Things are quieter than they were. The annual peak is over.

Things are quieter than they were. The annual peak is over.

It's said that the peak occurs nine months after Carnaval. A few weeks ago, we did the rough estimate with the pregnancy wheel (which calculates expected date of delivery): start 14 days before late February to count the women who were ovulating during Carnaval, and the due date indeed lands on mid-November 2008.

Also, I'm told that it's quieter because many people have left Port-au-Prince to visit family for the holidays, dans les provences.

Still, my estimate is that we're doing about 30 deliveries a day, rather than the 50 or more that we did in October.

Yesterday, I happened in the courtyard just after a woman had been brought in with hypotension after having delivered at home; a presumed post-partum hemorrhage. I found another woman sitting up against a garbage bin, in a puddle of blood and, at her side, one of the chauffeurs for the ambulance holding the baby, still attached by the umbilical cord. I turned on my heel to get the necessary things and people but, as I did, one of the midwives came out with the instruments she needed.

Yes, the chauffeur was wearing gloves. There's always a box on the dashboard of the ambulance.

A few days later, the same chauffeur took us to the beach. (We are not allowed to drive ourselves) I remarked that I had noticed that he 'did' the delivery.

"J'ai l'habitude," he said. (I'm used to it.)

Turns out that this was about number six or seven, since he started working with MSF. He's lost count.

We are all told before starting that flexibility is one of the key properties you need to work with MSF. Our local staff also have a clause written into their job descriptions that says something like, they might find themselves doing pretty much anything, depending on necessity.

Let me add that driving in Port-au-Prince is also an extremely skilled task. Different than delivering babies, of course. Roads here are generally unpaved, sinuous, without drainage and so subject to much erosion. The hills rival San Francisco. One of the most impressive turns between the house and the hospital consists of a gravel road on a steep incline, that after cautiously descending, requires a 90 degree turn into a road, only just wide enough for the Land Cruiser to pass, bordered by a cement wall. The corner is blind, so when coming home from the hospital, we have to build up speed in the alleyway, honk to warn other traffic, turn the blind corner, and gun it to make it up the hill. Four-wheel drive is essential.