Thursday, November 11, 2010

Last day in Vanuatu

Oh it is so sad to leave. Today was our last day at Vila Central Hospital in the maternity ward. The midwives were sad to see us leave and so grateful for our help. They presented Susanne and I with little gifts. We brought a big chocolate cake, biscuits, soda and chips. Not the healthiest of snacks, but they loved it.

Susanne and I each delivered a couple babies today. No suturing though. My first baby was very tachycardic (190-200 beats per minute). We started an IV with normal saline, but it did not help. As soon as she was fully, she pushed so strong she got a nose bleed. I have never seen that before. But baby came out (in moderately thick meconium stained water) and was fine. No problems. Later, she could not pee so we put in a urinary catheter. Out came 750ml of urine! So much. Then I pushed 3 large clots out of her uterus.

Tonight we have gathered a bunch of locals and non-locals to go out dancing. Yay. Then at 7am tomorrow we leave for NZ. Hopefully tonight we won't be out too late :)
Now off to town to pick up a bag of powdered kava to bring a friend in NZ, a quick swim in the pool, kava, dinner and dancing.
Peace and love (and kava!),

**Elias, I never got the CDs but I do have a note for you from MW Sam.

Wednesday, November 10, 2010

Over 100 births total...

Hiya! Again, sorry about not writing in so long. Total births my whole midwifery career: 107!! Tomorrow is our last day in Vanuatu, I am a bit sad to leave but also looking forward to our next adventure in New Zealand.

I forget where I left off last time, so sorry if anything is repeated. A baby was born was a huge tumor on its lip, which it kept trying to suck. The peds docs did surgery and it looks amazing. That baby will not even have an outside visible scar.

Last Friday there was a 5.1 scale earthquake here. Susanne and I were reading by the pool, and the ground was shaking. She thought I was pushing her chair, haha, but no. I did not hear of any casualties or damage done by it. The funniest part was the reception lady was in the toilet when it was happening and she thought the plumbing was acting up. On a totally separate note, the brand of toilet paper at our hotel is "ABM." I find that quite funny.

Today a baby was born acynclitic (head was a bit crooked coming out). The momma pushed for a very long time, eventually the midwife in charge cut an episiotomy, and baby came out with the longest/most crooked head ever. Both momma and baby were fine. I helped suture the episiotomy.

Lots of other NSVDs (normal spontaneous vaginal deliveries) at the hospital.

Outside of the hospital, we have been having lots of fun! We went to Blue Lagoon, a lovely little lagoon where the water is a mixture of sea water and fresh spring water. There are several rope swings, where first you climb up on a tree and swing into the water. It was great fun, but I have some sweet bruises on my inner thighs from gripping. Ouch. I took a picture :)

We also went to White Sands Beach and swam in the ocean...the proper ocean, not a harbour or lagoon. The water was so warm and nice, and the sand was white and soft. We got a lot of sun that day. Still working on our killer tans :)

Yesterday we went on an island tour to Lelepa island. We caught a small ferry boat there, did a mini medicinal herb walk with a local guide, snorkeled in the sea, had a yummy BBQ lunch, saw a big cave (where they used to take lepers to live out their final days). Then we fed some fish chicken bones (from our BBQ) and bread, while in the water snorkeling. They were right up in our faces, I even touched some. The snorkeling was unbelievable, saw some huge and brightly colored fish and lots of cool coral. Then a boat ride in the choppy ocean where we all got soaking wet, finishing at a little village where I bought my mum a gift :) Overall, a great day.

Tonight we are going out with the lovely NZ midwife Christine for a Korean dinner. Should be good. Tomorrow we are bringing cake and biscuits to the maternity ward for a final goodbye party. And we brought the midwives each a shirt "Support Your Local Midwife". They will love them. Then tomorrow night BIG partying, lots of dancing, maybe a few cocktails.

Our time here has been amazing, life changing and so rewarding. I learned LOADS, had so much fun and feel like a more confident and competent midwife.

Not sure if I will blog again, maybe a quickie from NZ. Thanks for reading and following and leaving comments (if you did).
Be well! Peace and love,

Wednesday, November 3, 2010

Ups and Downs

Hi again, been so busy lately have not had much time to write...and no access to internet either. Today my friend Jeremi let me borrow his computer, cheers mate!

It has been a whorlwind of emotions for me, both in and out of the hospital. Last Saturday (30th of October), I helped deliver a VBAC (vaginal birth after cesearean, she had previously had a prolapsed cord). The woman was making noises like a hose whinnying (it made me smile, but not in a sadistic way). As she was pushing and I could start seeing the head, a steady trickle of blood started to escape. It was more than I wanted to see, and I could not see any tears. At first I thought, "Shit, maybe the placenta abrupted a bit." I listened to the fetal heart tones and they were fine. As the head crowned and came out, more blood came. The baby came out, and with it more blood. She was given an injection of Syntocin and the placenta quickly delivered. Still more blood. I rubbed her uterus which was very firm, so the blood was not uterine. I checked for tears, using gauze to try and wipe away the blood, but it could not be wiped away fast enough. So, I inserted a finger and felt for tears. On the left side of the vaginal floor my finger sunk DEEP into a tear, and I could feel the blood pulse out with her heart beat. Shit. I had the midwife in charge call the OB (who thankfully was in the hospital) and I packed the vagina with gauze to try and put pressure on the bleeding vessel. The blood was soaking through the gauze and pooling on the sheets,. It clotted and was an inch thick. I was worried, though I remained calm and spoke clearly to the woman and told her what was going on. She was a sweetie. The OB finally came in, had a look, and decided to wheel her off to the surgical theatre to deal with it. Over an hour later she was wheeled back in, with a third degree tear and a lot of blood loss. In just the time I was with her, I estimate at least 800ml blood loss, which is a lot for Vanuatu. I can't even imagine how much more she lost in the theatre. This was the first time I was VERY grateful to be delivering babies in a hospital setting.

I was a little shaken from this, but the next birth totally redeemed my love for midwifery. A G2P2 momma pushed for only a couple minutes, out came a lovely baby, no tears and no blood loss. Such a contrast to the previous birth.

The next day Susanne delivered a baby with gastroschistisis (spelling??), its insides were born on the outside. I wasn't there, but apparently everyone but her stood there in shock and didn't know what to do. The intestines were covered with saline covered gauze. The baby is still alive, and if it makes it until Sunday some doctors are coming from Figi to do surgery. But, it is looking very pale and vomiting meconium and probably will not make it.

Follow up: the baby who was brought in dead from the mum who killled it...the mum was taken to jail. THe sad thing is, what she really needs is some mental health help, which she will not get here. She probably came from an abusive family or was a rape victim, but she will not get the help she needs.

The baby who was born breech and needed resuscitation died. It was seizing and had brain damage. Sad.

Two days ago I delivered two babies. The first one was a lovely birth, and I sutured a first degree tear. The second baby was born with club feet. It will likely be given some sort of therapy, but perhaps not for over a year when a volunteer medical team comes from NZ. Maybe they will do boots or braces.

It has pretty much turned into the tropical rainy season here. Sunshine in the mornings (which we are avidly soaking up) followed by torrential rains in the afternoons. And, I freakin lost the umbrella, darn.

Only one and a half weeks left here in Vanuatu. I am up to 34 births now, and only need 4 more to reach 100 total.
Be well,