march 31st 2010

so...
i enjoy writing this blog, it feels like writing in a journal, except i know that i am sharing it with all of my friends...i hope that you guys find it interesting...for me it helps me to feel connected to all of you...there would be no way to capture everything or describe the real details of what i see here all the time, but at least this can give you guys a glimpse into some of the parts of my life here...my work here...
things seem to be going better and better...man, it was so hard in the beginning...it still is, but at least now i am getting the language more, and am more used to my daily life...it's so good to put ourselves in these situations, where we have to drastically adapt ourselves...you look around yourself and see how the people are so proficient at living on nothing, and you really see how easy your life is...it is amazing...and very sad...you see the injustice in it...how is it possible for the resources in some places to be so limited and for other places to have such an overabundance? of everything? it's incomprehensible.
so...yesterday we worked at the hospital...today there was class for the students with the volunteer american midwives and marthonie and i had our weekly planning meeting...i am happy with the way my relationship with marthonie is unfolding...we have alot to learn from eachother and together...she is experienced with managing pre-eclampsia and eclampsia with meds, for example...and i have seen other people do it here but i need to do it with my own hands...so i have her to guide me...we both want to learn how to do manual vacuum aspiration (for women who come in with incomplete abortion) and we may be able to find someone here to show us...the 2 doctors here do it all the time...in the delivery room...i have seen it many times now...anyway...i can learn alot here as i also share my knowledge and experience...yesterday for example, i put this woman in hands and knees, she had an anterior lip (the top part of her cervix was not fully dilated)---and the new cuban doctor said that he has never seen someone use that position...he was asking me about it...so we all have things to learn...one good thing here is that there doesn't seem to be alot of ego involved in peoples' work...the haitian dooctor, he is a really nice guy...works cooperatively with everyone...i really like him as a person, and like everyone...it is a weird thing to like someone and separate yourself from your dislike for them when you see how they may treat the women...he is very rough, but always smiling...an interesting combination...the cuban doctor who was here, he got moved to another place...but there is a new cuban doctor...we went out and had a beer together tonight...the other guy, dr "papito"--that was what everyone called him--he was a character. very dramatic. we got into a few arguments, but we liked eachother and he showed me some things...we did a breech delivery together, and he also let me watch a cesarean and 2 tubal ligations that he did...and explained everything that he was doing...this new cuban dr, i like him well enough--it's the same thing: you get along with them, and then you see them be really rough with a laboring woman, and not even know that they're doing it---they think she isn't cooperating and they just keep going...but you know that they don't even see the pain that the woman feels. they don't TRY to hurt the women. they just have no awareness of how the way they are touching her is affecting her.
yesterday, we arrived at the hospital (me, marthonie, the students, and the american volunteers) and the first thing was a somewhat premature birth (34-35 weeks). after this, there was this woman who had come in the night before after delivering at home, because her placenta hadn't delivered. 2 midwives had tried the night before to get it, and couldn't. so, everyone was waiting for the haitian OB to arrive to do a manual removal. luckily, one of the american midwives had brought some ketorolac, a pain med, and we gave this to the woman. well, the doctor tried to get the placenta and he was just pulling out little pieces. he said his hands were too big, and when he said that i volunteered to help him. and he was grateful and let me do it. it was a very hard manual removal, it tool me awhile to get the placenta to fully separate, because it was implanted way high, way in one of the top sides of the uterus. it was HARD to get. finally it came, and was complete, minus the pieces he had already pulled out. this is what i mean that peoples' egos aren't involved. he was glad for the help.
he also left us yesterday with this woman who had been on pit augmentation and was pushing when he left...she started pushing before she really had a good urge--the cuban OB had pushed her lip back and then started doing fundal pressure, which i got him to stop...but that was how her push started...well, she pushed for almost 3 hours, and it was hard. defineltly some degree of CPD going on...we finally got the bb out with a vacuum...one of the MW's did it...now that i saw how it is done, i see that it's a very simple device, that we definetly should have on hand to use in situations like these...the FHT's (baby's heartbeat) had been good throughout the push, but for the last 10 minutes or so they were VERY high. the bb needed extensive resusitation...
we will see what tomorrow brings...
some days i feel like i am getting used to my life here and feel content, and i definetly always feel thankful for the opportunity to learn from the people here...not only in the hospital, but everyday people....other days, i can't imagine being here for as long as i committed and i just miss home and family/friends...but...this is what i chose so life will just continue to unfold here....
ok, love to all of you...
still no luck uploading pictures...
reina