Katherine Bramhall: Vermont Midwife of Global Humanitarianism

By Michelle A.L. Singer

Katherine Bramhall runs her own international disaster relief organization, works as a midwife, travels from Vermont to Bali twice a year to provide midwifery services to women who have no access to them, launches successful campaigns to supply families with much-needed resources, raises large amounts of money on behalf of those who need it, and meets the suffering of the world head-on. You, like others who meet her, might be tempted to think of her as a "legend." But Bramhall knows better.

"In [today's] culture, you can't just be someone doing good work," she explains. "You have to be a 'legend' for people to pay attention." Compared to those of so many of us, Bramhall's efforts do seem superhuman. "But," she cautions, "that [description] doesn't recognize the truth of the work I do: that it takes every person, no matter the role they play, to make what I do possible."

Bramhall worked for 20 years in the Boston area as a holistic health care practitioner and doula, then returned to school to train at the Birthwise Midwifery School in Maine. Recently graduated, she is now practicing as a midwife apprentice and doula with Erin Ryan, licensed midwife, in Barre, where she moved in 2004.

Bramhall also started her own disaster relief organization which responded to the 2003 earthquake in Bam, Iran, the 2005 earthquake in Pakistan, as well as the Chechnyan crisis in Russia - and currently addresses the health care needs of women and families in Indonesia affected not only by the 2004 tsunami, but also the terrorist bombings that crushed the tourism industry in 2002 and 2005. "Additionally, my husband and I are beginning the plans for a youth center in Barre that will offer young folks an opportunity to work on humanitarian projects-sewing baby blankets to send to the clinic and emailing with youths in Bali to help them learn English," Bramhall says. "This youth center will be linked with the youth center in Nyuh Kuning Village in Bali."

Bramhall is currently focusing much of her considerable energy on creating sustainable support for the Yayasan Bumi Sehat Free Birth Clinic, also in Nyuh Kuning Village, run by award-winning midwife Robin Lim, author of After the Baby's Birth. The non-profit organization has another clinic in Aceh, Indonesia - Ground Zero for the tsunami. "The tsunami is considered 'over' by the world, unless you live in Aceh and need good-quality care," says Bramhall. She notes that maternal mortality rates in Bali are currently 373 deaths per 100,000, compared to 12 per 100,000 in the U.S. Postpartum hemorrhaging, largely due to malnutrition, is a constant concern.

Bramhall's work in Bali is a labor of enormous love, both in the scope of care she offers and the magnitude of need. The Yayasan Bumi Sehat clinic provides free pre-natal care, vitamins, and support to women and families. When it is time to give birth, the women receive expert care, blankets, hats, and medical support for free. Bramhall travels there at least twice a year, usually laden with bags of medical supplies and donations. "By returning to the same village, I'm woven into the fabric of village life and that helps me more effectively see their specific needs and how I might meet them," says Bramhall. "The best part for me is how large my 'family' is becoming."

Bramhall has secured ongoing donations of pre-natal vitamins from Brattleboro-based New Chapter Vitamins for the clinic, which serves 40 to 50 birthing women per month. She has also raised money for much-needed supplies, including a clothes dryer for the piles of towels and sheets they go through, and a new computer to keep up on paperwork.

Bramhall has thrown her entire heart behind supporting the people of Nyuh Kuning Village, and her work there. Her policy - and a probable reason for her far-reaching success - is to stay in email contact with everyone who donates their time, materials, or money. "So many people are starving to help with the suffering that they see - whether it be in their home, their neighborhood, their nation, or places they don't even know how to find on a map," she marvels. "People are seeking a 'link-up' to the actual and direct effect of their giving. For me, this is the most important thing I can do - link people up. I'm only one person and my scope of influence will never be large enough to affect change as large as it's needed, no matter how hard and long I work."

Bramhall uses her lengthy international email list to keep givers informed of the work she is doing, which they directly support [see info below]. "I carry every single person's generous heart and their donation of time, money, [and] supplies with me. I am just the person who gets on the plane and delivers. What I deliver is an army of loving and connected help. I then put each person's generosity to work. By emailing home, I hook people up to what they have done so they have the direct experience of how helping is fulfilling a heart's need - both theirs and the recipient of their love."

Bramhall's current goal is to raise $100,000 for Yayasan Bumi Sehat to help with the purchase of land in Bali for a permanent location for the clinic.

"The clinic is at a pivotal place in its growth and development," explains Bramhall. "Growing pains are felt daily due to lack of clinic space, cramped staff and volunteer housing, and structural damage, because it is not an earthquake-proof building."

Bramhall will return to Bali in February. She invites people to join her email list and help collect funds and much-needed supplies. In this season of giving, Bramhall is one woman who "breaks the bank" of giving. And it makes a difference. "It takes every small and large donation, literally every single person who offers whatever it is they can, to create this web of people who, together, can touch human suffering in this world. In fact," Bramhall adds, "it's the only way."

To learn more about the clinic, visit www.bumisehatbali.org. You can also reach Katherine Bramhall at katherine@gentlelanding.com to join her mailing list, send donations, and inquire about midwifery services or the next phase of work for Bramhall and Robin Lim in Indonesia.

Michelle A.L. Singer is a freelance journalist living in East Montpelier who has had the good fortune to meet many "legends" in her line of work.

Diary of a "Legend"

During Katherine Bramhall's most recent trip to Bali, from August 26 to September 26, 2007, she sent regular emails to a list of 100 people all over the world. This is an abbreviated collection of those emails, a record of her trip.

Friday, August 31, 2007

Friends: I'm in Indonesia. After three hours of sleep following a 30-hour trip here, was called to the birth of a little girl...meeting with Robin Lim (director of the clinic) for four hours immediately following the birth (at 5:30 a.m. over "breakfast"). She is thrilled w/ the donation of almost 200 baby blankets, the vitamins, dopplers, stethoscopes, med supplies, etc.

Turns out that during the birth that night someone had to go iron a towel in order to dry it so that the mom could have a dry towel after birth...the clothes dryer is totally dead and they do 35-50 births/month. The clothes dryer that a businessman in Vermont donated... is desperately needed and so the clinic is thrilled! Even I didn't know how desperate the dryer situation was.

Napped from 6:30 to 9:30 pm and got called to another birth. Five hours... beautiful little boy. Mom did well, but bled postpartum of course. Almost all of them do. While suturing, what you notice is that instead of the classic tears that you see in US, the tissue sort of blows apart, instead of tears. So it's more like suturing hamburger.

Sunday, September 2: The perfect afternoon

Came home from setting-up-house errands to rest because sleep has been pretty hard for the last week. Phone rang after one hour... Robin calling. First-time mom arrived at Bumi Sehat-never been here before-in full labor. She was six centimeters, so Robin and I agreed there was time before I head over.

Twenty-five minutes later a woman from the clinic came running over to get me... come NOW. I bolted across to clinic, tying my hair up as I ran, got into the room-there was baby crowning. I grabbed some gloves and R said, "Come catch this baby." In Indonesia, because of the malnutrition, women's tissues are so weak that just having a baby, no matter how well she is supported during the birth, her tissues will tear and massive postpartum hemorrhage is expected. As a result, for each birth here, they use four hands: two to support mom's tissue (top and bottom) and someone to actually guide baby out in whatever way necessary.

Robin supported tissue during a long crowning of baby in the bag of water. Her tissue stretched so softly with that water bag. Then out came baby's head...in the bag of water (in the caul). Four sets of hands trying to puncture this bag... so strong and healthy. Ibu Agung finally got it. Over baby's head, wiping her sweet face... such a delicate little face. Then her sweet body surrounded by four wondrous birth attendants. No bleeding! No tears! That is an event here.

This mom had never been seen at Bumi Sehat. She just showed up in labor. They had gone to hospital and were told that if they couldn't pay, got to Bumi Sehat. Lucky them!!! Lucky us!!!

This couple showed up with nothing. They had no blankets, sarongs, baby clothes, hats... nothing. They went home the next day with blankets, hats, clothes and vitamins from my suitcases.

Monday, September 3: a poignant day

Back to clinic to meet with some tourist/visitors/potential donors... three of them. One Australian, one Swiss, one American. As it was pediatric clinic day also, the clinic was quite chaotic. But it was amazing to see Robin float into the cacophony and touch each surface in a truly effective and personal way. Two hours later we lost a baby in hospital. 31 weeks, chromosomal defect. Cesarean. Robin held baby until mom came from surgery... "I sang him every song I knew." Baby lived long enough to hear his mother's voice say, "I love you. It's ok."

Thursday Night, September 6

A really hard 2 days. An all night birth Tuesday night that ended in a transport after five hours of pushing. Mom and baby doing fine... Hindu woman was told by the Christians to leave her village immediately because she is pregnant out of wedlock. If not immediately, she would be stoned to death. She arrived at Bumi Sehat today and we are de-traumatizing her, hoping... What? Hard to know. For today, just as soft a landing that you can offer in a situation like this.

Saturday Night, September 8

It's a poetic night in the village after prenatals. We do prenatals on Tuesday, Thursday and Saturday evenings from 5-8 p.m. and see between 30-40 women a session. There are two midwives and two assistants. Prenatal visits look very different than in US, but the women here are so very grateful to have care during pregnancy. They come in with worried and hopeful looks on their faces much of the time. This is a "caring" that is truly unique in their reality.

Worked with Eka for hours on donation receipts, sample bottles of vitamins for the Indonesian Health Ministry, waybills, etc, etc, etc. All this just to be able to feed women. She just returned from a trip to Aceh. Essentially nothing has changed there since January. She kept referring to the continued suffering and poverty. Eka had been aching to talk about her experience there. I just listened. We both cried as we spoke of our shared experience. The thing is, even the people in Bali can't figure out why things are still so bad there. I say it over and over...it's HARD to imagine if you haven't been there. Because a disaster of that magnitude is the definition of unimaginable.

Tuesday, September 11: only tears

Five minutes after waking up, a woman walked into the compound and called for Robin. Work here is 24 hours.

We both came out. This woman is a third wife (I forgot her name) and was returning to Robin for help. Her husband beat her so badly a few weeks ago that her right eye now needs to be removed and Robin has arranged to get her an operation so she can look normal and not lose her other eye.

The situation is even more complicated.

She was born almost deaf, so with sight in only one eye, limited communication b/c of her hearing problem and perfectly traumatized by repeated beatings... Finally, enough translation gets done and the woman agrees to go get an operation. The ramifications of her NOT getting the operation are too gruesome for even me to want to know.

One step at a time.

I never cry in these situations. I look for help. I make things happen. This morning all I can do is cry.

Wednesday, September 18: an endless day

I just returned from an emergency homebirth of third baby in Sanur. Walked through an alley...rice field on one side. Came upon a building that in America would only be considered sufficient as a wood shed. A new baby's new home...outside of the relative comfort of a malnourished mom. Most dogs in America live better than this baby will. We moved directly from there to re-arranging the Ashram for the mom I wrote about earlier who was told to leave her village so as not to be stoned to death for being pregnant with a Christian man. She arrived with baby and sister and Kelly. Ida, Robin and I settled them in to a new and very, very strange place. This is what a refugee looks like.

Thursday, September 26: leaving Indonesia

Beloved friends,
Tonight I leave Bali, the clinic, the people here who I love and who love me so tenderly. A story that Robin and I reference often: There was a man walking on a beach and he came upon tens of thousands of starfish washed up by the water onto the sand. He began picking them up one by one and tossing them back into the ocean. Someone walked up to him and said, "Why do you bother? You'll never be able to help them all." The man picked up the next starfish, tossed it into the ocean and said, "But I helped this one. And this one, and this one..."

I am grateful for your help and love,
Katherine