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, August 27, 2010

life in haiti

yes...
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!
reina

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...
reina

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.
Reina

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...
Reina

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.