Dengue

Ok, so I have not had access to internet since leaving Manila and therefore have not been able to post an update, well that and contracting Dengue Hemorrhagic fever of course...

I am quite sure anyone reading this, already knows about the whole me getting Dengue Fever thing, but anyways...

After a 3 hour long bus ride with a screaming child in the seat next to me, I finally arrived back in Olongapo at the Mercy In Action birth clinic safely Sept. 2nd, I had mixed feelings about being back, and was already missing Manila. After a stressful rest of the day, and not much sleep that night, I woke up early to assist at a birth, and then after contemplating going back to Manila, I came down with the chills. I felt so cold I was shaking from head to toe, but my skin was hot to the touch. I knew that I was coming down with something different than just the average flu. I just felt strange. By morning my fever was 102F and it felt like I was hit by a semi-truck. My body was so sore including a severe headache behind my eyes . The fever was steady that entire day and would go down only if I took Tylenol, but came right back up after the medicine wore off. Basically the only thing I could do was lay in bed. I felt this way for 3 days and on that third day of still having the fever and my eye/face also suddenly becoming painful and swollen, I convinced the people there at the clinic that someone needed to bring me to the ER. No one was expecting my diagnosis in the ER. For starters I was so dehydrated my blood resembled black tar. After also having a couple other tests done, I was immediately diagnosed with Dengue Hemorrhagic Fever. The doctor said, I needed to be admitted in the hospital for 8-10 days, have an IV started, blood drawn every 12 hours, and may be needing a blood transfusion if my platelets got any lower. After hesitating for a second the doctor went on to tell me that they don’t like doing transfusions on foreigners because they couldn’t guarantee that the blood would be disease free. Wow, was that scary! I never in my life felt so alone. Being thousands of miles away from home/family in a 3rd world country and told I have contracted a dangerous disease requiring hospitalization, was one of the most frightening things I have been through. Since they wanted to admit me, I decided to transfer to a better hospital, especially after a mosquito landed on my arm as this doctor was explaining my diagnosis to me( I had someone chase it down and kill it.) The hospital I transferred to (George Dewey Medical and Wellness Center) is one of the nicest/private hospitals in that area of the Philippines. I was treated very well, the worst part was having to have my blood drawn twice a day. Whereas the other hospital was going to admit me for 8-10 days, I only had to stay 3 days in the George Dewey hospital and was able to be discharged with instructions to be monitored at the birth clinic where I was staying. I am not going to lie, during my time of being sick, I cried several times as I am sure several people in my family were also crying for me. I feel like I have had enough Philippine experience to last me a long time, and after much thinking/praying/and discussing I have decided to cut my stay short and come home ASAP. I have since returned back to Manila and will be flying out the 20th. This has all happened so quickly, but my doctor had told me I can get dengue again 3 more times, with worse symptoms presenting themselves every subsequent time. I hope I am making the right choice by coming home, all I know is that neither I nor my family can go through this again. So, get ready America, here I come!   

In the hospital for the 2nd day  

My Kasama Kelsey(a Kasama is someone who stays with you like a friend
in times of need

The first Dengue rash type thing I got, my doctor called it white islands in a red sea.
When I was recovering I got a 2nd rash, more like an itchy measles type looking rash all over my body.

Itsy Bitsy Spider

While I was in my room getting ready for bed, I saw something out of the corner of my eye scurry past on the wall. Being used to seeing geckos and cockroaches running past me on a daily basis, I casually looked to see who was coming out to say hi this time, when low and behold I found myself facing death itself! I could suddenly hear my heart pounding in my chest and following my automatic instinct, I ran out of my room all while screaming "Oh. My. Gosh!!" After taking a couple of calming deep breaths, I slowly turned around and tiptoed back in my room, confirming what I had seen...Yep, I found myself face to face with a huntsman spider. This dark brown creature native to the Philippines, was at least the size of my right hand; gigantic and hairy. After some research I found out that they can have a leg-span of up to 10in.!) Basically, it's not something one would like to have staring down at them in their bedroom. At that moment I desperately wanted my dad there to protect me from this spider that I was sure had crawled right out of that arachnophobia horror movie. Now, I was faced with a decision. To kill, or not to kill, me or the spider. I stood there cringing, while a million thoughts were running through my head. How in the world would I even kill this monster, let alone conjure up enough bravery to? Its not like I could just take a shoe to it, the Huntsman's are known for their speed and are able to jump. They have good eyesight with eight beady black eyes and very large/long fangs. Even though they are pretty harmless to humans, if bit, it means a trip to the ER, localised pain and swelling, nausea, vomiting, fever, and headache.(can you tell I have been doing some research hehe.) I probably stood there for a good half hour or longer debating with myself about killing this spider. I had found 2 large shoes, a bucket, and a broom, while I was trying to decide what my weapon of choice should be, I am sure anyone watching me would be peeing their pants from laughter. One moment I would stand there saying to my self, “I think I can, I think I can” and the next, I would be running out saying“ there is no way I can do this!” It was about 10 at night and I was alone; there was no one else around who I could get to help me with this spider situation. Call me a wuss, but in the end I just couldn’t do it, I couldn’t kill it and there was no way I was going to get close enough to the thing to capture it. I decided to shut the door to my bedroom, and sleep out on the prenatal bed waiting till morning where hopefully I could bring in some reinforcements. Well, after getting little sleep and waking up this morning, the spider was gone. What was I expecting? I guess my now pet spider didn’t get the memo to stay there all night and wait patiently to be killed. Now, I have to live with the reality that this thing is somewhere loose in my room. I have a feeling I won’t be getting much sleep in the next few days to come. The local Filipina’s tell me that the huntman spider makes for a good house pet, because it eats the cockroaches, geckos, and pesty insects. But I am sorry, I would rather live with the roaches than this spider... Shall I name him Itsy? 

My now pet spider, Itsy

Here is a way better pic of the Huntsman spider, this is taken by 

someone who was willing to get close to it obviously, I was standing at least 10 ft away

zooming in with my camera when I took my pic...

Meow, Meow

I saw her walking towards me, a little girl about 9 yrs old with an orange and white baby cat in her hands. Aww how cute, was my first thought.  As I was pointing out the cute kitten to my preceptor wondering where the girl was taking it, Gerlene nonchalantly explained to me that the girl was taking the wide-eyed meowing kitten to the garbage pile we just walked by...actually, the same garbage pile I saw the other kitten struggling for life in last week that I so desperately wanted to save. What!? Why would she do that!? Well, apparently it is common for animals especially kittens and puppies to be discarded like a piece of trash once they are done nursing on their mothers and start scavenging for food; food that can feed a famished child instead of that starving animal. Sadly, there is no such thing as a humane society or pound, its hard enough to acquire human rights here, animal rights definitely do not exist. Did you know that there are over half a million stray animals in the Philippines! Some would argue that I am caring too much about a kitten who did not belong to anyone. But, I believe all animals deserve respect, and this was very saddening for me to witness. I am thinking that once 1 woman every minute of every day stops dying preventable deaths in childbirth here, I just might start trying to save those poor kittens.

This lil kitten was just crawling around through the garbage, the lil guy looked almost dead

Speaking of human rights...Maribel(the baby twins mother) was rushed to the ER last night, apparently she was having extreme pain in the lower right quadrant of her abdomen. Since the family has no money, the only thing the Dr. did was tell her what her problem might be. Maybe gallstones in her gallbladder, or even appendicitis, but she needed to pay for and get certain lab tests to confirm what was really going on. He handed Maribel the prescription/list of the tests she needed to undergo, like a CBC, urinalysis, ultrasound ect. then handed her a prescription for pain medicine and sent her with instructions to return when she has money. Yeah, you read that right, they would not let her stay, despite the fact that she could have a life threatening condition ending her life and leaving 10 orphans behind. One of Maribels children ran here to the clinic handing me all of the lab tests/prescriptions including the medical supplies the family would need to purchase. Yes, here one actually has to purchase their own medical supplies and bring it with them to the hospital; like IV’s, Syringes and needles, blood(in case a transfusion is needed) anesthia ect... I was very appalled by the fact that the Dr. was allowed to just send Maribel home. I told the little girl to tell her mother she needs to go back to the hospital right away and then gave them enough money to cover the lab tests including the ultrasound (only about $25 US dollars!) Its really hard to comprehend how people can be so poor that they can't even come up with $25 to save their own or a loved ones life. Now I am just waiting for them to come back bringing the results and plan of action. As long as I have the means, I am going to help this mother as much as possible. If her life ended, it would end the lives of an entire family including 2 newborn babies, and that is not ok with me. This is an amazing song that reminds me, we need to care...

Gerlene and I are still keeping pretty busy here at the clinic. When we are not delivering a baby or doing prenatal checkups, we go around house to house and check on the moms and newborns. We are looking foward to midwife Eva getting back to have an extra set off hands again.

Here are some pics of the moms and babies we delivered this last month...

This mom came to the clinic in an ambulance! It scarred me so bad when I answered the door to a bunch of freaked out paramedics and an ambulance, but then realized nothing was wrong, there was just a woman pushing out her baby...The paramedics had no intention of delivering that baby. They quickly carried her into the delivery room, and then left when I put on my gloves...  

Gerlene and I doing post-partum checkups...Believe it or not this baby was 10lbs when he was born!! Biggest baby ever born at this clinic! It was a crazy birth with just Gerlene and I. He was another shoulder dystocia (5 minutes) and his mom hemorrhaged, but we were able to handle it and now mom and baby are doing great!  

Ooops, preceptor didn't make it to this birth...at least God was with me :)

P.S. Just realized that for those of you reading my blog through e-mail, you can not see/listen to the song I was talking about unless you come to my actual blog site...

Update from me :-) Finally!

To all my followers:  Sorry I haven’t written in a couple weeks, you are probably wondering what I have been up too lately, so here goes...

    We are temporally short staffed at the clinic this month because midwife Normi is not working here anymore, she is in the process of moving abroad to Taiwan to work as a caretaker, and midwife Eva went to America to write her exam to become officially certified as a midwife...so that leaves me and my preceptor Gerlene for most of the week. But we do have Grace (a nurse) who comes and stays in the clinic with me Thursday, Friday, and leaves Saturday morning. Despite the fact that I ended up delivering a baby on my own, we have been able to keep the clinic running well with it just being us. And ironically, it has been busier than ever before with 7 babies born just since the beginning of this month, and not all of them have been complication free. I want to say that even I am amazed at how much I have learned and how far I have come throughout this journey in Asia as a midwife. The things I know and am confident doing now is so awesome!

I just got back from visiting the baby twins again, and I am sad to say that they are not looking much better; also the mother still seems sick...

    It was after dinner and almost dark when we walked into their home, the only light was from the fire cooking the kettle of rice. I grabbed my handydandy cellphone which has a built in flashlight on the top so that I could see the babies. It is hard for one to comprehend the living conditions of this family without actually seeing for oneself, but I am almost in tears while I type this. Despite the help/medicine/formula we have given this family, the unbathed barely clothed babies are well over a month old now, and still look like they were just born yesterday. They don’t have the infections in their lungs anymore, but James(the boy) has dark green goopy stuff in both his eyes and has a major rash on the inside of his thighs, back, stomach and bum. Jasmine even though born bigger than James is smaller now, this could be the outcome of her twin brother being fed all the milk because he is a boy, and boys are prized here, just like in any other 3rd world country. Someone had put a filthy teddy bear over Jasmine to act as a diaper of sorts, and James had a cloth wrapped around him that was already soaked with urine. All James and Jasmine do is sleep. They don’t smile, they don’t move their heads or eyes towards me or anyone else for that matter, they are not thriving. Dear God, will these twins even make it to the age of one? Here there is no help from the government. Social services would definitely be involved if this was a family in America, but I am not in America, I am in a country where dying from starvation is just as real as dying from old age. If the wealth here in the Philippines could somehow be equally divided, everyone would have enough; no more, no less, just enough. .. All I can say is that we will do our best to help this family in every way we can...when walking back to the clinic from the twins house and on the way passing and having to leave behind an abandoned crying kitten in the middle of a garbage heap, I realized I cant save the world, God is going to have to do that. 

For those who are unaware, I am due to go back to Olongapo at the end of this month with Mercy In Action again. During the time I have been here in Manila, Mercy In Action’s birth center has been opened, is up and running, and very busy with sometimes even 3 women coming in 1 night. I have made many friends here in Manila interning at Gerlene’s clinic for these past almost 3 months, and will miss them dearly, though I can’t say I will miss the cockroaches as much, hehe! but, I have gotten used to living here in Manila. The grocery boys at the local store all know my name, and are going to miss seeing me there every week ;-) and I am sure the tricy drivers will miss driving me around and getting lost because I, the foreign girl, has no clue where she is going. In Olongapo, I will be living in the birth center just like I am here, but with 2 other midwives (the same midwives I was working with before) whereas here I have been living alone. The plan is to stay in Olongapo for the rest of my time being in Asia.(4 more months to go!)

Sick Babies

It was Tuesday morning when I walked into a small concrete/dirt, dark, hot home. This was the home of the twins James and Jasmine...and many other children. Sounds of a crying toddler in the back room separated by a dingy curtain filled my ears. I glanced to my left and noticed a small girl who looked about 4, but was probably 7yrs. old scrubbing dishes on the floor. There was a kettle on a hot coal fire cooking the family’s rice in the corner of the floor. Is that the only food they have? I left with Normi that morning with plans of doing a postpartum visit to Maribel, the mother who gave birth to James and Jasmine about 3 weeks ago, little did I know that this is where her, her husband and their 10 children lived. Pushed up against the right wall of the house was a small wooden bed where Maribel and her twin babies were laying. At first glance over the twins I noticed immediately that they were both very sick and desperately needed to be bathed. While I was doing vitals on the mother and babies all the other 8 children were staring at me wide eyed, isn’t it a school day? Unfortunately these kids don’t get to go to school, soley because they were born into this very poor family. Little James was just laying on the bed loosely wrapped in a dirty blanket with his head turned to the side, eyes open and mouth gaped open trying to breathe through his very snotty nose. When I picked him up he would not respond to my voice or touch, his goopy eyes had the look of suffering in them.  I could hear fluid in his lungs. He hadn’t even gained an ounce of weight since birth. Was he going to die? Jasmine didn’t seem as sick but had the same snotty nose, raspy sounding lungs and hadn’t gained any more weight than James did. I didn't realize that she wasn’t wearing a diaper under her dingy blanket, and could feel warm fluid running down my legs. She was peeing on me! Oh well... Is their mom to ignorant to realize her babies are very sick, why didn't she contact us at all or take them in to see the doctor? Upon talking to Maribel I realized that yeah, she knew her precious babies were sick, but what could she or her husband do about it? They have no money to take them to a doctor much less buy medicine. The contract the husband had where he worked had expired leaving him with no job. Their older children were providing the only income for this family. The mother was giving the babies some liquid vitamins hoping they would get better on their own, that’s all she knew to do... Upon also examining Maribel I noticed that she was just as sick as her babies! She had this horrible cough, was extremely stressed/tired, still bleeding from birth, and producing hardly any breast milk for the twins. Wow, all three of them needed to see a doctor ASAP. I left the home with a feeling of sorrow in my heart. In a country where using any form of birth control is looked down upon due to 95% of the population being catholic, where abortion is truly illegal, and there is absolutely no financial government help, this is the situations family get stuck into.

I walked back to the clinic and immediately told my preceptor Gerlene and midwife Eva about my findings. We prayed and thought about it, and came to the conclusion that we would take the mother and babies to the doctor the very next day and pay for everything, including the tricy ride...the doctor concluded that both the twins had severe infections, were malnourished, and the mother has severe pneumonia. We got them all the medicine that was prescribed to them and also bought some special substitute formula for the babies, meanwhile the mother will still breastfeed as much as possible. All that only cost about 1,000 pesos, which is equivalent to 25 US Dollars...It has been 3 days since and the family has been bringing the babies here every morning to get nebulised and checked on. The mother and babies seem to be slowly getting better, also the babies have both gained weight! We feel so much more at peace that we were able to help them. These twins will always stay in my heart and prayers.  

     

Tough Times

Wow, where do I even begin...the last couple of weeks have not been easy.  It is coming closer to the end of the month and we have only had one successful delivery here in the clinic this June. We have had to transport 4 patients and unexpectedly one of those patients baby boy died in the hospital for reasons we will never know.  That’s not the only death our  team of midwives experienced this last month, a family member of my preceptor passed away, and the father of Normi the other Filipina midwife who works here passed away as well. All of us have been in mourning, I have never been to so many funerals in my life. Now, you are probably wanting more information about the pt who’s baby didn’t make it... It was the mothers first baby and she was 22 yrs old. When we transported because of lack of progress during pushing stage, the baby and mom vitals were great, the bigggest problem was that this pt wasn’t able to push her baby out effectively. After trying all the midwife tricks to help this mom deliver, we decided to transport because no progress was being made. This pt and her baby had no complications during prenatal care or the entire time she was with us in labor, when we found out the next day that the baby had died in the hospital us midwives were shocked and angry. We were angry at the hospital/doctor because as far as we knew there was no reason that the baby boy should have died, it didnt make sense to us; but the hospitals here are still performing dangerous outdated procedures that are outlawed in developed countries like America, and neonatal resuscitation is something that they rarely do... Now, I cant sit here and say that it was the hospitals fault that the baby died, we really have no clue about what actually happened in the delivery room that night and there are no witnesses because when a laboring woman is admitted in a hospital here no one else is allowed to be in the room with her expect the nurses and doctors. We will never know if the baby died before or after being born, did all the baby need was a couple of breaths, but they automatically claimed the baby to be dead instead? These are questions that will be left unanswered. The family is blaming the hospital and the hospital is blaming the pt. The reality is a baby boy died and nothing is going to change that. I have had to rely on God in abundance during this month and I thank those who are praying for me and a turn around here at the clinic. The good news is the one actual delivery that we did have here went really well, she was a 17yr old first time mom and I was her primary midwife and so relieved that things went smoothly. I hope and pray that this challenging "season" here at the clinic is over and next month will be a good one. But, no matter what, I am learning so much from every situation good or bad here that is shaping me to be a better midwife in the end. 

my patient and her brand new baby boy in their home

When you don't see where you're going, when you don't think you can stand it one second more, if you only keep putting one foot in front of the other, chances are, you'll come out on the other side. Either that, or you come across a road sign that will point you in the direction that will get you out.

-unknown

Wait, there's two!

This last week has been a shall we say...interesting/crazy/unique week. We had a baby born almost every day. First off, I wanted to say how honoured I feel to actually have a family here name their little baby girl I delivered after me, and appoint me as the childs Godmother, they are a really sweet family who I had been doing most of the moms prenatal care before she gave birth, so we knew eachother well. Now let me tell you about the rest of this crazy week of mine... I think the most amazing part was delivering the twins that were both born breech(butt first)! It is so very rare for a Filipina woman to even become pregnant with twins, and also more rare (for a Filipina) that the babies would both be breech. It was 5:20am when she rang the clinic doorbell, she was a drop in pt who hadn’t had any prenatal care. Upon doing an internal exam I could feel not a baby’s head, but a knee, I also noticed her belly looked bigger than usual, but she was a tiny woman. The other midwives walked through the door only minutes after I txted them that the baby was breech, and once they started talking to the mom in her own language, the mom confessed that she believes that she is carrying twins. Sure enough, I found the other baby’s heartbeat . To tell you the truth, all of us midwives were a little nervous(but none of us dared to show it) Transporting this pt. was out of the question because her cervix was fully dialated, birth was eminent we were just waiting for her to get her “urge” to push, and it would be horrible if one or both of these babies were born in a tricy on the way to the hospital. The midwives and I agreed that midwife Eva who has been wanting to deliver a breech baby for so long would be the one to deliver the first twin, and I would be the one to deliver the 2^nd twin, whom we thought was in a head down position. Once that first twin (girl) was born without any problems, we were all so relieved. Upon doing an IE to confirm what position the second twin was, I thought that I was feeling a head, but I was actually feeling the baby’s little round butt through the tight bag of waters. 45 minutes later, the baby’s body was born all at once, but the cord was around his neck so it took my preceptors guidance and a little maneuvering to get his head born; he needed a couple breaths with the ambu bag to get him to start breathing, and he was smaller than his twin sister, but all in all, they were both healthy. They were named James and Jasmine; us midwives helped the family come up with the names. They were so very cute!! But, before these delivery of twins, we had another drop in pt who’s labor was so fast, and she hemorrhaged(which unfortunately is a common complication here due to the mothers being very malnourished and anemic) so I had to start an IV on her...and another pt. who’s baby had aspirated meconium at birth and had respitory distress syndrome ...ugh!! All these rare things we had happen in one week only. We ended the week with a little celebration that all of us midwives, moms and babies had made it through, we ate pizza and had some soda pop...unfortunately now all of us are taking turns one by one being sick with the fluL This is the 2^nd time since being in the Philippines I have gotten sick, and it really does suck...but I know I will make it through

P.S. Happy 4th of July!! I miss the celebration, no fireworks going off here:-(

On a homevisiting checking little Kian, the baby who had respitory distress after birth from aspirating meconium,
he recovered so well

The twins!

What a handful, I don't know how my parents did it with my twin sis and I

The boy, James is the one in camo, and the girl Jasmine is in yellow

My preceptor Gerlene on the left holding the baby girl

Eva and I holding the twins we were so blessed to be able to deliver

This is me on a home visit with the mom and the baby that the
family decided to name after me

There she is, Alyssa JoAnn, don't you see the resemblance? Hehe

baby Alyssa's daddy holding her, so cute!