84 JULY-AUGUST 2026 | THE FOREIGN SERVICE JOURNAL From what little I understood of Notee’s words, I knew he wanted me to take charge of Arwa while he went to the neighboring village, by oxen cart, in search of the village midwife. I ran back to the cabin to gather a pile of towels and my sewing scissors, just in case. They needed to be sterilized if I were to cut the umbilical cord. I lit the gas burner, put water in a saucepan, and dropped the scissors in, but almost immediately Notee was back again at the door, motioning for me to return. I grabbed the towels and the scissors and raced back to the hut. Arwa was now howling in pain. I had no experience delivering babies—a fact I couldn’t have shared with Notee even if I had wanted to—but had seen a program about the Lamaze method of childbirth several years before. I knelt down beside her. “Everything is going to be all right,” I said, smiling as calmly as I could, and demonstrated breathing as the instructors had done in that long-ago video. “Breathe in,” I said, taking a deep breath through the nose, followed by “out,” releasing the breath by mouth. I smiled again, breathing in and out with her, while laying my hand on her abdomen, pushing gently with the “out” breath. When she had calmed down and was breathing rhythmically, I got up, took a towel, propped up her legs, and laid the towel on the sand beneath her. I was shocked to see the baby’s crown was already appearing. I continued to call, in rhythm: “Breathe in, breathe out, push.” She relaxed as much as possible Bang! Bang! Bang! Very early one morning as I slept in our tiny wooden cabin, isolated on the shores of the Toliara Lagoon in Madagascar, I was awakened by someone frantically pounding on the front door. Cries of “Ma’am, Ma’am,” followed by an incomprehensible shower of words, catapulted me out of bed. It was Notee, a fisherman and our cabin guardian, whom we paid to take care of the many issues that cropped up at our small house. He lived with his wife and young son in a circular thatched hut nearby. There was no mistaking, despite our mutual incomprehension: This was an emergency. Grabbing a wrap, I raced after him, across the sand to his hut, where I ducked down to follow him in. There on the sandy floor lay his wife, Arwa, writhing in pain. We knew Arwa was pregnant. My husband had agreed to drive her to the hospital when she needed to go, but he had already left for work that morning. I was alone. It was too late for Notee to undertake the perilous 20-kilometer journey to the Toliara hospital in his oxen-drawn cart. A Birth on the Shore of the Toliara Lagoon BY FREDA WHITE-HENRY Freda White-Henry served as a USAID Foreign Service officer from 1990 to 1998, with one posting in Mali, where she oversaw education and human resources development programs. Her pre–Foreign Service teaching and consulting work in Madagascar, Cameroon, the Central African Republic, and Nigeria laid the foundation for later service in Mali and informed her broader approach to international development. White-Henry passed away in November 2025; this story was shared by her sister, Anjela. REFLECTIONS There was no mistaking, despite our mutual incomprehension: This was an emergency. COURTESY OF ANJELA WHITE-HENRY Freda White-Henry
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