#Today, March 9th we decided to bring our laundry to a place to have it done by a Philipino here just down the road. It worked out really well!!! This saves so much time and energy as they do it all including folding. At the clinic we paid $1 for washing and $1 for drying it per load.Well, it almost works out to be the same.
#An intense 24hr. Jocelyn worked from 7.30 the night before till about 8.30 this morning. I worked my shift and set up the nursing students to lead us into some Tagalog worship songs and did a bunch of hematocrits [some really low levels like 28 and 29] Then later into the morning Jocelyn was called in for a continuity client, who was in early stages of labour, so I dropped what I was doing and went home to stay with the kids. When Jocelyn came home I went back in for a little bit. Jocelyn was pretty tired as she had a sleepless night taking care of a newborn as the mother had to be transported to the hospital due to not being able to deliver the placenta. They attempted manually to remove the placenta at the clinic but with no success. 48 hrs later the baby is still at the clinic and the mother is in hospital receiving blood after a D&C. After lunch I went with two other guys to buy some medical supplies, including an otoscope and an instrument set to use in wound care.Jocelyn was able to rest just a little bit as Marijke and Matthijs were sleeping and Danieke was doing her own thing [ended up doing dishes and sweeping the floor]. As I was coming back, I planned on stopping to pick up some food for supper because we were having people over. Just before I was going to enter the store Jocelyn texted me to let me know to come home because the patient from that morning was in more active labour. Someone stayed with the kids until I came home. Jocelyn came home from catching the baby at 10.30pm and missed supper (that she had prepared!) with friends...'the life of a midwife'.
#The holistic approach to the people we minister to. We feel strongly about treating the whole person, a physical, emotional, and spiritual being. So, we try to be sensitive to each aspect of the person and show Christ's love to people by helping them in every area of their life. Doing this is not always easy and requires building trust with the people, listening to the Holy Spirit and letting Him guide us into His wisdom and discernment. We share Christ and His hope with our patients as there is opportunity. Pray for courage to speak the words God puts in our mouths!
#Today Saturday March 11th I went out with Marijke and Matthijs and walked down to the Baranguay hall. This is like a community centre with a basketball court. I went here for the first time [During this time Jocelyn was doing a home visit at a patient's house with Danieke]. The kids loved it, there is a little swing and push mary-go-round and a trail of people wanting to know our names and kids ages. Later in the afternoon I went back with Danieke to this place. Danieke met some new friends and so did I on the basketball courts. The last time I really played some ball was probably years ago with Jon Wieser. Me being out of shape and the hot climate made for quite the combination of huffing and puffing and sweating like you would not believe. It was great though, connecting with people that live in our neighbourhood area and having a great work out. The kids that I played with were between 12 and 14 years old. I also happened to see a little kid that looked very skinny. I grabbed his arm to say what big muscles he had and quickly measured his arm circumference with my fingers. His upper arm was thinner than Marijke's. I found out that he is 7 years old, Marijke is almost 5. And yes, there is a difference of course with measuring arm circumverence in Asia compared with North America...but he was definitely malnourished.
#Book reading recommendation... "Caring For The Least Of These" This is worth the read. The book is made up of real stories of poor people in the states and overseas. They tell the stories of their lives and how they have felt when treated by the healthcare system or welfare etc.. Also included in the book how christian organisations have approached reaching out to people in healthcare as ministry...the holistic approach. "And The Word Came With Power" by Joanne Shelter. This is a very touching read, about how a village in the Philippines (just one mountain away from the But But tribe MIA works with)lived in fear of spirits that they had to keep happy... these spirits ruled their village and the mountain region. Then a missionary came into this headhunting tribe. God used her mightily to bring transformation to this tribe by doing medical work, saving lives, and at the same time translating scripture into the local language. For those of you that are not the "praying type", this is still a really great book to see what the power of God can do.
#Jon is a Christian Filipino taxi driver in Manila. His mission is sharing the gospel with customers and handing out information about Christ and info on his church. He hands out about a 150 per day.Can you imagine doing this back home. How many people would be offended...but he is the kindest man and not pushy...just has an open conversation!
#When Jocelyn went into Welfareville with Danieke she was asked by a pregnant woman if it was ok to squeeze Danieke's nose. They have a superstition that if you squeeze a "big" nose while being pregnant that the baby will have a "big" nose too. Danieke and Joce laughed at their "big" noses.
#Yesterday March 17th we were given the day off to get out of the city for the day. We really needed this day for our family to do something fun. The other family and kids and three others also came. The place we went to is called "8 Waves",a wave park with all kinds of pools and this huge wave pool, all outdoors of course. What a nice break to get away from the city and clinic.
#On Tuesday March 21st I went to Welfareville to go back to the family that has scabies. It is getting better, but their kids still have it really bad all over their bodies. The worst is on their heads. Their hair is full of scabs, bleeding in the hair from scratching, and parts are now infected. We will keep going back to this family to help them and keep giving them more ointment.I also asked if I could pray for the family and we did. It must be so distressing to go through this as a family. I am going to look for a shampoo with sulphur to treat the kids heads.
#Today March 23rd. This morning I had planned to go into Wellfareville with a British medical student named Andrea, to visit some patients and follow up from last week. About half an hour before she arrived,Jocelyn was called in immediately as a lady came in that was in labour. Jocelyn caught the baby with her friend Joanne, did the postpartum checks and completed all the paper work. So, we decided to go later in the day. Half an hour later Andrea was called in as well for a different labour. We might go later on this afternoon or have to postpone it till later.The day was not done yet!! At nine o'clock pm Jocelyn was called in again, another woman in active labour. She caught the baby and did all the other checks etc...Came into bed at 3.00AM. Altogether yesterday, there were 6 births at Mercy and one woman transported to hospital while she was in labour.Things are getting busy!!
#March 24th. I was on shift this morning and was busy! I took blood and tested 12 women's hematocrit levels and some vitals. Also went out to look for shampoo with sulphur for the family with scabies but no luck. Jocelyn had taken the kids and some friends to the playground at Market Market mall. She met up with another midwife and some women from Welfareville who delivered their babies with Mercy last year. They had a great morning together! The older siblings of the babies had a blast at the playground. They had never seen anything like it!
#In the next little while we will get a yaya for two days a week as a start. This lady attends the community church around the corner and is known by others. One of the students had a homestay with her. Having her help will give our schedule a bit more flexibilty and free up some time. We will do this as a trial first and see how it works out.
#March 22, Joce did a couple of home visits. Usually, the families are difficult to find because in Welfareville the numbers are not clear and there are sometimes no defined streets. Joce went to find one patient and couldn't find her. There were about 50 people gathered around her and trying to figure the address and "sketch" out. (all the pts here draw a sketch on how to get to their house) So, Joce and Danieke moved on the next patient. (after an hour and a half of looking). Joce prayed that God would help to find this woman, because her baby was born only at 2000g and the midwife who tried the first home visit also was unable to find her. While Joce was on her second home visit, she got a call from the birth center saying that two of the women who had seen her looking had returned to the center by tricycab to get Joce and remembered where to find her pt. So, Joce came quickly back and piled in to the tricycab to go find "Ruth". What an adventure. They got to a store, climbed out, walked behind the store and discovered a river...that they had to cross. There is a small ferry boat with attached bamboo floats to cross the river on. There is also a rope that spans the river. A man PULLS the ferry boat across to the other side barehanded. Joce got on with the two other women ( it costs 1.50 pesos or about 3 cents a person) and crossed. One of the women asked her if she knew how to swim and Joce said she did. The woman confessed that she couldn't swim, so Jocelyn reassured her that she would "save" her if they sunk. Actually, the water, according to Jocelyn was really bad. Black and sewage, garbage floating, etc...so it's a good thing they didn't sink! Once they got to the other side, Joce was able to get to the house and do a home visit. It was at an address the clinic did not have, because ruth brought her baby home to her workplace (there is a small room there for her to live in as she has no fixed address) What a blessing...God is good. Mom and baby are both doing well!
# An entry by Joce:Well, I am working on 6 hrs sleep over 48 hours! So this will be short! Two days ago, I caught 2 babies in the span of 12 hours and then I had to work my intake shift at the clinic... last night I worked the night shift and at around midnight we heard the birth bell go off. We ran to the door and a couple were there, no "buntis" (pregnant lady) no baby! They came because a woman had delivered in Welfareville (a family member) and said the baby and placenta were out but they needed someone to clamp and cut the cord...so, we waited on an ok from our supervisor and then Patricia and I piled into a tricycab with the couple and Ging (our nightshift security guard) and left for Block 31 in Welfareville. We had no idea what we were going to find. We got out and weaved through the dark alley ways (read no light) and I prayed literally "Lord guide each step I take", especially as we stepped along narrow boards with sewage running underneath! We got into their place and thankfully there was light and someone had the presence of mind to find a flashlight. To our surprise, the baby had not been touched...even though by this point the baby had been born for an hour. No one had dried him off or wrapped him, so his temperature was a very cool 96oF (normal is 98.6oF) He felt seriously cool to the touch, but was crying as he was lying in a pool of blood. The placenta was NOT OUT!(very dangerous because the uterus is unable to clamp down and stop bleeding. So...I quickly clamped and cut the cord, dried the baby, placed him on the mother's chest skin to skin and covered him in blankets/towels. Slowly over the next two hours, the baby's temperature came up to 98.4oF wow... While I was doing this and getting the baby nursing, Patricia, one of the other midwives at MIA, was doing controlled cord traction to get the placenta out. It came out (looked a little funny at first, thought we were missing a piece, but once we cupped it in our hands, saw that it was complete - HUGE sigh of relief). I gave an injection of Pitocin to keep the uterus contracted, as we had just found out that this was baby number 7 with her "second" husband. We had no idea of her hematocrit level before delivery, so we wanted to minimize any more blood loss. I had already scooped up all the clotted blood to get an idea of how much blood she had lost and we were at about 300cc. So after getting everyone settled, with baby warm, I did a quick newborn exam. Baby was totally fine and mom was doing well too. I gave the baby eye medication and a vitamin K shot.We had an opportunity to pray with her and bless this baby!This is her first baby in 10 years and first with her "second" husband. Her family was teasing her because she is 40 and he is 27. They were saying "he's so young, he's still a cry baby!" Anyhow, the night ended up being pretty fun after the initial adrenaline rush and Patricia and I worked really well as a team. At our "after action" review, we both said what a great experience it was. We always debrief after every birth. (what did we learn, what did we do right, what can we do better next time) We both agreed next time we'd bring a flashlight! So Patricia grabbed a spare we had and threw it into the transport bag/ emergency childbirth bag we have for situations like this!
Her name is Marievic and she named her son Arnel. We had asked them to come into the clinic today for a check and they did! I had already done two home visits this morning, one for a baby I caught two days ago and one on my little 2200g baby from almost a week ago. So, I stayed to help with the check up, snapped a couple of photos and we prayed together before I left. Her "kasama" - friend came running after me and pressed two 50 peso notes in my hand for "marienda" -"snack" they were really grateful we came last night. So, 100 more pesos for the clinic and I am really ready to have a sleep!!! I got off shift this morning at 7:30 am, slept until 9:30 am at the clinic and then scooted home to change for my first home visit (the husband came and got me at 9:45am) All babies and moms are doing great!
Family Ice Cream
