32 days in St. Lucia.....and then some

Another mountain....climbing time!

2009-10-12T12:21:00.000-07:00

Almost a year ago I was preparing for my time in St. Lucia. I worried, wondered, and took the leap of faith. Now here I am 10 months later, but feeling very much the same way. Test day....10 days from now. Its a culmination of all I have learned and done. I feel confident, and yet..... I took the road less traveled, applied apprenticeship versus the more modern training of attending a formal school. I didn't sit through A & P in a classroom, I explored with my hands, listened with my ears, and watched. Now is the test, was it enough. The doors of this process have opened, and I have stepped through each feeling sure and ready. Now the test will tell. I will spend the next 9 days doing what I have been doing for the last 4 years, studying, but this is just refresher time. I'm excited, nervous, scared, sometimes near panic but I know who I am when I work with a client in clinic or help a woman bring her baby into the world so I think I must know something right? Am i nervous? Well I wasn't until people started asking me if I was and then I thought "oh God, I need to be nervous" so now I am officially SCARED OUT OF MY MIND ok, maybe I'm being a tiny bit dramatic, maybe we will just go back to nervous or the cousin of nervous.... cautiously optomistic. Now I'm rambling when I should be studying.... but i just had to get it out so that I could keyboard vomit and then let it go. Did it work, you ask....I'll have to get back to you on that.

Seek First the Kingdom of God and His Righteousness

2009-01-12T03:53:00.000-08:00

The last sunset.

8 am- My last morning here. I'm feeing naustalgic, and finding myself reflecting on my time here. The kids are in bed asleep still and I'm able to just think. Not every woman I came in contact here was easy to love, this tested my faith and belief that every woman has something to teach me about God. I had to pray for understanding and wisdom, patience and kindness in some cases. The majority of women offered kindness to me in large quantities, but what about the young ones hardened by life, or the men on the street who let their eyes wander my body while I walked by. What about the one who attacked kevin to steal his phone??? Is he too loved by God? I found that prayer became an even greater necessity during my time here, and that when I asked for love for a woman who didn't smell or look desirable that I was able to see past those things to the person God had created her to be. So many times I have been humbled during this journey realizing that there is so much to learn about humanity as a whole. I wish I could have blended in better, not been so white while I was here. I didn't want to look like the "Rich spoiled priveleged American" I just wanted to blend in and serve where I could. I hope I have accomplished at least part of that while here. Last night I watched the sun set over the Caribbean Sea for the last time, and I wondered if I can do as much good at home as I can here. The women here don't have choices, they can't interview 5 midwives and decide who they "like" the best. (I'm not mocking the choices we have in the states, but if only we realized how fortunate we are to have the choices we do, perhaps we would demand less and appreciate more.) The ladies here just pray that when the time comes and they are alone in the cold sterile delivery room that the Midwife they get will treat them with some kindness. That often doesn't happen. I wonder, can I find a way to make a difference in my world as a Midwife? As I leave this place and the remarkable people who have taught me much about life and my beliefs in the goodness of humanity I can only hope so. Seek first the Kingdom of God and His righteousness and all these things will be added unto you.

Our last few days- playing tourist

2009-01-12T03:35:00.000-08:00

Zip lines in Denary.

With my time at the hospital over, we decided to be tourists for a few days. On Friday we braved the crazy windy roads and insane drivers and hopped on a bus headed to Soufriere where we visited the volcano and Sulfer Springs. Both worth seeing if you are ever here. We also ate some local BBQ.... and didn't die from it :) I've gotten pretty brave with food around here, mostly out of fear of starvation. It wasn't bad, and we are all still alive, so I count it a small miracle.

Saturday (see photo at top) we headed a different direction with our friend Fiona who is here from the UK and whom I met while working at the hosptial. She is also a student. The 6 of us met in town and took the bus to Danery to the Zip lines. This was quite the adventure, and scarier for me than I thought it would be. The kids were fearless, and loved every minute. There we were hundreds of feet above the rain forrest floor zipping along with a birds eye view. It was beautiful once I got over a mild panicky feeling and was able to look down and enjoy it! Yesterday we went to our lovely beach for the last time. We spent several hours playing in the sun and waves, and even convinced Kevin to make the trek down the steep trail to come swim with us. Then it was back to the house to BBQ. We had made plans for the other people in the house to join us for dinner and Kevin made tons of food, but as it is here, they decided to eat their food instead. There are some social customs here that are lacking, namely the ability to make plans with people. They are very non commital around here. You invite them, and they accept, but then maybe follow through and maybe not....maddening at times like last night. Although I wonder how many social faux paxs we have committed while here.

The end of a story....my time at Victoria Hospital

2009-01-09T04:55:00.000-08:00

How does a story end? With a moment, a word, and action? And if something happens after that moment, does the story not continue, making the end a beginning?
I watched the sun rise today, my last day at Victoria Hospital. After 2 shifts without a single birth I was anxious for today knowing it would be busy. My 7-2 shift brough me just one birth, but I was prepared to stay as long as need be to deliver number 20. I had worked long and hard toward toward this goal. I would not walk away one short! Baby #20 came at 3:12 (over an hour after my shift officially ended!) followed by bonus baby number 21, who was the 6th child for that particular family. He was born in thick meconium, and we had to do quite a bit of resuscitation on him, but by 10 minutes old he was fine..praise God! I surpassed my goal! Meanwhile one woman delivered in her bed on the ward, and three more were in active labor all between 7 and 9 cm in labor and delivery area. It was time for me to go. Kevin was waiting for me. I clipped a thank you note to the bulletin board, hugged the nurses who had turned into friends, and slipped out. I walked down the ramp, deciding not to look back. My heart felt torn. I came to this place a different person, less understanding of the human plight and the struggle of women. Of the burdens they bear here and many places. They neither offer nor largely accept compassion. They have been scarred by the struggles they face and the injustices they must endure. Their strength has amazed and deeply humbled me. I am humbled by their kindness and acceptance of a white woman in their world. They didn’t have to allow me into their lives, didn’t have to trust me, but they did so and with open arms! They gave to me more than I could ever offer them.

My time here has been a wonderful, unforgettable and priceless adventure.

At the end of my day Kevin waited in the entry of the maternity ward, and I arrived home to hugs from my kids. I showered, and walked out on the balcony, needing a quiet moment to reflect on this day. The sun was setting over the sea, a farewell to the day, and my time at Victoria Hospital. I smiled and the voices of the women echoed in my mind…..”thank you, nurse, thank you”. If only they knew how grateful I was for them….. God is so good.

Day 25- social crimes that leave me seeking answers

2009-01-06T06:29:00.001-08:00

Day 25- Before I came to St. Lucia I wondered about the women I would come in contact with. I knew there would be stories, cases, that would break my heart and leave me searching for answers, and yesterday I encountered such a case. Her name is Najma, and she is 13 years old. An age that should be celebrated with birthday parties, trips to the mall, movies, and ice cream, but for Najma, it is not a coming of age year, but a becoming a mother year. At 13 years old she is 9 months pregnant. She arrived at the hospital yesterday morning having mild contractions. When I arrived at 2 pm, those contractions were about 10 minutes apart. She was alone, her 19 year old boyfriend who she professes is the father of this baby was nowhere to be found. Neither were any family members. Najma lay in her hospital bed alone, and afraid. When the doctor examined her, she fought and squirmed, and did not act like a sexually active teenager. 3 hours later she came to me and told me her pains were stronger. I asked if she wanted to be examined, and she said yes, but when we got to the exam room and I attempted an exam she clamped her legs shut and squirmed up the table. I have no idea where she was in labor because I could not complete the exam. She looked at me and said can I go clean up now. I peeked in on her about half an hour later, she had showered, changed her gown (which was not soiled) and put powder on so thick her black skin was white. I knew at that moment that this young girl had been violated at some point in her young life. Hours came and went and it was time for the head midwife to do an exam. This midwife is gruff to say the least, not a lot of compassion. She got the same response I got, but was not willing to let it go. As I patted the girls arm, the midwife tried to fight, coerce, and plead her way into an exam. Finally, I had had enough. I looked at the midwife and told her to ask the girl if she had been raped. The midwife looked at me and said, “She wasn’t raped!” (And I’m thinking hellooooo lady, look at the signs!!) I turned to Najma and asked her, “How old were you when you were raped for the first time?” Her answer broke my heart…..Eleven.

A new beach, and a fabulous coral reef!

2009-01-02T16:08:00.000-08:00

We were introduced, a few days ago, to a new beach that, like the other beach is within walking or hiking distance. This beach requires a bit of a hike through a bit of rain forest, but the beach is larger and way more sand to play in! The water is also calmer as the coral reef breaks the waves long before the shore. We have been 3 times already, and are loving the change of pace. Yesterday Kelsea and I swam out to the reef to have a look. We saw some tropical fish, and amazing sea plants, and also came too close for comfort to several sea urchins. It was amazing to see and be apart of. We also video taped and when we later viewed the video saw many more fish that we hadn't originally seen. The photos were taken with my amazing Pentax underwater camera.

The other thing I have to say is that when you take 3 kids on a month long trip and put them all in one bedroom you (or at least I) expect lots of fighting. But what I have found has surprised, amazed and delighted me. My three very different kids have bonded like never before. Kelsea and Ki have shared a queen sized bed for 3 weeks now, and both girls have gotten up almost nightly with their sleep walking brother to help him get his sleep walking butt to the bathroom. They have played, laughed, shared dishwashing duty, and ok fought over whose turn it is on the internet. I'm not saying they haven't had their moments, but they have been way fewer than when they are at home and have their own space. I am attaching photos of them playing and helping one another! I also have to say that Kevin has been incredible. He has given up his career, hobbies, and time to support me. He has done dishes, laundry, grocery shopped, taken the kids on outings into town, and encouraged me to work as much as I can. I'll admit I was worried about how this trip would go. I asked him before we came if he could just support me, and listen when I had gross birth stories to tell, and he has done just that. With money tight, we haven't been able to afford to do as many outings as we had planned, but he has been so great about it. I hope he knows how priceless that is! Well, off to bed for me! I delivered numbers 16 and 17 today, just 3 more needed!

Why Abortion should be legal everywhere...yep, you read that right!

2009-01-02T15:55:00.000-08:00

Now before you jump to conclusions, I want to say hey from St. Lucia. Take a deep breath, try not to judge and read on. I myself am a believer in life, all kinds, in utero and out!!! Let's go beyond the crap that women have the right to choose, because unless she was raped (which make up a very very small percent of abortions) she did choose. I met one such woman or maybe I should call her a girl, last week here in St. Lucia where abortion is illegal. Now, illegal doesn't mean its not done, it just means its done any way it can be. In this case the mother of 4 who was 24 I think bought pills off the street. These pills, knows as cytotec, are used for ulcers and in many places to induce labor. Here, they are prescribed for ulcers and sold on the street as an "abortion pill". The patient, who thought she was around 3 months pregnant thought long and hard. She has 4 children fathered by 4 different men who don't support them (her right), got a little tipsy at a party last year (also her right) and got knocked up without using birth control (again, her right). WHy didn't she use birth control we asked her....well, she told us, she didn't have a boyfriend so didn't see the need. Note that birth control here is about $5.00 US a month. Much less than the $100 per pill she paid (she bought and took 5 of them). This caused her to have "cramps and bleeding" for several days, and on day 5 she came to us. Sadly, she was not 3 months pregnant but 5-6. Somehow she did not realize that in her own words "the baby would be formed". What was born was a baby who had suffered greatly at the hands of his mother. He was dead, but a precious, perfect tiny little boy. He had all of his parts, and his hands and feet had all their digits. Not only was this woman uneducated, but by the time she made the decision to abort, raised the money to buy the pills, (money which would have gone quite a way in feeding her 4 children at home), and found a seller, she was farther along than she realized. It was a sad, horrible situation! When she saw her tiny son she was crushed, she sobbed, looked at him, and then looked into our eyes and said, "I didn't know he was already formed!" I wanted to scream at her, but what I felt was heart ache for her. She bore a son someone could have adopted, and who, if he hadn't suffered in her womb, would probably have survived despite being born vey premature! Legal abortion would have changed things for her, maybe she would have had an early abortion, or maybe someone would have educated her, let her know how far along she was. When we make abortion illegal, something that so many want, we don't abolish abortion, we make it a back alley event that scars mothers and babies!! Enough about it, but I will never forget holding that tiny boy in my hands!

Vaginas aren't for cutting!

2008-12-27T14:22:00.000-08:00

Bet that got your attention!!! For the most part I am going with the flow here, after all I am the guest and they are so generous to allow me into their hospital. But there is one territory that I just won't vernture into. Yes, if it was a life or death situation I could do an episiotomy but I REFUSE, utterly refuse to take a pair of dull ( as in can hardly cut an umbilical cord with them) scissors to a womans vagina (and into her gluteous muscles!!!) And I swear if I have to hear one more midwife ask if a patient needs "an epis" (as they casually call them) I might flip my lid. I have found my place here and it is to save women's vaginas one at a time. My day brought 3 more deliveries!!! First one up was about 15 minutes after I arrived this morning. She was a primip who delivered an 8 pound baby without any tears!!! If it had been up to the midwife they would have cut her, and I found it deeply satisfying that I saved her vagina!! I'm serious about this if you can't tell that from past posts. They keep telling me that primipa (first time moms) all need episiotomies, and I'm starting to argue the point and prove it to them. I'm not trying to change how they do things, but I am letting them know that when it comes to the patients I deliver there will not be unwanted episiotomies done unless they are very necessary!!!

So, that is enough on that subject. I am amazed how quickly I have adapted to all the medical stuff, and surprised that I have found enemas very useful (gasp!!! Never thought I would say that) but they do seem a better option than the drinking of castor oil and somewhat gentler on the moms. Other skills that I was afraid of - IVs, cathetars, suctioning babies, cathetars....no problem any more!!! IVs were one of the things I couldn't grasp at home, but after having done a few I have jumped that hurdle with ease...yah me!! I can't believe how much I have learned and grown in just 2 weeks. It seems, though, that we have been here for much longer!

Transportation has been a challenge the last few days, so yesterday I just decided to walk home since it is hard to get a bus from the hospital to the house (by the time the busses reach the hospital they are always full!) So I took on the walk yesterday (about 3 and a half miles I think) pepper spray held tightly in my hand. Except for a mangy dog who debated trying a taste of my bony frame I didn't have any incidence. I arrived home feeling proud of myself! The down side of all the pride I am feeling in myself though is that exhaustion has begun to set in. I am the only one in my family who has adjusted to this time zone, which means they are all up til midnight when I am trying to go to sleep...ugggg!!

Today Kevin took the kids into town to swim at the pool. They all needed to get out of the house, and it allowed me a guilt free day to work overtime at the hospital. Well, that is about it. I will try to post pics of the hospital in the next day or two but I am currently on Kevin's laptop and the pictures are not.

Christmas Day- 13 days into our trip

2008-12-25T10:41:00.001-08:00

No more babies since i last posted. I went in yesterday but it was quiet. Came home early with another student who is here from the UK. She went to the beach with us and stayed for dinner. Christmas day, at home my family is hopefully together surrounded by lots of snow and laughter. We found most of our traditional fixings for Christmas dinner here, although the oven is really heating up this house which is not air conditioned. The weather is as it has been the past few days. Sunshine, then tons of rain. The kids opened their stockings and gifts outside on the patio this morning, it was nice.

Day 10 ...I think

2008-12-23T15:00:00.000-08:00

Well, for the first time since we arrived we have internet access in the house we are stayin in....never thought it would excite me so much, but here I am back connected with the real world. I finished my observed births here on Sunday (they require you to observe 10 before beginning to deliver yourself). So yesterday was my first day delivering....I delivered (caught) 3 babies but worked 2 shifts to get it done. Only one today, but she was a primip so labored for quite a while, and there I was by her side. When she finally began to push I put off alerting the midwives because once you start pushing here you have about 20 minutes to get baby out or they cut an episiotomy...or in this case make me cut one. Luck was on my side, by the time the Midwife got there the baby was low, and mom was pushing well. The midwife mentioned the need to do an episiotomy and I just told her I thought things were fine. Episiotomies are done here more for the midwives than the moms. It means sewing up one area (large area) instead of searching for tears. This particular patient did have some small labial tears and a small tear in her pelvic floor, but in the states they would have just been left but the midwife wanted me to stitch. I began but she didn't like the style I was using so ended up taking over. Fine with me. Another grand day here. 4 catches dwn 16 to go.

2008-12-18T11:17:00.000-08:00

day 4 at victoria hospital- all is going well. I haven't posted in a few days but my second day at the hospital the midwife had me do a big IV (versus the butterfly IVs that we normally do), dark skin scared me because you can't see the veins very well, but bingo!!! it was in, another first over with. i have to observe 10 births here before they allow me to catch. I saw my 7th today, 3 to go. I may go back tonight if they have some ladies laboring as I have the next 2 days off and would like to begin next week catching. I love the mamas here, and they treat me with such kindness. They told me today that they want to deliver when I am on shift so they can have a "nice nurse" :) Those are in short supply just like the beds and linens. Often when I arrive in the morning there are no more clean linens (sheets). At first I felt sorry for them being so packed into rooms, but I have learned that there is commeraderie and they help each other. As I walk by the rooms I often hear them call, "nurse, nurse" so they can speak with me or ask for help. I wish I could clone myself. To the other midwives credit they are just so overworked that there is time for business only. Did I mention that the ladies have to bring their own toilet paper to the hospital and that even the staff bathroom doesn't even have a toilet seat??

Hot water also seems to be a problem here, sometimes you get it and sometimes....its cold. I have to just smile and adapt. Thank god I didn't come with any expectations. We have adjusted to the heat even at the hospital where you jsut get light breeze through the windows.

Oh, and did I mention I did my first enema today???? Yikes, ladies be glad you didn't have to give birth here!

Life is good. One day closer to my license. Tomorrow is my anniversary....16 years!

2008-12-15T14:01:00.000-08:00

Well, thanks to a private beach with a tiny bit of internet signal I am here again. Survived my first day at the hospital. Talk about a trip back in time! There are about 10 rooms in the maternity ward each room has 4 beds and there is a bathroom (one toilet and one shower) shared between 2 rooms....which makes long lines for the toilet. Imagine how many times that toilet flushes each night. I'm sure they don't get much sleep. I was told I would just be observing and learning this week, but within 2 hours was given my first patient. Taking vitals included using a glass thermometer...haven't used one of those since I was 12, and you should have seen her face when I told her to put it under her tongue! Guess that isn't how things are done. I began the day with a lovely midwife but spent most of it with a stern midwife who had no patience for my lack of understanding the language they speak (which is a weird mix of French spanish, and creole along with heavily accented English!) All is all it was a good day except for my poor patient who, though doing fine was not pushing fast enough though she delivered after pushing just one hour..,, I couldn't stand to watch the large episiotomy they cut on her!! I pray they don't ask me to do the same...I think I would have to object!! Well, signal sucks here, but we are alive and well! Mosquitos are coming out and it is almost dark so time to head back up to the house.

2008-12-15T09:19:00.000-08:00

Well, I am finally online, though the connection is tentative at best. After 2 days of flying and losing sleep we finally made it!!! Last night was rough to put it mildly! WHile our room has air conditioning the kids doesn't even have a fan so they suffered until I gave them ziplock baggies full of ice and half a sleeping pill each!
More to come. Internet keeps dying.

Day 2

2008-12-14T12:55:00.000-08:00

2008-12-10T17:55:00.000-08:00

December 10, 2009
The last pet has been delivered to his caretaker...things are getting done. I'm feeling more calm...maybe it was those naturopathic stress relievers I took. Now if I could just get this crazy headache to go away! 36 hours to go. I'm ready!

Standing at the precipice

2008-12-09T22:28:00.000-08:00

December 9th, 2008- We've been dreaming of this trip for months, counting weeks, then days...and now we are down to just 3. In 3 days we leave behind familiar ground and step into the unknown. I' m a firstborn, a planner, never good with change..and yet I stand at the precipice....knowing that curiosity overrules fear, and the adventurous spirit in me will overrule the anxiety that the unknown carries. And so begins the journey, 32 days in St. Lucia. I will be working in a hospital there....a place I usually dislike, but that now embraces me and carries with it the chance to become what I have desired....a Midwife. In 32 days I will watch the sunset and rise, laugh on the beach with my children, celebrate a 16th anniversary with my husband, and use my hands to guide unborn babies into the waiting arms of their mothers. I will learn and grow and doubt myself and rejoice. The voice of my mentor (you know who you are) will be in my ears " you know" she says "just trust your instincts". Standing on the precipice I look out over my life that is to come, hold my breath.....and jump!