Sunday, June 29, 2008

Cousin Sheri touring Cebu

Andrey's cousin Sheri is in town. We love her. Besides being a fantastic human being, she is a low-maintenance guest that is totally fun and easy to be around. I love having the chance to get to know her better. She came all the way from Eston, Saskatchewan just to spend 9 days with us in Cebu. She arrived last Wednesday and we have all week with her before she leaves on Friday. We've had a full weekend and I'd like to share about that later. For now, I just want to share that tomorrow (Monday) we are taking Sheri to a beach in an area of Cebu island called Moalboal - about a 2 1/2 hour drive away (that's assuming we don't accidentally take the scenic route like we did the first time when our trip turned into a 6-hour ordeal - I think we learned our lesson that time.) We'll be staying at a small resort until Wednesday. We are all looking forward to some relaxation as we've kept Sheri quite busy meeting people and helping out at a Glory Reborn event yesterday and going to church and meeting more people and hanging out with youth and visiting friends in the squatter zone. There's no internet access at the beach where we are staying so I'll be out of touch for a few days. Will post an update upon our return and hopefully a few photos.

Saturday, June 28, 2008

Ligation Discussion Follow-up

Some friends have made some helpful comments regarding my ligation fund idea. One that was particularly insightful was the need to offer to subsidize other forms of contraception. There is an ethical issue in only offering to connect women with and pay for ligation when their only other seemingly viable option is to do nothing. This isn't much of a choice after all and may result in some women choosing ligation because it's free, when another form of contraception may have been more appropriate in their particular situation. There will need to be much education that surrounds these choices and they need to know all their options.
I think what I am going to do is research all available contraceptive methods in Cebu and their cost so I can make that information available to our moms. For those who really want help with family planning - whichever method they choose - and who wouldn't be able to afford it otherwise, I'd really like to be able to help them get it. I'm not sure yet how/if that will work but other forms should be offered so the moms really have a choice. My goal is to make these things available to those who really want/need it. I'll let you know what I learn. I did recently learn of an establishment that provides ligation for around 600 pesos ($15) and several women in our church community have utilized it. I'm going to find out more - is it safe? who's funding it?, etc... it may be a viable option for those women who choose to go that route.
Beginning now, I'm no longer calling my idea a ligation fund. Perhaps it should be called a Family Planning fund. I expect the title will develop as I figure out what this will look like. I still need to pray about it. Is this really something the Lord wants me to do? Maybe just making the information available and referring women to certain services will be all, as opposed to funding all forms of contraception. Another thing to think about is regarding the long-term contraceptive methods like birth control pills and depo shots. These forms require on-going funding and support. I'm hoping there are still some free options available in the city that we don't know about that we could just refer to. Will keep you posted.

Adoption Update

Great news! Our social worker called on Wednesday to tell me that she completed our home study report. This is happy news. The home study report was the last remaining piece of our dossier packet that was needed. We were expecting that the entire packet was going to have to be sent to our US agency (Holt) via regular mail to be approved but some good news is that the guy in charge of the Philippines program was recently in Manila and he was able to see the packet himself. So now the home study report only needs to be reviewed and approved via email before it can be submitted to the Philippines government on our behalf. This will save time.
It is possible that our dossier will be approved and submitted to ICAB (Inter-Country Adoption Board of the Philippines) within a few weeks. Once submitted, we are told it takes 2-3 months for ICAB to approve us and add us to their list of approved applicants. Information about us then gets circulated to social welfare offices and children's homes all over the country. At that point we'll officially be "waiting for a match." Exciting!

Tuesday, June 24, 2008

Ligation Fund

Friends. I have an idea and I want to know what you think. I'm considering starting a fund that will sponsor tubal ligations for the women that really want it and really need it.
In my short time at the clinic I have seen numerous women give birth to their 5th, 6th, 7th, 8th, or 9th babies. Many of these have had several other pregnancies in addition that ended in miscarriage. The majority of these women are anemic. Some of them are in their 40s. They all have a higher risk of hemorrhaging to death with each subsequent pregnancy. Most of these women really want to stop having babies - as they can barely feed the children they already have. Many of them have husbands who don't work for whatever reason, there is a lack job opportunities, especially for those who never finished high school. And so this story goes for so so many Filipino families struggling to survive. For at least the few women who have specifically requested help with having tubal ligation done, they have husbands who refuse to use condoms and the other forms of birth control - IUDs, Depoprovera shots, & birth control pills cost money and require regular check ups in order for them to be used safely. Frankly, these birth control methods are rarely used by the moms that we see.
So let me say clearly that I am not interested in advocating that every woman with lots of babies has tubal ligation done. I am just thinking about the few women that come along every once in a while that are desperate to stop having babies. I can think of two very clear examples. One being Florenda that I posted about recently. She is desperate. She can not take care of her children adequately. She's had 7 pregnancies and she's only 27. What's to keep this from happening again? She's not using birth control. And I can guarantee that she doesn't want to get pregnant again.
Example #2: A 41 year old woman who we go to church with. She has become our friend. We are in the same home group. I have been to visit her in her tiny one-room house. This is her 10th pregnancy and she was so upset with the news that she was pregnant... again. Her husband has no job. The only income that they have is when she is able to find some work washing clothes and this is very inconsistent and doesn't pay much. She also sends her 13 year old son to collect garbage to sell it. I have taken her on as my patient at the clinic. We have paid for all of her labs and meds so far and we will continue to pick up all of her birth-related expenses because of her desperate situation. They have little to no food to eat so we've been providing weekly groceries so she can at least get some nutrition while she is pregnant. And she is anemic and is taking iron provided by the clinic. She has made it clear that she wants ligation. And I told her we would help her.
I recently asked the obstetrician I know who works with our patients how much it would cost to have her do ligation at the public hospital. She doesn't charge any personal fees. The only fees are that of the anesthesiologist and the use of the OR. She estimated it would cost about 5,000 pesos - that's about $120 USD.
I'm considering starting a fund that would sponsor the ligations of only the most desperate of women. I would choose them wisely and would blog about their situations. I would personally arrange the procedure and may even get to observe one. What do you think?

Operating Room


I had ONE-OF-THE coolest experiences on Sunday. I observed a C-section at the public hospital with a very compassionate, generous obstetrician. Here's the background and story.
One of the helpers at the house we lived in up until a few months ago (remember Fancy Nancy's house?) became pregnant last year. She and her husband were very excited as they really wanted another child (they have a 9 year old daughter who also has been asking about a sibling). I too was excited and offered to deliver her baby at Glory Reborn, if she was interested in that. She was and so she began prenatal care at the clinic at the end of last year.
A few weeks later she started having some bleeding. I accompanied her to our obstetrician who has agreed to see our patients. Now, a quick note regarding the obstetrician: She has agreed to see our patients and Hilary pays her some small monthly fee but she basically does it out of the kindness of her heart. That way, our patients don't have to pay anything for the actual doctor visit. Meds and hospital services however, if needed must be covered by the patient. So this doc has been working with Glory Reborn for a while now and she says things like, "I'm always happy to help" and "You do such great work at the clinic." She is a real blessing to us and especially to our patients who can't afford the consult of a doctor. She is a devoted catholic woman and is always super nice and accommodating.
So back to my pregnant friend. It turned out she was experiencing subchorionic hemorrhaging which is caused by incomplete attachment of the placenta to the uterus. In her case it is likely caused by the D&Cs she had from 2 past miscarriages. A D&C (Dilation and Curatage) is a procedure done to remove the remaining products of conception left in the uterus after an incomplete miscarriage has taken place. This is also the method used in early abortions. At any rate, it can cause scarring to the inside lining of the uterus so when a subsequent pregnancy takes place, there is a risk of incomplete attachment by the placenta if implanted over the portion that is scarred. It seems this was her situation. It was also discovered that she had a septated bicordinate uterus (A uterus with two cavities with a membrane separating the two portions). With these two things this made her pregnancy high-risk and she was not longer advised to give birth at the clinic. She would have to give birth with our OB at the public hospital.
Long story short the subchorionic hemorrhage was treated and stopped and never returned and so my friend went on to carry her baby to term.
I had asked the OB if she would allow me to attend my friend's birth at the hospital to which the doctor agreed. At the hospital no one is allowed in the delivery room, not even the husband so both my friend and I were happy that I'd get to be there to provide labor support.
About 3 weeks ago her baby turned breech (head up position). After several unsuccessful attempts to get the baby to rotate into the ideal head-down position my friend was advised that she would likely have to have a C-section.
On Sunday I got a call that my friend's water had broken and that she was experiencing painful contractions. The doctor was called and I was given permission to observe the birth in the OR. I was elated. So I went, I saw, I held my friend's hand, I tried to stay out of anyone's way and I tried not to miss anything. So on my tippy toes I watched the entire procedure - from the cutting open, to the pulling the baby out butt-first, to the suturing. And just like on TV the baby was immediately handed to the pediatrician who whisked it away to do APGAR scoring (assess the baby's well-being) and to wipe her dry and wrap her up. They brought the baby in for just a few seconds and let my friend see her and kiss her new baby on the cheek before the baby was brought to the nursery.
The coolest part (besides the healthy baby girl that was extracted, and the tears in my friend's eyes when she saw her baby) was when the doc brought the top of the uterus into view so that we could see it's heart-shape as opposed to the normal, dome-shape of the uterus. So cool!
Praise God for a healthy and happy mom and a very happy dad and sister to welcome such a cute and healthy baby girl! I was so privileged to witness it.
Hilary told me later that the OB doc texted her and told her that I would be welcome back any time and that maybe next time I could scrub in and assist. Can you believe that??
Prior to the operation, I walked by the OB ward in the hospital with the doc and she said, "This is our OB ward. It is very dirty. Your clinic is so much cleaner."

Weird Dream

Two nights ago I dreamt that I had a young infant that was suddenly mine. I didn't give birth to this child but I was breastfeeding. The experience of breastfeeding this little one was so vivid - even down to me looking down and assessing the latch and the effectiveness of my baby's suckle (may have something to do with the many hours I spend at the clinic doing this - on other women, that is). I was so happy because me and my baby were in a great rhythm and I was breastfeeding successfully and I felt elated at this.
Then, I passed the baby to my friend Dana while I ran out to run a few errands. Hours and hours went by as I became so distracted with getting things done. After what felt like a very long time of living life as a childless person I received a call from Dana. She informed me in a very calm and controlled manner that the baby was screaming and that she couldn't breastfeed for me and that I needed to get back. Suddenly it hit me, Oh yeah! I forgot! I have a baby! And panic set in.
I called Dana yesterday to tell her about the dream because I thought it was interesting and she told me that dreams like this are common in pregnant women - fearing they will forget about their baby-to-be. She said that it is as if I am gestating or nesting or something. Funny but it seems to make sense.
If everything goes as planned we'll officially be on the waiting list in approximately 3 months. Panic?? Anticipate. Plan. Prepare. For what exactly? And when will I need to be "ready"?

Saturday, June 21, 2008

Typhoon Frank

Yep. We have a typhoon sweeping through the Philippines right now. Funny how I didn't hear a thing about it until it was here. Good thing it's only category 2. It's been raining non-stop since Thursday. Yesterday and today especially we have gotten some heavy winds. It passed just north of Cebu sometime last night and now it's heading northwest and is expected to reach category 3 soon.
Andrey is on the island of Bohol which is just southeast of Cebu for a work retreat. He was supposed to catch a ferry back today at 4pm but due to high winds they are cautioning people to stay put. There are a few ferries that will apparently make the 1-2 hour trip but only for brave passengers who will sign a liability waiver stating the trip is at their own risk. So yeah, the staff have decided to wait it out. Smart move.

Friday, June 20, 2008

Florenda's* Baby


Remember the pregnant woman at the clinic who I posted about before with many children and no food to eat? The woman who when I first met her, looked into my eyes and with desperation on her face asked if wanted the baby growing inside her. I wrote how she came to the clinic famished and shaky after days of not eating and how her countenance improved when the clinic began feeding her lunch every day. I shared that we explained to her that if she was serious about giving up her baby that we could help connect her with a children's home in the area that works with international adoption programs.
She gave birth Monday evening. I wasn't on shift during her delivery but I was in the clinic the following morning for a meeting and heard that she delivered a baby boy weighing 5 pounds 7 ounces. Small but just below the low end of normal for a boy. This is good considering her fundal height was only 29 centimeters when she went into labor. This was her 7th pregnancy. She has 4 other living children. 2 of her other babies died shortly after birth for unknown reasons. She is only 27 years old. The really disturbing part is that her husband isn't willing to give the baby up for adoption because he wants to sell the baby. Yes, sell it. Because they need the money. After observing this man, some of us think he may have a drug problem. My boss spent hours with the mother trying to convince her of the better option. Apparently nothing can be done without the father's consent. When I heard this I felt crushed. Our meeting started and we began our worship and prayer time.
As I spoke up in prayer on behalf of this little one with an uncertain future, I broke down crying. I prayed, "Somebody wants this baby! Lord, intercede on his behalf. Work in the hearts of his parents. Provide a better way!"
During the last few days, with this mother still in our care we brought in a social worker from the children's home to talk to both parents. The father still insisted on selling the baby. According to my boss the father is a very mean man. The social worker got very angry at him and chewed him out. She explained that what he wants to do is illegal and how she is going to report them. She got their names and address and then went to the neighborhood social welfare office and reported them. Hilary told them we wouldn't release the birth certificate to them unless it was clear they weren't going to sell the baby. She also said that at least for the next 6 weeks, if they don't show up for their scheduled baby check-ups we would report it to social welfare.
Many staff talked at length with the mother about how she is going to care for this baby boy. 3 of her 4 older children are all living with relatives because their parents are not able to adequately care for them. It is possible that just based on that, the social welfare department could take custody of her children. We'll see what happens and if they actually do anything.
I worked on Wednesday and while the mother went home briefly to find money to pay her bill I got to hold her baby boy. I prayed over him and I spoke to him. I told him that he is wanted and that Jesus has a plan for his life. I prayed for his protection. I prayed that he would know the love of his Heavenly Father. I sang worship songs over him and held him close. I fought back my tears and I did not allow myself to think about how much I wanted him.
*(Not her real name)

Monday, June 16, 2008

Father's Day Thoughts

Yesterday was Father's Day and it's a big deal here in the Philippines. Our church community especially makes a big deal of both Mother's and Father's Days with special Sunday morning programs. Yesterday was delightful. After an extended period of worship facilitated by music and singing, the little kids did a few presentations. I really wish I would have brought our camera because the costumes were adorable. Apparently one of the young guys living at our church's transitional home for trouble boys created all of the costumes himself. Impressive. There was the sun, a tree, butterflies, a bird, a tiger, a zebra, a fish, and Adam & Eve. They danced to the song, "Let everything that has breath praise the Lord." They also danced to "I could sing of your love forever." The best part was seeing some of the kids smiling huge and looking over at their parents to see if they were watching, and then seeing them smile even larger when they found a proud-faced father or mother watching them. I really hope our future kids get some time with us while still in Cebu and get to be a part of this community. It feels so alive.
Andrey received his first Father's day card. I didn't mention it before but I also received my first Mother's day card last month. Both were made by one of the youth in our church that we have become close to in the past several months. She is 18 but you wouldn't know it if you met her as spending time with her is more like being with a bubbly, affectionate 13 year old. Her father died when she was younger and her mother verbally, physically and emotionally abused her for most of her life. She was also neglected and received very little love and attention during her childhood. Just 2 years ago she finally left her mother's home as the abuse became unbearable and the Department of Social Welfare stepped in. Anyway, she and another girl the same age with a similar difficult past (no father around and a mother who struggles to provide for the family's physical needs, much less their emotional needs) have grown very close to us. We try and spend time together with them regularly. Some Sundays we take them out to lunch or other days they come over for a meal. They call and text us regularly throughout the week and we encourage and support them as much as we are able. They are beautiful girls. They are both very involved in our church community which has been loving them since they were much younger and they really have grown a lot and have experienced the love of the Father as they've drawn closer and closer to Him. It's awesome to see them experiencing the love of Jesus and then be challenged to step out and share him with others. I could go on about that...
But the point is that Andrey got his first Father's Day card and I feel like it is significant. It is possible this is the last Father's Day without children. That's a fun thought.
I am incredibly thankful for my father. I see the kids in our church that grew up or are growing up with both a mother and a stable father and how much more mature and healthy they are compared to the majority of the youth in our church who have only 1 or no healthy parent in their lives. What a difference!
Both Andrey and I grew up with fathers. Good fathers. And a big part of us knowing the love of our Heavenly Father is due to the love and presence of our earthly fathers. I believe it's been easier for us to relate to and be loved by God since we were brought up being loved by our earthly fathers. It's much easier to believe we have a Father God, Abba father, Daddy in heaven after we have been loved through our human fathers. The same goes for mothers as I believe God is neither male or female but embodies both male and female characteristics since we were made in his image - but for some reason we refer to God as our Father more than God our Mother which I think is equally as accurate. Due to the limitations of our language, I guess. Although in the bible, there is something to relating to God as our Father and I think that maybe God knew that there would be more of a need for us to know our Heavenly Father, as he knew so many of his children would have to grow up without earthly fathers. I know men are not all bad and that there are plenty of women out there not involved in their children's lives but you have to admit that there are many more absent fathers than absent mothers.
Well all that to say is - I am SO thankful. I am SO blessed to be loved by several fathers. My Abba, my American dad, and my Canadian dad whom I've grown to love in the past 6 years. I know I am loved and supported and I receive much encouragement every time I speak with any of them. They leave me feeling built up and boosted, like I can do anything.
Andrey is going to make a fantastic father, I just know it. And I am so excited to see that. And I am equally, if not more excited to see a child or two without an earthly father inherit one when they become a part of our family. And through that I know they will come to know their Heavenly Father more deeply and intimately. It's gonna be great.

Thursday, June 05, 2008

Living with Termites and then some...

A few weeks ago I noticed termite droppings under our bed. I did what any level-headed person would do: I ignored it and told myself I was imagining it. Then Andrey noticed it and by bringing it up, the possibility of termites that was stored in the "Don't want to deal with it" file in my brain was accessed and brought to my fore brain where I realized I'd better do something about it.
So when I gave our landlord the rent payment on Tuesday I mentioned it to her and she sent someone over today to have a look. Two men flipped the bed on it's side to inspect by tapping all around the edges to find the termites. I guess they found at least one because then the guy had one in his hand and he showed it to me. Gross! My head is suddenly itching as I type this. I hate critters!
So they injected and saturated the wooden bed with cancer-causing chemicals and proceeded to replace my mattress and sheets and pillows. No thanks! I told them to just leave those things in the other room. We'll be sleeping in the guest bedroom tonight and until we figure out if we want to continue to use that thing. Does sleeping on a bed infested with and treated for termites sound strange to any of you? It sure does to me, too. And that's for two reasons:
1. There were termites in my bed. Now there are dead termites in my bed. It's my bed, where I sleep. At night, with the lights turned out. I know I'm not made of wood and the likelihood of them crawling on me is small but the thought of those things bed-sharing is more than a little creepy.
2. I really don't like the idea of sleeping on wood that is soaked with chemicals that I usually try to avoid.
I hate pest control chemicals. I hate them. When/if my residence has to be sprayed, I try to leave the house for the entire day. Currently my entire bedroom is thick with that smell. And it's not about the smell so much as it is about the fact that the smell is an indicator of the presence of the chemicals. I've been running the fan with the windows and door opened all day and it's still so thick. I hate it because every time I inhale it I worry about cancer. So I hold my breath when I have to go in there but that means I can't stay very long. It's my bedroom! I have stuff to do in there.
I really don't know what to do about these things. When we moved in we found tick-infested base boards in the part of the house that the past tenant's dog lived in. We also have roaches and after they sprayed when we first moved in, we found a dead rat. And since then, we've seen a mouse or two in our kitchen. Oh great, now my head is itching again. I'm so grossed out by the thought of these things. Now nobody is going to want to stay here as our guests! I promise it's not nearly as bad as it sounds. We now keep our fruit bowl where the mouse can't reach it. We never leave food out and so we really haven't seen much of it since then. And I think I've had to kill 2 roaches in the last 6 months. It's just easy to exaggerate these things.
I can't imagine what it'd be like had we never been sprayed. What are you supposed to do when you live in a tropical place? Is there any alternative? Anybody have any input?
If it were up to me (if I felt I had a choice) I would never have those chemicals come anywhere near me. Like I said, I hate them. I hate the thought of them and worse, I hate wondering if my liver is doing a good job processing the toxins I am inevitably inhaling. I try not to worry. I pray and say Lord, no doubt YOU are bigger than all of this. My hope is in you. Please protect me from the potential impact of these chemicals. I know I am probably exaggerating and I know that there are lots of other chemicals that I inhale/consume that I'm just not aware of but having had cancer before, it's just a little too touchy and real for me, especially with something I feel I should have some control over. Which is the better of two evils? The chemicals or the critters? I struggle with the same thing regarding bug spray. Since dengue fever is common here, and I have been told that because I lack a spleen that I'd better not risk getting it, I have started using bug spray more often - especially in the rainy season when dengue is more prevalent. But I don't like the idea of DEET being absorbed by my skin. So I buy a lower strength form of "Off" made for kids and that seems to work at least for a couple of hours. I just don't like the idea of applying that stuff daily. Every time I use it I think the same things - how I'm inhaling it, my skin is absorbing it, cancer, if I use my hands to apply it does it really come off with soap and water or am I consuming it as well when I eat and happen to lick a finger? Wow. Now I think I sound like a nut job. Am I being unreasonable? Help!