La Guardia (Night shift) # 1

I’ve delivered four babes here now and am technically getting accustomed to hanging the baby upside down after delivering, but don’t think I will emotionally acclimate. Though baby hanging is seemingly set in stone at this point, other practices might not be so firm. I was thrilled last night that I almost convinced the team to help mama get into hands and knees for an occiput posterior baby. They were really thinking about it!!!! I thought we were about to do it, and then the mama pushed so hard and out came her sunny side up, facing directly up, BIG for Peru, baby.

My second baby catch was beautiful and everyone applauded me for doing it their way.  The mother of that mama came back to the unit during the afternoon of the next day and gave me a huge bag of fruit. Wow did that feel so nice. See photo of mama and her 2kg baby! I shared the bag of fruit with everyone. Here, everyone shares everything. It’s beautiful.

On another note, I can officially say that I have slept with an intern now. I’m not sure that was a goal exactly, in fact, I’m sure it wasn’t !!! but…  See pictures of my best friend on the L and D unit who helps me with millions of things. We haven’t been super busy on the unit, so we found a bed to lay down in. Everyone sleeps together in the few beds on the unit when it’s slow. I actually slept for a minute despite the two of us beinig squished into a tiny single bed! Also see photo of one of the Midwives who is so kind to me. They wear purple scrubs.

Though I don’t have fleas, thank the lordee, I did discover ants all over my bed. Ick! They are tiny and all over the place here. I am desperately trying to be ok with sharing my bed with them and making them my friends, but am having a hard time. (see photo of my bed and my bathroom that I have made all my own).  I have never been a bug killer, but have had to make some tough choices here... Look what I’m becoming! Killing bugs and hanging babes upside down...  

I still feel short of breath when I think of home. I have realized that these are mini panic attacks that I experience anytime I’m alone and without distractions. They are REALLY hard. Sleep deprivation isn’t helping and I had my second major breakdown.

Came into the city to call family and friends in the US. Call and Cry I call it. Like Shake and Bake, only different. Hee heeeeeee.

Came up with a plan and am busy implementing it today. Decided that one thing I need is to not work 18 hour shifts twice a week. That’s hard in the US where I have a support network and get great sleep during the day, let alone when I’m trying to learn a new language, culture, make friends, live in a room where the water comes out brown, sleep with ants,… All that stuff. I had a friend come check out my ants and she said it’s totally normal here. Vivimos en la tierra, Elizabeth! We live in the earth!

As I went to talk to the director of Midwifery today to tell him my plight, the one and only psychologist at the hospital called my name, and called my name again and again, until I realized he was calling to me! How apropos!!!! He must be goooooood at his job. I confided in him and he was so supportive and lovely. He opened his door to me and said that anything I told him would be in confidence. What a good psychologist/therapist man. This gave me more courage to talk to the director, who also completely understood and informed me that they want to support me in whatever way they can. Of course, I could possibly be making up stories in translation again J. Either way, I like the way it all turned out and I will work less hours during the week now.

Really want to find some Spanish classes to take, but haven’t had any luck. Found some salsa classes and hope to start tonight. I need to dance!!!!!

Encountered my first english speaking looking person on the streets of Pucallpa after crying in a telephone booth during my Call and Cry session yesterday. I couldn’t help but approach him for some English conversation. He is from Australia and we talked for an hour before meeting up with his two friends from Spain. We ate a refreshing dinner together. They left for Spain today. Hope to have a few more encounters with English speakers soon!

I think about how great it would be to just come home ALL the time and every single day, over and over again, question whether I have the strength to do this.

We’ll see!!!!!

Love to you all,

Beth

PS, couldn’t help myself - took my dirty clothes to a lavandaria today. Thank GOD!

Does your Husband Travel? – Day 3 at Yarinacocha Hospital

That’s right. It’s a very VERY important part of the medical history here. If your husband travels, your chart is marked with a POSITIVO in red pen. Negativo if he does not travel. What it means is that you have a much higher risk of STDs and it is their way of finding out about it. Sneaky and hilarious!!!

Today was a slow morning, but I work tonight from 7pm until 1 in the afternoon tomorrow so I will make it short. My schedule is a rotation of Manana, tarde, noche, manana, tarde, noche. That doesn’t sound so bad until you realize that EVERY day is a manana day. For example, I work every single morning Monday through Sunday from 7am to 1pm. In addition to that I work a rotation of 1pm to 7pm one day, next day 7pm to 7am, etc … So, Monday = 7am to 1pm. Tuesday = 7a-7p, Wed = 7am-1pm and then 7pm – 7am, Thurs 7am-1pm, Fri = 7am – 1pm, etc. I don’t know if I can do it and be so immersed in new culture and language…

I had a nice conversation with a midwife today who tells me that just like in the US, midwives here are trying to improve the conditions of birth for mamas. She says that there is a struggle between doctors, nurses and midwives around what positions women can and should deliver in, what happens with their baby immediately after birth, etc. She says that some midwives don’t hang the baby upside down to cut the cord, there are some that attempt to immediately pass baby to mom after delivery but they receive lots of resistance to this from nurses.

I can’t eat all the rice that the cafeteria gives me at each meal so my leftovers along with chicken bones go to the dog that lives on campus with us, Josephina or Roberta (she has two names), the mascot they call her. She gets really excited to see us.

The midwife interns are teaching me all the local slang. It’s reallllllly fun! And also really hard. I’m so exhausted just from attempting to understand and learn, let alone work so much. Woooooh!

Headed to sleep for a few hours if I can.

Found a place to wash my hands and see that some others wash their hands sometimes too!

Beth

Angels of the Night - Day 2 at Yarinacocha Hospital

Here they say that the frogs that sing are angels of the night. I’m not sure why yet. I can guess and make lots of stuff up (which is basically what I do full time now). Though my Spanish is improving, I still only catch words in sentences and then I create stories around the words. It’s pretty fun! Pema says that life is like dreaming anyway and in order to stay unattached we must perceive this life like a cloud passing, or leaves falling, or foreign chic that doesn’t speak the language so well making up stories! I told my new Peruvian girlfriends about all the stories I make up daily and they laughed and laughed. I informed them that I probably understood 10-20% of what they tell me, but that each day the percentage is growing. It’s so nice to feel like this is all ok. Like I don’t have to know every detail. What a lesson in letting go. Of course I ask lots of what’s and where’s and how’s and huh’s but usually it’s just a lot of work to really get to the bottom of it all. Better to let it all soak in, in time. “Poco a poco” they say here.

Today we received 5 babies between 5 of us. We each got one and all supported one another. In Peru, the Midwives are about half and half men and women (or so it seems thus far). They deliver twins, preterm babes, normal pregnancies, complicated pregnancies, breech babes, etc. They deliver as though they have been doing this their whole lives, have each caught at least 200 babes already and are expected to attend at least 250 births before graduating. They study for 5 years intensely before having one year of a very intense internship.  They are pros at catching babes in the hospital style to which they are accustomed and have swift and remarkable hand techniques.

Because they are so accustomed to one way of birth, I share the way we do things in the US with them, how we are attempting to transform birth in many ways, empowering with education, water births, various positions, etc and they are very receptive to the ideas, but…I’m not sure but what yet. More understanding to come. Nothing is ever really as it seems in life I am finally accepting.

One of our babies today was 27 weeks with gastrochisis born with its stomach and intestines hanging outside of his tiny little body. He is still living and doing well thus far. He was born to a baby mom of 14 years old. She pushed him out with such confusion and fear.  He has been transferred to Lima for surgery.  I send him love.

I sprayed the whole room with cord blood today and we all laughed and laughed. I am so used to waiting to cut the cord!  Now I am learning to wash the blood out of my clothes by hand with the rusty water in my bathroom... A new friend showed me how they filter the water with a plastic bottle that has cotton stuck in the top of it. Hang it upside down with your shower head inserted, and Vua La!

I have decided that Peruvians are the nicest, most genuine and welcoming people on this planet. This hospital and everyone that works here have simply accepted me into their space as a fellow human being (and midwife) wanting to learn how they do things here and share how I have learned to do things in the US. They feed me and house me and train me for free, without question. They smile at me, call me beautiful all the time, grace me with patience, never seem to judge my mistakes as far as I can tell (I especially mess up the paperwork!). When they are laughing, I never feel like they are laughing maliciously. The interns aren’t upset that I am yet another person wanting to attend births (births that would be theirs if it weren’t for me). Walking this small hospital campus each day fills my spirit with a sense of love. Peruvians seem to love, simply. They take care of their homeless dogs, their neighbors, their friends, families, and me. And I feel so grateful for it.

No fleas in my bed!

More to come!

Beth

The Trembling Earth Beneath Me - Day 1 at Yarinacocha Hospital

Spent the day with Fernando yesterday enjoying conversation, gourmet Peruvian food, and the Parque Natural of Pucallpa. It was a perfect day and just by spending the day with me, Fernando gave me the gift of feeling more at home here. Thank you Ferndando!

Today was my first day in the hospital. Threw on my cute new Obstetra outfit as I attempted to shake away the natural nerves of first days anywhere in the world. I was very kindly received by all and feel completely welcome.

Rain poured down as we received our first patient and little did I know how metaphorical the earth’s tears were. She was 12-13 weeks pregnant and began bleeding heavily this morning. We had to do a vacuum aspiration as the babe had died. Rain, rain, and more rain. Mom was anesthetized to physical pain, though it didn’t kick in so well for her, and I can’t begin to imagine the rest.

Our second patient came in at 4 cm dilated with her 3rd baby. I tried listening to babe’s heartbeat with that cone instrument (fetoscope :) for the first time and had no luck. They all laughed at me kindly and said it takes time. This mama was started on a Pitocin drip and with manual dilatation by a Midwife intern for the following 15 minutes delivered a healthy baby boy. They had me catch this baby and were confused (and a little panicked) when I somersaulted the baby out of its tighter nuchal cord instead of reducing it or cutting it at the perineum. They were REALLY confused when I tried to give the mom the baby right away instead of hanging it upside down by it's feet and clamping and cutting the cord immediately. Pitocin is standard practice to create faster labors. EVERY mama gets it (unless they are preterm). Very little fetal monitoring is done, even with the fetoscope and pit drip.  Family members aren’t allowed into the delivery rooms and women lay on their backs on an exam table in stirrups. For first time mamas episiotimies are also standard practice. Handwashing is not done nor are there resources to wash hands if one so desired. There is no waste in this hospital. Everything used is re-usable and nothing is wasted. Babies are hung upside down (as I described above) just after they are born until the cord is clamped and cut and then passed directly to nurses. After being dried and warmed they go back to mom and stay in bed with moms until they are discharged 24 to 48 hours later. Breastfeeding is the only way here and I haven’t even laid eyes on a bottle of any kind.  Good news for breast feeding!

Windows are numerous and ALWAYS open. The fresh air is SO nice. I LOVE that.

Gathered up all my things after work and loaded up a Motokar. Off to my new house. See the pictures of my incredible view of the jungle and lake Yarinacocha. The windows are in fact only screens and the frogs and dogs are singing loudly to me as I type.

As life in this new world whirls around me, the earth feels unsteady… and it literally is! We had a mini earthquake as I explored the streets near my new abode this evening. I was in a small street side shop asking about the neighborhood when the earth seriously rocked gently under my feet. “Tembloroso” everyone said as we exited the tienda to be sure not to be buried underneath it.

As I expected, here just as it is in the US and around the world, women are suffering in birth. We create the world in our wombs and then summon the strength to share it and yet we suffer so tremendously. Others telling us how we should do it, where to put our hands, our feet, our backs, our legs, stay still, just breath, relax, so many impertinent rules for our bodies, families and babes. When will we summon the forces to embrace our incredible strength, beauty and natural connection to the heart of life in order to follow our instincts in creation? And how can I be a part of helping this happen?

ON another note... I think I might have fleas in my new bed…

ALWAYS Take Note of a Man's Tshirt

Today I awoke early (unfortunately) and started my day with another yummy excellent hotel breakfast.  These are my last few days in the rockin' hotel in Pucallpa with air conditioning, big comfy beds, wireless, fridge, running water... so I am thoroughly luxuriating in these pleasures while I can.  I thought that tonight would be my last night here but Fernando informed me that they payed for me to stay through Sunday night.  YAY!  Though i am looking forward to living on the hospital grounds, I also realize that life will be VERY different there.

Moto'd over to the central market to buy a man's work shirt to hide my burning skin (see my photo of the man's shop I bought it from, hee hee) and then off to lake Yarincocha, which connects to the river Ucayali and rented a boat for the day.  My motokar man was lovely (or so I thought).  His name is Joseph and I enjoyed talking to him.  He says he's been a single dad since his babe was 1 and a half and that mama lives in Lima.  His son is 10 years old now and Joseph is 35.  He invited me over to have lunch with his whole family (mom, son, aunts, etc.) tomorrow.  I thought I'd met my first friend outside of work.  Later, as I downloaded my photos for the day, I took a closer look at him.  Check out the T shirt on that boy!  DUDE!  Really?  The picture is self explanatory and the words in Spanish say "Fast Food."  I won't be having lunch with him tomorrow.  Call me a judger, what can I say!

Nonetheless, I did arrive safely at Yarinacocha, so I thank him for that.  

Met a true friend named Mario who motorboated me around Yarinacocha and to the first indigenous community in the Ucayali region, the Shipibos.  Wonderful, colorful, kind people. See the boys that watched our boat while we went to check out the community.  Also see the little Shipibo puppy and I.  Mario has been tour guiding for 30 years and showed me LOTS of cool things in the jungle.  We saw dolphins, chameleons, monkeys, anacondas (monkeys and anacondas in cages in small zoo for tourists, :( sad to say), and he introduced me to a yummy seed (see the pic).  You eat the white fur off the seed, which tastes a little like banana, and then spit the green/red seed out.  I ate a few seeds as he laughed at me before showing me that we are to spit the seeds out.  Silly American in the jungle.

We ate dinner together on the river after a 4 hour journey to San Francisco (where the Shipibos live) and back.  I had my first Cecina (dried, salted meat - maybe cow, maybe not) and fried plantains.  Mario taught me about all the different meats that exist in the jungle and how yummy they are, but I am filled with new Spanish words and won't remember all that he revealed.  I've got Cecina down now and that's about it.  

Shipibo girls  and one little guy sang a beautiful Shipibo song that I will try to download (download didn't work...).  Shipibos are famous for their pottery and yet I saw no pottery.  I bet we didn't go far enough into the community.  I will have to ask Dan's mom Flora who has been to where I went today.

That's it for the day!

No breakdowns yet and getting ready for bed so I think I am in the clear.  It was a wonderful day full of adventure and new people.  Just what I love.  

Loving you all too, 

Beth

I'm Pregnant!

Everything is different in the jungle and as it poured down rain I was suddenly 40 weeks pregnant and ready to pop!!!!!  See my preggers photo.  I'm telling you, things grow rapidly here.  

Fernando, Kati, Anita and I laughed and laughed today after I put my rain coat on over my purse and decided that I would be the first mama to deliver at Monte de Los Olivos.  Anita will attend my birth.  JaJaJaJaJa.  I delivered rapidly and am back in the city. No pains!  That place is magical.  Now ALL the mamas will come from everywhere.

Today was SUCH a better day.  Thanks for sending all the love.

Arose early again to clouds and impending rain, had breakfast on the roof terrace with Fernando, and motored over to pick up Kati.  We set out for the jungle and wow was it a beautiful drive.  Finally I could breath.

Met my newest friend Anita who works for Centro de Salud at Monte de Los Olivos and her and I will travel to all the small communidades together starting in March.  I love her!  She is smart and kind AND I understand her Spanish.

Also visited my casita (which you all have seen in the evite photo) and will LOVE living and working there after I finish at the hospital. On the weekends, I will live with a family here in Pucallpa if I chose to come back to the city.  I might never come back to the city ;).  I attached a picture of the beautiful Monte de Los Olivos school house, one of Anita, Kati, and I waiting for a taxi to take us back to Pucallpa (Anita is on my left, Kati on my right), one of our Monte de Los Olivos meeting where we made very important decisions today, and one of all of us drinking fresh juice on the side of the road.  One of my favorite things thus far is how I have NO idea what we might be doing next.  One moment we are driving along in a taxi to Pucallpa and the next moment we are relaxing on the side of the road.  Who could have guessed.  Life is different here.

Sister, I've been telling EVERYONE about my new little nephew Tillman.  They are so happy for you and our family to have a new little one.

Not much else to report.  Thinking of you all.

Beth

 

First Big Breakdown

Oh man.  Up and down and up and down.  I thought I was in the jungle now, not the mountains!!!!  

Before leaving Lima, I had a HUGE plate of ceviche.  OH YUM!  It was awesome.  Just before the ceviche, I managed to burn the bejesus out of my arms while sitting on the top of the MiraBuuuuuuus touring central Lima.  Really?  Did I really have to start my time here with a wicked sunburn?  I did descend into some very cool catacombs at the San Fransisco cathedral to no avail.  Arms are still a-burnin.'  I included a picture of the burnin' for your enjoyment.

Arrived in Pucallpa late last night and one of the first things I saw was a woman riding on the back of a motorcycle breastfeeding her babe.  GO SUPERSTAR mama!!!!!!  I was cheering for her in my mind as I enjoyed my first motokar ride.  I want to be like her someday I thought to myself. 

I LOVE Pucallpa thus far and am enchanted.  Lima felt a little like Spain, while Pucallpa feels a little more like India (though it's really NOTHING like India I'm sure, you all know what I mean...).  I am told that there are no available maps for the city of Pucallpa because it changes so rapidly that no one can keep up.  Hmmmmm... I've never been so good with maps anyway...  I think this is just my kind of town!

Arose early with Fernando to meet all the top dog health dudes and chicas of the Ucayali region.  Holy crazy!!!!  Couldn't believe that the hospital director in Yarinacocha took the time to have a meeting to welcome me to the hospital and understand every detail of what kind of experience I want to have.  He had a band of executives with him.  He also had a very health director kind of face, only the angel executive kind :) that sometimes find ways to work good in a not always so good system.  He reminded me of an old lab director boss of mine only Peruvian style and I loved him for that (Ridgway in Peru!  Who knew). 

After a 3 hour tour of the hospital and my future abode (Plans have changed and I will work at the hospital for 2 months - thank the lordeeeeeee!  Because of my intense intern style schedule, I will live on the hospital campus with a BEAUTIFUL view of the jungle in a little apartment and in the same building as nurse, midwife, and med interns...I might have friends in Pucallpa one day ;).  All the blue abodes in the pictures are hospital buildings.  The building I will live in is the 2 story one, clinics abajo.  You can see the farmacia and the little cafe in which I will eat all of my meals.  And it's all free!!!!  And also check out the really cute veterinarian house with Oliver's picture outside.  WOW, someone has met my little Oliver here in peru and loved him so much that they drew him big on their shop.

  

So, back to ...after a 3 hour tour... we zipped off in another motokar (la la la I love you motokar) to meet the regional director of health, director of women's health, director of public health programs, director of directors of other directors of health.......  LOTS of directors today. And the other thing - Motokars do NOTHING for my hair as you can see in the photo. But they sure are FUN!!!!!

Anyway, finally to the "mountains." After a long day, I simply lost it everybody.  Toooooooo much Spanish and toooooooo much meeting directors and I was exhausted!  Came back to the hotel and thought about little Oliver curling up with me for a nap, practically suffocated in missing him so much and had my first big breakdown.  OOOOhhhh did it feel oh so bad and oh so good, but mostly really bad actually.  Read a little bit of Pema Chodron's "Comfortable with Uncertainty" (Thanks Chris!!!!!) and pulled myself together for dinner.  Wooooooh.  

Took my favorite new form of transportation (Motokar! Could you have guessed?) to a dinner spot and thought all was well until a little doggy mama came to eat with me.  Then a doggy guy without a front right foot hobbled over.  Then the kids with the gum.  Then the old man with few teeth and very little meat on his bones with a handmade newspaper to sell.  Then the woman with the necklaces.  Then different kids with the same gum.  

I couldn't help but feed the mama dog. Bought the paper from the old man and thought I was ok, not going to lose it again... then a young teenager, maybe about 11 asked if he could sit with me.  I had seen him pass by a few minutes earlier and this was his second passing.  He had a backpack on and seemed harmless and lovely and friendly and I REALLY wanted him to sit and chat with me...  Nonetheless, out of fear I told him that I had other things to do.  Reallllllllly Beth?!!!!?  IT KILLED ME!!!!!  And that's when I lost it again.  I got scared of that little guy sitting with me.  Scared of what? I wondered after I balled my eyes out at the table again, thinking of the teenager, my fear, my heart nervous with fear to be as open as I am in places I know well, the little dogs, the woman, the old man, the suffering.  Holy shit!  The old man came back after I finished my food and asked if he could box up the rest and take it home with him. "Hell YES!!!! " And then I balled again as I walked home until I didn't feel safe walking anymore and hailed those cutest of transportation motokars ever.  They sure do cheer me up.

I feel much better after lots of love from friends and family via email and I am SO ready for bed. 

Tomorrow I will focus on breathing.  Just breathing.  That's all I have to do tomorrow.

We go to Monte de Los Olivos tomorrow to meet everyone there.  It's an hour away by car and considered a very small community of about 70 families.  After my 2 months of "internship" in the hospital at Yarincocha I will spend 4 months in tiny communities around Monte de Los Olivos.  That's the new plan for now and I am filled with hope for more spiritual, personal, emotional love growth, open hearts to help me, love from all of you, and more more more jungle fruit juice!!!!

WOW the jungle is beautiful here.  I can't wait for more of that too.  And the food!  I spent $2 on dinner which included a huge fried yucca, a big pile of something orangish and starchy and yummy, a grilled chicken and a glass of the best fruit juice on the planet to my knowledge thus far called maracuya (this just means passionfruit, but still!!!!  It's gooood.)

Love to you all and thanks for all the WONDERFUL blog and email comments!

Janice, I am TOTALLY using your pastry idea for the birth house.  Consider it done :)

I move to my new abode Sunday and start at the hospital on Monday.  That's when it gets really good and really hard too I bet.  I'll keep you all posted.

One day down sin diarrhea!!!!!!

That's right!  YAY!  

Hello all!  

You've inspired me to start this blog action.  Thanks!

Oliver and Dan sent me off in the airport at the security gate yesterday morning as I balled and balled after saying goodbye to my little man.  Little man...I love him... (he's my doggy

guy).  I arrived in Lima late last night.  A wonderful couple from INMED held the sign inscribed "Elizabeth Tucker" in a sea of similar signs at the airport and I was overjoyed

to find my very own.  Big smiles and laughter introduced me to Ursula and her husband Carlos.  They are LOVELY and have taken great care of me.

Now, my first full day of this exciting and emotional Peruvian adventure is coming to an end.  I can't believe it. Started with a meeting with Doctor Fernando Perez about the projects I will work on in the Ucayali region of the Amazon and an introduction to the next few months of life. Though i am enjoying Lima for it's easy access to internet, food, etc, I am ready to bust OUT.  I leave for Pucallpa tomorrow night with Fernando and after brief introductions in that smaller city, we will travel about an hour to the "selva" jungle and stop in Monte de los Olivos.  This is a newer community in and around which I will be working primarily.  

A few days later we will travel back to Pucallpa.  I will live with a family for a month there and deliver babes in the local hospital in a suburb called Yarinacocha.  The following 5 months will be spent working with small communities around Monte de Los Olivos.  As I practice, deliver, see mamas, babes, adults, and children in the clinic, etc I will focus on attempting to discover why women aren't utilizing the local waiting (birth) house to deliver their babes.  They seem to prefer the home.  My job is to make the birth house at Monte de Los Olivos a place where women want to come.  Sounds kinda big (and super exciting!) so send me any ideas! :)  

On a different note, today I enjoyed my first glass of chicha morada (a sweet juice made from purple corn! yum), a canelone which was seriously an italian burrito stuffed with spinach and cheese and smothered in red cream sauce (it was pretty good considering), and got kissed by a llama at the famous Lima Incan ruins.  What fun!  I also found some of my favorite cookies in the whole world, pet a sacred peruvian hairless dog (they are found in Mexico also and are believed to heal bone and joint ailments. sweet!),  and took my first ciesta.  Ahhhhhhhhh.

My spanish is already rapidly improving, though Ursula and I laugh hysterically when I get super tired and say things like "when I pay for something, I buy it."  I guess that's better then when I started in the clinic at Denver health and said to my first patient "I would like to take your breast now" instead of "I would like to take your weight now."  WOOOOoooops.  

Thank you all for each and every blessing and farewell in the last 2 weeks and an AMAZING goodbye party!   I am still swooning from the fun.  Also thank you for all the well wishes and thoughts that I have received electronically, emotionally, spiritually, financially, and physically. I can feel them all!!!!  :)

I miss you all tremendously and will share when I can.  Sending my love.

Beth