Guess What?!

As you may have guessed, we're coming home!

We look forward to seeing and chatting with all of you.

Thanks for all the prayers!!

Hey everyone!

This past Saturday, I had the privilege of getting to go on a medical outreach. It was such a great experience. We set up our little clinic and started admitting people. You never know what you are going to encounter with these things. We saw everything from the common cold to some nasty wounds and boils. Kendra, who is a nurse and also from Iowa, and I got to work together. Between the two of us, I'd say we did a pretty good job of questioning, diagnosing, and prescribing the individuals. It was so neat to see my nursing skills come together and pay off. I really felt like a real nurse, even though I was acting more like a doctor. We only had limited supplies, a few otoscopes and flashlights. We had some saline and alcohol to clean wounds and disinfect. We were fortunate enough to have a small selection of medicines, enough to cover symptoms anyone who is not feeling well might have. All in all it was an excellent day!

They first checked in with Beth. She checked vitals and took their basic complaint.

Beth sat them behind the divider in our make-shift waiting room. I felt badly for them, because they had to sit on chairs for little Sunday school kids! It reminded me of the confirmation and helping with Sunday school days. I don't think the kids below were sick. There were so many kids running everywhere. Some belonged to patients but others were just neighbor kids who just came by to check out all the excitement and "pretty white girls" haha!

Once we were available, Kendra and I (as well as a few other girls) would take the next available patients. These three were all not feeling well. The baby was very out of it and it took a lot of stimulation to get her to cry. She had a very high fever and was severely dehydrated. The little girl we are guessing had Dengue. She had a terrible headache and kept hitting herself in the head it hurt so badly. She also had a UTI. The mom, we think, just had a cold.

The boil things on this little boy's head, had to be cut opened and drained. He was obviously NOT a happy camper throughout the procedure. It was also frustrating because he was a Badjao. They don't speak cebuano, but instead speak their own tribal languages. None of the adults knew what the heck we were going to do and were getting very, very upset. I couldn't imagine someone taking a knife to my child's head when you have no idea what they are saying or what they are going to do! Poor things.

When we were done examining, diagnosing, and prescribing,

we sent them to our little prayer area.



After receiving prayer, they stopped by "the pharmacy" and got whatever they needed if they were prescribed anything.

These pictures were taken on the way back to the van. None of these pictures show very good pictures of the huts, but they were all pretty much open with a roof overhead. It was located right on the ocean so the shelters were built up on stilts. Under the homes was water. I don't think it was from the ocean, but more from rain. I'm sure a lot of it was human waste as well. There was a TON of garbage under there since they have nowhere to throw trash. Kids were playing under there and there were all kinds of animals around...well i guess I only saw dogs, cats, and rats, but who knows what all lives there. It was definitely an eye-opening experience.

We're Catching Babies!

Megan and I are super excited to inform you all that we have both now been able to deliver a baby!! Megan delivered a baby boy, named Nathaniel, on June 27 @ 2:58 a.m. She got to do an IE (internal exam) and the mom was 7-8cm. The supervisor told Megan this could go quick since it was the mother's 3rd baby. And quick it did! Only 20 minutes later the baby had come out. It was a very nice birth for her, and she had a great first experience. Megan was able to do follow up care on the mom and baby, such as the bath and newborn exam. She also got to do the first day check up this morning actually. Sounds like everything is going well for mom and baby, except the mother told her she only breastfeeds the baby every two hours for ten minutes. Megan informed her that is not enough time and that she needs to breastfeed for 20-30 minutes at a time. Pictured below is Megan with the baby :)

My birth, on the other hand, was not as smooth as Megan's. Here's how it played out. I was on swing shift and was assigned this labor patient at 2:00 pm. She had an IE at 10:30 am and was only 2 cm. So we did another one at 4:20 pm and she was 6cm. So I thought for sure it would be a little while longer before she delivered, I thought I'd be lucky if she delivered on my shift. Well, I was wrong. At 6:00 pm she was fully dilated and wanting to push. Even though she was fully dilated, whenever she pushed there was no opening. So we got her up to a squatting position and that seemed to help because not shortly after the head was visible. So we laid her back down and the head started to come out. When the head came out I had to check for a cord around the neck, but that baby was so tight in there it was hard for me to get my fingers around the neck. Kind of had a hard time getting the rest of the body out but it did and it was a boy! June 27 @ 6:25 pm he was born. But when I set that baby on the bed it was very limp. It wasn't crying and they were having to do deep suctioning by putting a catheter down his nose and mouth to suck out any gunk he might have swallowed. Still very unresponsive and was getting very blue. They next had to do PPV, I think it stands for positive pressure ventilation, basically just a bag and mask. At this time I was pretty nervous and praying like crazy! I just kept thinking to myself this baby had got to make it! The mother had all ready experienced a miscarriage at 3 mos. of pregnancy during her first, and this baby was her second. Thankfully, the baby started to breathe on his own and was regaining normal color. Everything was just fine after that. They named him Jhonel. It was quite the experience, I must say. Really felt like a real midwife, because I too was able to do all the follow up cares after birth. And tomorrow morning will be my baby's first day check up.

Megan and I both share in the feeling that we are so glad we were able to deliver a baby before we left. We can now officially say we're ready to come home! Which will be very soon. Only two more days here, crazy! We both work the day shift on Tuesday and then our flight leaves Davao at 12:20 on Wednesday afternoon. Who knows, maybe we'll get to catch another baby before we leave ;)

Let Freedom Ring!

Last Friday, the staff at Mercy Maternity Center threw an Independence Day party for the Philippines, United States, Canada, and Switzerland. The Philippines Independence Day was June 12, Canada's is July 1, and the U.S. is obviously July 4th :) And I'm not sure when Switzerland's Independence Day is, but we have one girl from Switzerland here and we didn't want her to feel left out. So, we were instructed to have each country bring food that represented their country, come prepared to sing their national anthem, and whatever else they felt would help represent their country. All I've got to say is that the Filipino's won, hands down!! They totally went all out with their outfits and the skits they performed. For food, they had bread in the shape of a pig, because its customary to have a pig at celebrations. They also had some other Filipino dishes. Here's some pictures/videos of what they did:

The video is them singing the Philippine National Anthem.

The girls perf0rmed a dance for us, it was so good! I believe they are representing the Manobo tribe.

The 3 bottom photos are the guards at MMC . Abs is representing the first flag carrier of the Philippines. Felix is dressed as a tribal person. And then Roamie, if I can remember, is the person who helped bring independence to the Philippines. But I can't remember the name.

The Filipino women performed a native dance for us as well.

Then the Canadian gals gave a presentation on the history of their country. They showed a hockey clip on youtube and then we proceeded to play a little game of hockey as shown:

Then it was our turn to try and demonstrate a U.S. 4th of July celebration. We started off with a parade, complete with a marching band and a cowgirl and horse (it was just a girl riding piggyback). We threw candy and the kids loved it! After that we decided to dance the Virginia Reel (video below), and then turned out the lights and had a fireworks display via the projector. We also had to sing our national anthem and said the Pledge of Allegiance. All in all, it was a great party! We had so much fun! It was so fun to see how excited the Filipinos were for the party, and they put so much effort into it. It was awesome to be able to be with people outside of the birthroom setting.

Megan and I pictured below, although you can't see our whole outftits, we were decked out in red, white, and blue! It made us so excited to get back to the states and celebrate 4th of July! We can't wait!! :)

Cultural Issues

First off, the babies! First up we have Cianice Chanice. Kind of a different name, but then again I am in a different country... She was born on the 23rd.

These are the mom's friends. They man who got her pregnant is no longer in her life so the baby will be raised the mom and the house maid to the right. The house maid helped her all throughout her labor and did such a fantastic job! They seemed like the best of friends which I thought was pretty sweet. The helper was all interested in the different techniques and positions the mom could give birth in. She wanted her to try them all. She was very good at helping her exercises, supporting her through contractions, and getting her to focus for the birth. Most importantly, she made the mom laugh between contractions and got her mind off of all the pain. Someday, I hope to have someone that will do the same for me.

This is Lislie Jane. She was also born on the 23rd. Here, the midwife Jane, is showing the mom how to care for the cord. Baby Lislie does not appreciate cleanliness from what I can observe.

This is baby Jemima, also born on the 23rd. Ali was her midwife. She is number six in her family. The mom was a seasoned pro and knew exactly what was going on. Her and her husband liked to guess everything! They wanted to guess boy or girl, weight, length, and even the time she was going to be born. They were pretty funny.

All of these babies were born super close together! Cianice was born at 9:26am, Lislie at 9:48am, and Jemima at 10:13am. I got to assist for all of them which was very busy and exciting!

Today, was a very busy day as well. However, I only saw one birth. I was assigned to a postpartum patient who had given birth at 5:42 and I came on shift at 6. So, I had a fresh baby and mom to take care of throughout the day. We had, I don't even know, at least six labors throughout the day and two births, on top of baby check-ups. It was one hectic day. We were completely full at one point. I'm not really sure what we would have done if another labor had come in!

This is Romuald Jr. and his mom, Melissa. This was the patient and baby I took care of all day.

This is an unnamed baby boy. Ali, who was pictured above, was also the midwife for this little guy. He was born at 8:42 this morning, the 24th.

I have been wanting to tell you all a little bit about the Filipino culture and now seems like a pretty good time to do it. This was all described to us at our orientation. There are three main values upon which much of the society functions. The values include: Hiya, Pakikisama, and Utang Na Loob.

Hiya: Hiya is another word for shame. It is also known as the "saving face" and is very strongly seen in Asian populations. It controls and motivates almost all social behavior. It is incredibly hard for Filipinos to understand our Western values such as independence, individualism, and nonconformity. Because of hiya, Filipinos will not ask for advice or admit they need help; if you are ever alone, it is common for someone to walk next to you to cover the shame of being alone; people won't disagree with you even if they know you are wrong, a landlord may not collect a long overdue rent; and if one falls in a public place, no one will help but act like they did not see to cover shame.

Pakikisama: Pakikisama is the art of "togethernes" or SIR (Smooth Interpersonal Relationships). It involves sacrificing the individual welfare for the welfare of the group. The ability to get along with others is an absolute necessity. I definitely wish the US had a little more of this. Here, every employee is expected and tries to get along with their co-workers. There is very little to no talking behind someone's back that you have to work with.

Utang Na Loob: or the debt cycle. Everyone is expected to have utang, therefore, everyone is obligated to many other people. It never stops, thus validating the importance of identification with a group. Creating utang with an outside group (Americans) is extremely disloyal to the primary group. For example, if a Filipino were to ask to borrow P50 from an American, the American could give it to them no problem. However, say the Filipino needs to borrow money again but this time they ask a fellow Filipino who was in their "group." That group member, might not lend them money because last time they asked outside the group by asking an American.

Here are some more cultural issues:

-It is actually polite to be late. 15-20 min. is ideal

-There is neutral gender no "he/she" You can say, "What a beautiful baby girl!" when it is actually a boy, and they will not care.

-If you go out for a coke with a Filipino it is polite to pay.

-F and P are interchangeable. (helper or helfer)

-Pedestrians do not have the right of way---no matter what!

-It is customary to remove your shoes when entering a house.

-Dress is modest.

-Body Language

+ Raised eyebrows means 'yes'

+ Pursed lips is directional. So, instead of pointing a finger, they would look in the direction they are talking about and make a kissy face.

+ 'Come here" is a hand going downward gesture

+Staring is common, however a stare down is aggressive and confrontational.

+Hugging is culturally unacceptable but is tolerated mostly among Christians.

+When going between two people, cut the air with clasped hands and head lowered to interrupt a conversation.

+ Younger 'bless' older with their hand

+Snapping your fingers is rude, however clapping or hissing is an acceptable way to get someone's attention. I, personally really dislike the hissing that people do in public. It just seems terribly rude, but I have to remind myself a lot that it is acceptable here. Loud verbal noises are also unacceptable to get someone's attention.

+Same sex contact is appropriate. It is common to hold hands or walk arm in arm.

+Shaking hands woman to man is usually not practiced.

+Personal cleanliness is a must. Most people going to the mall or public areas are impeccably groomed.

-Filipino "yes" may mean :maybe, I don't know, if you say so, if it will please you, I hope I have said it enthusiastically enough for you to understand I really mean no!"

-you cannot assume that what is being said to you is necessarily correct. For example, when asking for directions a very polite person will give you directions even if they have no idea where you are going.

-They are terrible at waiting in lines. If there is room for them, they will cut in line. Chantel and I got introduced to this right away at the airport when we first got here.

Well, that's all for now!

HAPPY FATHER'S DAY!!

Hi Dads! We made a video for you and we hope you enjoy it!



Chantel and I have been so busy working, but don't worry, we have also taken some time to get massages and do a little shopping! Upon our entrance to the massage place, we were greeted by the lovely Filipino staff who made sure we were always happy. We told them what kind of massage we wanted (aromatherapy) and we were seated to wait while they set up. They gave us the famous iced tea here and we drank that down! Then we were whisked away where a lovely, warm shower greeted us. After that, we sat in a dry sauna and let the toxins drip out of our bodies...although we think there should be no toxins left in us after all the sweating we have been doing! We then got to have ANOTHER shower. We were led to two beds just waiting for us. The massage was wonderful, despite the somewhat odd positions they bent us into. Needless to say, we had a really great time there.

The next day we went to a touristy area called Al Davinco. Everyone at the house was telling us what a cultural experience it would be. Chantel and I were expecting something like the market but it wasn't really like that at all. It was in a big building that held small individual shops. Most of the shop keepers sat outside and as we walked by and would say, "Hello mom, (mam) please come inside." If we actually went in, they would try to get us to look at everything that had in there. You couldn't stare at anything for too long or they would catch you looking and flock you and try to get you to buy it. However, it was not the scary cultural experience everyone was kind of making it sound like.

The rest of our week has been spent charting and finally assisting with the births! We were supposed to see ten births, then chart five times, and now we can FINALLY assist. When we assist, we grab the baby from the midwife when they catch it and dry it all off, put it on the mom's tummy, bulb suction all the juices out, and then call an APGAR score. We also check fundal heights, mom's pulse, give the baby eye meds, and try to get the baby breastfeeding. Once the placenta comes out, we massage the uterus and check to see how much blood comes out. Overall, it is very exciting. I kind of hope nothing goes wrong while I am assisting, because that could be a lot a pressure, such as deep suctioning, resuscitating, or when a mom hemorrhages.... those could be scary moments.


First up for babies we have Keana Mie, she was born at 12:27 on the 19th.

This little guy is Arwin. He was born at 3am on the 19th.

This baby is unnamed as far as I know. They will have to pick a name soon.

Miranda is the student midwife who delivered the baby.

This was the first baby I got to officially assist with! They named him Niel John. He was born this morning while Chantel and I were both working. This baby was so stinking cute, and whe I say stinking, I mean stinking. He pooped all over and he was covered in it! haha. When we were checking his reflexes, he gave us this aweful glare but he was just so darn cute!

I don't blame him for being upset here. He received both a Hep B and Vitamin K shot.

Poor baby.

BALUT and BABIES

Hi All!
On Monday, Kinshasa and I went to the hospital to visit a patient we had to transport on Friday. She came in with premature rupture of membranes due to a UTI that had not been treated. I will never forget the look on the parents' faces when Kinshasa told them they would have to be transported. I told this story in the last blog. Anyway, we pulled up to the hospital and had to get through a set of guards. Good thing Kinshasa could speak the language! The guards said visiting hours were over. Kinshasa just kept saying, "No it's ok, we will go. No really, we are just going to go." They finally let us. Then we came to another set of guards to get into the room where the patient was. They did not want to let us in either. She said the same thing to them and told them who we were there to see. They wanted to let us in one at a time. Kinshasa pointed and me and said, "Oh, no! We will go in together, it is her first time ok." Then they finally let us in. She said you just have to be a pushy American and act like you know it is ok. She is Canadian though, so I don't know what she meant by pushy American... haha! I will never forget what the place was like. The room was the size of a gym and was lined and filled with beds. There were two moms to a bed which left husbands and visitors in the aisles or sometimes on the bed as well. Needless to say, it was extremely hot, and extremely cramped in there. It smelled absolutely terrible right next to the bathroom. Kinshasa and I started walking the aisles looking for our patient. As we walked, everyone, and I mean everyone stopped every conversations to stare at us. Most smiled as us as we walked by hoping we would stop to talk to them. A lot of people pointed and said to the person next to them, "Mercy!" Any time a white girl goes into the hospital, they know we are associated with Mercy Maternity Center. I wanted so badly to stop and visit each patient, however we would have been there for at least four days. We finally found our girl and were greeted with the biggest smile ever. She proudly showed us her baby girl which she had delivered Saturday evening. They named her Shanna Pearl. Overall the hospital was extremely cramped and understaffed. Kinshasa said none of the moms there have been able to shower since delivering and sometimes they are there for a week because the nurses get so busy and forget who is where and how long they have been there and such. She also said sometimes they have outrageous infections from not being able to wash properly, especially if they tear. A lot of the times when she goes to visit, the mom's will not have even seen their baby or know the sex, even if they delivered two days ago. It was sad to leave them, but we left them with a bag of clothes and soaps that people from Kinshasa's hometown put together. We prayed over them and sadly said goodbye.


When we got home, Chantel was in the living room, so I sat down to tell her about it. Not ten minutes later, Kinshasa comes running in the house and says, "Perfect, you two are here! Have you ever had balut??" Chantel and I look at each other and then back at her and said, "No, do we want to?" She led us out to the street where Genevive (a Filipino midwife) was ordering balut from a boy on a bicycle. She was so excited that we were going to try it. I purchased an egg for 15 pesos not really knowing what I was getting myself into. We were told it was a chicken fetus 16 days old. Genevive showed us how to open the egg by cracking the top and peeling the shell away. We added salt and vinegar to the juices inside and then drank it. Disgusting. Then, we had to take a bite. I'm sorry, but it was looking at me I think. I timidly bit into it but did not rip any off. I said, "That was a bite of bones and feathers, this is so gross." Amber came out to watch us and said, "Ha! You got the wing!" She pointed out where a good bite to take would be. However, I don't think it was that great of a bite. I took a bite, definitely got more bone, feather, and some yoke. It was gross. I was able to swallow. Chantel had it in her mouth and spit it out. I can't say that I blame her. It is a Filipino delicacy. Mom always says, "We eat pig, and it doesn't get much worse than that..." Apparently, it does.
I worked a double shift again, swing and night. There was one baby born during the swing shift and three in the night. None of them had decided on a name however when I had to leave. They were all very normal births. I got to chart for all of them. I absolutely love charting!

This was baby number one, born to LiliBeth.

He was born sometime in the evening...all the times seem to run together.

His footprint is below.

This is baby number two. She was born late in the night a bit prematurely. She was covered in vernix, making her a pretty gross and sticky baby. We rubbed the vernix into her skin and then gave her a bath. However, she was still very sticky.

Same baby, all ready for her footprints!

These are the proud parents.

Greetings Everyone!

Chantel and I have been keeping ourselves busy over here! Friday, I began the night shift and saw Teesha Nicholle arrive Saturday early morning. That same morning, a mother arrived and said her water had broken. She had had a urinary tract infection but had never gone to the doctor to get it treated. We are assuming that is why her water broke prematurely. She was not in labor at all, but after performing an IE, she was 1cm. Before transferring her, we admitted her to try to get her to go into labor. We walked with her for six hours and she had a few contractions. The whole time we knew her going into labor was going to be a miracle. After six hours we performed another IE and she was 2cm. After the second IE we could technically refer her to the hospital because we had shown we had tried and she would be admitted and treated. Kinshasa, a student midwife, and I sat down to tell the soon-to-be parents that they would have to be transported. Seeing their faces about broke my heart. The banna's (husband) face and whole body just sank. Being transported to the hospital means they have to pay a lot more than what they would pay at Mercy. We started an IV since everyone gets an IV at the hospital and it costs way more there. Kinshasa and I rode with them to the hospital, dropped them off, and wished them the best of luck. We promised we would come back to see them after the baby was born. It was so sad leaving them behind.

Teesha Nicholle

Friday morning is my day for prenatal checks. The day begins with some praise, worship, and prayer. One of the student midwives gives a health teaching lesson. Jenna gave a talk on the benefits of breast feeding, especially for these women. It is free and will provide the most nutrients for their babies. She taught them about colostrum, positions to hold the baby while breastfeeding, and how long the mothers should be breastfeeding. I learned a lot too! The moms got a kick out of the different ways to hold a baby while breastfeeding because she also showed them how not to hold a baby with a doll! It was so funny watching them laugh. Below is a mom looking at a little science project Jenna created at the house. It was supposed to represent a mother's milk. 88% of milk is water, so there is no reason for mothers to give their babies water, even when it is very hot out. The oil was the vitamins and fats in the milk. She used red pepper flakes to represent antibodies.

Saturday afternoon, Chantel and I headed to the mall! We stopped for a refreshing drink and upon looking at the menu, I ordered her a surprise... Can you guess from the picture what it is??

It is fried sharks' fin!!!! I thought it was absolutely delicious. I'm not too sure if Chantel liked it... It looked like ground up shrimp in the middle and was served with like a sweet and sour sauce. After our refreshing liquid treat, we got a foot treat. We enjoyed a nice little manicure at a price unbeatable in the US! We payed about $4.

As we were leaving the mall, our ears got a little pick-me-up as well when we heard a band playing. We looked over the railing and sure enough, a small ensemble was serenading the customers! They were advertising for a big sale! It was sooo funny!

We snapped these few photos on the way back from the mall. Chantel is displaying the beautiful Mercy building. The middle is a picture of the building and road across the street from the clinic.

We spent a lovely Sunday at Paradise beach. Although, we just have to say, neither of us were too impressed. No one here likes to lay out. They prize fair skin and it seems to be a way to distinguish the wealthy from the nonwealthy...or the materialistic. Since the sun doesn't seem to be their friend, there was nowhere to sit on the beach! It was long but cramped. There was a restaurant right on the beach. Since it was a holiday weekend, the beach was insanely full. Chantel and I had a hard time finding a place to sit. She, like a mature responsible adult, remembered a towel, while I on the other hand, forgot. I just drug a chair from the restaurant and parked it next to her towel on the beach. They probably thought we were nuts. The sun was pretty intense, so we only layed/sat there for about 45 min. Chantel got a blackforest parfait and I got broccoli and a sprite. It was the only thing I recognized. Then, like the tourists we are, we drug the chairs from the restaurant and plopped them in the water. It's was us and the kids out playing in the ocean. All the mom's were fully covered and big hats on (you were right mom). There was one lady tanning on the beach...later we found out she was white. ha! Chantel would like me to say how often I put sunscreen on...only like every 20 min. And guess who got fried! ME! She hardly put any on. Lucky duck. As soon as the tide came back in, we headed back to the restaurant for more drinks. Chantel got BBQ chicken and I had a sprite. It hit the spot. We then said goodbye to Paradise.

Chantel's first ever steps in the ocean!!! What an exciting day!

This is what the boat looked like that we took to and from the island,

where the beach was located.

Here is the restaurant.

She was the cutest little girl in the world! She liked playing by us and we

certainly did not mind! This picture is for you Beth!

The beach!

Our view from the restaurant



This was a little group that went around to random tables and sang to the people there! It was so funny, and they were so good! I hope you can hear them!

Today, when I worked, I got to help chart for the delivery of this little guy. He does not have a name yet, but hopefully I'll find out when I work tomorrow. It was a very normal birth with a normal healthy baby. He was born at 9:29 this morning. I also got to see two suturing jobs today. It looked pretty hard to me. It all looks like mush down there anyway. It was nothing like any sewing jobs I've ever done.

This is Jenna, again, she was the student midwife for the birth of this baby.

She did such a great job!