A most considerate infant.

I was helping Ate Car do a health teaching presentation for some women in their third trimester when a woman came in to the clinic and sat down close by. She seemed rather restless, and she kept shifting her weight from side to side of the chair. Finally Ate Car asked her, "Are you here for the teaching, or are you in labor?"

Yep, she was in labor.

We brought her inside and to do an internal exam. It was about 10:30 by this time and I was supposed to be meeting Ate Rhonda for lunch at noon. So I texted her and told her I was so sorry, but I couldn't make it, there was a labor.

She was 7 cms. She really seemed to be quite active though, so we brought her upstairs to the delivery room. Her younger sister was attending her. This mum was so funny. She suddenly was starving and wanted food. Her little sister would spoon a mouthful in and as soon as it was in her mouth, she asked for the next one. She had a baby to deliver, she needed food!

About 10 minutes later, we transfered her to the delivery bed. She was 10 cms, ready to push! I pulled on some gloves, she pushed, and I cought her baby. Just like that. It wasn't even 11 am yet.

So I texted Ate Rhonda. And we met for lunch after all. How awfully considerate of that baby to accomodate my lunch arrangements!

Please Don't Leave Me!

As soon as I squatted beside her low bed, she grabbed my arm and clutched it with an iron grip. Tears were streaming down her face. All at once a contraction hit her with the force of a hurricane. Her whole body quivered like a trembling aspen tree. She held her breath and pushed.
"Ayaw, ayaw!" I gasped, horrified. She was still only 8cms dilated, and if she pushed now, she could do herself some serious damage. I told her to look at me and breathe with me. She adjusted her hand so our fingers were locked together and grabbed my other hand as I tried to steady her with my arm. Slowly, we made it through the contraction. She closed her eyes and she looked like she was sleeping, but she was softly and frantically rubbing my hand with her thumb.

...

She had flitted into the clinic about nine in the morning, in her strapless orange sundress and her hair in a high ponytail on the top of her head. She was cute as a button, 19 years old, and this was her third pregnancy. I had a feeling she would go quickly. But I was busy that morning and I didn't see her again until she waddled into the delivery room a few hours after being admitted. She was crying, and moaning in pain. She laid down on the bed and rolled back and forth, writhing. Her partner follwed her into the room. He looked just as young as she did, was super skinny and looked like he'd just watched a horror movie. He was holding up the IV tubing with two fingers, standing out of sight at the head of the bed, and shifting from one foot to the other. Poor guy, he needed just as much help as she did. But as soon as I knelt down beside her, I forgot all about everybody else.

...

Soon I could sense the next contraction coming. It hit with equal power. Once again, I did everything I could think of to keep her from pushing. I felt as if it took all my energy, and I couldn't imagine how much it took from her.  My knees began to ache from kneeling on the hard floor, and my feet were completely asleep, but I didn't want to move. I kept talking to her, urging her, rebuking her, comforting her, commending her. This went on for several minutes, the gripping contractions, the sudden calm, then the storm again. It was in the calm after one awful contraction I heard her saying something in English, but I didn't catch what it was. I bent closer to her, so I was only inches away from her. "Unsa?" I asked.

She pulled me even closer, and tightened her grip on me. "Please don't leave me," she said, the tears dripping down the side of her face.

"I won't. I promise," I told her, and I honestly don't think there is anything that could have torn me away.

After what seemed like hours, but was really more like 30 minutes, an internal exam showed she was fully dilated, ready to push. But another woman was pushing on the delivery table at that exact moment, so she would just have to give birth on the cot.  Ate Sheila asked me if I'd like to catch the baby, and of course I said yes.

Somehow this delivery was so much more emotional than usual. I don't think I've ever felt that needed by someone during their labor.  I really felt like we'd be fighting in a war, and the birth of her baby was our victory. I knelt with one knee on the low cot, balancing myself with one foot on the floor. I felt the baby's hard head with it's soft hair, as it steadily moved closer and closer towards me. She didn't have to push for long. Once the head was out, the baby girl almost slid out right out. She was a healthy pink color and cried right away. "Oh thank you, thank you, thank you, thank you!" her mother cried, over and over again. I couldn't help getting teary too.

Things got a bit tricky once the placenta was delivered. Because her labor had progressed so quickly she started hemorrhaging. There was a very tense few minutes, the baby almost forgotten as we consentrated on keeping her from bleeding to death. It was scary, very scary. I ran out of options right away, and told Ate Sheila to swap me spots. I ran back and forth getting gauze and other materials, asking someone to take blood pressure, praying. The euphoria of birth can turn so quickly to horror. But thanks to God and the skill and quick-thinking of Ate Sheila, the bleeding was eventually stopped before the situation became emergent. 


Some time later, when everything was cleaned up and our patient was sitting up, I came and sat beside her on her bed. I held her baby on my knees and we admired her together.

"She's so beautiful," I told her.

"Thank you," she said, smiling at me with glistening eyes. 

I Caught a Baby!

The guard woke me up at 10:30 pm. The primie mama had come in at 9:30 only 6cms dilated, but at 10:30 she seemed to have transitioned, so an internal exam was performed and it showed she was 10 cms and ready to push! I arrived a bit breathless as always, but quickly gravitated to the side of the patient. She was very young, probably younger than me, and she smiled when I introduced myself. All at once a contraction hit her and she grasped my arm and squeezed tightly.

"Ginhawa!" the midwives urged, "Breathe!" The woman squirmed around on the delivery bed. I knew she would just wear herself out this way, she needed to push straight down.
"Ate," I said quietly, and she looked up at me, and deep down into my soul. I didn't say anything else, just held her gaze an took deep exaggerated breaths. She breathed with me, and for a few moments it seemed as if the delivery room, the midwives, and everything else dissipated away, and it was just her and me, breathing, breathing. Moments later, everything flew back into focus. She was really pushing now.

"Anna," said Ate Rose, "do you want to catch the baby?"
"Yes!!!!!!!!!!!!!!!!!!!!!!"
I pulled on a set of sterile gloves and stood beside Ate Rose, and watched the head slowly move down, and then back, down and back up. But gradually, it began to move back less and forward more. Ate Rose performed an episiotomy, and quickly the head moved downwards. Ate Rose and I cupped our hands around it as the head and face suddenly were out!  With hardly any effort, we pulled the rest of the baby out. It was a baby boy, so slippery and pink and beautiful. At once, he let out a lusty cry, letting the world know he was alive.

At that moment, I had the sensation, not that this was something I had been waiting all month to do, or even a long time to do. I felt like this was something I had been waiting for all my life.

Recipe for Mango Float

Seriously, if I were you, I would literally drop what I was doing and go make this thing. If it wasn't cliche to say it tasted like heaven, I would say that it tasted like heaven. Cause it really does.

What you need to get:
Mangoes (But I bet you could use strawberries or something like that too)
Graham crackers
Condensed milk
Cream.

What you need to do:
Mix up the condensed milk and cream....maybe 1 can of condensed milk to 2 creams, otherwise it's a bit sweet (as we discovered).
Put a layer of graham crackers in the bottom of a pan. Pour the milk and cream mixture on top. I am going to call it "the mixture" from now on to make it easier.
Use a spoon to scrape thin slices of mango. Then lay the slices on top of the graham cracker layer.
Put another layer of graham crackers, and pour on the mixture.
Put another layer of mango.
One last layer of graham crackers (you can crush it if you like).
Pour the rest of the mixture on top.
Put in the freezer of fridge depending if you like it soggy or frozen.

I am not even going to describe how divine this is because if for some reason you aren't able to make it, you would feel so disappointed I would feel guilty for describing it to you.

Amber and I made this on Monday as a thank you for all the staff for all they have done for us. And yes, I am still here in Cebu until July 4th, but Amber headed home for Canada on Monday night. I am trying not to be sentimental but honestly I was slightly heart-broken when Amber left. It's just not the same without her, but I am grateful for loving staff who make me feel like I'm part of a big family.  I am also grateful for TONS of work to keep me busy! I am certainly trying to make up for lost time this week. I have been working all three shifts everyday, and just taking breaks now and then. It's just heaven. Like mango float. Same same. 

Attempts at Communication in Carbon Market.

We both had the day off, so Amber and I decided the best thing to do was to hop on a random jeepney, see where it took us, and get off when it looked interesting.

Whether it was truly the most interesting or not we will never know because as soon as we saw Carbon market, we just couldn't help stopping. We decided just for fun we would see how far we could get without speaking English. Our private conversation went something like this:

Anna: (attempting to say) "Do you enjoy eating green mangoes?"

Amber: "Do I want to play with the mangoes? Do I want to join in with... the... mangoes?  Do I want to be a mango? What are you trying to tell me???"

Remarkably, our shopping actually went quite smoothly. We bought a pair of shoes, 3 pair of socks, a handtowel, another pair of shoes, a dress at an OkiOki (second hand) store for $2.00, and 6 apples, in Cebuano. 

Regardless of our lapses in recall, I have to admit, it is an unbelievably thrilling feeling when people stop trying to speak English to you. And when you really understand everything they are saying to you, and when they really understand you. At least usually.

As we strolled along, I suddenly had a recollection that the ocean was somewhere nearby. So we asked a lady selling vegetables where the ocean was. She didn't understand. So we showed her front crawl, and various other swimming strokes to the vast amusement of everyone within eyeshot. "Oh!!! Sa dagAT!" and they pointed down the street and to the right. We followed their directions and when we turned the corner we could tell we were getting somewhere because the street seemed to end a few hundred meters away.

As we got closer, tiny wisps of suspicion began to float through our minds. Where was the fresh sea breeze, and where the wailing of gulls and the scent of sea weed? There was a scent alright, but it wasn't sea weed. The road ended just up ahead. We came up to the embankment and looked over.

It was rectangular in size, although the edge was not well defined. The water was brown and had floating plastic bags, styrofoam wrappings, banana peels, crates, and a great deal of greenish scum floating on it.  And there was a man peeing in it.

I think we almost died of inadequate air supply related to gut-wrenching laughter while we sped away in the opposite direction. I couldn't help but wonder what the vegetable ladies were expecting us to do in the "ocean."

And....the Baby's Out.

In my dream, the person I was talking with was starting to annoy me. They were rapping their knuckles on the table over and over. They just kept on drumming away incessantly, all the while pretending to be listening attentively to my story. I was just about to tell them how annoying this was when I woke up. Knocking. Somebody was really knocking. Knocking... means...AHHH! I flew out of bed, tripping over the garbage and getting stuck in my sheets. I swung open our door and was blinded by the small hall-way light. Somebody was saying "there's a labour."
"Ah, kuya Niox, Salamat kuya. Pila ka cms na? Wala pa?"
Ok, so she like JUST got here. I woke Amber up and we raced to the bathroom, and literally 2 minutes from the time we woke up, we were flying down the stairs and were at the clinic. As we entered the gate, we heard the shrill, high-pitched, distinct and unquestionable cry of a newborn.
Screeching to a halt, we just stood there. Then we rolled our eyes, trudged upstairs and confirmed what we knew was true. Yep, baby out, and we missed the whole thing.

So we went back down and sat with Kuya Niox on the bench on the street in the warm darkness and lamented our bad luck. We asked Kuya Niox how long the patient had been at the clinic, and he said he literally ran to get us the moment he had informed the midwives that the patient had come. She'd come in fully dilated and as soon as she got upstairs, she pushed once, and the baby was out. Golly.

The night before, a patient had come in at 2 am and was only 4 cms dilated, but because she lived far away, the midwives let her stay downstairs. At 2:20 am, the husband was knocking on the midwives' door in a frantic and persistent way, and 2 minutes after that, the baby was out. OUT! Yep, we didn't make it for that one either.

Amber and I came up with several ideas for how to avoid missing births in the future, including sleeping in our scrubs; giving the guards different strategies for noisemaking devices to wake us up if unresponsive to knocking; sleeping in the clinic; sleeping in the delivery room; and, as last resort, sleeping on the delivery table.

I honestly don't know how Hilary didn't miss a single birth for what was it....the first 750 births or something? Dave, her husband, said if you try to wake her up by talking to her, shaking her, etc...it is ineffective, but if you whisper "labor...10 cms"in her ear, she is up and out of the room by the time you're done saying it. Maybe I can train my subconscious mind to associate knocking with labour.

Practice on Pork makes Perfect on Perineums.

I squinted, blinked, took a deep breath and then tried again. The slice of raw pork on my plate slipped again under the needle which came out on the other side in entirely the wrong spot. Arg. If that hunk of  pig on my plate had been alive it would have been crossing it's arms and sticking out its tongue at me. But honestly, I wondered, how on earth are you supposed to do this on a real live PERSON???

Hilary, the clinic manager was doing a little workshop on suturing, so I decided to to join in. I learned so many interesting facts, techniques, and strategies. Suturing is really ridiculously difficult to get right. And when it comes to a perineum, it is quite a job, I can say that for sure. I have seen quite a few suturing jobs now, and before they start I always wonder how on EARTH they are going to manage it. The repair process is so interesting. You have to start with the very deepest layer, top to bottom, then the next superficial layer, bottom to top, and then the skin is very last, top to bottom. But the thing is, you can plan all you like but every single tear is different, and you really just have to be awfully creative. And the problem with practice makes perfect is that this is a women's body we're talking about here.

Thus, the pork.

I actually stitched up a banana first. That was pretty fun. I was rather impressed with my neat row of stitches, but apparently they were too close together. I'm beginning to think a short jaunt to sewing school might be a good step on the path to midwifery.

Oh by the way, if you are a young and terrified girl reading this, don't despair, please be assured you might never need suturing, and if you do, it will probably only be once. And even then, you get a baby out of the deal. So don't worry. Honestly.

This was Saturday, my first day back. I also attended a seminar by the clinic's OB doctor about management of labour (fascinating!!), and went to another dumpsite. Great day back in the clinic. Thanks God for health at last!!!

A Conversation of Anna and Amber over an Evening Snack.

Anna: Hey look what I found in the fridge.
Amber: What is it?
Anna: I think some of the volunteers left it here like 2 months ago.
Amber: Yum. What IS that?
Anna: It says muesli on the package. ? It looks like oatmeal with nuts and stuff in it? And these things are....milk...with yogurt-something...?
Amber: The muesli is expired.
Anna: Smell it. Does it smell ok? I can't smell or taste anything right now. If it smells ok, taste it. Yeah this smells fine actually.
Amber: Well I'm not going to trust your analysis because you just told me you can't smell or taste anything. Yeah it smells ok.
Anna: Yeah it's fine. What about this milk stuff?
Amber: Expired.
Anna: Smell, then taste. Yeah I think it's ok.
Amber: This is really strange tasting. But it's not sour or anything, so I guess it's ok.
Anna: Yeah,  it's fine. Dumping it on the muesli.

Long pause full of munching.

Anna: Wow this is actually surprisingly enjoyable.
Amber: Yeah it's actually pretty good.

Long pause interrupted only by chewing noises.

Anna: Oh my gosh.
Amber: What!? What Anna!!? Why do you always do that, I hate it when you do that, why don't you just say it!?
Anna: I have just been eating ants.
Amber: Oh my gosh I have too. They must have been in the muesli! What are we going to do?

Short pause.  

Anna: Well.....I think I'm going to pick them out.

Silence.

Anna: What are you going to do?
Amber: I just ate half a bowl of them, I might as well just finish them off. They're dead right?
Anna: Yep. Ok well I'm still gonna try to get most of them out.

Short pause punctuated by Amber eating and Anna disposing of floating insect corpses, and then eating. 

Amber: They're not going to give me a disease are they?
Anna: No
Amber: You sure about that?
Anna: Yeah

Eating noises, short pause, then howls of laughter. 

Anna: You know that really was pretty tasty actually, considering there was ants in it.
Amber: Yeah. Pause. I better not get a disease.

P.S. Quick update: Apparently I have bronchitis, but I'm on antibiotics, so the end is in sight. Thanks for your prayers friends! =)

Ok Ok I'll be honest with you

Sometimes I get so into writing I forget I am writing to people who genuinely care about me, and don't just need to be entertained. So, I'll be honest with you and say this won't be an entertaining post. I don't want to be dramatic, but truth be told, I am sick, and I'm getting a little sick of it.
I actually picked something up towards the end of my stay in Cagayan. I have been tenaciously attempting to kick this nasty cold single-handedly, but the clinic director took one listen today to my chest and said I'd better go see the pulmonologist. I have pretty much just been lying in bed the past 4 days.    Everyone has good strategies for getting better. Eat mangos. Don't eat mangos. Drink calamansi juice. Drink cold water. Drink hot water. Take vitamin C. The best one so far was eat coke boiled with rice. Hmm. Apparently, it has a suburb track record.
Everyone is so kind, and I've really felt loved. Ate Maymay gave me a full-body massage last night. Ate Nifa keeps making calamansi tea for me. Amber helps me rationalize the situation.

As much as being sick is stupid, I can honestly say I'm grateful. I have had a week of spiritual revelation. Normally, I don't read much. Ok I don't read. I mean I love to, but I'm just too busy. Well I've COMPLETED 3 books this week, and I have 3... wait 4 others on the go. This is a substantial record for me. I memorized 60 Cebuano adjectives today. I have thought through problems, come up with solutions, planned, strategized, and contemplated.

I have prayed this week too. I have been talking to God a lot this week, and it's beginning to sound more like a conversation, and less like a telephone recording.

But, I'm missing births right now. And prenatals. And I couldn't go to the jail today. I know these 4 days have not been a waste. But if it's supposed to happen, I really wouldn't mind getting better either.

You know, I'm willing to attempt reading a book with a clear chest on a busy schedule. I think I could swing it. 

Spitting Contests and Truth or Dare

Christian's Haven is one of those places that once you leave,  it feels like a dream. There is this sense of wholeness and healthiness and happiness there.

There are three big families at CH. The girls, the big boys and the little boys. We got to eat meals at each of their houses, and spend some time learning all their names, and getting to know them a bit. I loved each experience, but in the end, I think my funniest memories will be with the little boys.

We were eating lunch with them our last day, and there just so happened to be watermelon for desert. Funny how Amber and I were at opposite ends of the big long table, but we both got the same idea at the same time. I mean let's be real here, what is the first thing that comes to your mind when you see all those big, black, shiny seeds in that juicy slice of watermelon?

So we got all the boys (16 actually) to collect five seeds each. I really think they thought we were crazy, especially when we tried to explain to them what we were planning to do. I had just recently learned both the Cebuano words for spit and vomit, so I don't deny the possibility I may have gotten them mixed up in the explanation. Nonetheless, they seemed to be up for a game, so we left all the rest of the meal where it was and tramped outside and got everybody lined up with their heels against the wall so it was fair.
I kid you not, the whole time the competition lasted I was doubled over laughing my head off. It was funny how the length the boys were able to spit seemed to have a direct correlation to their height. The cutest thing was one little boy with all his front teeth missing. Hard as he tried, and no matter with what gusto, every time he spit the seed just dropped politely down at his feet.  Jason, one of the older boys, made us howl with laughter because just as somebody was winding up for it, he'd make a big spattering spitting noise which of course made them laugh so hard their seed sputtered out only a few feet away.

Later on, Amber and I were sitting with 4 of the little boys, and they decided to teach us a game. It was supposed to be concentration, but each of us was an animal name. So as you're clapping your hands and legs you say your animal, and then somebody else's, etc...
I must attribute my blunder to momentarily mixing up the Cebuano for Cat. Regardless of the cause, all at once, all the boys were clamoring "Kinsa'y imong crush? Kinsa'y imong crush?" "Oh my goodness, I think it's truth or dare now," I said, turning to Amber, who was laughing as hard as I was. The next time somebody messed up, they asked them their preference: trut or dear? I never ceased to be entertained by their dares. One dare was the boy had to take a chair and sit about 20 feet away and play from there. Another time, I had to touch a cat. I touched the cat and looked back to see if there was more to it, but they just kept playing so I'm assuming I really only did have to touch it. I just can't tell you how much I enjoyed that game. There is something so special about playing a game with people of a different race, language, culture, gender, age, and socio-economic background. Because you simply forget you have any differences at all.

I'm Dancing for Joy

Do you remember the post I wrote about the jail a few weeks ago? My heart was groaning then for the pregnant women who were receiving no pre-natal care whatsoever. I want you to know friends, that God heard the prayers of our hearts.

Last week was the monthly Glory Reborn Worship meeting. It was a lovely time of sharing, singing, and eating dunkin' donuts! But the highlight of the evening was when Hilary described a new project the clinic is taking on. It is part of a list of ministries that the clinic will be involved with, so that every month, three nurses and midwives will go to help at each ministry. Ministries such as the dumpsite ministry, feeding programs,

And prenatal clinics at the women's jail. 


I literally thought I was going to start crying then and there, I was so full of gratitude to God.

"Before a word is on my lips, you know it completely."

Now these women will be receiving the proper vitamins necessary for their baby's healthy development, they will be screened for diseases prior to delivery, they will get to hear their baby's heart beat.

I am so proud of Glory Reborn for being an organization which is not focused inward, but is looking outward. 

Sindong on Mindanao

Since I last wrote I have come and gone to Mindanao, the beautiful island in the lower third of the Philippines, and one of my favorite places on earth. In a quick four-day holiday we visited good friends at Christian's Haven, (CH), and the "College house", the first a ministry to orphans and street children, the second, a transition place for them as they attend college and move into the world.

Cagayan de Oro looked just the same from first glance, but it is a different city from the one I visited two years ago. In December of last year, the Sindong fell upon the city in a rush and roar of water that within hours had claimed the lives of well over 1,000 people. Older people would tell you that in all their lives they had never seen a typhoon of such magnitude and bringing with it such destruction. My friend Ate Jane told me that after it happened, if you walked along the streets, you saw bodies laying everywhere. They had to import coffins from Manilla because they simply could not make enough fast enough. 

There is actually a refugee camp right in the same neighborhood as the College house. Our friends led us through it on our way out to the street. It is actually very tidy, more organized than most communities of urban poor. The houses are all constructed together in two or three long rows. Each row has perhaps 15 "houses", each one room, the size of the average bathroom. They are made of a basic frame of lumber and covered in blue tarps, with a piece cut out for a window, and a flap pulled aside for a door. As we passed through the camp, the women were squatting together doing their laundry. They smiled so cheerfully at us as we walked by. There were lots of children everywhere, very curious, and very very sweet. 

The problem so many of these people have is that the government will not provide any support for them in a new life until they can provide the land title to a new piece of land. But if they were only squatters to begin with, there is no way they can afford to buy a piece of land. And they cannot go back to where they were before. It has all been washed away, but even still, the government does not want anyone living anywhere near the rivers which so indiscriminately swallowed up everything around them.

Out in the country at CH, the Lord truly protected my dear friends there. Although the river flows literally right beside the property, there is a high stone wall surrounding the campus. The Sindong eventually took the upper half of the wall away with it, but praise God, the water did not reach as high as the houses. They kids said they watched the river carry houses, caribau, vehicles, and trees with it. But my friends were all safe.

CH has changed somewhat in two years. There are many more little children now, most of them orphans from the Sindong in December. I didn't ask many of them their story. I think I was really just too scared to hear it. One little boy I fell in love with was only 8 but he looked more like 6. He was so tough looking, he always had this determined little frown on his face. We got talking about muscles or something one time and the end result was we ended up arm-wrestling. After a solid interval of straining, we decided to call us both winners. And I saw that tight, frowning mouth start to smile just a little bit at the corner. 

I have more to say about our time on Mindanao, but I will end THIS post by saying that the day we were planning to leave, a huge storm hit Manilla and sunk a passenger ship, killing some of the passengers. Apparently, the storm was moving South towards us, and we had a TWELVE hour journey across open water to get home to Cebu. While freaking out to our college house friends, one of them (who happens to be a sailor), said, "so what are you afraid of?" "Of DYING!" we replied together. "Oh don't worry, if that happens, you'll just go to heaven anyways," he replied, satisfied he'd cleared up that problem. 

We laughed at his calmness, but in the end, he's perfectly right. With Christ in your life, if the worse case scenario in any scenario is death, then what have we to fear, death has been conquored! 

Mama Knows Best

Unfortunately her bag of water had already broken. This is not a problem exactly, but more a potential problem because it increases the risk of infection. So Ate Kat, the midwife I was working with decided to give our patient some labor tea to speed things up a bit. I'm not really sure what labor tea is exactly except that it comes in a little bottle, you give 15 drops from a dropper, and it looks disgusting. I don't think it tastes as bad as it looks though because nobody makes a face when they take it. Not right away anyways.

Our patient was 5 cms only. Quick OB lesson. The cervix has to dilate to 10 cms in order to deliver the baby. If you try to push anywhere before 10 cms, you will certainly do some damage. So 5 cms means this patient had a way to go. She was quite a quiet girl, very sweet, not too talkative. Ate Kat left me with the reclining patient and I sat with her, took vitals now and then and bobbed absentmindedly on the birthing ball while we waited for something to happen. Ate Kat came back in, gave another dose of labor tea, and left.

All of a sudden, the patient started moaning and breathing deeply. She was having a contraction. Finally, something was happening. Two minutes later, she had another one, stronger this time. In a matter of 5 minutes she was moaning and calling out for her mother. She was making so much noise Ate Kat came back in. She did another IE and this time she was 7cms. Typically if a patient is 7cms I would feel fairly confident that I could go home and eat lunch, (including a mango, which takes a while to enjoy properly), make a little small talk, and come back long before delivery was imminent.

So what Ate Kat did next surprised me. She called the other two midwives and got me to help transfer the client to the delivery table. "But she's only 7cms...?" I wondered out-loud, but the patient was making so much noise I'm sure nobody heard me.

We got her up on the delivery bed and by now she was definitely being much more vocal than any other Philippina I've seen in labor. Ate Kat did another IE.

Ok so just to reiterate, when Ate Kat did the first IE she was 7cms. We moved immediately to the delivery bed, so the second IE was  literally less than five minutes later. This time, she was 9cms. But we didn't have time to celebrate. All of a sudden, the patient started grunting. "Ayaw! Ayaw!!!" "Don't!!!!!" We all cried at the time time. We all know you really have to be 10 cms to push.  But this lady just knew what had to be done and she did it. She pushed. The baby's head was out. Ate Nonette didn't even have her gloves on yet. Ate Kat was frantically trying to get the supplies out. Resourceful Ate Tina grabbed the baby's head with the mum's dress so it wouldn't fall out on the floor! By the time Ate Nonette had time to put her gloves on, the baby was out. TWO pushes, and she had a baby. And the crazy thing is, she had no tearing whatsoever.

Despite the training, knowledge, and experience between all of us, we were no match for that mum. She listened to her body, and her body wasn't wrong.

I wish more women were as in tune with themselves as this mum was. As I always say, there is SOO a time and place for medical intervention, but that should be the exception. Really,  each women has everything they need within themselves.

And golly. That's the fastest 7 to 10 cms I've ever seen!

From the bottom of my heart, thank you.

My dear church family at Deer Park Alliance Church sent me off with 11 stethoscopes and 5 BP monitors as a gift to Glory Reborn.
I had not had time to unpack yet before my first shift, so the first set of vitals I did was with a BP cuff that had been taped from top to bottom to hold it together. Imagine how thrilled I was to pass over the lovely new and nearly new cuffs from back home.

There is now a lovely new stethoscope by every bed at the clinic, instead of one per room. Ate Bev's yellow stethoscope is in the yellow isolation room, looking very smart.

Salamat kaayo friends back home for your kindness and generosity. It is really making a difference.

Trip to the Jail

It took quite a while to get to. Cebu City's Jails are extremely high up in the mountains and the road twists and turns while climbing at an almost impossible steepness. It is the sort of steep that would simply not be drivable in Canada with icy roads.
We were going to the women's prison for a ministry called Narcotics Anonymous which actually is a group for women with all kinds of addictions to gather together for support. Apparently the women's jail houses between 150 and 200 ladies. The men's holds much more than 2,000.
Before we left our van, Pastor Dave, the leader of this ministry asked us each to say what word we would be bringing with us today. Someone said acceptance, comfort, joy. My word was friendship.
It had started to rain as we got to the top of the mountain, so we had to run from the van to the main gate. A guard let us through there, and then we ran to the next check point where we got a stamp. Then we ran to the main building and got signed in.

I've never been to a jail before, in the Philippines or elsewhere. My entire knowledge base came from movies, and the word jail conjured up images of sullen, angry convicts in orange jumpsuits, ready at any minute to find a way to escape.

As I stood in line waiting to sign in, I looked around me. We were in a busy room with lots of people. But the only thing that was different from any other room full of women was that everyone wore yellow t-shirts of various styles and shades. Otherwise, their faces were bright and everyone I looked at smiled at me. I couldn't help but be surprised. My first impression of this jail was that amid the dozens of people around me, there was no one that fit the description I had been entertaining. 


We gathered around in a big group outside, with maybe 30 women. We went in a circle and shared our names, and then one by one the women shared what they were learning or feeling, or what they needed to confess. 


Afterwards I chatted with several of the women. I couldn't get over how sweet they were. They were SO lovely, I simply couldn't picture any of them doing anything that would place them in prison! It made me realize that although they are clearly not without fault, most people in prison simply have come from very difficult, challenging circumstances but at heart are really good people.

One girl I talked to was five months pregnant. She was worried because she received no prenatal care in prison. I desperately wished I had a fetal heart rate monitor with me, and could do a quick check-up. Who knows, maybe this is a ministry for the future. I had such a lovely conversation with her, half Cebuano, half English. She was taking high-school in the prison, and was also learning how to cook. She introduced me to her best friend. They both had children whom they have not seen in many months.

Much of the conversation went back to what happens when you get "outside." Life inside the prison is one thing; it becomes routine, and in some ways, it is easy. Going outside is difficult because suddenly you have to look after all your own needs, and somehow stay away from the temptations that brought you to jail in the first place.

Pastor Dave told us after that the prisoners often told him the hardest part of the day for them way the half hour before they fell asleep. The rest of the day is busy and filled with conversation, but at night you are alone with your thoughts.

As you fall asleep tonight, pray for these women that the Lord will be their strength and their comfort and that they will turn to Him for help.

Arachnid in the laboratory

The baby was jaundiced. But more than usual. The blood work came back, and the search was on. This baby needed blood. In the Philippines, if you need blood, you need to find it yourself; there are not available supplies of blood. If you are desperate, you can go outside the hospital and find one of the people who's occupation it is to sell their blood. But if you can, it's best to find a friend.
In this situation, none of the baby's family could donate, so our staff was asked if they could help. Dear Ate Maymay, our social worker, is terrified of needles, but she was willing to donate blood if she passed the screening. But she asked if Amber and I would come with her for moral support. She got the initial blood work done, and the answer came back: she was a match.

At the public hospital, the lab staff are friendly and relaxed. There were four of them on duty in the lab, and beyond a little divider, there were two analysts. Usually, one patient is allowed in at a time, and they get their blood taken right there by the door. But because this was a bit different, they brought us behind the counter that said "staff only beyond this point." Maymay lay down on the cot, and we sat down beside her.
It was an interesting place we were in. There were some green potted plants growing on the counter. There was strange paraphernalia here and there; mainly discarded pieces of technology which no one could quite bring themselves to actually throw out, like type-writers, and things like that. The lab staff wore flip-flops. The furniture was wooden and quaint.

Amber and I were snacking on cookies and chatting when all of a sudden, with no prior warning or preparation, there before us on the wall above Maymay's head was the biggest spider I have EVER seen in my ENTIRE life. It was at least as big as the palm of my hand. While I froze in terror Amber leaped on top of me, as supposedly the further you are from the floor, the least likely you are to experience attack.

At this interesting juncture, the lab technician came over with the necessary equipment and began to prepare our dear Ate's arm for the procedure. DO YOU NOT SEE THE MASSIVE ANIMAL RIGHT ABOVE YOUR HEAD MISTER??????? Things seemed to be heading in the wrong direction, especially when the spider suddenly darted down towards Maymay's head. This time I cannot hide the fact that all three of us shrieked and threw ourselves to the other side of the lab. The lab tech, seeming to realize that it would be impossible to continue his duty under the present circumstances, went to find a broom. The other three female lab techs were by this time well aware of the situation and had armed themselves with various defensive and offensive implements such as an umbrella. The first lab tech returned with a broom and after a moment of internal preparation tried to squash the spider. Unfortunately, it was too quick for him, and as it flew across the wall, I can assure you the broom-wielder jumped back just as quickly as the rest of us.

Poor man. We started screeching directions at him, which, naturally, we would have done ourselves had we been the ones performing the operation.

"Just hit it!!! Don't be scared, hit it!!"
"Don't fling it, KILL IT!!!!
"Kill it kill it kill it!"

The funny part was, the two analysts on the other side of the potted plants were still studiously bent over their specimens, analyzing away, as if there were not seven screaming and endangered humans 10 feet away from them.

Amber and I were both crying by this point, one of us from sheer phobia and the other from the pure and undefiled hilariousness of the situation. We all clung together, supposedly under the raw instinct that there is safety in numbers. The broom-man kept getting scared because every time he went in for the charge, the spider flew across the wall in the opposite direction.

At last, in a moment almost too horrible to recall, the spider met it's fate at the end of the broom. Peace slowly was restored to the laboratory, Maymay's blood was extracted successfully, the baby was infused, and he is now in excellent health. I am sure that baby may be told someday that he was given a blood transfusion shortly after birth. But I think he will never know the lengths that were gone to, the exploits which occurred, or the bravery that was shown all in an attempt to get him that blood.

First Baby!

What is it about birth? The whole entire process, labor and delivery; it fascinates me, it thrills me, it boggles my mind.
I got to see a baby born this week. It's my 16th to date, but somehow, it is still just as amazing as the first one! It was a wonderful labor. It would be my patient's fourth baby, so she knew what she was doing. Her labor progressed exactly as it's supposed to. We chatted just a little during her labor. She told me she had three boys already, so she would love a girl.
When it came time to deliver, she literally pushed about four times and she had a baby. Of course it's more important that the baby is alive, and breathing, etc...but I couldn't wait to find out. A minute later, the midwife announced it: it was a baby girl! I was ready to cry anyways, but when the daddy's eyes filled with tears of joy as he buried his head in his wife's pillow, I couldn't help but tear up. It is such a wonderful thing that this women had just done. I never want to lose my sense of awe and wonder about birth. 

Asking for Directions

Sometimes I'm so vague when I pray. "Dear God, please help me today. Please help everything go well. Please bless everyone...."

I think the pastor this morning added an extra "s" by accident, but somehow it made a big difference to me. He told us we need to remember to ask God "for directions."

Immediately a mental image appeared of someone in a car, pulling over to ask a pedestrian how to get to a destination. Well, take your first left, then your third right, go past the school, then the first right after the post office. This is pretty different than pulling up to someone and saying, should I go East or West in order to have a happy life?

God thankfully provides both direction and directions. But even if I know which direction He's leading me, I need to remember to ask God about the best route to get there. 

Sleepy Time

What I LOVE about this clinic is the way the graveyard shift is run. The theory is, if there are no vitals for 4 hours, why would 4 midwives sit around twiddling their thumbs, nodding from exhaustion?
During the night shift, if there are no labors and everyone is stable, you go to sleep. Brilliant.
Of course I still have to set my obnoxious watch alarm for every half hour or two hours, or four hours, or whatever the case may be. But everyone takes turns, so I'm generally only up a few times each night. No labors for me yet, but I have hope there will be one soon! 

First Shift

"I am praying so much that I will not have to have a Caesarean," the young woman whispered to me. "Oh I am praying that too," I told her, my heart heavy.

Transfer to a public hospital is never something we like doing. Hands down, they will get better care at Glory Reborn, but when the patient's BP is too high, or her labor has slowed down for two long, protocol gets the better of us.

After nearly half a day of a stalled labor, there was not option but a transfer. Shortly after our shift started at 10 pm, the patient, her sister, her husband, the midwife, me, and the driver, all climbed into the clinic's vehicle and we set out for one of the city hospitals. Instead of going into the front entrance, the driver took us over a bumpy road all the way around the hospital to the rear. As we drove up to the building, the light from the hospital windows illuminated a surprising scene. Remnants of construction; long beams and huge piles of rebar lined the path, and covering it all were dozens and dozens of sleeping people sprawled out or curled up on top and in between. When we stopped at the entrance to get out it seemed we had landed in a refugee camp, there were people everywhere, some sitting, most trying to sleep. Some had literally set up camp and had food and blankets. I realized that these were all the families of the patients inside. The midwife and I took our patient to the door, but we could go no further.

I felt like a betrayer as I stood fuming on the doorstep and let the poor girl go in to fend for herself. She would have to proceed through the rest of her labor without her husband or any family, without anyone to rub her back or hold her hand.

So that was that. I didn't get to see inside, but I was talking to a young nursing graduate today who was describing the inside of this city hospital. He said when he walked in to the room of 30 beds there were 3 women and their babies on each bed. For this patient population of 180, there were 8 nurses. I am too scared to do the math.

Say a prayer for strength for all those incredible nurses who continue on in their jobs, every day giving their best to their patients, despite seemingly impossible situations.

First Impressions

May, 2010. Glory Reborn is composed of a small prenatal room downstairs, and upstairs, one tiny delivery room and an equally cramped postpartum room. The labor room is smaller than my bedroom. It works; every corner was put to good use. But it's a little squishy.
May, 2012. Glory Reborn has indeed experienced some kind of rebirth. I woke up on Thursday morning in a spacious and beautiful clinic! I can't even begin to say how impressed I am with the expansion project. It is so logical, organized, and convenient. They basically expanded the clinic to include the apartment immediately behind the clinic. There are now several rooms downstairs for check in, prenatal visits, examinations, and antepartum. Upstairs, there is a much larger delivery room that can actually comfortably house two deliveries at once now. Then there is a spacious post-partum room with 4 beds, a CR (Comfort Room), and kitchen area. There is a logical flow through the clinic, and there is a place for everyone in any stage of pregnancy.

I don't have much of an eye for interior design, but even I can tell, this was a job well done. 

Dumpsite Day

I'd heard about the community that lived in the dumpsite. I was quite familiar with the ministry Glory Reborn has there. But I never ever imagined that it could be as difficult to see as it actually was.

Before we even arrived, children had jumped on the back of our van and others were running behind it. As soon as we stopped, they instantly lined up, single file directly behind the van. Some of us handed out crackers, a few doctors from Finland listened to people's chests, and antibiotics, tylenol and other drugs were given out according to need. I squatted nearby and little children came to talk. It was so lovely to be able to ask them questions in their own language. I was shocked how much I remembered from last time! As we walked along after the clinic, all the children came with us, on our backs, in our arms, holding our hands.

As we left the road and entered the dumpsite a smell so foul met my nose I could do nothing but consentrate on walking so I didn't turn around and run. I can't believe I complain about going out to empty the compost, when these people live in a place that smells worse than my compost pile. We passed a huge mountain of white paper cups. Then a similar mountian of styrefoam containers. The ground squished under my feet and if you didn't step on the tires or coconut shells or backpacks or pieces of cardboard that were laid down, you would sink right down into the black flilth.

As we passed people's homes, those fluent in our group spoke with them, and the rest of us smiled and said good afternoon. They were all very smilely and friendly. It was so bizarre that these people were LIVING here! We passed a house that looked like the leaning tower of Pisa. I felt sure if anyone so much as breathed on the second floor the entire thing would come crashing down. Most houses were only one story though, or one with a small one above it. We passed under an arch way covered in beautiful pink flowers. It seemed strange that such beauty could be found in such a place.

When we finally came out to the road again, we saw what looked like bleached sand dunes stretching into the distance. But it wasn't sand dunes, it was garbage. Children ran about on the hills closest to us, laughing, and chasing each other.

I have seen many poor places in my life. I was in a dumpsite community in India last summer. But somehow, this one filed me with the most sorrow, the most hopelessness. It is such a dreadful situation to live, to raise a family. Yet I know that there is hope. And if I think of Jesus, walking through that dumpsite, what would he do? I don't think he would start programs to get them out of there, or programs to clean up the houses, or make better paths. I don't think he would start any programs at all. I think Jesus would sit down and gather the children to him and love them. He doesn't care where people are living, he just loves them exactly the way they are. I don't even know what I could do for these people to improve their situation, but I know I can love these kids, and with the amount of love they show me, I know that will be easy.

Bumpy ride

I'm in Cebu! For those of you who are wondering how I managed to take a month to get here, I must tell you I took the scenic route and detoured through Thailand and Vietnam. Amber and I had a wonderful time, but that is another story for another place.
We have actually been trying rather hard for the last 4 days to get to Cebu from Hanoi, Vietnam. It was honestly an unsurpassably irritating experience. Our flight from Hanoi to Ho Chi Min was over 30 minutes late. We rushed to the check in counter, but there was literally NO one there! We flew around frantically trying to find somebody.  We ran with our bags past security (they were busy chatting with each other), and up to immigration. The officer was playing a game on his ipod. Trying to stay calm, we explained the situation. He didn't say anything, but very slowly got up from his chair and SHUFFLED slowly in the direction we'd come. He certainly didn't seem to have internalized the EXTREME RUSH we were in! He conversed in a relaxed manner with several people, and the end conclusion was they would NOT let us check in because we were too late. We tired whining, arguing, asking to speak to managers, tears and speaking with authority, but to no avail. They would not let us get on the plane. If only bribery were more ethical. So, one in the morning in a huge city, alone in an airport of people who really did not care to help us, we sat on the cold floor and felt prodigiously sorry for ourselves.
But by 4 am we had a nice hostel and had booked our flights for the next day.....again at 1 am.

After a full day in Ho Chi Min city, we were in plenty of time for our 1 am flight. Everything was going smoothly until the lady at the check in counter asked to see my return ticket to Canada. I had not seen or thought about my ticket since the day we left Canada. And if you have ever seen my backpack, you would realize that to find something in it is similar to trying to find a Tim Hortons in Vietnam. Impossible. But they would not let me go the the Philippines without it. So I began pulling out souveneirs, socks, underwear, clothes,  etc... and digging around my bag. Nothing. After probably 10 minutes we began to feel frantic and Amber decided to try to find internet somewhere so she could try to print another one off. Shortly after she left, I prayed I would find it, and seconds later I did. I got checked in, repacked my bag and handed it over. But Amber was not back yet. I set out in serach for her, but she was no where to be found. I began to get worried because our flight was departing soon. As the elevator opened at the end of a huge floor full of stores and green plants, I suddenly saw Amber running away from me at the very end of the long hall, and beginning to decend a flight of stairs. "Amber!!!" I screached, but she didn't hear me! I took off, running as fast as I could, but by the time I got to the stairs she was gone! I did appreciate the drama of the situation, but rather wished it was not quite SOOO soon before our flight took off. You can imagine my relief when I finally found Amber again!!
After that, we got on the flight with no hiccups and arrived in Manilla at 5 in the morning. We still had a few hours before our flight, so we had coffe, ate pizza (it really seemed the most appropriate thing to do), exchanged our money, and then hung out at our gate. We closed our eyes, but heard all the announcements every 15 seconds or so. Finally, we began to wonder why our flight had not been called. It must have been dreadfully late.
"No sorry ma'am, it is already gone. We called your names many times but you never came." No. No. No no no no no no no no  NO way. It is just NOT possible. Between the two of us, Amber and I have literally taken hundreds of flights (we actually counted), and never have we ever missed a single flight. How could we miss TWO out of THREE flights this trip????
It wasn't until several hours later when we walked into an airport convenience store and stood staring at the clock in the wall for several minutes that we realized our clocks were wrong, Manilla was one hour ahead of Vietnam, and nobody had cared to mention the fact to us.

Well the cheapest flight to Cebu was 10:40 pm that night. A solid 13 hours away. So, we made the best of  it. We tried on mascara that makes your eyelashes grow longer. We made friends with the people selling the mascara. One of them was turning 25 that day so we bought her a donut and a drink. Because it was her birthday, we sang happy birthday to her, fairly loudly and discordantly. Then because some of her family was visiting, we had lunch with them including her aunt who wanted at least one of us to marry her son.

We went and watched a movie in a nearby cinema. We chatted. We read our books. We slept. We pretended to be sleeping. We watched people. We sang little songs to ourselves.

We got to our gate hours ahead of time, set our watches, and told the staff exactly where we were sitting with strict instructions not to leave without us and to please wake us up in the unforgivable event we might be sleeping. Thank goodness we had that thought. When our flight was called, I was in such a deep sleep I woke up neither to the announcement nor to the concerned staff member shaking me. Good thing Amber is a little more easily roused than me, and the end of the story is that we made our last flight, and got to Cebu in the wee hours of the 24th. We made it to the clinic where we crashed at once in the nurses room and slept until this morning. It was certainly a journey and a half, but we're here, and that's all that matters.