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!  

Missing Home

Okay, okay, I think I am officially homesick...I have been here for 2 ½ months, but it seems like 2 ½ years!(okay maybe not that long, but still)...the whole medical emergency involving my dad, made me realize how far away from home I really am, and how much I really do miss my family. Then there was a scary typhoon, a twister in the city right next to me...and this is only the beginning of rainy/typhoon/stormy season here in the Philippines. When I wake up in the morning to my clothes still wet from being washed the day before, a cockroach in the middle of the bathroom and a cold shower with a worm crawling out of the crack in the tiled wall, I just want to drop everything and catch the next plane outta here! Living in a third world country is like camping 24/7 and my family knows just how much I enjoy camping, not! LOL! But then when I am sitting around the table with the Filipino midwives eating original Filipino food right after a wonderful birth, or when I am with the labouring women being able to give them love that most have never received in their entire life, or when my hands touch the baby’s head as it is being born...those are the moments I cherish, that’s when I think for a second I could live here my entire life...but then it’s gone in a flash, when I am here in the clinic alone lying in my bed at night, I am counting down the days I have left till I come home. Mom, Dave, Dad, Kelly, Darby, Colten, Dayten, Kacie, Jason, Jeremy, Brandon, Shannon, Jenna, Jessica, G-ma, G-pa, all my sister in-laws, uncles, aunts, and nieces and nephews (did I mention I have a big family) I miss you guys so much! 171 more days till I come home...I think I can, I think I can, I think I can...

 This birth was so fast, my preceptor didn't make in time...

Brand  new mommy and baby

"Rain, rain go away, come again another day"

Look how safe I am in this area, the water level everywhere else were waist to head high! 

Philippine Culture

Every day during my time here in the Philippines it seems I learn something new about the culture here, and I love it! Here are some things I have learned/observed during my time here...

when you go to ones house they will serve you a merianda(snack), even if they are dirt poor. It usually consists of a packaged snacky food like a brownie, muffin, crackers, ect... and coca cola to drink. It is considered very rude to refuse this merienda, so when we go on postpartum visits to do checkups on the moms and new babies, we really can’t plan to see many people on the same day, because if we did, we would get fat! When one is eating a meal they should always ask everyone who is there if they would like to partake in the meal, saying “lets eat!” One should be asked at least 2-3 times before actually partaking in this meal though, or it is equally polite to say, “no thankyou I am full.” Also, when eating the meal, never take the last “bite” like the last spoonful of rice, or piece of chicken ect... because there should always be enough for one more person to eat. So, in America parents often say to their children, "you are not getting down from this table until you eat all that food that is on your plate, you know there are starving children in Africa who don’t have any food to eat!" But here, there is always some food left on the table for that starving child just in case he walks through the front door during suppertime. As far as everyday mannerisms go... the Philippines is a fairly modest country, despite the extremely hot and humid climate, jeans and a t-shirt is what most Filipinos wear on an everyday basis. Short shorts are considered very risqué here, and spaghetti strap shirts/tanktops are rarely worn by the local women and girls. Now the people here are used to seeing foreigners wearing tanktops and shorts and do not judge them, but since I have been here for 2 months now and am trying to fit into the culture more, I am becoming more aware of my clothing choices everyday. But, it is seriously way too hot to wear jeans!!! So I am trying to stick to skirts, and Capri’s. Some other things I have learned is to never point with my index finger, if you are calling someone towards yourself, reach out the whole hand pointing all fingers downwards and wave them towards yourself. To point to something, you use your whole hand, or more commonly by pursing your lips. And of course I am now used to drinking a coco cola/all soft drinks out of a plastic bag with a straw, eating all meals with a spoon and fork only, and of course getting used to eating rice with every meal!  I never enter ones house without first standing outside, asking if anyone is home, and being invited in. Always taking off my shoes upon entering a house, even if the floors are made out of dirt, and stay standing until invited to sit. I am not going to lie, being a foreigner here is challenging at times, like...

-Being literally stared at by everyone around me wherever I go with people yelling after me things in tagalog, and the abundance of questions I am asked on a daily basis like... where are you going, where are you from, do you know how to speak tagalog, how long are you staying here, are you single, can I take a picture of you? Ect...

-When shopping, being stalked by the store attendants, they follow me like little children wherever in the store I go repeatedly saying “yes, maam?” –I think this is probably my biggest pet peeve here, I just want to shop in peace, and it is always very awkward shopping for feminine products when I have at least 3 male attendants standing around me...therefore, it takes me double the time to get what I need!

-Getting used to bargaining because since I am American EVERYONE tries to charge me more money when buying something

-Being followed by the starving street children begging me over and over again for money-now this is the hardest thing for me, everyone who knows me, knows that my heart goes out to children, especially ones in need, but when I can, I try to buy them some food, instead of giving them money.

-Making friends with the reptiles and insects that live with me because there really is no way to get rid of them no matter how hard I try, and I have had to come to terms with that...maybe I should start naming them, what do you think? hehe!

-Throwing away toilet paper, never flushing it

-Hand flushing the toilet with a bucket full of water

-Cold showers

-Living an ocean away from my family and friends, I miss you guys!!!

Now, could you survive in the Philippines?...I know my mom would definitely not, LOL!! Comment and tell me what you think? 

What could be better than drinking a coke out of a plastic baggy:-)

"Here we are children, start pecking...now!"

That poor mama dog looked like she was starving, but her pup looks nice and plump!

What are you looking at?! 

 

This is an older pic of me doing a prenatal on one of the moms
 who lived in the landfill area in Olongapo 

Shoulder Dystocia

Here in the Philippines, the biggest fear among the doctors, midwives, and mothers during pregnancy is growing a big baby. As some of you who are reading this might know after 20 weeks gestation the fundal height(measurement of the baby in the uterus) is supposed to match up with how many weeks the mom is pregnant, so if she is 28 weeks pregnant her fundal height should be 28cm. Well, it is different here in the Philippines. The mothers fundal height needs to be 2 cm less than her weeks gestation or else the baby is considered too big, meaning if she is 28 weeks pregnant her fundal height should be 26cm. And at the time of birth if her fundal height is more than 34cm everyone is worried about the baby being too big and there being a shoulder dystocia at birth. (this is supposed to be a very rare occurrence of when the head of the baby is born but the shoulders are stuck, it is a true obstetric emergency and the baby can become brain dead or die after only a few minutes). I have always believed that God created a woman’s body to give birth, and he created the baby inside of her, therefore the baby is usually the perfect size it needs to be to fit through its moms pelvis, I really didn’t believe in baby’s being "too big" to be vaginally delivered until maybe now... just 3 hours ago we delivered a baby girl who’s head was out for 12 minutes before her body was finally born. When the baby's head was coming, it took a long time, it was like the head was stuck as well, but when the head was finally born, and the baby's shoulders did not rotate and come out with the mothers next contraction, we knew right away that this was a shoulder dystocia. We got the mom on her hands and knees while I called the other staff midwife to come help who lives just right across the street, I asked Gerlene to go in and reach for the baby’s posterior shoulder/arm to manuever out, when that didn’t work we flipped the mom on her back putting pressure on her pubic bone to try to get the babies shoulder unstuck, then again on her hands and knees ect...apparently the baby had her arm twisted behind her back as well... finally we got the babies posterior arm born, but the baby was still stuck for 2 more minutes until with 2 midwives hands maneuvering and pulling that this baby girl was born. At birth she was totally flat, no heart beat, no respirations after stimulating, I immediately gave the mother an injection of pitocin to prevent hemorrhage and initiated neonatal resuscitation, I was giving breaths while the other midwife gave chest compressions, 1-2-3- breathe, 1-2-3 breathe... was the only words being spoken, other than the prayers that were being whispered throughout the room. For 3 minutes this little baby girl didn’t breathe, cry, or move...but miracousely she slowly started coming around, she would gasp every once in a while, her heart tones started coming up to the normal range, and she finally started breathing on her own, but it was only once she cried for the first time 15 minutes after birth that us midwives let out a deep breath and knew she would be okay. As crazy as this sounds this is the 2^nd shoulder dystocia we have had during the 2 weeks I have been here, the first one was a little baby boy who’s head was out for 9 minutes before his body. During a shoulder dystocia, you really only have 3-5 minutes to get that baby born, any longer than that, and there is a high chance of the baby having damage to the brain from lack of oxygen, and after 10 minutes it is a known fact the baby can die. We only have God to thank that these babies are okay, with no signs of damage to the brain, or body. Its after births like these when sitting in the silence of my room that I wonder, now why am I choosing to be a midwife again? But with birth the good much outweighs the bad, and even in the bad times just one look at that mom and new baby I know its meant to be...

We are made to do this work and its not easy...I would say that pain is part of the glory, or the tremendous mystery of life. And that if anything, it's a kind of privilege to stand so close to such an incredible miracle.
~Simone in Klasson 2001

You gain strength, courage and confidence by every experience in which you really stop to look fear in the face.
~Eleanor Roosevelt

There she is, all 8.6 lbs of her, which is considered huge here in the Philippines,
I thank God that she is okay!

And 2 hrs later I wake up to another woman at the door in labor, she had her baby 15 minutes after she got

here, and the baby just slid right out, I think it was just God reassuring me, in most cases birth is normal, and that I 

can do this :-) oh the life of being a midwife!  

Pictures!

All of us(my preceptor and her family)at the coconut house...everything is made out of or from a coconut

The Malls here are crazy!! 

Its weird to see all of the poverty here, and then walk into a huge busy mall realizing that
the people here are either dirt poor, or rich, there is rarely any middle class. There has to be somewhere for the wealthy
people to shop

So sad, this is supposed to be a playground

When it rains, it floods. This is taken out of the window of a taxi I was riding in 

The delivery room here at the clinic

The waiting room

The kitchen, now mom you have no room to complain about your "small" kitchen, LOL

My room/the midwives room 

Our lovely bathroom with the toilet you flush using a bucket and water

The prenatal area, we pull down the curtains for patient privacy

What the clinic looks like from the outside, "Daughters Of Faith Lying-In"

The clinic

Bathing a lil baby girl before they head home

My first "catch" here in the Philippines, have delivered 3 babies since then

Angelo

Just a couple of days ago we had the most emotionally challenging birth I have been to yet...a girl who had just turned 14 walked into the clinic in labor. She was a rape victim, her father was the one who had impregnated her. This little girl was very unhappy and scared when she walked in. She had rejected her baby for the entire pregnancy and was not eating or taking care of herself, therefore she only looked about 6 months pregnant but was actually 9. She was planning on giving the baby away to a neighbor once it was born, we explained to her and the family that if she was to give up the baby, it wouldn’t erase what had happened to her, and it might even add more trauma, because she would always remember the day her little baby was born...ect. Anyways, despite the odds of this being a high risk case we decided the best thing for her would be to let her stay here and give her the most safe, gentle, loving birth experience as possible; so we admitted her. During the labor we had the lights down low and we took turns one at a time supporting this girl along with family members she wanted with her. We were all quietly praying for her and this baby since the moment she walked in. At first during contractions it seemed she was re-living her rape experience, she would just cry. But she was a tough little girl, and started coping very well after awhile. She was only in labor for about 7 hours, and pushed for a half an hour. Once the little(4lb, 3oz) otherwise healthy baby boy was born, we put him skin to skin right on his mama, he cried vigoursly right from the start. I guided the mothers hand to her baby and said, "look at your baby, isn’t he just so cute!" But she just checked out. She fell into a sleeping state, and even though she had minimal blood loss from the delivery, by her vitals it seemed she was going into some sort of shock. We were thinking it was emotional? It never got to the point of being dangerous or anything, we just stayed right with her keeping an eye on her vitals, and keeping the baby skin to skin/nursing. We would gently wake her up every so often making sure she was still responsive, and have her take a drink or something. It wasn’t until after that first hour that she actually came into the present realizing reality. She was eating some soup meanwhile the baby was still nursing, and every once in a while she would look down at him, I think in disbelief that she actually had a real live baby in her arms. Slowly but surely she started bonding with that baby through the night and was interacting with him, and responding to his needs; she fell in love with him. By morning she had decided to keep the baby and raise him with the support of her family. Overnight she had transformed from a hurt scared little girl, into a woman; into a mother. When we were filling out paper work getting ready to discharge her and the baby, we asked what they were going to name him, the family said, “oh, we don’t have a name yet,” but all of a sudden the new mama piped up and said, I will name him Angelo, which means Angel.

I have permission from the family to share these pictures...

Me and the other student Megan helping mother breastfeed
and "protecting the space"

She is helping her lil baby latch on, he is such a good little nurser! 

I totally fell in love with her and that baby!

Angelo

Manila

Wow! It has been a crazy couple of days. I am moved here to Manila, and the first day I arrived I turned on my computer to find that it decided to not work any more! I kind of freaked...but it is finally fixed, thankfully. Anyways living here in Manila actually isn’t all that much different from Olongapo. I mean I am definitely living more of the Philippine lifestyle...no flushing toilet, no water pressure, ants, cockroaches, and geckos are part of the building no matter how clean we keep it, and last but not least nothing is convenient. But this is all part of living in the Philippines, right? I have been here for 4 days now, and we have already had 2 births! I am living here in the clinic, currently there is another wonderful student here named Megan with me who has been able to show me around and teach me the way things are done here. The other day we went out to eat at a really awesome restaurant called the coconut house where all of the food, drinks, and dishes had coconut incorporated into it someway or another. It was sooo yummy and unique. but, Megan is leaving in a week and then it will be just me living here in the clinic. We do prenatals every Wednesday and Friday, where we start by teaching a childbirth education class, then do the checkups. It seems to me, the main clientele here are teenagers, our youngest patient is 13 years old. My heart totally goes out to these moms and it is very hard not to fall in love with them and their babies! I am practicing my tagalog alot, because I will most likely be the one here who answers the door in the middle of the night to a laboring woman, and I need to be able to communicate with her. The midwife Gerlene who is my preceptor and owner of the clinic, just lives walking distance from here, and then there are 2 other staff midwives who rotate being here. So, I hope I wont be too lonely. It is definitely going to take me awhile to become confident enough to travel around in Manila on my own, I mean, I got lost in Olongapo, and Manila is just so much busier. As my friends and family know, I have never had a good sense of direction...but, I feel like that is going to change very soon :-) I hope all of you back home are doing well, and I will post pics of the clinic and Manila ASAP, I am alot busier here than I was in Olongapo so I haven't had the time to take many pics yet.

"I've heard there are troubles of more than one kind, some come from ahead and some come from behind. But I've brought a big bat. I'm already you see, now my troubles are going to have troubles with me!"
-Dr. Suess

Would you like a Boca?

When Jen and I were waiting for our buntis(pregnant woman) to come for a prenatal checkup in Mercy land yesterday morning, the neighbor asked me if I would like a Boca(coconut). I said sure, thinking she was going to just give me a piece of coconut she had or something, But she asked me to come with her to get the Boca. She led me to a young couples house, told them I wanted a boca, and the young man literally climbed up the coconut tree with his bare hands and feet and chopped a boca down for meJ It was very fun to watch, and I videod it just for you guys!… but I was holding the camera in a vertical angle and don't know how to flip the video the right way :( oh well, its still fun to watch...

The coconut was very yummy! And the coconut water that was inside was way better tasting than when I have drank it from a coconut in the states...it was naturally slightly carbonated, sweet, and coco nutty!

Right before he jumps on the tree like spider man hehe!

Coconut trees are so pretty, and did you know that coconuts are actually very large, shiny and green in their true form...

Change of Plans...

Well, while Cecille and Emelda are packing up and moving into the temporary birth center we have set up here, I will be getting ready to move to…Manila! Yep, that’s right, plans here can change in a blink of an eye, it’s the fun part about living in the developing world…I will be moving to Manila in about 2 weeks and staying for 3 months apprenticing with a Filipina midwife who has a VERY busy birth clinic down there. Moving to Manila now while the birth center here is being built and clientele established, is giving me the chance to immediately start catching babies getting the experience I came here for. Manila is about a 3 hour bus ride from Olongapo, and one of the largest cities in the world. To tell you the truth, I am a little nervous, because I just got used to living here in Olongapo, and I feel like moving to Manila will be like culture shock all over again, but I know that it will be good for me; and I am definitely learning what being flexible actually meansJ(gotta be flexible in order to be a good midwife!) I will also miss everyone here during the time that I am gone, but I will be back in Olongapo after the three months in Manila just in time to jump into all of the action here. Manila is definitely bigger, busier, and more polluted. Also, Manila does not have as many “Americanized” products that I am able to find in this area. the reason being the US military was based here for a long time making in impact on what food and other products were sold...So, I won’t be able to have my little American treats that remind me of homeL... but, I am excited to get busy and start catching babies!      

A Day Out On My Own

Oh my Goli! (oh my goodness in tagalong) where do I even began…First off, I am feeling much better(thanks for all the prayers!) So my day began with this morning doing checkups on our moms in Iram, and coming home realizing I really needed to go grocery shopping. Since I have been here for 3 weeks, I decided that I should be confident enough to go out on my own for the very first time and go grocery shopping myself, right? Boy was that a mistake! Now, in order to get to Royal (the grocery store) I have to take the brown jeepney with the white top to the market(15 min. ride) then hop on a yellow jeepney to the Subic Bay gate(15 min ride) then walk to this parking lot and hop on a bus which takes me to Royal(5 min ride). Easy enough, right? Well I got to the grocery store just fine and was all proud of myself(I even stopped in Starbucks, it reminded me soo much of home, I almost cried!) but on my back, well, that is a total different story….So, I was on the yellow jeepney needing to get off to switch to the brown jeepney with the white top, when I totally realized that I had no clue when to get off to get to their terminal. By this time, I knew I had already totally missed it, because I had been in this yellow jeepney for quite a while, and he was driving in an area I did not even recognize at all. To make things worse, it was also getting very dark outside! So I prayed that the driver would know english and surprisingly he knew enough to understand that I needed to get to the brown Jeepney with the white top. He informs me that we had passed that stop a long time ago! Ugh! Right after he tells me that he would turn around and take me to where I needed to go, I got a random txt message from Vicki saying “hey Alyssa, where are you!?  How would you like to go to a birth right now!” Well, of course I told her I would love too, and I would try to get there ASAP! While thinking to myself, “Shoot, what a great day Alyssa to think that you were able to go out on your own!” LOL!  Traffic was crazy, but I told the jeepney driver to drive fast because I needed to get to a birth! So, I finally got to a brown jeepney with a white top to take me to Kalapati and arrived in this health center right when the mom was pushing, like 10 minutes before the baby was born! I was able to assist this “government” midwife for the delivery and after. To fill you in about this midwife…Our Mercy In Action team had introduced ourselves to her awhile ago and she informed us that if she had a birth she would call us so that I could assist her, she is also open to learning some new things from us to improve her quality of care... The baby was a girl, weighing about 6 ½ pounds, which is considered “big” here in the Philippines, she was healthy and oh so cute! And the mom did so well. I was able to initiate breastfeeding and basically I wasable to "protect” the baby from being taken away from the mother hehe… It was great! I stayed there for about an hour and a half after the baby was born, and then had to get my groceries in the refrigerator, so I said my goodbyes and took a tricy home. Wow, what a day! 

Yes, Starbucks has made it all the way to the Philippines!! 

So happy!! Every sip reminded me of home!...okay maybe I am a little too
excited about this whole Starbucks thing hehe

Mom, dad, and their new baby girl...my first birth in the Philippines!