Bye Phils! Hello America!

Today was my last day volunteering. I had prenatals until about 12:45. Everything went smoothly and I was glad to leave on a good note. After prenatals I got a text asking if I could cover a shift for one of the students. Turns out four girls at the other house are sick and have a fever. I ran home and grabbed scrubs so I could make it back for swing shift at 2pm. There was one labor waiting for as I found out I was first up to catch. This would make #10! Unfortunately my patient was transferred to the hospital. She was fully dilated but exhausted. The head had trouble making it past the pubic bone and once it did our mom just didn't have enough strength to push. She was twenty years old and it was her first baby. For some reason she just did not have the urge to push or the energy. After we transported the rest of the shift was dead.

A few days ago I finally found out how this country operates! I have been so confused how everyone is so poor and then a few are not. There were no big companies I could think of that would actually allow people to make good money and be able to live highly in this country. Even people with a college degree can barely provide for their families. For two months I have seen these 'rich' Filipinos walking around the mall in nice clothes, hair done, and whitened skin. Yes, they use whitening lotion. Most Filipinos think lighter skin is better. Turns out most families who have money have just inherited it. On this island of 3 million plus, only 25 families own everything. From the electricity company to renting some jeepneys and taxis. This island is a huge monopoly that leaves too many with nothing. There is no way to work up the ladder. Even those with a college degree do not even get paid as good as a minimum wage job in the U.S. What a frustrating environment to grow up in.

Tomorrow night my plane leaves at 10pm. I cannot wait to get back and see my family and friends! Thank you so much for the prayers, support, and encouraging notes. See you soon! I can't believe I am saying that! It has gone by so fast!

Love you all!
-Kelsey

ITS BEEN REAL

ITS BEEN FUN

ITS BEEN REAL FUN!

Goodbyes

I am sad to say that my time here is coming to an end. Only two shifts left and three days until my plane leaves. I cannot believe two months has already past. I feel like I just got here and adjusted to the country. When I look back at my experience I am shocked at everything I have accomplished. Not many 22 year olds can say they have delivered 9 babies or assisted with several births. I am so blessed to have had this opportunity and experience. At baby checks I have been telling my patients it will be the last time they will see me. Several have sent me text messages thanking me for everything I have done and to have a safe trip. I am going to miss my patients and all the women I have worked with. I have had a great time with the girls I have lived with and it is sad we may never see each other again. They all have a heart for missions and plan on taking their degree to developing countries. I am proud of them for learning the language and making it through this rigorous program with only a one month break in two years. They are amazing! It has also been a blessing to have Tilly and Casey with me on this trip. We have grown together in our friendships and nursing skills. We have had fun times together and this trip would not have been the same without them.

Tilly, Me, Casey

Glad we could have this experience together!

I am excited to come home and see all of my family, church family and friends. It will be nice to get back into a normal routine with a normal sleep pattern. I would just like to thank everyone who has supported me for this trip. You will never know how thankful I am for your assistance. I cannot even put into words how much I have learned and experienced. I am just so thankful for everyday I was able to have here in Davao. It has been amazing! With one year of nursing school left it will be interesting to see what God has in store for me. I am anxious to know if I will be overseas or traveling in the U.S. I have had a lot to think about as far as what type of nursing I want to do. Although I am still unsure I think God will let me know once I pass my boards. Living in this culture has definitely given me a taste of what it would be like to live outside the U.S. I guess we will wait and see where God wants me next.

Here are some fun lists

Things I will miss
Delivering babies
Living with these girls
Milo; nestle chocolate powder mix
McDonalds Delivery
Coke Floats; coke, ice cream, and chocolate syrup. Don't judge it until you have tried it!
Never being cold
Things I will NOT miss
Constant honking
Every man saying "Hi ma' am"
Being stared at everywhere
Grocery shopping; So busy and long lines!
Having Filipinos cut in front of you in line
Language barriers
Things I am looking forward to
Deli meat; does not exist here
Table Napkins!!!
Sports
Air Conditioning
My Family!

Happy Birthday!

July 24th!
I arrived at night shift at about 9:45 and caught a baby at 10:01! Another boy! Jr. Jeremiah. I don't know if I can say I officially caught this baby because the dad wanted to help. He use to work for the red cross so our staff allowed him to help. I put gloves on and delivered the head. The dad quickly stepped in to catch the body. He looked shocked after it was all over! He couldn't believe what he had just done. I stayed up all night doing their checks and paper work and were able to discharge them in the morning before 6am. They were so kind! The dad brought us all Jollibee at 3am! No one was awake but that didn't keep them from eating burgers and soggy fries at 6am.

One Happy Family!

Jr. Jeremiah

July 26th!
What a crazy, crazy day! I showed up at shift knowing I was last up to catch but that didn't keep my work load light. We had probably four postpartum patients and three labors. Not long after our shift started they transferred a patient and a new labor came in. I had only been on shift for 50 mins and found myself taking care of a postpartum patient and a labor! As our birth room was already busy it soon filled with several patients who had already delivered. It was BCG day (immunization) so all the patients who delivered in the last two weeks came in with their baby. After BCG several of them were in the birth room for a baby check or newborn screening! It was soooo busy! At one point I was trying to discharge my postpartum while my labor was very active and a baby check showed up. I tried to work quickly and when I thought I was finally done my baby check said she wanted new born screening done today not at her next check in two days. Another student kept and eye on my labor while I got the newborn screening done. A little after 12 I checked on my patient who was wanting to push. 1cm head was visible and my supervisor was nowhere in sight! I got ready to catch while another student went to find her. I heard her coming through the birth room yelling "Baby out!? Baby out?!"  She made it in plenty of time and after about 5 minutes I caught my first baby girl. Everyone was so busy that it was just me and my supervisor. We didn't have anyone to chart for us so we had to watch the clock and memorize when we did everything and chart it when we were done. We got everything done and the mom and dad were happy parents! Today was a special day because it was my first girl and it is also my birthday! Happy Birthday to us!

The Birthday Girls!

Random

The other night my roommates bought Durian to have after supper. It is the fruit of Davao. It is known to smell like dirty socks and in my opinion it tastes like it too. I was not a fan.

Slimy





Poverty and Problems

Thursday
This morning I had out reach in Agdao. It is a neighborhood not far from the clinic and I have been there once before. Today we did not just do prenatals at the church but went out into the neighborhood for some home visits for some women who had already delivered. A woman from the church directed us down several alleyways to each little shack. The first 'house' we went to I found myself carefully walking up 5 steep stairs. I was praying they would not snap in half. At the top of the stairs I walked into what could be described as a tree house with out a tree. I was standing on a thin wooden floor, obviously at a slant. There was one hammock that I assume was for their 3 year old. We came to check on the one month old baby who was also in a hammock made of a baby blanket. We did our check before moving to the next home. To get to this home we walked down a few paved allies with gutters on each side filled with dirty water. When the ally ran out we found ourselves stepping carefully on small planks of wood over standing water. By small plants of wood I mean slivers of scrap wood. This house was closer to the ground but we still had to take a high step into the house. It was just a little bigger than the size of a car with one hammock hanging in the middle. One dresser, a tv, and small table lined the wall. Decor of Mother Mary were everywhere. I wondered if that was their entire home or if they had a neighboring shack with beds. I left wondering if that mother and her family laid on the floor to sleep each night. That is probably the case. The final house we went to is almost indescribable. We first crossed a large amount of standing water with bags of cement as stepping stones. We came to the house and all I saw was tin strung from one wall of a house to another. We were still outside. In one part of the wall I saw a bench, in another cove I saw a pile of mud filled with trash and wrappers and a stuffed animal. I just kept thinking to myself, this cannot be where they live. I was wrong! It was not were they lived. There was a small door that I hadn't seen and soon we all ducked inside. I literally had to bend over at 90 degrees to fit into this house. It was dark and moist just like a basement. One rug was on the floor where we were able to sit down. In a dark corner was a little hammock where I assumed probably two of the three children shared. The baby was laying on the floor, a blanket pinned around his bottom as a diaper. The ABCs were written on a piece of wood with chalk. I did not see a bathroom at any of these houses. I wondered if there was a community bathroom that the whole neighborhood used.

After seeing the homes these families live in, the reality of their poverty became real. I became a little irritated thinking of some of our supervisors who scold patients who do not get new born screening. I know how important newborn screening is but 550 pesos is a lot for these patients to pay. If they say they do not have the money, I believe them. I just wish their was a solution but we will just have to encourage them to save up their money for 9 months.

After outreach I ate some lunch and got ready for swing shift. About twenty minutes before shift started I was endorsed a labor who was ready to deliver. I was informed that she was non-compliant with the staff. She was not changing positions like they asked or breathing through contractions. I walked into the cubical to her laying in bed, eyes rolling back in her head. The midwife was telling her to breathe but she continued to grunt and push instead. BOW was visible and we did artificial rupture of bow. Then 2-3 cm of head was visible after AROM and I took over. Once head was out the woman got very tense. She straightened her legs and pushed her butt off the bed. The rest of the body was not able to come out because she was squeezing all her muscles down. We were attempting to pull the baby out but were unsuccessful until the mother calmed down and opened her legs. Baby was out at 1:49pm (another boy!) and I got all of the paper work, checks, and immunizations done and we were able to discharge at a little before 10pm. In between 2 and 10 I charted for two other births.

Catch #7 Jorian

The first birth I charted for was a little hectic because the patient was hemorrhaging. 1500cc was the final estimated blood loss. I was charting frantically as the midwives did everything they could for this patient. Giving oxytocin IM and starting an IV, giving methergine, external manual compression on the uterus, and finally sticking gauze packs internally. I was charting and handing everything the midwives needed to them while still keeping track of the time and shouting out when more meds could be given and when it was time for the next check. Some how I kept everything straight and got everything charted! The patient did great but if she would have been at home the staff said she probably wouldn't have made it.

The next birth I charted for was also interesting. She pushed for two hours total. When I arrived we had her laying the wrong way in the bed with her legs on the birthing stool. The husband was squatting behind her near her head doing nipple stimulation while our supervisor was seated between her legs doing head stimulation on the baby between contraction. When a contraction would start the patient would pull her legs up to her chest in a hyperflexed position with the help of midwife #2. Soon there were four midwives in the room and I was charting with each contraction. We did a position change that I had never seen before. It is called tug of war. So midwife #3 stood behind our supervisor who was seated between the patients legs. She leaned over her and reached for the patients arms. The patient took hold and would pull on the midwife as she pushed on the birthing stool with each contraction. It was quite the site if I say so myself. Once she delivered we had her lay the right way in the bed for the placenta to come out. Placenta was coming but had trailing membranes. Our supervisor attached a hemostat to the membranes but it took 15 plus minutes for the placenta to be completely out. Both mom and baby were healthy and it was time for shift change. What an exciting shift!

Waiting, Waiting, Waiting

The clinic has been slow lately and my last baby was on the 6th! For days I was not even first up to catch so I got a lot of reading done. I have never sat through so many dead shifts. Finally some patients started coming in and for the last two days I was first up to catch. On the 14th I had a labor who came in that we quickly transferred to the hospital for preterm labor. I had helped with several transfers before but this time my supervisor had me fill out the transport papers and talk to the dr. once we were at the hospital. I was so nervous I think the only thing I said to the dr. was that our patient was preterm and her water had already broken. She shook her head in agreement and I got back in the ambulance and headed back to the clinic. Luckily a second labor came in and I labor watched for several hours. At shift change my patient's water broke and my supervisor had me endorse her to the next shift. Five minutes later someone else got to deliver the labor I took care of for so many hours! What a disappointment, I was so close!
 On the 15th I was determined to catch a baby and was just waiting for a fully dilated labor to walk through the door. Nine days without catching a baby is a long time! Your life seems so boring without that excitement. Soon a labor walked in the door but after her I.E. we determined she was only 1cm. We told her the signs of labors and when to come back to the clinic. I went back to reading my book and wondered if I was ever going to catch a baby again. About an hour later another labor walked through the door. I took her initial vitals and found out she had high blood pressure, 140/100. I figured we would transport her but we monitored for awhile. We had her sit up for 10 minutes, took her blood pressure, still high. We had her left side lie for 10 minutes, took her blood pressure, still high. My supervisor had me do an I.E. and we found she was 8 cm! By the way, I actually found the cervix this time because my supervisor did not understand why I couldn't find it and had a student talk me though it instead. Successful I.E. #1!  My supervisor had me start an IV of normal saline to help with my patient's high pulse, 112-120. Soon after that the patient's water broke and she felt the urge to push. I got in position at the end of the bed and soon saw head was visible. When head was out the shoulders were stuck so we had to really pull the baby out. Baby was out at 7:32 pm, apgars of 9 and 9! Another boy! We Incorporated 10 units of pitocin in the IV for bleeding before discontinuing the IV and hour later for possible fluid overload. I finished all of the mother's 5 and 15 minute checks, had her eat, did the newborn exam, gave eye meds and Vit K, and moved mom and baby to postpartum. By that time it was shift change and I endorsed the rest of her postpartum check list to the night shift.

Stats so far:
4 for 4 IVs
6 boys for 6 deliveries
1 for 7 successful I.E.'s

Catch #6 Yohann

Prayer Request

Hey Everyone,

I have a prayer request today for a woman named Angie. She is a young woman who came in for prenatals today. It is her first pregnancy and she is 23 weeks and 5 days. Today I was doing her prenatals and was unable to find fetal heart tones. I searched and searched for at least five minutes. Two other students volunteered to help me out. They too were unable to find fetal heart tones and we found out the mother could no longer feel the baby moving. We called the supervisor over to try and find heart tones and she too was not able. By this time Angie began to realize what was going on and started to cry. We prayed with her before sending her to get a ultrasound with her bana. She returned to the clinic a few hours later and informed us she was unable to pay for an ultrasound. The supervisor on shift at that time sent her directly to the hospital. I do not have any further information but I would appreciate your prayers for Angie. I can't even imagine what she is going through.

Thank you,
Kelsey

Work Hard, Play Hard

Hello Everyone!

I am so sorry I have not updated my blog in a week. I have been so busy volunteering at the clinic. The last two weeks I have worked two doubles instead of one and although it does not seem that bad it has been tiring. I'm pretty sure I have been at the clinic everyday except 2 or 3 since I arrived in Davao. I will try and update you really quick on what has been going on.

BIRTHDAYS

Catch #4 Kyell Deven 7/2/12

Catch #5 Daisy Rhei 7/6/12

Another busy shift with five new babies!

Mama and Papa

The family of my second catch came for their baby check in matching t-shirts.

Are they not the most adorable family ever?!

SNORKELING

Last Saturday about 40 students, family members, interns, and visitors went on a snorkeling boat trip. We swam and snorkeled all day in the nice warm sun. I only saw a few fish but the entire floor was covered in coral so that was fun to look at. We could not even put our feet down unless it was deep. Some of the kids on the trip dove down and were able to find starfish. For lunch we stopped on one of the islands and had a picnic which everyone brought an item of food. It was a fun trip and I was glad to get some sun. (Probably only cost about $10 USD for the day)

                                  

  

Just a few of us from the clinic. You think we are doing peace signs but no....We are midwives so that is definitely measuring a cervix pose.

JACK'S RIDGE

One night a few of us went to Jack's Ridge for supper. It is a well known place in town that has a few restaurants that over look the entire city. Some people hold their wedding there while other just meet their lover on a bench to watch the sunset. The only creepy thing is that there is a huge grave yard down below.

Squeeeeezing in a taxi

A restaurant overlooking the city

Tilly, Me, Casey, Salome, Lorie

The cemetery down below

 

WHITE WATER RAFTING

Five of us students/interns decided to take a risk at white water rafting. It cost about $40 USD and included rafting for four hours, the alligator park which was more of a zoo, zip lining, lunch, a t-shirt, and two DVD's with pictures and videos from the day. Just between us five girls we had 3 from the USA, one from Canada, and one living in China. Another couple joined our group and they were from Germany/Australia. A second boat went with us which was filled with Filippino boys our age, one who actually lives in NY but visits often. So we were really representing quite a few countries. We drove an hour out of the city to the Bukid where we were surrounded by mountains. Huge rock walls were on either side of us throughout our way down the river. Several times we saw people showering in the river or they had their cow tied up in or beside the river bank. At one point there were even what looked like wires hanging over our head for electricity. We found out they were pipes that locals had put in the rock wall to collect spring water and were stretching across the river to their village which was nowhere in sight for us.
We had an awesome group and a lot of fun. The first two rapids went well and I was posing for pictures at the end of each one. The third rapid was called the washing machine. Lets just say I got the spin cycle and maybe a little more! We hadn't caught on yet that our guide would hit rocks on purpose so we could get some good pictures. We hit a huge rock and capsized, sending everyone into the river. I found myself under the water for a minute getting spinned around. My knee hit a rock pretty hard before I made it to the surface. I began to float down the river a few feet before I got washed by the strong current onto the top of another huge rock! I literally got washed up one side and had to jump down from the rock on the other other side to get back in the river! Everyone said I looked like a mermaid. I beg to differ. I'm sure it was quite the site! The raft got so far ahead the camera man finally had to pick me up in his kayak. Through the rest of the rapids I was a little more timid and sat in the middle of the raft when things got rough!

Really? Our guide couldn't miss this big rock?

Tilly is afraid of heights and did the zip line.

You rock Tilly!

TAXI STORIES

So whenever there is about 4 or 5 of us we usually take a taxi because it would  be the same price or cheaper &  we   get air condition and to our location faster! We have this secret way to get taxi though since you are only suppose to fit 3 in the back seat or the driver could get fined. The girl who jumps in the front seat is suppose to immediately start talking to the driver while the other four or five quickly squeeze in the back before he can say anything. Most drivers don't care except our last one. We were on our way to go white water rafting when five of us tried to pile into a taxi. The driver told us right away that he could only take four people. We kind of acted like we didn't know what he was saying and squeezed the door shut and smiled at him. He told us he would get fined but one of the students talked to him in Visayan and told him one would hide. After a few minutes he finally let in and laughed about it. I have never seen a cop and the ones I have seen have been on foot looking for motorcycle that have too many people on them (today I saw 6, family vehicle I suppose). So anyway it was rush hour and the road was packed. We made it a few blocks when who was in the median but a cop on foot! We  quickly tossed bags on the girl who was ducking. The driver thought it was pretty funny even though he had told us earlier it would be a 2,000 peso fine.

Sorry I had to do a quick summary. Hope it wasn't boring! Talk to you soon.
-Kelsey