Delivering Babies In Rwanda

In 1994, an estimated 250,000 women were raped in Rwanda, part of a deliberate genocide; in many cases, HIV-infected Hutu men raped Tutsi women, often announcing to the rape victim that she would pass the disease on to any resulting children and that both would die a slow death. Three years ago, a friend who is a pediatric AIDS physician told us about his work in Rwanda, helping develop medical protocols for the children of HIV-positive women.

My family found an eerie echo of Jewish history in this sub-Saharan African version of genocide; this time, we — individually, and as North Americans, and as Jews — were the bystanders who were silent while one million died. So for the past two summers my family has spent three weeks in Rwanda, working on health care projects.

I am a midwife with more than 20 years of clinical experience in hospitals, homes and birth centers. A not-for-profit organization hoping to improve maternity care for women and children with HIV/AIDS near the capital, Kigali, invited me to work with Rwandan midwives, and offer my assessment and advice. The decision was really made for me when our 22-year-old daughter declared, “Come on, Mom — we’ll be like Shifrah and Puah,” the midwives we read about in the Passover narrative who save newborn Jewish boys from death at the Pharaoh’s hands.

Rwanda has one of the worst maternal mortality rates in the world. I was impressed by the courage, dedication and skill of both the professionals and the childbearing women themselves, where conditions challenge adequate care. At Muhima Hospital in Kigali, the busiest maternity hospital in Rwanda, the obstetric and midwifery staff deliver approximately 40 babies a day — that’s more than 12,000 babies a year — yet the labor ward has only four beds! Two or three laboring women share each bed, while other women walk around, kneel or squat while they labor.

In addition to reflecting on a shared history of genocide, we did other Jewish learning in Rwanda. Reading Jewish texts and davening in a poor, pre-modern, vulnerable society led us to read some of our familiar texts in a more literal way. Praying for the blessing of a good year in which we are sated by the good of the land is no metaphor in a land of subsistence agriculture. Praying for the restitution of judges, justice and law is no metaphor in a country where the legal system has collapsed, and where almost five percent of the population stands charged with genocidal acts. It made us think of our rabbis, who wrote these prayers not only as poets but also as social commentators and spiritual activists. Their words reflect the social needs of their day and should inspire us to see and address the social needs of our own time.

Adapted from The Canadian Jewish News, Sept 12, 2007.