Introduction to the Second Emergency Skills Workshop, Lviv, Ukraine

September 23, 2022

(Written from Memory after it was given(because Viktoriya said, “We should have taped that.”)

I am very humbled by being in your presence and witnessing the trauma that is going on here in your country. I have been thinking about what our psychologist, Gertrude asked you all to do in the exercise carried out tonight. You were asked to draw on the piece of paper she handed to each of you, what you really value, and then cut out what you have kept in spite of the war, while leaving behind as scrap what you have lost as a result of the war.

For my way of thinking, I think what we have all lost is a feeling of innocence. We know that the war is real; we can no longer pretend that the evil is not here and acting out. I have heard from women from Bucha that even as they could hear the tanks rolling towards them, even as some entered their town, they were still in denial that this was really happening.

I worked in Belize, in Central America, that was hit by a hurricane a few weeks after my first baby was born there. I have experienced being in an earthquake in Guatemala in 1976 in which all the houses in our village were flattened. I have worked in Nicaragua after the Sandinistas took over from Samosa in 1987, when traditional midwives were being killed as they went to births in the middle of the night--tactics to scare the local population. I have worked at the border of Afghanistan and Pakistan in the Afghan refugee camps, prior to the existence of the Taliban. And I worked in Afghanistan after the Taliban had entered the country.  

But I have never been quite so affected by a disaster or war as the one in Ukraine.

It may be that this war affects me more because my maternal grandparents were Ukrainian, living at the border of Poland  and Ukraine. (We believe from DNA testing that our family came from Ivano-Frankivsk.)

It may just be that as I get older, rather than being desensitized, I have become more sensitive. But I think as well, this war seems so utterly pointless-- not that any of them are-- but this one seems to be under a particularly bad pretence –that Ukrainianswant the war, to be made “free” by Russians. When I know nobody in this room has bought that.

My husband constantly asks me,

“Why do you always want to go off to a place that is at war? Can’t you find some other nicer country? The rest of the world will always be there for you to ‘save.’”

I tell him,

“Because war does something to people. It changes everybody’s categories, breaks down the hierarchies in society and among the professions. It upsets the apple carts. People can see more clearly about what is important to their lives.”

Still, I did not come to Ukraine planning to do what we have done over the last week with the first group and what we will do with you this week.  I originally just came to Ukraine to see where my grandparents lived and great grandparents and lineage were from. I don’t know how many of you know that by the 2016 consensus, there were more people of Ukrainian heritage living in Canada than in any other country in the world with the exception of Russia and Ukraine.

I didn’t know a soul when I arrived in Krakow, nor anybody when I first entered Ukraine. I suddenly found myself meeting Viktoriya, a mother from a human rights’ group who found out about me from Dr. Maximo (Italian pediatrician) and had had her baby at home. I met Alona, a psychologist, who had been dealing with some very sad experiences near Kiyv after the Russians moved in. We met with a pediatrician, two doulas who were also cranial sacral therapists, then a lactation consultant.

Everybody I was meeting seemed to have this same sense that there were changes going on in the way people in Ukraine think about everything, including how to give birth. As we walked and lunched together in Lviv in May, there was high anticipation that we could be part of that change. Many of the women at those first meetings were returning to Ukraine for the first time since they had fled after the eventful days of the start of the warin February and early March. Because of my ancestry, although I had never been to Ukraine in my life, I too felt in an odd waythat I was returning. 

I have been asked what I will present over the next few days in our “Emergency Skills Workshop.” I will present on postpartum hemorrhage, shoulder dystocia, prolapsed cord, undiagnosed twins and vaginal breeches in the upright position, as they are now happening in Frankfurt, Germany and my own home town. I will talk about home birth and how to prepare to do a birth anywhere—in a bomb shelter, on the bank of a river, or in a woman’s basement. 

But it is clear that these workshops have become much more. You will all get to know each other well during the next four days. You will be eating and sleeping here altogether, sharing what you do in your respective hospitals and what you see as inevitable need for revision of protocols. You will be learning not just about emergency skills but about a potential systems change in Ukraine.

If you keep an open mind, it is just possible that some of your prejudices you had about people representing certain groups here will fall away. (There are doulas and some midwives who may have done home births among us.) Some assumptions you had about place of birth and how to treat certain situations may change. I will be sharing a great deal about how we set up a midwifery system in Canada. As many of you may have seen if you were on the zoom calls, Canada had no legal midwifery system until 30 years ago, so we went shopping to find the best system for women, and I will share how we did that. 

By the end of the four days, we hope we will become more united and you will return refreshed in spite of the war, ready to fight on the front for every woman’s right to appropriate technology but also a humane birth.

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