cool video

and one i thought was apropos with my trip!!

Morning trip to boracay

We arrived from the ferry terminal on the smaller green boat at 5 am monday morning. This is the early light scene on the water ways of people being boated about.

Last night in Boracay

It was almost massive overload to come to this obvious busy resort after 2 weeks of dealing with very poor women and limited local foods. It felt good to not take it for granted and really understand the contrast. Going out on the beach strip tonight to have Italian food and celebrate the last night the Fantastic 5 Ninja Midwives are together. A few are staying to Wed, with 2 flying back to Oregon and 2 others continuing on their trip to thailand and cambodia. We have been discussing travel and how it seems Europeans do more traveling and plan more trips abroad quite often--living in small places and and saving money as the means to traveling a lot. Traveling every year is often done as opposed to lots of material things or owning new cars. Interesting concepts of what is important to a culture.

Birth is Cultural

Being exposed to pregnant and laboring women has shown that how we respond to birth is cultural based. Our emotions about it and our perceptions of pain even.
Here in the philippines (and even in Jamaica) there is little emotional support nor do women doubt they can birth--it is expected if you are a woman and that your body will work. There is very very little noise made even in hard labor. They are very stoic and quiet even when pushing. but the reality of the risk of them or their baby dying is very very high and very real in the poorer areas. So many women who came to the clinic for prenatals have miscarriage or stillborns or deaths in early life--it is very common.
How a midwife approached the women and their pregnancy and labor is also cultural. Because the population is poor and generally malnourished or anemic their is more active management to the immediate birth and postpartum--this has proven to save many maternal lives as well as a decrease of infant deaths by 22% if babies are nursed in the FIRST HOUR!!!! and another 14% if nursed in the first 24 hours. Breastfeeding is the key to decreasing the infant mortality of the 3rd world countries. The issue is the people buying into not nursing right away cause they have no milk or using watered down formula.
Seeing the cultures and how different they are is eye opening and yet women birth the same and nurse the same and need physical and emotional support when issues come up.

midwives

we bought a cake for the midwives to say thanks for their kindness.. .... it says
Midwives ROCK!!!

electrical lines

Note the main post with all the lines running out to places..then the lines all bundled on our balcony!!

Our ferry

this is the ferry we rode and me and natalie on the ferry... 4 hours on this..with no clue how to get around or when to get off..if they were sinking we would not know cause of course announcements are not in english!!! We tried to sleep but several small "cucarachas" as alexandra our argentinian comrade says were everywhere!!! Being the only white women mostly everywhere we always get lots of stares and even stalkers.

Saga/part2

Here is the town of Roxas from our balcony..very small but interesting.

our saga to Boracay part 1

So with high hopes we set out sunday morning for the 2 hour van drive to Roxas to catch the 4 hour ferry trip across the ocean to Boracay to take a 10 min small boat to the island then a tricee ride to the resort!! whew. It ended up taking longer than the 18 hour plane ride TO Manila!~!
So there are 5 of us with huge bags so we get 4 tricees which we get separated..3 of us end up on one side of town and the other 2 elsewhere. There is no communication between us so we wait for about 30 mins..then decide to head out to the other side of town even though we are told this is the ONLY place with AC van rides to Roxas!!!... we take the 20 min tricee ride and We find them!!! and 45 mins later finally start the Van ride. now this van is for 16 people...but along the 2 hour quickly turning into a 4 hour trip he stops and picks whoever up going his way which eventually we have 19 all squashed in. So the stopping cause the ride to be 4 hours~along with his stops to get his snacks and talk with friends. Every time we stopped we have venders all around the van selling water/cokes/banana chips/eggs etc.....
We get to roxas to catch the ferry..we missed the 11 am one but we knew we could catch the 4 pm one to get to Boracay by 8 pm..but NO!! they cancelled the 4pm due to not enough cargo!!! So find a small hotel and get a room to rest...this is our gloriously colored room... and bathroom..and all sacked out just waiting for the ferry time. We did have an aircon room--air conditioning!!! Along with Vodka and Sprite!!!!!!!

angie

Angie is the mom who went to the CR and the student nurse hollared for us to come NOW..and I caught the baby there. She is very very poor but the sweetest smile. I gave her a necklace I had on and she is wearing it now. It says Faith Love and Hope on a silver circle. Roman Catholic is the main religion here.

typical

A house near one of the families ...makes one appreciate our US homes.!

view

from a mountain top of a moms home

2 postpartum moms

these are the home of the one of the moms we caught babies for...not rooms in their house but the actual home..one room.Usually made on planks with planks on the floor. Shoes always come off to come into the room. This is a room for the whole family even with several children

plank bridge

this is the very interesting plank bridge...made for small philippine people not for large american women!!!

Buntas

Buntas means pregnant woman. Isnt that a nice name?
We did a great birth this morning. Mom pregnant with #6 came in about 7 and baby born an hour later.
this is the cutest baby ever!! The 2 little girls are the older sisters of the baby named christina and their names are Marjorie the oldest and Mary Lucy the youngest. The youngest kept touching my skin as white skin is seen as superior and more modern here. There are tons and tons of skin whitening creams here as its seen as very important to have whiter skin.
The other picture is Grace the midwife and me checking out the placenta!!!

Salamat Po

It is very interesting here and quite different. There are power outages sometimes for several hours to help conserve energy. Mostly in the afternoons when it is the hottest and so fans or cold water. Its hot and humid and sticky. Last night we went out to town and got some groceries to restock out shelf...we spent 1000 pesos which is about $20. We got quite a bit--6 tunas, mayo, ovaltine, pears, oatmeal, soups, cokes and sprites, small ice cream thingies, box of cereal, and a few odds and ends.... not bad for all we got.
Walking here is fun... everyone smiles and says Morning or Evening.. all the little kids wave and hollar at us. All the moms seem so nice about us measuring their bellies... we pulled up tagalog transalations to ask questions. Salamat Po is thank you in the formal way.Magandang umaga po is good morning. Magandang gabi po is good evening. oho/opo is yes and Hindi po is no.
The streets are the social hub of the culture... everyone has small sari sari in the front of the house and even cooking foods that people going by can just bye from chips to cokes to hot meals. almost like a street party every nite when it is cool outside.
A lot of people speak english and more understand some of the language. Even their TV shows will be part Tagalog and part english. It isnt hard to be understood here but trying to learn some of their language is most respectful.

CR

So the bathroom called the comfort room is interesting. It is really the shower with a toilet in it. Often no sink but sometimes there is a small one. Its all tile and a bucket that fits under a small spigot to put water into to flush the toilet as some toilets have no handle to flush. You simple dump water into the toilet to flush and all TP goes into a trash can not the toilet. Taking a shower of course gets everything wet and must be wiped down. When we had the birth and there was blood everywhere it was so easy to use the shower handle and wash it all off.

birthin rooms

This is the birthing room. There are 2 beds separated by a curtain.
This is late in the night when all the moms and babies and dads were asleep on the small twin beds. usually the moms stay 6 hours but these 2 moms stayed 24 hours as one lived far away and one had a low birth weight baby and needed extra monitoring.

2nd birth

our 2nd birth and very low birthweight!

Green bus

This is the Jeepney we rode from Tamaraw where we had our training on the beach to Calapan where the clinic is. It was some seriously big mountains and winding up and down on small roads. These are hand welded buses made locally and engines from Japan where the law is they must replace all engines every 2 years.

midwives

2 of the midwives at the clinic....Jen on the left who is 8 months pregnant (i had a previous picture of her) and Grace. All the midwives have been so kind and gracious as they have taught us how to do births here which is very different than in the US since there is so much poverty, malnourishment and illness.

Postpartum visit

This is a mom who had her baby before we got there but we did a 4 day postpartum at her house to check everyone. Cuteness!!!

CR Birth

Here the bathroom is called the CR...Comfort Room. :) Took me a few days to figure that one out. This mom- Angelica is a first time mom and had been laboring all day. At about 7 cm decides to go to the bathroom..a student nurse goes and hangs out and when she hollars at me cause she is feeling the head I come running and hold the head and i catch the baby.... no gloves of course and no towels...placenta out and baby good.

1st birth

First catch of the day... Joy is the mama's name..baby boy is unnamed at 7lbs 10oz. Awesomely cool birth.

house

Our house where we are staying and our food stash.

maternity clinic

Our maternity clinic and the orphanage right next to it.

another view

from the restaurant.

disaster training

We also had disaster preparedness training every day. How to deal with natural disasters and helping people hurt or stranded.

Sunsets

the sunset was beautiful!!

Translator

this is the gal who translated a lot for us in the rural villages. She took us up some serious rocky hills to get to the houses and the women.

In class on Saturday

We learned how to use the vacuum extractor. In poor countries or very rural areas, getting to a hospital for obstructed birth is just not viable or safe. So knowing this skill to get babies out is vital.

Safe

Note the guard that stands at the ATM at the bank with the gun!!!

more pics

note the Quiet please sign and you know we were not being quiet!!!

Sat night festivities

is our last night here at Tamaraw. We head out this afternoon (sunday) to Calapan where the birth center/orphanage is located and do clinicals there.
So last night we had scrumptious meal at the Italian place on the cliff over looking White Beach-where the partying places are mostly located. Afterwards we went to one of the eating places/bars and watched a trannie show. Cross dressing men putting on a Karaoke show for the crowd. It was fun! These men/women were just gorgeous and fun--and loved us Americans. One sat with us to discuss the woes of boyfriends!!! They are called Baklahs-- and they are not looked down on for being gay/crossdressers but more seen as a 3rd gender here in the philippines. I find that interesting that a culture does not judge them but simply accepts the life as a another type of orientation.
Then we headed over to a sari sari that is a bar--A german guy owns it who is married to a Philippine woman- and watched the World Cup as one of our nurses is from Argentina and is a diehard soccer fan. It was a nice community adventure. Walking home at 1 am several Tricees wanted to give us a ride home--its a 15 min walk back- and we said no we did not want to pay 150 Pesos as we could walk. One driver finally talked us into paying 20 pesos each. (there was 5 of us).
It was a fun evening to round out the training week and into the more serious clinical week.