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.

Monday, June 20, 2011

6-20 june, 2011

6-11-11

Things here are going really well. This is the easiest time so far this year. The students are doing great; we’re over halfway through the class year. The house is way more relaxed--for the 1st 5 months of this class year, starting in January, we had volunteers every single week, with no break. For 5 months. Now, we have had a couple of breaks, and, for over the past month, we have had all really great, really easy (low maintenance) and fun volunteers. And, Kirsty and Mackenzy have now been here for 2 weeks, and this has added a wonderful element to the household. It feels like more of a community now. We’re living with people who we share a lot of things in common with, even just with our lifestyles and overall beliefs…we get along really really well. It is so good. I like Kirsty so much. Also, with them here, and knowing their vision for their life here, it makes living in Haiti more appealing. They have land in the south…they have lots of gardens…

What a blessing. Blada and I are great, just more and more connected and in love with each passage of time. He is so wonderful, I just can’t wait for those of you who can, to meet him when we come to the US. This weekend is our one year anniversary. A year ago, there was a day that marked a change in the course of our friendship. We had already been getting together for awhile, on and off for 1-2 months, to dance. To practice. Well this one day, we had finished practicing, and then their was a huge downpour of rain. A thunderstorm, with lightning, wind…and 2 full arc rainbows in the sky. A beautiful storm, a sign from nature. This day, we danced in the rain. And then sat down and talked for awhile, in the rain. This day, the energy began to shift. This was the beginning of us dating.

Anyway I could go on about that but I’ll leave it there.

Nothing else too spectacular to report…well, one sad event, which repeats itself every 1-2 months without fail: a woman died at the hospital. She was a small woman, who was very pale and weak from anemia. She came in with a hemoglobin of 5, not as low as some people who make it here--got a transfusion after days of waiting for blood, and then was at the hospital still for about 2 weeks. I spent some time with her, talking to her about her ailment (to her it was a sickness that someone had sent upon her with black magic, someone who was jealous of her…)…talking to her about nutrition and all the thing sshe could eat at home for iron…
Well, this came as a surprise to me because I had just seen her 2 days before, but yesterday I heard that she had died. Apparently she started having diarrhea and vomiting. I don’t know if it was cholera--but it definetly could have been, and I think she should have been rushed over to the cholera tents (in front of the hospital) for treatment. Anyway, I guess she got really dehydrated and died. I don’t know more info about it except for that. She had one child.

6-20-11
Well, this week was crazier than last week. Another woman died at the hospital--this time from a placental abruption. I wasn’t there--apparently she had the classic signs--her belly was hard and full of blood (but no external bleeding). Anyway, they didn’t do a c/s--they don’t always do them for abruptions, if the mom isn’t bleeding a lot and she’s stable--but, in this case, she had already lost so much blood when she showed up, it may have been too late anyway even with a c/s (they don’t have blood available in the hospital)…so, she birthed (a dead baby), and then died 1 hour later.
The next day, there 2 eclamptic women--one of them was 16 years old and came in seizing. She was in labor, 6cms. We got her on mag sulfate…I had to leave before she had her baby, but she was pushing when I left. Most of the time when I was there, she was unconscious, after the seizure. She started coming around a little, getting a little responsive…but really out of it, thrashing her body around, really agitated…when she was unconscious, you could still tell when she had a contraction…she would moan and kind of thrash around..it was still hurting her..
Well, she had her baby after I left (the FHT’s were great the whole time I was there, and we were listening often). I guess the baby wasn’t OK when he was born, and needed to be recessed, and then they gave him to the “ped unit”…(it’s not a real ped unit…)…anyway, he died the next day..there were 2 or 3 babies who died this week…1-2 days after they were born…the hospital just doesn’t have any means of giving care to babies who need anything more than IV antibiotics…they don’t even have oxygen to give them…anyway…this mom, I’m not sure how well she’s doing…I haven’t heard any really bad news, but, I heard that the next day, after her birth, she was unconscious again…I guess she seized again….I don’t know if they were monitoring her appropriately and keeping her or mag sulfate to prevent more seizures…
Well, the same day that she birthed, there was another woman, who had a previa. (the placenta is situated over the cervix…so when the cervix starts to open, the placenta separates and the mom bleeds a lot and both mom and bb can die). This woman, at one moment, I thought she was dying in my hands. She was waiting to be wheeled into the OR for a c/s, and I was doing vitals on her. She was bleeding A LOT, and a few times said that she was going to die right there. Well, she lost consciousness at one point, and I opened her eye and looked into it and it looked like it was flat, fixed. I took her B/P, and it sounded like either 40-20 or nothing at all…it was faint. Well, she was still alive and when I took her B/P again, it was actually 80-40. She got her c/s and a blood transfusion and was OK. I don’t know if her baby made it though.
The next day after the 16 year-old eclamptic woman and the placenta previa woman, there was another woman who came in with an abruption, but birthed and was ok, and another woman who was eclamptic, and, to top it off, there was another woman, who had a bowel obstruction and was vomiting shit. I’m not kidding. Thank god, she was transported to Cange and hopefully had her operation STAT and hopefully was ok.
So, this week was crazy. The students see so much here. They are like 6 months into the program and they’re working on super super high risk sick women. Being a midwife in Haiti means that you will work with a high-risk population, no matter what. You will see death, and severe pathology that midwives (and doctors) in the states would never see. People here become midwives because they want to save peoples’ lives. If you ask anyone here why they wanted to be a MW, that is what they say.

Our new housemates, Kirsty and Mackenzy, we are really enjoying them. We flow super easily, enjoy hanging out together, etc. it’s great. We always had a sort of community here at the house, but now, it’s on a totally different level. They’ve started gardens, compost…he’s an agronomist. He’ll be bringing his little daughter here soon too, which will be nice for the house…we already have Jamlex, our cook’s baby, who comes here with here all the time and is SOO much fun (he’s 14 months old…), so this will make it even more like…a family. Really cool.

What else…I’m still trying to figure out in my mind some way to not be affected by the way people can often be in the street…comments all the time about the white girl…I’ve written about this before…anyway, I haven’t found a way to filter it out yet…but it must be possible, because in order to survive at the hospital, I have had to convert myself to not being devastated every time I see birth rape…somehow, as a survival mechanism, I did that, without even realizing it…so it must be possible to filter this out as well…the thing is that with this, the way people make me feel is that I will never fit in, I will always be strange, different…anyway, still working on that…in the meantime it still hurts my feelings all the time, and Blada has spent countless nights holding me in his arms while I cried about it…there has to be a better way…

We visited Blada’s family this weekend in Okap…(Cap Haitian)…it was so nice to be with them…but traveling there and back is exhausting…plus we went on eday and returned the next…it’s a 4-5 hour ride jam-packed in an old pickup truck, that they have to push start…seriously, the whole road is just rocks…you’re bottoming out the whole time, bouncing so hard that you feel like your organs are just slamming against each other constantly…seriously, this is the reality of traveling in Haiti. Since there’s no actual real government that provides any kind of services to its citizens, such as mail service, it’s the chauffeurs who deliver packages and letters for people along the way…part of the way, it was raining, and the road was just all mud…going up and down hills…this guy, the driver, he is so experienced at driving those hills, he was fishtailing on purpose just to get the heavily-loaded truck up and down those hills…you have to cross a few rivers too…(drive through the river)…one time the water was deep enough that it came into the cab of the truck…
All of this is just another day for people here, who, that has always been the way you travel…you have no other option. I don’t mind it, it is interesting, but also very tiring.

The students are doing great. I am really proud of them. They have the right attitude. They really care about the women they serve. It shines through in the ways they talk to the women, and the energy that keeps them on their feet all day instead of sitting down and yelling at patients from across the room…

Well I guess that’s all for now…
Love all fo you…thank you to all fo you for reading my blog and staying current on my life…

Sunday, June 5, 2011

5/26-6/5/11

5-26-11

Today is my birthday!
What a big difference from last year--last year I didn’t have anyone to celebrate with…had a good day, by myself…made the best of it…today, the students insist on coming over to sing to me…after we work at the hospital this morning…I made some cookies and sweet cornbread last night to share…I think it will be sweet…
The rainy season has begun…just about every day it starts raining sometime in the afternoon…sometimes it rains really hard, sometimes it rains slowly and for a long time…it makes everything more beautiful…the trees are greener…there is less dust on the road…it’s cooler…the insects sing more…(I still never hear birds sing…sad…there should be lots of birds here…)

I never got news about the lady with the severe abscess, who we transported to Cange. I think she’s probably at home and OK, however I don’t know if she continued BF her 1 month old baby…
Yesterday though, I did see the other lady we had transported that day…the 24-week pregnant lady with the strangulated hernia…she is OK….coming in every 3rd day for dressing changes on her bandage…so her life was saved, but her life sounds impossibly hard…she was talking to me yesterday, hoping that I could help her with some money…it’s so hard because SO many people have lives that are this hard and need the same help, and you can’t help everyone…I’m here to train midwives, and to provide healthcare…that’s all I can really do…but sometimes I do give people money when I see that that is the only way they’ll make it…anyway, here is her situation: she is staying in Hinche with one daughter, at someone else’s house. The husband of the friend letting her stay there is starting to be outraged at her presence. She’s from really far away in the country and she has 4 other kids out there, with no one taking care of them. They’re on their own. One of them Is 3 years old. Her husband is in the DR working and they have no communication and she doesn’t know when he’s coming back. She has no money, not even for paying to get on a truck to go home. She still needs to come in every 3 days for dressing changes and needs her stitches removed in 2 weeks. So she has to stay in Hinche for atleast that time.
Peoples’ lives are so impossibly hard here. You hear stories like this all the time. And most of them, they’re not exaggerated. That’s the real truth.

5-28-11

I had a really really happy, joyous, fun birthday. It was wonderful. Apparently the students and Marthonie had been planning a surprise party for me since last week. They came and made a party! They were so much fun. This group of women is really special. They are heartfelt, caring, sincere, loving, and FUN. There is one girl in our class who is HILARIOUS. She is one of those people who is always joking, always laughing, always making people laugh. She had me laughing throughout the whole party…some of the students danced together, and she was dancing too, but kind of in a joking way…I wish I had a video of it. I’ll never forget it. The most wonderful thing was that they all came together to show me their love and appreciation for me. It was so real, so unpretentious. One of the best birthdays I’ve ever had. It really is the happiest of them all because now, I’m not missing true love anymore. Blada and I are together, closer every day. So, because of that, I feel like my life is on track, even though sometimes I can barely stand living in Haiti and with the American volunteers.
The past few weeks with volunteers have been really good though. Really great folks who have come through, helped a lot, given us personal space, just been overall really easygoing. That’s been so nice. Now, we have 1 week with no volunteers. Such a blessing to have a little break. We should have a break regularly--it’s not normal to never have a break from people.
Anyway…
We had a really great birth yesterday…this poor lady had been being induced for a couple of days (for pre-eclampsia) and was exhausted…1st baby--finally was close to having her baby…pushing on a 3cm cervix, flailing around, screaming…it was almost time for us to leave…I stayed by her, and got her grandmother to come in too…just stayed there and massaged her and tried to slowly quietly soothe her fears and help her to calm down…well, during this time, of course there were other people standing around, watching, doing nothing to help, even laughing at her as she struggled…(these people are students in an auxilliare school--it’s like nurse’s aid school, 2 years long)…anyway, I usually talk to them about stuff and try to give them advice about how to treat people, but in this l=moment I just ignored them. Well, after awhile of struggling, this woman gave in and relaxed into her labor and let it happen…pretty soon she was complete…pushed her bb out fast, in hands and knees…had a really beautiful birth…I think she tore her cervix, because she was spurting blood at first (not from a vaginal tear), but then it stopped…so we let it be…I had thought that her bb was going to die right after birth, because of being so premature, but, the baby was more weeks than we had thought…maybe 32 or 33...was breathing on his own, and rooting…he looked like he was going to make it when I left…if he nurses a lot and stays warm…if not, he will not make it. So, hopefully.

6-5-11

The above baby DID make it! His mom was rally connected to him and breastfeeding him. I was so happy to hear this a few days ago!

Things here are better than they’ve ever been. Our living situation: the house: it is so much better because we have these new housemates, who we knew were coming and have been waiting for for months. Their names are Kirsty and Mackenzy. She is a Canadian MW and he is her Haitian fiance. They’re really down to earth, relaxed, cool, fun, nice, etc. they’re really into gardening and have already started gardens here. I feel like we can learn a lot from them. Having someone else here to help hold the space & who understands the realities here feels so good. They’re only been here for a week and we already feel so at home together. I feel like a layer of stress has been lifted off of me, because I don’t have to carry the house alone anymore, and interact with the visiting MW’s alone anymore. Thank god. The past few months here, until about a month ago, were really stressful. Getting the house going, starting a new class, having CONSTANT volunteers coming, each week, never ever having a break for ourselves.

There are things that are hard to address with people, such as people walking in here and taking pictures of everyone all the time. It’s a total underlying attitude…what do you say to them about that? Even if you ask someone’s permission to take their picture, and they say yes, that doesn’t mean that they’re really consenting to it…no matter what you do, there is a power differential when you come to a place like this and you have a camera and you are white…people don’t usually know how to say no. to me, it’s voyeuristic and exploitative to come to a place for a week and feel entitled to take all these pictures of people,,,in town, in the hospital…would you walk into a hospital in the US and take peoples’ pictures that you don’t know? I don’t think so. What makes you think that’s ok to do here? Because you paid your money and volunteered? Things like this that fucking drive me crazy sometimes…and I’m the one who’s here each day, seeing people come and go, seeing people repeat the same patterns…asking myself how the people here feel about having their pictures taken by all these white people who they’ll never see again…this is an example of why I’m glad Kirsty is here. To help hold things down and explain things to people so that hopefully they’ll think about it in a real way.

Anyway, like I said, everything has taken a turn for the better since about a month ago. The volunteers have been great, things have flowed more easily, and the house has been less stressful. The place you live shouldn’t be a source of stress in your life. It should be a place to relax and unwind from your work and outside life.
Even though the past month has been really great, I see that I am still processing the undue amount of stress that has been here in our house for the 1st several months of the new class (january-april).

Nothing too crazy at the hospital recently…let’s see…there was a lady who had had eclamptic seizures and was still there and I guess was in a coma the night before…well, she was the most agitated post-eclamptic person I’ve ever seen…she was talking NONSTOP, like a crazy person…going on and on about all kinds of crazy things…total drama about her aunt trying to kill her and just crazy stuff.

Then there was a woman who had a ruptured ectopic pregnancy (the fertilized ovum had embedded in the fallopian tube, which eventually burst, and then she was bleeding internally)---I didn’t see her myself but apparently, she was admitted the day before for abdominal pain,,,the OB did a sono and couldn’t see anything…only fluid…(it was blood)--well the next day apparently she was in more pain, and he did another sono, and still didn’t see anything…so what he did was insert a needle into her abdomen and withdrew to see if there was blood…yes, there was bright red blood…he rushed into the OR with her and operated on her ruptured ectopic pregnancy…she got a blood transfusion…after which her hemoglobin was 5...she really could have died…and would have if he hadn’t done surgery on her when he did…she had already lost a lot of blood…

Anyway…so, yes, things are good here…not too crazy, just moving along. The students are doing great. I taught NNR (neonatal resusitation) to them the other day, and we practiced a lot…they did great…I felt really good about the information I delivered to them…simple, complete, all the essentials.

Blada is great…I love all you guys…