Rio Helmi (originally posted on the Huffington Post)

In the first 8 months of 2011 alone, the Bumi Sehat foundation, set up by CNN Hero Robin Lim in Indonesia, has provided compassionate pre and post natal care for 20,500 mothers, as well as delivered 400 babies. Many of these she has either cared for herself or overseen their care, sometimes even by phone to remoter parts of Aceh.

Impressive as that number may seem, midwife Robin Lim reminds us that every 15 minutes around the world, 23 babies die during birth, 28 are stillborn, and 86 infants under 1 month old die of various causes. She also reminds us that there are many mothers who die in childbirth:

“They are dying in the prime of their lives, doing the most natural thing in the world: having babies. Nine hundred and eighty one mothers a day: imagine if two 747’s jet planes full of passengers, (832 people,) fell out of the sky every single day. Now wouldn’t that be front page news?”

In truth these numbers are conservative owing to a lack of effective data collection around the world. She points out that Indonesia itself has a surprisingly high mortality rate – surprising because the medical community here works hard, but they are up against bad nutrition that leads, for example, to hemorrhaging. Robin admits to being obsessed with the United Nations Millennium Goals of reducing child mortality, improving maternal health and combating aids.

However it’s not just the numbers that make Robin passionate. Her obsession with compassionate birthing, done as naturally and lovingly possible, is a very personal one. Twenty one years ago her younger sister died of complications during pregnancy from hypertension related to medical interventions beginning in her youth. This was in the USA, a nation which spends more on pregnancy and birth technology than any country on earth.

It lit a fire under her that was still burning when she first arrived in Bali two years later. Life in the hills around Ubud was basic then, and maternity care in the villages was inadequate, to say the least. Dealing with her own pregnancy and helping other women around her finally drove her to found the Bumi Sehat Foundation in 1995.

Robin not only wanted to provide a natural, healthier and more holistic alternative, but also to provide a service for poor villagers who simply could not afford proper maternity care. She wanted to do it in the villages “with the village people”. The results are tremendous, and it does not go unappreciated by the many she cares for. Said one village mother in an interview earlier this year:

“I do not have money, and I tell my friends to also come here. I wish there were more people like her to lift up the suffering of the poor people.”

Yet that same fire that drove her initially also singed her relationship with local modern medical practitioners. Despite early advice from a long-term expat working in national health care to “work with existing systems and improve them from within and not do an end run”, Robin set out very much on her own track. A number of misunderstandings on both sides of the divide created unpleasant tensions.

It was perhaps the fall out from this period that finally brought her around to reaching out to the Indonesian medical community. But it was also through the agency of an Indonesian doctor, Hariyasa Sanjaya, that Robin’s transition to fruitful cooperation with the medical community became more complete.

When Hariyasa came back to Bali in 2006 after a stint in Australia he was struck by the unusually high percentage of cesarean births here: up to 50%. Once a staunch critic of Robin who proclaimed her a crank, on his return Hariyasa had something of an epiphany about “the stiffness and the arrogance” of the medical community whose ‘evidence-based’ mentality seemed to completely ignore the thousands of years of experience-based lore that existed heretofore. He saw a need for the medical community to give a greater place to the power of nature: “after all, women have been giving birth for thousands of years!”.

On the other hand, he admits he felt that Robin’s back to nature stance seemed uncompromising to the medical community at large. Her vocal championing of water-birthing, the use of natural herbs and homeopathics, all of these and more seemed outlandish to them. While Hariyasa acknowledges that a doctor does need a certain amount of ‘negative thinking’, for example anticipating problems in surgery, he now sees a middle way:

“Robin was a somewhat controversial figure when I finally met her, but I saw in her three things – clear understanding, a strong conscience, and courage. Now she has learned to compromise on things which are not essential, not fundamental, in order to achieve a greater good. That’s a sign of maturity. She can now take others’ viewpoints on board and consider them. It’s important to ‘go back to nature’ but it’s also important to ensure the patient’s safety.”

Robin welcomed Hariyasa’s timely positive interest in her methods. Years ago, as she was featured more and more in the media, some of her comments, in particular her criticism of the medical institutions, had irked midwives and doctors in the regency of Gianyar in Bali. They had pushed the health department to look into her practices. Dr Hariyasa’s interest drove him to investigate waterbirths. The positive conclusions of his study helped to calm the storm.

Nowadays in Bumi Sehat’s project in tsunami-stricken Aceh, traditional midwives in remote areas work in tandem with the medical community, keeping in touch with mobile phones provided with special hand chargers that don’t require electricity. Robin herself now readily acknowledges how hard the medical community in these remote areas works, and how important it is to be inclusive. It is becoming a two way street: in Bali, Dr Hariyasa has even referred patients to her from the clinics he works in.

Today Robin has been nominated as one of the CNN heroes who are candidates to become “Hero of the Year”, and the voting is soon coming to a close. At stake is a grant that would provide much needed funds to help her rebuild her clinic. Discussing her ‘hero’ status, Dr Hariyasa sees Robin as “a rock” and yet:

“She has learned through the experience of conflict and adversity. This is extremely important. Every great person must have the courage to acknowledge their limits, then they can go forward.”

Robin herself says she has stopped tilting at windmills:

“I guess I got older and maybe a little wiser. I figured out I could stop offending people. By liking myself enough I could speak with real love in my heart to people, not just with saccharine words”.

Perhaps this is the real mark of a hero: the ability to acknowledge one’s limits and shortcomings, and then strive to go far beyond them.