Random Medley

Today I lost my perfect attendance score at my regular church to attend a Thanksgiving service at a church in the slums. Oh wait, I was never in the running for that perfect attendance...oops. Anywho, it was a fun and unique morning.

I've gotten into discussions with several missionaries about the Philippines love for celebrations. Do churches in the US really celebrate church anniversaries? Mine does, but not very many do. Here it is a BIG DEAL. Literally a marathon all day event with prizes, bands, food, several sermons, games, and the list goes on. There are also thanksgiving services which are usually different than anniversary services, but just as BIG a DEAL.

When I arrived at the town center's covered basketball court, the party was just starting. I was welcomed by a greeting committee of 8 ladies in bright pink and white shirts. As the sole foreigner and as the guest of the guest speaker (Philippines director of Compassion International), I was given a seat in the front row, much to my chagrin. I really dislike sitting in the front row because I stand out enough as it is...and I have to really watch my p's and q's in order to avoid making a cultural faux pas. But it is an honor so I try to do my best to be grateful.

Soon, we were serenaded by the local school's xylophone marching band. I was surprised to hear them playing the US Marine Corps Anthem, then tickled as they transitioned into Auld Lane Syne, then laughed out loud when it smoothly switched to My Heart Will Go On. Only in the Philippines!!!

It was such a neat service with all the different kids' groups performing dances, skits, songs, and even giving testimonies of God's provision for them. Because this church partners with Compassion International, many of the kids were sponsor kids. Let me just say once again how impressed I am with Compassion.

After the 4 hour service, the director of Compassion came with me to visit Shalom. There might be an opportunity to partner with Compassion to provide the prenatal care and delivery for women enrolled in their Child Survival Program. This is a neat program which follows little ones from in utero to 3 years old, at which point they are enrolled in the regular sponsorship program.

Right now there are no churches in our area partnering with Compassion, so please be praying for a nearby church to meet the criteria for Compassion enrollment. It would be so neat to be able to directly partner with this amazing organization to really impact our nearby communities.

Below is an example of the truly unique Pinoy xylophone marching band that I found on youtube. Awesome or what?

Josh & Neni

When they walked in the door for an ultrasound I had to do a double-take. We've seen young girls at Shalom before, but this gal was still a child! She was beautiful, but her body was definitely not fully-developed. Her face was innocent and she had a wide-eyed look about her. She was wearing pajama bottoms and a t-shirt, holding her medical record in one hand and a motorcycle helmet in the other.

Her boyfriend was with her and it was all I could not to stare at him in disgust. His hair was spiked, his guyliner was thick, his earring winked proudly, and he had this toughened, yet bored look about him.

I called Neni to the ultrasound room and Josh hung back. I firmly asked if he wanted to come, leaving no doubt to my expectation. He was going to see this new life he had helped create if I had my say. I took a bit of history and learned that Neni is 14 and Josh is 19. He was the one with the motorcycle...the same motorcycle responsible for breaking Neni's arm last spring. Neni is so young that her body hasn't had time to regulate her monthly cycles and so it was difficult to accurately date the baby. My job was to determine the gestational age so we could set a due date.

My heart was heavy, half-way hoping there was no baby for the sake of this girl. As I placed the probe on her belly, I looked over at Josh and he had this hardened expression on his face with his arms folded defiantly on his chest. The urge was strong to get up and smack him, knowing that in the US, his actions would land him in jail for statutory rape. However, I smiled at him, praying that God would soften his heart.

As soon as my probe touched her belly, a little beating heart showed up right away. Yes, there was a baby. It was still very small, but I showed Neni all the parts of her little one and her face at first showed disinterest, then slowly transformed to curiosity, then wonder. She hadn't felt the baby moving yet, so I'm sure she was in some sort of denial that she was pregnant at all.

I took the necessary measurements and estimated her due date, scheduling her for a repeat 4 weeks later. I tried to educated Neni as best as I could, but I could tell her heart still wasn't really in it and Josh was shifting uncomfortably in his chair. I asked if I could pray for them and Neni shyly nodded yes while Josh glanced furtively at the door. Afterwards, Josh moved the fastest I'd seen him walk to get out of there.

Today was the 4 weeks follow-up. I was somewhat surprised to see Josh back with Neni, but thankful. Perhaps his heart had softened? Or maybe he was her only transportation? Or maybe he was controlling? I don't know.

Without much ado, I started scanning Neni's new little bump and was happy to see an active, kicking baby. The baby was growing well and it's size confirmed my earlier guestimation of her due date. This time, while I tried to educate Neni, I included Josh as much as possible. Neni's blood test from earlier had shown a hemoglobin of just 9.0. In the US, that's nearly grounds for a transfusion! I discussed diet and put much of the responsibility on Josh to make sure he took part in caring for his girlfriend and new child. I closed once again in prayer.

Please pray for this young couple. Neni seemed more somber today, as if reality is sinking in. She had to drop out of school when she broke her arm, then opted not to go back when she got pregnant. I'll be honest, I walked out of the exam room fairly depressed, feeling like my head is uselessly beating against the wall. Josh seemed just as prideful, but I know deep down he must be terrified.

There is some hope, knowing that he has a motorcycle, which means that there must be some money in his family...though how he comes by it I have no idea. But please pray that God will continue to soften their hearts and prepare them for parenthood. Please pray for family support as well. Neni is now living with Josh and his family, a common practice here. And also pray for compassion and hope for all of us caring for her. Thanks.

M is for Makulit

I had an interesting conversation with a 31 year-old G3 P2 this morning. As we discussed her due date, she asked, "Am I really due in February?"

"Yes." I confirmed. "February 27."

"But the baby could be born in March, right?" she asked.

"Well, yes. It usually comes anytime two weeks before or after the due date," I replied.

"Ok. I hope it's March." At this point, I must have had a puzzled expression on my face because she gave me an exasperated look and said, "Because babies born in February are all makulit!" (Makulit means mischievous, into everything, and generally creating mayhem.)

Before I could stop myself, I gave a little laugh and then asked why she thought that. "Everyone knows that! All the children I know who have been born in February have been makulit."

Huh. Learn something new every day.

:)

Donuts for the Dead?

At first glance, the deja vu was incredible. Big grassy knolls, portable shade tents, picnic foods, guys playing frisbee, and even the hotdog vendors brought all those Memorial Day weekend memories rushing back. But wait, something about this scene was different. It was at a cemetery!

What!?

All Hallows Eve (Halloween) and All Saints Day are a big deal in the Philippines, not for cute little fairies, batmen, and witches tromping to your doorstep singing out "Trick or Treat!," but because it is a day that people make an annual pilgrimage to the cemetery to pay "respects" to their dead ancestors. Anything from candlelight vigils to full on barbeques take place. People leave flowers, Krispy Kreme donuts, KFC, and even beer cans for the ancestors to enjoy. It is such a big deal here that both days are non-working holidays. And any experienced foreigner has learned to steer clear of all cemeteries to avoid major traffic jams.

In a way it's humorous to think that people believe this helps their ancestors (I mean, a donut? Really?), but at the same time it's sad. As a Filipino said, we should be giving them the flowers while they're alive. Yes, it's cultural more than religious, but it's also a good indicator of the amount of fear some people live in. To constantly live with the fear hanging over one's head that an action might anger a dead ancestor can be absolutely debilitating, and it is for many of the folks we work with. Many old practices (what we call "old wives' tales) are continued for fear of upsetting a spirit and causing harm to the family, often at the cost of the health and development of a newborn baby, something I see all the time.

So please pray for us as we try to bring them the love of Christ that casts out all fear. It's a delicate balance to bring it in a culturally sensitive way.

Raising the Uterus

I'm going to go out of sequence with my Palawan story-telling to post something that happened yesterday...

I've recently started doing ultrasounds for patients on my own, after being trained by a wonderful Swiss doctor. I just do the very basics: check for all major body parts, take measurements to get approximate gestational age, determine placenta placement, how the baby is lying, how many babies are inside, etc... I don't check for organ defects or other tricky issues. I normally scan 4-5 women in the afternoons following a prenatal morning.

Mavis approached me yesterday morning while I was checking hemoglobin levels, if I thought I should scan young Jolly who had been to a hilot with inappropriate size for dates.

A hilot is your run-of-the-mill village healer. This can be a witch doctor, a traditional birth attendant, the wise lady, abortion inducer, etc... They often do more harm than good and this appeared to be the case with Jolly.

That afternoon I sat down with Jolly and her boyfriend to get the story. It turns out she is only 19, but miscarried in February at 3 months. When she got pregnant again, she was pressured by her family to go to the hilot to "raise her uterus." Huh? I asked her how she went about doing this and apparently the hilot uses deep pelvic pressure to "massage" the uterus up, basically jabbing her hands into the lower belly while applying upward pressure. Supposedly this painful process helps prevent a miscarriage.

This prompted a quick anatomy and physiology lesson to explain how things work down there, and the danger of deep manipulative pressure during pregnancy. I also explained that miscarriages at three months are common if there are major defects or problems with the developing fetus. Jolly was very receptive and eager to do whatever was best for her baby.

Then we got on with the ultrasound. Her baby was extremely active and sucking it's thumb. I have so much fun pointing out basic anatomical features of the baby and the wonder in the mama's eyes never gets old. Her little one looked healthy, but a bit big for her dates. My guess is that she got pregnant a month before she thought. This happens quite a bit as women mistake their last period for implantation bleeding which happens at about 4 weeks. (PS - this picture is from the web, but you get an idea of what it looks like...)

I'm going to scan Jolly again in 4 weeks to make sure her little one is growing appropriately and confirm her due date. Please pray for Jolly, her boyfriend, and this new little one growing in her tummy.

Compassion International

Today was probably the most exhausting day of the trip (I'm writing this a week after the actual day). We were supposed to see 1500 Compassion International kids for their annual medical check-up. We arrived at the center where the kids meet every Saturday for kids' club to a full yard of kids waiting. What cute kids!

On first glance, these kids were day and night from the kiddos we'd seen over the past two days. Unlike the others, the Compassion sponsored kids were nourished, looked healthy, and had radiant smiles on their faces. Talking with them later, they could carry on a good conversation with me, look me in the eyes, and just had such a sense of inner joy. I was amazed at the difference. If I had ever doubted the effectiveness of child sponsor programs, all doubts stopped today. I am a firm believer now!

We were told there weren't going to be many prenatals as we were focusing more on the kids today. So I prepared to sit next to an MD and jump in. However, it soon became clear that perhaps someone could specialize in talking to the girls with "girly issues," and since it's such a sensitive topic, especially at that age, as a Tagalog speaker I fell into the role. I loved being able to dig deep into some of their fears in their own language. But no matter the language, teenage girls are teenage girls...no matter the country or culture. It is always neat to empower these girls about their own bodies and the unique needs and strength that women have.

I also helped a couple of the surgeons translate for their patients, such as the all important, "holler if it hurts!" after the lidocaine has been given time to work.

I haven't really mentioned my best coworker of the week. Jenni is a clinical nurse specialist (CNS) in education and used to work at the labor and delivery unit manager for a time. She brought a wealth of information and it was fun to learn from each other as the week went by. One of my favorite times was watching Jenni bring in whole families and talk with everyone about a specific person...such as the need to eat the right food, or practice good dental hygiene, or getting enough sleep. I've read about the family approach in textbooks, but hadn't really seen it in practice. Way to go, Jenni! (And a big thanks for the NRP and Fetal Monitoring textbooks!)

We worked until early evening, pulling out the emergency lights to help the doctors sitting at tables outside. We worked for about 30 minutes this way before the organizers realized that it was a lost cause. It was hard to turn kids who had waited a few hours to see us, but we couldn't keep going on empty.

Later over a light dinner, people started to spontaneously debrief and it became obvious we were worn down and at the third day hump. Were we doing any good? Was seeing 1500 kids in one day even possible? At what point were we perhaps compromising our medical judgment just to get through the day and as many kids as possible? Having been on the mission field for over half my life, I like to think I've gained a bit of perspective. It's not about diagnosing a hidden disease...after all, it's not until symptoms appear that diseases get diagnosed even in near perfect medical offices. Today was about seeing kids. Smiling. Touching. Encouraging. and sharing joy. A stethoscope placed on the chest wasn't just about listening for an irregular heartbeat, it was about showing that kid that they matter and have incredible value. I spoke up and shared this with the group... Most of those kids will never meet their sponsors who send in $30 a month...to them, we were the faces of their sponsors. And that matters deeply.

We then started praying and encouraging one another. The night ended on a positive note as we fell into our beds before our last day of medical outreach.

Napsan

The road today started out the same, but then we made a right turn onto a very bumpy dirt road for an hour and a half. If I'd had a jar of whole cream, it would have been butter by the time we arrived! We stopped several times for a potty-in-the-bushes break, a nausea break, a clear-the-giant-rocks-from-the-road break, a climb-out-of-the-van-so-it-can-make-it-over-the-muddy-hill break, and a crossing-through-the-river break before we finally arrived at the local community center. (pic of our military escort jeep bringing up the rear of our convoy. We road in the vans again, not these jeeps, FYI)

The dental and dermatology teams were set up in the existing midwifery rooms, while the medical team was set-up in little huts outside. In addition to medical/dental, there was counseling and hair-cutting provided by Life Church. I loved the open air feel of it all.

The highlight of my day was meeting a local young midwife towards the end. I commented on how amazed I was at the patient from yesterday who knew to take her iron with vitamin C. She got this big grin on her face and said, "that's my region and I'm the one who teaches them that! I learned it from a missionary birthing center in Davao." Stunned, I asked her for the name, and it turns out it's Mercy Maternity, the same center I visited in May. Not only did she spend time at Mercy, but she is the daughter of a helper (aka housekeeper) of legendary missionaries, Steve & Dottie St Clair...good friends of mine. It just warmed my heart so much that the work we do as missionaries MATTERS! This was the long term effects...the stuff that we normally never hear about and just have to trust God that He is continuing.

Another sweet time was after the clinic was over. We were all exhausted. It had rained during the middle of the day, which made things muddy and miserable for a time. The team members had worked tirelessly completely out of their comfort zone. As we were wrapping up, I noticed some of the kids playing a team building game in which they all put their left foot on one plank and their right on another. Ropes are attached that are used to lift the planks and you all have to step together, as in "1-2-3-LEFT! 1-2-3-RIGHT!" Some of the docs and nurses decided to race a group of the kids. What a sight! A group of Americans and Filipinos, laughing, falling, and speaking the same language of FUN. (picture "stolen" from Life Church)


The day ended on a sweet note as I ate dinner with long time friends, Bill & Donna Davis. My folks and the Davises both arrived in the Philippines in 1981 and went through language school together. They have both just celebrated 30 years here.

Tomorrow we start out medical outreaches with Compassion International. 1500 kids in one day. Yikes!

Inagawan

One thing I will never understand is people who willingly wake up before the sun. My body just is not wired that way... *sigh*, but when the alarm went off at 4:45am, I dragged my body from the sheets and blindly dressed and painted on a face. (Isn't it amazing how sluggish one can be in the early morning? I wonder if any adult has fallen back asleep brushing their teeth? Anyone?)

After a quick breakfast of rice, beef strips, and copious amounts of decent coffee, we piled into the same 15 passenger vans. (Note, these are typical US sized vans but with extra seats jammed in.) After an hour and a half of driving through stunning countryside, we pulled up to a village school in Inagawan, a Geographically Isolated and Depressed Area (GIDA). Our medical clinics were to be the kick-off for a huge environmental, sustainable agriculture, medical, and outreach project of our partner church, Life Church. I loved this part of the week, we weren't just dropping a Gospel bomb, there was going to be critical follow up!

The school was set up nicely for a medical outreach with the triaging in one of two courtyards and a waiting area with live entertainment set up in the other. The various classrooms were occupied by the docs, dermatology/minor surgeries, dentists, etc... They weren't expecting to have some nurses qualified to do basic prenatal exams, so we got placed with the minor surgeries for privacy. I actually didn't mind because it was more quiet, a bit off the beaten path, and I loved keeping tabs on what kind of surgery was happening across the room.

I was SO impressed by the ladies I saw. We had copious amounts of prenatal vitamins to pass out, so before I handed a pack to one preggo, I asked if she was already taking something. Iron with Folic. Great! (The Philippine Gov't has really gotten the ball rolling for handing out free iron and folic to all pregnant women through their community health centers) As I gave her the vitamins, I instructed her to take it with her biggest meal to avoid stomach upset. She then said, "But I take my iron at dinner time with a big glass of calamansi (lemon) juice, should I take it at the same time?"

WHAT?!?! What women knows and volunteers the info to take iron with vitamin C, especially in a small, rural village like this? Absolutely unheard of. I really encouraged her to keep taking the iron and C at night, but take the prenatal vitamin with breakfast. Later I snapped a picture with her, her cute-as-a-bug's-ear daughter, and the other nurse, Jenni.

My favorite surgery was on a middle-aged man who had a grapefruit sized sebaceous cyst removed from his right buttocks. How in the world did this man sit with that thing? I cannot imagine living with that thing for years as he did.

While we were treating the sick, another team was doing community service, painting a little native hut to be used as a classroom for the high school students. They were supposed to be building high class playgrounds they had shipped from Hawaii, but the mafia run ports kept slapping them with all sorts of "fees," even though they had all the correct documents. Now we're praying it gets released in time for the follow-up trip next year! :) Here's a picture taken by one of the team members.

After we finished seeing over 1000 people, we got back to our hotel and showered and got all dressed up for a fancy-shmancy dinner with the mayor of Puerto Princessa. It was a delightful dinner that he couldn't attend due to other obligations, but after sitting through 30 minutes of a powerpoint presentation regaling all the good he had done for the city (do I sound ungrateful? sorry), we got to see a wonderful cultural show put on by an award winning group.

Again, LOUD or LOUDER. I wanted so badly to turn the speakers directly at the sound men and give them a sampling of the pain they were inflicting.

Tomorrow is a 5:30am departure time... (thus the reason I am writing all these posts a week later and adjusting the post date...haha!)

Palawan Trip Day One

I got an email the day before my flight that due to a Philippine Airlines strike, our flight had been bumped up from 8am (nice) to 6am (horrid). This meant that I had to wake up 3:15am to get to the airport on time. BUT, I was so excited to go to Palawan (an island in the Philippines, NOT Hawaii!), that I didn't care...well, maybe not too much!

But let me back up a bit. Last June, I shared in my church about the building project at Shalom (blog here). A week later, an American approached me who had newly arrived in the PI and was looking for opportunities to get involved in local missions. He was excited that I could speak the language because his church back home in Hawaii, First Presbyterian of Honolulu, was sending a huge medical and pastoral team out in October and could he pay my way for me to join them. He thought that only good could come out of having an American nurse who could speak Tagalog on the team. I got the appropriate approval from my agency and purchased tickets.

When I arrived at the airport, I was surprised at the size of the group - TWO tour buses full of mostly haoles. It turns out there were folks from First Pres, Aloha Medical Mission (non-faith based), an Arizona dental office crew, and a few odd balls who heard of the trip and joined...like me. I sat by a dermatologist and nurse on the plane and just got so excited about their stories. The nurse was an 80+y/o retired nursing instructor! Talk about gumption and guts!

When we arrived in Puerto Princessa, the capital of the island, we were greeted by a tiny airport with one baggage claim thingy, a shell necklace, and the beautiful smiles of our "buddies," selected youth from the partner church who would act as our tour guides, liaisons, and friends for our week. We were piled into 15 passenger vans (think NO leg room!!!) and brought to our beautiful hotel for a buffet breakfast and orientation. After, we were given the option of attending church or resting. Let me tell you, after the 3:15am wake-up call and knowing the grueling week before us, the message on "dreams and visions" at Bedside Baptist was amazing! ;)

The afternoon consisted of unpacking and sorting meds, a mandatory souvenir trip, followed by a major outreach event that evening. As much as I love Filipinos, I have never understood their need to rupture ear drums at big events. Being the honored guests, we were of course placed right up front and center, just by the speakers. I'm not sure how well our hands over our ears were received, but we DID have to listen through stethoscopes the following day!

We all fell into bed that night, warned of our 6am call-time for our first day of medical clinics. Sweet dreams!

Layers

One of the things that MKs (missionary kids) get really good at is saying hello and goodbye. We don't necessarily LIKE saying it so much, but it's a fact of life. Our lives are layers of acquaintances, friends, relatives, and even relative strangers (pun intended). There are the folks I grew up with on the mission field from all over the world, my Biola days, my study abroad in London days, my nursing school days, church friends, work friends, and now back on the mission field.

There are times when I see someone and have to think hard for a minute to place them. Where do I know them from? What's really weird is when you see someone out of context, like a church friend from the US who suddenly shows up at my church in Philippines.

I think the greatest challenge comes in maintaining those friendships from all the layers. When life gets so busy, we (I) tend to live in the moment, and it's hard to remember the incredibly important people in my life who may not be a phone call or quick drive away. These people have had such amazing influence in who I've become and they STILL mean so much to me.

So for those of you reading this, I'm sorry if I haven't been as faithful in sharing life with you. Please never doubt for a moment how very much I miss you all. A busy life helps take out some of the sting, but each goodbye is just as painful. So when you get a chance, please send me an email or catch me online. I miss you!

getting creative

One of the things we at Shalom are really promoting is 100% exclusive breastfeeding for the first six months and supplemental feeding for up to 2 years and beyond. Formula and potable water are just so expensive and impractical here that there's no reason NOT to breastfeed. (And every single study shows it's best for babies in all social stratas!)

So what do you do when you are donated 120 brand new cute t-shirts that have a big ole' baby bottle on the front?

You get all corny and cheesy and do this. It's looks silly but at least I feel like we're not compromising our breastfeeding campaign!

...a time to weep

"For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die..." (Ecclesiastes 3:1-2a).

I love the first part of the second verse, "a time to be born." That is what our work at the birthing home is all about. We help during that time to be born. But we really dislike the second part of the verse, "a time to die." There aren't supposed to be deaths at a place where life is introduced to the world. And yet it is inevitable.

The maternal mortality rate for the Philippines according to the World Health Organization is 1 for every 500 deliveries. And Antipolo, the city where we serve, has an even higher rate than that. If Shalom were in keeping with this statistic, we would have a death every 2-3 months. Last week, we had our 3rd maternal death in over 19 years. The fact that we have such an incredible track record doesn't make the few deaths we do have any easier. It is still unspeakably difficult to have a mom die.

And yet, we cling to promises that God is in control of life, He is sovereign, and He works all things together for the good of those who love Him and are called according to His purpose, even when the process of that "good" hurts terribly. Please pray for all of us at the birthing home as we grapple with that hurt. Please pray Isaiah 26:3 for us, "You keep in perfect peace whose mind is stayed on you, because he trusts in You." Pray that when the doubts come raging in, we would cling to the promises we know in our heads, but sometimes forget in our hearts. Please pray that we would grow stronger and closer as a team who are seeking to show the love of Christ to a hurting and oh-so-vulnerable group of people. And please pray for the family of the mother who died, that they would come to know Jesus as their Savior, Provider, and Sustainer during this time of intense loss.

Thank you for your prayers. I cannot emphasize this enough. When the tears were pouring last week, I took great comfort knowing that I have a powerful group of people praying for me and the work at Shalom. I fully believe I am sustained by God through the power of your prayers. They work. They matter. They help. Please keep them coming!

Visitor!

Today was a big day for multiple reasons:

1.) I spent 5 hours sitting in bumper to bumper traffic that I will never get back

2.) I FINALLY cleaned my office/guestroom and it's mostly organized and functioning. I FINALLY took the empty boxes up to the garbage to get carted away. I FINALLY assembled/spliced/put together light bulbs in all my closets and cabinets to keep away mold.

3.) and best of all, I picked up a sweet friend from the airport who will be staying with me for the next month. Joy (her blog here) is a single American RN and a CPM (nurse and midwife) who is working and living in Davao. Joy and I connected during my trip to Davao last May and I am so excited to have her staying with me. I can't tell you how wonderful it is to have another single missionary to talk, laugh, vent, and maybe even cry with. There are things that we single gals go through, especially on the mission field, that only another single gal can possibly understand.

<---Joy & I at an outreach in Davao last May

On the ride home, Joy and I were both commenting how much we need this. Joy has come out of an especially stressful season and is looking forward to the break from the routine. She is here primarily to work with Dr Scott, the missionary doctor I've mentioned before...but she's also here for some time away to focus more on her walk with God. I know I could certainly use some more intentional times in the Word.

So why did I spend 5 hours in traffic? Manila Water brilliantly decided to tear up the ONLY road out to our area and leave just 1 lane of traffic for each direction...during rainy season, of course, which means they can only work on it for a few hours a day. Like I said, brilliant.

The Need to Be Right

One thing that I have always struggled with is the need to right. Perhaps this comes from being the youngest and so often having to prove myself or perhaps this just comes from being human. If I'm right, I want everyone to know it, by gravy! It's not just enough for me to quietly to know that I'm right, everyone else needs to recognize that I'm right too.

It was a story by James Herriot that made me realize how much of a problem this is for me. Dr Herriot was a country vet in Yorkshire, England back in the post-war era (that is, WW2). I've always loved his stories, such as Moses, the Kitten. In this latest story, he tells of Mr Pickersgill, a distinguished country farmer who loved to throw big words because he was edjumacated during his "college days," a two-week basic agricultural class at Leeds University. He called on Dr Herriot because his cows kept suffering from "them masticks." (Mastitis) The vet realizes that the cows are suffering because Mr Pickersgill is so forceful when he pulls on the teats to milk them. However, he can't tell the dignified man that without insulting his intellect. Then he realizes that Mr Pickersgill is suffering from lumbago, a painful back condition that is caused by bending over to milk the cows. In a moment of brilliance, Dr Herriot suggests that perhaps his should stop milking the cows to stop the pain and leave it to his daughter, NOT to cure the cows' mastitis. Mr Pickersgill happily agrees, but suggests he try a cream his beloved professor back from his "college days" recommended to help his cows. Dr Herriot knows it won't work, but rather than insult this man, he is willing to let him believe that the harmless cream is what solved the mastitis and not the traumatic milking of Mr Pickersgill.

This would be like swallowing straight apple cider vinegar for me. I would have a hard time letting someone else believe they were right, and yet it is my own pride that wants to be recognized. In Dr Herriot's story, the man's dignity is saved and his cows are cured of their recurrent mastitis. I admire that and need to work on that more in my own life...especially when I am dealing with more experienced nurses/midwives and also dealing with cultural differences between me and my patients.

PS - if you ever get a chance to read some of Dr Herriot's writings, do! They are loads of fun...great mind resting books. :)

Must be some sort of record!

I don't know the record for how many prenatal check-ups Shalom has done in a single morning, but we must have been close today. 141 ladies. That's right...141 blood pressures, 141 fundal heights, 141 fetal heart tones, 141 weights...yikes! Praise God we had some very welcome guests to help with the blood tests of about 40-50 of those ladies so I could go and help check these ladies out to speed things along. And then of course we had a delivery of a sweet new life in the midst of it all. :)

In other news, one of my sending churches, Whittier Area Community Church, sent out 25 handmade baby quilts to be given to the needy moms. We pair these with donated baby clothes and this gift means a lot to the families. Most likely, this is the first real quilt these women have ever seen and will become a treasure.

If you are interested in how you can do something like this, such as sending blankets, used baby clothes, and other items needed at the clinic like IV cannulas, please send me a message through the tab above or write me an email. :)

As usual, here are some photos!

La Familia!

The very much anticipated day of August the 4th finally arrived, my brother, his wife, and their three kids FINALLY arrived in the Philippines for their pre-field visit. This is the brother that we always knew would want to come back to the Philippines as a missionary (I was the surprise sibling who decided to come back). We eagerly grabbed some balloons, a bouquet of flowers for my sister-in-law, and headed to the airport.
So. Much. Fun. We've had a blast reminiscing with my brother and showing his family the country that is such a key part of our family. While they're here for over two weeks, we only get to spend a few days with them as the purpose of their visit is determine what their roles will be at Home of Joy and not play with us the whole time.
But it's been SO good to get squishees, kisses, and extra long hugs.
Please pray for them as they seek the Lord on how He will use them in their areas of expertise. Home of Joy is an orphanage that is highly respected by the Dept of Social Welfare but could use some help in the area of behavioral therapy and getting the kids caught up developmentally after much abuse and trauma. (My brother is a behavioral specialist and my SIL is a Christian educator. Both trained at Biola.)
Here are some pics from their first three days:

Meeting at the airport!
(that is the string to a balloon around my niece's wrist)

Playing at the new pool of our alma mater, Faith Academy

A visit to the largest American War Cemetery outside of the USA

Holding the hand of mannequin wearing traditional Filipina formal wear

Life changes a little bit

I've learned a new acronym: TIP. In the movie "Blood Diamonds," they use the phrase TIA, which means This Is Africa as an explanation for things that just don't make sense to an American mind. The same applies to TIP: This Is the Philippines. Now, some of the things don't necessarily have to do with culture or frustrations...but there are times that it just hits me in unexpected ways that I'm not living in Southern California anymore. For example:

• Being delighted by the fireflies dancing about INSIDE my bedroom as I nod off to sleep
• Watching my housemates' cats pounce on the 20-30 termites flying around my living room while I try to read
• Trying to figure out how in the world to line-dry my clothes when it rains for days on end
• Getting frustrated with local farmers using the national 2-lane highways to dry their rice, causing countless near-accidents while trying to avoid driving through their only livelihood

A missionary friend is trying to teach the locals about crop spacing by carefully spacing corn in order to yield larger crops. One local said, "Wow! Those ears are HUGE," after seeing the beautiful results. After explaining why they were so big, she just shakes her head and says, "Just imagine how many you could have gotten if you'd planted more in that space!" Sometimes you just have to laugh and say, T.I.P.

Nordstroms?

It's time for another update...past time.

I moved out closer to the birthing home last week and have been scurrying around trying to set up a house, from buying a fridge (called a "ref" here), waste baskets, toilet paper, and the like. Though I couldn't bring myself to buy rags...too much of an oxymoron. Things are slowly coming together and it's feeling more like a home. Curtains are next.

One young gal at the clinic broke my heart. Jing* is just 21 and expecting her first. I was preparing to get a blood sample to test her hematocrit when she asks me in flawless English, "Are you from the US?" Surprised after speaking only Tagalog to her, I switched to English and said yes.
"California?" Again, yes.
"Why?" I ask.
"I used to live in Irvine*."
My jaw dropped as I stared at her. To my knowledge, we've never had a patient who has lived abroad! Turns out she was living with her father, uncle, and aunt. She got a job at Nordstroms* and was adjusting to life in the US when her uncle started making advances at her and eventually abused her. When she confronted her aunt about it, her aunt denied it and she was forced to leave the US and return here. Her family has shamed her because she failed to survive in the US and now she is staying with her new boyfriend, who is the father of her baby, barely eeking a living. So much hurt.
We had 3 Master's College girls with us during this day, 2 who are studying Biblical Counseling. I asked them to speak with Jing as they are her age and just came from California. I was so thankful for them! They were able to spend far more time with Jing than I could have.
You can bet I'll be watching for this sweet girl for her future visits. Would you pray for her?

The presentation at GCF regarding the building project went really well and I'm trusting the Lord to move in the hearts of those who heard.

To those in the USA, happy Fourth of July! I hope you enjoy the long weekend and yummy grub! :)

(*names changed for obvious reasons*)

urgent prayer request!

A couple of weeks ago, we submitted a funding request to a large church in Manila where several of us attend. This was specifically for the building project (I hate that word, makes me thing of yet another mega church building an even bigger monstrosity!)

Anyways, it was very well received and two of us (Ruth Ortiz and me) have been asked to speak in all four services THIS SUNDAY, inviting the congregation to join our project through funds, volunteers, and of course prayer. We'll be showing a video and then speaking for about 3 minutes. This is incidentally missions Sunday as well.

I'm really excited about this opportunity because it's Filipinos helping Filipinos. I love that. The money for this ministry doesn't all have to come from the US, Canada, England, etc... There IS money here, and I really hope that we can get the local church excited about this ministry.

Please, please, please pray that it is well received. There is no realistic way to portray how desperately we need the new building...just try to imagine 120 prenatal check-ups in 6 hours with a couple deliveries tossed in there...all in ONE SMALL LIVING ROOM! You know that unpleasant feeling of sweat running down your chest or standing up from a chair and feeling like you sat in a puddle of water because your pants are wet from sweat? Yeah...we need that new building.

Who makes the decision?

One of the things that I've discovered, especially since working at the birthing home, is that in this culture (and apparently most South Asian cultures) the mother-in-law rules the roost, big time. If a mother-in-law tells her son's daughter that she needs to wear socks for the first 3 months after giving birth so she doesn't catch a chill and get sick, she doesn't question, she obeys. Or that she's too stressed out and her breastmilk is spoiled so she needs to formula feed, she obeys. Or that evil spirits might enter the baby through it's umbilical cord stump if it's not tightly wrapped with a belly-band, she obeys.
I don't want to give the impression that mother-in-laws are evil, because they're not. But they are mostly uneducated and uninformed. Tradition is truth and fixed.
In a recent article by the Royal College of Midwives, a Nepali midwife conducted a survey and discovered the same thing. The mother-in-law makes all the decisions, including the need for prenatal care, the household jobs that must be done while being pregnant, who delivers the baby, and much more.
Often the very young moms at our clinic come with their mother-in-law. This actually makes me very excited! It means I can respectfully teach the new mom with the "old" mom. I try to always ask if the mother-in-law breastfed her kids and for how long, who delivered her babies, and if SHE has any questions for me. These are my favorite teaching times because I feel like there's a better chance that what I teach might make a difference.
It's amazing to me how much CULTURE influences healthcare. I could have all the right training and techniques, but unless I am able to successfully put it into the correct culture context, it's useless. I'm so thankful I have 18 years logged in this culture, but at the same time I'm very much aware that I have much more to learn!

One week down!

I just finished my first week at Shalom for all prenatal clinics (Tues, Wed, Fri). It's a whirlwind! We see about 110+ preggos in about 5 hours... The incredibly efficient, organized, and competent American nurse who normally keeps things on track is gone for the summer so that role has defaulted to me. It's been a bit of baptism by fire...I've learned what works, what doesn't work, and to BE ASSERTIVE.

We get Filipino nursing students who are at the clinic for their maternal health rotation...they are usually quite young and definitely still teenagers. The first day I felt badly telling them to stop doing something or to let me do it instead. No more. After mass chaos in pulling the patient records for their appointment, I simply took over the task. There's too much to screen the patients for to risk letting them do it.

We also had an Emmy award worthy mom come in (the Filipina midwife's words...not mine). I had finished checking the women in (which takes place outside) and had moved inside the one room clinic to help speed things along when all of the sudden this huge commotion starts outside.

Screams, yells, and gasps fill the air.

Suddenly one of the 2 Filipina midwives on duty cries out, "There's a mom in the driveway who's baby's head is out!" The other midwife took off out the door and after fumbling around to make the delivery table ready (we use it for prenatal check-ups when no one is delivering), this poor lady is carried in by two men, one presumably her husband. Her hand is between her legs, holding what I thought was the head. They maneuver her onto the lithotomy table, pull the curtains shut, and get ready to deliver the rest of the baby.

Suddenly the midwife bursts out laughing, "She's only 1cm! This lady needs an Emmy Award!"

We all laughed and sent the mom outside to walk around for a bit while we finished prenatals. Turns out this lady is having her 5th, but her last baby was 11 years ago. Maybe she's forgotten how things work? In any case, it was a good adrenaline rush for all of us.

My ear is a bit better, though it's still partially clogged. I'll take any improvement, though! Thanks for praying for that. :)

Learning to Listen

It was bound to happen with all the busy-ness and running around I've been doing. I finally got sick. My body is no longer immune to these tropical bugs and so I caught the cold going around. Now a cold all by itself is not so bad, though a friend commented that it is a bit weird in such hot, sticky weather instead of the frigid winter colds we're used to in the US. But a cold combined with flying is a horrid combination. I managed to handle it ok on the flight down to Boracay, but on the flight back to Manila, my ear never equalized on the descent. All that to say, my right ear is still plugged after a week. I feel like my head is under water. I hate it. A doctor took a peek at it and it looks ok, just angry, red, and really retracted...but no infection. A little research and I learned it may take up to 3 months to resolve.
On my drive to the birthing clinic this morning, I got so discouraged by this feeling of a plugged up head, that I just wanted to turn around, go back to my bed, and lie there until I can hear again. I'm tired of saying, "what? I can't hear you." I feel like I'm operating at half mast and that's not a fun way to start out a ministry.
However, and I think you know where this is going, it's really made me come to grips with the fact that I will never operate at 100%. Even when my body is fine, there will still be things I miss. I feel like God is using this time of frustrating deafness to make me focus more on listening to Him and hearing His voice instead of the constant cacophony of traffic, people, chickens, construction, and all manner of distraction.
Every time I talk, it sounds twice as loud. I don't like that. Maybe I'll learn to talk less and listen more intently.
I hope so.

this and that

Ahhh! I've gotten remiss in my blogging! Oh wait, maybe it has something to do with the fact that I've been traveling and then sick for the last month. But persist I will! (Wow, that sounds like Yoda...no, I'm not a Star Wars fan, honest)
Less than 24 hours after getting back from Davao, I got on another plane with fellow missionary, Ruth Ortiz and her son. We were on our way to Boracay, a gorgeous island in Central Philippines. Manila is such a huge smoggy city. It's really not that pretty. Poverty, crowds, trash, smells, humidity, pollution, traffic, stress are everywhere. It's hard to get away from it. These first few months of being here have been unusual in that I've gotten to travel outside of Manila quite a bit and see the beauty of the Philippines. Boracay is such a place. The water is the most beautiful of any I've seen. Most water in the Manila is NOT like this. It's usually dirty, cloudy, and with a slight film of oil on the surface. Boracay is stunning. Here's a picture of Kai suffering as an missionary kid.
I was in Boracay to speak to wives at a pastor's family conference. I focused on basic health concepts such as hand hygiene, good and bad body responses to illness, how to make oral rehydration solution, basic prenatal care and much more. The ladies seemed to really appreciate and learn from what was shared. Most of them come from provincial areas and this was new information for them.
After the conference ended on Friday, the rest of Ruth's family and a team from The Master's College in SoCal came out in preparation for a children's outreach program they are running through today on a very remote island. What a fun bunch of kids!
May has been super busy with lots of travels and meeting some great people. Definitely helped satisfy my travel bug for a time. :)
Enjoy the pics!

a cheap laugh

When I first arrived in Davao, the motel I stayed in had a flooded street. The only way out was to walk up a hill and catch a cab. There were no shops or restaurants in this direction and there was no way I was going to walk through calf deep, nasty, putrid water to get some Adobo and rice. So, I took advantage of McDonald's delivery. For under a buck delivery charge, McDonald's will deliver any order, large or small, straight to my motel door.

After ordering my quarter pounder with cheese value meal, the lady on the phone warned me that the order may take 30-40 minutes to be delivered so the fries may not be fresh....then promptly asked if I wanted to add a caramel sundae to my order. So if I don't mind slightly cool fries, I guess I don't mind melted ice cream?

Hmmm...

Davao Delight

Ever since I arrived in Manila, I've been hearing about this wonderful birthing clinic run by missionaries on the southern island city of Davao. I ran it by my supervisors and was given the green light to fly down for 2 weeks to learn and observe all I could before I begin at Shalom full-time in June.
I arrived last Wednesday and was bewildered. It looks a lot like Manila but there is NO traffic! (LA friends, you have no idea what traffic is until you've been to Manila, trust me!) And the people are definitely Filipino, but I don't understand what they're saying...it sounds like Tagalog but it isn't. It feels like my brain is one cog off the machine.
My first impression of Mercy Maternity is amazement. I have never seen such a well-run, organized, and efficient birthing clinic. It's beautiful, there's respect all around, it's open, and it's fun to watch all the teaching...from perinatal teaching to peer teaching among the foreign and national midwives (usually the nationals teaching the foreigners, which I love!).
Yesterday, I took a day-off from the clinic and joined some fellow Action missionaries, Will & Joanie Feuerstein, in their Face to Face ministry to prison inmates. What a FUN experience! Who knew that going to jail could be so much fun? These ladies are often separated from everyone they know, sent down to a faraway province where they try to live life in some semblance of normality....and yet they are so joyous and eager to be around us. We are a fun diversion from their monotony and we even come with some music, stories, and even comfort food, Jollibee (like McDonald's) fried chicken and rice. Because the order is so large, they send along their little mascot. I've never seen fully grown women act so silly around a giant bee. You would think they were a bunch of tweens meeting Rob Pattinson or Justin Bieber. It was highly entertaining to watch.
I wish I could post pictures of the beautiful, courageous women, but for their own protection and privacy I cannot. But please pray for these women as they face a life they never planned, trying to live with courage in spite of life's disappointments.

Some of the team members "behind bars"

Becoming a Papaya

Medical professionals, among others, have to become papayas. I don't know when the last time you cut up a papaya, but the meat is soft and tender, yet the skin is super thick and tough. In order to survive here, we must develop thick skins but keep soft hearts.

For the last several weeks, I've had the privilege of sitting in with an American missionary doc who is absolutely amazing. He is a teacher at heart, and not a day goes by that I don't feel like I learned more than my brain can contain (and feel a bit stupid for how much I DON'T know!). I'm learning some great medical Tagalog like balisawsaw (ball-ee-sow-sow), which means urinary frequency. But most of all I'm learning that there are times when you can lead a horse to the water, but you can't make him drink.

Example: I met an older lady, probably in her 60s, who has just started going to Dr Scott's medical clinic for cleaning of her breast tumor. Most likely it is cancerous because she had chemo 10 years ago for the same. I could smell her before I saw her. When she undressed, I could not believe my eyes. I had never seen anything like this before. Never. Her tumor was about 8 inches in diameter and about 4 inches raised above the breast tissue. It was oozing pus and blood. At this point, there's very little we can do except clean it and redress it. She won't go to the hospital for treatment because the line is too long and she'd probably die before her turn came up.

I was surprised at how happy she still is. Smiles, laughter, still a sense of modesty. Though underlying I could sense some grief in her eyes. Life is fleeting and I think she's come to terms with that. Death is real and can only be put off for so long. Sounds fatalistic, but it's true.

As a medical professional, it's hard to see something like this and feel like my hands are tied behind my back. There's so little that I can do, except give her a soft touch, a smile, pray with her, and help her sit up from the exam table. (btw - I did not clean the tumor, another gal did that...I just oogled dumbfounded)

Please pray for those of us here. That we would be able to think like a papaya. That our compassion would stay strong, but that we would realize that we are but hands and feet. The decisions of life and death are not ours. A life lost is not our fault, a life saved is not our victory. We simply do what we can, with what we have. God is sovereign - I really believe that. Inasmuch, we can rest knowing that we do the best we can.

- Posted using BlogPress from my iPhone

Holy Week as we know it

It's Easter weekend, which is hardly mundane around here. Tradition is extremely important in the Philippines and Easter week is a BIG DEAL.

Here are some interesting Holy Week facts about the Philippines (these are generalizations and do not apply to every Filipino!)

- People do not see doctors during this week because they believe God will heal them instead
- Malls and most shopping centers shut down from Thursday on
- On Maundy Thursday thousands upon thousands of mostly youth walk more than 20 miles one way from their homes in greater Manila to the stations of the cross in Antipolo, near the birthing clinic
- Some believe that Jesus dies every Good Friday and is raised every Easter Sunday
- Life grinds to a halt from Friday to Sunday because "God is dead." (This is the BEST time to travel because there in NO traffic!!)
- All over the Philippines, Good Friday finds all forms of penance from crucifixions, flagellantes (self-beating), and even sliding up the side of a mountain on one's belly with hands and feet tied in an effort to earn favor and forgiveness
- Palm fronds blessed on Palm Sunday are prominently displayed in the home all year long as good luck and nearly a year later are burned to use the ashes for Ash Wednesday

One unforgettable story was when we visited the region that holds crucifixions (San Fernando, Pampanga). As a note, the men and sometimes women are tied to the cross with nails driven through the palms and feet, then raised for 3 minutes before they are lowered and the next people get their turn - they do not die. We paid a small fee and got into the press circle at the base of the small knoll where the actual crucifixions take place (hey, we write newsletters so we're journalists too, right?). One forlorn looking man was sitting on the grass waiting for his turn on the cross. When asked why he was getting crucified, he shared that his wife had been very sick 17 years ago. He "made a deal with God," that if He spared his wife, then he would crucify himself for 20 years. He had 3 years left.

This is so sad because God does not make bargains...we cannot earn His favor...we cannot earn forgiveness. It is a gift. And yet it is hard for our finite minds to grasp this.

I am so grateful to serve a Risen Savior who paid it all. He is no longer on that cross like so many crucifixes show. It is an empty cross because it was paid once, for all.

I praise Him because He is Risen. He is risen indeed!!

"He is not here; he has risen , just as he said. Come and see the place where he lay."
Matthew 28:6

Giant Waves, Circumcisions, and Awesome Beauty

After a very rough trip there, including battling rough seas and lots of sea sickness casualties, we finally made the island nearly 12 hours after leaving Manila. (Praise God I was spared from hanging over the side of the boat!)

When we arrived to Balesin, we were all struck by the incredible, unsullied beauty. Until a year ago, there was no electricity on the island and the people barely scraped by with fishing. After a brief recovery period, we jumped in and saw 200 patients our first afternoon. We limped back to dinner and our bunkbeds in small cabins (leftover from the old family who sold the island to the development corp).

The next morning we were back at the elementary school where the clinic was held and went back to work. I took vital signs and then later assisted with minor surgeries such as circumcisions (it is a rite of passage for young boys here) and cyst removals. I was too chicken to help in the dental room with tooth extractions. Yuck. I think we saw about 400 patients total. The prevalent issues were vision problems, hypertension, tuberculosis, and rotten teeth.

Before leaving the island, we were given a few hours to play on the beautiful beach and take a quick boat ride around the western side of the island. It was stunning to see such a beautiful island without neon signs and bars. It looks much like it must have looked 100 years ago.

Thanks so much for your prayers and partnership! It was a wonderful trip and I look forward to hopefully going again during future annual trips.

Visa Success!

Thanks for your prayers! After waiting around for 2 and a half hours, in a hallway crowded with nuns, what looked sort of like Buddhist monks, and several boring looking people like me, my name was finally called by an overworked commissioner. After taking up to 30 minutes with some cases, he quickly glanced at me, our mission director, and my father, flipped through the pages of documents that are required for my application, and looked at my passport. He grabbed a piece of paper and had the director and I each sign our "Acceptance of Authorization." Then told us we could go. Three minutes max. YES!
Now I need to wait 2-4 more weeks for them to process the application (what that means, I don't know), and then I can take my passport back to Immigrations and get it stamped with the right visa.
THANKS for praying!

On to the next adventure!

a letter

In case you don't get my prayer letters, sent tonight:

Hi folks!

Well, after missing my first immigrations hearing because I never got the summons, I have a second chance thanks to a friend who is a judge and knows the boss of the boss of the boss who is in charge of the hearings...and of course because we all know the Big Boss! That second chance is tomorrow at 9:30am, Philippine time or 6:30pm Monday night Pacific Standard Time for West Coast peeps. PLEASE be praying for God's name to be glorified above all, and of course that the commissioner in charge of the hearing will show favor. (This need for first-time applicants of the missionary visa to have a hearing is very new, thanks to a new commissioner appointed by the new president.)

Then, at 1am on Wednesday morning, I will be departing Manila with a group of 30 Christian medical doctors, surgeons, and dentists to help conduct the very first medical clinic on a remote island off the eastern coast of the Philippines. To get there we take an overnight 5 hour bus ride to the coast, then a 4-7 hour outrigger boat ride across the waves. It is a 1.6 sq mi island that is privately owned by a multi-billion dollar development company who is planning to turn the island into a 5-star resort, employing the 850 local islanders as hospitality servers. The organizer of the trip is an elder in our church who is also in this company. He has warned us that the island is full of darkness and that there is only one professing believer. Please pray for God's holy anointing on us, for protection from the powers of darkness, safety, and for God's name to be lifted high. The goal is to return annually to assist with the medical needs of the community.

Thanks so much for praying for these two items. It's exciting to be a part of His obvious working here...and so are you!

Joy!
Pami

real anger

*note - this deals with an issue that may not be appropriate for some folks. read with discretion*

Today I drove along with the sunrise up to the clinic to help out with prenatal check-ups. There were about 10 nursing students there to help out and help they did. Before the day started while they were in preclinical (at about 0730), I introduced myself and shared a bit of what we are about and why we do what we do. I also stressed the importance of breastfeeding, family planning, and how we are equals with those we serve. I asked them to sit beside the mom while they interview new patients so that they are participating in therapeutic communication. It's the little things that make the difference. I also asked them to refer to me any moms who indicated that they were planning to give formula to their baby.

There was one 16 year-old primip who looked older beyond her years who came for her first check-up at 7 months (most come around 12-20 weeks). The weight of the world was in her eyes. Now, most moms say they plan to mix feed their babies, such as when they go back to work or if they "don't have enough milk." This gal said she was planning to exclusively formula feed. WHAT?!? I gently asked why and she said her "mister" wanted her to. I had recently heard from a long time missionary doctor that sometimes the fathers don't want their wives/girlfriends/mistresses to breastfeed because it causes the milkbar to sag. So when I asked if she knew why her mister didn't want her to breastfeed, she just shrugged. I delicately (as delicate as one can be when asking this) asked if it was because he was afraid her breasts would sag and she hung her head and slowly nodded.

At this point I was ready to put my fist through the wall. Are you kidding me? This idiot of a schmuck would keep himself and his girlfriend poor, scrapping together money for formula, mixing it with non-potable water, risking malnutrition, disease, and developmental problems for the sake of delaying gravity? This guy is only 20 and most likely very uneducated. His friends have probably encouraged him to keep his girlfriend from breastfeeding as a matter of machismo. I had to remind myself that he is just as deserving of grace and education as his poor girlfriend.

I asked the girl if he was here and no, he wasn't. I explained to her the importance of breastfeeding and asked if perhaps I could share this with her boyfriend the next time she came for a check-up. She said she would ask him to come. I really hope and pray that he does. Will you pray with me? Before she left I made sure she understood that I wasn't upset with her and that we would work together for the best care of her baby.

Those pesky pests

There are all manner of pests here in the Philippines. Rats the size of a small cat, flies, mosquitoes, roaches, scorpions, itchy caterpillars, and the kind on two wheels. They are simply everywhere on the road like so many fruit flies. It didn't used to be this way...I think there's a motorcycle conspiracy here. Now, I'm not anti-motorcycles, in fact, they can be quite fun. But I absolutely HATE them when the weave in and out of traffic with no regard for the bigger vehicles. I can easily count at least 20 of them idling at any given red light as they squeeze their way through waiting cars. I've had no less than a dozen near misses since my arrival and have been repeatedly warned about them. Motorcycle deaths are to blame for the highest road fatality numbers.

Yesterday I had my first run in with one. I won.

I was driving up to a medical clinic run by an American missionary doc to learn how to conduct ultrasounds. There's this "secret" back road that skips out on much traffic and angst. It's pretty small and unused. At this particularly sharp turn going up a steep hill, I get stuck in a line of vehicles behind a big truck chugging in first gear up the hill. It was too tight to safely pass him. Folks, he was going PAINFULLY slow. Of course there were dozens of those little fruit flies passing us on the left and right. We finally neared my left turn to pull into the subdivision of the clinic (and the birthing clinic!) and I was excited to skip out on the rest of the funeral march behind the truck. I put my blinker on, glanced in my mirrors, checked the oncoming lane and started to turn left.

BANG!

Shocked, I checked the left mirror and there was a motorcycle falling to the ground in very slow motion. I quickly pulled into the subdivision, hopped out, and ran down the road to check on my victim (or was I the victim?). Not only was there a thoughtless, reckless dude driving the motorcycle, he had his two young kids he was taking to school!!! The kids were standing up and walking to the edge of the road and the guy was picking up his bike, quite shaken but appeared to be unharmed. I checked over the kids, kneeling down to see their eyes while I asked them if they were ok. The driver pulled off his jacket and revealed a cop uniform! Yikes, this guy was a cop! By this time all the guys hanging around the clinic came running down and started chewing the driver out for being reckless. Then I yelled at him because he still had part of his bike in the road, just asking to be hit again. I asked him if he was ok, he sheepishly showed me his scraped knuckles, but he was extremely lucky he was ok and his bike was unscathed. His kids piled back on the motorcycle and he skedaddled before the other guys took their own vengeance on him.

I didn't bother with taking him to the police office to file an accident report because who knows what cronies he has there that would conveniently make it my fault. As a white person, it's always our fault. A friend recently had a drunken motorcycle driver hit the back of her car, dislocating his shoulder. And SHE was expected to pay his hospital bill and purchase his sling simply because she's white. So I wasn't going to push it.

My car has a scratch and a small dent which I should be able to get hammered out. I was shaken, but thankful it wasn't worse. A different missionary turning left at the same corner creamed a motorcyclist and that dude had broken bones. God knew I didn't need that kind of drama this soon.

On a happier note, I scanned my first fetus yesterday under the gentle and guidance of a fantastic Swiss missionary doctor. I loved it! I'm very excited to be able to do this confidently and competently in the future for the moms at the birthing clinic.