Daybook, April

Outside my window: It’s a Tuesday in April.  Therefore it must be snowing.  I love snow, and even I’m over it.  Of course this is also the day we have a donation arranged, so we have all sorts of things we had to sneak out of the children’s rooms disguised as laundry that we’re giving away.  One of them caught us this morning moving it out into the alley.  Child:  “You can’t give that away!  I LOVE that!”    Parent: “When was the last time you played with that?”  Child: “Um…”

In the kitchen: last week, non-local strawberries were in season and cheaper(er) than usual.  Sam brough home a bunch, and I made jam.  So now we need some bread to go under it.

Month-at-a-time menu planning is still happening, though the once-a-fortnight shopping has stopped.  I can’t fit it all in the cart, it takes too long, and I find the size of the bill depressing.  And I didn’t really save any money.  So once-a-week it is.

In the school room: ITBS testing this week.  After all my grand pronouncements yesterday, we started.  On the third section, one of my children asked to take a bathroom break.  It was only a 12 minute section.  She didn’t dally, but 12 minutes doesn’t give you a lot of leeway.  She came back and was perseverating on each question.  “Well, I know really has two l’s, so maybe real should too?  Hmm?”  All I could really say to her was, “Please don’t talk out loud.”  The timer went off, she had six left to do, and I told her she had to close her book and put her pencil down.  Tears, weeping, gnashing of teeth(hers, not mine).  I’m hoping she takes bathroom breaks between sessions today.

Grateful: for my church.  And for the Church.  A good, long run (the first in almost 2 months).  For Mandy, who inspired me this week to make some small changes in my life.  For healthy babies and Centering Pregnancy– one of my groups this week was just like a party.  A loud, hilarious party.  In Spanish.  That I got to go to.  I was so honored to be there.

And [trumpets, fanfare] I just got an email from a midwife who helped coordinate last fall’s training we did in Thailand.  She attended a difficult delivery in the jungle and saved the life of the young mother. (Truly, not just “Well, anybody would have done the same.”  No, there was no one else.  God used her to save that mother.)  The baby looked bad, and she and one of the medics we trained were able to resuscitate the baby using the skills and equipment we shared with them.  Mom and baby walked out together, healthy.  Praise God!  Thank you so much to those who supported that trip.  It is now officially All Worth It.

Side note that is truly irrelevant: I made that skirt in 1984.  8th grade.  It is my most-traveled piece of clothing.

Praying for: Mandy, Lynn, Jen and her family.  For hope despite chronic pain and suffering. For Lala & her family.  For the homeless, who must dread the snow even more than I do today.  Discernment: to use our resources and gifts wisely, and to make the most of every day, especially here at home where the “daily” can easily feel mundane.  Friends who are moving to Thailand this week: for safe travel, jobs, friends, a church.

Post-Push Letdown

The summer was a time of heightened productivity for me.  With my Thailand trip, school prep, and a writing deadline looming, I found myself focused and efficient.  I accomplished a handful of other tasks as a side effect of my intense work habits.  My “no” to projects that weren’t on my list came a little more easily than it usually does.

But now I’m back, home, and all the deadlines have passed.  I’m happy to be on the far side of all of that and have just a few reports and post-trip talks still to prepare.  Now what?

I know my jet lag is a factor, but I find myself looking around (at 4 AM) for the next project.  Which is ridiculous, because the simplest task (like staying awake past 6:30 pm) has been beyond me this week.

But once I’m back on Colorado time, what will it be?  Is it a half-marathon?  (Oddly, I was able to find more than one Colorado half-marathon in every month except for January.)  Is it a new writing project?  I’m a little bit at sea.

Like resuming regular running after a race, I hope that the miles I put under feet this spring and summer continue to reap benefits.  I want to hold onto the discipline and strength I gained working at a heightened pace—even if I don’t keep working at that pace all the time. But instead of looking for the next big thing, I need to sit back and rest a little.  Catch up on being instead of doing.

Does this happen to you?  How do you keep from throwing yourself into the next project too soon?

Day Two Teaching

While we were back at our hotel, the students were practicing their resuscitation skills. When we came back in the morning, they were ready to go.

This day was full of laughter and good connections. We heard more stories of the medics, how long their journeys had been to get to the school, and a few of their hopes for the future.

After a ling afternoon of testing, which everyone passed, they had a cekebration feast. They gave us traditional bags and a beautiful song of blessing.

Indeed we were blessed by this brave and determined group of students.

Day One Teaching

I woke up nervous: nervous about translation, nervous about setting up, nervous about making some huge cultural gaffe that would offend all the medics we were teaching.  We had breakfast in our stunning guesthouse and went to the truck only to find a flat tire.

An hour later, we were on our way up the mountain to teach.

We had a class of 12 medics and a handful of expat medical professionals (midwives, midwife students, RNs, and MDs) who were all eager and ready to start.

The curriculum is very hands-on.  We taught for a few minutes (all facilitated by our excellent translator), and then the medics got to try their new skills on the NeoNatalies.  Then we’d teach some more, and practice some more.  The babies were a hit.

Some of the medics are talented actors and leapt into the drama of the simulated birth with gusto, which made for a fun day of teaching.  They were attentive, quick to learn, and so gracious with us.  If we were terribly offensive, we never would have known.

I guess when you’re far from home, no one knows quite as well as a refugee how to make you feel at ease.

No Cell Phone Service

How great is this: we have wifi but no phone service.  I guess that helps me see what life is like around the world.

We are meeting incredible people have eaten incredible food. Somehow we only have photos of the food.

This was Sonia’s breakfast today: a fried egg, kimchee, and roquefort cheese.

This was lunch in Tokyo:

Here’s Sonia preparing the baby so we could practice in the restaurant in Seattle.

 

Tomorrow we teach!

What about Infant Mortality Anyway?

In this country, I find I don’t think about infant mortality or under 5 mortality.  It’s not that infants or children never die in the US… but when it happens, we think of it as an isolated tragedy.  Something that might and ought to have been prevented.  With a national infant mortality (IMR: that is, death of a child under 12 months) rate of 5.98/1000, we are in the lowest quartile.

Burma’s IMR is 47.74/1000.  48 out of every thousand infants don’t survive the first year. (Source: CIA: The World Factbook.)

The World Health Organization estimates that 33/1000 infants in Myanmar don’t survive the first 28 days, and 40% of that mortality is in the first 24 hours of life.  Babies just have a hard time transitioning to life in the “real world.”

Mae La Refugee Camp (home to 45,000 IDPs) has a maternity hospital, staffed entirely by Karen (one of the ethnic groups that have fled).  They have been able to reduce their IMR significantly.  I hope that introducing HBB among more of the Karen medics and their FBR partners, will be another step toward helping babies survive.

Why Thailand?

Thailand, just east of Myanmar, has been a primary refuge for those fleeing the violence in Myanmar.  According to the UNHCR, 90,000 Burmese refugees currently live in Thailand.  Nine closed camps opened in the 1980’s, and some of the refugees have been confined there for more than twenty years.  The Thailand Burmese Border Consortium reports that an estimated 450,000 Burmese nationals are currently displaced along the east and south border.  The refugees (IDPs, or Internally Displaced People) live in terrible poverty and often have little or no access to medical care.

Free Burma Rangers is a non-governmental organization (NGO) that works to document the refugee situation and alleviate the sufferings of Burmese IDPs.  Sonia and I will be teaching HBB (Helping Babies Breathe) to a group of Burmese medics being trained by Free Burma Rangers.  The Huffington Post had a great article (with great photos) recently on the Jungle School of Medicine.  The mission of the school is to train indigenous health workers to provide world-class health care to themselves.  I am so honored to be a part of their work.

 

Why I’m Going to Thailand

Four days till I’m on a plane to Thailand.

My journey began fifteen months ago, during my second trip to Haiti to work in a cholera clinic.  One of the women who had come in during the night was having a lot of pain.  When I examined her in the morning, I thought she didn’t look like a typical cholera patient.  Actually, she didn’t have cholera; she was in labor.

Our clinic staff mobilized quickly, preparing a semi-private area (that had just been bleached) in which she could have her baby.  It happened to be a day we were short on gloves, so I washed the pair I had in as much soapy water as I could.  We disinfected scissors and found clean blankets.  The neonatologist began winding IV tubing into the adult sized ventilation mask to try to make it smaller in case the baby wasn’t breathing and we had to rescuscitate the her.

Our clinic had a very specific mission and very specific rules about what the volunteers could do, and letting me travel in the back of a tap-tap in case the baby came on the way to the maternity hospital was not of them.  My supervisor heard my fears that the baby might die in the back of the truck but couldn’t allow me to deliver the baby in the clinic.  She asked me what to do.  I said Pray.

This is a tap-tap.  Well, actually it’s a cola truck.  But if you took out the cola and filled it with people going to work, it would be a tap-tap.  If you put a woman in labor in it, it would be an ambulance.

While Maggie was praying, I caught a beautiful, little baby and laid her, crying, on her mother’s belly.  God is good.

The next week, when I was home, it was time to renew my NRP certification.  The NRP is the Neonatal Resuscitation Program, and every licensed birth attendant in this country maintains certification in this program.  I told my story to the person retesting me and said I had a desire to adapt it for the developing world.  She said the AAP had already done it.

That program is Helping Babies Breathe, and it’s brilliant.  In February I was trained to teach others to teach it.  This is the program Sonia and I will be teaching in Thailand next week.  Stay tuned.