Imagine instructing your mother in Haiti over the phone on how to deliver your cousin’s baby. In 2012, Winfred Tovar’s cousin, Rose Annette, not realizing she was pregnant, suffered a seizure and stroke while delivering twins in her home. Rose Annette believed that she was menopausal and consequently was unaware that her ill symptoms correlated to an unplanned twin pregnancy. Following the delivery, Winfred could hear the agony in his cousin’s voice as she suffered a postpartum hemorrhage. The excessive bleeding was increasingly worrisome and he knew her life was at risk.
This experience taught Winfred Tovar, M.D, an important lesson: in the developing world, maternal mortality remains unacceptably high. Expectant mothers in poorer communities experience high-risk pregnancies due to the lack of resources and are in jeopardy of suffering hazardous complications during and following pregnancy and childbirth. Statistics show that 99% of all complications result from lack of prenatal care, often because the ratio of patients to doctors in third-world countries is so high that most women choose to stay home instead of visiting a hospital or a clinic. Consequently, 75-80% of women defer to untrained individuals for home births with no knowledge of underlying complications that may kill them.
A former attending physician at St. Barnabas Hospital in NYC, Winfred’s close connection to his mother, strong belief in female empowerment, and desire to invest in humanitarian medicine has inspired him to launch and serve as Executive Director of Mimsi International (Modification In Mother-Baby Mortality Statistics Initiative). Mimsi, a nonprofit organization, is a community-powered organization that provides training and pregnancy care to women in remote, rural areas of the developing world via mobile technology.
The Mimsi process sets up mobile clinics, so that community volunteers can enter the home of the expectant mother with the materials needed to transform the patient’s home into a clinic. Mimsi trains young women and men to enter one of three programs: a two-year Pregnancy Care Provider Program to master prenatal care for members of the inner Haitian community, a one-year Ultrasound Provider Training Program or a one-year Postpartum Care Provider Program. The objective of these programs is to provide didactic and hands-on education to members living in disenfranchised, rural areas of Haiti and to transform these underserved areas into fully functioning clinic spaces to serve patients. Volunteers are trained to weigh the pregnant mother; to measure her vitals and blood pressure; to measure fundal height and fetal heart rate; to perform obstetrical ultra-sounds to establish due dates and evaluate the baby’s development; and to engage in preventative measures such as screening for STDs that could adversely affect both the mother and baby.
When the members enter the patient’s home, they input all the information about the mother’s vitals into a prenatal mobile application, which is then uploaded to the Cloud and returns with possible diagnoses. In cases where a woman receives a critical diagnosis suggesting she is at high risk of a complication, a community volunteer will accompany her to a nearby hospital to seek medical care. Women in labor or with complications receive assistance in paying hospitalization fees and in obtaining free medication and medical supplies. Expectant and new mothers are also provided social services and support in collecting clothes, linens, sanitary items, and newborn articles for their new family.
When Winfred started Mimsi, he felt inclined to pay homage to his family and beloved Haiti. Currently, Haiti has the highest maternal mortality rate in the Western Hemisphere. Every 20 minutes, a woman dies from childbirth in Haiti, a statistic that captures the grave nature of maternal mortality. According to estimates by United Nations Population Fund (UNFPA), a woman over her lifetime in Haiti has a one in 83 chance of dying due to pregnancy or childbirth, compared to a region-wide risk of 1 in 510. Poverty, flawed healthcare infrastructure, and lack of access and education are among the biggest contributing factors to this tragic statistic. Winfred aspires to convert the economically depressed villages into facilities that will ensure safe deliveries and available care to expectant mothers. As a result of Mimsi’s objectives and widespread presence in over 60 rural villages in Southern Haiti, the maternal mortality rate has decreased to 1 in 1,300. The mission continues to increase services with the ultimate goal to decrease and—hopefully one day—eliminate maternal mortality rates.