10/10/2011 evening

 

Hey, everyone :-)

 

I've been here 3 weeks today and I am already reminded of the bittersweetness of serving here. Some things are very hard to put into words How do you explain what it's like to see kids starving to death for lack or enough protein or lack of food in general to the richest people in the world--we who say we are starving when we haven't eaten in a few hours? How do you explain what it's like to be part of saving a life? What it's like to see a 4 year old who came in unable to walk, leave running and smiling? How do you explain what it's like to try your very best and see a little one die despite your best efforts from something as "simple" as lack of food? How do you explain the joy and welcoming a new little one into this world and help insure that it's mother will be there, that they will not die from simple obstetrical complications that often require only an injection to manage? How do you explain the pain and sadness when you fight for a baby's life only to transfer care to an uninterested doctor and learn that the baby died for lack of compassion? And, even if you find the words, they seem insufficient...mainly because, before I came here, I would have read the same words and not really have understood.

 

kwashiorkor /kwash·i·or·kor/ a form of protein-energy malnutrition produced by severe protein deficiency; caloric intake is usually also deficient. Symptoms include retarded growth, changes in skin and hair pigment, edema, immune deficiency, and pathologic changes in the liver.

 

A medical definition of what we see here every year. And, somehow the words just don't paint a clear enough picture of the little ones that come through the doors in a slow but steady stream every summer as the beans run out before the new crop comes in. You think its a newborn or at most a couple months old, but this one is almost 2 year old. A tiny body with peeling skin and ribs that protrude but deceivingly plumb hand and feet and not enough energy to even cry as we attempt over and over to place an IV into the tiny, hidden veins. A 4 year old weighs 15lbs and has raw, open wounds all over her skin for lack of vitamins and minerals. Even after 2 weeks of IV therapy and careful feeding, she barely has the energy to walk around with the support of her mom. But, she is improving slowly and has gained 5lbs. Hope is rising among the staff that this will be a story with a happy ending. Another 4 year old weighs 26lbs, but it is all water weight because of kwashiorkor. She looks deceivingly plumb, but she is in grave condition and dies after a few days at the hospital. They stay here for weeks, slowly regaining strength. Little by little gaining weight and with the weight come the smiles and laughter. The ones that walk out of the hospital are unrecognizable as being the same the ones that were carried in. But, some of them will never walk out--the hospital gives what it can until all that is left to give is a sheet to bury them in. The pediatric room is a place of struggle and triumph, sadness and great joy.

 

I've caught 5 babies since I arrived here, but only 4 are alive. 2 were born with thick pea-soup meconium, and one had meconium aspiration syndrome. Vanessa (the head nurse here) and I worked and prayed trying to keep him in the best condition possible as we transported him to the hospital in Guachochi where they have equipment and personnel who are able to care for a baby that has complications and they can transport him to Chihuahua if needed. Every breath was a struggle for him and every minute of the almost hour and a half transport time we were praying for him to continue taking those breaths. We arrived with him in a stable condition but still laboring to breathe and turning blue/purple without oxygen. The doctors and nurses greeted us with unkind remarks and even though they put him on oxygen because they saw that he was turning blue without it, they still told us that we should not have brought him because there was absolutely nothing wrong with him. The baby they pronounced healthy and scolded us for transporting died a few hours later at their hospital. A young mother of 19 will go home to recover from her labor and birth and to bury her first born for lack of attentiveness and compassion.

 

Deaths of little ones are not easy under any circumstances, but they are even harder when they seem like they should have been preventable--a little more food, a little more compassion, a little more education, a little more attention. Be praying for the hospital staff during this year, to be strong in the joy of the Lord. Be praying for the hospital staff in Guachochi--that they will either be convicted and change or that they will be found out and replaced. Pray for grace and pray for justice.

 

How do you explain what its like when songs that you sang as a child, take on a realness and a deeper meaning?

"Jesus loves the little children"

"they are precious in His sight"

"Little ones to Him belong. They are weak, but He is strong."

 

May the Lord bless you all as you serve Him where He has you.

 

God is good,

Michelle

 

 

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10/10/2011

 

Hey, everyone :-)

 

Dr. Bruce, the general surgeon here, wrote this and included a memorial to Manuel. He was at the hospital all of last year when I was there and he died just a few weeks before I returned :-( I thought you all might like to read the story and see the pictures.

 

Love,

Michelle

 

 

In Memory of Manuel

 

On the windswept, barren mesa where six adobe huts are scattered in what constitutes the traditional Tarahumara village of Rajavo, a male child is born in the summer of 1991. The child is raised in the two room adobe, amid the smoke of the open cook stove, widely ventilated by gaping holes in the structure that lets the smoke escape, but are little barrier to the gale-force winds of winter. Reaching school age, he travels on foot for hours each day across the virtually impassable terrain of the Copper Canyons to attend a primitive school, where he learns the foreign language of Spanish to compliment his native Ralamuli. By the end of his schooling six years later, he is even able to read some of that language as well, were he to ever have the luxury of a book of his own. But, in the absence of a father in the home, as the oldest son, he now must be concerned with helping his mother feed and care for his several younger siblings. So, the possibility of living in an alberge or dormitory at the secondary school miles away in Samachique never crosses his mind, while he hacks at the rocky ground of the mesa to plant the corn rows to sustain his family. But all is not miserable, for he has other Tarahumara boys to race across canyon trails, for seemingly inhuman distances, as has been the heritage of the tribe known as the greatest ultra distance runners in the world. Time passes as the boy grows into a teenager, but the games of youth give way to the realities of life in the Sierra Tarahumara. Amidst the vast canyons and mesas of the Barrancas del Cobre, the Mexican drug cartels have found a perfect environment for growing their crops of death in splendid isolation. And with that industry, they provide a means of employment to compete with the bare existence of sustenance farming that characterizes Tarahumara villages. But that change also brings the violence of guns, virtually unknown to the indigenous culture for hundreds of years, where knives constitute the weapon of choice. Barely eighteen years old, and probably only peripherally involved in the violent world of the cartels at the lowest level, Manuel takes a bullet to his chest that rips through his right lung and penetrates his spinal cord, leaving him permanently paralyzed just below his chest level.

 

In this moment, Manuel Acosta is introduced to the staff and doctors of Hospital Mision Tarahumara. Transported near death to Samachique, he is stabilized and then transferred six hours away to the charity hospital in Chihuahua. Miraculously, he lives through chest and spinal surgery, but is returned to our hospital with extensive pressure sores as a result of his immobilization and paralysis. The hospital in Chihuahua no longer considers him salvageable, so he is sent back to a facility medically hard pressed to take care of such a complicated patient. But the staff members of the Mision have what the hospital in Chihuahua lacked. They, as a result of their faith, see Manuel as a child of God, not merely another victim of the drug wars. So, with intensive effort and personalized care, their love for what Jesus called the “least of these” sets into action frequent daily dressing changes and wound care to cure the life-threatening infections of the wounds. Manuel is fed eggs, tuna, and the precious few cans of high protein drinks donated from the United States, in an effort to reverse his malnourished condition. Gradually, his condition improves but the wounds are so deep that the surgeons realize they will never heal. So, at intervals, complicated operations are undertaken to remove the bones from his useless legs, sparing damage to the soft tissues which are then rotated to cover the exposed bones of his pelvis. Six months pass, with four major operations interspersed between months of recovery, but Manuel survives, and the life-threatening wounds are healed.

 

With the passage of time, more than the wounds of Manuel’s body are ministered to by the love of the staff of the hospital. Manuel’s mother, Maria Rosario, his brothers, and sisters become well known and also loved by the entire staff of the hospital. In fact, living on the hospital grounds in one of the adjacent huts provided for patient families, they quickly become part of the Mision family. Each day they can be found pushing Manuel about the grounds in his wheelchair and even for miles along the roads to the nearby villages. His loving mother, caring for seven children, mostly castoffs from other families, begins to circulate in the waiting room of the outpatient clinic, greeting and conversing with the other Tarahumara patients. Through the months, various medical conditions arise in Manuel’s siblings that result in them receiving themselves loving care at the hospital. Regular church services and bible studies held in the outpatient clinic waiting room pique the family’s interest in the music, and progressively they gather at the door to experience this worship, so different from their indigenous animistic rituals. Each morning, the hospital staff’s devotional within earshot of Manuel in his bed and prayers offered by indigenous pastors in his native language begin to make Manuel aware of why this hospital is so different from that one in Chihuahua that saved his life, but discounted his worth. With the daily attention of the surgeon to his colostomy and other medical conditions, a growing relationship of friendship, love, and spiritual concern develops, that opens up in Manuel a joyful personality not seen since the bullet tore through his body and destroyed his already marginal life.

 

In the early summer of 2011, Manuel celebrates his 20th birthday with his extensive hospital family. Though cakes and songs cannot replace his absent legs, and he will never again race through the mountains and canyons as his ancestors have done for centuries, Manuel and his family are coming to realize that this physical body and earthly existence are superseded by an eternal nature and the possibility of a new life in Christ. With this realization, Manuel opens up to spiritual discussions with Jacob, the hospital chaplain, and attends the bible studies, even attempting to read the Spanish bible held in his lap. In an attempt to further normalize his life, though confined to a wheelchair, a trip is undertaken to bring him back to his village, to the home where he was born and grew up. Not having seen it since he was taken from there eighteen months earlier near death, he has the opportunity to fly a kite for the first time in his life in the winds of the mesa and once again gather around the cook stove with his family for a meal in the family adobe. The feel of the wind and the tugging of the kite string in his hands provide to Manuel a sense of freedom that he thought he would never again experience. And with that rush of exhilaration, a huge smile breaks out across his face, and he giggles like the child that once lived carefree on this magnificent mesa from which it seems you can see forever.

 

With budding hopes in the minds of the staff that Manuel might join local missionaries in the effort to translate the Bible into Ralamuli, the aspiration for a future of acceptable quality becomes the mind set of all. But, suddenly several months ago, acute shortness of breath struck Manuel, laboratory studies went awry, and a chest x-ray revealed massive dilatation of his heart. As a result of one of the many transfusions Manuel required throughout the multiple surgeries in Chihuahua and here, a viral infection of his heart muscle has destroyed his twenty year old heart. With medications and careful fluid balance, his symptoms are controlled but the American doctors know that in the US such a condition immediately places the patient on the heart transplant list. In the Sierra Tarahumara, it is a death sentence. From that time on with each passing day, the importance of the spiritual state of Manuel’s new belief in Jesus supersedes his medical condition. Periodic decompensations of his heart require intensive efforts to restabilize his condition, and even his mother cannot maintain her stoic indigenous composure during these times. One evening, the night of August 12th, Manuel tells his nurse that he hears beautiful music that is not actually coming from the TV on that night, that he “estoy bailando” or is dancing on legs that he no longer has, and quietly passes into eternity.

 

What can be said of Manuel’s life? With callousness, we could decry the sequelae of involvement in the drug trade, but who of us have never cried to God for deliverance from the “wages” of our own bad decisions. And could all the medical resources expended over the eighteen months following his injury have been better utilized? Jesus told the parable of the ninety-nine safe sheep left by the shepherd to search for the one lost lamb. We believe we know the eternal state of Manuel’s soul, but he certainly was a lost sheep at one point in the whole experience. What will be the eternal significance to Maria Rosario and all of Manuel’s family from seeing the loving care and friendship lavished on their loved one? And once part of our family, can they ever become strangers again? Talk to anyone of the staff that cared for Manuel and not one considers that their time or resources could have been better spent. Manuel gave as much back to all as he received. Even the surgeon might have been healed. As Paul said in Galatians 5:14 “For the whole Law is fulfilled in one word, in the statement, YOU SHALL LOVE YOUR NEIGHBOR AS YOURSELF”. Hospital Mision Tarahumara found that to be so easy with Manuel and, through your prayers and support, will continue with all his fellow Tarahumaras who come through the doors.

 

 

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9/28/2011

 

Hey, everyone :-)

 

I've been here for a week and a couple days now and it has been very good and very busy :-) I had a lot of fun going around and surprising the staff here that I was back (I didn't tell them the date that I was planning on arriving) :-) Everyone is doing well and I was very happy to find that with the changes in staff (some people left and some new people came), the hospital has a much friendlier atmosphere and people are working together better and being much more sensitive to the unique needs of the patients to have things explained to them and such! Jacob (the pastor that moved down here that is in charge of village evangelism and the church here at the hospital) has started doing a lot of the devotions here in the morning and they are very practical! (Like about the importance of being careful how we speak to each other and about each other and about the needs of the patients here being more than just physical.)

 

They haven't been having many births this year, so far but we do have a good number of people that are coming for prenatals that are due in the next 6 weeks or so. The doctors have been letting me do a lot of the prenatals, so that has been good! This year has been the worst drought and crop in the last 40ish years, so we are getting a lot of malnourished kids. It will be a whole year until a new crop will come in, so please be praying for the Tarahumara and all the missionaries down here as it will likely be a very, very hard year with lots of starving kids and complicated pregnancies. We have a little girl here who is 4 years old and weighs just slightly over 15lbs :-( It is very sad to see so many children that don't even have the energy to cry or struggle when we are trying to put in IVs and such.

 

A woman was brought in from the village with a uterine prolapse--the uterus fell out of her because she was up lifting heavy things a couple days after her birth. It was out for a few days before she was brought here. They did a hysterectomy last week, which was really interesting to see, but it’s a bummer that she had children so closely spaced and didn't rest after her births...

 

A 24 year old with her first baby came in to the front for a visit with the doctor and the doctor sent her baby for an ultrasound to see how far along she was and for me to take a look at her. As I was talking with her and doing the various exams, I started being suspicious that this was not a regular prenatal. Eventually, after a lot of asking she admitted that she had been in labor since Friday (this was on Money afternoon). She had been in very strong labor for three days and then in the morning on Monday, her labor stopped so she came to the hospital so see what was going on. She was completely dilated except for a tiny lip of cervix in the front. Her uterus was thin at the bottom and very tightly knit around the baby (the water had broken at some point so the baby was very easy to feel). No uterine activity at all other than a what seemed like a constant contraction that she said didn't really hurt. We hydrated her with a glucose solution and gave her juice and water and food, but she never started labor again in the 3-4 hours she was here so we decided to transport her. That is just a long time to be in labor and I didn't really like how the uterus felt and didn't want to risk something really bad happening here because we don't really have what we need to he able to handle something really serious. At the same time, I had another first time mom (Marisela)that had never come for prenatal care in labor with what seemed like a term baby . And, a lady was brought in from the village to wait in one of the little "houses" here for her baby to be born because she lives to far away to walk once she is in labor. And, a lady came in with a ton of bleeding and a uterus big enough to be a 16ish week pregnancy but she was not pregnant. The uterus felt very odd and looked odd in the ultrasound, so they did a D&C and sent off tissue to be studied to see what is going on. She had lost a lot of blood (hemoglobin of 8), so they also gave her some blood.

 

Marisela labored with her husband andIduring the evening and the night. She is 16 years old. She was not happy about the whole thing at all, and fought the contractions the whole way! It was very difficult, because no matter how much Christy (a tarahumara nurse who was helping me) and I tried to help her relax or explain how the whole process works, she was determined to do it her way which meant basically pitching a fit through every contraction. I felt really bad for her...but she refused to try anything we offered that might help... oh, well. Finally at about 2am on Tuesday morning she had been complete for awhile and had been trying to push her own way long enough without success that she started letting us help her and the baby was born pretty quickly after that (at 2:45am) The heart tones had been excellent the whole time and the water was clear so I was fairly shocked when the baby was born limp and in very thick pea-soup meconium!! APGAR 4/8, but it took over 30 minutes to get her airways all cleared out. I couldn't believe the amount of mec. I sucked out of her airways!!! Anyway, everything ended well and we kept her here longer than usual just to make sure she is going to be fine and she is nursing well and has continued breath without problems and to have completely clear airways :-) The baby was definitely post dates and had a lot of caput, so I am wondering if the mother was actually in latent labor a lot longer than she said...but who knows. hahaha...I'm going to have to get used to working here again after being spoiled with all the healthy pregnancies and generally uncomplicated births in the states :-)

 

I have gotten all settled into my room up above the hospital and am working on getting my Spanish back up to speed. Things are going really well here for me so far, so I'm very thankful about that. They are going to be converting part of the hospital into a place for mothers to be able to labor and birth that will be much more private and comfortable, so be praying for that to happen quickly! That will make things go MUCH smoother here at the hospital because right now, births tie up the emergency room which is where a lot of the equipment needed for everything else at the hospital is located. Also, be praying for things to work out well with the plans for better prenatal care and education and village out reach. The hospital is working towards being able to help prevent more of the complications here through education and eventually training woman in the villages to be able to provide basic prenatal and postpartum care and be able to help with births that occur too rapidly to get to the hospital and for the births that happen at home because women are too embarrassed to come.

 

I hope that you are all doing well :-)

 

God is good,

Michelle

 

 

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9/20/2011

 

Hey, everyone :-)

 

I arrived here safely and its been great to see everyone again!! I am exhausted so I'll write more later :-)

 

Love,

Michelle

 

 

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9/16/2011

 

Hey :-)

 

Just wanted to let everyone know that Daddy and I are headed out to El Paso, TX to meet Dr. Mike and Macie. The Lord willing, I will be in Samachique on the 19th and my Dad will be home on the 19th. I hope that you are all doing well!

 

Love,

Michelle

 

 

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9/1/2011

 

Hey :-)

 

Just wanted to let you all know that I got the test results today and I passed my test so I am officially a midwife :-) Wooohooo :-D Thank you all so very much for all the prayers and encouragement! I have about two more weeks at home before I will be headed down to Mexico again, so that is coming up fast. I hope that you are all doing well and that you all have a great weekend!!

 

Love,

Michelle

 

 

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8/21/2011

 

Hey :-)

 

I just wanted to thank everyone for the encouraging e-mails and prayers! I felt like the test went pretty well and I'm really glad to have it over with :-) I will not know the results of my test for another 2-3 weeks or so. I will definitely send an e-mail to all of you when I get the results!

 

I hope that you are all doing well and thank you again for everything :-) I really appreciate you all!!

 

Love,

Michelle

 

 

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8/15/2011

 

Hey, everyone :-)

 

Well, I've been at home since April and I've had a great summer! Its been nice to be at home, get to spend time with family and get to do some fun things, like working on a quilt with a very kind neighbor of mine, riding horses with a friend of mine, and going to Jekyll Island and getting to see some sea turtles at night with my cousin :-) Tomorrow I am headed up to Nashville, TN to take the NARM to get certified as a midwife on Wednesday, the 17th. Its hard to believe that I'm finally at the last step of midwifery training/certification!! I've been studying a ton this summer and I'm looking forward to being done :-) If you think about it, I'd appreciate prayers on Wednesday, mainly for me to relax and be able to remember what I have learned.

 

I am planning on going back to Mexico to work in the same hospital that I was in last year. I'm planning on leave for El Paso on the 16th of September and catch a ride with Dr. Mike and Macie--we are hoping to arrive either on the 18th or 19th. There are plans for making separate maternity ward in the hospital and they are also enlarging the emergency room and pediatric ward/room. The rains came very late this year, so being praying for the Tarahumaras. It is likely that there are going to be a lot of starving children and a lot of complicated pregnancies as a result of the lack of rain.

 

I hope that you are all doing well :-) May the Lord bless each of you with joy and grace.

 

Love,

Michelle

 

 

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3/28/2011

 

Hey :-)

 

Just wanted to give a quick update about where I am and what is going on with me right now :-) My Dad is flying into Phoenix today and we are planning to go to the grand canyon tomorrow and spend a day or two there before the long drive home. I have been here for about two months and have been getting a lot of great midwifery experience and was even allowed to shadow and work in an OB-GYN's office while I have been here which was GREAT! I finished up all my requirements for being editable to sit for the NARM exam to become a midwife :-) That test won't be until August. I am planning on being home until then and studying and hopefully doing some doula work in the hospital at home. It has been quite adventurous here for me and I'm very thankful for this time!

 

I hope that you are all doing well and I'm looking forward to seeing those of you that are in Huntsville or near there :-)

 

Love,

Michelle

 

"Every good gift and every perfect gift is from above and cometh down from the Father of lights with whom is no variableness neither shadow of turning." James 1:17

 

 

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1/13/2011

 

Hey, everyone :-)

 

Just wanted to let you all know that I'm on my way to Dallas, GA (near Atlanta) to my Aunt and Uncle's house to spend the night and leave tomorrow morning with my cousin, Sarah Grace, to Phoenix, AZ :-) I've had a wonderful time...that went by faster than I would like...at home with my family! And, we had the first white Christmas I ever had plus a lot of snow that came on Sunday night and is still here!!! It has been a LOT of fun!

 

I'm going to Phoenix to finish up my midwifery training there and hopefully take the first of the two tests for being certified as a midwife (it’s a practical skills test). I am hoping to get my paperwork and all turned in by March 10th and be able to sit for the NARM written exam in August. I would appreciate prayers for things to go smoothly and that I would be able to learn a lot and get a lot more experience while I am there :-) Nathan and Misty Marr are very kindly allowing me to stay in their home during the next couple of months (I'm planning on staying until sometime in August) and I'm really looking forward to seeing them all again :-)

 

I hope that you are all doing well and that ya'll have a great week! The Lord bless your year with much joy :-)

 

Much love,

Michelle

 

 

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12/9/2010

 

Hey, ya'll :-)

 

Well, I'm starting the journey home today. Its amazing how fast this year has gone by! The last month or so has been very, very busy with surgeries and births and getting ready to come home and making plans and such. Its been a really special year for me. God is very faithful. Thank you all for your prayers and encouragement and I'm looking forward to seeing a lot of you while I'm at home :-) I'll try to write an e-mail when I'm home and give more details. I still have a lot of things to get done before I leave, so I can't write much right now. Hope you are all doing well and that you have a great week.

 

Much love,

Michelle

Psalms 121

 

 

 


 

10/21/2010

Hey, everyone :-)

Wow--what a couple of weeks! First of all, I'll give some updates on what happened with some of the situations in my last e-mail: the baby boy whose Mom died is back in the village so we don't know what is going on with him and its not likely that we will hear news of him, but I'll let ya'll know if I do; the lady that had pre-term labor and an appendix infection was sent to Gauchochi and they operated right away to remove the appendix and she is doing just fine and the baby is still inside and growing well, so praise the Lord for that!

Since then a lot of things have been going on!! I had a really busy week on top of being sick last week. There were two full days of surgeries that went really well. They were the first surgeries that the student nurse and I did without Mary (the surgery nurse) doing anything. Everything went very smoothly and it was rewarding to realize that we have learned so much and can work as a good team :-) I also had 3 births last week and one transport. The first birth was a load of fun because she came in pushing her baby out and Dr. Paco says..."well, maybe you can do this one since she isn't wanting to get up on the table right now??" :-) So, I run and get sheets to put under her and Dr. Paco runs to change, Christy the nurse has gloves on and is right there, so I slowed down a bit with putting on my gloves and let her catch :-) That was a lot of fun and I think she was pretty tickled about getting to do that :-) The second birth was an easy one, but a piece of membranes tore off and we had to take some time to gently pull that out (Dr. Pedro let me do that birth), so that was a good learning experience for me. The 3rd birth was soooo much fun!! A first time Mama that Dr. Paco let me manage. It was the first birth of a first time mom that Dr. Paco had seen done without an episiotomy. After the birth, Dr. Paco said, "Thank you so much, Michelle!! I would have done an episiotomy and would still be trying to sew her up right now!" :-D He also mentioned that the nurse (Belen) and he had noted that they tone of voice I used and the things that I said as I talked to the lady during her birth were very calming and that they wondered if maybe the way they usually did things (shouting at them to push and not explaining what is going on) makes the ladies feel afraid and maybe that slows things down. hehehhehe...amazing how showing and letting people see for themselves works so much better than trying to tell them :-) The transport was one when Dr. Carmen was on duty and I absolutely LOVE working with her. She is very caring for the patients and making the decision to transport is always as hard for her as it is for me. She truly wants to provide the best level of care that we can and worries about sending them to Gauchochi where it often is not better care. It reminds me very much of working with Shelley and is a huge blessing to get to have someone to share that burden for the patients with!! The transport went very, very well. I went along and explained to the doctor there what was going on and we were received very kindly and respectfully!!! That was such a huge blessing :-) I saw the baby a few days ago--everything went well :-)

Early this week, a 22 year old woman came in. She had been about 6 months pregnant with twins. By the time she got here, the twins had died and been born on the way here. She was quite anemic (6.8 hemoglobin). She has one 3 year old boy that is still living, her last baby was born and died shortly after birth in Gauchochi. Please be praying for her. Her name is Susana and the people at the Biblical institute have been working with her a lot. Be praying that through this hard time, maybe she will come to know the Lord and His love for her. She was very sad.

A couple days ago, Dr. Paco let me do another birth. It was my 60th birth :-) It was a 9lb 12oz baby girl!! The shoulders got stuck so I got to manage my 3rd shoulder dystocia. It was really amazing working that shoulder dystocia with Dr. Paco because he asked if I wanted to cut an epsiotomy and I said "no, I'd rather not" and he actually helped me keep the mom from tearing as I had to pull the arms out and such. He said that he really likes working with me because it makes him feel so much calmer and ends up not having to sew afterwards, LOL :-) Its just been soooo amazing here to realize how far things have come since I got here. God really has blessed me so much with good relationships and its such a blessing to see how things have worked out :-) The picture is of Dr. Paco, the baby girl, and me.

The Shanks are saying that they might be back this Saturday so we will see if that happens! I'm excited because they are bringing some packages from home! Its been cold here and I just wanted to say "thank you sooo much" again to all of you who helped get me the sleeping bag last year!! It has been a huge blessing :-) I spent many nights in it at the birthcenter and now I'm using it while I'm living upstairs with the nurses because it is cold up there at night and in the mornings :-) I realized that I only have about 6-7 weeks left here!! Time has gone by very quickly. I'm very much looking forward to coming home :-)

I've been really blessed by the study of Ephesians that Pastor Jacob is doing for everyone at the hospital. Its been such an amazing thing to study how "in Christ" we have so many blessings. If ya'll get a chance, just read the first chapter paying attention to all the things we have been given "in Christ" and how many things He has done for us. Its really amazing and I think ya'll would be blessed to read it and be reminded of how richly the Lord has blessed us :-)

I hope that you are all doing well and that ya'll have a great week!! "Rejoice in the Lord always and again I say, REJOICE" :-)

Much love,
Michelle

 


 

10/6/2010

Hey, everyone :-)

I hope that you are all doing well. I have been doing good, but this week has been a pretty hard one so far for me. The Shanks are in AZ and I'm living with the nurses right now, which is working out quite well.

On Sunday, my dog died so that was a sad day for me...and brought back a lot of memories from home so I've been fairly homesick the last couple of days.

On Monday a lady came in with upper abdominal pain and pre-term labor at 28weeks so we sent her to Guachochi but they sent her back to us. Dr. Bruce thought she might have a gall bladder infection so we started treatment for that but the pain has gotten worse so now its looking more like an appendix infection. So, today we sent her off again. Please pray that this time they will be more careful and take better care of her. I'm very concerned that they are going to blow it off again. Something is definately wrong and if it is an appendix infection then she and the baby could die if they are not taken care off well.

Today some people brought in a newborn and the mother saying that the mother had the baby in the night and had fainted. Actually she had died from what appears to be postpartum hemorrhage. The baby appears to be about 35 weeks and weighs 4lbs 12oz. It looks like he suffered from growth restriction because he is very skinny and you can see his ribcage very easily. Please be praying that his family will take care of him. This was her 15th baby so be praying for her other children as well!

I need to go for now. Thank you all so much for your prayers. May the Lord bless you all with much joy!

Much love,
Michelle

 

 


 

 

9/19/2010


Hey :-)


I hope you all are doing really well! I've been busy and having a really good past couple of weeks :-) Last weekend, I was allowed to catch a baby on Saturday by Dr. Pedro. Miriam was working at the hospital that day so it was so nice to be able to work with her again! The birth went well but it took a long time due to the baby's head being in a bad position and being fairly big. We were a little concerned because the baby's heart was skipping ventricular beats a lot and we weren't sure what that meant, but the APGARs were 9/10 and the baby pinked up nicely and never had a problem. Ivan Wang researched the problem for me and it looks like it is usually something that doesn't cause problems and that she will likely grow out of with time. Always interesting to learn new things!! Right after the birth, a lady came in with a cut on her forehead and Dr. Pedro let me suture it :-) It went really well and she came back to get the sutures taken out a few days ago and it looks like she will barely have a scar so I was really happy about that! On Sunday, I helped with another birth that went very well :-)


We had some really slow days at the hospital so I made cinnamon rolls for everyone at the hospital. If you ever have a bunch of cinnamon rolls and want to get rid of them, just bring them over here ;-) That was really fun :-)


They celebrated Mexican Independence day on Wednesday and that was sooo much fun!!! Lots of different kinds of Mexican food and singing and games and then the "grita" (scream/yell) of "viva Mexico" which is a lot of fun with so many people :-)


We haven't been having so many sick babies and young children with diarrhea so that has been very good! They say that the fall and early winter are usually calmer with not so many sicknesses. Its funny how everything seems to come in spurts.


Dr. Carmen let me catch a baby this morning :-) That birth went really well! It took awhile because the head was in a bad position again. We recommended squatting to her and she just naturally kind of squatted between contractions and then lunged on one leg or the other during contractions and the baby's head rotated quite nicely and was born not long after that on blankets in the floor of the ER room :-) A very nice birth! It was her 7th baby and she had most of them before at home so it was really interesting that she came here for this birth. The mom and baby girl are doing great :-)


Well, I guess I'll be going for now. I'm trying to work a lot on learning Spanish and more Tarahumara and building good relationships. There are plans for building a birth area onto the hospital and integrating the midwifery program with the hospital. I'm very, very excited about this! Please be praying that things will work out and that everyone here will be able and willing to work together as a team for the good of the mothers and babies that come here. I think that it is going to be challenging in some ways--as it always is when you try to get people to work as a team--but I'm super excited about the midwives and doctors working as a team here. I think that maybe the Lord is using all that has happened to set the stage for really good relationships with the doctors and a willingness to work like that as a team. I am very excited so see what the Lord works out. So far all the doctors have been very happy about the idea and are talking about how much better it will be that the women will have a more private place to birth and that the emergency room won't be tied up anymore and that the midwives can do more births and make it easier for them :-) So, we will see. It will be awhile before that will be built and more time before it is ready to be used, but that is a long-term thing to pray for :-) God is good.


Hope that you all have a great week!!! May the Lord bless you all with grace and peace.


Love,


Michelle


"Because Thou hast been my help, therefore in the shadow of Thy wings will I rejoice. My soul followeth hard after Thee; Thy right hand upholdeth me." Psalm 63:7,8

 


 

9/1/2010


Hey :-)


Well, last week was quite the week!! Monday, I was asked to pack up everything in the birthcenter and get it ready for Dr. Bruce to live in it while his house is being built (probably a year). That was a really hard thing for me. It brought a lot of emotions to the surface again and I had to do a lot of praying and thinking about things and re-focusing. Another step in learning to trust the Lord and rest in Him even when things don't make sense.


On Wednesday, Marta and Jonathan and their family came over to watch a movie and I could tell that she was going in early labor. She had been starting and stopping labor for the last week, but I could tell that this was not going to stop. Jonathan came and got me later that evening. It was such a beautiful birth. It was a huge blessing to watch such a great team--Jonathan did a great job supporting his wife! She wanted noise for a distraction...I think its the only birth I've ever been at with Veggie Tales silly songs in the background, LOL. Miriam came at about 10pm and Lester James was born at 12:24am, Thursday morning. It was my first homebirth to catch (all my other catches were in birthcenters or the hospital) and my first birth to do as the midwife and not the apprentice :-) It was very, very special. They brought their two year old daughter and 3 year old son in and the son was too tired to wake up but Lilian was delighted :-) She is sooo excited about her baby :-) Everything is going well with Marta and Lester, praise the Lord! I'll send a picture of the Pinkham family and me.

Michelle Hopkins and Pinkham Family


On Saturday, I was invited to go to the hot springs and I was there all day! It was a lot of fun!! I got sunburned, but not bad and it was totally worth it :-)
This Monday we had a going away party for one of the nurses (Diana). I helped with getting food ready and decorated the cake. We will miss her a lot. She was very kind!!
Maybe you all remember the little ones that I told you about a few months ago that were really malnourished--the 14 month old weighed 9lb and looked like a skeleton that I carried around with me when I was working one day and his 3 year old sister whose mother had left them and whose father wasn't taking care of them. Well, today Mary bring two little kids back and says "Do you remember Erika and Nicholas??" I could not believe it!!! They look so much better!!! I wish now that I had taken a picture but at the time I couldn't do it because they looked so pitiful and we weren't sure how they would do. They are precious. Sandra and another lady that works with her in another village have adopted them and they are so sweet!! I'm going to send a picture so that ya'll can see them :-)

Mission worker with two previously starving children


Please pray for me to really be able to learn Spanish and to be able to build really strong friendships here. I've been really working on that recently and trying to be active in looking for opportunities to serve everyone here. I've had some really great opportunities--like not having much to do in the hospital and helping the kitchen staff prepare food and them teaching me more Tarahumara :-)


I hope that you are all doing really well :-) May the Lord bless and keep you all.


Much love,


Michelle

 


 

8/26/2010

I caught a 7lb 8oz Pinkham baby boy this morning at 12:24 am :-) It was a beautiful homebirth--the very first one that I've caught at a person's home and the first that I've done without a midwife or a doctor "over me." :-) Marta and Jonathan did so well and it was such a blessing to see such a sweet husband and wife team. It was also such a blessing to me to see the reaction of their little girl to the new baby :-) She was sooo excited and when they were praying to thank God for the new baby she wanted to hold his hand so that he would be part of the circle, too :-) I felt very privaleged to have been able to be their midwife...it seemed so funny to hear them call me that sense I'm so used to being the apprentice! It was very, very special. I just wanted to let you all know the news first and to say thank you soooo very much for the part that you have all played in helping me learn and encouraging me!! You have all been very special people in my life and in my journey in learning to be a midwife and I appreciate you all so much. Hope you all have a great week!! I'll send pictures tomorrow :-)


Much love,


Michelle

 


 

8/5/2010

Hey, everyone :-)

 

Well, the last couple weeks have been really good here! I did another birth with Dr. Dago and this one went much better. She had a super fast labor and everything went very well :-) I usually work from about 8:30am to 3pm and sometimes end up working later if they need me or if there is a labor. I've been doing a lot of the blood draws for the lab. tech. Its fun because in the beginning he had to teach me a lot and help out when I had problems, but he says that now I am a lot of help because I free him up to do the other things so he gets a lot more work done. One of the patients was a little nervous about me doing it because she had only seen David draw blood, but when I was done she said "that didn't hurt--just like when David does it" :-) Its very fun to make progress in things! I've been able to help with a couple surgeries and really enjoyed that!!

 

I decided to go ahead and take a Mexican nursing course. I got the books yesterday and I can do the assignments and tests online and of course I'm working at the hospital so I can practice all the hands on stuff there. Please be praying for that to go well. Its going to be a challenge to do that in Spanish. I think it will be really good for me--it will really force me to work hard on my Spanish and should help me a LOT when it comes to communicating in proper medical terms in Spanish.

 

A group from the states came down for about a week and me and Christina were able to go and play guitar and volleyball a good bit this past week so that was really fun :-)

 

Things have continued to be challenging but they are definately going smoother especially as I learn to think about the Lord and remember that He is good and that He has a plan even when things don't make sense to me.

 

Please be praying that the Lord will open and close doors and make it clear to me what His will is for this coming year in the right time. I am hoping to finish up and get my CPM and I would like to become a surgical technologist. I'm praying about coming back here or whether there is somewhere else that I should go. I'm excited to see what the Lord has planned and looking forward to being able to look back and see a little better what He is doing right now that I don't understand at the moment :-)

 

I hope that you are all doing well. May the Lord bless and keep you all.

 

Love,

Michelle

"I had fainted unless I had believed to see the goodness of the Lord in the land of the living. Wait on the Lord: be of good courage, and He shall strengthen thine heart. Wait, I say, on the Lord." Psalms 27:13-14

 


 

7/10/2010

Hey :-)


I hope that you are all doing really well and having a good weekend! I've been here for about two weeks now and what a two weeks it has been! I knew that things were really going to be different when I came back with the Riveras leaving and the birthcenter probably closing, but I never knew just how hard this would really be... I remember last year being here and praying and feeling very strongly that the Lord was leading me to come back here for this whole year. I really struggled with that, because at the moment I was quite homesick and anxious to get back home and the thought of being away from my family was just very overwhelming. I remember being in the hospital and one of the nurses asking me about what I might do next year and me saying that I might come back for a year but I was afraid. As soon as I said that, I started crying and it was a major turning point for me because I realized that a major motivation in my life was fear.


"Have I not commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee whithersoever thou goest." --Joshua 1:9


cour·age (k?r'ij): the attitude of facing and dealing with anything recognized as dangerous, difficult, or painful, instead of withdrawing from it; quality of being fearless or brave; valor


I continued to pray about coming here for a year and I felt even more strongly that the Lord was asking me to commit to coming to Mexico for this year even though I was afraid of it and even though there were many uncertainties. I had no idea what this year would bring...and its not over yet!! (I think that sometimes God doesn't show us what is on the road ahead because we would scream and run, LOL) Violence, narcos fighting between each other, the Riveras leaving, the birthcenter closing, trying to figure out how to help now that the birthcenter is closed, struggling to understand what God is doing and realizing that its past my ability to understand...struggling to trust Him anyway.


Courage is not the absence of fear, but rather the judgement that something else is more important than fear. The brave may not live long, but the cowardly never live at all. ~Ambrose Redmoon


The Riveras left two days after I got here and there were sooo many tears shed after they left. They are very missed by everyone. The worst part is having to tell the women that come to the birthcenter that she is gone. Many of them had no idea that she was leaving and having to tell them that the birthcenter is now closed and that Shelley is not coming back anytime soon and seeing their faces has been sooo hard. I am now helping at the hospital during the day and am on-call for births and some emergencies at night. The hospital is not well set up for births and they just don't have time to wait long for them to happen so they transport basically all the labors where the baby is not just ready to be born. That has included a few of the ladies that we did prenatal care for. I can't describe how hard it has been to see them transported for no other reason than than their birth is going to take awhile and knowing that the people in Guachochi aren't likely to treat them well.


I wanted you to see what real courage is...It's when you know you're licked before you begin but you begin anyway and you see it through no matter what. ~Harper Lee, To Kill a Mockingbird


There have been so many days when I came back from the hospital and went to my room and cried. There have been several days when I want nothing more than to leave. But, I remember what I commited to do and the fact that I came here to serve God and because I felt like this is where He asked me to be. But, I have also been really blessed here. It seems like a lot of times deep sadness is also accompanied with joy. I've been able to practice a lot more Spanish now that I'm working at the hospital so much, I'm learning a lot of nursing skills, I am now able to go out to the villages to help with things more freely, I have been able to go out hiking with people and am developing stronger relationships with the peope here because I'm not on-call all the time anymore. I was able to help with a vacation Bible school in Napuchis which was really enjoyable and I am going to be able to go to Santa Rita next week with the Shanks and will be helping Josefa teach classes for the children :-) Please pray for me to learn and grow during these next 6 months and that I would just really learn to trust the Lord and love Him. Even though this is a hard situation, I am really, really thankful because I know that its an opportunity to understand His faithfulness even more. I know that many of you are going through hard/difficult times in different areas of life, too. I am sure that many of you are struggling with things that I don't know about and maybe even things that no one but you and God know about. May the Lord help us all to have courage and to trust Him no matter what we are facing. If there is ever anything I can pray for any of you about, just let me know :-) Thank you all for your prayers and encouragement!


The joy of the Lord is our strength,


Michelle


Courage is not simply one of the virtues, but the form of every virtue at the testing point. ~C.S. Lewis

 


 

6/28/2010

Hey :-)


I'm in Mexico and doing really well. We arrived in Samachique yesterday afternoon and haven't had internet until this morning. The rainy season is here and that brings with it storms which sometimes means that we don't have internet. They had a going away party for the Riveras last night so that was a really bittersweet time. The Riveras are leaving tomorrow morning. Well, that is all the news I have for now. Thank you all so much for your prayers and I will continue to keep you all updated :-)


Love,
Michelle





6/26/2010

Hey, everyone :-)

 


Well...the the month I spent at home sure did fly by! I'll be flying to Houston and then to Mexico with Dr. Mike and his wife, Macie in just a few hours. I really enjoyed my time at home and getting to spend time with my family and friends and relatives :-) I'm really looking forward to being back in Mexico, but I'm really feeling sad about leaving...


I recently received an e-mail from the Riveras and they have decided to leave Mexico, which means that I will not have Shelley to work under when I return. I will probably be working in the hospital the rest of my time in Mexico and may not be doing much midwifery. There is a midwife planning to move down and take over the birthcenter, but she might not be able to do that until late in the year. The hospital is also losing a few nurses pretty soon and they haven't been able to find any new ones. So, the rest of this year is probably going to be a busy and challenging time for everyone down there. Please be praying that all the staff down there will be able to work through these next few months, that God will send the people that He wants to work here, and that everyone will be able to adapt well to all the changes. I'm sad that I won't be working at the birthcenter very much this year, but I know that I will get a lot of experience at the hospital that will be helpful in my learning even if I can't get it signed off for my paperwork to become a CPM. I will also be able to learn a lot more Spanish while I am there which I am excited about :-)


I hope that you are all doing well and I will continue to keep you all updated on what goes on while I'm in Mexico. May the Lord bless and keep you all.


Love,
Michelle

 

 


 

 

5/25/2010

Hey, everyone!


Well...the last week has brought many changes and many things to do. On Sunday, my Dad decided to ask me to come home for awhile because of the violence going on down here in Mexico. I will be traveling with the Shanks tomorrow to AZ and will fly out to AL on the 27th, the Lord willing. I am excited about seeing my family but leaving with much sadness. Please be praying for Mexico and for wisdom for all the missionaries down here and also for my parents and me as we re-group and make plans for the future.


Things have been going well here and everyone is safe and healthy. We had a couple more births--one of which was yesterday. We also had a transport today. The birth went very well--healthy mom and baby girl :-) The transport was a 14 yr old girl (well she says she is 14 and her birth certificate says that she is 13 so we aren't sure...) with her first baby. It was not an emergency transport--she just wasn't progressing and we didn't want to risk things getting worse and having to do an emergency transport late at night right now.


Thank you all sooooo much for all your prayers and encouragment. I hope to come back here pretty soon, the Lord willing. Hope that you all have a great day!! May the Lord bless you and keep you all.


The Joy of the Lord is our strength :-)


Love,
Michelle

 

 


 

5/16/2010

Hey, everyone :-)

How are you all doing? I hope that you are all doing very well! Things have been slow at the birthcenter for awhile with only a transport for a girl with pre-ecclampsia in early labor and a few prenatals.

I was able to help with some eye surgeries that a group from the states came down to do. The team from the states was really small because so many of the team cancelled because of the violence down here. It was really, really neat to get to help them out. I got to be the non-sterile member of one of the two surgery teams--there was the surgeon, his wife who was the instrumentist, and me. I got to bring the people in, write on the chart, prep the patient, sterilze instruments, get things that they needed, open up things for them, etc. The first few surgeries went slower because I had to learn how to do things quickly and a lot of it is anticipating what they will need next. After awhile, I got the hang of it and it was soooo much fun to get to the point where they didn't need to ask for things anymore because I was able to anticipate what they would need. The surgeries went much much faster and they got all the surgeries done in the two days they were here which was wonderful!!! It was an amazing thing to see the people come in and be blind because of cataracts and need a helper to get around and the the very next day they could see enough to walk by themselves!!! I have never seen the Tarahumaras be sooo emotional as after those surgeries. Just before the team went back to the states, they gave instructions of how to care for their eyes and such and explained about how they had come down to show them that the Lord loves them and prayed for them all. I was soooooo shocked at what happened next!! A lot of the Tarahumaras actually smiled and came up and shook all of our hands and said "thank you"!!! I hope that maybe they understood a little bit of what they were told in the waiting rooms--they did devotions and such for them and maybe some day they will have spiritual sight as well. I can only imagine how it must have been to see Jesus make someone that was blind able to see perfectly!!

One of the babies born at the birthcenter about a month ago has a problem. His newborn screening test came back abnormal. When he was born we noticed during the newborn exam that he had a large space between his big toe and his other toes and he didn't have the best muscle tone which are possible signs of a genetic problem but sometimes can be normal. We wanted them to stay a few days so that we could watch the baby and so that we could to the newborn screening test at 3 days so that it would be more accurate but the mother insisted on leaving that day. The health workers from Gauchochi came here and told us and then went out to her village and brought her back. Her baby is jaundiced and seems to be growing okay but he doesn't seem to respond like we would expect--he is a little bit lathargic. Anyway, he is going to a specialist to get more tests and see what the problem is and whether they can treat him or not. We are very concerned that even if it is something "treatable" that the treatment will probably too complicated to get the mother to do. The Tarahumaras will barely take a 5 day dose of antibiotics much less give a baby medicince every day and bring him back every so often for a doctor to re-evulate his situation and such. Please be praying for the baby and his mom to understand what is going on and the doctors in the city to care and at least try to provide appropriate care if possible.

I don't know if you remember the young lady that came here from one of the villages and was scared of the lights on at night. Well, she came for a prenatal a couple times. A couple weeks ago she started bleeding and they rushed her to the hospital. There was a placenta problem and the baby was born alive but he was pre-term. They transported him to a bigger hospital but he died during the transport. The people in the bigger hospital told the mom that it was her fault that the baby died because she must have been working too hard :-( Esperanza and Lupita work in her village (they are missionaries that work from the hospital out in this village) and they say that her husband beats her. Please pray that they will have opportunity to minister to this young lady.

Another of the ladies that came to us a few times for prenatal care decided to birth at the hospital and the doctor really mishandled her care. Her baby was born almost a month ago and he is not doing well. They just transported him to Chihuahua. Please continue to pray for the doctors here and our relationship with them and that they will have wisdom with the births that they handle and pray for this baby and his family.

I have been helping at the hospital regularly and getting more experience with drawing blood and putting in I.V.s. I've been enjoying interacting with the patients here more and more as my Spanish improves and I learn a little more how to interact with the Tarahumaras :-) Yesterday Miriam taught me to make corn tortillas--well, more like she showed me how with one and then had me do the rest. She said that the fastest way for me to learn was to have to do it myself :-) You cook them on a flat, retangular pan that has no sides on the stove top and she taught me to flip them with my hands. It took me a little while to figure it out--especially the flipping part because it is easy to accidently burn your hands. After I got the hang of it she pulled out a spatula and told me that I could use it now if I wanted but she wanted me to learn to do it with my hands because the only people that flip tortillas with a spatula are Americans :-D

The people at the hospital LOVE me to make bread and cinnamon rolls. In Mexico, when a single woman can cook then she is told that she is ready to be married so they tell me that whenever I make things. Well, the other night I was eating with them and they were eating hot salsa with their food. One of the doctors realized that I was eating it with no problems, too, and he says, "You can cook, so you are ready to marry. You eat hot chiles, so you are now permitted to marry a Mexican." :-D

We have several ladies due the end up this month so please be praying for them to have safe births and for us to have wisdom in their care. Some of them are anemic and one of them has a history of bleeding a lot and this is her 17th baby if I'm remembering correctly. Her husband says that he is going to give this baby away...which in this case could be a very good thing for this baby because the family he wants to give it to are strong Christian Tarahumaras that would take good care of this baby, but it is still a sad situation.

Well, I hope that you are all doing well :-) I'm sorry it has taken me so long to write. This past month was not an easy one for me. The Lord was very faithful through it all to help me through all the hard situations by providing me with comfort through various people and through His word. May the Lord bless you all with much joy.

Much love,
Michelle

 


 

4/20/2010

Hey :-)

I hope that all of you are having a great week and doing very well! I have been doing very well here :-) Last week we had a birth on Wednesday. I was helping at the hospital when a lady came in that was in labor. Dr. Paco was on duty and checked her and she was at 9cm. He asked me if I could do the birth and whether I would like to do it in the hospital or in the birthcenter, so I picked the birthcenter :-) Well...one of the nurses strongly objected to that, but Dr. Paco looked at her and said, "We are all a team--the hospital and the birthcenter. The midwives are here because they specialize in births. I am a Dr. and I have a lot of check-ups that I have to do today--it is so helpful for me to be able to let the midwives do their job and me do mine." That was such a blessing for me to hear :-) He told both me and Shelley later that he considered the birthcenter to be a huge blessing and that he knows that we are able to offer better care because of our training and because that is our one focus here whereas when he does a birth he still has to worry about other patients. Dr. Dago and Dr. Carmen have also said positive things about the birthcenter recently. Please keep praying for all of us to be able to work as a team. God seems to really be blessing the relationships of hospital and birthcenter staff and this is really exciting! Also, be praying for the one nurse...she is known to be a trouble maker in general so just pray that we will have wisdom in dealing with the things that she says and does to try to trip us up. The birth went really well--a healthy baby boy and a healthy mom :-)



Today, another lady came while Dr. Paco was on duty and he called me on my radio (I was doing a prental with Shelley) and said that he had a lady in labor that was 8cm and would like to let her birth with us. (The nurse that was unhappy with the hospital giving us births in on vacation for a couple weeks, so that wasn't a problem.) The birth went very well--a little girl this time :-) We have been having difficulties this afternoon with her uterus not staying firm a little more bledding than we would like, but she seems to be doing just fine now, so that is great!



I have been enjoying being able to hike and play basketball over here a few times in the last couple of weeks. A guy named Luke has been here visiting and helping at the hospital and he has been filling in as the big brother down here so that us girls can go hiking (we are not allowed to go by ourselves for safety reasons). That has been a big blessing. Tonight had some excitment when a neighbor's pig broke into the Shank's garden and was discovered and promptly chased out :-D ...Pigs are much, much faster than I had thougth :-)



Well, I am going to go over and check on the lady and her baby now. May the Lord bless you all with a joyful week.

Love,

Michelle

 

 


 

4/12/2010

Hey, everyone :-)

I hope that you are all having a great week so far! Things have been going well for me down here. The Riveras are back home--they arrived here on Saturday so I get to go back to being the apprentice again (which I'm very happy about) :-) I have been helping a lot at the hospital and learning more Spanish and getting more confident in various skills and learning more nursing skills which is really a blessing.

 

This year was one of the quietest years for semana santa that the missionaries here remember--hardly any accidents and not that much drinking and drum beating compared to other years. We still got several accidents related to drinking. One man came in with a really bad burn all over his side and told us that he "accidently" fell in the fire. The Dr. asked if he had been drinking and he said, "No." Then the nurse said, "no one falls in the fire like that if they weren't drinking--are you sure you aren't lying???" The man says, "welll....maybe I was a little drunk." There are 4 men in the hospital right now--two have very badly broken femurs and have been here for months and will be here awhile longer, one is paralyzed from the waist down, and the other has the bad burn. All of them had their "accidents" because they were drunk. The one that is paralyzed is only 18 years old.

 

One of the villages that Dr. Carmen visits has two men that live near it that they are pretty sure are believers. They are always eager to come to the Bible studies that they do in the village and they are even meeting together every Sunday. One of the men has requested prayer because he says, "I want to keep following God. I do not want to turn back...but I am afraid that if I cannot know what the Bible says then I will turn back and I cannot know what the Bible say unless somone comes to meet with me because I cannot read." I was really convicted when I hear what he said because here is this guy that has a Bible and wants soooo badly to know what it says but he can't read. I can read and I have a Bible and often I just take it for granted. Please be praying that the Lord will send more people down here to work in the villages. Right now the people that are here are doing outreaches, but there is such a need for people to live near the villages and be able to meet with new believers and ones that are interested in learning more about the Lord. Pray for the new believers that the Lord would encourage them as often they are the only ones in their village that are believers.

 

 

The weather has been really beautiful down here!!! For the last few weeks it has been sunny and about 70 degrees in the day :-) It hasn't rained in quite awhile so it is very dusty when the wind picks up, so we are never able to get everything clean around here. I have really been enjoying the nice weather!

 

 

Well, I hope that you are all doing well :-) May the Lord bless you all with much joy and grace.

 

Love,

 

Michelle

 


3/31/2010

Hey, everyone :-)

Things have been slow for the birthcenter in the last couple weeks, which has been kind of nice in its own way. I was able to help out at the hospital more and got to help with surgeries :-) I was able to suture again--a cut on a man's foot so that was great to get some more experience with that!

 

Riveras have been in the states for a week now and will be back in about 8 days, so it is just me and Miriam at the birthcenter. We have been glad that it hasn't been too busy. We did have a labor a couple days ago but we had to transport because of some complications--mainly that the baby wasn't coming down. She and the baby both had great vitals and she is Mexican so she wasn't afraid of transporting and speaks perfect Spanish. They tend to treat the Mexicans better than the Tarahumaras at the hospital in Guachochi so we are hopeful that they took good care of them, but we haven't received any word back yet.

 

I've been able to play basketball with Christina, Tony, and some boys from the Bible institute in town many of the evenings this past week and that has been a lot of fun :-) We have been enjoying really, really nice weather for the last couple weeks!! Its almost always sunny with no clouds in the sky and about 70ish during the day. It is the "windy season" so, as you might guess, there is a lot of wind which can be a bit annoying because it is also quite dry so the air gets really dusty. We sweep the floors about 3 times a day and every time there is a lot of dust in the house!

 

The Riveras' dog, Sparky, got hit by a truck a couple days ago so I got to clean up all his cuts and such. He can't put any weight on one of his back legs, but other than that he is doing great...hopefully he will be more careful on the road next time! They have been working on getting the road in Samachique all paved and it is nice and smooth now, but that has been a rather dangerous thing because now people are driving very, very fast on it. The town is planning on putting speed bumps up near the hospital to at least slow them down around here so that it will be a little safer...but things in mexico take a long time to get done so there is no telling when they will finally put those up.

 

This is "Semana Santa"--the holy week...which means that many people will spend the whole week drinking. Be praying especially for the children. The Tarahumaras view "God" as an angry, drunken father that has to be appeased and one thing that appeases "God" is to offer him alcohol and to drink it yourself. So, all of the religious holidays here are celebrated with a LOT of drinking by both the men and the women, which results in a lot of "accidents." Please keep these people in your prayers--that the Lord will show them the truth and that we will be able to show them the love of Christ.

 

There has been a lot of drug-related violence lately in surrounding areas, so also be praying for protection for people around here and for the government to have wisdom in how to deal with the things that are going on down here.

 

down here, there is a lot of debate about politics and what the politicians are doing and I'm sure there is MUCH more of it in the states with all the media that we are...deprived (???)...of having down here. It has been interesting to hear it all discussed down here. The thing that I have been challenged by and have been thinking a lot about is the fact that often "the only thing necessary for evil to triumph is for good men to do nothing" and I just wanted to challenge and encourage you all to remember to stay faithful. Each one of us that are Christians are part of the body of Christ and have unique talents and opportunities to have an impact on the world. And, whether we do something or do nothing, we DO impact the world. Christina had some music on today and the lyrics caught my attention:

 

"We are not blind. We know the truth. Still we don't stand. Still we don't choose. We'd rather stay so comfortable stuck in our world under control. We may not pull the trigger but we stand by and watch and pretend not to see. Silence is worse then evil done--what in the world have we become?

 

This is war, so pick your side.
It's time to move, not time to hide.
Don't let lies, make up your mind.
'Cause you will see
We're Running Out of Time."

 

I hope that you are all doing well! May the Lord bless you all with joy and grace to serve Him where He has called you to serve.

Love,

Michelle


3/18/2010

Hey, everyone!

I hope that you are all doing well :-) I'll give a couple quick updates on some things I talked about in my last e-mail: 1.The little old man that had the bad burn is still here and they will do surgery on him on Satureday, the Lord willing. He seems to be doing pretty well so far. Be praying for the Lord to really work with him and give him freedom from the lies that he has believed for so long. 2. The lady that we transported and her baby were able to come home the day after we transported them and they are doing very well, praise the Lord :-) 3. We haven't heard anything about the premature baby that they transported...which is not too uncommon since the hospital probably had to transport him to a larger hospital.

On Friday night, some of the hospital staff that has been working out in a village in a clinic that they have started out there brought in a 16 year old that is pregnant. She had never been out of her village and when they got close to Samachique (it was dark) and saw the first lights, she got very afraid and was asking "what are those???" She was very surprised with things here :-)

On Sunday, a first-time mom came to the hospital and Dr. Pedro transferred her care to us. She was 15 years old and was 10cm when she came to the hospital! She had a baby about an hour and a half later :-) It was a cute baby boy and everything went really well. They went home the next day. She was brought here by one of the Tarahumara men who works on the Bible translation team. It was nice to meet him--he lives in Creel so I had heard about him but I'd never been able to meet him.

Early on Tuesday morning, Maria Rosa went into labor. She had been staying here until she delivered. She and her husband, Silvario, live in a village where Rueben and Emmy live (they are mennonite missionaries). They go to the church that Rueben has started and are very sweet. She labored all day and during the day I stayed at the birth center doing labor watch. I had my computer with me and Silvario saw my screensaver which is a picture of a place near home and he was so interested, because he had never seen those kinds of trees and green grass before. He LOVED looking at pictures of my family and asked how far it was to my home and was astonished that it would take 3 days of driving all day long to get to my house!! I showed him a map of North America with Mexico and the United States and he saw all the blue around North America and asked "What country is that?." I wish I had a picture of his face when I told him it was water!!! He said, "OHHHHH...MUCHO agua!!!" It was priceless. I showed him a picture of the earth from space and he was just amazed that there were other countries and how much water was in the ocean :-D Maria Rosa is about 4ft 8in and she told us that all her labors were really hard and that they all hurt her back so it seems like she probably had all of her babies posterior which is opposite than normal and usually hurts more. This birth was no different. The head came down crooked (asynclitic) so we had to deal with that (thank you all the midwives for your e-mails about dealing with that problem!!!!), once the head was straight, she ended up with a lip of cervix and we had to deal with that, then we started getting decelerations with the baby's heart rate, and the head really wasn't coming down well despite the fact that there seemed to be plenty of room in her pelvis and everything...we started to be suspicious of a cord problem maybe holding the baby back. We had been praying and praying for her and the baby the whole labor and hoping that he would just be born, but once we started getting the decelerations and starting wondering about maybe a cord issue we had to transport. I went with her with all the equipment I needed to catch a baby just in case. Not long after we left Samachique, I started to have a feeling that something was going wrong with the baby. I couldn't check heart tones because that is not possible in the ambulance with all the noise and how bumpy the road is so all I could do is pray and wait. We got to Guachochi and took her into the hospital. They don't have a doppler there so they use an ultrasound machine to check the heart beat. The OB-GYN was terrible. The difference between the way that they treated her and how they treated me and Edwin was just heartbreaking. They yelled at her in Spanish and were all mad that she didn't answer them. We explained that she spoke Tarahumara and very little Spanish, but they continued to speak quickly and loudly at her. He did the roughest exam I have ever seen and then checked the heartbeat. I was the only other person that saw the ultrasound because he turned the machine away from everyone but I moved so that I could see it. He focused on the heart and it was beating so very slowly and not very regularly. A young doctor that did care had been concerned because she asked the mom if the baby had been moving and Maria said "no" so the doctor was asking the OB if there was a good heartbeat. He said, "oh, yes." And, told them to take her to the delivery room. That little baby needed a c-section, but that OB didn't care at all. We were there for about 15 minutes before me and Edwin had to leave and the whole time the OB was laughing and joking with the nurses in the front while Maria who now had fresh blood on the back of her gown was waiting to go into the labor and delivery room. I felt like I was in a nightmare and all I could do was lean against the wall and watch...

 

 

The next day was really, really hard for me. Its the first time I've witnessed for myself what I have been told happens all the time out here--a doctor doesn't care about the stupid indian and just lets them sit in a corner and if they live, they live and if they die, they die. So, many of the babies that they transport from this hospital aren't taken care of at all in the bigger hospitals--it all depends on which doctor happens to be assigned to their case. I kept seeing that little heart over and over and wondering how anyone with the ability to do something to save a little life, could witness it starting to slip away and do nothing.

We received word that the mom had been released from the hospital, but they were keeping the baby because it wasn't doing well. We are praying that the Lord will work through this situation and bring good from it. We do not know if the baby will live or die or if it will be healthy if it does live. It is a miracle that the baby is even alive, because they never did do the c-section so he went quite awhile with really bad fetal distress.

I am doing better today, but it is still very hard to think about. Shelley told me that this is what happens when you work in a third world country. You see really awful things happen because people afflict other people and show no compassion. She told me that "we can never get hardened to it--it has to break our heart every single time it happens, because God sees it and it breaks his heart, too."

May you all have a great weekend and thank you for your prayers.

 

Much love,

 

Michelle

 

"Some through the waters, some through the flood, some through the fire, but all through the blood; some through great sorrow, but God gives a song, in the night season and all the day long."


3/12/2010
Hey, everyone :-)
Well...I've been having quite an interesting time these past couple of days...
Monday went pretty well--it was Abby Rivera's birthday and I did a postpartum visit with Fabiola she and her baby both are doing well.
Tuesday was a really good day--I got to help at the hospital and in the afternoon I gave an English lesson to some of the Tarahumara young ladies that work at the hospital and they gave me a Tarahumara lesson! That was quite the lesson with three languages going. I have to explain things about English in Spanish and they have to explain things about Tarahumara in Spanish and when I want to know how to say something I have to ask for it in Spanish :-) My brain got quite the workout :-)
Wednesday was kind of a hard day...a backpacker brought in one of the witch doctors from out in the middle of nowhere with a burn that the villagers said was a month old. The witch doctor had put dirt and grass all over it and wrapped it up in a cloth of some kind. He looked really old--the nurses guessed that he was about 90 but its hard to tell with them. He didn't understand any Spanish so one of the translators came in and tried to talk to him in Tarahumara. He just stared at her and randomly would laugh and mumble a bunch of noises that didn't make any sense to anyone... He didn't understand and acted really odd. Anyway, Dr. Mike came in and had to clean up the wound and start removing all the dead tissue. The smell was awful. It was hard to tell how much of the tissue was dead from the burn and how much was dead from infection. One of the fingers was only bone left and all the fingers had to be removed--much of them were completly charred and the bone was starting to dissenegrate. A lot of the skin had to be removed on his hand and wrist and some of the bones on the hand were exposed and had to be partly removed as well. The whole time he was soooo scared and we had to hold him down while he was yelling and everyone once in awhile he would say something understandable like "they are taking out my blood--I'm going to die." I was holding his legs, Tony had an arm, and Jovita had the other arm. I felt so bad for him. They did a nerve block and the tissue was dead so he was just scared and not really in that much pain. He has likely never been out of the village and most of the witch doctors believe that medicine is evil and will hurt you. I felt bad about his injury but even worse for him in general...he lived his whole life believing things that were not true and it seems like he has some kind of mental problem going on now so he will never be able to learn the truth. Its really hard when you have patients that you can help physically but you can't help in any other aspect of life :-( We will see how much more of the hand/arm will have to be removed in surgery this next weekend.
Thursday we had a labor that ended in a transport. It was her 8th baby and the labor got to a certain point and then didn't progress anymore. She and the baby both had good vital signs so hopefully everything went well in the hospital in Guachochi. We are still waiting to hear back about what is going on with her.
Today some parents brought in their baby. He was born 2 days ago and is premature--we think about 33-34 weeks. He is 4.4lbs. They transported him to Gauchochi, today. His heart rate was a little slow and he was working hard to breath. He also has several signs of having some kind of genetic problem and doesn't have a sucking or rooting reflex. I really hope that they will take good care of him in Gauchochi...a lot of times the doctors there really do not care and know that they can get away with not providing good care with to the Tarahumaras because they don't know any better... It was so sad to see such a little tiny baby like that...
The Shanks may be able to come back tomorrow...I am hopeful that they will!! I hope that you are all doing well. Thank you for your prayers!! May the Lord bless you all with grace and peace.
Love,
Michelle
"The only things we can keep are the things we freely give to God." C.S. Lewis
"And people who do not know the Lord ask why in the world we waste our lives as missionaries. They forget that they too are expending their lives... and when the bubble has burst they will have nothing of eternal significance to show for the years they have wasted." --Nate Saint

3/5/2010
Hey, everyone :-)
I hope that you are all doing well! Things have been pretty busy over here for me! First of all, an update on Maria and her baby: they seem to be doing well. We got to see them and do a postpartum and newborn exam. The hospital had a transport the next day so they brought them back. The baby was about 6lbs when he was born so he was a pretty good size :-) We are still a little concerned that he may have some kind of mental problem...his face does not look quite right, we can't get a startle reflex, and he moves his hands and arms in an unusual way. We will get to see them a good bit, so time with tell as he gets older how he is doing. Out here, there really isn't anything to do about that...there are no resources out here for children with those types of problems--IF he does have a problem which we aren't sure about. But, they both seem very healthy, so that is a BIG praise :-)
I got to suture a few days ago!!! A man came in with two cuts and Dr. Pedro knew that I wanted experience suturing, so he sutured the bigger cut and talked me through everything he did and then he let me suture the smaller cut :-) I was sooooo happy for that opportunity!
On the 3rd of March we had a busy day! Dr. Pedro gave us a woman in labor and we got her settled in and she was only 3cm but her first baby was born really fast (they said that the Dr. said she was 3cm and the the baby was born about 45minutes later!!), so we wanted her to stay for awhile even though she lives in town very close to us. While we were still getting some charting done with her, Reuben (a missionary that lives about an hour away) drove up with a lady from the village out there in very active labor! Miriam was not here, so it was just me and Shelley. Ivan Wang came over to help and watch (he is a P.A. that is training to work in the villages). She was already 10cm, so things went very fast. I put her I.V. in very quickly and had no problems, which I was really happy about! (Miriam is the best at them, so she does many of them and I don't have that much experience yet--I think that was my 5th one.) The baby was born at 12:16pm--a baby boy, 7lb 0oz. He had a very long cord and it was around his neck twice, but everything went well :-) Fabiola had not progressed in her labor after a few hours and didn't seem to be having contractions so we let her go home. Edwin drove Rosa and her husband and their baby home at about 5pm. We cleaned up the birthcenter just in time for Fabiola, who came back and said that she was having regular contractions. We couldn't tell when she was having contractions so we didn't think she seemed to be in active labor, but she was 5cm when I checked her. That was the most painless labor I have ever seen!!! She could smile during contractions even until she was 10cm and only had a lip of cervix left!!! Things went well but much slower than her first baby. The baby was born "military attitude" which means that instead of the head being flexed and the smallest diameter of the head being born first, it came looking straight ahead which means that the diameter being born first is larger than usual. She also had a very short cord! She was 7lb 2oz. Her front soft spot (anterior fontanelle) was very large so we are keeping an eye on that.
The next day I organized, re-stocked, and cleaned the birthcenter and then we did postpartum/newborn visits for Fabiola and Candelaria. We were still concerned about Fabiola's baby because the soft spot was still large and was "puffy/bulgy" so we had Ivan Wang look at it and learned a lot about what to look for to tell if that is a sign of a problem or not. It seems to be normal for her, but we will continue to keep an eye on that and the parents were educated about what to look for, as well.
The Riveras left for Chihuahua today so I'm all alone here at their house. Miriam is back, so if there is a birth me and her will do it. The Riveras will be back tomorrow, the Lord willing. They are trying to get their vehicle permit, so if they can't get it today, they may not be back until Monday. The Shanks were supposed to come back on Monday, but Mrs. Shank lost her visa paper so that may take awhile...please pray that they will be able to get that taken care of quickly, because I am really, really ready to have them back! Its been quite the adventure "camping" out at the Riveras...it works fine, but is just a little inconvenient :-) My stuff is at the Shank's and I go over there a couple times a day to keep the fire going at their cabin. I'm ready for my family away from family to come back ;-)
Well, I hope that you all have a great weekend! May the Lord bless and keep each one of you.

 


 

2/25/2010 7:55 PM
Hey, everyone :-)
We just received word that Maria and her baby seem to be doing fine :-) We do not have any details about what happened or how the baby is or anything other than that they seem to be fine and are expected to be released in 3 days.
She stated having regular contractions yesterday early in the morning. By yesterday afternoon they were strong, and regular. I stayed with her at the birthcenter all night. She was not dilating past 2cm. Her cervix was thin as paper by this morning and it was painful when I was checking it, but it was still 2cm and the baby's head had not moved down at all. She was exhausted and the baby was starting to have decelerations. Guachochi cannot do c-sections right now, so we decided to transport to San Juanito (about 2 hours from here). Edwin drove the ambulance and I went, too. It was a very bumpy, windy road to San Juanito and I guess that helped because she only had a lip of cervix left when we got to San Juanito. The baby's head was still high. We asked if I could stay and watch but they didn't want me to. Its a good thing that she did dilate because we found out that San Juanito can't do c-sections right now either. But, the good thing was that San Juanito is close to a big hospital that does have the ability to c-section and has pediatricians and such whereas Gauchochi is actually farther away from that, so we felt like it was worth it to take her to San Juanito.
Anyway, one of the doctors in San Juanito is friends with Edwin and he said he would try to find out how Maria and the baby were and let us know. He was able to find out that they seemed to be okay but he wasn't able to get any details about the birth or anything else.
At 11:57pm on the 23rd, I caught a 5lb 8 oz baby girl :-) The mother is Candelaria--the woman that had 3 miscarriages from syphilis and really wante dto have a baby. The baby was born posterior which was a first for me AND the placenta came out right after the baby so we had to get her to stop bleeding. She ended up losing 400ml which isn't even considered a hemorrhage so that was great! At the same time, the baby was having trouble breathing (retractions and nasal flaring) so we were keeping a close eye on her. She ended up being fine and everything turned out well :-) We will go and visit them on Satureday. I didn't get much sleep for two nights in a row so I am very tired, but when we got back this afternnon I was able to sleep some which was sooooo nice :-)
Thank you all so much for your prayers! I will let you know when we hear more about Maria's birth and her baby. I hope that you all have a great night :-)
Love,
Michelle

 


 

2/25/2010 7:51 AM

Hey, everyone,
We are transporting Maria to San Jaunito. Please pray for the doctors there to have wisdom and that they would be ones that care about their patients. I will explain more later--I'm going on the transport and we are leaving right now.
Michelle

 


 

2/17/2010

Hi :-)
Well, so far Maria is still not in labor. We are going to be checking up on her and the baby until it is born or until we need to transport. They both seem to be doing fine, which is great. She is staying with family right across the street from us, so we are able to keep a close watch on them. Just keep praying that things will go well with her and her baby! She did seem to have more amniotic fluid today so that is good.
We have another first-time mom here and it looks like she may be starting labor. I'm not sure if I mentioned this lady or not but her name is Candalaria and she has had 3 miscarriages from syphilis in the past couple of years. She was treated for it at the hospital last summer and she got pregnant soon after being treated. Things went very normally with this pregnancy, and she is almost 38 weeks pregnant. She and her baby seem to be in good health although she is a little bit anemic. She will also be here until she has her baby. She has really wanted to have a baby so be praying for things to go well for her birth.
Also, be praying for us, because with two first-timers due to deliver anytime we may be in for a few all-nighters :-)
They transported an ecclamptic woman to Guachochi the other day. She was having really bad seisures and they were really thinking that she and the baby were going to die. We heard from the hospital and both the woman and her baby are alive and doing well :-) They have been having a lot of young todllers and babies with uppper respiratory tract infections at the hospital. They transported a really bad case last night. Its always sooo sad to see the little ones that are really sick. I got to help with a few of them and its so sad to be holding them down so that the nurse can put the I.V. in and they really can't resist very strongly and some of them can't even really cry because they are working soooo hard to breathe :-(
Well, I hope that you are all doing well. May the Lord bless you all with joy and grace.
Love,
Michelle

 


 

2/15/2010

Hey, everyone :-)
I hope that you are all doing well! I am just writing a quick e-mail to ask for prayer. We have a young lady here named Maria that is due and possibly over due and she is starting to have contractions. We have seen here a couple times during her pregnancy and her baby is very small. We are pretty sure that we are dealing with either a growth restricted baby or this baby has some kind of genetic problem and is small for gestational age. So, far the baby's heat tones are just fine and Maria is doing well. The chance of a genetic problem is higher because the baby's father is close relative of Maria's. There is also hardly any fluid around the baby. So, please just pray for wisdom for all of us and that if this baby is born with a genetic problem and is going to die that we will all have what it takes to deal with that and help Maria through that. We are hopeful that maybe we are just dealing with a small but healthy baby. Thanks for praying. I hope that you all have a great night!
Love,
Michelle

 


 

2/12/2010

Hey, everyone :-)
I have had a busy few days here! With all the births, we've had a lot of postpartum exams and we have had some prenatals, too. I've been able to help a lot at the hospital in the past couple weeks and more of the nurses are teaching me things and having me do them. On the 10th, a lady came to the hospital in labor and she was so far along that the doctors weren't sure about giving her to the birth center because it was her 5th baby or so and sometimes they come out really fast. Dr. Pedro was in charge of the birth and he said for me to get ready because he was going to hand me the baby after it was born. I was also assisting with things for him during the labor. After a little while, he looked at me and said, "You can do this right? I want you to manage the birth." So, I caught a baby in the hospital :-) hehehe...I did things a little differently than the typically do at the hospital--listened to heart tones a lot more, waited to cut the cord until it stopped pulsing, talked the Mama and told her what was going on, waited patiently for the placenta, etc. Everything went well and it was a littlle boy that weighed 6lb 2oz :-) I wasn't really sure what Dr. Pedro thought about what I did, but later that day Dr. Paco came up to me and said, "Dr. Pedro said you did really, really well! He said you really know how to do things! He said you knew just as much as a Dr. and that you were a very, very, very good midwife." It was really funny, because he seemed really surprsed that I really KNEW things :-) I think part of it is that my Spanish is not very good, so it gives the impression that I don't know that much. I guess when they got to see me work, they realized that I did "know things" :-D I'm really hopeful that me doing the birth in the hospital will really help to cement the doctors trust in the midwives at the birthcenter.
Recently one of the adminstrators that works at the hospital came to us and said that we needed to read the Mexican regulations on births and that she didn't think we were following them and such. So, we got a copy of the regulations and we are supposed to meet with the hospital staff sometime to discuss that. Well, the Mexican regulations on birth are EXACTLY the same as what midwives are trained to do!!! We were sooooo excited! You are supposed to let the woman labor in any position she likes (not confine her to being flat on her back in bed) as long as the baby and mom are doing well, you are not supposed to cut the cord until it stops pulsing, you are not supposed to use fundal pressure (pushing on the mother's stomach while she is pushing the baby out), you are not supposed to manually remove the placenta unless its an emergency, you are supposed to keep the baby with the mother and have it learning to nurse within 30 minutes of the birth, you are not supposed to give the baby anything other than its mother's milk, etc. Basically, it turns out that all the things that have concerned the midwives that happen at this hospital and the one in Guachochi are things that are adressed in the Mexican protocol. Pray that during the meetings, Shelley and Miriam will have wisdom in explaining that we are following the protocols and that maybe this will open doors for the Doctors to look at the things the typically do and research what is the best way to handle births. (All the Doctors here are general Doctors and they all went to medical school many years ago, so what they do is what Doctors were taught to do back then, but medicine changes a lot and better ways to do things are discovered. General Doctors here are not required to get more education in birth so although they have learned about new medicines and such they haven't learned more about managing birth, so they are still doing the same things they did many years ago.) This administrator is kind of shoving this in our face and its going to be discussed at the meetings. So, please pray for wisdom to be able to discuss the Mexican protocols and what we do without causing any problems with the doctors. We are hoping that the Lord will work through the administrator trying to trip us up and work things out for good.
A couple days ago, Dr. Paco called me in to meet Cecilia. She is the sister-in-law of David who is the lab. tech. at the hospital. David is part of the Lopez family which was basically the first Tarahumara family to become Christians. She was due on the 12th and he was telling her that if she wanted to, she could have her birth with the midwives. She and her husband are very well-educated. So, she came to the birthcenter to see it and to meet the midwives and she had a LOT of questions about us. Here in Mexico the "parteras" are only trained for 3 days!! So, when people hear "partera" they think of that so we have to explain how we are tranined and what we can do and such. Anyway, she choosed to birth with us and I caught her baby at 6:02pm yesterday :-) It was a priceless birth!! Her husband stayed with her during the labor and he was sooo kind to her. I wish I had a picture of his face when the baby was born!!! He said, "Oh, look!! The baby!!!" :-) We gave the mother her baby right after birth and they were both soooo happy!! Their little girl got to come and see the baby right after it was born and so did the grandmother and an Uncle and Aunt. It was such a joy to do a birth for a Christian family! They said "thank you" to us sooo many times! I think they really liked how having their baby at the birthcenter :-) David's sister in due in April and she said that she wants to have her baby with us, too :-) I didn't really realized how sad it makes me when a baby is born and the parents aren't really that interested until last night. I guess you just kind of deal with it and don't think about it too much, but when I saw them soooo happy I was really, really happy but I also almost started crying because it was like something I always want to see at a birth but know that its not going to happen here so it was like getting something you really, really want but had been dissapointed so many times that you just gave up on it. It was a very special birth :-) Hope you enoy the picture of them :-)
It snowed again yesterday morning so I got some more pictures. I'll send a couple of those, too. The Shanks left for the States to drop Katy off early this morning. I will really miss her! My room feels kind of lonely... Joy will come to stay with me during the 3 weeks that they will be gone or I might go live with the Riveras for 3 weeks--it hasn't been decided which one will work better...but, I'm guessing I might live with the Riveras because that will probably be easier on their family's scedule than trying to have Joy come here at night and then her having to go back home if I'm at a birth and such, but we will see.
I hope that you are all doing well. May the Lord bless and keep each one of you.
Love,
Michelle

 


 

2/5/2010

Hey, everyone :-)
How are you all doing? I'm doing very well! We haven't had another birth, but we have been fairly busy with prenatals and postpartums and newborn visits. I have also been able to help a lot at the hospital and they are giving me more and more responsibilites--giving injections, putting medications in I.V.s, taking blood for lab work, helping with dressing wounds, and getting to assist with mostly everything that goes on there. I'm really enjoying getting to learn so much. Several of the nurses really seem to enjoy teaching, so they teach me something and let me watch/assist and then they have me do it myself the next time. Its a great way for me to learn, because I tend to be a hands-on learner :-) Today Dr. Pedro had me do a prenatal at the hospital and it was kind of fun to see my name on the blood work results as being the medic that ordered the lab work--"Partera M. Hopkins" :-)
Yesterday I got to go to Guachochi just for fun. It was a beautiful drive there because it had snowed a couple days here and even more in between here and Guachochi!! The pines and the mountains are very beautiful covered in snow!
A couple days ago, the Tarahumaras started beating the drums. They believe that it gives the sun strength, so they start beating it near the beginning of February because the sun is weak in the winter and can't stay up very long. They keep doing that for a couple months and every year it must work because the sun obviously gets stronger and can stay up longer. hahahahaha--I'm kidding ;-) That is what they think, though. I think that if that really works, we ought to try doing that all year so that the sun will stay strong and it will stay nice and warm and then when it starts to get too hot in the summer we can stop so that it will cool off :-D It is very interesting to hear the drums on and off during the day and the night. Sometimes it gets a little bit creepy sounding--especially at night. The first day that they start beating the drums is also a drinking day. There actually weren't too many accidents that came into the hospital from that day. Usually on all the holidays, the hospital ends up being very busy. It is possible that they just haven't come yet because it snowed several days this week and was pretty dark with all the clouds. We have been seeing a lot of little ones come to the hospital with various problems probably partly because of the cold weather and because this time of year they are starting to run out of money and any food stores they had. Be praying for all the little ones and especially that the parents will bring them in as soon as they have a problem and will not wait until it is too late.
Well, that is all for today. I hope that you are all doing well :-) May the Lord bless you all with much joy.
Love,
Michelle

 


 

1/28/2010

Hey, everyone :-)
Today I went to the hosital for devotions like I do every morning and a lady had just come in to the hospital in labor. Dr. Pedro was on duty and he let me check the baby's position and such and then he told the mother that she could deliver at the hospital or could go with me to the birthcenter and she choose to go to the birthcenter :-) This was her 7th baby and it went well. The baby was born at 5:39pm. It is a little girl and she is very cute. She is short and plump :-) Everything is going very well with the mom and the baby. I'm going to stay the night here with them. This is the 5th birth for the birthcenter this month so its been pretty busy! I'm really thrilled with getting to do so many births :-) I also put in her I.V. today and it went totally fine, so I was really happy about that!
We also had a postpartum visit for the baby that was born on the 25th. Everything is going very well with Lucia and her baby :-)
It has been raining quite a lot over here and it is very slippery with all the mud so walking around can be challenging. It is kind of fun if you aren't in too big of a hurry, though :-)
Well, I will go for now. I hope that you are all doing well. May the Lord bless you all with joy.
Love,
Michelle

 


 

1/25/2010

Hey :-)
Things are going well here! We had a birth this morning at 10:48am. God really took care of this little one. Lucia came to the birthcenter at about 9:20am with contractions since sometime last night. She was about 5cm and this was her second baby. Her first baby was born quickly--about 4 hours. This baby was having decelerations during contractions down to about 80 and then taking a long time to recover. A baby's heart rate should be in the 120 to 160 range. We put her on oxygen and that helped a little bit, but not much. We really prayed a lot because we were concerned about trying to transport since it is so far to the hospital and it would be hard to do a birth safely in the ambulance. Shelley really didn't feel at peace about transporting. She ended up having the baby at 10:48am and the baby did just fine when it was born :-) He was born quite fast and that was exactly what he needed. He had a very bad placenta and a cord wrapped around his shoulders and body. He is a little bit IUGR--his growth was restricted by something (probably the placenta) during the pregnancy. Lucia and her baby are doing very well. He is 6lb 8oz and 19 3/4 inches long.
I'm at the birthcenter just keeping an eye out for them. Its been such a blessing to have about a birth a week since I've been here, please pray that this will continue to happen :-)
Well, I will go for now.
Love,
Michelle

 


 

1/20/2010

Today went really well :-) They are setting up a schedule for me to start working more at the hospital--all without me ever having to ask!! This is a HUGE blessing :-) They are going to teach me and then let me do the skills that are "midwifery-related" so today I did two blood draws, a newborn screening test (PKU) on a baby and they gave me a prenatal for the birthcenter. The hospital is transfering her care to the birthcenter and she is due in 2 weeks so I'm very excited about that. The lady's name is Esther and she is very excited about having her baby with the midwives--she is soooo sweet :-) Please be praying for things to go smoothly with me working with the hospital and the birthcenter--that this will help develop really, really good relationships with the hospital staff.
I am starting to teach English classes to some of the hospital staff here. Please pray for me to have wisdom and that I will be a good teacher. I've given two classes so far and it was a LOT of fun, but it was also a lot of work trying to figure out how exactly to go about teaching them. They are also helping me a TON with my Spanish, so please pray for me to pick it up really fast.
I hope that you are all doing well :-) Thank you all for your prayers :-)
Love,
Michelle

 


 

1/19/2010

Hey, everyone :-)
Yesterday was really a fun day for me, although it was very tiring! I was able to attend a birth at the hospital here and they let me do the newborn care. Then a little while later, another lady came in labor to the hospital and Dr. Paco gave her chart to me and said, "Here is another one for you to get more experience" :-) Her birth went very well and I was able to catch her baby, which was the 50th one for this birth center! He was born at 9: 35pm and he was big for a Tarahumara baby--8lb 8oz! I stayed with the mom and the baby last night. He seems to be asymetrically large for gestacional age and he was very red so we were concerned about him. He ended up throwing up all night, but it was always just clear fluid. He is not as red today as he was and he seems to be doing well. The lady lives in Samachique very close to here, so she will be able to come back and see us in a couple days. We sent her home with lots of instructions. Just be praying that if there is anything wrong with the baby, she will be quick to bring him back here.
Well, I need to go for now. I have some things I need to do and then I have an english lesson to teach :-) Hope you are all dong well.
Love,
Michelle

 

 


 

1/17/2010

Hey :-)
I had a good day yesterday. I got to watch a surgery and I helped in the recovery room for several hours. The surgery I watched was tying a ladies' tubes, which is better described as burning the tubes. It was very interesting to get to see everything through the camera--they put it up on a good-sized screen and so I am able to see really well when they do surgeries with the laproscope :-) Its very amazing to get to see what God has made inside us!! One of the surgeries was a little girl with 6 toes on one foot. Dr. Mike removed the toe. The anethesiologist used a drug orally that Dr. Mike didn't prefer and then the anethesiologist left...which is awful that he did that...Dr. Mike was not/is not happy with him. Anyway, it was kind of a stressful few hours waiting to see if the girl was going to be okay and when she was going to wake up. She ended up waking up in 3 hours and she is doing just fine :-)
The young lady that had the baby went back home today with her Dad. She and the baby are doing just fine :-) We checked her hemoglobin and it was 10.1 so that is pretty good considering she lost about 1,500ml of blood!! She went into it with really good hemoglobin, so that helped.
Today has been a restful day. All of us English-speaking missionaries meet together on Sunday morning and sing and Mr. Shank is the pastor here. Sometimes other men give messages, too. I really enjoyed it!
Well, I need to go now.
Love,
Michelle

 


 

1/15/2010

Hey :-)
Yesterday I got to watch an interesting surgery. Dr. Brian was removing what they thought was a simple mass from a lady and it turns out that it was an ectopic pregnancy that had already ruptured and formed a huge blood clot. They were doing the surgery by laproscope (not sure how you spell that...), but they ended up having to open her up because of blood loss. They had to give her two units of blood, but she is doing just fine now! He had to remove the right fallopian tube because it had ruptured. It was very interesting to see the effects of an ectopic pregnancy and it was amazing that she did so well, considering the fact that it had already ruptured!!
Today we had a birth :-) Shelley let me catch, so it was fun to do that again! It was a 15 year old girl that came with her father. This father really loved his daughter which is very rare here. He was actually crying because he was so sad that she was in so much pain. He translated for us, because she doesn't understand too much Spanish. Things went well for a first-time mom. She started having painful contractions this morning about 6am and the baby was born at 5:02. The baby is a little boy 20.5 inches long and 7lb 12oz. The mom had a huge hemorrhage!! It was partly from blood loss from a tear. It did not involve the muscle (so only a first degree tear), but it was like everything kind of shredded...probably due to poor nutrition mostly. We ended up asking Dr. Brian to come over and suture it because it was so odd and hard to figure out where things went. He did a GREAT job--hahaha...he is a surgeon so that would make sense ;-) He was very kind and explained everything he was doing and taught us a lot as he was working.
Well, I am going to stay here at the birth center tonight and do postpartum care/watch. I am pretty tired so I better get some sleep before I need to wake up again :-) I hope that you are all doing well!
Love,
Michelle

 


 

1/12/2010

Hey :-)
I'm all settled into the Shank's house and all my stuff is put away. Yesterday was a very busy day! An OB-GYN (Dr. Brian) from the States came down to do well-woman care and will do surgeries on Thursday. He let me follow him and ask him any questions I wanted to and went well out of his way to teach me things. He even took me up to the lab and let me look at cells under the microscope! He is hoping to be able to come down for a week every few months and do surgeries and well-woman care. A lady that had delivered at home at about 3am was brought in by a village ambulance, also known as a truck, because the placenta hadn't delivered at 1pm. It ended up delivering on the way but her abdomen was huge and she was in a lot of pain when she came in. It turns out that her bladder was full of almost 2 liters of fluid!!! ...can we say lack of postpartum care??? Anyway...that was an easy fix--they just catheterized her, because she insisted that she did not need to urinate. The baby was doing just fine and I visited the woman today and she is totally fine :-) They say that she had been drinking the homemade alcohol they make out here and that it has been known make some people not be able to urinate for ahile for some reason... It was such a blessing to be able to learn so much from Dr. Brian. He was a very good teacher! We are hoping maybe he will move down here sometime--he is very open to the midwives doing all the births and him just doing the complications and it would be SUCH a blessing to have a OB that really cares right here to be able to transport to!!! The OBs in the hospital we transport to are usually very, very uncaring towards the Tarahumaras. Dr. Brian was very careful to be gentle and to explain what he was doing in a very simple way so that the women could understand. I was very impressed at how compassionate and humble he was--he was constantely asking people what the best thing to do here might be. I was very encouraged to see that :-) He was speaking English, it was translated by Miriam into Spanish and then translated from Spanish to Tarahumara for the patients! It was quite the experience to her all the translation going on :-)
They also brought in a little girl not even a year old. Her left hand had been cut and her ring finger was completly severed, the middle finger had a pretty bad cut but just needed stitches, and the pinkie was cut deep enough that the extensor tendon was cut and the finger is curled in. They had taken good care of the severed finger, but unfourtunately Dr. Mike was not here so they had to throw it away and just suture the cuts. I got to watch everything and help hold the little girl (her name is Erika), so that they could work on her hand. It is really hard to see a little one in so much pain :-( She looks very good today, though :-) When Dr. Mike gets back, he will be able to look at that pinkie and see if he can fix that or not. The good thing is that it is her non-dominate hand and the two "least important" fingers.
Today will probably be a little slower. Mr. and Mrs. Shank are going to Santa Rita until sometime on Friday. Me, Shelley, and Jean (a CPM from Colorado that is going to move down here with her husband sometime in about a year or maybe a little more) will probably do something this afternoon. Jean and Mark (her husband) will be here for 2 weeks.
The lady that was due has not shown up so we aren't sure what that means. She might have already had the baby.
Well, I will go for now. I hope that you are all doing well :-)
Love,
Michelle

 


 

1/9/2010

Hey :-)
I'm in Samachique!!! We got here last night after a 14 hour drive from Tuscon :-) Everything went very smoothly with the border crossing and the car ride! It was soooo neat to see some snow remaining on the mountains. It was about 60 degrees but they must have had a good snow because there was still a good bit left :-) The roads were very clear, though and not much traffic. The Riveras are gone right now and so is Miriam and Carlos and Josefa. I did go over and visit Mary (one of the nurses) last night and she was soooo surprised to see me--apparently the Riveras didn't tell anyone at the hospital that I was coming back sooner than February! It is going to be sooo fun to surprise everyone :-)
I am settling into the Shank's home and we are going horse back riding soon. It is really nice to be here again! A lady that is due soon is supposed be coming here tomorrow and I'm going to help her settle in and do a prenatal. I am so excited that there will probably be a birth soon :-)
I hope you are all doing well--thank you all for your prayers and e-mails!
Love,
Michelle

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