She had the baby in the plastic tents with her sister.  They did not dare to go the health center as they were Vietnamese and had no papers.   They had no home.  The baby ws born small and did not breathe.  She was grateful for this silence. She looked up a the the orange tarp.  It was just getting light.  There wold be no  baby after all. She had not killed it.  It simply never lived.  The afterbirth came and the girls offered her some tea adn washed the blood from her.  Maybe now her boyfriend would forgive and love her again. She would work even harder and sleep with the men who wanted her.  She would save.  Her sister and her would go back to Vietnam and start a business.  They would find their family.  But then the baby cried.  Her sister picked up the baby; a boy and handed him to her.  He looked up and then she knew she would always care for him.  Her sister sat beside her.  "Don't worry. I 'll work mornings and you can work at night.  We can raise him together."

The boss, who was the baby's father, had her checked for tears and when there were none set her back to work the next day.  The baby grew in the orange tent community on the border of Vietnam and Cambodia.  She holds his small hand and lets him pick out what he wants from the carts.  They are still saving but now he goes to a pre school and they pay for that.   "I am neither Vietnamese or Cambodian. All I am is my son's mother."  

She wipes his mouth and hurries him to eat.  "We have moved into a room so it is better.  We work hard and still hope to make a business.  I have to work now.  Bye - bye."

She leads him onto a path that leads to her room.  The cousin is impatient with me and hurries me.  Tomorrow we will be in Vietnam.  I stand and look at all the Casinos and all the girsl who have come to work there and no one cares what country it is. It belongs to the night.

Children form Vietnam and Cambodia

Nhan has come to pick me in Phnom Penh and take me to Ho Chi Minh City.  Neither of us speak each other's language though I suspect she understands more English than I do Vietnamese.  I have just returned from a workshop for the midwives at the Russian Friendship Hospital and am both tired and pleased.  

I am to go with Nhan ( sister number 5 ) on a tuck tuck to the bus that will take us to the border crossing.  At the hospital, I no longer tell anyone I am going to Vietnam.    The Rescue Party is uniting its followers around an anti-Vietnam platform.   I ask a young man what Vietnam looks like.  "Like Cambodia because it is Cambodia.  All of Vietnam belongs to Cambodia."   "Really." I ask.  "All of it."   He nods with certainty.

They tell me that thousands of Vietnamese are being told to come to Cambodia, to marry their women and to vote against the Rescue Party in the elections.

My Cambodian family offers Nhan some rice and chicken that she picks through. They stare at her.

The doctor says,  "Why would you give anything to Vietnam.  They already have enough. '

Nhan and I climb into the tuck-tuck as I wave good-bye to my daughtes family and begin life with my son's Vietnamese family.  At home, in Oregon, we are all one family with grandchildren who played together and loved each other since they were young.   In the schools of the United States they are Asian and few faculty take the time to distinguish between the borders of Southeast Asia.   They large Asian grocery stores sell anything Asian;  Chinese, Korean, Cambodian, Phillipino, Japanese, Cambodian.  The aisles are felled with customers of every race.

I do not see any signs of Vietnamese taking over Phnom Penh.   There are no signs, no schools or places to eat.  They say I cannot see them but a trained eye can.  They are everywhere and they vote for the party in power which is really a puppet government for Vietnam.

As we settle into our bus seats and I watch the city streets turn to rice fields, I feel like I am a traitor going into enemy territory.

My daughter's sister tells me life was worst under the Vietnamese than Phal Pot.  I squint my eyes in disbelief.  My daughter hesitates.  "Well, the killing stopped."  Later she explains that it is better to be killed by other Khmer people than be ruled by outsiders.

I suggest that no matter the past,  the Rescue Party might want to focus on some common goals than creating a common enemy.  I say it is never okay to call anyone a racial slur like the ones they use for Cambodians.

They say, "We know Vietnamese people. We like them. We just don't want them to live here."   I tell them that this is what people use to say about African-Ameicans in the United States.  They protest.  This is different.

"The Vietnamese took our land?"
"When?"
"I am not sure.  The kingdom of Funan."
"That was thousands of years ago."
"It is ours and the Rescue party will get it back."

"The Khmer Rogue slaughtered thousands of Vietnamese and the King killed the Vietnamese boat people."

"That isn't true."
"It seems like it was true.  I can read it everywhere."
"It isn't true.  The Vietnamese invaded Cambodia and stole everything.  Now they are rich and we are still poor."

I say, " I have children and great grandchildren from Vietnam and Cambodia and I have to spend time in both places.  It is never a good idea to raise a new generation to have a common enemy; a hisorical enemy.  No good ever comes of it."

They shake their heads.  Everything I read is a lie. I am being tricked.   With this is my mind I sit in a bus. I look around.  Wh is Vietnamese and who is Cambodian anyway.  The Chinese ruled Vietnam for over a thousand years and most everyone I know in Cambodia, is so proud to be Chinese.

I close my eyes and sleep.   I hear John Lennon sing. "Imagine theres no countries.  Its easy if you try."

Exploited young women

Child sex trade

 A midwife’s work is to help to safely welcome the newborn of every society and to assure, as best she can, the well  being of that child.  This baby, nested within its mother’s arms is held  by the family and community in layers of tradition, earth and well being.  To do this safely,  girls must be guided into puberty and child bearing with the deep respectt, love and protection of that society.  Each child must be of equal worth and each child helped to find their own best way to help and protect the community they live in.  Midwives, therefore, become natural protectors of young women and their right to choose partners who are healthy and committed to their growth and well -being.  Nowhere is this more violated than in the case of the child sex trade and prostitution.  This story is the collective story of several stories I have collected over time in many countries, including the city where I live in the United States. 

Currently it is estimated that there are 80,000 to 100,000 prostitutes in Cambodia with 17,000 of them in Phnom Penh. It is believed that 30% are under 18 with an estimate that there are over 5,000 child prostitutes in the country. 

For many men, having sex with a virgin or young girl, is believed to make them strong, successful in business and have greater health.  It is seem as an inevitable  part of society.  A young woman who is orphaned or left without a mother is at greater risk of ending up being sexually exploited.   It is the community midwife’s work to protect young girls from exploitation and to take away the many causes that may contribute to its existence.

I come from the countryside…..

It is dark at the health center.  We sleep in the patients beds in case a woman comes ready to give birth.   Our dreams are interrupted  by  loud  voices .  I rouse myself quickly and grab  pants and a flashlight.  Stumbling outside, I go to see who has come.  There is  a car and not a moto.  It is big, black Lexus; a car we see frequently in Phnom Penh but never out in the countryside. There is no gathering of sisters, mothers, and aunties who  accompany a woman in labor.   A man ,in a suit, opens the back door and motions for us  to look inside.

Crumpled  on the back seat is a very young girl lying in a pool of blood soaked sheets and rags.  She is still and makes no noise as I gently pick up her limp hand and feel her pulse.  The midwife asks the man questions and he answers nervously as he lights a cigarette.   Another man sits in the passenger side seat and does not get out.  He stares straight ahead into the sleeping countryside.

We tell them we must start an IV and give her medicine, even before, we try to move her.   He is pointing to his car and the blood and yelling at the midwife. I call for the translator. This is clearly not a husband or a miscarriage.  He motions for us to take her.  

As she is given fluids and oxytocin, the man tells me she is his maid and got pregnant.  He tells me she took a pill she bought at the market and started bleeding.   I say she is wearing pretty fancy clothes for a maid in the middle of the night.  Her nails are painted bright red.   I ask about the marks on her face and he sneers, “Maybe her boyfriend hit her.”  

I ask how old she is and he shrugs.  I ask how she came to be his maid. 

“Look, we bring them from the countryside and give them a place to live and more food than they have had in  their whole life.  We send money to their families each month.”

She opens her eyes and looks in my own.  It is too much work and she shuts them again. Gently we lift her off the smooth leather seats  and carry her to a bed.   We find water and rags to wash her, trying to be gentle where the blood has dried and stuck to  her skin. Outside the Lexus and the two men pull away and vanish into the night.

The midwife shakes her head, “They brought her all the way out here because the police in the city are watching them.  They have brought too many women to the hospitals there so they have to keep going further and further out.”

I hold her hand and put cool cloths on her forehead.  The midwife skillfully suctions the failed miscarriage from her so that she will stop bleeding.  

After the suction, we rub her utereus and the bleeding stops. The baby was over twelve weeks .  She tries to get up and go outside and find the men.

“They will beat me if I run away.”  She cries.  We tell her they left her and not to worry. 

We bring her fruit and some crackers we packed in our bag. Slowly she tells us her story. 

“I am the second daughter and was in school in my village.   My mother died after my little sister was born.  The family had no money for school and we were very poor. A man came and said he would take some girls to work in the clothing factories.”

“I did not want to go. I wanted to stay with my family.  I begged my father. I said I would work in the rice fields and not go to school. “

I ask what grade in school she was in and she answers,  “I was in seventh grade.  I was a good student.  I wanted to be a nurse.”

She says she believes she was twelve when she came and is now fourteen.  She has never seen her family again.  If she stops working there will be no money for them. 

Her pulse is becoming more regular and the bleeding has all but stopped.  

She begins to cry.   “They will tell my father I was a disgraceful daughter and ran away with a man.  My family will never accept me again.”

“You can stay here until while we figure something out.” I say as I stroke her forehead as my mother once did for me.

She shuts her eyes and sleeps.   The translator and I lie down beside her.  It is dark and the rooster crows.  There are crickets and the sound of small frogs.

When I wake up, the bed is empty. I ma afraid but  she is outside bathing by the large, clay water jug.  She looks up and smiles shyly.

I hurry her back to bed and go get her warm tea with sugar, banannas and later a bowl of warm noodles.    When I touch her back, I feel the bones of her back and she cringes.

“They said I would work in the factories but then they said there was no work and I stayed at the man’s house to clean.”

She looks down and straightens the sarong we have given her.

“One day the man brought me to a room and forced me to be with him.  I screamed and cried and he hit me many times. When he was done, another man came in. They did this for many days.  I cried and cried but they did not care.  They said I could never marry now and was ruined. “

Outside the monks are chanting in the temple.  It is the anniversary of the king’s death.  I ask.  “Wasn’t the king a supporter of the Khmer Rogue?” She does not answer.

Young, beautiful girls ride their bicycles to school.  I consider that  she was once one of those girls; a clean white shirt and blue skirt; laughing and talking with friends. 

When she recovers, we bring her to the guest house to help with small chores so she can eat and rest and feel safe.

We learn that she worked at a dance club but she will not tell us where.

“They will kill me.”

One day the big black Lexus returns and a man gets out of the car and asks at the health center for her.  I watch from the upstairs porch as another volunteer hides her.   He is screaming at the midwife who is shaking her head and I can see  her saying she does not know where she is.   We watch as the car stops at the chief’s house.   We hold our breaths. 

We sit, in the evening, peeling the small fruit of the logan tree; each one white and lovely like a pearl.

“Not all the men” she begins, “were unkind. Many were lonely and old and wanted someone to dance and talk with. They said their wives were not nice to them and they were sad.  Some were worried about their businesses or their children or the government.   They cried in our arms.  We all tried to get a rich man to favor us so that we would be treated better and our families would get more money.  I thought of my younger sister and hoped that she would have a better future for my sacrifice. This is how I survived.  “

“But what about diseases.  Didn’t you get STD’s?”

“We were given medicine every morning to prevent pregnancy and disease but sometimes it did not work.  Every night we washed the inside of our private parts with lemon and water.  Sometimes we were sent to health centers for a test.”

We were all quiet.  She was fourteen.  

“Once” she continues, “a group of people tried to come and get us but they found out and were waiting.  They shot at the people. Many were Barangs. I wondered why white men and women were coming to get us and I was afraid of them too.  We hid and did not run away with them.  Some girls left with them but I was afraid and did not.  They say they helped them but I was afraid and there was much shooting.  Later I thought it might have been better to be shot or take my chances with the Barangs. “

We light incense in the spirit house and leave a bunch of bananas.  She asks that we pray for her future and we do. The spirit house is connected to a small solar panel that lights the small house each night.  We stand and watch the twinkling lights; silent in our own prayers.

The next morning we hide her in the bottom of the car and the driver takes her to  to live in a temple.   We beg her to let us contact an NGo but she says it is better to live in a temple for awhile.  

After her abortion, the nurse throws the contents of the pan in the tall grass out behind the center.  The baby spirits visit the spirit houses looking for candy and small toys.   I had asked when they tried to explain this to me, “But who are the baby spirits.”

They shrug.  “Just babies who wander around looking for a little treat.  If you leave one they will protect your house.” 

I think of all the baby spirits and leave a small candy for the little gang of baby spirits roaming around together in the night.