Thursday, May 13, 2010

Last day!

It's so hard to believe it's our last day here! I can see why people recommend staying 6 weeks if possible. It feels like we've just gotten adjusted to being here, and figured out how things work at the hospital and gotten comfortable with it, and now we're leaving. It will be really great to get home and see everyone! Not really excited to go back just in time for an entire week of class though. 

I was thinking over everything I've seen and done here. I've done some suturing and feeling a bit more confident about that. Also watched a student OB/GYN repair a tear that I wasn't sure what to do with, so it feels good to add that piece of knowledge to my brain. Dealt with some bleeding without feeling freaked out about it, and lots of mec, and babies that needed some serious stimulation, and all without someone looking over my shoulder to make sure I'm doing it right, so that feels good. I've started some IVs and done Syntocin augmentation. A few babies have died since we've been here, but none that were in our care. Basically I'm feeling much more confident in my abilities, which was really the point of the trip, so I'm really happy I came!

About to head out for some kava, followed by dinner and drinks with some of the friends we've made here. Then off to the airport in the morning!

Wednesday, May 12, 2010

We've been spending lots of time at the hospital this week. Lots of babies! I've caught 1 girl and 3 boys so far, and assisted with a few others too. I think the girl was actually named after me, which apparently is a fairly common practice. Today we spent the morning at the hospital and then took the rest of the day off, since after a few morning babies there wasn't much more going on. We took a kayak from the resort down to the lagoon that's below it and paddled over to another resort to lie on their beach and on their lawnchairs by the pool. To get to the lagoon we had to go through a village. It seems that there are many villages in Vanuatu, and you typically need permission to enter them. One of the Ni-Vanuatu employees here helped us take the kayak down to show us where to go and take us through the village. It was basically some lean-tos for a few families, and of course a big clothes line with clothes hanging up to dry. It was a bit weird to be walking through there with a kayak. Random side note: people who come to the hospital wash their own laundry in the utility sinks outside and hang them to dry.

We went to the free outdoor movie tonight at Nambawan Cafe. It's such a great venue, with a screen set up right in front of the water outside of a local restaurant/cafe, and they serve their full menu and popcorn and drinks throughout.

It's hard to see in the dark, but this is the movie screen with the water in the background.

Going to the hospital again tomorrow, and then I think we're taking our last day off to enjoy the last bit of Vanuatu that we can. It's so hard to believe we only have 2 more days here before we come home! It feels in some ways like it's been so long since we left to come here, yet it feels like we've barely been here at all and saturday feels really soon. 

We just ate some delicious bread that we got on our way home from the little store around the corner. They have all this amazing fresh local bread. The one we got is super soft and a little sweet, so good! We also got our last bit of produce from the market today, an avocado and 2 fruits that we were told are called nouse? Not sure about the spelling and Google gave me nothing. They look like a mango and have a pit in the middle, but taste sort of like a cross between a pear and an apple and... something. Really light and refreshing and crisp.

I'm really excited to come home and see everyone, but sad to be leaving here too.

Sunday, May 9, 2010

I'm way overdue for an update here. Caught an adorable baby girl today at the hospital. It wasn't Mother's Day here, but it's Mother's Day at home so I suppose that's close enough. :) We went in to the hospital twice yesterday but there wasn't much going on. We got lots of homework done though, so that was good. I finally got a bunch of work done on my senior paper presentation, so I'm happy about that!

Ok, this is kind of gross, so if you're sensitive to that you may want to jump ahead to the next paragraph. It's normal for women to pass stool while pushing their baby out, lots of them do. We just wipe it away and move on. The one today had a big worm in her stool... I just pulled it out, tossed it in the garbage, and hoped there wouldn't be any more. Ick, that was a first.

We've been seeing a lot of meconium stained fluid here. It's strange to deliver a baby with thick mec, because we just don't do that at home if we can avoid it. A lot of babies get suctioned, some serious stimulation, they cry a bit, and then that's it. It's interesting how many babies just cry for a brief moment, then go to the warmer and just lie there quietly. The babies just don't seem to cry much here in general, except when they're getting their 3 shots (Hep B vaccine, TB vaccine, and vitamin K).

A few random observations:

People tend to just hang out on the edge of the street. It's a little disconcerting at first to be walking by groups of guys hanging out on the street corner, but then you realize that it's just what everyone does.

The streets near our lodging and the hospital seem to be a bit more poor than most of Vila... at least that's my impression from all the walking around and riding buses that we've been doing. Couldn't say about the rest of Vanuatu of course. Many homes in general seem to be put together with random found materials and have dirt floors. The street directly across from Tradewinds is interesting in that they seem to have their cooking/eating area in the little strip across the street from their homes. 

There are random chickens and scrawny dogs everywhere.

You can say hello to any Ni-Vanuatu (native Vanuatu) and they'll say it back to you.

People from Australia, New Zealand, and the like don't seem to be especially fond of Americans. Not that they treat me poorly, but they do tend to make negative comments about Americans in general, especially before they've found out that I am one. I guess I've heard that people don't like Americans, but I wasn't anticipating that.

There is not much tequila to be found here. Or fresh milk, it's all in aseptic boxes. Fortunately they also have boxes of soy milk, since I don't drink regular milk anyway.

The fruits and veggies at the market are cheap, but pretty much anything in the grocery stores is expensive, even more expensive than home sometimes. Eating out is surprisingly pricey too.

They have surprisingly good espresso here.

There is not a single stoplight anywhere that we've been.

There are apparently not any poisonous snakes or spiders here, and the bugs aren't bad either although there are enough that I'm glad for our screens. There are a lot of tiny little ants that like to crawl on the kitchen counters though. 

I'm really thankful for this experience!

Monday, May 3, 2010

A concert on the water, HIV/AIDS training, a white sandy beach and an earthquake.

Yesterday we went over to Iririki Island Resort because we had been told there would be a reggae show at noon. Sara loves her reggae! The little ferry to Iririki leaves right from downtown Vila. Iririki is a big, beautiful resort with all these amazing pools that run into each other, and a nice restaurant and bar, and lots of tourists from Australia and New Zealand. There were lots of Ni-Vanuatu people and some from Fiji as well that came over for the show. The stage was set up right in front of the water, which was an amazing backdrop for the show. They had a few food items as well as Tusker (the local Vanuatu beer) for happy hour price. so of course we had to take advantage of that. After a few episodes of sprinkles/threatened rain, the music finally started. Turned out it wasn't a reggae band at all, but the Vanuatu, Fiji, and Solomon Islands Idols. They did a variety of music with only 1 or 2 reggae songs and even a country song, but that one just didn't sound right. After the show, this guy walked up to us and asked if we were American or Canadian because of our accents. It turns out he's the head of the Peace Corps here and is American but has been living here for many years. He told us they were having an HIV/AIDS training about educating the community all this week and invited us to come! It's interesting the connections you make when you least expect it.

This morning we went to the training, which turned out to further out than we anticipated. We were told to go to Honeymoon Beach, and it would be right across the street. Getting there involved going out of town, down continuously more narrow and bumpy roads full of crazy potholes, in a bus (which are vans which will generally take you wherever you ask them to) that seemed a bit rickety to begin with. Fortunately there aren't too many buildings out there, so it didn't take long to discover that it was being held in a large community room at a campground. One thing we hadn't been anticipating was that they were all speaking Bislama. Fortunately we've been working on trying to learn some, and it's close enough to English that you can pick out a fair amount. The native English speakers are so much easier to follow because they speak it more clearly and precisely. Since it was a subject we're familiar with, were able to understand enough of what was being said to follow along. They gave us a binder full of fliers and info and articles, pretty much all in Bislama too. Fun!

After the training, we went over to check out Honeymoon Beach. Apparently it's one of the few white sandy beaches in Vanuatu (or this island at least?) It was beautiful and completely deserted, just this little strip of beach. There were a few small shelters that must be used for wedding ceremonies. We saw lots of little crabs, and some bigger crabs, and I saw a little sea snake too. Then down the beach there was garbage - tin cans and pieces of metal and plastic, and apron and a shoe and part of purse. Such a shame. When we left we had to walk up the road a bit to catch a bus. It was a bit like walking down a road through the jungle.

Sara wading in at Honeymoon Beach

We tried a new grocery store on the way home - Au Bon Marche Numbatu. Bislama is very phonetic, that would be Number Two. It was much bigger than the other one we've been going to, and actually had some good fish. Fish has been surprisingly hard to find here, at least some that we'd want to eat. We got a big, wonderful looking tuna steak for about $8! Just ate it for dinner, yum.

We actually just felt a small earthquake a moment ago.  It's funny, I had just been thinking earlier today that earthquakes are supposed to be common here, but we hadn't felt one yet. It was just the slightest shaking and didn't last long.

Back to the hospital tomorrow!

Saturday, May 1, 2010

A few pics of the hospital

Wall outside the maternity ward

View down the hall of the maternity ward, where laboring women are often walking and leaning against the wall.

Room where babies get weighed, bathed and immunized. The big blue cooler holds the Hep B vaccines.

Days at the hospital

We're way overdue on an update!

The first day at the hospital was rather overwhelming. It's so different that what we're used to of course. They had several babies born early that morning before we got there, so we only saw one birth that day. The midwife asked if we wanted to deliver the baby and suture, but we wanted to watch one of the local midwives do it at least once. They have their own routine there so we wanted to observe their way of doing things. They have 2 delivery "theaters," and each one has 2 delivery tables. The 2 rooms are connected in the middle, so you can hear (and partially see) what's going on the other room. The women are admitted when they are contracting regularly and are are at least 4 cm dilated. They are assigned to a labor bed and either labor there or wander the halls until they are really moving along and seem to be getting closer to pushing. Then they move to the delivery theater. Their standard procedure is to do active management (give medication to prevent bleeding after the shoulders are born), then give additional medication to prevent hemorrhage a short while after birth - ergometrine (methergine) if her blood pressure is ok, or more syntocin (pitocin) if it's high. Personally, I feel fine with following their protocol on this, as they don't have someone checking on their bleeding to the degree that we do at home. There just isn't the staff and the time. Also, I don't expect that they will be able to rest after they go home the way we expect our moms to at home. They seem more likely to repair tears here than we might be inclined to as well, but it seems like that's probably a good thing.

Our second day at the hospital was pretty crazy. Apparently this is a busy time of year for them, as their independence celebration was 9 months ago. :) We had several women in labor and only 2 staff midwives working. 4 women delivered within a short time of each other. Sara and I each caught one baby, and the midwives caught the other 2. I was assisting Sara while we waited for the other lady in the next bed to start pushing. We had a kind of scary moment where Sara's lady was bleeding, she had gotten her injections and her uterus was firm, but she had been bleeding before the birth of the baby's head so we suspected vaginal tears. I was holding pressure trying to reduce the bleeding while Sara went to find someone to assist and suture. It turned out she had quite an extended tear on both sides that the docs came in and sutured, using multiple suture packs, but it only qualified as a 2nd degree tear. Nothing poor Sara could have done to prevent it since it was inside, but she still felt bad. The thing about the suturing they do there is that they use 1-0 suture (much thicker than what we use), and they do interrupted stitches on the outside of the perineum. Sara referred to it as "Frankenstein sutures." (ok, I think she actually said Frankenstein crotch. nice.)

Day 3 at the hospital was just a crazy as the day before. It started out seeming more mellow, but once again we had 4 women close to delivery at the same time. I was with a young woman having her first baby. She actually told me (through her wonderful family support ladies) that she wanted me as her midwife... after the local midwife had given her a rather rough cervical check. Sara caught the babies of 2 multips in the meantime... it's kind of crazy to be in the next room able to hear what's going on, and not be able to go assist because the woman in front of me is close to crowning, and no one is there supervising me. I had a student doctor from the UK assisting me though, which was great. So nice to have an extra set of hands, even if she's new to the maternity ward! Her perineum was so tight I was afraid she was going to have a bad tear, but she only had the tiniest one. She did have a few internally that I sutured though. Again, a bit surreal to do that without supervision!

Today we needed a break, so took the free ferry over to Erakor Island to lie on the beach for a while. The water was really shallow around the island and there were starfish everywhere! It was very nice and relaxing and beautiful. Really need to take some pictures of normal island life here though, it's not nearly and lovely and gorgeous as the pictures so far might suggest.

Monday, April 26, 2010

Day 2 (Hideaway Island and snorkeling-Kylas first time!!)

Here we are, day 2 of our adventure in Vanuatu. We arrived yesterday bright and early at 1am. We were greeted by an amazing string band at the airport (not just for us-but I am a big reggae fan so this music is awesome) and a man holding a sign saying "Grundie" that was taking us to our hostel. haha! Just when I thought I had a funny enough name already...

We arrived at our hostel, Tradewinds, that is probably the best hostel I have ever stayed at. You walk in and there is a pool and a beer pong table. Er I mean ping pong table and barbeque right beside it. In fact, Kyla and I are bbq'ing some local fish called...uh...actually...I forget what its called but it was right beside the reef fish at the market. Oh, Kyla just said it was called Cherry Perch. I thought it was Sunny Fish. Close enough.

In our bungalow is a kitchen, bathroom with a big shower and 2 twin beds and a couch and tv and dvd player. We have everything we could possibly need. We are very lucky. Being here really opens your eyes about HOW lucky we actually are. I always knew that money doesn't buy happiness...and that is truly evident regarding the Ni-Vanuatu people. The hostel is right in the middle of the village and local huts and small houses surround us. The roads are dirt and there are clothes hanging everywhere and chickens, ratty dogs, and children running around everywhere. The kids are so sweet and all say hello when we pass by them. It feels weird to walk by them today with our snorkel equipment in our white foreigners. :(

Despite how poor people are here...they seem content and very nice. Today, was a wonderful day. We went snorkeling at Haidaway Island. A bus ride is taken (the buses are small vans) to a spot where a boat docks and then it takes people over to the island. You have to pay a fee to get on the island, but we got a reduced rate due to being volunteers at the hospital. We haven't actually made it to the hospital yet but we plan to go tomorrow for our first shift. So, we decided that we were going to make the most of another day off before going to "work". Snorkeling, and just hanging out on Haidaway was amazing! The local beer called Tusker is also really good. We may have been indulging just a tad. Now, we are about to eat our fish with an avacado and mango salsa Kyla made from the produce we picked up from the market. I could actually write a whole otehr entry on how much I loved that market. Fresh massive avacados for 30 vatu (30 cents) and so much other yummy stuff that I had to ask what it was. The lady would just look at me and go "huh?" They didnt understand that I didnt know what the vegetable was. So, we just bought it anyway. I cant wait to tray all the stuff we got. Pretty much that was the cheapest place/thing we have experienced since being here.

Port Vila is a city, or large town located right on the ocean. However, there does not appear to be anywhere to just walk to from our hostel if you want to spend time on the beach. So, I suppose it will be a bit of a treck when we want to do that.

Anyhoooo I better go. Dinner's ready!

Sara XO