Midwife Robin Lim Ministers to Tsunami-Born Children in Bali

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Midwife Robin Lim helps tsunami survivors at her clinic in Sama Tigeh, Aceh.

IT’s BEDTIME FOR ME AND  lunchtime the next day for Robin Lim, but her liveliness crosses 14 time zones, from a birth room in Bali to my bedroom in Iowa, linking two friends halfway around the world.

“I’ve been up for five nights in a row catching babies,” Robin tells me. “And now I’m sitting with another woman who’s gone into labor.” Ibu (“Mother”) Robin is on call 24/7 as a volunteer midwife in Indonesia.

“How do you do it?” I ask.

“It’s not that hard for me. I have my staff and family to help me.”

Like the “herald of spring,” Robin spreads cheer wherever she goes. She combines a midwife’s sharp senses with a poet’s sensibility and a compassionate heart. Robin keeps several “broods” under her wings, her family of ten, extended family in the Philippines and U.S., friends in many countries, her staff, and all the mothers and children she helped bring into the world. A migratory bird with a “winter home” in Iowa and a “summer home” in Bali, Robin has begun flying back and forth to Aceh, the region on the northern tip of Sumatra hardest hit by the tsunami of December 26, 2004, spreading new growth to this devastated land. During her first visit in February 2005 to set up a clinic for tsunami survivors, Robin wrote several poems. From “Notes Taken Flying Low and Slow on a Red Cross Plane”:

Sarjani’s six-year-old daughter was torn from her arms.
All the mothers repeat and repeat the story of not holding onto the baby.
A water buffalo offered her horn
and swam to the surface, an old cow
dragging a pregnant woman skyward
to leave her by the roof of the Masjid.
She gave birth that evening, right on the
roof of that mosque.
Seventy people found refuge there.
Imagine that one would be a birthing woman,
another a midwife.
When the water receded, they lowered
the baby down
in a black plastic bag.

Like Walt Whitman, Robin has the gift of connecting her heart with her hands and voice to rise above catastrophe.

Robin’s family lived in Fairfield for many years. Daughter Deja is an Maharishi University of Management graduate and daughter Zhouie is currently a student at the University of Iowa. In addition to receiving babies, Robin found time to write a guide for postpartum women, a cookbook for pregnant and breastfeeding mothers, and two collections of poems.

Newborns in Bali
Two years ago the family returned to Bali, where Robin had founded a clinic in 1994 in the village of Nyuh Kuning. Yayasan Ibu Bumi Sehat (Healthy Mother Earth Foundation) is a much-needed free clinic, especially since many people lost their jobs after the Bali terrorist bombings in 2002. Hospitals will not release a newborn baby until the bill is paid.

Robin always takes time to share emails with her family all around the world. In one, she says she spent eight hours in the hospital after she and her Balinese midwife partner realized that “the placenta was really stuck and this mom was slipping away.” They decided to transport her to a hospital rather than risking going in after the placenta. “Nyoman got the IV in and I cut the cord. We usually wait at least an hour or more, and lately have been burning rather than cutting. It’s an old Chinese practice to move the chi from the placenta into the baby, which also avoids the many infection risks of cutting. Plus the babies seem to sigh, relax, and get so calm, whereas I notice they tense, or worse, when the cord is cut.”

At the hospital, “Nyoman and I had to practically arm wrestle the on-duty bidan, as she immediately started to do some brutal cord traction. Dr. Wandia went in shaking. It was such a mess of a placenta that we must wait and see if she needs a hysterectomy. I’ve honestly never seen a placenta so ‘off.’ ”

The mother had used all the type B blood available at the hospital, so Robin sent the husband off to get family donors. “We asked for six possible, he came back with none. I explained clearly, with Nyoman’s help, that donors must be sought from her family members. Well, the husband ignored that, as ‘everyone knows’ that since she is married to his family, her family has no responsibility toward her. ‘So why would they want to give blood?’ he asked. Clearly his family was not willing to try. If he does not come back with her sisters and brothers, I will activate my rare blood-type people. But the hospital cannot legally give blood from outside the family, so we would have to lie, and get one of his brothers to say he’s married to our donor! Complicated, that’s Bali culture, on the dark side of the checkered cloth. So, I’m off to sleep this off a bit, then back to protect the baby from bottle feeding.”

Robin recently joined the Indonesian Midwifery Association, allowing her to help with continuing education for Indonesian midwives, implementing hygienic and gentle birth protocols, postpartum care, and breastfeeding support.

Help for All in Aceh

Tomorrow Robin is taking a month’s leave from her clinic in Nyuh Kuning for the beach at Cot Seulamat, but it’s no vacation. She’s returning for the second time to her new clinic at Sama Tiga, Aceh, a geological hot spot, malarial swamp, and rebel conflict zone, cut off from the rest of the world for over 30 years. “We hear gunfire every night near the clinic.”

The Aceh clinic is a neutral place where tsunami victims, host families, military personnel, and the most marginalized peoples feel comfortable coming for help. “Some of them are very sick, or have infected injuries. There are an increasing number of malaria victims. Others are pregnant. Most all the people we saw were malnourished. 100% were traumatized. We don’t ask ‘Did anyone die’ but ‘Do you have anyone left?’ For many, just telling their story, saying the names of their dead children and wives, brothers, sisters, mothers, uncles, gave enough comfort to allow them a night’s sleep, finally.”

The clinic is more than a medical center, it’s also a human resource center. “The roads have been destroyed, so finding where the people have gathered is often tough. We help determine who has potable water, food, clothing, and shelter . . . . Putting these small rag-tag communities of traumatized people together with the large NGOs who can help them survive and perhaps recover is an important part of what we do out there. All too often people go without food and water due to lack of communication and logistical problems inherent when working in a disaster zone.”

Rotating teams of volunteers for the Tsunami Relief Project come to this perilous region from all over the world. Every team has included at least two members of Robin’s family. A number of Acehnese also help at the clinic. “Bang Hanifi lost his wife and children and his entire extended family. Isnyadi, a 16-year-old boy, lost his father and brother to the conflict, his mom to the tsunami. He’s the only surviving male in his family. He came to the clinic asking to trade work for food for his family. We pay to keep him in school half time. He is brave, full of love and life.”

Robin chokes up as she recalls standing on the beach at Meulabouh, littered with children’s sandals, behind her a mass grave and the only building still standing, the mosque. Later they took some orphans to the beach for the first time since the tsunami. “They looked around and saw the destruction of where their homes had been. They put their feet in ocean and were quiet. Half an hour later they were running and playing. Children want to be joyful even with nobody left.” Robin is impressed by how the Acehnese have pulled together. “There are no orphanages. The children are taken in by the extended family, even if distant. Old people, even wandering cats, are taken in by lost, hungry people. A quality of love, a new spirit was born of the tsunami.”

Robin’s booklet, Clean, Safe, and Calm Childbirth, is given to all midwives and surviving pregnant women. Eighty percent of all the women and children died. “Men were sometimes able to save one child. One man came in with a baby who looked like one month, but was 6 months old. The father climbed a coconut tree and saved his child, but there was no breast milk, so the baby was starving to death. We started an IV, and now the baby is fine.”

“It’s hard to find a mother who hasn’t lost a baby before the tsunami, mostly to tetanus. The vaccine has to be refrigerated and there is none here.” Robin says she found one midwife using a pair of blunt school scissors to cut the cord. “We introduced cord burning to the remaining midwives. It’s clean, you don’t need instruments or boiling water, just candles and banana leaves under the umbilicus as a guard. Malaria is rife, new cases every day. If we don’t keep the clinic open, people will die for sure. They can’t get to hospital, but they can come to the clinic to get a malaria injection. We send our team out to the tent villages every night. They see as many sick people as they can who can’t get to us. It’s a huge responsibility. The triage care volunteers are seeing 40-100 patients a day, eating sardines and rice, and not complaining.”

A second massive temblor struck, March 28, 2005, while the second Bali team was in Aceh. “I couldn’t reach my staff for 17 hours,” Robin says. “We didn’t know if they had attempted to evacuate the coastal zone. Their hand phones were not picking up. When we finally got through, they were really traumatized, waiting for the tsunami to come again. In the village a woman in her 60s died from fear. The quake shook the clinic for 7 minutes, but there were almost no buildings left to fall down on people.”

Two thousand tsunami survivors live in tents within walking distance of the clinic, but there is only one road from the coast and it’s not good enough to evacuate large numbers. “My staff were worried that I would have to evacuate them, but each one offered to stay longer, even though their lives are in danger. When the second team came back, their faces were shining. Some are going back already.”

The latest quake has set everything back. “People were beginning to envision a future without wives, husbands, children, parents, home. They were planning a nursery to replace all their fruit trees lost in the tidal waves. They didn’t act like zombies anymore. Now people are back to staring blankly. You hand them water or rice, they will eat. If you don’t hand them food, they will just sit and be hungry.”

Robin says the crisis is not over in Aceh. “The survivors are homeless, but for tents and military barracks. These are the lucky ones. But ‘internally displaced people’ without a village are outsiders in their own country. We got a clinic going and must try to keep it staffed.” She admits that the Bali clinic is under-funded with so much energy being poured into Aceh. “We have a bigger work load now in Bali. When I’m in Aceh, I will have no email contact. I won’t be able to do fundraising.”

While Robin has one ear turned to Iowa, the other ear is tuned to Bali, and it’s time to press that ear to the belly of the woman in labor and listen to the fetal heartbeat. She says, “I’ve been so busy this week with babies a-borning that I’m not packed.”

Before we lose contact I ask, “How can you live with birth and death every day?”

“When you cry that much day after day for weeks, you let go of layers of stress. It really helps. People hold you and cry, total strangers, especially if they have lost everyone. I feel like part of the solution. It’s the most inspiring work a person can imagine doing.”

To become part of the solution, visit  Robin Lim‘s website or call (641) 472-3880.