The Agdao "BUNtis" Party!!

"Buntis" means pregnant in Visayan. And thIS morning we organized a party for the patients of the Agdao Clinic - it went SO SO well! Out of the 17 patients I've taken on as continuities, 15 showed up and 3 of them were also able to bring their husbands/bfs. This party was a reason to get these girls together for a morning to really inform them about pregnancy, labour, and delivery, and especially, what this looks like at Mercy Mat. They miss out on the regularly scheduled health teachings done at Mercy, so we invited guest speakers (supervisors and students alike from Mercy) to come and share their knowledge of family planning, nutrition, labour and delivery, postpartum, and what to expect when they actually come to deliver at Mercy. We were able to serve pancit bihon (a fav fil party food) and rice, compliments of Krys and Mercy's cook Ate Lori. Also, the YWAMmers that help out every thursday brought and grilled fish.. the whole morning was just amazing. My favourite part was afterwards though, when - after a morning of conjured up awkwardness - they all flOOD to where Lois and I are sitting with smiles of recognition to ask personal questions about their pregnancy or hand in their required labworks and the chaos of it all and the girls calling me miss jenna or ate jenna or maam and Lois doing most of the work while i just sit there and marvEL at it all... ahhh man. It's just great!

mga cONTinuities.. =S

Since July 3rd I've had not one, not tWO, not thREE, but fOUR continuities deliver!! THe latter three have actually been in the past 3 days!! CRAZINESS.

The first delivered July 3 @ 12:30am - taken on as a continuity because I had already done a random 4 prenatals on her, and thought it must be fate (char). THIS one took the longest, and tested my patience...although her vitals were always so good and normal, she was only progressing at about 1cm every 3 hours. GOOdness! I spent over 20 hours straight with her at the clinic, starting at 8:45am in the morning, seeing 2 shifts of midwives come and go, and fINally on nightshift, and with a little encouragement and mORE than a little help from CS, her second baby boy came out at 2:30am very normally. Her last birth ended in an episiotomy, which split open this time, but other than that, a very normal, uncomplicated birth!

The second delivered July 19 @ 3:05pm - taken on as a continuity at 9 months because her husband, who happened to be my motorcycle driver that day asked if she could deliver at Mercy. She'd been prenatal care elsewhere, but was so thankful to be allowed to deliver her baby girl at Mercy! It was a thE best birth I've seen for a primigravida - so smooth, and fast, and easy.

THe third delivered July 21 @ 12:36pm - taken on as a continuity because she was Allison's cont last pregnancy, plus was scheduled for EPO (something to naturally stimulate labour) on July 22 because she was postdates. BUT, praise the Lord, EPO wasn't needed, labour started spontaneously, and went as fast as the last time (hahaa, supposedly AR had mentioned something about not being sutured the first time, and therefore her pwerta was big enough to facilitate a very fast birth! She was very proud of this fact and told me upon admission). Her third baby boy was born a fighter, with great APGAR scores and whatnot.

The fOURth delivered July 22 @ 2:42am - taken on as a continuity because she dazzled me early on in prenatals (and she has the same name as one particularly dear to my heart, aND the last name of a friend here in the phils - I wanted to ask if it was a relative of some sort (it wasn't)). Michelle delivered her first baby girl after a night of praying she wouldn't need to be transported due to fetal tachycardia and borderline high bp. She opened at a rate of 2cm per hour - twice as fast as normal - and pushed like a champ. So much so, that she had a third degree tear, and we ALmost transported the suturing, but dear Ate Susan came on shift jUST in time to stitch her up. What a great night!! Michelle (pictured above) is such a sweetheart!

The right words...

can never be adequately expressed thru words spoken or words written. How can one ever say goodbye to a lifE so unknown at first and yet created and sustained merely through the relationships of strangers turned frienD? I can't really think about it, without a dark shadow settling over my head with, dare i say, a few rain clouds in and amongst. These girlS have shared this experience with me- together w the uncertainties and fears, lumps and bumps, hurdles as well as successes...2 years is more than enough time to get to know a person, especially when you're living together. But now they're gone (well, 3 out of the 6) and life in the philippines will never be the same again. These girls are now, and will forever be my friends slash co-workers slash sisters. To the above mentioned, please grasp the true amount of bonding bonding that has happened here, and always remember NISM'08 (hOW could you nOt, right ;p). And to enD- one thing you'll nEVER miss about the pilipines, the inevitability of public urination!! haahaha char. i love you aLL.

HAPPIEST EVER 1st birthday dear Alexis Joy Patricia Konkle~~

there's NO good way to celebrate your life thus far when I'm thIS far away... anything and everything I come up with to send you pales in comparison to the actual tIME I wish I could give you - time spent just hanging out, getting to know each other, building relationship [blahh, i'm going to make myself cRY!] I didn't even feel like calling, like I can do with so many other ppl's birthdays, because you can't hardly speak! Just know that I'm thinking of you, and love you.

FIL Supervisor Appreciation Night!

Last night we prepared tortillas plus all the toppings for burritos, and served the supervisors that have welcomed us, put UP with us, taught us, and affirmed what we know in the BIRTHroom over the past two years. There is really NO adequate way to repay them, or express to them just how much they've given us - not including their laughs and friendship that has made it all that much more special.

After dinner we let them relax and watch a slideshow of all the pics accumulated over the past couple of years (it was a loooong slideshow, and a gREAT conversation piece ;p) WHILE we gave them foot masssages, did a foot spa and pedicures for them! hahaaa, they lOVEd it! It was so fun to watch their faces, and hear their expressions as we worked! If I were leaving soon, i DEFinitely would have cried...gOOD thing I'm staying on for a few more months, which will probably only make it harder to leave but..

ESTILLES, Amelita

- 41 year old
- G11P10L7 (this is now her 11th pregnancy, she's given birth to 10 children (aka no miscarriages), 7 children are still living)
- Due date is toDAY! (the baby is now 40 weeks)
- She has zero labwork completed (a requirement to delivery at Mercy)
- She has a 27 HCT (dangerously low, and indicates anemia)
- She's been experiencing false labour already...promises to bring her lab results in tomorrow and will take the iron supplements I gave her this morning. She hasn't come for prenatals since her first visit, and nOW she's in danger of not being sufficiently prepared, being too unhealthy, and/or being transported for any of the above! She needs prayer!

Someone who has had thIS many babies is already at risk for so much in labour and delivery, including hemorrhage, which can be controlled, but the ramifications of such blood loss with her already depleted system - goodness. I'll admit I'm scared to be called-in for her delivery..

OTHerwise, she's SUCh an amazing lady - the kind who demands the attention of an entire room because she's had so much life experience and is exploding with joy to tell someone (and everyone) about it! She speaks visayan a million miles a minute, even though she knows i'll understand her more thoroughly if she speaks slower...she's just too excited, and has sO much to say she has trouble getting it all out at once!

Please remember her today and in the near future, and hopefully there won't be any complication in labour and delivery and postpartum.

The week AFter graduation:

Just to give you a little TASte of why I haven't been updating blogs, or answering emails, or writing letters (LIKE I have ever sent much snail mail before but) thIS week was nUTS! I don't think I spent more than an hour at a time at home this entire week =(
MONday - Grad
TUESday - newborn screening training and "appts" in the afternoon
WEDnesday - prenatal clinic, plUS had a continuity in labour (pictured above)(w her for 18 hrs at the clinic- starting at 8:45 through dayshift and swingshift and she FINally delivered at 2:30am- we're into THURSday now).. slept for 3 hours and then had
THURSday - Agdao prenatal clinic, shopping, goodbye dinner/evening for Kuki (going back to Singapore)
FRIday - dayshift, caught another baby, cooked for a goodbye party for kAYE (going to Japan), hAD the goodbye party
SATurday - Samal PREnatal OUTreach (a new venture I'm more than a little excited about), went paintballing, thEN had nightshift
SUNday - caught another baby (end of nightshift - that makes 3 babies in 4 days..), met ppl at the mall for lunch, hung out, bought a wATCh (yes, mom!! I found one!), and just got home around 9. I should go to bed...

NISM'08 Graduation Ceremonies ~

"Midwives sila gyud!", "Midwives na sila!", "Ha-happy GRADuation" - have been just a few phrases floating around these past couples of days. We're DONE SCHOOL!! Yea-hey. I'm not so sure I believe it yet but, dO feel like if in a situation on a plane where some unsuspecting woman were to go into labour, I could boldly and proudly say "Don't worry, I'm a midwife!" ;p (we miss you sw). In addition to receiving my diploma, I also was awarded Excellence in Attitude and Service (thanks to mishewah for making that possible ;p). The ceremony was soencouraging, Matthew gave the commencement speech, there was singing, swimming, eating, and fellowship.
CONGRATULATION GIRLS - we did it!!

and we aLL PASSED!!!

Krys texted us saturday night, during our "grad getaway" saying "would it help the grad party if you knew you ALL PASSED?!?" We had been swimming and upon drying off and checking our phones a whole nother celebration erUPTEd!! my goodness...the weekend was awesome. Just such a good time hanging out, solidifying memories and relationships, eating and eating, and i think we even managed to not burn ourselves to a crisp! Reddened faces wasn't such an appealing thought for grad photos! THe ceremony is toNIGHT!~ more to come..

The FINAL EXAM - is OVERRR!

We'll get our mARKs back on Monday :D - AFTer the bEACh! ;p

OUr last week as students!!

Ok, ok so THIS pic isn't a pic of my classmates here at Newlife, BUt it IS just one of the many things i've been uP to recently...

LIFE has been inSANEly busy these past couple of weeks, as you've probably noticed by the lack of updated blogs...THIS Friday, June 27 marks our absolute final exam - testing EVERYthing et al. of what we've learned these past 2 years. And, it's been a tRIP - let me tell you that. NOT only have I acquired an amazing hands-on education, i've come to know 5 other amazing women along with it. The girls in my class blESS me dAILY, as in (which, is THIS country means "to the highest level!").

I've been hanging out with these amazing fils a lot lately...1st birthday parties (the biggest celebration in this country), going out to eat, going to the park, hanging out, getting to know each other's cultures and families, etc. It has blEssed my heart in more ways than onE!

And, i'm SOMEhow (covering shifts and whatnot) working EVERY DAY this week - which rEALLy cuts into studying time, but I'm confident the exam Friday will go well (you could pray for that, though!) AND THEN, the girls and I have a huge beach weekend planned...sleeping out under the stars, we've already started food preparations, Lois has a big check list going, and plans for celebrating our graduation. The actual graduation ceremony will take place the following Monday, June 30th - to which we'll all be sun-kissed and refreshed from the beach!

SPEAKing of celebrating Grad, my mother and FAther sent a package to help commemorate the event! It was so unexpected and incredible to receive!! [thank you both very very much!]. I'll be posting pics of all of this commotion soon!

[at long last!] our DIAMOND anniversary~

My graduating class of 2008 celebrated reaching 75+ handles yesterday. The original plan was to have ultrasounds done on our uterus' (because we make our girls get'em, we thought we should try it also!), but weren't able to coordinate that with our consulting physician. SO, we went to the mALL and got halo-halo (the one and only true filipino dessert). We were playing president in the food court and enjoying our halo-halo until a security guard came up and told us management prohibits gambling (aka any type of cards) in public places... yIKES! hahaa, we quickly put the cards away and got OUTTA there!

AND then, we went to a cheap bowling alley (yes, each player can bowl a round for $0.25)...which is aLways a good time just before dinner! After which we crammed into a jeepney with maybe 10 other people we didn't know and got a ride to another part of town to try out a new Indian restaurant.

Lois (the indian cuisine EXpert) chose what we'd share for dinner and it was inCREDible! The owner is an Afghan who was born in Indian and raised in CANADA! That's right, Toronto actually! He graduated from McGill with a business administration degree and married a filipino a while back. It was SO nice to hear him talk of home - Niagara-on-the-Lake and the Shaw festival, and peaches, and whatnot...oh goodness, I asked him to stop so that I wouldn't start to crY!

....meet Jhuliana, just another cUTe baby i had the privilege of delivering.

The commencement of our AGDAO Clinic -

This, the 5th day of the June, 2008, Krys, Jenny, Lois and I headed off to the Four Square Church in Agdao for the very 1st day of the prenatal clinic I'm starting in that community. We were there for 8am...the signs all said 8am start time...and we waited... =D - four very capable midwives (one highly experienced, and the Di-RECT-or of the largest lying-in clinic in all of the Philippines) - ready to POUNCe on the very first pregnant lady to walk through the door! hahaa, that miGHt be a little bit of an exaggeration but, I was nervous enough to actually feel that way!! I was pretty sure I had everything ready - we'd brought a bed and mattress in the day before, I had copies of forms, stethoscopes and bp cuff, a fetoscope, TK's Doppler, alcohol and cotton, lancets, capillary tubes, folders, and pens, etc, etc. Not that I had to go to great lengths to obtain ANY of this (Mercy clinic is our neighbour and is funding this little operation). But still. I think the first lady walked in around 8:30ish, followed closely behind by our second patient! They starting filling out forms and things picked up from there!


Krys was gracious enough to step back and watch us do our thing, while still willing to totally help out and answer any questions that faced us. Jenny and Lois were SUCh a big help (hahaa, even though we only actually did 5 prenatals- which is NOthing compared to our prenatal days at Mercy seeing 60+ women daily but - it's a start). Two of the five girls have already had an initial prenatal at Mercy, but would rather just have prenatals done closer to home, plus they don't have to wait with all the other women at Mercy.

ANother fun thing about the day was the eager pastor of the church, Pastora Nora, kept going outside and inviting people in, even if they weren't pregnant, EVEn if they weren't women, to have blood pressures checked and hematocrits taken! As such, here is a pic of me, serving this new prenatal clinic by giving these old men a check-UP! It was so fun. We were just able to hang out all morning, talk, and have merienda (snacks =D).
But THE COOLest event of the morning came with the patient pictured above. She walked in saying she didn't know if she was pregnant or not, but that she'd gone without a period for 3 months but had been bleeding heavily for about 7 days now. THEN she says, I had my son at Mercy last year. When we asked who her midwife had been she couldn't remember BUT then said that the midwife had NAMEd her son... BRY-den LIAM! I just sat there for a minute, to let it sink in! hahaha, IT WAS ME! I had been her midwife! After looking back, and reading what I wrote after her birth, I totally remember...the baby had come out in ROUGh shape, blue, limp - it was the most dead baby I'd ever seen, let alone delivered (it was only my 11th birth). We transported him right away, and I just sat there with the mother, watching her stare straight ahead after having her first born son whisked away from her. I focused on making her comfortable, if nothing more and we started talking..after which, she asked me to name her baby. SO BRY, this little boy is named after yOU! Cool eh, i can't believe we ran into her again! [As it turns out, she's MOSt likely just had a miscarriage, but didn't want a baby now anyhow, so is kinda ok with it - times are tough right now in the economy here, rice is at an all-time high price, etc].

ANYways, it went SO well. And I am SO excited to hang out there every thursday...these girls are now my continuities! Most are due in September but that's ok, because that gives us a while to get to know each other!

continuity - delma FELIX

Came in this morning at 3:20 and was 4cm at 3:45am...i was called out of bed. And it was a SUPER busy night shift (including transporting a breech), and the poor girl had to listen to 3 other women come in "fully" and ready to push and have their babies. Her husband kept counting as the babies kept poppin' out. SHe needed an IV because her blood pressure was borderline high. She was wanting to push around 8am but was only 8cm - the head still very high. I got her to walk stairs and do other exercises to help bring the head down the birth canal. THe flood gates opened at 9:32am as her bag of waters burst. At which point the head was visible and baby slid out at 9:39am. The baby boy, weighing 3.42 kgs (7lbs. 9oz.), was named John Paul F. Mamontayau - her second son (and she's ONly 19).

This week is SUPER SUPER busy. WIth one last review test before the final, AND the Agdao prenatal clinic is starting up THIS thursday. I'm heading up these prenatals, and all the girls will become my continuities...AKA from thIS thursday forth my life is not my own! Any second one of these girls could go into labour, or be having problems with their pregnancy, or postpartum and its my responsibility to be there as their MIDwife. This is the real deal... i think this is more of what it's like to practice as a midwife in Ontario (which might nOT be such so enticing anymore). But, we'll see. My prenatal clinic (run under supervision and with the HELP of MANY at Mercy, of course) will be every thursday at a church in the Agdao community. A lot of people i've talked to already are SO excited to get involved...it's really cool to see! I'll have pics next post of thursday morning..

Joecel Madula and her baby Jaiden Kyle

Last 04-10-08 Joecel came in to deliver her first baby...we did a lOT of exercises throughout labour, and really bonded well during that time. She had had a cold for about a week prior and sure enough, as ALL the textbooks warn, the baby came out with signs of infection (temp, high resps and HR). We referred him immediately and he had to stay in the hospital for a week due to pneumonia.

When I went to visit them in the hospital and finish the paperwork for the birth certificate they STILL hadn't thought of a name for their son! And I was like "WHAT?! IT's been 3 days already, you need a name!!" She said she wanted ME to choose! Which, is SUCh an honour, but ALSO a big responsibility - naming a child, a 1st born son, no less, is not something I take lightly! THey'll have that name for their enTIRE life! I thought about it for a few days, and came back with suggestions that were both nice and sentimental. They ended up going with Jaiden Kyle =D - in honour of another Jaiden i know, and the kyle because the first 2 letters spell JK!

I LOVe my job..

SOMEone once said,

“I've learned that everyone wants to live on top of the mountain, but all the happiness and growth occurs while you're climbing it.”

And THAT was DEFinitely true for me...guys, seriously - I've never done ANYthing like this before in my life, and I feel like I've done a lot of hiking and camping and whatnot but GOODness, it was an inCREDible 4 days. A quick rundown - it RAINed the first 2 days climbing, and we got a little behind schedule but I liked it that way (for one because my thighs were dONE for after hiking uphill for 5-6 hours the first day) and I really just wanted to enjoy the whole experience, you know, not rush things. The 2nd and 3rd night we stayed in a "bang house" (pictured below). We weren't able to camp closer to the peak because of a storm. BUT, the 3rd day the sun shone (i got burnt) and we were blESSed with blue skies hiking to the top of the kidapawan peak. Actually, a few of us got separated from the group and ended up climbing up the wRONG peak (davao peak), but it was cool because I got to see Samal Island and its accompanying Talikud Island from above, and eventually made it to the other peak, after a search and rescue from our guide (i'm exaggerating a bit). The entire 4th day was spent climbing down down down.

I really can't describe to you the feelings associated with hiking Mt Apo. It was all-terrain, sometimes we'd be walking a skinny dirt path in the middle of a jungle, and other times we'd be forging a raging river, and then have to scale a short rocky cliff, not to mention climbing hundreds and hundreds of manmade dirt/root stairs. Some parts reminded me of hiking in and around the Niagara escarpment, which was SO nice. AND, it was frEEZing - def. in the mid-teens, i think...plus EVERYthing was wet, ALL the time (even when it wasn't raining). Putting on cold, wet clothes at 6am in the morning sucks for the first few minutes, but once you start climbing, all thoughts of comfort and luxuries fly out the window. It was amazing. And, of course, it's ALways about the company your with - we had sUCh a good time hanging out in the tent, while it rained or winded around us. THe fOOD went SO well - I didn't have to worry about refrigeration! AND, another completely different part about thIS camping trip from any other I've been on was there are NO bears! Or any OTHER animal for that matter, so we didn't have to worry about putting food and such away at night. There were rumours of monkeys, but I never saw one!

Fresh springs offered fresh cold water in the middle of the trek.
We lugged fish, grilled chicken for curry, ground beef, aND pork adobo UP the side of the hill! Everyone was fairly satisfied before retiring to their tents.
The eerie fog and frigid cOLD of Lake Venado, a plateau about 8000 ft up Apo.
We had to cross this river 6 times total, as the trail curved through it when needed.
If there were no logs to shimmy, we'd forge through (already wet from the rain, it didn't really matter hOW wet we got).
A higher view of Lake Venado (an extreme difference in scenery when the sun cleared the fog and rain). Richard and Rachell (Joan and Genesis' friends) flew down from Manila to conquer the hIGHEST peak in all of the Philippines.
THis is on the plateau again, going to meet the only other climbers at the time. They had set up camp on the other side of the Lake.
At the kidapawan PEAK!...there was SO much of NOThing up there - except for the WINd, and the VIEW (which still takes my breath away). It was such a different climax of anything i've ever waited in anticipation for, but it was good.
Friday morning, back at the tourism office. The government regulates the amount of activity going up the mountain by enforcing a fee (extra for foreigners ;p). This also makes them aware of exactly how many climbers there are at a time, and able to search and rescue, if need be. They gave us a certificate at the end.

MOUNT APO - the tallest peak in the Philippines reaching a whole 9,691 feet above sea level, this volcanic peak (Apo, meaning "grandfather"), dominates 72,796 hectares of the national park where natural wonders bOW before thE towering peak.
and I am going to cliMB it =)

We (a team of approx. 12 ppl including guides) start super early monday morning may 12th, spend the day climbing to a (supposedly) freezing lake and flat ground where we'll camp for the night. THe second day will take us to the summit. The anticipation of sleeping there is ALmost too much to bear! Early Wed. morning will be spent viewing thE most beautiful sunrise (I'm sURE) I've EVER seen, at which point we'll hike back down to the lake to spend another night there. One more day will take us back down to the bottom, but we'll stay over (sOMEwhere) one more night in order to be there Friday morning when the office opens - this is to secure a certificate verifying we trekked the second highest mountain in all of southeast asia! In total it'll take the week, 2 days UP and 2 days down. I guess I'm planning the food.. we'll have one little gasul burner - dry wood is scarce. And. I don't know how to incorporate rice and canned corned beef into every meal - as per request =D hahaa.. it's going to be so much fun.

a bit of lIFE outside clinic walls -

Some of my friends take the fun (and art) of karaoke very seriously. This is at World Palace, a whole building of rooms done up in different themes from around the world to accommodate its tone-deaf customers! We rented the CLOUD room full of puffy cushions made out to look like we were floating on a cloud! IT was pretty cool.. and we sand our windpipes hoarse =)

This pic was taken at Gardena Fresca, in Matina. Tiffany is delivering Cathy's baby and threw her a baby shower here. The fun, food, and games made for a very successful baby shower! aaaaand, when Cathy delivers, Tiffany asked me to be the assist! Which is cool, because Cathy isn't just another patient, she goes to our church and has a caucasian husband.

In the middle of last week we all packed in the Germains jeepney and took a day trip to Samal Island to visit Hagimit Falls. It's an incredible place where you can jump into different pools of water that the rushing water have carved out.

And, who can forget IV-insertion class?! Not me, especially when I have 2 gross bruises on the back of both my hands, one goes down onto 3 of my knuckles - it looks like I've been duking it out with something/one. The first-year students had this class, and a few of us were asked to "supervise"! It was really fun, and also very successful...after 7 some odd pokes =) (TK's a rock!)

Update from the birthroom - we had [surPRISE] TWINS born at the clinic last April 16th. It was during a dayshift that the unknowing patient came to the clinic already in active labour, and ready to push! Naomi, a first year student, quickly got things together to facilitate the birth. Krys was supervising at the time, with Ate Elsa assisting. The mother had a normal size tummy for a pregnant, full term baby - there weren't any signs that would lead one to suspect a multiple pregnancy. I had even done one of her prenatals, a few months back but couldn't determine the position of the baby (nOW i know wHY!). THe first baby slipped out weighing 5lbs. 5oz... when the patient's stomach still looked pregnant, Krys checked with the Doppler for another set of fetal heart tones inside, and sure enOUGH, another baby was waiting to be frEE! Krys ran to get another filipina supervisor while Ate Elsa double-clamped and cut the cord of the first baby. THe mother pushed again and the second baby fell out, weighing a mere 3lbs. 5oz. [both baby's were born in the caul]. THANKfully, everything went ok - the mom DID have to be transported after a few hours due to continuing bleeding but she got to spend time with her babies first and also Naomi was there to care for them. They hung around the clinic for almost a wEEK while their mom was in the hospital! - basically FAMOUS in Mercy circles, we started calling them bean-sprout and sweet-pea =) ...so thEN the mom gets out of the hospital and her and her husband pick the names Swheety and Cuttie (pronounced like sweety and cutie) for her two new daughters. GOODNESS! hahaha, what fun we have here in the phils!
It's a crazy feeling to hold something tHIS small and fragile. But, they are both thriving (thanks to a little wet-nurse action from Naomi and the love and care everyone has been showing to them). The family is now at home with their TWINS, and Naomi is going thERE for baby check ups, instead of having the mom pack everyone up to come to the clinic! But SERIOusly, as a midwife, you wait and wait and wAIt for the chance to see something like this...and i miSSed it! Sayang!