In Mexico

Hi friends. Just want to share that Andrey and I are having a blast hanging out in Mexico with Dana and Andrew and their two kiddies. We spent the first two nights in Monterrey at a great hotel. Yesterday we drove to Torreon, where we'll be until Wednesday when we fly back to the D.C. area.

I don't have any photos to post right now because I didn't bring my computer or the cable I need to download any photos. Will have to do that another time.

Best things so far about being in Mexico:

• Quality time with great friends including lots of chats and laughs and silliness (for the kids' sake, of course)
• Real Mexican food - spicy salsa, gorditas ("little fatties") for breakfast, endless amounts of tortilla chips and fresh limes, queso, yummy cerveza... if i keep this up I'll turn into a gordita myself! I've just been ignoring the painful burning in my stomach post spicy salsa. I figure it will be over soon...
• Dry air - the chapped lips are a bit annoying but the novelty of dry air is being enjoyed just for that reason; it's even a bit cool here still in the morning
• Seeing Andrey and Andrew chatting it up and giggling like a couple of girls, just delighted to be in each other's presence
• Dana & Andrew's trampoline

Not so fun things:

• Burning stomach after spicy food and indigestion after too many gorditas
• Looking like a dumb-ass when I give the nervous blank stare when someone speaks to me in Spanish; Dang it! This dumb foreigner tourist thing is just uncomfortable. Thankfully, Dana and Andrew's Spanish is quite good (as if we would know) so at least they look good, which is the way it should be

We're very blessed to have this time with D & A. We've made the trip since it looks like they won't get to join us for Nerdfest in August this year so it might be a while before we see them.

Hasta luego!

In America

Andrey and I made it to the D.C. area today. We had one of the best itineraries. We flew Korean Airlines. Cebu-Seoul-D.C. The flight out of Cebu left just before 2 a.m. It was just okay as it was a smaller plane and we both found it difficult to get any sleep. But that flight was only four hours. We had a 3 hour layover in Seoul, which has a very nice airport. The best part was the seating that was very conducive to sleep. Andrey worked on his computer and I took a nice, long nap.

Our long flight to D.C. was great. We slept on and off throughout and enjoyed good food and excellent service. Korean airlines is great. They fed us two nice meals. I chose the Korean option both times and loved it. We watched Slumdog Millionaire, which we really liked. It was probably one of the most enjoyable 15 hour flights we've ever taken. In my sleepy state, I recall hearing fussy babies and toddlers nearby and I thought about how tired I felt and wondered what it would be like to take a flight like this and have a child or two to care for. Oh dear. I guess I'm enjoying these days while I only have my own whiney needs to deal with.

Now we're at a friend's house. We'll be staying here tonight. We're going to Mexico early tomorrow morning to visit Dana & Andrew. We're meeting in Monterrey, where we'll stay in a hotel for a few nights before driving to Torreon. We'll be back in the D.C. area on Wednesday, where we'll be until we go back to Cebu on April 8th. We'll be attending the global prayer gathering before Andrey has a week's worth of work-related meetings. Then we get to spend a few days in a cabin in the woods with the Litton family. Their daughter is our god-daughter. We were quite close with them during our time in Thailand so we're really looking forward to spending some quality time together. We are so blessed with such great friends and so many fun things to look forward to on this trip and others.

For now, the goal is to stay awake until at least 9 this evening. The coffee is already wearing off so I'd better keep moving. Maybe a walk outside in the brisk air will help.

Our Compassion Child, Ivy

When our former Compassion sponsored child graduated from her program in Africa, Andrey and I decided to sponsor a child from the Philippines. We knew that the child they picked for us could come from anywhere in the country. What we didn't expect was that the child they'd assign to us would not only live on the same island, but would live an hour's drive from Cebu City. Perfect!

Andrey's mom is a Compassion advocate, which means she represents Compassion's sponsorship program and finds sponsors for waiting children around the world. In January, while Andrey's parents were in town we made it a point to visit our sponsor child together. Her name is Ivy.

The four of us drove an hour south of Cebu City along the coast to a small town called Sibonga. There, we met with the leaders of the local church that run the Compassion program. It's a new program that provides sponsorship to 100 children in the area. The children receive everything they need to go to school and regular medical and dental check-ups. The pastor and administrator who hosted us were very excited to meet us. We were the first sponsors to visit one of the children.

In Sibonga, we met at the church where the program is held and were introduced to Ivy and her mother. We chatted for a few minutes and then we all went to lunch together at Jollibee in a bigger town nearby. Jollibee is the Philippines version of McDonald's. Kids light up when they see the restaurant's mascot, "Jollibee," which is just as it sounds - a very jolly bee. Ivy was ecstatic when she heard where we were headed.

Like most Filipino children, Ivy was incredibly shy and nervous to be around tall, white people. She would barely make eye contact with us. In the car on the way over her mother kept telling us (in Cebuano, thankfully I could understand her) that Ivy is so shy around us because she is afraid of our long noses. Filipinos make a very big deal about the differences in our noses. They are quick to make disparaging remarks about their own short, flat noses. It usually comes either just before or right after the self-deprecating remarks regarding the "blackness" of their skin. Why can't we all just be happy the way God made us!? Anyway...

We enjoyed our time at Jollibee. After lunch we followed the leaders to Ivy's home where we gave a few gifts and were stared at by a gathering crowd from the community. We met more of Ivy's family before we drove back to the city.

Ivy enjoying her lunch at Jollibee.

Andrey, Ivy and me with Jollibee (the poor girl was terrified of us)

Walking to Ivy's house

Ivy at her door step

Ivy with her grandmother, brother and mother

Starved Baby Boy

Can I just tell you another ridiculously shameful story of crap that happens in the Philippines that I have the joy of witnessing? It would be oh so easy to assign 100% of the blame on the poor excuse of a city hospital here but in this case the mother herself left me bewildered.

Last week we had to transport a patient to the hospital because she was in early labor and the heart beat of her baby decelerated to a dangerous level. This patient was 38 weeks pregnant with a fundal height (belly measurement) that reached 30 centimeters at its largest. At the time of admission her fundal height was 28 cm. This is incredibly small.

During the first half of her pregnancy her belly was growing as expected but since about 20 weeks or so, the growth of the baby really started to lag and never caught up. All through her chart there is evidence that our staff advised her to eat well and take her vitamins. Numerous midwives explained to her the importance of good nutrition in pregnancy and the risk to the baby if it doesn't get the nutrition it needs and doesn't grow well. She claimed she didn't have money for food, yet there was evidence that she actually did have more choices available to her.

In fact, she was spending her money on white bread and fortified, powdered chocolate milk drink, which has a lot more sugar than protein. We know for one that the milk powder is a lot more expensive than fresh vegetables and eggs, for example. And since she apparently had no problem paying for meds we prescribed for an infection she had and the lab work we required, several of us agreed that something just wasn't right about her story.

We have numerous women in our clinic who have very little money and who truly struggle to eat well and pay for needed labs and meds but this woman didn't fit the usual profile. Most of these patients still find a way to eat at least three meals a day. It may not be the ideal diet but at least it's not one that induces the level of malnutrition seen in this woman and her baby. In addition, our women who are truly impoverished do not have a husband with a decent, stable job like this woman does. And this was her first baby so it's not like she had many other mouths to feed. Each midwife attempted to get to the root of the problem but she maintained that it was a financial problem that kept her from eating.

So that brings us to this point, where we were last week with this patient in early labor and her baby giving us some very nonreassuring signs of its well-being. Unfortunately she was only 2 cm dilated so there wasn't much we could to facilitate delivery. We hooked her to IV. We filled a bag of medical supplies and gave it to her husband to hand over at the hospital to alleviate some of the cost just like we do for all of our patients who get transported. I called the OB resident and told her we were coming. We took her to the city hospital. After waiting over 30 minutes for a doctor to see our patient, the OB finally determined she needed an emergency C-section.

They informed me that the provincial hospital (the only other public hospital in the city) is closed for two weeks for fumigation just like it does every year and that because of this our patient was 5th in line for C-Section.

24 hours later... Yes, 24 hours later our patient had her C-section. Although I haven't confirmed this, we heard that the woman just ahead of our patient, in line for C-section because of dangerously high blood pressure (preeclampsia), went into eclamptic shock and died - waiting for C-S.

As for our patient, she delivered a three and a half pound baby boy. He required resuscitation at birth. Once he was stable they did a gestational age exam and determined that he was indeed 38 weeks (full-term) and therefore was confirmed to have suffered from intrauterine growth restriction (IUGR), which is in most cases a result of extremely poor nutrition. It was exactly as we had suspected. That in and of itself is more than enough for a little baby to be up against.

Unfortunately though, in addition to this the baby clearly experienced hypoxia due to the decelerations of his heart beat and was likely in metabolic acidosis at birth. (Acidosis is what happens when there is deprivation of positively-charged oxygen molecules in the tissues and organs, and there is a subsequent build up in hydrogen ions, which have a negative or acidic charge. Organ and tissue damage is certain when prolonged.)

God knows what additional damage has been done just by leaving him in so long. His heart rate was dipping down to 80 beats per minute when we took them to hospital, which is always an emergency situation. A normal fetal heart rate is 120-160. Since then (a week ago) the baby has stayed in the ICU (which is really just a small room adjacent to the pedia ward with 3-4 babies to a bed, no incubators, and only 1 oxygen tank) and has been receiving meds for metabolic acidosis. We learned yesterday that he coded again and had to be resuscitated again. So far, he's still alive.

According to the obstetrician that works closely with our clinic and who saw our patient in the hospital, the patient admitted she didn't eat because she didn't want a big baby. I can't say for sure that this truly was the reason why she decided to starve her baby but the thought of it is heart-breaking. Awful. Awful. Awful.

Internet Troubles

After days of little to no internet connection, several phone calls to the phone company, and a long-awaited visit from a technician, our internet connection is back up! Yeah!

Without internet connection for what we consider to be a significant amount of time, we were surprised at how disconcerted and discombobulated we felt. We felt isolated, disconnected and cut off from the world and from friends and family especially. It's an awful feeling actually.

It makes me realize how much having the internet enriches our life overseas and how different life would be without it. At the same time it's disturbing at how dependent we are on it. I'm not sure it's worth analyzing whether it's a good or bad thing. It is what it is. I'm just thankful we're back in action.