so...we are into our 2nd week of clinicals with the students at St Therese hospital, and our 3rd week of classes. this morning we had a beautiful birth! i feel so happy. this was how it went: a first timer, 19 years old, who came in in active labor and then soon started pushing...she was tired--hadn't slept or eaten for 2 days, and was pushing weakly and not making much progress. she pushed only for about 1 1/2 hours maybe--maybe a little longer--and at the end of her push, we gave her an IV with pitocin in it to help her contractions get closer together so she could push her baby out--it really worked. we also got her squatting on the floor, and she pushed there for awhile and brought her baby down. i caught her baby; she had the placenta there on the floor too. everything was good. she had a small laceration that i sutured...the students tight now, they are more observing, and practicing their basic skills, but they're not catching babies yet or suturing, for example. what i really loved about this birth was that we were such a team! i had one person documenting everything--every fetal heart tone count we got, everything--and one person assisting--listening to FHT's after each contraction--it really felt like a team, plus, we were able to get her onto the floor which helped her so much. she did a really good job, even though she was so exhausted. it was a nice slow birth where i was really able to explain alot of things to the students and get them involved in supporting her.
last week: it was a little crazier. there was one day where we had a woman who was only 10 weeks pregnant--severely anemic--her hemoglobin was 4.6--maybe it was 3.6--she was having a hard time--we were going to do a blood transfusion but the red cross had no blood. i don't know what happened with her. at the same time as she was there, i was catching this lady's baby who had died inside of her--an IUFD (intrauterine fetal demise)--she was "8 months" pregnant but the baby looked more like 20 or 22 weeks (5 months)--so i caught her baby, and really tried to get the students right there by her side supporting her, stroking her, massaging her...we had induced her that morning with 100 mcg misoprostol (cytotec)--she had her baby like 5 hours later--a footling breech--so, she had cried some, i thad told the students not to tell her not to cry--to encourage her to let herself cry and that we were there with her--so she had cried some before, and now too, and then now, with this bring her 1st baby, and being 18 years old, after all of this hardship, there was another problem: her placenta was partially separated and she was bleeding...we decided to do a manual removal (after trying uterine massage and giving pit)--so i had to do that. we had no anesthesia to give her. she did her best to cooperate but she was up the wall and i had to follow her up the bed. it was excruciatingly painful for her. as soon as i was done i looked at the placenta, which was complete, and showed it to her and everyone else, and then got up right next to her and agnowledged that this had been really traumatic for her and that i was sorry...i am really trying to model compassionate behavior for the students...also for these other students who are at the hospital...they have no supervisor...they don't know anything...they just watch and sometimes help with something...these other students are in an auxialliare school (like nurse's aid)....
besides this IUFD, there was a twin birth maybe the day before, or maybe it was the same day...an 8th timer...with polyhydramnios (too much amniotic fluid)...the babies were premature (24-26 weeks?) and didn't make it...there was a midwife here last week, Jill, who just so happened to be the one who held all the babies as they were dying...there were the twins, then there was another baby that died who was premature, who she held as he was dying...she used this opportunity to model behavior to everyone that basically was showing love to a dying baby....counting babies born already dead as well as those who died after birth last week, there were 6.
the premature baby i just mentioned was born to a very sick mom the day before. she was severely preeclamptic, to the point of having pulmonary edema. she had very labored breathing and also was coughing alot and appeared to have something else going on with her lungs. she also ended up with a manual removal of her placenta---really hard---she is still sick and was also very anemic. i am going oto check on her today when we return to the hospital.
the household here is going pretty well. alot of things to orchestrate all the time and lalot of communication to do with the volunteers. but it is going well. we have also finally 'more or less planned our upcoming classes, so that is a relief.
blada and i are doing great. i love living with him and spending time with him. there are so many things we want to do together. little by little we do them.
i am really enjoying being back in haiti and feeling that my comprehension of creole is on a new plateau. really exciting to see the progression. languages are so interesting. seeing where words and expressions come from...it is endlessly interesting.
i love all you guys...
reina
Wednesday, January 26, 2011
Sunday, January 16, 2011
Back in Haiti! January 2011
I am back in Haiti after being in the US for 6 weeks. It feels so so good to be back! Although I was so ready for a break from Haiti when I left, I actually missed Haiti alot while I was gone. Not only did I really really miss Blada, but I also did miss Haiti: walking everywhere you need, having time to do each task, like washing your clothes by hand, the music and people in the street....lots of things.
I got back to Hinche on Jan 3rd, and had 5 days with Blada, and then on Saturday the 8th, the MW4H leaders came and were here for 1 week, and they just left yesterday. This past week was so so crazy...now that they're gone I'm realizing how stressful it actually was. Nonstop activity, meetings, talking, coordinating, problem solving...it was really important and great and amazing to be a part of this group of people who are undertaking these monumental tasks and pulling it off with such a positive attitude, but even with that, it was stressful.
I am really impressed by these people and love knowing them and working in their organization. Right now is a time of amazing growth and expansion in the organization. They are finding places to put our graduates, putting them out in the country all around, making alliances with parishes and communities...
The mobile clinics are expanding also...they go 4 days a week, each place they go is once a month...so that makes about 20 different communities where they goa nd do prenatal care...we JUST got our new Jeep which is for the mobile clinics...this whole week was also revolving around getting the Jeep out of customs...unbelievably difficult....the Jeep is here now, and it is PINK with the MW4H logo on it...really awesome...
We started classes last Monday, the 10th. Our new class has 15 students, and they all seem really bright and eager...so exciting...I am so so excited to be working again with Marthonie, my co-teacher...she is so fun, so interesting and compelling...
We are going to start having classes out here at the house starting tomorrow...it will be alot more comfortable here than at the hospital...we have electricity, we have all out teaching aids here...it will be good. We are basically going to be with the students from M-F 8am-5pm, either teaching classes or doing clinical teaching in the hospital or in mobile clinics.
We have one student from Port au Prince who will be living at the house here, and she is moving in this evening. I like her alot and I am happy there will be another Haitian living in the house.
I will try to blog as often as possible and may actually start writing more often and then posting like once every 1-2 weeks. I like keeping people up on my life here. There is this woman who has a blod--her name is Wendy Dotson--she's a midwife who's a big part of
MW4H, and maybe her blog is more descriptive than mine--it would be a good thing to read--maybe someday I'll be a more descriptive writer and be able to explain things more about daily life here.
We have a baby in the house now too...our cook is bringing her 9 month old baby M-Sat so she can breastfeel him during the day...it is so so much fun...he was so playful yesterday...Blada and I both like to hold him and carry him around alot...that's fun...
Ok I love all you guys...it was so wonderful to see everyone when I was back...I miss all of you and love you...
Reina
I got back to Hinche on Jan 3rd, and had 5 days with Blada, and then on Saturday the 8th, the MW4H leaders came and were here for 1 week, and they just left yesterday. This past week was so so crazy...now that they're gone I'm realizing how stressful it actually was. Nonstop activity, meetings, talking, coordinating, problem solving...it was really important and great and amazing to be a part of this group of people who are undertaking these monumental tasks and pulling it off with such a positive attitude, but even with that, it was stressful.
I am really impressed by these people and love knowing them and working in their organization. Right now is a time of amazing growth and expansion in the organization. They are finding places to put our graduates, putting them out in the country all around, making alliances with parishes and communities...
The mobile clinics are expanding also...they go 4 days a week, each place they go is once a month...so that makes about 20 different communities where they goa nd do prenatal care...we JUST got our new Jeep which is for the mobile clinics...this whole week was also revolving around getting the Jeep out of customs...unbelievably difficult....the Jeep is here now, and it is PINK with the MW4H logo on it...really awesome...
We started classes last Monday, the 10th. Our new class has 15 students, and they all seem really bright and eager...so exciting...I am so so excited to be working again with Marthonie, my co-teacher...she is so fun, so interesting and compelling...
We are going to start having classes out here at the house starting tomorrow...it will be alot more comfortable here than at the hospital...we have electricity, we have all out teaching aids here...it will be good. We are basically going to be with the students from M-F 8am-5pm, either teaching classes or doing clinical teaching in the hospital or in mobile clinics.
We have one student from Port au Prince who will be living at the house here, and she is moving in this evening. I like her alot and I am happy there will be another Haitian living in the house.
I will try to blog as often as possible and may actually start writing more often and then posting like once every 1-2 weeks. I like keeping people up on my life here. There is this woman who has a blod--her name is Wendy Dotson--she's a midwife who's a big part of
MW4H, and maybe her blog is more descriptive than mine--it would be a good thing to read--maybe someday I'll be a more descriptive writer and be able to explain things more about daily life here.
We have a baby in the house now too...our cook is bringing her 9 month old baby M-Sat so she can breastfeel him during the day...it is so so much fun...he was so playful yesterday...Blada and I both like to hold him and carry him around alot...that's fun...
Ok I love all you guys...it was so wonderful to see everyone when I was back...I miss all of you and love you...
Reina
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!
reina
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!
reina
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
reina
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
reina
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
reina
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
reina
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
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
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
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