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A Planet Of Pain, Where No Words Are Quite Right

Tuesday, October 21st, 2008 AddThis Social Bookmark Button

There are no pink ribbons to wear if you’ve had a miscarriage, no walkathons or T-shirts to encourage awareness and prevention. And to the extent that we have a language to talk about miscarriage, it’s full of airy platitudes: “Don’t worry, I had one once, too,” or “I had two, and then — poof — Davey was born, and he’s graduating from college this week.”

But until you belong to the imaginary club of Mothers Without Children, it is a secret planet of pain, all but invisible to the outside world.

I recently had my third miscarriage in a year. It happened early in the pregnancy, and it was dismissed as no big deal — “chemical pregnancy” seems to be the term of art. Let’s not overreact, no need for hysterics, keep moving. “We’ll treat it as though you’re just getting your period,” as my doctor put it.

But honestly, it is not just like getting your period. Psychologically, of course, it is nothing like it, but physically it is different, too. I had cramps for hours that left my ribs feeling bruised, and then four days later I was back at work and exhausted because I was still bleeding a lot — not an alarming amount, but enough to make me schedule meetings in rooms near bathrooms, and to send me home in the afternoon for a two-hour nap. I wonder how men would cope. All of the pain, mess, furtive tidying-up, shame and soldiering-on seem so fundamentally female to me.

People act as if a miscarriage were a locatable event on a calendar, with a beginning, a middle and an end. But in fact it starts when you feel that first unmistakable twinge that something is totally wrong. It continues through the rough days of sorrow and deep cramps, and then it meanders through every single day of the rest of your whole stupid life. I will probably mourn about this miscarriage in some outwardly unremarkable way until I either have a healthy baby or die.

Talking about miscarriages is so loaded and pitiful and hushed and fraught with meaning about age and usefulness. It feels as though having three miscarriages in a year means I did something wrong, when the reality is that most miscarriages take place for chromosomal reasons out of our control.

Yet a woman who has had a miscarriage has likely asked herself why. “God must not want me to have a kid,” she might think, or “I am too old.” There are moments when you can feel that the miscarriage and the calamities of the world are your own doing and you should have somehow known better.

Maybe we don’t talk about our miscarriages because we don’t want women with children looking at us with pity, or teenagers in their immortality-flushed way thinking, “That’ll never happen to me.” We do not want happy families to whisper, “Thank God that’s not us.” We don’t want to wonder if men are thinking, “If they can’t have kids, then why are they here, anyway?”

I cannot tell you, though, what you should say to women who have had miscarriages. While it can be touching to hear other women’s stories, it can also be irritating: it makes our moment of extraordinary sadness feel ordinary and unremarkable. Why would I want to hear about your miscarriage when I am lying on the floor trying to lift 500 pounds of failure, disappointment and crashing hormones off my chest?

I can tell you that I want people to know. I don’t want it to be a secret or a shadow or something that is endured only alone. I want people to know that I have been through something, that I am tired but optimistic, that I’ve been knocked down but don’t help me up because I can get up myself.

It’s fair, I think, to want witnesses for our suffering. But with the sorrow also comes hope. And after all, we are resilient creatures. A friend of mine said it well in an e-mail message after she heard my news. “I hope you don’t give up,” she wrote. “I want to take a picture of your child one day against the tallest sunflower.”

Source — The New York Times

Lesson From Ike: Cuba Gets Evacuations Right

Thursday, September 11th, 2008 AddThis Social Bookmark Button

HAVANA, Cuba - When Hurricane Ike struck Cuba, Ronald Matos didn’t think twice about fleeing his one-room wooden house for a government shelter.

The 34-year-old construction worker and his wife, Emma Jean, got soft beds, free meals, the attention of a doctor and solicitous social workers — and the companionship of other friendly Cubans.

“We passed the night talking and telling stories, because Cubans never lose their smiles or their sense of humor,” he said. “There is no electricity, but we are better protected than in our homes.”

With an inefficient centralized economy and a U.S. embargo that has stifled trade, Cuba doesn’t have resources to build new, hurricane-proof buildings. It doesn’t have fleets of Humvees to charge through the floodwaters. Few of its people have cars to flee in, and fewer still can check on loved ones by cellphone.

But if there’s one thing the communist island does right, it’s evacuations. And in the end, that saves more lives than anything else.

Diplomat: A lot the U.S. can learn

Cuba sees more than its share of killer hurricanes, and yet in the past decade only 22 Cubans have been killed by them.

When Hurricane Gustav roared across western Cuba as a Category-4 hurricane on Aug. 30, it damaged 100,000 homes and caused billions of dollars in damage. Nobody died. The storm then moved onto Louisiana, which launched a massive evacuation and saw 26 people die.

The death toll from Hurricane Ike this week was shockingly high by Cuban standards: four. This, for a giant storm that tore across the length of the island, flattening houses in its path. Compare that with Haiti, which took glancing blows from Hanna and Ike and saw hundreds die.

The secret is the evacuations system. A quarter-million Cubans evacuated during Gustav, and the number for Ike was a staggering 2.6 million — nearly a quarter of the island’s population. Most of the evacuees found family or friends to stay with, but nearly 400,000 were housed in 2,300 government shelters.

“We clearly cannot simply mimic their system, but I think there is a lot the United States can learn from Cuba’s hurricane response system,” said Wayne Smith, the former U.S. top diplomat in Havana. “They have a whole system of alerts that keep people clued in and we don’t have anything like that.”

He spoke by telephone from Mobile, Ala., where he was talking to preparedness experts about Cuba’s disaster response model.

A lesson in preparedness

Cuba’s evacuations differ greatly from those in the United States, where people rush to airports for overbooked flights or pile into cars that clog highways. In Cuba, people are already prepared, part of a sophisticated system overseen by the president and the armed forces.

Standing evacuation plans are distributed to each household long ahead of time, and evacuation drills are held regularly. When a hurricane is approaching, state news media issue early warnings and civil-defense officials activate local response networks, organized down to each block of each town.

Schools and other government buildings are quickly turned into shelters, and each is assigned a doctor and sometimes a nurse. Volunteers check stocks of blankets, water and food. Forty-eight hours before an expected hit, residents are told to prepare to evacuate.

When the storm is a day away, volunteer civil-defense workers go door-to-door to ensure everyone gets out of harm’s way. Government buses, cars and trucks transport evacuees to higher ground. Government shelters take in anyone who can’t find a place to stay.

Of course, this is easier done in Cuba than in the United States because the communist government owns and controls most of the nation’s resources. Unlike the U.S. Federal Emergency Management Agency, it doesn’t have to buy supplies or contract services from private companies, or pay overtime.

Most Cubans work for the government and don’t have to worry about losing wages if they take off from work. And because police keep a close eye on evacuated areas — and because most Cubans have few possessions of value anyway — looting isn’t a major concern.

Cubans are taught from an early age to move quickly in the event of a natural disaster and to follow authorities’ instructions. So the government rarely has to force people to leave.

The only people for whom evacuations are mandatory are pregnant women and mothers with young children, who can be fined if they don’t comply.

When Ike approached, Anay Estrada was reluctant to leave the single room she shares with six others. But as she is seven months pregnant, two police officers showed up at her door.

“I didn’t want to leave my mother,” Estrada said from a shelter at a maternity hospital, where she waited out the storm with her 7-year-old daughter, Melani. “But they came in a patrol car so I had to go.”

In addition, special attention is paid to the elderly and handicapped — people who critics say U.S. authorities abandoned when Hurricane Katrina ravaged New Orleans three years ago. Several hundred elderly and handicapped people and their companions waited out Ike in an Old Havana convent, a white, bouganvilla-covered structure with an imposing bell tower.

Good track record

Part of the reason people are so obedient is that the government has a good track record of predicting what storms will be dangerous.

“By predicting hurricanes accurately almost all of the time, (Cuban) meteorologists have engendered the public’s trust,” said Jane Griffiths of Center for International Policy, a Washington think tank. “That’s why people voluntarily respond to evacuation orders.”

And if anyone has doubts, authorities quickly put an end to them. The state news media often makes examples of people who fail to move out — and who are killed or injured.

On Tuesday, an elderly man was trapped under the rubble of his evacuated Havana apartment building when he returned home before the building was inspected for safety.

“Unfortunately, there was irresponsibility in this case,” said Lt. Col. Rolando Menendez, a firefighter overseeing rescue efforts. “But in general, the population is following civil defense measures well.”

Source — MSNBC