Welcome to my blog!

This blog was created with the intention of sharing my life and midwifery experiences with my community as I branch into international midwifery. I hope to keep people up to date and in touch with me, and with the places and people where I'll be.

Friday, November 19, 2010

post graduation, 11-19-10

it has been a long time since i blogged!
i haven't had internet for...months.
one day that will be remedied. i would like to blog more often.
so...i am sitting at teh airport in fort lauderdale. on my way to el paso for a few days, to visit and take care of stuff like relicensing, renewing car registration, etc...then headed to NC for thanksgiving and the whole month of december!!! i have been looking forward to this time off for months. although as the time got closer, i also felt apprehensive about leaving haiti, especially about being separated from blada for 6 weeks. but, this is important and i will be back soon.
so looking forward to the holidays in NC! seeing my family and friends!
let's see...yes, cholera is in hinche; i don't know how many people have died there yet, but they've probably seen a few hundred cases there (in hinche) already...it's all over the radio...people are pissed because it most likely came from the UN, who they kind of resent anyway, fand yes there have been riots...nothing severe in hinche, yet...some throwing of bottles and burning of tires on the street...some people kind of joke about cholera...the cholera handshake (touching elbows)...people who sell candy in the market, calling out that the candy is good for the prevention of cholera...stuff like that.
this year has been relentless for haiti.
blada and i have been camping out at the new house for the past month. it is going to be really nice, once it's all set up. it will be where we live, plus where the midwife volunteers stay, plus probably 2 students from port au prince will live there, plus this canadian midwife and her haitian partner...they are coming in april...everyone was in hinche this past week for graduation...yes, graduation was special. i even got up and did an improvised speech in creole. everyone was really happy that i spoke in creole, even if it wasn't totally fluid and perfect. i took my time, paused before i thought of what to say, and just basically tried to express my appreciation for being part of this project. it was good. i have a video of the speech...if i could ever upload videos to FB...
the canadian midwife coming in april, i really like her. she will be helping marthonie and i with curriculum development and classes. i am really excited that she is coming; they are definetly cool. her partner is super into organic farming, and is planning for us to have lots of gardens. i feel like i will be returning to a home that is nourishing for me. having this midwife there, who seems like a kindred spirit, and having gardens, compost...imagine! it's also really exciting because blada and i will be able to learn alot about growing food in haiti. a very useful skill!!!
i am returning to hinche on january 3rd. the new class will start jan 10th.
we had graduation on the 14th. it was really great. really enjoyable. it was so good to have several days of fellowship with nadene and steve, the directors of midwives for haiti (nadene is also the founder). they are so, so appreciative of all of our work in haiti, all of us, and they are so heartfelt, just really great people. each time i see them i like them more and am more excited about working in their organization.
there is still alot to be done in the house, but it is starting to happen. blada and i have been living there well, it has gotten better and better. we pump all of the water we use; there's no electricity yet, so we use an oil lamp; and we cook on an old kerosene stove that makes lots of smoke. fun, and funny. every day, we make basically the same thing: salad (grated beet, onion, garlic, avocado, cabbage...) and boiled maniok (yucca) and/or green bananas, pumpkin, potatoes, malanga (another root vegetable), yam...we have been making these fresh beans too...we eat really well. we could be eating white rice 2 times a day.
we did interviews for the new class each morning for the 3 days following graduation. we saw 35 people! one crazy lady, who didn't pass--she was there bright and early, and met us outside the hospital, before we even started.
we definetly have an apparantly excellent group of new students. the majority of them seemed to have a bright interest in midwifery, and a tendency towards compassion. yes! that will make my job easier. we had this one question that we asked all of them, that embodies many other questions: imagine you have a 14 or 15 year old patient, who is in labor, and is out of her mind, screaming, writhing around, really scared. won't let anyone do an IV or vaginal exam or anything. what do you do for her? how do you help her? well, some people answered that they would take her blood pressure and give her an injection. some people added that if she wasn't able to birth and needed a c/s, they would call the Dr in. the response we were looking for was that they would show her compassion. some people said that they would massage her, some people said that they would stay by her side and talk to her. well, about 5 people said that if they had another person there with them, they would have that person HOLD HER DOWN, while they did whatever care was necessary. and that if they were alone, they would TIE HER DOWN to the bed, and then do whatever care was necessary. well, we were appauled by the first few responses like this, and then after 4 or 5, we realized that this is what these ladies have seen done to people, when they were in school and did their hospital rotation in maternity. we realized that we can't hold this against them 100%. they don't know. this is literally what they have seen. one person even started out answering the question well, saying she would massage the girl and talk to her, but then ended by saying that if she had to, she would tie her down. well, guess what. she ended up in out "possible candidates" list, and we ended up choosing her for the class!!! it's funny to me. it will all be fine, as long as people are open. she seemed open to us.
so, it was a sad goodbye with blada this morning. he accompanied me to port au prince yesterday, and we spent the night there at my friend beth's house. this morning they brought me to the airport. it's harder for him because he will be in the same place, and i am in a different place, with lots of people, and lots of activity.
so...ok, i will prob start blogging again in january, once the new class starts...love all of you guys! thanks for your continued interest!

Monday, October 11, 2010

october 11th 2010

finally, i am able to blog again!
i have been wanting to write a blog to tell about things here for the past month of so, but unfortunately i have NO INTERNET where i stay and so when i do get on the internet it's every couple of weeks or so.
i have lots of stories to share!
things at the hospital never cease to be interesting. there have been some crazy stories, like always. some of which i was there for, some of which i heard about secondhand.
a few of them:
there was this female OB who came with this MW to do this kind of community teaching course, and the OB helped with some surgeries in the OR. one of these was this woman who came in with a placental abruption. when they did the c-section, this woman had already bled out so much that where she cut into her skin, it didn't bleed at all. and her uterus was totally white, not pink. also, as they were preparing to do the surgery, they discovered that there was no electricity in the OR, and they had to call the guy who maintains the generator to come turn it on for them. as this lady was crashing. her blood pressure was 80/40. they did the surgery, almost lost her, then when they tried to order blood to transfuse her, there was no blood that matched hers: she needed blood that was A-. so, it turns out that this visiting OB, who did the surgery to save her life, she has the same blood type. she herself went and donated blood, which was then given to this woman, again saving her life. this story was incredible to me.
the same night they did the c-section for this lady, at the same time as this was happening, there was also this lady in the delivery room with active TB hacking her lungs out, and then at the same time, there was a lady with severe pre-eclampsia, with blood pressure of like 200/130. all 3 of these super high-risk ladies, one of our students, our star student actually, who is amazing, she was actually managing all 3 of them simultaneously. crazy.
the volunteer midwives for the past few weeks have been donating blood at the local red cross. such a good idea. there's often not blood when someone needs it.
the other day, someone brought a baby in, a week old, whose cord had just fallen off and had WORMS in it. i saw 2 of them. we told her to bring the bb to the pediatric unit (which is a joke)--and she said that they had sent her to US. so, we just cleaned the cord stub, and luckily we had some silver nitrate and i cauterized it, and we explained danger sings and sent her home.
a few days ago a lady was brought in after giving birth at home in the morning. her 3rd birth. came in for retained placenta. they said she had already bled alot at home. we started an IV on her and antibiotics and gave her an injection of ketorolac--thank god we had it--a painkiller--then about 15 minutes later we started doing the manual removal (of the placenta). i wanted marthonie to do it, she wanted me to do it, so i did it. i knew it would be a hard one. the placenta was implanted way high up in the fundus, on one side. it was really hard to get my hand around the placenta and reach up to where it was implanted. finally, when i separated the placenta all the way and came out with it, i looked at it and it was definetly not complete. it was one of those long placentas. one side of it looked like it had been ripped off from the other part. i went back inside for the other part, and it was really hard to tell if what i was feeling was a huge piece of placenta, or the inside of her uterus and it was rough feeling. it felt like the whole anterior part of her uterus was covered with a big chunk of placenta. i started to try to separate it, but then i stopped, because it felt weird and i wasn't totally sure of what i was feeling, so i stopped, because i didn't want to to poke a hole in her uterus. so, we called the Dr, the OB, and explained everything to him, and asked him to come in and see her. also, this lady had a 4th degree laceration from a previous birth that had healed over like that--she had a fistula--the anterior part of her anal sphinctor was gone--retracted behind the skin.
her hemoglobin this day was 8; 2 days later it was 4. she got transfused--another high risk situation that one of our students managed basically on her own.
she is doing pretty well now. once she is stable enough, they will decide about her reconstructive surgery. and, the OB did a sonogram (abdominal) on her and said there was no placental pieces inside of her. her uterus is involuting well and she hasn't had any signs of infection...but, i know from her placenta that there still is a piece inside of her. maybe it will just come out on its own or maybe it is reabsorbing.
the other night the american volunteers and a couple of students worked the night and had a twin birth. well, at 11pm the electricity went off and the birth of the first twin was AT 11:40PM. the second twin came about 20 minutes later, with like a 1 apgar, and they resusitated this baby for 30-40 minutes. in the dark, with a headlamp. this baby seems fine now.
lots of crazy things all the time. the hospital is crazy...i don't even try to go into detail about the personalities that work there and the politics. crazy.
and my personal life...things are going well. blada, my partner who i met here, he is wonderful. we are doing so well, letting things unfold naturally, getting to know eachother, having a good time, etc. he is a beautiful beautiful person.
being with him is the main reason i decided to come back here and do the next class here for midwives for haiti.
last night we participated in a little dance program at the place we always go dancing. we danced a salsa and he also danced a haitian folkloric dance. it's like african dancing. so beautiful. it felt really significant to me that we were invited to perform at this event, like, it felt significant to me with him as my dance partner and partner, and also for myself as a part of this community.
i got a video of both dances--sometime when i am able to, i will put them on facebook. the lighting isn't good and our dance, i felt that i didn't dance so well but whatever.
the group i work for is going to rent a house in order to centralize everything. once i come back here in january, hopefully it will be ready. i will stay there, as well as the volunteer midwives who come each week. and we'll keep all our materials there. i hope we have internet!!!!!!!!!!!!!!!
i will be in NC for the month of december. really looking forward to seeing folks there!
and in el paso for just a few days, before that.
i feel relieved--i had alot of things to write about!
once i have good internet access again i will hopefully start blogging again regularly, like once a week.
take care

Thursday, September 16, 2010

september 16th 2010

time really feels like it's flying now. it's already mid-september.
this post will be brief. i have been wanting to write in the blog but haven't had internet for a few weeks. right now i am at marthonie's house--she has internet each evening--i think i am going to start coming here more often and using it.
things are going well. i had gone back to el paso a couple of weeks ago, for 4 days--it was a really nice break, i saw everyone i wanted to see, and got some stuff i needed to bring back. it was good. coming back felt really good. i actually gelt happy and relieved to be back in haiti. with all the noise on the street and everything. the weather has been a little cooler than it was--it's still hot, but not AS hot--and, it is really green and lush right now. so that is really nice--i am enjoying it alot.
the class is doing really well. just 2 months off from graduation. starting to prepare--they have been practicing these beautiful songs that they are going to sing. it's exciting.
i have decided to come back and do the next class with marthonie. i really like working with her. even though the conditions here are so so hard--i am intrigued enough and comfortable enough to want to stay longer. i am going to leave haiti after graduation and then return in January for the new class.
another reason that i am coming back is that i am with someone here, who i want to be with and continue building my relationship with. he is a lovely lovely person and we are having a really good time getting to know eachother. things are really good between us. i don't know what else to say about it except that we both are wanting to move forward in our relationship and both trusting eachother alot.
so, that's a brief catch up of things here. at the hospital, there's all the same things. always interesting. lots of pre-eclampsia--that's the biggest thing here. a couple of days ago we had this lady who was carried in, 8 days postpartum,. could not walk or talk...normal vitals...i thought she was post-seizure or that she had had a heart attack or something...no doctor in sight to consult with...marthonie thought maybe, maybe it could be hypoglycemia and gave her a glucose IV...what do you know...she perked up, could talk, walk, etc. it was amazing. this lady hadn't been eating.
always interesting cases. we don't have the tools we need to diagnose things, but we do the best we can.
love all you guys

Friday, August 27, 2010

life in haiti

i feel like there are alot of things to catch up on in the blog!!!
first of all, thank you to all of you who are interested in reading this blog, it means so much to me that you guys find it important enough to keep up with--and it helps me so much because i am processing my experiences and also sharing them with the people i love---which makes it a little easier to be in haiti.
so...yes, i was in port au prince, helping this friend of mine, beth, who is one of the kindest people you'll ever meet--it was so nice, we did prenatal and postpartum care together in her little center...i got to spend time with people who live at their little hospital...people who were affected by the earthquake...so touching. so eye-opening...these peoples' life stiries, the severity of their lives, you can't even imagine. i can't even begin to retell their stories. but they're in my heart.
i returned to hinche, and moved houses--now i'm in this hotel--it's a really nice place--lots of plants, a huge outside area, a pool...super fancy--i'm enjoying it but it's also really strange, because the niceness of it seems impossible compared to the reality of haiti, and hinche. it's an opposite reality. nevertheless, it's peaceful for me, and my room is bigger and nicer than where i was, and, the best thing, is that i can hang our with blada there. so we have been spending alot of time there together. it's great.
there's no internet there right now though. hopefully they'll actually fix it--they say they're working on it, but i don't really think they are. oh well.
2 days ago at the hospital there was a 7th timer who was eclamptic--she had 2 convulsions at home, then was brought in, and then had 2 more in front of us---Marthonie was working on her all morning, and trying to get the drs to do a cesarean--but they were busy, already doing other surgeries...she was doing everything she could, and then this lady seizes again 2 times. she was on mag sulfate. we worked on her together with the students--gave her 2 more boluses of mag--2g IV each time after she seized--so finally she got wheeled in for the c/s but then actually delivered in the OR. yes, we should have checked her before sending her in--yes, she was in labor, but we didn't think she was imminent. and she was so combative and agitated from the convulsions that it felt like all we could do was start a new IV to give mag (the one in place was shot)...anyway, her baby weas FINE--and her, the mom--well i don't know the outcome yet--right after the birth, she wasn't in a coma--she was semi-conscious--maybe she'll be Ok, but I don't know.
I spent the day yesterday in Cap Haitien with my boyfriend, Blada. I met his mother and his family. they recieved me with open hearts.
blada and I are more and more in love...it's just happening naturally...what can i say...
I posted some fotos finally!!! on facebook. a new album called "haiti fotos".
so if you want you can see Blada, Marthonie, the students, the place i go dancing with blada, etc. i will try to get more fotos up soon.
love all you guys!

Saturday, August 14, 2010

august 14th, in port au prince

so...not too much has happened since i last wrote...a couple of days when i arrived to the hospital, when i walk into the delivery room, there is a dead baby on the counter, from the night before, just still on the counter, laying on dried blood (i guess from when the cord was cut)...the baby remained there for maybe half the day...there was no box to put the baby in...no one acted like they really noticed...things like this, there are times when i really step back into the neutral observer role, it's not my job to change the way everything is handled...
there was a baby born (by c/s) with hydrocephaly...the c/s was done for failure to progress despite really strong labor, and after the bb came, we could all see why she hadn't been progressing...the only way this baby will make it is if they come to port au prince and see a specialist...which may or may not be possible for this family to do..
someone came in with an abruption the other day too...bleeding alot...no FHT's...first she was put on and IV with pit, but then she kept bleeding alot so they did a c/s...and she got a blood transfusion...
the lady who was 25 weeks pregnant with blood pressure 230/180, she was induced and had her (dead) baby, a couple of days ago...she is doing ok...still has facial swelling and very high B/P, but hasn't had any convulsions...there is a shortage of blood pressure medication in the hospital, so it's hard to treat people, and so many of our ladies have really high B/P...
you know, i never see really bad tears here, or hemorrhage, or shoulder dystocia...the things i saw alot where i used to work...but what i do h=see here all the time, is hypertension, pre eclampsia and eclampsia, severe anemia...
yesterday i came to port au prince, because there is this lady here named beth, who is becoming a midwife, and her preceptor is out of town and she has ladies due, so she asked me to come...beth is an amazingly warm, sweet, compassionate woman, who has been living with her husband in port au prince for 20 years. they raised their kids here, and they do alot of work here. they have an orphanage and help place children for adoption, they put up tarps and ran a small hospital after the earthquake, they have built houses for people who lost everything is the quake, stuff like that. really giving. she has some AMAZING stories, just stories of peoples' lives here...things that happen here all the time. she has a blog, that can be found on their website: heartlineministries.org--if any of you are interested in reading some really interesting stories right from the ground here, i would encourage you to check it out.
anyway, i am here, going to do some prenatals with her this week, maybe help with a class for new mothers, and hopefully we'll get to have a few births too. she has 5 or 6 women in dates now, so we'll see.
we went yesterday to this public hospital here to check on this lady she had transported there...oh, such sad conditions at this hospital...basically the same conditions as where i work, but bigger. there were women everywhere laboring, no one ever checks their vitals, they don't have any tools to even check peoples' vitals. she said the night before was even worse---way more people--blood everywhere, trash everywhere...a huge chaotic mess. wow.
it is fun having a little change of scenary...i think it's less hot here too...maybe because we're right next to the ocean...i will be here for 6 days total i think--returning on thursday, in order to get ready and pack to move on friday or saturday...
the guy i've been dating, blada, he is so sweet...we are having such a good time together. things just keep opening up and getting better and better. he's a really cool guy. super easygoing, at ease. one thing i'm looking forward to about moving is that i can have him over whenever i want. that will be so nice. like normal adults.
taking the bus here (actually it was a van) to port au prince was fun...a little adventure...we were all packed in there...it was fun seeing how it is done here...part of the road between PAP and hinche is paved, part of it not...they're working on paving it (finally??)--there are no real roads in haiti. there is no infrastructure in haiti. i haven't taken a tap tap yet (they don't have them in hinche--there are just motorcycle taxis) and i don't care if i never do...you're totally exposed to all the truck fumes, and the dust on the road...
i am feeling really thankful to be here, to have the privledge to sit with these people, to be learning creole, to be witnessing peoples' lives...wow. and spending time with beth is really special, because she has so many years here, and has such a big heart, so talking to her about all of the issues in haiti and hearing her perspectives is really cool.
i am loving and missing all you guys too. i think about all of you all the time-you're always in my awareness. i am cherishing this time here but also looking forward to coming home, re-centering, seeing many of you, eating healthy food and getting in shape again...those things will be so good too. in the meantime, i am just soaking all of this in. i don't think i'll ever be able really to describe this experience in words, in writing or in person...there are so many levels...you see so many little things that contribute to the whole picture...how do you remember all of those little things you saw or felt...the reality in haiti is SO different, so completely different in so many ways, to what most of us are used to...
anyway, take care, all of you, thank you for your support and love, i know it's there and always feel it, so thank you...

Tuesday, August 10, 2010

august 10th 2010

Yes...it has been really hot here...it always is, but some days are REALLY hot.
Blada is out of town, and...I really miss him! Spending time with him has become a huge part of my reality here and is something that helps me to bear everything else. I won't see him until next weekend because I am going to Port au Prince this Friday and returning next Friday or so. It has been really fun dancing with him. We practice once a week, and go out 2-3 times a week. Some days we are more in tune with eachother and dance well, and some days not so much, but it is always fun and positive. We've been trying out some new things, like things we each remember from before, so that has been exciting.
The hospital...it is so crazy. Like today, this woman comes in, with blood pressure of 230/180, with +3 proteinuria, with swelling in her face...probably all the other signs too...so, there is NOTHING to give her. Our little cabinet has become depleted and I need to go and get more supplies to replenish it--which I will do tomorrow--sometimes things dissappear really fast...we are totally out of syringes...we had alot last week...anyway, so in the hospital pharmacy, there is NO IV TUBING, NO IV FLUIDS, NO ANGIOCATHS, NO NEEDLES OR SYRINGES, NO BLOOD PRESSURE MEDICATION. Luckily, in our little cabinet (of supplies that the American midwife volunteers bring down), we had 1 20cc syringe, and some needles, so we gave the lady 10g mag sulfate IM. She had no family with her to go and buy the supplies she needed to start an IV and give her mag in the IV, and to give B/P medication. It just felt like such a helpless situation. Like, it was a dead end, nothing else to do. The thing is, this happens ALL THE TIME here, situations just like this. Stuff you can't even imagine. There have been times where I felt like like I would go crazy if I heard one more person say "pa genyen" (there isn't any) about some material that they were looking for. I hear people saying "pa genyen" all the time. The people here are so used to working with nothing, to having nothing, and to having nowhere further to look, to find a solution. We are so used to in the US always having a next step, a way of finding the answer, the solution.
This woman, she's just one of so many people here who come to the hospital in such a precarious situation, so close to the possibility of death. She's only 25 weeks pregnant.
I have been happy with the way the students are working recently. They're doing a good job. Like today, one of them was doing her best to take care of the pre eclamptic woman, even though she had nothing to work with.
That's about all, I guess. Just one little part of the picture here. I miss all of you, thank you for your comments and support, can't wait to see you guys again.

Thursday, August 5, 2010

august 5th 2010

The time feels like it is passing fast. I think this month will pass fast, because there are a few big events happening that are already filling up the time. Right now, Marthonie is on vacation, she left today, to go to the Dominican Republic for a week or so, with her family...I am glad for her--she really deserves a break. Then, next week, I am going to go to Port au Prince for a week, to help out this lady named Beth who is apprenticing to become a midwife and has a little clinic there but her preceptor is out of town for a couple of weeks. Hopefully we will have some births!
Then, when I come back, I am going to move. Probably on the 21st. The good thing about moving is that I will have more autonomy--it's a hotel, so I can bring in whoever I want, when I want. That will be so nice. Then, at the end of this month, I am going to still go to El Paso for a few days. For a short visit and to retrieve some more clothes and things for here. I hardly have any clothes here with me.
The students and the graduate midwives and everyone here is so happy that I'm staying. They really have taken me in and accepted me. It's amazing. I feel pretty lucky.
For the past few days there have been these doctors here, I think from Cange, (Haiti), doing this kind of test for HPV (very simple--paint vinegar on the cervix) and treating lesions right there with cryotherapy (freezing cells on the surface of the cervix). It has been interesting to see. There have been SOOO many people lined up to have the procedure. Today was CRAZY--so many people--so loud--comical.
We had 2 births today, they were both nice--the students did really well, they were on top of it, which was really nice to see. The first one was a 1st timer; she wanted me to touch her lower belly, I was doing it really softly and slowly--she wouldn't let me stop. I did it for a couple of hours, until she gave birth. It was really sweet. Sometimes the nurses and doctors and other (graduate) midwives would peep in and look a little puzzled but curious.
The there was a "7 month" stillbirth; with a slow but significant blood loss. I had one of the doctos who was around come in and do a manual exploration--I could have done it too but since there were all these people there, and I knew it would be very painful for her, I asked him to do it. He retrieved a little piece of placenta, not big at all. We gave her pit, misoprostol, and methergine. The bleeding slowed after the manual exploration, but was still present.
The hospital has been difficult recently because the hospital administration is...on a rampage, doing these useless changes, like putting up thtese half walls in the delivery room, that make it harder to get around, and moving things around, like putting all the ambubags in the other room...stuff that doesn't make sense...but you can't reason with the director AT ALL, and everyone knows it, and just lets him rule with an iron fist. (He yells at people, very abusive behavior)...I don't knwo what will happen with that.
I am having a good time getting to know Blada, this person I have been dating for the past couple of months. Spending time together is enjoyable, and we dance together, which is wonderful.
I anticipate being in NC by the end of Nov; my aim is before Thanksgiving. And to stay through Dec, then be in El Paso, Jan and part of Feb.
The experience here never ceases to be interesting, really hard, and beautiful. I feel really lucky to have such a close up, intimate view into another culture, people, language. It is really interesting and I know it ismaking me stronger, andmore adaptable.
Love you guys...

Sunday, August 1, 2010

staying longer

well...after agonizing for months over whether to stay or leave after the 6 month committment, then actually deciding to leave and getting tickets to leave, the decision to leave just wasn't sitting right with me; i really couldn't imagine leaving in 1 month. it was starting to feel like it would take more energy to leave rather than to stay. only 2 more months, and i could see the class through the whole way. and i didn't want to leave marthonie all alone. the MW4H directors came here this week; we interviewed one Haitian MW, who didn't impress all of us that much; if we had found a really good person to replace me that would have been one thing. so, i just thought about it some more and decided to stay. i am going to need to move in 1 month, but, that will be ok. the people here are so happy that i'm staying. like, the guy i've been dating, Blada, he was so so happy when i told him yesterday. it just seems like...now I have some things going here, like dancing and practicing with him, like french lessons with another friend, like the class being on the cusp of finishing...it makes sense to stay a little longer. i am giving up something else by staying: being on NC for sept-oct, but, i think i can still be there for part of Nov and Dec. so, it will still be really good.
so, that's what's happening. going to stay another 3 months and really finish everything up the way i should.

Tuesday, July 27, 2010

a young woman dies today

the woman who i wrote about yesterday, who had had eclamptic seizures and then was in a coma all day, she died today. this morning she was actually conscious for awhile, although disoriented. i was surprised; there seemed to be hope. but then, she fell into a coma again, and it was obvious that her whole body was shutting down. there was no urine output today (and only very bloody urine since yesterday), her lungs were totally congested today, and she went into agonal breathing. i stayed there as she was in the process of dying, but wasn't there the actual moment that she took her last breath. it is sad. she has 2 kids here. she was 29. this makes 3 women in the past month here who have died from eclampsia. maybe 5-6 in the past 5 months.

Monday, July 26, 2010

eclamptic woman today

today the first thing when i walked into the prepartum room, there was a woman having convulsions (eclampsia). a 4th timer. i got marthonie quickly and she administered 2g mag sulfate; she had already been on mag; her blood pressure at its highest had been 170/120, and she had been there since the previous night. she then delivered a stillborn baby, about 35 weeks gestation, and then seized again, and then, was unconscious the whole rest of the day, until i left at 4pm. there is so much eclampsia here. peoples' health is so borderline. everyone has high blood pressure, is undernourished, and chronically dehydrated. i stayed through the lunch break, basically holding vigil with her family, and doing rounds on her. the urine in her foley catheter was wine red. kidney failure? her family sang over her, prayed over her...
i didn't want to leave their side today when i came home...i think she is going to die tonight, because her state didn't improve at all today...she never regained consciousness...her eyes were jaundiced also, and her pupils unreactive...her lungs sounded a little congested...not alot, but definetly a little...
this was day one for the american midwife volunteer for this week...welcome to st therese hospital...
i was once again impressed by marthonie's competance in managing eclampsia...
maybe tomorrow morning there will be good news...maybe whe will have come out of it...but i feel like that's not likely...

Sunday, July 25, 2010

leaving in 1 month

It's very hard for me to imagine leaving so soon. Last weeIk found out that my living situation here at the rectory would be ending after august, and I took it as a sign and decided to make arrangements to leave here instead of searching for another living situation. There are many good reasons to leave after august--which would complete the 6 month committment--such as spending a long quality visit with my family in NC...which I have been longing for ever since i arrived here...but there would have been many good reasons to stay as well, such as: it's only another 2 months or so (Nov), helping Marthonie to finish everything up, continuity with the students, getting stronger in Creole, continuing to develop friendships here....even after making the decision to leave, I can't help but feel conflicted about it, and wonder if I made the right decision. my seat is reserved on a flight leaving Haiti on the 27th of August. It is really hard for me to imagine the reality of leaving so soon. Am I ready to leave? There have been so many things that have been so hard here for me...nontheless I have become more at ease with the whole situation as time has passed...and so many people know me around town...
It's like I finally have a life here, I finally speak Creole, I am close with Marthonie and the students, and really enjoy being with them...why has this been such a hard decision to make and why does it continue to torment me? I imagine leaving, eating lots of vegetables again, playing with my niece, playing my mom's piano...I imagine coming back for graduation in November, if Midwives for Haiti will help pay for the trip...that would make it okay, perhaps...
My relationship with Blada is very sweet too, just sweeter and sweeter...I love the fact that we dance together...and practice together...he is beautiful...
Nadene is coming this week and we will talk about everything again...it's probably the right thing to just continue with the plan to leave...but what if they don't find a good person to replace me? I can't help but feel responsible at this point.
I think after this week, after Nadene's visit, everything will feel more clear and definite.
Love you guys...

Wednesday, July 21, 2010

bathing in the river

my experiences here just seem to get more and more interesting and intense. several recent events i wanted to write about...ok, one thing that i haven't mentioned but i will now is that i am dating someone here. for about the past 1 1/2 months. his name is blada. we dance together. he is my dance partner!! and we have been developing a relationship, that has just gotten sweeter and sweeter. it's pretty simple also--simple, slow, and sweet.

so, the other day, we knew it was going to rain, but we (blada and i) set off walking to go to this place where they made a hang out spot, like a mini beach, on part of the river...as we were walking there, we got drenched. then when we got there, it was unreal...i saw several people i knew from town, there were alot of people there hanging out...it's out in the country...so we get in the water, it's shallow but has a current and i was able to swim in it...which felt so good...we swam together for awhile, danced in the water together, then got out, then sat with some people in the water further upstream...then walked around, danced on the grass...then...what do you know but this BAND comes walking all the way down the muddy dirt road, to the "beach", and is playing this kind of traditional music called "rara"--similar sounding to what they play in the street in funeral processions...it is homemade metal horns and a drum with drumsticks and a hand drum...so they are playing, and it was so interesting...it was like the group consciousness was altered by the music...people were dancing, some of them almost trancelike...this one guy, he was either really drunk or crazy, the way he was acting...it was really intense...plus of course wherever i go i am really noticed, and lots of people make different kinds of comments/commentary...so of course that was mixed into the situation as well...oh and the band was playing and actually walked into the river, and was standing in the river playing...this guy was waving around a Haitian flag...it was wild. i felt really honored to be there, to have such an intimate glimpse into this corner of peoples' lives here, of the culture here...i feel that way all the time, but this was really pronounced...

things at the hospital never cease to be interesting...there have been steady births...i just attended the 100th birth today at St Therese hospital since i have been there...yesterday there was a woman who had already had eclamptic seizures, who was in labor and birthed a stillborn baby...who was growth restricted but also premature...it's hard to say how many weeks she really was...when she birthed, another MW caught her baby, but i asked her if she wanted to see the baby, because i noticed that the baby was just being tucked away in the sheet below her...she wanted to, so we sat her up...she started touching the baby, and the MW's scolded her, because it would make her hands dirty, and then she would contaminate things around her...so i gave her a glove...so she touched the baby, a little, then the MW who caught her baby asked her if she was done (she wasn't really done) because i guess she wanted to finish up...those brief moments were important...
the 29 week baby that was making it got DISCHARGED...2 days ago...it wasn't time yet, the bb was still being fed with a tube, the mom wasn't good at putting in the tube yet and also wasn't on top of expressing milk...i am worried about how this baby will do...

today one of the OB's did a surgery for an abdominal cyst on a woman and he brought in the contents for us to see, because it was so interesting...it was 2 ovarian cysts--one was almost the size of a basketball...i don't usually think that ANYTHING is gross, but, honestly, this grossed me out. the big cyst was filled with fluid, all of these little clay-covered balls, that were soft, maybe 1/2 cm diameter, balls of hair, there were TEETH, embedded into the sack of the cyst...the smaller cyst was mostly full of this yellowish jelly-like substance, and also with balls of hair...it was really gross but fascinating.

there is always the usual mix of ladies there with hypertenstion (like 180/120), pre-eclampsia, and eclampsia...today it looked like almost everyone who had an IV in place, the IV's were dry, with blood infiltrating into the tubing...they get left like that for a whole day sometimes...because people usually have to buy their own supplies so since no one has any money, they walk around like that...
i found out a few days ago that the house where i stay with the catholic priests, the rectory, they are going to have some new priests coming to live here and are going to need to occupy my room after august. they have been planning for that. which means...that i am probably meant to come home after the 6 months. this seems like a pretty strong sign. i have to admit though, as much as i have suffered here and looked forward to returning home, i still feel really torn about leaving, especially about leaving before this class is finished...it would be only 2 more months...it feels like i am being torn away from the people here, from marthonie and the students...from a rich intimate cultural experience, which has been both so precious and so relentlessly hard...i guess wither way that things turned out, i would feel like i didn't complete the other side of it...if i stayed, i would feel like once again another year has passed without being able to spend quality time with family and community in NC...who knows next year if i would be able to set aside 2 months to come and visit...

i am still waiting to finalize my plans until Nadene and Steve from Midwives for Haiti come here next week...but it looks like that it what is going to unfold...
that's about all i guess. i feel so thankful for this experience which has been so so interesting and has helped me to remain fluid, adaptable, open...i have recieved so much, and i hope that i have shared an equal amount...maybe, hopefully...
love you guys...


Wednesday, July 14, 2010

july 14th

so...the last few days have been interesting...i just got home from doing a birth with marthonie, of a lady who it was her 12th time giving birth. she had a huge belly, and we weren't sure if she didn't have twins. marthonie and i stayed late to do her birth. i had talked with her yesterday and she was telling me that she had 5 living children. the other 6 had all died at various ages--3 months to 2 years. her pushing stage took ashile because she had this huge swollen anterior lip (of the cervix) but she wouldn't let us push it back. she was praying and singing the whole time...along with another woman in labor who was also singing (the women here sing and hum alot in labor) and who was going to get a cesarean after laboring all day with the same dilation (6cms) with a face presentation, which wasn't applying good pressure to the cervix. i was in a cesarean today too, because there was this lady in active labor, not progressing well, with thick mec, and i came in in case the bb needed to be resusitated. he didn't, all was fine. there was a baby born the other night who was about 29 weeks gestation, and is making it. we are tube feeding him colostrum. he weighs 1 kilo (less than 2 1/2 pounds). there is another baby who is 1.2 kilos, who is a little premature but mostly growth restricted, as the mom had pre eclampsia and probably has chronic hypertension. this baby is BF well, because he is able to suck. the other baby can't suck yet. it's interesting how this little 29 week old baby is vigorous and doesn't need oxygen and just needs help eating, whereas we see 33 week old babies that die.
just a little update...

Thursday, July 8, 2010

already july!

today is july 7th or 8th. june went by pretty fast, and july already seems to be moving along pretty fast too. things here are flowing along pretty well. all of the time, with so many little things in the hospital, in the street, everywhere, the depth/richness of the culture becomes apparant. the way people talk, the different accents people have, body language, etc. it is so, so interesting. i feel very lucky to have such an intimate look into another culture. there are many things that are always hard, but i guess i have gotten more used to them.
sometimes i get annoyed with the american midwives who come here for 1 week and have so many ideas of things to fix at the hospital, and so many questions for me that i cannot answer about the system here...they notice many things that i have already been dealing with for 4 months, and some of it is also their culture shock. i get really frusturated too, i feel overwhelmed too, at the enormity of the problems of the hospital, the healthcare system here (there is no healthcare system), peoples' apathy, etc. but...if i tried to fix everything at once i would go crazy and also, it's not my place to do that. it's very interesting, the constant influx of american volunteers. they all have really true observations and god ideas, and they witness death here and it is sad, and hard to understand, when we come from a culture where we can fix practically everything, where there is always a next step, a further option, for finding help. the opposite of here.
there is alot of death here. a couple of weeks ago there were 2 women who died from eclampsia. one of them was only 25 weeks pregnant. newly wed, first pregnancy. it happens. it is very sad. babies die, there is no NICU in this hospital, there is barely oxygen. babies who are slightly premature, who would definetly make it in the states, they die.
the woman who i was worried about, whose family took her out of the hospital, who could barely breathe and needed to be on oxygen etc, who i wrote about last time, well, i never saw her again. i imagine that she has died.
last week one morning when i arrived at the hospital there was a procession to behind the hospital in front of the morgue, and a large group was mourning the death of an 18 year-old, who had died at the hospital. i just was there, as a witness, it felt natural to be there. people were all mourning together...women throwing themselves on the ground, weeping...chanting...this one woman kept chanting: "pa gen moun anko...pa gen moun anko" which means something like "there is no one left anymore".....afterwards i asked someone what problem the 18 year old had had, and they said "nothing" in a very sad way, almost as if to say "people die here for no good reason"...
there have been more births recently; i have been in almost 100 births now since feb. today we had 2. there have been some interesting births for sure. nothing too crazy. also i am trying to focus on postpartum care with the students, having them follow up with the women and babies from the births they do, doing pp education, newborn exams, etc. i have also been spending some time with them in the prenatal clinic. we always do pn, pp, post op care with them in addition to labor/birth.
it has been really hot. it cools off a little when it rains. i miss cool weather. i never thought i would say that. i do miss cool weather. i think el paso may have been hotter than here, but it's a different kind of heat, it's so humid here. and i wear more clothing here.
still contemplating every day how long to stay...there are good reasons to stay longer and to go...i love learning a language...i'm at the point now where i'm just absorbing so much...feeling more ready to delve into French as well...
my friend sergio from el paso is visiting me right now...it's been interesting...it's cool having someone see where i am...there is nothing to do here though...but it's cool. i hope that he's happy he came. i think he will be leaving in 2-3 days. i wish i could make it more comfortable for him here, but the reality here is that nothing is easy. nothing.
so...maybe i will leave this post at that...i love all of you...thank you for your comments...i look forward to seeing all of you again one day...

Saturday, June 26, 2010

june 26th 2010

things are going smoothly here, as smoothly as i could hope for in hinche, haiti. things seem to be flowing more and more easily. each week seems to be passing more quickly. understanding and speaking more creole helps sooo much, with everything...things can still be as difficult as always here, but having the ability to communicate...we take it for granted don't we? it makes a huge difference.
i have made a new friend here, who has become kind of my dance partner...it's so nice, having something else to look forward to...i never thought i would find salsa dancing here...but yes. we have been practicing together once or twice a week, and going out maybe once a week...the house where i live i have to return before 10pm, but...it's still nice to go out for a couple of hours...i hope it continues...
i am 4 months into my time here...still on the fence about whether to stay longer or not...the longer i am here, despite how bleak it was for the first 2 months, how difficult it is still on many levels, i feel myself habituating more and more...especially with the language barrier becoming less...i feel more like a part of things here, like alot of people know me, i have some people here i call my friends, i feel close to marthonie and the students...we'll see.
today i dropped into the hospital to visit a woman that i sat with on monday night...she is gone, 5 days later, her family took her away, to bring her to a witch doctor. she may die. on monday night she could barely breathe, her respe were very shallow and labored, more or less 60-80 resps per minute, breathing with alot of effort...i stayed with her, with my hands on her. there was nothing else i could do...i got a nurse up, she found a doctor, who said just to keep her upright...there was no oxygen at all in the hospital...nothing else to do for her...her lungs sounded congested, she was coughing alot from time to time...i was wondering if she had tuberculosis...her dx was severe anemia...yes her hemoglobin was about 4.6 or so...but she also had some kind of lung infection...the next day she was put on o2, in the "ICU"--which is just a room with 4 beds in it, nothing fancy...they did a chest x-ray and a TB test and HIV test...i don't know the results of the TB test yet...she was given a blood transfusion (250cc) and needed more but the red cross was out of blood...today she is gone...i hope they bring her back in before she dies...apparantly her family thinks that her sickness is a "sent" sickness (voodoo)--sent by someone out of jealousy...so they are taking her to someone who deals with healing those kinds of sicknesses...
today there was also a 25 week pregnant woman with eclampsia...she had already had convulsions this morning...placental abruption, fetal demise...on B/P meds but not on mag because her urine output was so little...
there havent been any really spectacular stories recently...normal births, the usual amount of severe pre eclampsia, women getting D & C's with no anesthesia, and some normal births...i always notice that when a woman is starting to push, whoever is in the room kind of descends upon her and starts to order her around, what to do, how to put her hands, how to push, how to breathe...it's annoying, because it doesn't help, it only takes away from the moms' confidence in themselves to push...the other morning this started happening with a nurse and the cleaning lady...i finally just asked them to please STOP talking to the mom...this mom was really fun, she was very vocal, yelling very loud but in a productive way, just following her body...she was very sweet...during her labor i sat with one of the students outside as she was walking around outside in front of us...it reminded me of the old days...labor sitting...how i miss seeing midwives labor sit...
the students are doing ok...they are trying...sometimes i feel more hopeful for them becoming skilled midwives and sometimes i have very little hope...but they have progressed, i have seen that in my time here.
every night i have worked recently i see that the dogs (yes there are dogs that live at the hospital and go in and out of the rooms...) push over one of the trash barrels and eat all the bloody stuff inside...it is so gross...the other night, every single time i walked past where the trash was, there was this really strong smell of blood...then as i rounded the next corner it smelled like old piss...that's just the way it is here...
that's about all...i'm thinking alot about the woman i sat with monday night, hoping that she will be ok...she is still so weak, i can't imagine her being moved around, off oxygen, etc...i'm pretty worried about her.
love you guys...

Wednesday, June 16, 2010

other experiences

so, i have been able to have some other experiences outside the hospital recently...last weekend i went to this other town, called Pinin, with my friend Acner. It is his hometown. We rode on his motorcycle, about 1 1/2 hours each way, on a dirt road with huge trenches, had to traverse a shallow river a couple of times...quite an experience. it was relly beautiful to see the countryside, to see a different place...it just got greener and greener. really fun. people have this plant here that makes a natural fence, like a kind of hedgge, but it's a kid of cactus...really cool...saw alot of places with walkways made out of this plant...walkways and fences. at the town, we went to the market---soo loud and dusty---wow--and the hospital--bigger and nicer than the one here. very interesting.
then the next day, it was this endlessly long day, where i just laid around in my room and didn't do anything, i felt like i had nothing to do except lay down in bed or sit in a chair and read old obstetrics books...so i did that all day, oh yeah and think about my family...so that was the whole day on sunday, until...i went to go practice salsa with my friend Blada, and we had a good time dancing...at the end we danced salsa to a few old school rap songs--which i always want to do with people but people always say you can only dance salsa to salsa music--not true--this was so much fun. Then, it started raining really hard. i just stood in the rain, letting it pour onto me. there were 2 rainbows. it felt like, oh yeah, i do have things to do here, i do have a life here. doing things like this makes me feel this way.
blada and I also went down to the river the other day...and sat on the riverbank...there is green grass now from the rains...not like when i first came, and the riverbanks were just brown and dusty...being there, just right outside of town, it was so peaceful. sooo relaxing. i want to go there more. it's right there, a 10-15 minute walk.
today i helped in 2 births; there were 4 births all together this morning--i have the afternoon off and then am going to work tonight with 3 students. helped one student suture...she did pretty well, for her 2nd or 3rd time...
so...the time seems to be passing faster, which is nice. and, i am enjoying things here more. really enjoying working with marthonie. and the students. and the american MW's who come and volunteer. things are going allright overall. i think there are things that i will never be able to impart to the students and that's ok. but it is frusturating and perplexing too.
it's nice to do other stuff outside of the hospital, to have friends to hang out with, especially to go into the countryside and experience a slightly different vibe.
in a few weeks, one of my best friends, sergio, is coming to visit me. i am so excited!!!! can't wait for that.
i love all of you...

Friday, June 11, 2010

june 11th 2010

So...things are going allright...each day is passing...I am more than halfway through my 6 months here now. Each group of midwives that comes...it's so interesting hearing what they observe about this place, the hospital, the students, the program...everything they see are things that I have already been seeing and thinking about since I arrived in Feb...one of the MW's described this place/town/the overall atmosphere here as "bleak"...that is exactly the same word that came to me to describe the feeling here, a long time ago...there is a detachment that you see in the people...it's hard to understand...someone like me will never fully understand it because we did not grow up under these kind of circumstances...everyone asks me if this detachment may have to do with all of the death that people see...like when moms have their babies, and they just totally check out...is this because so many people have babies that die here? many people have had several babies die. it is very common. yes, maybe that is part of the reason. I'm not an expert on Haitian culture. I don't know fully all of the reasons for this.
Yesterday the day guard at the entrance to the hospital was being really uppity with this woman who was bringing food for a patient there (the families take care of the patients--bathe them, empty their pails that they pee & shit into, bring them food)---this woman had a few mangoes in her hand along with the other food she was bringing. apparantly, bringing mangoes into the hospital is "against the hospital policies". I couldn't believe how rediculous it was. So, mangoes are messy and attract ants, and they are against the rules, but, it is ok that the cleaning ladies in the delivery room are mopping the same bloody stinky water around on the floor, that there are sharps left all around, that there are splatters of blood left on the floor for hours, and dried blood on the beds that never gets fully wiped off, it's ok that there is not enough chlorox to use to clean up...the cleaning ladies bring chlorox in in these tiny juice bottles...just with a little chlorox inside...they have no rags to use to clean up...all of this is ok, but it's against hospital policy to bring mangoes inside? The hospital is ALWAYS out of the most basic supplies, and the familis have to go out and but stuff like IV tubing, antibiotics, IV fluids...all the time...but they are worried about mangoes? The same thing happened yesterday--there was this woman who came in and we were going to make a bed for her in the prepartum room and she had this multicolored blanket...the students said that the hospital wants people to only put white sheets on the beds...oh, so these people who have not enough money for food, and have to buy their medical supplies, they have to buy white sheets to put on their beds? Give me a break!!!
It's ok that there is all of this overt medical negligence...people who are really sick, barely being monitored...but, no mangoes and only white sheets. OK.
Yesterday, Marthonie, she was managing 3 different high risk patients with the students: a woman who had had severe pre-eclampsia, who had birthed the night before (B/P in labor was 240/140), another lady with eclampsia, who had already had 3 episodes of convulsions before arriving, a 38 year old G9 P11 (hx twins and triplets) L 7...also with same B/P, 220/140, and at the same time she was supervising a blood transfusion for someone with a 3.6 hemoglobin. She is really good, she is used to high-risk situations like this. I think that our skills and experience really compliment eachother. If it were possible for me to feel capable of staying here for the next class, I know that we could be a really good team. But...I can't stay here longer. It's not my culture, it's beautiful and special and interesting and I feel so thankful to have come here, but my heart doesn't feel at home here, like it does in some other places, like Mexico...but anyway, yes, I am impressed by Marthonie all the time; I feel like we both are seeing things that eachother know and that we could learn; that's really nice. I am enjoying getting to know her as a friend as well. Sometimes I think that it's hopeless with the students and the grads, but I see growth in Marthonie and myself, and I think that maybe that's the reason I'm here. I don't know. Sometimes I feel more encouraged by the students, and there are certain ones that are more motivated than others, but other times I feel really hopeless for them ever becoming skilled and wise MW's, and I think that some of them don't have the heart for it, it's just a guaranteed job for them...I guess it just is what it is, and maybe it's better than I think...
Part of me would love to stay here and keep working with Marthonie, and really follow through on ideas that would help with our teaching and with the hospital policies...but....no, I can't really see myself staying here.
Right now I am at the UN base here...I have become friends with this guy named Ratna who works here...they have internet...we're eating fried chicken and beer...I don't see the Un guys doing anything useful here for the people, but...maybe they are, who knows. The guys on this base are all Nepalese. They never learn Creole because they barely interact with the Haitians, except for their translators. They all seem like nice individuals though.
There have been steady births, nothing too spectacular...well sometimes there is but I don't always write about stuff in the blog because it's just too much I think for everyone out there who isn't a midwife...
I love you guys! Thanks for keeping up with me through the blog and through email...it helps me to feel connected to all of you...

Monday, June 7, 2010

dissappointments/achievements with students 6-7-10

i felt so discouraged the other morning after working the night with 3 students...one of them was really on point and helpful and helping me to massage and listen to fetal heart tones on these 2 women in labor, and the other 2 were not erally helping...you would think that if they saw me, their teacher, standing there doing this that they would come and do it...one of these women had twins! this is now the 4th twin delivery i've seen here. everything was fine. small babies though. 2.1 k and 1.5 or 1.7 k.
but today, we had skills practice class and it went well, and i could see how they are progressing with certain things. they still need so much help! but they were practiving vaginal exams for dilation, station, effacement, with these models, and that was really good,. we need to keep doing this. practicing htese basic skills. becasue in real life, when i do VE's with them, so many times they are way off. why? still? i don't understand why. there are many possible reasons.
what else...just going day by day, dreaming all the time about my family and community at home...in NC and EP...but atleast here, i am understanding the language alot more, and enjoying my friendship with marthonie tha tis slowly growing, and seeing her open up more and more as a midwife...
i miss and love all of you!!!

Wednesday, June 2, 2010

2 beautiful births today

hello...well it seems that my internet access is more stable now...yes! and each day i have had things to write about. today, i stayed late (till 8pm) because i didn't want to leave this woman who was laboring...also i was concerned about her and about this other woman, and no one there listens to fetal heart tones so i figured maybe i would wait until the students and american midwives arrived for the night shift and then i would leave.
so, i caught this woman's baby...this lovely lady, having her first baby. she was hypertensive, actually she had mild pre eclampsia (B/P around 160-170/100-110) and + 2 proteinuria, but no other signs. she had been on mag sulfate but now was just on B/P meds (hydralazine). anyway, she had appeared to be in active labor last night, when i left, and had been 4 cms BBOW 0 station. then in her chart it was documented that at 6pm last night she was 8cms. well, today in the afternoon, when one of the midwives checked her, she was 6-7 cms. she lad been laboring for awhile. she stayed the same dilation for awhile so we gave her an IV with pitocin (10 IU in 1000 ml). also, we started B/P meds again. there was no more of ANYTHING at the hospital pharmacy, so we couldn't give her the B/P medicine in IV fluid. there was no IV fluid, no IV tubing, no angiocath (to put the IV in the arm--like an IV needle), and also no medication (hydralazine) for B/P. so, basically, what happened after this, was that around 5 pm or so, the american MW's left, and maybe about an hour later i checked her, to see what was going on...hoping that she just had a cervical lip...well, i find her to be only 4-5 CMS. after the night before being 4 cms, then 8, then today being 6-7. the first time i check her, and she is 4-5. her pelvis feels roomy enough...also, she is pushing and can't stop. so, i thought we should call the OB in order foro him to come in and eval her, or atleast for him to know. there was also a VBAC laboring there, her 1st vaginal birth, and they don't usually do VBAC's at all. she was in active labor. i couldn't leave with both of these ladies there. the grad MW's don't monitor fetal heart tones AT ALL. i told them a few times that they should listen to the VBAC lady's FHT's every 15 minutes, because she was in active labor, and they never did. i also told them that we need to listen to the 4-5 cm lady's FHT's atleast every 30 min, because she was on pitocin, and because of her labor progression and her high blood pressure. well, i ended up staying and monitoring them both myself. we called the Dr, who I guess was busy because he said just to continue normal care on them, and didn't say if he was coming in or not. well, my lady, she walked around and squatted and pushed with contractions even though she was 5 cms, and after awhile, she was complete and pushing!!!! so i stayed with her. it was awesome! she was totally present, connected, doing really great. her 2 family members were with her. the cleaning lady came in and tried to kick everyones family out, but i told her we should let them stay because her bb was almost here. so, she did amazing, and had a beautiful birth. a beautiful slow head delivery. here everyone tells the mom what sex her baby is, which is not what i do--i like to let them see and tell us. i asked her what sex her bb was and held her baby up for her to see and she told us all it was a girl, and there was this climactic moment of joy, that i saw in her and in the 2 women with her, that i used to experience all the time in birth with families at MLL, but had never seen here yet. they had tears in their eyees! and she was happy! normally what i see is moms just totally checking out after the baby comes. she was happy! what a joy to experience that again. she had a tiny nick, i gave her 3 stitches. well, while she ws pushing, the other lady who was there, the VBAC, also started pushing. i helped to get stuff ready for her birth, and encouraged the MW to listen to FHT's after each contraction, which she didn't do because she just isn't used to doing it at all. i listened a couple of times. this lady had her baby, all was fine. the cleaning lady kept telling them both how to push, and finally when she said something to my lady, i told her to stop telling her what to do and what not to do, because she was doing great on her own and the bb was coming. geez! people want to help, but they end up taking away peoples' confidence by telling them what to do. my lady, i was just so happy for her. i had been worried about her. i had thought that maybe she did need a c/s. she was so appreciative for the help. it was really special. after all of this. Dr Celestin, the main OB here, he arrived, and saw that they had both birthed, and was really happy and left.
It was great. Another great thing from today was my meeting with Marthonie...things are just getting better and better with us. We are becoming better friends, learning together, trusting eachother more. I am so thankful for this. I never thought that this would happen, at the beginning when I first came, and there was not this openness, this collaboration. Man, the beginning was so hard. I am so glad to be 3 months into it.
Now, if we could only get our graduates to listen to fetal heart tones...

Tuesday, June 1, 2010

busy-ish day today, 6-1-10

today...it was a somewhat busy day...we had 2 nice pripip births, normal, nice, no big issues. there were also several women there with incomplete abortions...the OB did 3 D & C's in a row (scraping out the rest of the uterine contents). the third one, this woman was just in agony, in so much pain, and people are just standing around...ignoring her...i had to lead a student over to her side, and tell her to comfort her. she was doing some kind of paperwork, and was conflicted about what to do, and i said, what is more important? this woman or the piece of paper?! geez. there was a woman who was "5 months"--maybe 20-24 weeks, who had pre eclampsia, had swelling all over, and delivered a dead baby...i caught her baby, it was very small, the placenta was small, and friable and pale...there was another woman there whose baby had died in utero, she was around "7 months"--an 8/7 (8th pregnancy, 7 previous births). being induced. one of the knees was coming down through the cervix, which was about 3 cm dilated...poor lady. yesterday there was this woman who had been in the earthquake in port au prince, who came in and said that in the earthquake, something had fallen on her head, and that ever since she has had a headache that doesn't go away. it's so hard to know how to help people sometimes...is she just chronically dehydrated and undernourished? is she just traumatized from the quake? PTSD? is something really wrong? there is nowhere to send her for any of the tests that you would do to rule out a real problem, so what do you do? what do you do about people not having enough food and water? i see so many people, kids and adults, who yes, you look at hem and they look like they are starving. you want to help everyone, but you can't, and you know that if they have already come to the hospital here, they're at a dead end...where else are they going to go?
marthonie and i have been talking about trying to do some kind of continuing education for the MW grads who work at the hospital...i think we're going to start with neonatal resusitation, and then do labor monitoring, fetal heart tone patterns, kinds of decelerations and their significance...that would be a good place to start.
there is no one else here to do that for them.
well...just another normal day here. a few ladies with pre eclampsia, a few stillbirths, a few normal births, a few abortions...all in the same room.
it is very interesting. very very interesting.

Monday, May 31, 2010

lovely primip birth

We had a lovely birth today--I caught, a 1st timer, who was awesome...me and the 3 new American midwives, they were my birth team. There was a MW grad there, who asked me if I didn't think I needed to cut a episiotomy, and I explained why not, and there was a dr who kept coming in and hovering and then backing off, shaking his head, because he thought we should cut an epis, and never sees primips take their time and stretch. I really felt that I was protecting her from getting an epis, just standing my ground there. I kept explaining to him why she didn't need one. All was normal, good heart tones on the baby, progressing each push, etc. I wish he could have just watched the whole delivery. This woman kept eye contact with me and I knew that she knew that I was the main one taking responsibility for helping her. I understood everything she said and she understood everything I said. She did amazing with the head delivery: she would push a little when I said, then stop when I said. It was slow and controlled, and she didn't tear at all. Totally intact. The Dr was gone already or I would have showed him. Oh, and he came over a few times also to tell her how to push. He said "I have 3 children". Like, as if that makes him understand her experience. I really wanted to say: "And did you push them out?!" But I thought that might be taking it too far, since i was already making him stand back, literally pushing him away energetically.
> I was just happy that this woman got to have a good birth.
> But I wish it wasn't just me and the Americans doing births like this.
> The other day, the floor birth with Marthonie and the students, that was a very encouraging sign. The first time I've seen something like this here.
So maybe there is change happening? I definetly have seen Marthonie open up alot...to other ideas of doing things, to trusting me. And I have seen the students make progress in their ability to emulate compassion. I see a great need for continued guidance and education with the graduate midwives. I will try to do some of this while I am here, but there needs to be some kind of structure in place for them also. For them to practice skills, enhance their education, etc. One problem, one big problem, is the lack of books and teaching materials in French. They must be out there. But, they're not here.
There was a wonderful rain today...long and strong. Tonight the internet is suddenly working here, at the rectory...so, I am so happy to be able to blog!
Last evening I sat with a few different people and talked to them for awhile...at the plaza and at this outdoor little music club...I am understanding so much more Creole, all the time...I love understanding it...I am so thankful to be at this point, where I am over the hill...more or less cruising now...compared to before...with the language, with how comfortable I feel here...
I love all of you!!!
I miss you guys too!

Friday, May 28, 2010

may 28th 2010

I still don't have internet, but...I am at a new friend's house...this Nepalese guy who works for the UN here...they have internet here in their camp. So...
I saw something 2 days ago on my 30th birthday that really really made my day, and was the best birthday present ever. I walked into the delivery room, where Marthonie and the students were with this woman who they had allowed to labor on the floor and she was now starting to push there, squatting, and they were letting her stay there. they put a towel beneath her. I got behind her and she continued pushing, pulling on my arms as she pushed. It was a beautiful birth, easy, physiologic. Her placenta came there too, squatting there. It was the first time I have seen anything like this here, besides when the American midwives have caught babies on the floor. When one of the MW grads came in and reprimanded everyone for letting her birth there, because "the hospital admisintration would be mad", Marthonie stood up to her and explained why it was better this way for this woman and told her that she would "take the blame". I was really touched by all of this.
Later on, in the evening, I noticed that it was nearly a full moon, basically a full moon, and with both of these things, everything felt in balance.
Things are basically flowing along pretty well. I feel like I am in the groove with Marthonie and the students. I have seen more change than I thought I would at the beginning. There are so many differences here that make it hard to achieve the same level of education that you would expect normally, anywhere else. And cultural differneces in the ways that people learn, and the ways people communicate.
It is all very interesting. This is a very interesting and special experience for me, and I hope for those around me as well.
Oh, I ws going to tell you guys something else: the day after my birthday, it was so sweet, I was included in the birthday celebration of my friends' daughter, who turned 2. They had this party, for the both of us. They had this cake that said "bonne fet reina galjour" and they had this speech and this beautiful prayer before we ate...it was very special. they were so happy to have me as part of their celebration. they sent me home with the cake--on the back of a motorcycle--and i got home and shared it with those at home, where we were also co celebrating someone's birthday who lives there. except there was nothing there to celebrate with, except the beer i had bought and the cake that was donated. it ws so nice though. we each got 1 beer and some cake.
i love all you guys...

Monday, May 24, 2010


Hello to everyone...
I have missed writing in the blog...unfortunately the internet where I am staying is down, and I think it is going to be AWHILE before it is fixed. So, I have been unable to blog...but I will continue to do it as much as possible; it is a relief for me when I can, because I feel connected to all of you and like I am sharing my life/story with all of you...right now I came to this building at the hospital that has internet...so, good.
Things here are going allright. Each day I feel that I can understand more Creole and speak more. When you are learning a language you always understand more than you speak. That is how it is for me. I feel more accustomed to the hospital, although still surprised and dismayed at things there pretty often...I have made more friends in Hinche, so that is nice...
What is going on here currently...well, my 30th birthday is in 2 days...still don't really have any kind of plan for how to mark it...I want to do something, but here, there is nowhere to really go, and I don't have a house where I can throw a party...so, I don't know...maybe I will just spend the evening (after work) alone, reflecting, writing...which I have been doing alot of recently...there is alot of time to think here...maybe too much time...that was what one of the Cuban doctors was saying the other day...I went to the house where they all stay...we were hanging out, talking about living in Hinche. He was saying that you have too much time to think. He was saying that there have been doctors that have come here and left crazy. Everything he was describing...were things that I have noticed and thought about already, but it was interesting hearing him put it all out there. He was saying how, this is a hard place to live. It is a town with no electricity. There is nowhere to go and sit, listen to nice music, dance. There are a few little nightclubs, but they mostly play Haitian Kompa music, which to me and them is very boring and repetitive. To me it is like generic watered down carribean music. sorry to say. I would rather listen to salsa, merengue, anything Latin. I was thinking about this the other day: it dawned on me that I really miss Latina culture in general. The vibe here is different. I think that is part of why I am also not really attracted to any of the men here. They don't have that sensual Latino energy. Anyway, this doctor, he was describing how hard it is for himself and others from Cuba to live here, and, he just sounded so burned out already. He has onloy been here for 4 months. He has 2 YEARS to be here, in Haiti. It is a hard place to be. You also get burned out on the apathy of the healthcare providers around you. That was another thing they were talking about. I am thankful that I only have another 3 months to go. I am at the halfway point of the 6 months that I committed. I may possibly stay longer--through Nov--through graduation of the students--but, I don't really want to. I am trying to just enjoy and appreciate the life experience that I am getting here. I don't want to be pessimistic about it. I really do want to enjoy the culture and people. I stop and talk to alot of people on the street. I let people talk to me. you have to put up somewhat of a protective shell around you, because you are constantly on display. People just stare at you, or yell out "blan!"--it gets taxing when it is people over and over all day every time you go onto the street--but, I try to not take it personally. I know not to but I still have to really make an effort not to. Sometimes I feel like I could stay longer, when I feel really uplifted because I am understanding so much more creole, or when there is a busy day in the delivery room. But, it is also just so hard to imagine staying longer, because it is such a harsh environment to live in. Lots of dust and pollution in the air. Not good access to food. I am not in shape anymore the way I used to be, which is depressing to me. I want to leave after the 6 months, get in shape again, get healthier, and also, spend time with my family in NC. It has been almost 7 years that I have been living apart from them and seeing them 1-2 times a year for 2 weeks at a time. So, we will see what happens. I am still open to the possibility of staying longer than the 6 months, but at this time, I just have to think of it as 6 months.
Interesting things recently...I did another hard manual removal (of the placenta) the other day--this lady had birthed at home about 5 hours prior--the placenta was way up there, on one side of the top of the uterus. Hard to get. But I got it. Also, I sutured someone 5 days after they gave birth--at this same hospital--she had a tear that separated her clit hood from inner labia, shich was just hanging down--it was easy to do, and easy to debride--just with gauze. Haven't had a lot of births, but some...I stayed late the other day and caught someone's baby who I had been supporting since she was in active labor--a 2/1 being induced on misoprostol (cytotec) for 44 weeks gestation--who know if those dates were really correct...maybe they were...anyway, her birth was fun...she benefitted from the support...the midwives here, they don't do any kind of labor support, at all. There was this woman the other afternoon--I stayed after class with 2 american MW's until the night shift arrived (with more american MW's and 3 students) because this woman was in agony, being induced with pitocin after being diagnosed with placental abruption and fetal demise...her first pregnancy, 18 years old...just writhing on the table...myself and the 2 midwives came into the delivery room where she was, and the haitian midwives were just doing paperwprk, not doing anything at all with this lady, except telling her not to cry...
I know that part of the lack of compassion & support for the laboring and birthing women is cultural, and I accept that. I just don't know how much of it is cultural and useless to try to show another way, and how much of it is just training and experience with that model. Same thing when there are dying babies. They just get left on this table to die by themselves. How much of this is worthy of attention, of discussion, of trying to show another way, and how much of if is appropriate, in a place where so many babies and people die all the time...a survival mechanism, to be able to keep functioning, in a place so devoid of resources and help, options...I don't know the answers to these questions, but I think there must be a balance of both realities in the answer...it is possible to improve certain aspects of the care we provide, even in a place that sees so much death...it is also possible for someone like me to accept and validate the way they already deal with this...and respect it.
Certain things I just cannot accept though...like, the other day I walked into the delivery room and there were a few graduate midwives there, one wqas catching a baby...3 were seated, one was asking the mom, who was pushing her baby out, questions like "are you married/where do you live"---and no one was listening to the baby's heartbeat....things like this, it just feels like total negligence to me, and things like this need to be improved. basic midwifery skills, like labor monitoring, neonatal resusitation, etc. VERY IMPORTANT skills.
so, it is a long process. the graduates need continuing education. the current students, I hope that something I do here will be of value to them in their practice of midwifery.
Marthonie, my co-teacher, I am enjoying her alot. She knows alot of stuff that I want to learn, and vice versa. Our skills and experience are quite different and we both need what the other has. We both see that. SO, it is good.
American volunteers come wach week, and it is mostly my job to orient them and put them in the schedule. We have them doing 3 nights/week with the students, which is realyl good. I am glad that they are being utilized, since it takes so much energy and money to come here. Sometimes I have really felt that the volunteers are not being utilized well and that it's a big waste of energy to come here for only 1 week. As things have becoem more and more organized, it feels more worth it.
I hope this posts after all of this writing! I miss all of you and love all of you! I will write again as soon as I can...maybe in 1-2 weeks.

Wednesday, May 12, 2010

settling in more

i am still settling in here. trying to spend more time outside, in the street, with people. trying to reach out/respond to other people reaching out to me. the people here in general are so friendly, so interested in talking to you. it's still surprising to me in many moments because i'm just not used to being in a place where so many people are so open to talking to me like this. they ask all about your family and everything.
the other day i went with a friend of mine out into the country a little ways...it was so nice. so nice to see a different place, outside of town. the air was so fresh, there were more trees, there was a river....he helped me gather mangoes to bring back here...it was enjoyable. i think we are going to go back this week one day.
there haven't been alot of births lately; today there was this woman who had been referred from another hospital where they don't do c sections, who her baby was in a transverse lie, and basically what had happened was that she had probably labored at home for a long time and then finally gone to the hospital. when she arrived at st therese, the baby was totally impacted inside her, one arm was hanging out, and her uterus had ruptured. the OB had to do a hysterectomy and she got a blood transfusion.
i am enjoying getting to know Marthonie, my co teacher, more. she is really delightful and collaborative. it is really nice to be developing a relationship with her.
i am understanding so much more creole now. i can have a conversation with anyone, i can find a way to understand anything that they want to tell me. it is so nice to finally be at this point. not as good as it could be, but so much better than before.
i am halfway through my time here if i only stay the 6 months. i am not fully decided yet whether to stay longer or not. i am thinking of it as that i am staying the 6 months, and then going to NC to be with my family and community there, to have a nice long visit there before moving on to the next thing. we will see.
love you all...

Thursday, May 6, 2010

an almost c-section

So today was interesting...isn't it always so interesting here...this morning I arrive and there's this lady who was sent from a different hospital to St Therese because she had "CPD" (bab'y head can't fit through the mom's pelvis)---I ask how dilated she is, and the MW from the night before says she's complete...she has been there for half an hour, and they have already called the Dr and started prepping her for a c/s. I check her, and the head is low, and she is starting to push a little, and she feels like she has enough room to me. She is exhausted, out of her mind, and just chanting over and over that she can't do it and that she doesn't have enough room for the bb to come out. Because that's what everyone has been telling her. I say that I want to help her, and I start trying to help her. And monitoring her (fetal heart tones). The MW and nurse from the night before get angry with me and are being VERY negative and there are all these people talking at once--the students were all there--no one is trying to help her, or me, no one is tuning in. Except one student, she tuned in and came and stayed by her side and was supporting her. But there's all of this noise and negative talk about how she DOESN'T have room, etc...and they're like: "there's caput!" (swelling on the bb's head). that means that there is CPD! and I'm like: " no, caput is normal. " she has enough room. well, luckily Marthonie walked in, and I told her what was going on, and she checked her too, and agreed with me that she felt roomy enough to try for a vaginal birth, and she tried to explain to the people who were mad that she agreed with me. She really got my back. The Dr arrived, he checked her, and let us proceed. Unfortunately this woman was already so scared and convinced that her body wasn't capable of doing it, that it was hard, but she DID get into it. After a little while I was able to get her into a kneeling position, off her back, and that helped. And people started collaborating and helping (the students). And, she had her baby. It was fine. Everything was fine. The Dr came in awhile later and was very happy to see that he had birthed, and thanked me. I thanked him for his patience, and for him allowing us to help her. He thanked me for my patience. This lady was on the brink of getting a c/s that she really didn't need. It was like, she had come in, and the people here, they didn't eval her for themselves, they just said, ok, she can't do it and needs a c/s. when she was so close to birthing. Geez. The other thing is the chaos, the yelling, having all of these people around, with no one actually helping the mom. So, I was very happy, and very thankful to Marthonie for her support and collaboration, but also very annoyed at the fact that this other MW had gotten so angry at me for wanting to help this lady and for challenging a bogus diagnosis.
We had another birth later in the afternoon--a nice birth--another first timer, who was exhausted and out of her mind, but that is normal, and it was nice, no one was mean to her, the MW's and nurses who were there with me, we were a good team...in the end we ended up cutting an epis, and it was the right thing to do--but, everything was good.
Ok...that is all for now...the days are passing a little faster now...I am settling in a little more to my environment...accepting it more...I feel so thankful for that...
love you all...

Monday, May 3, 2010

May 3rd 2010

So...things have been really up and down since I've been back...there were a few days where I just felt so down, like I just felt so useless, at the hospital, so unsatisfied in my work as a midwife, like I am operating on 20% of my capacity, not finding ways to really effectively teach what I want to...like the other day with the 2 squatting births...I just really felt discouraged.
Then, after realizing how sad I was, and have been here all along, I think part of this sadness was liberated from me, and the weekend was really good. I made myself go out and sit at the plaza, and meet people and talk to them. I made some new friends, one guy, went to his house, met his wife and daughter...his wife is in nursing school and wants to be a midwife...she was naming everything that I see at the hospital, talking about it, all the behavior towards the patients, the lack of awareness and compassion, the lack of true care...with this kind of awareness I think she would make a good MW.
I also went and practiced salsa dancing with this friend, named Blada--he is a pretty good dancer...it was fun, and I hope that we can continue to do this regularly. I can definetly learn some stuff from him.
Yes, it was a very social weekend.
Then, today, it just so happened that the new American MW's hadn't arrived yet--I had thought they would arrive on Saturday--and that they would have a translator today and we would teach the class together on postpartum hemorrhage. Marthonie was out of town--she normally does the Monday class. Well, it turned out that it was just me, and I taught the class all by myself, in Creole, with no Marthonie and no translator. My Creole is nowhere near fluent but I am understanding more and more and able to speak a little better each day. Doing the class today felt like a big step/accomplishment to me. ANd I enjoyed spending time alone with the students. I really like them. I really care for them, and they care for me too. The Haitian people, they really open their heart to you. It's beautiful.
I met some people this weekend who used to live in Port au Prince. They lost spouses, children, parents. They lost their houses, and literally have nothing. It is so crazy, how can there be so much suffering? How do these people continue their lives? They are so stoic. It's really unbelievable the level of hardship that is normal for people to go thru here. I wish that the world could be more balanced, have a more equal distribution of wealth and resources. These people are just totally ignored. So many people here cannot access whatever aid is coming in. I asked someone if he could get a card that enables him to get food handouts each month. No, he couldn't get it. End of story.
Ok...tomorrow all day at the hospital...

Thursday, April 29, 2010


So, I am back in Hinche after a short break, which was WONDERFUL and REFRESHING. FIrst, I went to El Paso, spent a couple of days, saw Sergio, Kaley, and some other wonderful midwife friends. It was so refreshing. One unexpected really sweet thing was that Sergio and Eduardo organized a benefit for me, and raised money to help with my travels! That was so sweet. Sergio even painted this huge painting of me catching a baby in Haiti.
After this, I went to the Midwives for Haiti event in Virginia that was the original reason for me going to the US. IT was good and I got to learn more about the overall vision of the organization. And alot of work was accomplished.
After this, I was able to spend a week in NC, which was wonderful. I got to spend alot of time with my family, and saw some friends too...thank you to all of you...to those of you who I dodn't see, sorry, there really was hardly any time, but I am looking forward to coming back this year after my time in Haiti, and spending a longer, more relaxed time there.
Things have been mostly uneventful here. Today I ended up catching 2 babies in the delivery room with both moms squatting on the floor. Which the hospital administration HATES. They hate for women to birth "on the floor". (Even though you use the same piece of fabric under them that you would on the dirty table). But with both of them, it was simply impossible to move them onto the tables. I tried to use it as an example to the students of how we can assist women in different positions and how this is normal. The first woman, she had already had 2 homebirths, and was more self-directed than most of the women who come. She simply got herself onto the floor and was having a really hard time, alot of pain, and different people were scolding her and trying to tell her what to do. Her IV even came out from her thrashing around. To me it was all fine and normal. I caught her baby because everyone else was backing away from her and saying that she wasn't cooperating. I just stayed with her and reassured her that she was doing well. I hope that this example sinks in to the students who saw it. There was a MW there, who graduated from one of the prior classes, who wasn't pleased at all with her birthing there, and in fact I had already said something to her about that she doesn't need to yell at the women...she basically walked out of the room while the birth was happening. What was I supposed to do? Abandon her there? Force her to get onto the tiny metal bed while she was pushing?
Several times a day, everyday, I go back and forth with my feelings about being here. Sometimes, I feel like I will never learn the things I need to learn to really work effectively at this hospital...there are so many differences, and hardly any organization...and I lack knowledge about drugs...then I also feel that the model that I bring, is this tiny voice amid all this shouting...then other times I feel like I am making progress in my understanding of things there, and the language, it is improving day by day...I go back and forth about wanting to leave as soon as my 6 month committment is over, and going somewhere more peaceful, relaxing...having ample time to spend with my community on NC and EP...then I think that if I just stay a couple more months, I can see this class through their graduation, which would be very special. They are very sweet to me. Very sweet. I know it would mean alot to them if I stayed the whole time.
Time will tell.
Well, I guess that is all for now. Thank you to all of you again for all of your support and love!

Tuesday, April 6, 2010

Busy day...4/6/10

Today was a very exciting day at the hospital. I stayed there all day because there was so much going on. I used to always love it when it was crazy busy at MLL (Maternidad La Luz). So, I really enjoyed the craziness of today.
First off, we had 2 normal vaginal births. There are several volunteer American midwives here this week, so there were a couple helping in each birth--helping a student to catch. I helped one student, and at the same time, the other woman was birthing (in the open room where everyone gives birth). The woman I was helping with, it was her 6th baby I think. 5th or 6th. Her placenta was partially detached and after trying for a little while just with cord traction I just put on a sterile glove and went in and detached the rest of it--it was VERY easy--totally different than the other one the other day. That was it.
After this, there was a woman who had given birth at home but come in for sutures. I helped a student with that, but ended up doing alot of it myself. It was an easy 2nd degree.
While this is going on of course there are alot of other women in and out, and the other staff working with them. I try to help with births when I'm there with the students. The other staff is very gracious about letting us come in and work. I am pretty amazed actually by how easygoing they are with it.
So, after this, there is this woman who comes in, and I'm trying to figure out why...well, all she said was that they sent her from another hospital, because the bb wasn't coming well. So I'm thinking: not coming in a good position? Or has not good fetal heart tones? Well, finally someone pulls out this letter of reference from a hospital 2 hours away, stating that the cord is coming first. I look, and there it is: a piece of gauze in her underwear, and the cord in the gauze. She had come 2 HOURS to the hospital with the cord hanging out of her vagina. I immediately put her in knees chest position and put the cord inside and held it inside. Well, her bb was coming transverse. So I could feel a hand, arm, foot. It took a little while to get in action for the c-section but finally it happened, and the bb was actually ok. The woman, she was just praying the whole time. The mother. She was full of grace, just praying. It was beautiful. The bb needed resusitaion, of course, but was fine. I got to watch the whole c-section, which was cool. Both the Cuban OB and the Haitian OB were in there. Good outcome. I still can't believe she came 2 hours. The other hospital, they don't have the facilities to do c-sections.
After this, I returned to the delivery room, and it was still full. There were a few labor assessments to do, and a few people in labor, and a woman waiting for a curettage who had an incomplete abortion.
Two of the laboring women were laboring with twins!
The first to birth, it was her 11th pregnancy. Both bb's were cephalic. She birthed fine, the bb's were a little premature--maybe 35 weeks or so (from what they looked like)--weighing around 1800g. Marthonie was able to get oxygen, which they needed, and we kept that on them for awhile. 2 of the American volunteers stayed on the bb's until we finally moved them to pp with their mom. I was and still am a little worried about them--they could have used supplemental oxygen still--and they weren't breastfeeding too well yet. Alot of moms, they put their baby to the side, maybe for the whole night, without BF them at all--and the staff doesn't usually notice/help with this. I saw a baby die here once who I think basically had been left all night by herself without any contact with mom, and she just faded away. By the time someone noticed, it was too late, she was almost gone. Anyway, so I really try to help the new moms start breastfeeding and holding their babies.
The next lady with twins, she also birthed fine. Her babies were bigger. They looked term. They were also both cephalic. This lady had 2 seperate placentas, joined by membranes. The other lady had a fused placenta.
It was so great to have 2 MOMS with twins laboring at the same time...plus alot of other stuff going on--everyone was busy.
When I left tonight, there was still one woman in labor. She was 10cms, just with no urge to push. For atleast an hour.
Being busy at the hospital is fun, and gratifying, and interesting. But, however much I may be helping or teaching, I am aware that there is alot of stuff that I don't know enough about yet to really help. Like: I did a couple of assessments on ladies who just needed to go home and rest, everything was fine--and Marthonie agreed with me--then there was this other lady, who also was fine, who I was going to send home, but Marthonie prescribed her anti-vomiting meds. It's the pharmacology that I don't know enough about yet.
I guess there is stuff that I am teaching that is very important and needed and there is some other stuff that I don't know enough about to be helpful with, and that will just have to be OK. I wish I could be proficient at everything, but that is impossible. And I know that what I am bringing is valuable.
I really noticed the students today doing well with the laboring moms. Being sweet with them, massaging them. I wasn't seeing that at all when I first came. The other volunteers who come have been modelling that behavior as well. It is rubbing off...I hope it sticks.
I am going to the US for 2 weeks on Monday 4/12. I am going to a Midwives for Haiti retreat/brainstorming session. I am briefly going to see my family, which I am so thankful for. I have missed them SO MUCH. I would like to see other people but there just isn't time this time. I will be home after this fall. And have time so see people. This may be the last blog before I go. So if it is...thank you to all of you who are reading it and keeping up with my life here. Thank you for being present with me and sending your love and support.