delivery scare!

It finally rained here! really just a light sprinkle, but the rain is cold (especially in contrast to the hot air), and it smells exactly like when it rains at home after it's been dry for awhile... oddly enough, the people here tend to use umbrellas to block the sun and don't care so much about the rain. they all want pale skin and the stores have shelves lined with whitening lotions (I'm constantly telling the midwives they can have my pale skin if I can have their beautiful tan : ) They are so envious of our fair complexions and don't understand why we refuse to use umbrellas when walking the sunny streets. The grass is always greener right : )

More babies!! We've had several births in the last few days, so many baby girls and only one boy so far, though I think another might have been born last night. we spend the days in our "uniforms" - scrub pants rolled to the ankle, mismatched scrub top (the lightest weight ones we can find), and flip flops, and we blend in surprisingly well this way. I did my first internal exam (IE) yesterday!! which was exciting and surprisingly easy. The mother was dilated to 4cm and they have to be 10cm for delivery (we only keep them at the clinic if they are 5cm or more), so we sent her home to wait a while longer...

As much as I've tried to avoid getting attached to the three kittens (Tom, Jerry, and Sylvester), who live in the apt with us, it's proving difficult. They are so cute and playful and love to be held. Jerry (the biggest... and meanest according to Gina) is my favorite and I'm already contemplating how to sneak him home to the states with me : ) Tom just meows at your feet until you let him curl up in your lab, and when i try to draw they attack my crayon. (I bought a sketch book and some oil pastels to kill time in the mornings and at night... Lo and I have also discovered the scrabble game they keep in the clinic and battled it out yesterday :) it's weird having free time. Ive already finished reading The Five people you meet in heaven and I'm on to Mountains beyond mountains.

About the CCMC (Cebu City Medical Center): I have only seen from the outside so far, but should have the opportunity to visit it when i ride along on a transport. The building looks unfit to house livestock, nonetheless sick people!! and from what I've heard (Lo got to visit it briefly), you can judge this book by its cover. Inside it is two to three patients to a bed (yes, that is possible), no sinks, unorganized, random fluids everywhere, terrible sanitation... Hilary was telling us that recently 17 babies died there in one day when the water was turned off because the hospital had not payed its water bill. The health care facilities, like the social classes, are very extreme... so much disparity. You have the nice (and expensive) private hospital, the run-down public hospital that probably does more harm than good, and nothing in between. It is the story of a developing country.

Yesterday we came back from lunch (wait until you see pictures of some of the things we ate!! stomachs are doing really well despite our strange diets :) with Tess and Rosalie in time to see another birth! Baby girl again but this delivery was a little scary and Lo and I were really wishing we understood at least a little Cebuano. The delivery itself was quick, the head one second then the body, but the baby was overdue and there was so much feces in the mother and all over the baby (including in the lungs) that the baby wouldnt cry - and they didnt want it to until they had suctioned the lungs. It was alarming to see the nurses and midwives rushing to clamp the umbilical cord and watching the white baby (normally they are very dark and red) lie there somewhat lifelessly. The nurse brought the baby over to begin suctioning and eventually she cried, whew! The physician was brought in to do a full examine on her to confirm she was alright and she scored a 9 out of 10 which is really good. such a relief!! They just dont seem equipped to deal with much aside from natural healthy deliveries at the clinic.

Mari-Tess and Luna took us on a walking tour of the Basak neighborhood today (where we live). We started out on foot, the caught a taxi, then a horse drawn carriage (dont think central park big carriage with large horse... think small emaciated pony attached to an old cart that they stuff 4 to 6 people in despite how tiny it is), and Lo somehow ended up in the driver's seat!! As if we dont already make enough of a scene being young American girls here, she was driving "white horse" as the all-white pony was creatively named. It was pretty funny but also your heart just breaks for the overworked, underfed horse :( then again, it is hard to feel too bad about the horse when the driver is probably just as malnourished.

Came back to the clinic in time to help with the line up of women at various stages of their pregnancies. The prenatal checkups include measuring the fundal height of the tummy, asking if they can feel the baby move and if they're taking their vitamins, and finding the fetal heart beat (which can be difficult, especially with the mothers who are only a couple months into their pregnancy). It is really fun when you do find the heartbeat though, it's so rapid, between 120 and 160 beats per minute! There were many women waiting to be seen today, which is good that they are compliant with their prenatal checkups, and also good because it means many deliveries on the way!!!

Tonight Lo and I will meet Father Heinz to go to the dump site (essentially many feet of trash spread for miles where people make their homes). Then we'll head to the redlight district to talk to the girls there and watch Father Heinz work (distributing condoms and medicine). Ill have more to say on all of this tomorrow, it is going to be a tough experience no doubt.

Not missing much from the states yet (except friends and family of course :) we'll see if I can say the same in a few weeks!! much love!

~Linds

habo habo

k, this is going to be a quick update... i think :) sunday: lo and i helped with the gram stains and learned how to do the pap smears so that we can perform them in the future - so amazing what they'll let you do here!! we also learned how to find the Ballard score for newborns (it's used to assess gestational age)... we basically play with babies all day, can't complain about that, finding RR and HR and checking the mother's vital signs, simple stuff. Luna and some of the other nurses and midwives at the clinic like to hear about the US and usually know someone (a relative or friend) who lives there. They were telling Lo and I that they would be our Yaya's (live in nanny) once we have kids, but when we explained that wouldnt be for a few years they decided they would just come to be our Yayas now -we're ok with that :)

When it started getting slow around the clinic, Max (the guard) flagged us a taxi and we were taken to hiary and david's community of really REALLY nice houses in the hills above the city. the taxi's cant make it up the steep hills to the houses so you get dropped off at the gate and take a habo habo (a small motorbike) to the house... unfortunately, despite explaining countless times that we were there to visit the Overton's, the guards were still confused and unable to find Hilary and David in their directory. Being that we knew we were in the correct place and had the correct names it was very frustrating, until finally Lo decided to spell out "Overton"... at which point the guard says "Ohhhh, Oh-ber-tone!!!" and sticks us BOTH on the tiny habo habo (driven by a very large man), as he laughs about us mis-pronouncing Overton. For the most part language hasnt been a problem here because so many of the locals speak english very well, but in this particularly situation we had some serious communication issues that we laughed off as we sped up the steep winding road to hil and david's :)

Our reason for coming to their house was to use the community pool, which was amazing!! Then Hilary and David met up with us along with some of her friends from her NMAT (their version of the MCAT) class - their test is sooo different than the MCAT we take in the states. We had bbq and learned more about the philippines... For one thing, Hilary was telling us they move the holidays here so that they always fall on a monday or friday (people really value their three day weekends : ) even if the holiday is already on a weekend the president will move it to give everyone an extra day off work. Side note, the karaoke here is crazy, everywhere you go you hear it, lots of english songs... and birthday parties are also really extravagant. there was a kid's party at the community center where the pool is last night when we were having dinner and there was a crazy clown and it was catered with the tables all set up (Lo and I thought it was a wedding at first).

Lo and I stayed at Hilary and David's house last night. The AC and soft bed were incredible! and I dont even know how to describe the view from the bedroom and bathroom... when you shower you have a view of the entire side of the island and ocean, its breathtaking! I did have to fish a gecko out of the shower, which was interesting, but they like having them around because they eat the bugs (they make really odd sounds though, and we saw one that was at least a food long and had pink spots... not sure how i'd feel about him living in my house).

Two new babies at the clinic this morning, both born overnight and then one is still there from yesterday (they like to keep the mothers 24 hours after the birth), the baby girl's name is lindsey!! All three babies are really healthy and beautiful and the mothers are so friendly and sweet. One of the mothers who gave birth last night was telling us that with her first child she was at the hospital and had a lot of pain relievers but in the clinic they do a natural birth and she was telling us how loud she was screaming and how much in hurt... these women are so incredibly brave and tough!!

K, lo and i should head back to the clinic but the internet cafe has air conditioning so its fun to come hang out here (and to see what all the neighborhood kids are doing). All the best from Basak!!

at the 90 degree internet cafe

Hi Friends!

My blog might be a little descriptive when I talk about the deliveries (seriously, I try not to get too detailed, so don't worry), but consider this your warning : )

The good news is that I stayed awake through my first day here (not an easy feat since it was night back home), and I was able to sleep relatively well through the unbearable heat that doesn't let up even in the dark. My bed is rock hard due to the leather that binds the foam mattress to keep out fleas and lice, but at least I have a fan I can leave on high all night to try to stay a little cooler. It is quite a contrast from cold nights in Oregon where I prefer to sleep with about 6 heavy blankets...

Not surprisingly, there is a lot here that contrasts with home. Where to begin? Well for starters, the neighborhood we are in would basically be considered a shanty town. Think scenes from Slumdog Millionaire when the kids are running away from the police... Fortunately our tiny apt is very comfortable (considering the surrounding area), and the clinic has guards here 24/7 to let us in and make sure everyone else stays out! I actually really like my room with it's burgundy walls, deep wood floors and an armoire with just enough space to keep the little clothing I packed for the trip. Most of our time here will be spent in the clinic anyway (which is conveniently next door), with mismatched scrubs as our "uniform".

We were introduction to the clinic yesterday, Hilary gave us a tour and explained our duties... she is blond hair, blue eyed American who stands out worse than Lo and I except for her impressive Cebuano, which indicates she has been living here for some time - 9 years in fact. (Lo and I are such a spectacle that we get stared at everywhere we go and everyone is waving and saying hello and when we walk down the streets the children take our hands and press them to their heads -so that we bless them). The clinic is incredible primarily because they do so much there with so little. The facilities are reflective of the area in which the clinic is located and sterilization takes on an entirely new meaning here. In fact, the nurses and midwives wear flip flops around the clinic, and during delivery slip into "sterile" flip flops hanging behind the delivery room door.

Saw my first delivery yesterday and all I have to say is that is was AWESOME!! Lo has seen lots before having worked at a maternity clinic in El Salvador, so this was nothing new to her, but I found it extraordinary! This little Filipino mother was kept active (walking around and moving) up until moments before the birth. They like to keep the mothers exercising and upright because it speeds the labor process. They also prefer that the mothers wait as long as possible before they begin pushing - it prevents the mother from getting too exhausted from pushing too early. Their strategy undeniably works well. This mother tolerated her contractions in silence from a standing or squatting position, the only indication of her agony was her face, which would scrunch up uncomfortably for a few seconds then returned to relaxed exhaustion in between contractions... Finally, they put her on the bed and the midwives (in their sterile flops and christmas and valentine's day scrubs with the scrub pants rolled up like capris), delivered a perfect 6lb baby girl in a matter of seconds. Seriously, one moment there was the head, the next the whole deep purple body and only minutes later the placenta (which I would like to describe because it was awesome : ) but I'll do you the favor of skipping that part).

Even better than the remarkably fast delivery was that Lo and I had the responsibility of washing the little newborn!! Bath time is going to be a fun treat of our time here, bathing the babies is unreal! They are so alien looking and pissed off, it's pretty funny!! But despite the... ok, wait, hang on, I'm in the internet cafe down the street right now, we came really early to avoid the afterschool crowd of kids that come to myspace and play warcraft, and the only other person in here is the son of the woman who owns the cafe and he's sitting at his computer with headphones on singing REALLY loudly to whatever is on the computer and it is hilarious!! Now back to what I was saying... delivery = cool... and I'm so excited for when we get more responsibilities and are able to participate in the process. I have a feeling we are going to learn so much in our time here! And the stories Hilary has to tell about the public health care system and the experiences she's had at the hospital are enough to drop your jaw. She told us last night of a recent trip to the ER for a high risk delivery. The doctor never showed and the ER was no help so Hilary ended up having to try to save the mom and baby in the waiting room. They had all of the surgical tools with them because if you need a surgery in Cebu you are responsible for purchasing the necessary equipment (remarkable healthcare system... remarkably inefficient that is). Hil said she tried her best but the baby came out not breathing and they weren't able to save it, the mother did make it but while Hilary was trying to get the placenta out and stop the bleeding she said there was a rat (yes a RAT in the HOSPITAL!) that kept jumping in the placenta bucket. No words...

More stories.... well, we ate dinner in the clinic, tuna sandwiches, which is sounds like we might be living off of along with pb&j. While we ate dinner Hilary told us about the redlight district she visits on Fridays (Lo and I were unfortunately too tired to go last night but very excited for next weeks opportunity to go spend time with the girls there). It sounds like there are two levels of prostitutes: those who stand on the streets and those who are in the back buildings... but the more public aspect of the redlight district (those girls who stand on the streets) is declining because text message has taken over as the primary means of communication between prostitute, pimp and client... Father Heinz is a friend of Hilary's who visits the redlight district daily and hands out condoms and medicine. It sounds like everyone there loves him and it is safe for him to be there because the pimps are appreciative of his help too. I can hardly anticipate what it will be like to go there... the magnitude of it (hundreds of girls out on any given night...), and they are all very young... I'm guessing this will be one of the most difficult things for Lo and I to deal with.

Well, that is probably enough for one blog... Lo has been chatting on the computer next to me and it is so wild that we can see and talk to her mom while we sit here thousands of miles from home. I have also been able to gchat with people who are on right now, so if you want to be able to talk live with me just sign on to Gmail and my email is Linds.wenger@gmail.com and we can gchat.

Ok, last thing, gotta talk about the animals because I'm already sad about the two dogs caged up outside of the internet cafe... On our ride to the clinic from the airport we were in an open air jeep thing, it's like a long, short minivan type vehicle with bench seats on either side and no window (the exhaust from the other cars is suffocating and it puts crazy driving in mexico to shame - sorry mari!). These seem to be a main form of transportation along with old motorbikes (no joke, saw a family of five on a since bike... this is how it worked: littlest kid on the front in dad's lap, dad driving, two little girls between dad and mom and mom on the back... just a normal tiny motorbike, what?!). My point of all of this, besides our authentic ride to the clinic, was that I saw very few stray dogs, which is a good thing because you know i'd fall in love with one and want to bring it home. I'm already debating how to save the pitbull looking dogs in the cages outside and Lo thinks im crazy : ) And also, we have three little (when I say little I mean they look more like mice than kittens), living in the apt with us. They are trouble makers and you want to get mad at them but then they look at you with their freakishly big ears and all you want to do is take pictures of them (and for not really being a cat person I already have wayyy too many pictures of the kittens).

That's all f0r now, more to come soon!! This place is awesome and I'm loving it already! I particularly love never being cold, though the heat can be a bit on the unbearable side at times I'd take it over being cold any day : ) All the best!

~Linds

made it and loving it already!

Lo and I left SF Wednesday night and arrived in Cebu Friday morning. When we first landed in the philippines it was 4am and 86 degrees outside... lets not even talk about the humidity. Lo and I have been drinking water (bottled of course) like it's our job. I dont have time for a long update now, just letting everyone know I made it here safe! And that I saw my first birth today and it was incredible! The clinic is right next to the small apt we're staying in (so minimal and yet considered luxurious compared how our neighbors live). Extreme poverty where we are but hilary assures us that the area is safe. We were given a full tour of the clinic and told about our duties (which include taking vitals, bathing the newborn and hopefully "catching" the babies during the birth!!). we're soo excited and very hungry so we're leaving the internet cafe down the street to go get some dinner at the clinic. More to come! It is awesome here!!

departure tomorrow!

it's my last night home before i leave, already 2am, and i'm still not sure i have everything packed that i need... at this moment my biggest challenge seems to be figuring out how to turn off the alarm on the watch i got for the trip... it has been going off every 5 minutes for the past hour and i'm planning on leaving it upstairs for the night so i can sleep uninterrupted. great.

last day at Nords was pretty awesome, big sales ($1200 with one custie!!), good company (claire, you know you'll miss me), and a final "treat" from the cafe (if you havent tried the mocha cookies and cream ice storm you need to! : )

i think the last thing on the packing list is protective eye wear for our time in clinic... Lo left me a voicemail today expressing her - there goes my watch alarm again - concern that blood could splatter into our eyes during a birth - sounds funny but it's a serious issue with the danger of contracting HIV or other infectious diseases (i listened to the message - laughing - while on the floor at work, then made claire listen to it as well to remind her that i will not be "de-worming orphans in africa" but rather assisting midwives with deliveries, prenatal care and family planning education in the philippines).

time to get some sleep (although we are watching our neighbor's dog and he doesnt like to sleep alone, so he curls up next to my bed and snores - incredibly loud - the entire night), we'll see how well that goes, i think i might be too excited to sleep anyway! and it's fine if im exhausted for our red-eye tomo night... it is a 20 something hour flight afterall : )

ok, friends, if you want a postcard from somewhere in southeast asia all you have to do is leave me your address in a comment or on facebook or something, i'd love to send them, i just need the addresses!! i'll miss you all lots and wish everyone well! the next time you hear from me ill be almost 7,000 miles from home!!

hugs and love!
~Linds

packing time

how to fit everything for two months into a pack designed for a weekend backpacking excursion? i'm thinking i'll be making a few purchases while i'm over there.

the essentials:
-scrubs
-a few light weight dresses
-passport
-kyodophilus
-tampons (apparently they're difficult to find in the philippines)
-swimsuit!! (the philippines consists of over 7,000 islands after all :)

i leave in two days and couldn't be more excited! except that when i registered with the US Dept of State there was a bit of an unnerving travel warning for the philippines:

January 27, 2009

The State Department warns U.S. citizens of the risks of travel to the southern Philippine islands of Mindanao and the Sulu Archipelago and urges extreme caution if traveling there. This Travel Warning replaces the Travel Warning dated February 13, 2008, and updates information on continuing threats due to terrorist and insurgent activities.

Travelers should exercise extreme caution if traveling in the central and western portions of the island of Mindanao, as well as in the islands of the Sulu Archipelago. Regional terrorist groups have carried out bombings resulting in injuries and death. Since August 2008, there have been sporadic clashes between lawless groups and the Philippine Armed Forces in the Mindanao provinces of North Cotabato, Lanao del Sur and Lanao del Norte, as well as the Sulu Archipelago. Kidnap for ransom gangs are active and have targeted foreigners. U.S. Government employees must seek special permission for travel to Mindanao or the Sulu Archipelago. Travelers to these areas should remain vigilant and avoid congregating in public areas. Some foreigners who reside in or visit Mindanao and the Sulu Archipelago hire their own security.

i'll meet lo in SF on wednesday and then we'll be off on our 20 hour flight to cebu city. good thing i'm a professional at sleeping on planes :)