“Spinning Babies”

Last week we at AGGMC had a once in a lifetime training opportunity in resolving shoulder dystocia.

Gail Tulley, the founder of Spinning Babies, (www.spinningbabies.com) is a gifted teacher who has come up with a teaching tool that enables midwives to deal effectively with babies that can get “stuck” on the way out ~ and she taught us!

Karen and Gail doing hands-on practice.

We met Gail because we had one of her designs painted on our prenatal wall and we emailed  her a picture of it. She was delighted with what we are doing here in the Philippines and sent us her “Spinning Babies” training DVD for free!

The Fetal Compass Rose
The Fetal Compass Rose 

 

All the staff from our Tabuk and Bugnay clinics got together and watched the DVD. There was some crazy footage of stuck babies being freed …

This is what a midwife looks like when she sees a baby get stuck!
This is what midwives look like when they see a baby get stuck!

 

The next day we Skyped with Gail herself and she answered all of our questions and gave us some more tips and advice. Gail is a warm, generous and gifted teacher and we are so thankful for her taking time out of her busy schedule to meet with us … Oh, and I go the time change wrong and woke her up at 7am instead of 8am … she is very forgiving too!

Thank you Gail!

 

 

Maboy: One of the reasons I am here!

Beautiful Maboy when I first met her in 2004.
Beautiful Maboy when I first met her in 2004.

Maboy is one of my favourite mothers in Kalinga.

Every time I see her she has a huge smile on her face and she always asks how I am doing.

Since I very first came to Kalinga in 2004 she has welcomed me with open arms to her village of Pakak.

Maboy is the mother of 10 children – all of them as beautiful as she is. She came to deliver at our clinic when we first opened in 2007 but all the rest of her children she delivered at home unattended. This year Maboy found herself pregnant again. We had been doing regular prenatal visits in her village but she was always working in the fields when we were there so we barely saw her during her whole pregnancy. In the first week of July I happened to see Maboy at her home and asked her if she would come and deliver at the clinic. I told her we would come and pick her up no matter what time of night or day. I told her I was worried about her, because of her multiple pregnancies she was at risk for having a difficult labor and delivery. I think sometimes it is hard for mothers of so many children to believe they need help during their deliveries– especially when they have done it themselves for years! Maboy just smiled at me and said “we’ll see.” And so, I as very surprised to see Maboy come into the clinic one day for a prenatal check-up. She was having some common discomforts of pregnancy and we were able to send her home with a good quality medicine for a low cost.

We got word from Pakak a few days later that she was feeling better. Then, on the evening of July 7 , we got a text from someone in Pakak that Maboy was in labor. The midwives on duty drove out to the village to pick her up, with their emergency birth bag in tow – you can never tell if the women are going to deliver the minute you get there or even possibly on the way back to the clinic. Maboy was still in early labor so the midwives took her back to the clinic. By early morning I went into the clinic to see how she was doing. She was exhausted from having strong contractions all night but still no baby. We gave her IV fluids and lots of encouragement. A few hours later, with a lot of support and help from her midwives, Maboy delivered a beautiful baby girl.

A few hours later as Maboy lay resting in the postpartum room, she shared that this was such a hard labor for her and she wasn’t sure that she could have done it herself. She told me that she decided this little girl would be her last. I feel so blessed to have been able to help her with the delivery of her last baby and to have made sure that she stayed safe and healthy for all her other children too.

Maboy holding baby Zanelle as she gets her BCG vaccination.
Maboy holding baby Zanele Grace as she gets her BCG vaccination at the clinic.

The World Needs More Midwives … Now!

 

“Midwives are the unsung heroes of maternal and newborn health. They can prevent about two thirds of deaths among women and newborns. And midwives deliver much more than babies: They are the connective tissue for communities, helping women and girls care for their health, from family planning all the way through the postpartum period.” ~UNFPA State of the World’s Midwifery 2014

I don’t think that I could say it any better than that!

“Midwives need hands-on training to enable them to acquire and maintain competencies to provide high quality care to women and newborns.”~World Health Organization

Staff Midwives being trained in Neonatal Resuscitation.
AGGMC Staff Midwives being trained in Neonatal Resuscitation.

“Countries need to improve distribution and retention of midwives, especially in poor and remote areas.”~World Health Organization

The Bugnay Staff Midwives doing regular prenatal check-ups for the women living in the remote mountains of Tinglayan.
The Bugnay Staff Midwives doing regular prenatal check-ups for the women living in the remote mountains of Tinglayan.

“Many trained midwives work abroad for better salaries and more favourable working conditions. This creates a dearth of skilled staff in countries that need them most.”~World Health Organization

Training student midwives on prenatal care.
Training local student midwives on basic prenatal care. Many of the students we help to train, we eventually hire as staff midwives at AGGMC.

“[Midwives] check the health of the newborn and also counsel the mother on newborn care, birth spacing and family planning.”~World Health Organization

Our monthly Well-Baby seminars in which we train mothers on the keys to keeping their babies and themselves healthy.
Our monthly Well-Baby seminars in which we train mothers how to keep their babies and themselves healthy.

 

It is my hope that at AGGMC we are making an eternal investment into the lives of our midwives and in turn, the mothers and babies of Kalinga.

 

(UNFPA quote taken from unfpa.org)

(WHO quotes taken from http://www.who.int/features/factfiles/midwifery/en/)

“Birth House for Sale”

Abundant Grace of God, Bugnay
Abundant Grace of God, Bugnay

I just got back from a quick trip to the mountains to check up on our sister clinic “Lajad Apodios Lying-In” – that is the Butbut translation for Abundant Grace of God …sort of 🙂

I had the chance to introduce Suzie Campana, our new missionary midwife and Bugnay clinic Facilitator, to the staff and mothers of Bugnay.

Suzie and the midwives hiking into the Village of Bugnay
Suzie and the midwives hiking into the Village of Bugnay

We hiked into the village and shared at the Well-Baby seminar which we host monthly for the mothers of Bugnay. This month’s topic was all about Tuberculosis; the signs and symptoms as well as transmission and treatment. Tuberculosis is a disease that still has a huge effect on the families of Bugnay and surrounding villages.

Me and my shadow sharing at the Well-Baby seminar.
Me and my shadow sharing at the Well-Baby seminar.

The Bugnay clinic has been open for over two years now and we have been working out of an old home which we renovated into a clinic. The house is in a perfect spot as it is central to all five Butbut villages and is right next to the main road.

We only had a two-year lease on the house, so since we opened we had been looking all over and around Bugnay for somewhere we could build another clinic or renovate another house. Nothing was available or else it was way too much money.

Then, a few months ago, the landlord of the current clinic building told us that he wanted to sell it.

The price is reasonable (much less than it would cost to start from scratch) and the location is perfect.

The cost of the clinic building and lot is $12,000USD.  This August we need to give the first instalment of $6000. The next instalment is due in one year.

We already have $2500 towards the first payment. We just need another $3500 by the middle of August.

Would any of you like to be a part of keeping this very important clinic up and running? If so, I want to invite you to donate towards the “Bugnay Clinic Fund”.

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Donating is very easy and 100% of what you give will go directly to the project.

Just click on this link: http://www.msccanada.org/Donate/PayPal-donations.html

and when you get to the MSC site, click on the “Give” menu on the homepage.

Then choose my name from the scroll down menu on the “Mission Workers” menu.

Ok, it may be a little confusing if you are my dad … but I think most of you will be able to follow it 😉

If giving financially is not something you can do right now, please pray with us and stay tuned for the miracles that God does in the next few weeks!

 

A Night to Remember

 

Novelyn came to us in her second trimester of pregnancy for prenatal care. She was living about an hour outside of Tabuk at the time but she came faithfully for all her prenatal check-ups. There was something about this strong, determined woman that drew me to her and I took her as my “continuity of care” patient. A “continuity” patient is one that a midwife will choose to follow through her prenatal care, labor and delivery as well as postpartum even if they come in when the midwife is not on shift. I don’t often take patients like this because I am so busy, but I took Novelyn. During her pregnancy we were able to get to know each other and I had the opportunity to pray for her often. She was nervous about her delivery, which was normal, especially because her two previous deliveries had been difficult.
Novelyn came into the clinic in labor early one afternoon in April. My missionary Alex was helping me monitor her and everything was going well. After a few hours Novelyn’s labor started to get more intense and her bag of waters broke. The first thing a midwife does when the bag of waters breaks is to check the baby’s heartbeat to make sure that he/she is handling it well. We checked the heartbeat immediately and noticed that it was extremely low! I checked and felt that the baby’s cord had slipped over its head and was being compressed during the contraction. This is an obstetrical emergency call “cord prolapse” and the only course of action is to hold the baby’s head up off of the cord until an emergency C-section can be performed.
This is exactly what we did! I held up that baby’s head while Alex and some other staff carried Novelyn to the emergency vehicle and our emergency driver took us to the hospital 10 minutes away. Alex and I were praying out loud for the baby the whole way to the hospital. So that you know how amazing the next part of the story is, you have to know something about the hospitals in Tabuk. Even though we went to the private hospital where the care is considerably better than the public hospital – the hospitals are not staffed 24/7 with doctors and anesthesiologists. The operating rooms are not always ready to go in case of emergencies. Sometimes you will have to wait hours for a doctor to arrive or for the appropriate staff to be found. On some occasions we have had to pick up the staff ourselves at their homes.
We arrived at the hospital 10 minutes later and alerted the ER staff of the situation. They informed us that the doctor was just finishing up a C-section in the operating room and we would be taken in right after! We waited less than 30 minutes for the C-section and we were able to stay with Novelyn and I held the baby’s head off of the cord. We prayed for both of them the entire time. When we were wheeled in the OR it was only a matter of minutes before Novelyn was prepped and the doctor started the C-section. I got a close-up view of the operation as I was still holding the baby’s head! I kept my hand on the baby’s head right until I felt the doctor’s hands pull the baby out. She lifted out the baby and he gave a big cry and the whole OR staff cheered! We were all so happy! Usually if there has been a cord prolapse the baby doesn’t make it, so the staff were all so excited to see a healthy baby born!
I went to visit Novelyn and her baby at home two days later. We talked about what had happened and I explained exactly what was done and how much of a miracle it was that her baby was fine. She knew it already. She told me that the last thing she remembered in the OR as the anesthesia took effect was Alex right beside her, praying for her.
I am so thankful that we work for such a mighty and gracious God … and that he lets me be a part of amazing stories like this!

Double take? That is Alex, not me, with baby Kade the day after he was born.
Double take? That is Alex, not me, with baby Kade the day after he was born.

What’s your excuse?

Yes, it is true that I have been a bad blogger lately! My excuses are all of the following events that happened in the last few months…

Okay, first off we delivered identical twin girls at our clinic in the middle of March! This was the mother’s tenth pregnancy. In a regular prenatal check-up her midwife noticed that she was measuring large for dates. She was sent for an ultrasound … she came back with a BIG smile on her face and told us that she was pregnant with twins!  About a month later she came back to the clinic in labor. No chance to decide whether or not to take her to the hospital – these girls were on their way! It was a beautiful birth attended by about a dozen excited midwives.

The twins mother is sitting next to Jackie who is holding the babies! A very excited staff and babies' family members all around.
The twins mother is sitting next to Jackie who is holding the babies! A very excited staff and babies’ family members all around.

 

Irish and Aiza
Aiza and Irish – 2.5kg and 2.6kg

 

 

Next, I got to “catch” my first ever white baby! One of my  missionary-midwives-in training took the whole practical learning experience to another level! Edolbina, and her husband Andrew welcomed their first child Ariel Cornelius on April 29 at 3:12 am.  It was an honour to be a part of Ari’s birth. My boys are a little smitten with this guy as are we all!

Ariel Cornelius
Ariel Cornelius with Lucas and Emmaus admiring him.

I have also been making numerous trips up to our sister clinic in Bugnay over these last few months. My wonderful staff are currently awaiting a new clinical supervisor and so I have been trying to help them out and encourage them as much as possible.

The Bugnay Clinic Staff and their daughters!
The Bugnay Clinic Staff and their daughters!

In May my friend and fellow midwife, Jen Sawchenko and her daughter Ella, along with Filipino midwife Marielyn Basak, visited from Cebu City and accompanied me to Bugnay. They taught at a seminar for the mothers and staff regarding best breastfeeding practices.

Marlene and Jen outside the clinic.
Mar and Jen outside the clinic.
Jen shares at the Bugnay clinic - Ella helps her!
Jen shares at the Bugnay clinic – Ella helps her!

 

 

 

 

 

 

 

 

 

 

 

 

Along with all these happenings we still continue to do almost 100 prenatal check-ups and postpartum visits a week and reach out into 3 villages in the community and deliver over 20 babies per month.

Me and Lukay before she heads home to her village.
Me and Lukay before she heads home to her village.

Thank you everyone for your support that makes us able to do all of this!

There are many more stories to tell, but it will have to wait for next time. I have a good one coming … Stay tuned!

“In my day, we gave birth in the rice fields!”

by Crystal Meeks

The other day I met an elderly lady in her 70s from Bugnay who explained to me how times are changing.

Old lady in Bugnay with Zion.
Old lady in Bugnay with Zion.

 

She said in her day, the women were strong and they would give birth in the rice fields, tie the babies to their backs and keep on working. She stated that now-a-days the women are lazy.  She said that now, when the women get pregnant they stop working.  I needed her to define “work” because I have never seen any Butbut sitting idly.  They are always cooking, washing clothes and dishes, pounding rice and chasing after their children.  According to the old lady, in her day, women worked much harder.

So I asked,  “Do you think it was better in your time and the clinic here is not effective because the women should be strong enough to deliver without a midwife?”  She grabbed my arm and prepared to correct me, “Oh no Crystal! We thank God for the clinic!”  She continued to explain that before, they didn’t cut a woman’s stomach to get a baby out and that she didn’t like that many women do that now.  I agreed with her that I didn’t like that either.  She continued, “But at the clinic you let them try to deliver normal and if you think it’s better, you take them to the hospital to have their stomach’s cut and Crystal, even if they have to cut their stomachs when they come home they still have a live baby.”

The next statement I asked a few times to make sure I’d translated it properly.  My mouth gaped open when she informed me that she gave birth to 13 children but only three lived past their first year of life.  She shared she would have been willing to have her stomach cut also if it meant more of her children would have lived.  Our conversation was a reminder of our effectiveness here in Bugnay.  My favorite part of the conversation was that she didn’t thank me or the other midwives but rather expressed all her gratitude to the one that deserved all the credit…Our Heavenly Father.

 

Life and Death in the Mountains of Kalinga

Did that title get your attention?

I hope so!

The truth is that our sister clinic in the village of Bugnay is the difference between life and death for many in the remote mountains of Tinglayan, Kalinga.

Have you heard the story about the baby that suddenly stopped breathing?

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The parents noticed she was having difficulty breathing and by the time they brought her to the clinic she had stopped completely. The parents were about to turn around and take her home to bury her when midwife B-lyn grabbed the baby and started to resuscitate her. That baby is running around the village of Bugnay today.

 

 

 

How about the story of the woman who began hemorrhaging seconds after her baby was born?

Sinchong

 

 

If she had been at home without midwives attending her, like she had been for all of her other babies, she would have died. For this delivery she decided to come to the clinic and have trained midwives attend to her. They were able to stop the bleeding immediately. You can meet her in the village of Bugnay as she takes care of her five young children.

 

Did you hear about the girl who found herself pregnant and married before her sixteenth birthday?

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She was scared and confused when in her eighth month of pregnancy she began having terrible headaches and dizziness. Her mother and aunties told her it was because she was lazy that her legs and face had swollen up; if she would only exercise more, she would feel better. This girl came for a check up at the clinic instead and was diagnosed with pre-eclampsia. She was referred to the closest hospital two hours away and delivered her baby via C-section. Both of their lives were saved.

 

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Our midwives in the clinic in Bugnay are literally the difference between life and death for those living in the mountains of Upper Tinglayan.

Yet it is one of the most difficult parts of our ministry to keep going. We are challenged to keep the clinic appropriately staffed because it is such a remote area and it is a sacrifice for midwives to work so far from their families.

We are in the midst of such a struggle right now as we are down to one staff midwife and one volunteer. Neither of them trained to do deliveries without supervision.

 

These are the three things we see that need to happen:

1)  Missionary midwife Suzie Campana is willing and able to come and help at the Bugnay clinic but is still needing financial support to get here. We need her to receive all the necessary support to come immediately and help with the work in Bugnay.     (http://philippines.eaglemissions.org/suzie-campana/)

2) We need more experienced Filipina midwives who are willing to work and live in such a the remote area until more local midwives ready to take over.

3) We need funding to build appropriate staff housing for missionaries and Filipino midwives to live nearby the clinic.

Please pray with us for these things. If you feel you want to help in a more practical way please consider helping fund Suzie Campana to be a missionary here (see her information above), or help with local midwives and staff housing by sending a donation to us specifically designated for Bugnay.

(Specify Bugnay- no tax-deductible receipt available through this method)

 

http://www.msccanada.org/Donate/PayPal-donations.html

(Specify Georgia Macad, Bugnay – tax-deductible receipts available here)

We will keep you updated on how things progress!

(All stories are true however those pictured above are not actually the individuals written about)

Midwifery in a Disaster Zone

In December, following Typhoon Yolanda, one of our missionaries from Abundant asked permission to travel to Tacloban to help with relief efforts.

Here the first-hand account of an amazing experience Aisling had while in the Disaster Zone!

Aisling Lynch with fellow relief workers.
Aisling Lynch with fellow relief workers.

I went to Tacloban to help in the aftermath of Typhoon Haiyan (known locally as ‘Yolanda’). The following experience is one that has stuck in my memory and I think it always will.

We arrived at the hospital with a young man from the community I was living in, he was severely malnourished as he had not been able to get food since the typhoon hit, that was almost 2 weeks ago. The hospital had a long line of people, about 300 I estimated, sitting outside the emergency room waiting patiently to be assessed.

Outside the hospital waiting to help survivors.
Outside the hospital waiting to help survivors.

The Korean medical team that were assessing our guy were trying to arrange to refer him onto a medical ship that was docked just outside the harbour of Tacloban City. While we were waiting for information on his transfer, there was suddenly commotion, a stretcher appeared out of nowhere was was been wheeled at a run by the orderly. The Korean medical team were blocking the entrance door and repeating “No, no, don’t bring her inside, we have no OB/GYN on our team”. It was pretty obvious there was a woman in labour outside so I identified myself as a midwife and offered to help if she was pushing and there was no time to transport her somewhere else.

Myself and the medical team ran outside and sure enough there was a tricy with a woman, her family and a screaming newborn tucked up inside. The baby was pink, crying and had great tone so we congratulated the family and tricy driver on a successful delivery and put the mother and baby on the stretcher to be brought inside for a closer look.

 Once inside I got to the business of assessing the woman for blood loss and seeing if the placenta had delivered. I’m not sure exactly how this happened, but I think I went into ‘autopilot’ mode and took control of the medical team. Because we were unsure of the woman’s blood loss I asked immediately for her to be put on an IV of dextrose or whatever they had available (understandably in a disaster zone supplies are limited), then I got ready to deliver what I thought to be the placenta that was visible. But the minute I touched it, I realised it did not feel like any placenta I had ever touched before. 

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It was at that moment I realised the placenta was on the blanket so what I actually had my hands on was the woman’s uterus. There were still some membranes trailing so I twisted these out and then quickly checked the placenta was complete, it was. I remember looking to one of the medical team who was a surgeon and telling him the woman had a prolapsed uterus. He looked at me and asked what do we do with it. I admitted that I had never handled this kind of situation before but to the best of my knowledge we just need to put it back in. His answer was “well, go on then!”. 

 So with a deep breath and shaky hands I got down to the business of replacing this woman’s uterus back inside to its rightful place. It was surprisingly easy and when I was pretty sure it was back where it was meant to be I stood back and observed just to make sure it stayed put, it thankfully did. Baby at this stage had been looked over and wrapped up in a blanket, he was then brought over to his mum and started breastfeeding immediately. In the space of less than 5 minutes, everyone was stable and happy. 

Mom and baby doing fine
Mom and baby doing fine

 

It was the strangest feeling having people come over to say thanks. The entire medical team came over one-by-one to say thank-you to me. To be honest, it was a great feeling! This experience thought me so much; that a cool head in an intense situation is invaluable, that I can trust in my knowledge to guide me in medical emergencies and that good team-work can be achieved through clear communication, even if you have never before met the people you are working with.

Mother and baby got transferred to a nearby hospital that had OB/GYN on their team and from what I heard, both mother and baby were fine. All in all, a fantastic outcome for everyone involved!

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