A Traumatic Birth

Since moving to site almost a year ago, I've watched enough births to last a lifetime (which really isn't many). I was interested in seeing the birthing techniques used when resources are limited. The very first birth I watched included a baby who wasn't breathing and the birth attendant picking him upside down by the ankles and patting his back. When that didn't work, the doctor used the earpiece used for listening to fetal heartbeats to breathe directly into the baby's mouth. The baby started breathing but I was more than a little surprised with the techniques used due to lack of equipment (I ran into this mother a few months later and the baby was as healthy as can be). This sparked my interest in the Helping Babies Breathe program. Since the training I have only watched one birth and unfortunately it didn't end well. 

The rasazy (midwife) told me the birth was going to be difficult because the baby was breech. She prepared the ventilator and bulb suction (equipment from the HBB training) ahead of time. At 3:30am I heard knocking on my door and jumped up to run to the CSB. The woman in labor squatted on the bed while leaning her back against a family member. They fed her spoonfuls of sugar to give her energy. The rasazy kept yelling 'mafy, mafy!' or 'harder, harder!' The baby's body evetually came out but the woman was too exhausted to push the head. The rasazy had me run wake the doctor. Together they got the baby's head out but she was limp and blue. The rasazy used the bulb suction in the baby's mouth and nose which was so full of meconium that it was dribbling out. The doctor stepped in and rubbed the baby's back then used the ventilator. However there were no signs of life. After minutes passed they were forced to give up. The rasazy dressed the lifeless body which was just horrible to see. The baby didn't even get a chance at life. She set the baby on the scale and then helped mom with the placenta. The mood was certainly somber but no one showed emotion besides me fighting back tears. The mother stared at the ceiling without a word then moved to another room. One family member stroked the baby's cheek then showed her to the father. The family is responsible for cleaning up after birth and so the rasazy and I left at that point. She explained that the family would take the body to the tomb to be buried with other family members. 

I was so impressed with the doctor and rasazy for their quick actions and use of the new equipment. There was nothing more they could have done to help that baby. I understand this can happen no matter where you are in the world but there also many deaths that could be prevented with the proper equipment and usage. The hospital staff do the best with what little resources they have often serving more than 10,000 people and sometimes working without pay. I am constantly amazed by my CSB staff and AC's dedication to our community. 

Recent happenings

The last few weeks have been busy with preparations for upcoming project events like the HIV/AIDS festival in April, Healthy households beginning in May (my grant was finally funded!!), and GLOW (Girls Leading Our World) camp in June and July. In the midst of planning I've had several smaller events occur and certain hobbies become somewhat of a routine. 

The first is regular excersise with my best friend, Vola. She does the p90x and insanity work outs with me. She bought excersise clothes and brings her own water bottle at least once per week. We watch my tiny iPhone screen and share the little space inside my house. We are typically cracking up throughout the videos because we feel ridiculous but this is a great way for me to share a hobby. ACs and the midwife have also come over during these work out sessions although I can't convince then to participate. Who knows, maybe I'll be begin a Zumba club down the road!

Cooking demonstrations have become a cooking club. We meet once per month and the same ladies come each time. They are interested in learning how to cook food I eat in the States. We've made dishes such as spaghetti (a hit), guacamole (not well received at all. They eat their avacados with sugar!), and American cornbread (Malagasy cornbread uses only corn and bananas wrapped in leaves). This is another fun way to share cultures and give a little taste of home. 

I can't help it, I've starting dancing again. It started with a routine a friend and I made up to perform at a wedding. Since then, the AC have asked me to teach them a routine. I finally choreographed a dance to be performed at the upcoming AIDS festival on April 8. We practice at the end of each meeting and has now grown to include youth. Then, a few girls in CEG and Lycée (middle and high school) asked me to be in their routine to a song by Jennifer Lopez. We've had a few practices, decided on our costume, and will also debut at the festival. They asked me to wear my hair down and gave me a small solo so that I look 'just like the singer.' I'm not so sure about that. 

In March I had the privilege of talking to my cousin's 6th grade class. We successfully connected over skype and the class asked me their prepared questions about Malagay culture and my role as a volunteer. I had so much fun sharing Malagasy culture with Americans since it is normally me sharing American culture with the Malagasy. The class asked great questions and helped me realize how much I've learned over the past year! Definetly a highlight. 

Finally, I went on tech trip round two with the new peace corps trainees that arrived in February. We traveled to the east coast and did similar activities as the tech trip I went on as a trainee. The PCTs did their first presentations in Malagasy to several classrooms and a CSB, conducted house visits, and participated in a malaria festival. It was fun to see their progress, answer questions, give advice and stories (though they probably think i'm a little crazy) and also hear their thoughts about the beauty of this country on their first trip out of Mantasoa. Through their fresh eyes and perspectives they in turn motivated me to work harder and also to appreciate this experience. I hope I get the opportunity to train again! 

You know you're a PCV when:

-you can take a bucket bath with less than half a bucket of cold water no problem. 

-you reminisce about different food seasons, 'remember when we had mangos?'

A Few Pictures From the Last 6 Months

Cow wrestling or 'metseza omby'

Cooking demonstration and baby weighing

health presentation or 'fanentanana'

Hair braided and wearing a lambahoany for the Sambatra festival

Thanksgiving 2014

Some of the neighbors

Monica working out with me

My best friend, Vola

the flooded road to my banking town

Preparing 4 chickens for our New Year's party in March

The midwife during international women's day parade

Frip

Since living in Madagascar, I've been introduced to the wonderful world of frip. Frip is second hand clothes donated from all over the world and sold at stands on the street for very reasonable prices (most of the time). For example the dress I wore on New Years Eve in Paris was fripped for 1,500 AR or about 50 cents USD. Another great thing about frip is you never know what you can find. I've fripped clothes that were originally from banana republic or Ann Taylor loft for under $1 that originally cost $40, or a dress I'm going to bring and wear to my future job I fripped for $2 but cost around $60 in the States. On the other side I've found sports jerseys with spelling errors. Like a Minnesota timberwolves jersey spelled 'mihh sola timver woves.' I've seen people wear high school letter jackets from 1998 or 'rest in peace john, forever in our hearts,' that have been donated from the States. 

Anything goes here. I've seen men sport purple sparkley jellies or bright pink sun hats. I've seen little girls wear Halloween costumes to church. I've worn cargo shorts, socks and flip flops, and a knit blue hat and had not a care in the world. This is definitely an aspect of Madagascar I'll miss. 

You know you're a PCV when

-it starts raining and you jump up to set out buckets and basins to catch the water so that you don't have to fetch it later. 

-children shout your name. Even of you can't see them, they see you. 

Helping Babies Breathe

In January I had the opportunity to visit MercyShips, an international nonprofit healthcare organization located on a massive ship, in Tamatave on the east coast. I was aboard the ship for two and a half days and fully enjoyed my time there (apart from feeling seasick when looking out the windows). The ship has a fully functioning hospital and surgery ward, international school, pool, Starbucks, and many other amenities. It seemed pretty luxurious after living in the bush. The MercyShips volunteers got a kick out of watching us clean out the snack shop.

The first day we visited some of the patients as they relaxed on the deck. They were so surprised when we spoke Malagasy and couldn't believe we've only been speaking it for one year. That was encouraging! It was fun to see the workers playing the younger patients (everyone on MercyShips is also a volunteer) and hearing patients stories of their home and families. The second day was spent learning about the 'Helping Babies Breathe' (HBB) program, what to do when a newborn isn't breathing, how to use an ambubag, and how to train CSB staff on these skills as non-medical personnel. We received equipment for our CSB as well. 

I was very nervous to train my CSB staff because I didn't want them to think I was stepping on their toes or telling them they weren't treating properly. However, they were very receptive to the training and excited for the new equipment. My doctor helped me train which was so helpful as the midwives and birth attendants had questions with technical language that I struggled with. There were quite a few 'aha' moments and everyone did better on the post knowledge and skills test. I'll test them again in March and April. 

This program has been successful in other countries but this is the first time it's been done in Madagascar. The success (or failure) with the 10 participating PCVs including me will determine if the program continues here in the future, and our results may be published. My CSB was perfect for this program because I have a larger staff and also many women give birth at the CSB in my community. In other towns, the program was harder to adapt because more women give birth in their house with or without the help of a traditional healer that doesn't have medical training.This was apparent when comparing data with another volunteer. For 8 weeks prior to the training, we tracked the number of births at the CSB. 35 women gave birth at my CSB compared to just 4 women in a friend's community. It will be interesting to track the data for next 8 weeks post training. 

You know you're a PCV when

-about one year into service, most things you own are broken, worn with holes, or on its last leg. 

-after being away from site for a while, you worry about the state your house will be in when you return.