Saturday, October 26, 2013

A Month in Manila: Week TWO – Birthing Clinic and Around the Town

Monday, September 30 – Sunday, October 6


Monday:   Instead of going to school with Jacque, I went with Daisy to the Birthing Clinic.  Daisy is also a volunteer/missionary, and she’s been in the Philippines for 6 years now, working most the time at the Birthing Clinic.  The clinic provides prenatal check-ups, vitamins, well-baby check-ups, and immunizations --- all for FREE.  It is located in the middle of a poor neighborhood, and most of its patients are women who otherwise would not have health care during and after their pregnancies.  The clinic is not yet licensed to actually deliver babies, but two of its nurses are midwives and they go to patients’ houses whenever they get a phone call or text saying that a woman is in labor.  The majority of babies are born in the home, as hospitals are too expensive.  It was cool to see this clinic and how it operates.  It receives so much free stuff – like boxes of baby clothes and vitamins – that they almost don’t even know what to do with it all!  Prenatal and baby care occurs in the morning, and dental care is offered in the afternoon.  And, all day long is school.  Preschool-grade 8 is happening in the upstairs rooms, Monday-Friday.  The kids wear the cutest blue bottom, yellow top, plaid tie uniforms; receive books and supplies; and eat lunch – all for FREE. 

Daisy explained that if they would charge tuition, most of these kids wouldn’t be going to school at all.   I have no doubt that this is probably true.  In fact, this is very similar to the education system in Burkina; however, most schools in Burkina did charge tuition, and most kids still went to school.  Of course there were children who didn’t get to attend school for various reasons (too expensive, girls needed to stay home and take care of the house, etc.), and this was always sad.  But at the same time, there isn’t room for everyone to go to school anyways.  Maybe in a few years, but right now, Burkinabe schools are already bursting at the seams.  Plus, if everything is free, how are you going to pay the teachers and provide for the most basic of materials, like chalk for the chalkboard?   This is both the beauty and the downfall of mission work.  In short, everything is free and wonderful while it lasts, but it’s possibly not very maintainable in the long run. 

Beauties:  Everything is generally provided at no cost (schooling, food, health care, clothes, medicine), allowing anyone in need to be helped.  And all of this is being made possible by outside support.  Like by Americans who want to make a difference and do God’s work by helping the poor have a better quality of life, and can afford to give 20, 50, maybe even a couple hundred dollars a month to a church and/or mission, and by giving financially, they now feel pretty dang good about themselves (increased self-esteem, happiness levels, philanthropic outlook towards life).  Thus the missions have the resources to pay for everything, including the local nurses and teachers who are working at the missions --- the nurses/teachers are very rarely volunteers:  they need to be qualified (duh), locals (so they can speak the language), and paid a salary (they gotta feed their own families somehow).   So, the beauty of it all is that anyone in need can receive, because no fees are charged for anything.

Downfalls:  However, while all this (see above) is wonderful, it also has drawbacks:  
1) It’s probably not sustainable:  if the mission leaves, who’s going to continue providing everything?  No one.   That’s who.  Not the government.  Not the local community who used its resources.  Not the people who worked and/or volunteered there.  Personne.   It’s finished.  Au revoir, mission care.
2) People aren’t required to take responsibility for their own lives.  For example:  a family might think, “Well, we have 8 kids, can hardly afford to feed them as is, husband doesn’t have a job and just wastes the few coins the kids get from begging each day by betting on cock fights each afternoon; but hey, there’s this mission here and they’ll give us food and clothes, so we’ll be alright.  No worries.  We’ll be okay.  In fact, kid number 9 is on the way.  Good thing the mission offers free check-ups and the midwife will come help deliver the baby since we can’t afford to go to the hospital….”  Of course I realize that very few people in this world, even those who are struggling to put food on the table, just sit back, relax, and completely rely on a mission or handouts for their basic needs.  Nor is it entirely fair to say that a woman (along with her man, of course) has complete control over the number of kids she (they) bring(s) into this world, whether or not they can provide for them.  (Although I’m betting that if food wasn’t so readily available, they’d figure out ways to not have so many kids: food = population growth.  In any living species.  Humans included.  Fact.)  But at the same time, if your basic needs are being met, what else is there to search for, to provide for the family?  If you know food will be coming at least once a day and you already have clothes on your back, why not spend your day socializing, watching cock fights, napping, making more children…  I hate to say it like this, but if there’s anything I’ve learned from my time in third-world countries, it’s that people know how to work the system.  (Hey, I think Americans are pretty good at working the system, too.  Right?)
3) It forces western culture and thinking onto the people (whether intentional or not) instead of working from within their culture, traditions, and beliefs.  “Come to my bible study, and after I’ll give you a bowl of food to eat.”  “Uh, my family is Muslim….but we are hungry….alright, I suppose we’ll become Christians if being Christian means we get a free meal every Sunday.”    Also, sometimes this whole Point Number Three of mine can be related to capitalism and money-making matters (again, whether intentional or not).  Consider this.  Throughout the thousands of centuries of human existence, I’m betting people in Burkina Faso never used to use Johnson’s baby shampoo and lotion on their infants.  But then one day in somewhat recent history, a big box of it came as a handout for a local CRS (Catholic Relief Services) Mission and all the nurses told the women that this soap was better for babies than the soaps and oils they had been using for thousands of years (which is maybe true, but probably not.  And even if it is “better,” there didn’t seem to be anything harmful with their traditional baby lotions and soaps…).  It became a status symbol to use “western baby products” because they are (of course) “better” and before you knew it (after give or take a few decades), no one in the village even remembered what “traditional” soaps and oils they used to make for babies, how they were made, what they symbolized, etc.   A loss of culture.  All because “our” western ways were forced onto and on top of theirs, with us not stopping for a moment to consider their own traditions and way of life.  Not everyone needs to use the same soap, guys.  There is an abundance of unique ways to achieve similar results.  If using the oils from the leaves of a certain local tree has worked well for babies for thousands of years, and it’s FREE to make because the tree grows in your courtyard, why not use that?  Johnson’s baby oil has to be imported and costs money.  I’ll take the free and local, thank you.  We should let others do that too.  Western ideas and products are (more often than not) not the best in existence, and we westerners don’t always have all the answers.  Even if we think we do.

Anywho, like I said, mission ministries, as well as all humanitarian and development work throughout the world, have both their drawbacks and their blessings, and I’ll leave it at that for now.  This is a topic I could discuss in much further detail, maybe even write a thesis or something on it, but I’ll not get into it here.  Maybe in another post…

So back to Monday’s events.  Went to the birthing clinic with Daisy, mainly just sat there and observed; also held some cute babies.  Later that afternoon I made a pasta salad in Jacque’s apartment for the International potluck being held that evening, and then walked to Faith Academy (it’s about half a mile away) with the salad as well as a change of clothes in case I got really gross and sweaty during the uphill walk ( ½ mile uphill + muggy = really sweaty).  For some reason, I couldn’t seem to figure out how to get to Faith, though it’s a pretty simple route and you can see the buildings on the hill – I just couldn’t find the correct road to turn on.  I walked and walked, until I realized that, yup, I had definitely gone way too far and should have turned on one of those paths that I had passed.  To complicate matters further, the sky was getting dark and thunder was rumbling.  I turned on one path, but after a few minutes I discovered that it only led to a shack and a bunch of banana trees.  Down I went to the main road again, and continued back until the next path.  Fortunately, this one seemed correct – the houses sparked my memory.  I reached a fork in the path where I had to decide whether to go left or right.  Right it was.  It was all good, until I realized I was now going downhill.  No, no, no.  I’m supposed to be going uphill.  Why did this path stop being paved and change directions?  This isn’t right.  A few Filipinos working in the banana tree grove near me just stared.  I’m sure it was puzzling to see a white person walk by, headed to literally nowhere, and then turn around and retrace my steps a few minutes later.  Also, at that moment a huge bolt of lightning flashed and the thunder cracked.  It was as if the cloud and bolt were right above me.  I’m surprised I wasn’t struck by lightning; it seemed so close and was deafeningly loud.  And of course, that’s just my luck that I would be lost in a downpour, carrying a pasta salad to a potluck, with a cellphone that didn’t have any credit so I couldn’t have made a call, even if I would’ve needed to….   I went back to the fork and went left this time.  Ah yes, this looks familiar.  I thought that if I’d walk a lil faster, maybe even run, I just might beat the rain, so I started doing a weird walk/skip sorta thing, all with the big tubberware of pasta salad.  Well, it might have taken me about an hour (instead of 10 minutes) but I eventually found myself in Jacque’s classroom.  Jacque: “Where were ya?  I was startin’ to think that maybe you’d gotten lost.”  “No, I was fine.  No problems at all,” I lied. 

I went to change my clothes, but realized I was still carrying the stupid container of pasta salad, so I disposed of it in the band room office, next to my clarinet and flute that had been claiming a spot on the counter the whole past week, as if I was actually a real teacher at Faith.  Changed my clothes to look more “professional” (ha, black skinny jeans and a striped t-shirt, yeah, totally professional indeed), and went back to Jacque to find out the details of the event:  Where on campus?  What time?  What should I do with the pasta until then?  About 45 minutes later we went back down to the band room to get my clarinet and the salad, only to discover that the office was now locked.  Shoot, the 6th grade band was probably already starting, and the event was on the other side of campus, so even if we went and asked the teacher to open the office back up, it’d take a while – how were we going to rescue my clarinet and the tubberware of food in time?  “Well, sometimes, when I worked down here last year, I would see kids climbing through the window to get into the office….”  Jacque suggested.   (The office was set up so that the instrument storage area was behind it, with a sliding window about 12 inches tall and 4 feet off the ground, running along most the back wall of the office/storage area.)  So we slid open the window, I hoisted myself up, swung my legs inside, and placed my feet on the counter (I couldn’t simply jump straight down due to a drum set being right under the window).  Voila!  I was in!  I got my clarinet and the salad, and then started to pass it through the window to Jacque, while asking, “Ok, now will getting back out of the window go as smoothly as getting in?”  “Well, since you are inside the office now, I would think you could just use to door and skip the climbing through the window.”  Oh.  Good point.

We hustled back to the elementary gym and put the pasta salad on one of the huge lines of tables for the potluck.  There were 4 separate lines, each being probably 5 tables long.  There were almost certainly over 500 dishes of food present, representing delicious cuisines from around the world, hence the name “International Potluck.”  Needless to say, I ate a lot and it was all wonderful.  Curry chicken, sushi, Korean rice noodles, sweet rice cakes, Swedish meatballs, cheesy potatoes, Tex-Mex chili, cupcakes.  Yes, it truly was an international feast.

The concert went well, with Jacque and I being “guest performers” for the middle school’s performance of “Just a Closer Walk With Thee” and afterwards I chatted with a bunch of people I didn’t know.  Some had lived in Africa before, and so they wanted to know where, exactly, was Burkina Faso?  Naturally, they had never heard of it.  No one ever has heard of Burkina Faso.  Fact.  ***Tangent story:  So in the Peace Corps transit house in Ouaga, there’s a bulletin board and people put up stupid stuff all the time.  “Missing: my left black flip-flop, sometime after we went out dancing last night. Please return if found.”  “Check out this guy.  Sexy defined.” – a cartoon picture of a specific volunteer doing something stupid.  Also included on this magical board is a google map of West Africa, printed out from the internet.  All of the countries are labeled, including their capitals and sometimes another big city or two.  Except for Burkina Faso.  Sure, the country itself is there.  But no name or capital is included.   It’s just a blank chunk of land.  On this print out, someone had written,“Burkina Faso: not yet important enough to be included on the map.  Not even the internet knows it exists.  But maybe someday, Burkina, maybe someday.”  So yeah, poor Burkina.  It can hardly even get itself on the map. 

One missionary family at Faith had actually lived in Ouagadougou for a year, and so I spoke with them for quite a while.  Although, my highlight was speaking to the kids of this family – we spoke in French!  (The parents had never really learned French or local languages that well, but the kids had picked up on the French.)  It was nice to use my French again.  It’d only been about a week or so since leaving Burkina, but I already felt like my French was leaving my head.  All the other kids that passed us by were like, “Whoa!!!!  You two are speaking a different language!”  Although the kids are pretty accustomed to being (or knowing people who are) multi-lingual, it is more often than not the Asian kids who are speaking strange tongues.  Not the American kids.  And especially not a language that’s not Tagalog or maybe Chinese.  To hear two white people speaking French was probably pretty weird for everyone. 



Tuesday:    I was a bum and stayed in Jacque’s apartment all day.   Typing this stuff.  I’ve written a lot so far.  Too much, probably.  In Microsoft Word, I’m currently at 18 pages, single-spaced, size 11 font.  That’s a lot of writing.  And I have so much left yet.  Not to mention my final months of Burkina-life stories.  Must type faster.  Ouch, hand cramp.  Must be time for a dip in the pool!


Wednesday:    Today I went to the birthing clinic with Daisy again.  Since I was now somewhat familiar with what was going on, they asked me to help.  “Sure.  What can I do?”   And so that’s how I found myself at a table, taking the blood-pressures of expecting women before they moved on to weight, temperature, and then the actual prenatal exam.   Since I had worked at a nursing home for, gosh, over 7 years!, up until I left for Peace Corps, I had no problem doing blood pressures all morning.  I may be an expert.   Well, up until the one lady whose pressure I couldn’t read.  I tried 3 times, but couldn’t find it or hear it or visually see it on the gage.  So I asked her to let me try her other arm, and her friend who spoke English asked me, “Why?  What’s wrong.”  “No, everything’s fine.  I just can’t seem to hear it very well, so I want to try and see if this arm is louder.”  I don’t know what was wrong, but even the other arm proved to be near impossible.  I adjusted the cuff, checked the gage, turned the stethoscope on and off, and tried a couple times.  I was beginning to panic.  How could this woman not have a blood pressure reading?  What am I doing wrong?  I finally was able to trace it, just slightly, and it was like 85/75.  And really faint.  So weird.  I asked one of the real nurses to check it out, and everything ended up being fine.  But it was still strange.

As I took the blood pressures, I had to record the measure in the women’s flies.  This also gave me the chance to look at their names, current ages, and past history: how many kids they’ve had, how many have died, number of “husbands,” etc.  A lot of the women were teenagers, 18 or 19 years-old.  But also far too many were only 15 or 16.  And I even came across one fragile looking woman whose chart said she was 44-years-old!  44!  And this was her 12th pregnancy.  Wow.  I don’t know how they do it.

At noon, the prenatal exams were done for the day, and so Daisy took me to a nearby street restaurant lady so I could try some traditional and local food.  Rice with various sauces.  Deep fried, sugar-coated banana-plantain things on a stick.  Kwek-kwek (said like “quick-quick”), which is a hard-boiled egg inside a fried donut/bread coatingAnd various fish and squid balls, also deep-fried, served with a spicy-sweet vinegar dipping sauce.  SO good.  All of it.  And the total cost for both me and Daisy to have a smorgasbord was like 120 pesos, or 3 measly US dollars.  We were walking back to the clinic to eat, when Daisy called out to a teenage boy wandering on the street.  “Noel!  What are you doing here?  Don’t you have school?”  Daisy brought 15-year-old Noel into the clinic, sat him down, gave him some of our food, and tried to get him to tell her why he was wandering the street, why he wasn’t at school or, at the very least, in his home (orphanage) if he wasn’t feeling well.  Basically, he had run away…. or something.  He had some money in his pocket, and his school ID, but that was it.  After we ate, Daisy drove Noel back to his children’s home.  When we walked through the door, the staff (social workers) were completely surprised to see Noel.  They didn’t know that he wasn’t in school that day, and had no idea he had spent the morning just wandering around and entertaining himself doing who knows what.  “Thanks for find him!” they said.  I then got a tour of the home, a place for 0-16 year-olds.  The baby room had 4 different babies under 12 months in it, including one little angel who was only 6 days old.  He had been given up by his mom immediately upon birth.  There was a tree house and swing set outside, and a big dining area with over 10 small tables (and a few normal sized ones), so all the kids could eat meals together as a big family with the staff.  Like Josie’s Angels’ Zone, the children’s home had a nice environment and provided kids from abusive families (or no families) to have a safe place to live.

I got dropped off at Faith Academy, and as soon as school was out around 2:30pm, Jacque and I headed down to one of the girls’ dorms on campus.  It was Jacque’s night to dorm sit.  Each dorm has a set of dorm parents, literally a married couple who lives in the huge house and is there every day, acting as parents for the 16 residents of the dorm.  But naturally, dorm parents need a night out of the house once a week, so they can do errands and have some private time with their spouse and/or children.  So one night a week, another Faith teacher “babysits” the dorm from 3-9pm.  And tonight was Jacque’s night.  It was pretty chill.  After all, these are teenage girls, usually at least 16-years-old, who are all very independent.  They have sports and other after school activities, homework, and countless other things to do.  It’s not like we had to entertain them, or really do anything.  Just be there.  In case there was a problem or someone wanted advice or homework help.  So I took a nap in the afternoon, and read my book.  Then we ate supper with the girls --- delicious Korean food: kimbap, along with rice and various vegetables and other toppings, like spicy meat and fried egg.  I spent the evening playing the piano in the family room, and one girl even gave me her sheet music to play, since she heard me fuddling around with Canon in D and Fur Elise by heart, but with lots of mistakes and places where I got stuck and couldn’t remember what came next. 

Jacque and I went straight to bed when the dorm’s “dad” dropped us off at Jacque’s apartment around 9:30pm.  It had been such a tough night, eating Korean food and playing piano and chatting with teenagers.  Rough life.



Thursday:    Again, I found myself at the birthing clinic for the morning.  However, because one of the two main nurses was sick, I was promoted to prenatal-exam giver.   (Disclaimer:  I am not a medical professional.   I have no training in anything whatsoever related to pregnancy. I'm not even sure I actually know how babies come about.... But apparently that didn’t stop the clinic from deeming me “qualified” to examine women with very big bellies….  I repeat:  I am NOT a medical professional.)

Nurse:  You want to help?
Me:  Sure, what can I do today?
Nurse:  Do you know how to determine the baby’s position in the mother’s womb?
Me:  Uh….?
Nurse:  Come here.  Put your hands here.  Push, like this.  This baby hasn’t turned yet.  Its head is here.  Now you do it.
Me:  Uhhhh…  (I get up from my chair and, hesitatingly, inch closer to the exam table.)
Nurse:  Yes.  You try.  ***She grabs my hands and puts them on the expectant mother’s belly.***
Me:  ……uh?.....um….
Nurse:  You feel it?  Yes, push harder.  You won’t hurt her or the baby.  Feel that?  This is the baby’s butt.  Up there is the head.  All to the left side.  We write that down.   Now we’re going to find the baby’s heart rate.  Use this.  Put some lubricant on the belly first.
Me:  …ok….like this?.....this is ok?  ***a few seconds pass, but I still don’t hear anything in the monitor, so then the nurse takes over***
Nurse:  Yes, sometimes it’s difficult.  Oh, there!  You hear it!?!
***Thud-thud.  Thud-thud.  Thud-thud.***
Nurse:  Good, call in the next woman.  You’ll do her by yourself.

Within a few minute crash course, I had learned how to feel for a baby’s position, measure the mother’s belly growth, determine the anticipated date of birth and the approximate date of conception, find the baby’s heartbeat, and more.  Well, okay, I hadn’t really learned.  I literally had just observed and simultaneously sorta helped with one woman.  ONE.   Oh man, I am so not qualified to do this.  From starting a library and “coffee shop” and preschool in Burkina, to giving prenatal check-ups in Manila, wow, I don’t know why people trust me as much as they do.  They really shouldn’t.  I am not a professional!!!????

Before I could even argue no, or that maybe it’d be better if my job was just to measure the belly’s circumference (I couldn’t screw that up too badly, right?), or maybe, better yet, I go do blood pressures and the rest of the vitals, and the other volunteer lady who is there EVERY day and actually speaks Tagalog comes in and does this feeling-for-the-baby thing.  But nope, too late.  The next lady was already plopped down on the other exam table, waiting for me.  So I proceeded to act like I knew what I was doing and wasn’t scared to death…and imitated the nurse’s questions and steps.

Me:  Good morning, ma’am.  How are you?
Lady:  I am fine.  Thank you ma’am.
Me:  Any pain?  Problems?
Lady:  No.  I am fine.
Me:  Everything is okay?
Lady:  Yes.
Me:  You’ve been eating well every day and taking your vitamin?
Lady:  Yes.

The first few women’s exams were a little rough, but I managed…. I think.  (I hope I didn’t do too inaccurate off a job on those first couple of patients…. My apologies, ladies.)   I soon figured out how to actually press hard enough to find the baby and could recognize the difference between the head and butt.  Being able to locate the baby’s position led to being able to find the heart beat right away, and it was so rewarding to put the monitor up to the mother’s ear so she, too, could hear her baby’s heart beat!    One of the mothers I examined was deaf, which made it extremely hard to communicate, and also I felt sad that she could hear her own baby’s heart.  I smiled and nodded to help reassure her that, yes, we could definitely hear the little thud-thuds, while simultaneously tapping her wrist to the beat of her baby’s heart, so she could at least “feel” it. 

All the Filipina women probably thought I knew what I was doing.  And, to my surprise, everything went fine and I sorta felt like I knew what I was doing.  Well, except for the few times my measurements were a few centimeters smaller than the belly had been the previous week.  Whoops, better recheck that.  Oh, and that one lady when I couldn’t find the baby’s heartbeat.  I searched and searched.  I wasn’t even really sure where the baby was.  I couldn’t seem to feel it anywhere, but I didn’t want to tell her that, and, in my defense, she wasn’t that far along yet, like 20 weeks or so.  I kept applying more lubricant, and covered the entire surface area of her slightly bulging belly.  Still no trace of a beat.  Uhhh……oh no, please don’t tell me I’ve discovered a miscarriage.   I should not be doing this.  I wasn’t sure what to tell the mother, but obviously she knew as well as I did that we weren’t hearing a heartbeat.  Finally I heard something.  Sorta.  It picked up a rating on the monitor, but it was much much much lower than all the other womens’ babies’ rates had been.  I wrote it down anyways, and then went to find the real nurse.  (It was just my luck that she had disappeared for about 20 minutes, right when I actually needed a real professional.)  The nurse came back, and tried to find the heart rate as well.  But same story.  No sound.  We tried for about 10 minutes.  The nurse pushed the mother’s belly in all directions, trying to feel for a little bump, or maybe to shift the baby out of hiding.  More lubricant.  More hand-pushing.  More lubricant!  All of a sudden we heard it!  Thud-thud, thud-thud, thud-thud.  Oh thank God.  Yes, that’s definitely a heart beat.  Not very loud.  But it is one, and in a healthy range.  It turned out that the baby was positioned extremely high up and on the side, or at least, that’s where we could find the heart rate.    Or maybe the little tyke had just been swimming around and changing locations the entire time.  Who knows.  But at least it was there.

My morning at the clinic was such a great experience, and I learned so much!  It was awesome to have the privilege of working with pregnant women, especially in a manner that I would NEVER be allowed to do in America, unless I was a trained medical professional, of course.

Thursday evening found me at Kids’ Street Ministry again, and because it was my second time, several of the children ran up to me right away and even remembered my name.  (I also still had my braids in my hair, so I supposed that helped them to easily identify me.)  The previous week I had sang a few songs with some of the kids, and I was shocked that some of the kids STILL remembered the songs.  They were humming them and doing the actions and trying to show me that they wanted me to sing the song for them so they could do the actions.  I couldn’t believe they had remembered so well from last week!   Yet another cool moment.




During the night, while crashed on Jacque’s couch, I had the craziest dreams.  I was running to the top of a hill, but I had to run faster, and faster, because the lightning was trying to get me.  One of the bolts was just inches from striking me. 

In the morning, I noticed the floor next to the window was wet (it leaks) and so I asked Jacque if it had rained. 

Jacque:  Uh yeah.  Obviously.   Did you not hear the storm last night?
Me:  Storm?  No, I guess not.
Jacque:  HOW DID YOU SLEEP THROUGH THAT?
Me:  I dunno, I kinda thought it must’ve rained, but sometimes I can be a heavy sleeper ---
Jacque:  I don’t think there’s anyone in all of Manila who slept through that storm besides you!  Even the heavy sleepers.  That thunder and lightning was ridiculous.  I mean, one of those bolts must’ve struck down right on top of our apartment building.  It was seriously right on top of us.  How did you miss that?

Me:  Well, I mean, in my dream there was lighting….and it almost struck me….?

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