She bears witness to an African midwife's life and tragic death

NORTHAMPTON -- There is the painting of her above the dining table. Snapshots of her scattered around the house. And a cheap silver ring she once wore, sitting on a shelf in the family room.

The spirit of Monique Dembele , an African midwife who died in childbirth in 1998, is being kept alive within the comfortable farmhouse here, where author Kris Holloway spent five painstaking years writing a memoir called "Monique and the Mango Rains: Two Years With a Midwife in Mali" immortalizing the woman to the world when the book was published in September.

Holloway, who served as Dembele's assistant delivering babies during a Peace Corps stint after college more than 17 years ago, chronicles the midwife's struggles, accomplishments, and tragic death in a tiny village where food was scarce, disease was common, female genital cutting the norm, and pregnancies frequent among the largely Muslim population.

"When Monique died in childbirth, my world was cracked open," Holloway said in an interview at her home . "How could this happen to this woman? She saved so many women from that fate."

The book is also the moving story of Holloway's friendship with Dembele, and how their two years together in Mali -- a country that has one of the highest maternal mortality rates in the world -- affected them both.

Holloway, who already had a public health degree, met her future husband, a fellow Peace Corps volunteer, in Mali. And when the couple had their first of two sons, 12 years ago, Holloway gave birth at home, then in Michigan, with the help of a midwife.

Asked how she reconciled Dembele's death with her own low-tech births -- the second son was also born at home -- Holloway did not flinch.

"I think it's because I saw how much could be done with nothing, how little we needed," said Holloway, a sprightly 39-year-old. "I didn't see that many women die. Monique was doing an amazing job. Here, we're so wimpy. There, women were like, work, work, work, give birth, move on. My first [attended] birth was there. I saw the negative parts. I knew I didn't want to be anemic, have no prenatal care, or have five kids. You take all that away and there's a lot of power there."

The women Dembele and Holloway attended gave birth in a simple leaky hut, on a cement slab, without any pain medication or obstetrical instruments. What they did have was the warm-hearted support, encouragement, and wisdom of the midwife, who had a sixth-grade education, 10 months of medical training , and a two-year midwifery apprenticeship with an older woman in her village. Dembele often worked through the night with her own infant strapped to her back.

"First it was shocking," Holloway said of the births. "But it was beautiful. It was such a community event."

While in Mali, Holloway helped Dembele get funding to repair the birth hut, which is still in use. After Holloway moved back to America, she was researching contraception options for Dembele -- who was unhappy that she was pregnant for the fifth time -- when a letter arrived announcing the midwife's death.

According to the World Health Organization, women in Mali have a 1 in 10 lifetime risk of dying in childbirth. The cause of Dembele's death is difficult to determine. She appears to have died of a stroke or a heart attack during labor. She might have had dangerously high blood pressure that went undiagnosed. She could have had an infection. She was worn out. Tired. If you ask Holloway, Dembele died because "she lacked human rights . . . starting with the decision to become pregnant."

Holloway channeled her sadness and fond memories into the book, but she said the writing did not come easy. Because so much time had lapsed since her days in the Peace Corps, the author would bury her face in mud-cloth blankets, breathing in the lingering scent of Malian dirt that had stained the fabric in vivid brown and cream patterns, in an effort to transport her mind. And she would play tapes of Dembele's voice, recorded in the open air among the chirping birds or lilting background conversations. Holloway also had the help of her husband, John Bidwell , who served as consulting editor on the memoir.

Despite her troubles, the book -- Holloway's first -- is beautifully written. Published by Waveland Press, a small academic press in Illinois, "Monique and the Mango Rains" also piqued the interest of Literary Ventures Fund , a first-of-its-kind, private, nonprofit foundation with offices in Boston and New York. Founded in 2005 by grocer James Bildner , a venture capitalist and philanthropist, Literary Ventures invests in books it deems exceptionally well-written and meaningful but that might not reach their full potential without the group's funding, strategic marketing, and other resources. "Monique and the Mango Rains" was Literary Ventures's first nonfiction selection to support.

A portion of the book's sales will help pay for the education of Dembele's three remaining children, as well as the secondary education of some of her siblings, and to help fund Clinique Monique, a new general health facility run by Dembele's cousin in a nearby village. Although the clinic offers minor surgery and prenatal care, maternity services are not yet offered. Clinique Monique needs a midwife.