Repellent in November.

Greetings!! It's amazing to me that though this is our third November here in the Philippines, I am flabbergasted by the fact that I have to put on bug spray in the middle of November in order to avoid chronic itching driving me to madness. The manufacturers of OFF! are getting good business off of me! :) Unfortunately, one of my dear friends has suffered greatly from the November mosquito population. My fellow midwife, Ali, has come down with Dengue fever passed by a nasty mosquito bite. She has been bedridden for days on IV fluids and constant monitoring. Please keep her in your prayers...she is finally on the way to recovery, but very uncomfortable! Thanks! Dengue is both awful and dangerous.

Sorry about the pics above, I will explain each one below...blogger is being difficult. ARGH.

I have appreciated Tim's last couple posts and enjoy reading his rants. Sometimes the words that he finds trouble uttering appear on the blog and I get a better sense of where he is at. It's good.

In the world of midwife-mommy-wife, I am excitedly looking forward to January when my schedule will be less exhausting and Promise and I can give Tim a break. Until then, it's busy busy busy. Since my last post, I have delivered 3 babies and have been grateful for God's mercy in the deliveries. They have not all been normal.

First came Neravic (last pic above). Having her second baby, Neravic was not at all worried or fearful. She smiled throughout her labor despite varying fetal heart tones and seemed perfectly content to labor as long as it took. I was impressed by her calm nature. However, around 8:30 am, November 6, the descent of her baby's head into her pelvis took away her beautiful smile and she decided her baby was coming as fast as possible. She gave two long pushes and a meconium-stained baby boy flew out of her with barely enough time for me to grab gloves. :) Unfortunately, her pushing with all her might caused her to tear a bit, but her baby boy was finally out. However, within minutes, it was clear that her baby was having trouble breathing. Having been deep suctioned because he swallowed a lot of meconium, little baby boy, Glen was monitored every 5 minutes along with his mommy. His chest retracted and he struggled to breastfeed. I did a quick newborn exam discovering that his metopic suture was open (the frontmost suture at the top of the forehead). This can be a sign of some serious developmental problems...or nothing at all. So I had to transport as quickly as possible. I came back to Mercy to suture Neravic and monitor her bleeding. Within just a few hours, her bana returned to pick her up to take her to the hospital to be reunited with her baby.

I went to the hospital the next day to find Neravic and baby Glen doing significantly better and his sutures were beginning to firm up and close. God is faithful.

My next shift proved to be quite eventful. I was endorsed a pushing labor named Gina. She was having her 4th baby and decided that shift-change endorsements was the perfect time to push her baby out. Her midwife from day shift, Amber, called in a panic.."Head out!" Coming in to assist, the supervisor told me to catch the baby, as it was now shift change. Well, the hard part was done. Amber had labor-watched and directed the head out. I just caught the baby as he was sailing out! Healthy and strong, baby Jepson arrived at 2:12 pm (first pic above)

As the placenta came out, I noticed that it was flat...without much shape. It looked odd. I made a note of it and continued to monitor Gina's bleeding. The shift was super busy, but Gina's bleeding kept me inside her cubicle. We gave oxytocin, had her pee, gave her an ice pack, but still, she bled....just little bits here and there. I moved her to postpartum to get her out of the busy birthroom. In postpartum, I checked her pulse...rising...and her blood pressure was dropping...fast. I checked her fundus and blood loss...250 ccs!! She was hemorrhaging! I called my supervisor, Carmen. As she started an IV with another supervisor, I tried to keep her fundus firm to stop the bleeding while trying to keep her awake to avoid her going into shock. Gina looked pale, but was able to stare at me without emotion as Carmen tried to do a manual exploration of her uterus. I continued to check her pulse and BP. The IV was working, but she was still bleeding. Then we found out she had gone to see a hilot (tribal doctor, witch doctor) when she was 5 months pregnant for fundal massage. This often causes the placenta to adhere to the uterus upon delivery causing postpartum hemorrhage. This required us to transport to the hospital so that they could do a D&C. The placental fragments were just too stuck on uterine was for us to scrape out.

After transporting Gina, baby Jepson and I bonded a bit, but the birthroom was too busy for me to babysit. I had to hand him off to another midwife living next door giving the occasion bottle of breastmilk for feeds. Then I was handed another labor. Via came in at 7 cm dilation and all smiles. She was having her second baby and was accompanied by her mother-in-law. They were a JOY to serve. Hilarious.

Clutching her Rosary, Via prayed throughout her contractions while her mother-in-law encouraged by singing Catholic chants. They were awesome...asking questions, joining me in prayer for her baby, laughing between contractions and anxiously awaiting Via's urge to push. When it came, Via was sure the baby's head was out....and yet, the baby's head was not even remotely visible. I had her get up to walk a bit and she came back to the bed grunting, but not actively pushing. However, by the time she lay down, the head dropped into place just behind the pubic bone...slightly visible. Suddenly, her bag of waters broke open and the baby's head began to come. I instructed her to breathe deep and "blow" her baby's head out slowly to avoid a tear. With total control and focus, Via pushed baby Noli's head out without tearing. Baby was super healthy and began to breastfeed right away. Via's mother-in-law kept thanking me as though it was all my doing! Ha ha. (second pic above) Via's bana arrived all smiles but had to prepare for work. (He works the midnight meat market at Bankerohan market here in Davao). All was well and I finished with Via in time to steal baby Jepson away again for another feed. Three more babies were born on that shift. Whew. Super busy, but peaceful nonetheless.

Upon the first baby-postpartum checks of Gina and Via, both patients and their babies are doing great. Via even brought me TONS of Filipino sausage (called Longganisa) from her bana's meat market! LAMI! (Yummy!) I am looking forward to seeing them again tomorrow.

In other clinic crazies...I had a few transports for high BP and was able to visit them and their babies at the hospital. All is well.

Bible study continues to amaze me. An-An and I see God move with each visit. We have had two consistent attenders and have been studying the life of Christ together. We seem to struggle with the same things...this week we studied the temptation of Jesus and His response to satan. We were challenged to change our view of temptation and to pray for those around us who struggle, as well. It has been a powerful journey for all of us. We've been able to give away 4 Bibles in Visayan and two of our Bible Study patients had their babies safely at Mercy already....an answer to prayer. This week, we are studying the Beattitudes. I am already convicted. It's good.

I am leaving out all kinds of news, but I will leave them for future posts. Many blessings as you enjoy the preparations for Christmas. :)

Clean Water for Bulod

My writing on these pages is usually more subtle and nuanced. Today I'm going for blunt and in your face, though hopefully not manipulative. If it ticks you off, forgive me and understand my heart, and come back next week for some nice reflection on the imponderables of life. This week it's all business and there is nary a clever metaphor to be found.

As you may already know, most of my work is done right here in Davao City. Every once in a while I get to escape to another region of Mindanao, but even then it is likely that my experience will be limited to the inside of yet another board room. I miss getting in on the action. Recently the only filters that were distributed locally were installed while I was on vacation in Canada. Go figure.

The reality is that the greatest need is in an area that is just not very safe for me (another white dude was kidnapped recently). Add to that Bethany's work schedule, and my travel options are pretty limited for now. I want to make sure I don't sound like I'm complaining. I'm not. There is plenty to keep me busy here in town and I love the challenge of keeping this whole thing moving forward.

I bring this up because my absence in the field means that our readers no longer get much reporting from me in regards to the biosand water filters and their final destination. These filters are saving and changing lives and sometimes I forget to tell you that. I want you to do me a favor. I want you to check the Impact Nations website (not yet, keep reading). We recently began a project that is in the initial reporting stage right now and I want you to read the reports and see the pictures.

People from all over the world have been donating filters to very poor families who are living in a marsh and have literally zero access to safe drinking water. It costs $40 to bring a lifetime supply of safe drinking water to a family. The first batch of 50 filters are being installed this week and I am 100% convinced that we are rescuing lives.

If you are reading this blog because you are a midwife or are midwife-curious, then you likely have a heart for mothers and children. Imagine a woman drinking nasty, bacteria-laden water throughout her pregnancy. Imagine a child being fed infant formula made with this same water (yes I know breast milk is best, but these folks don't have great midwives like you to tell them so).

This is sounding kinda heavy, but it probably should. Bad water is a big problem. Less than 50% of the population in the Muslim region (that spans three provinces!) has access to safe drinking water. People are suffering from terrible illnesses and some are dying. $40 per family stops it.

I'd like you to click on the link at the bottom of this page and see what I'm talking about. Seeing the reports that are coming in reminds me of why I do what I do. If you'd like to join the effort, consider giving a gift of clean water to a family for $40. If you think I'm not talking to you, then you are probably exactly who I am talking to. If you are already giving to Bethany and I, or have given to the water project, then you've already been a part of the impact and I thank you.

So without further ado, click here to see the project I am talking about (tip: if you sign up for the network and join the group, you will get a little email telling you when we have updated it—we will not spam you and we don't update it so often that it will annoy the heck out of you). In the unlikely event that you have no idea what I'm talking about, you may want to start by watching our short video about the filter.

Okay, I'm done getting in your face now. Thanks for listening.

Tim.

Hong Kong, I Hardly Knew Ye

I wanted to write this yesterday, but things got busy (and I wanted to watch a movie with my wife). I was in Hong Kong for less than 48 hours this week for business, though I managed to fit in a bit of sight-seeing as well. The event that brought me to Hong Kong was the annual International Care Ministries fundraising banquet. Impact is in the beginning stages of a relationship with ICM, and they invited me to come to their headquarters in Hong Kong so we could get to know each other a bit better.

My plane landed at 5pm on Monday, which left me just 2 hours to claim my bag, clear customs and immigration, take the train into Central, get a cab to my hotel, check in, iron my wrinkled and frumpy suit, get dressed, and find a taxi to the banquet at the Marriott. It turns out 2 hours was just about right, and I arrived at my table minutes before the event commenced.

The banquet was quite impressive. I was seated at a table with some bigwigs from major corporations such as Coca-Cola and HSBC. I also sat with ICM's director of Health Education and was glad for the chance to get to know her a bit. There was an auction that included seven very elaborate vacation packages, one for each continent on the planet.

The highest bid was for a trip (first class) to Vegas to meet Manny Pacquiao, sit in on his sparring match the day before the fight, stay in the same hotel as him and visit his room for an autograph, and then sit ringside for his upcoming fight at the MGM Grand. Pacquiao is pretty much the #1 boxer in the world right now, and happens to be from a city only a few hours south of Davao. That auction item fetched 160,000 Hong Kong Dollars (more than $20,000 USD).

While it was fun to see rich people fight over fancy trips, the main benefit for me was to get to know ICM a bit better. I must say that I am pretty impressed. In several different regions throughout the Philippines they are doing preschools for children, meaning kids are much better prepared for grade school and far more likely to succeed. They provide health teaching and medical clinics to those living in abject poverty. They help people prepare government documents so they can apply for federal aid. They have livelihood training. They are doing more than I can list here and I am pretty excited to be working with them.

I was pleasantly surprised to hear a brief mention of our clean water project during one of the presentations at the banquet. The next day I met with a couple of their executives, and it is becoming clear that they are very much interested in including the biosand water filter in their programs. I'll tell you more about that as it develops. I'm excited for two reasons. The first is obvious. ICM has a pretty big reach and will help us to get clean water to a lot of people.

The second positive is a financial one. In one evening, ICM raised 7 million Hong Kong Dollars (nearly 1 million USD). They flew me out to Hong Kong just to have a 40 minute meeting with them. These guys are serious about ministry to the poor and they have the money to get some big stuff done. I'm not saying it's all about money, but the reality is that it takes money to do what I do. The filters don't build themselves. By partnering with an organization such as ICM, I can get lots done without having to think as much about the bottom line.

After my meeting on Tuesday I went back to my hotel room and grabbed my camera and tripod, stuffed an extra lens in my pocket, and headed out for an evening of sightseeing. I headed up to the peak for a great view of the city that I shared with a heck of a lot of tourists and other photogs. I then wandered Central for a while and had fun making some images while getting myself completely lost. The next morning I crawled out of bed to shoot some more before heading to the airport by 11am. I wish I had more time to see the city. I really only got to see one district, and I know there is so much to see across the harbor and on some of the other islands but I didn't want to risk missing my flight.

I'll post a few pics here, and a bunch more on Facebook (click here). I'm not thrilled with them. They don't make me feel anything, and that makes me feel sucky. But whatever. At least I had fun making them.

Cheerio.

Tim.

The journey.

Greetings! Thank you for all the supportive comments on Tim's last post. He has had an interesting week as he prepares for his trip to Hong Kong...things seem to becoming clear and he is feeling greatly encouraged. His post was convicting to me, as well, and I, too am making some changes. He is looking forward to a change of pace for a few days in Hong Kong as I am looking forward to spending one-on-one time with the Bird.

The last 8 days have been a whirlwind for me. The birth room has been consistently full on my shifts with labors, births and continued postpartums. Several times, every bed was full! We had quite a few transports last week. Mostly patients having their first baby with premature rupture of membranes (their water broke before they went into labor). Last Thursday was a particularly interesting day.

When I arrived on shift, every bed was full and my peers and I dove into work. We managed to discharge quite a few healthy women and their babies and tend to the labors in the birth room creating a bit more space for new patients. I was endorsed a patient that I had treated for anemia in prenatals and had become quite close with. :) I was so thankful she was my patient. She was very active upon endorsement and at 6:53 am, I had the pleasure of delivering her third baby....a boy. She and her bana were struggling to come up with a name and so, because it was my brother, Andy's birthday, I asked if they liked the name Andrew....it meant strong, wise, and manly. They loved it and named their baby after my brother on his birthday. Very special.

Just after their delivery, I was handed another labor and an immediate postpartum. My labor, Sheila, had PROM and was only slightly dilated. I had her in prenatals just two days earlier and was grateful to receive her as my patient in labor. Despite her many risk factors, she labored like a champ and at 2 pm, I was sad to have to endorse her to swing shift.

Instead of heading home after shift, I lumbered upstairs to the prenatal room to set up for Bible study....I was REALLY not in the mood for a Bible Study. I was tired....so was An-An. We were spent. But after a cup of instant bliss (that's instant 3 in 1 coffee), An-An and I prayed and felt a little better. However, 3:30 pm came around and no one had come upstairs for the Bible Study....so I asked An-An if it would be okay to ask the laboring patients (that were not too active or pushing) if they'd like a break from the birth room for a snack and Bible study. An-An agreed and I headed into the birth room, asked Erin, the supervisor if I could steal some patients. She loved the idea and I calmly yelled out, "Any bored patients and their families that want to come upstairs for merienda and bible study, come on up!" There was a little giggle that spread through the birth room and my patient, Sheila, her mother, two other mothers of laboring patients and one other preggo came up! We had 7 in all! What a great turn-out...hahaha!

We chatted a bit and I had an opportunity to give some midwifery advice, as the mothers were concerned for their laboring daughters. Then we studied Genesis 1 taking note of how powerful God is and just how special He made man...in His own image. That discussion led to whether or not we truly believe EVERYONE (even bad people) are made in the image of God. It was a good challenging discussion for all of us. We began to pray that God would give us His eyes to see men as they truly are... precious and in the image of God. We prayed for safe and healthy deliveries for the women in labor and just as An-An was finishing her prayer, the emergency alarm in the birth room rang....a patient was in trouble.

As I was still in my scrubs, I, along with several senior midwives from upstairs on the third floor, raced into the birth room to attend to the emergency...a baby had just been born, but was not breathing. The mother was bleeding and they needed a few more midwives to help stabilize the mother and resuscitate the baby. The grandma of the new baby had been in our bible study while her daughter was giving birth. She was totally mortified, but because she had just been with An-An and I in prayer, she was greatly comforted by An-An's words from God. After the emergency was under control and the baby finally took her first breath, An-An and I were able to explain to the patients and their mothers sitting outside what had happened and we had another prayer time. :) Interesting timing. We gave thanks for the baby's breath and the faithfulness of God....

After arriving home, I received a text stating that Sheila, my patient from day shift and from Bible study, had been transported and received a cesarean section. Despite the unwanted turn of events, Sheila's baby was healthy and she is currently healing well.

Monday was also a very intense shift. Another patient I had done a prenatal on walked in fully dilated and at 2:41 pm, delivered a very healthy baby boy named Arvey Jacob. Despite hemmorhaging, Grace stabilized quickly. Here they are with their new arrival.
The birth of her baby was quite significant, as we had several active labors and her baby was Mercy Maternity's 14, 999th birth! We were holding a drawn out contest between staff and midwives to see who would guess the time of birth for baby #15,000. With baby 14,999 out of the way (ha ha ha), the clinic was in party-mode awaiting the arrival of baby 15,000. The mother and baby would receive a huge prize (tons of baby items) and the midwife who guessed the time would receive a gift certificate. :) Well, our room full of labors began to empty...two transported....one sent home...only one patient left...a woman having her 6th baby who had a closed cervix with possible PROM. Mmmm.

We took care of our postpartums and prayed that Jhobee's patient would deliver and be the 15,000th baby....on our shift. However, 10 pm was quickly approaching and we were thinking we would have to endorse her to night shift. Alas, at 9:00 pm, Jhobee's patient had SROM...7 minutes later - BABY OUT!! Baby 15,000 was born a beautiful 8 lbs. They named her "Mercy Joy" and were so excited to learn of their new-found popularity. Pictures were snapped and the prize was given. Our director, Krys, guessed that the 15,000th baby would be born at 9:00 pm, so she won the gift certificate, but happily gave it to the patient. We cheered and enjoyed recounting the full story of her birth. Jhobee, her midwife, and Maria, her assist were busily attending to her as we shared the story to night shift during endorsements. A good day. Here are Jhobee and Maria with baby Mercy and our supervisor, Ate Estef, in the background.

And me giving her the prize..they were pretty overwhelmed. :)

Today, I am headed once again to shift. While Tim and I struggle to find balance in our marriage, I, personally, am also struggling to identify my priorities and truly hear God's desires for this season of our lives. It has been very difficult, both physically and mentally, to balance my desire to serve as a good midwife, wife, and mother. I have been reading some friends' blogs sharing their experiences of staying at home with their kids taking time to do decor renovations, make cute quilts for their babies, attend playdates and go on field trips with their kids...and there is a very real piece of me that longs for that freedom...and relationship...and peace.

While I am sure they have their struggles, too, I found myself REALLY wanting to take Promise to a pumpkin patch with the leaves in their beautiful Fall colors crunching under my close-toe shoes while I drink a pumpkin latte with my mom wearing a coat feeling a brisk wind on my nose and watching Promise climb orange squash getting muddy. I know, I know...."Stop feeling sorry for yourself, Bethany!" But truthfully...I DON'T feel sorry for myself, I feel torn. Torn between wanting to be a mommy surrounded by the familiar and wanting to live overseas in service for the rest of my life....now, you may say, "but you can do both....to a certain extent". Yes, in some ways I see that. But I am struggling to see how...I love being with Promise and learning/growing with her, but the demands of a busy midwife are high and right now, both are sacrificing. The physical, spiritual and mental cost to me, Tim, and Promise has been intense.

For now, I am going one day at a time trying to be obedient to what God is asking of me TODAY while trying really hard to not look too far into the future. I know that I would not be content with "ordinary"....however, I know that even the ordinary can be made "extraordinary" if it's God.

A friend asked me if I wanted to move back to the West....everything in me said, "no", but a very small piece of says, "maybe"....only to experience "seasons" again, wear warm clothes and to be close to our families. It's all a process...a journey. I'm tired of journeying. With that, I leave you with two new photos of the Bird. I sure love her.

Be blessed.

No Mo' Mojo

I've lost my mojo. It disappeared a couple weeks ago. My spell checker doesn't believe that "mojo" is a real word, but it is. I checked. You can check too, though I'll try to save you the trouble. One of the definitions is charisma. I keep misplacing mine. It's probably a good thing, though I'm not really ready to embrace such a theory at this point. I'll lay the theory out for you regardless.

To put it bluntly, I rely on my mojo too much. Some of you are having trouble with the word mojo (you know who you are), so I'll try to replace it with charisma. In the last two years, I have become a rather driven person. I'm the guy who coasted through high school, met the bare minimum requirements for my university application, and then dropped out during my second year of post secondary education, having come to the shocking realization that the institution actually expected me to put in an effort. Since that time, there has been an abundance of grace heaped upon me and I managed to get a few things done. Not the least of which was finding a fabulous lady, convincing her to marry me, and developing what I believe is a pretty strong marriage.

When I caught the vision for clean water in Mindanao, something deep inside me suddenly woke up. There was a drive, a determination that I had never known before. I'm pretty sure that it was the Holy Spirit. It seemed to compliment another part of me that has always been there, including a surprising passion for business. That's where the mojo comes in. My problem lies in the fact that I so often find myself relying too heavily on my charisma instead of the Holy Spirit who gave me this vision in the first place.

Frankly, I've made it pretty far on my charisma, but lately it has failed me. As the challenges (and failures) have stacked up this month, my ability to respond with renewed energy and determination has been eroded. Sure, when I'm in a meeting and I need to impress, the mojo is there. But when I'm at my desk and crappy news appears in my inbox, or people won't return my calls, my drive is nowhere to be found. And now that it's gone, it is becoming abundantly clear that the Holy Spirit was edged out a long time ago.

My vision is too big to be serviced by my mojo alone, especially considering it is M.I.A. these days. I understand that my charisma is one of my giftings, and it comes from Him. There is however, a subtle but important difference between putting my trust in God, and putting my trust in the talents and gifts that come from God.

I'm a stubborn fool. You may know that about me. I have just laid out before you a perfectly logical equation that clearly points to my need for God. Logic is my dear friend, but today it has betrayed me, leaving me to pout stubbornly alone. Ét tu, Logique?

I will come to a place of surrender soon, where I place my trust in the Lord and stop trying to do everything on my own strength. Bethany has been praying for that day. You can join her. In the meantime, my Father is still mysteriously merciful.

Yesterday Toti and I travelled to Koronadal, where we had a very productive meeting with the CEO of International Care Ministries and his Director of Community Development. The meeting was quite a distance from here (the equivalent of driving from Vancouver to Portland for one meeting and then returning the same day), so we ran out of time and weren't able to work out all of the particulars. Long story short, I will be in Hong Kong to meet with them again on November 3rd, when we hope to ink our first deal of many. They are planning pilot projects in four different villages and if those go well, we will be seeing a very fruitful partnership between our two organizations which will result in a lot of people getting clean water.

So that is good news, and I know that it is due to the Lord's grace. Imagine what he could accomplish through me if I would just surrender to Him and stop being such a jackass.

On a side note, I am left wondering why I can make myself so vulnerable here in the interwebs, but squirm when my wife addresses these issues in a coffee shop. Pray for me; I'm a jackass.

Tim.

Toti snapped a pic during our meeting. There are some more photos of Promise's wake up faces on Facebook.

Tim's refusing to post....

Greetings! So once again, I have promised to have Tim blog, but alas, he refuses....so you will have to settle with more birth stories...I hope I am not boring anyone. There are MANY things to report regarding the water project, but Tim has decided that he is too busy to blog as of yet. Maybe in a day or two....

For me, life has been a whirlwind...in other words...not much has changed. :) October 4 brought me a swing shift to remember. I had the privilege of delivering a very beautiful baby girl to my patient, Josie. It is her 5th girl! She was hoping for a boy, had boy baby clothes prepared and the perfect baby boy name, but her baby had the most gorgeous lady features...ALL girl. Slightly disappointed, though happy her baby was healthy, she gave the job of naming the baby to me. :) After a very full and mildly frustrating swing shift, I was hoping the name I picked would be one that suited the cherished baby...so that despite her 4 older sisters, she would know that she, too, is precious....Hence, I got to name her Precious....aka: Peanut. Yes, many of you who have been following the blog know that my very first handle was the fourth baby girl of a patient of mine...I named her Precious, too. It's a very good Filipino name for a family of all girls!
And here are Josie and Precious...aka Peanut.

The next two shifts gave me lots of transports to Davao Medical Center. The first patient had BOW rupture over 12 hours and the baby's heart rate was tachycardic (too high)..however, several hours after transport, she delivered her very first baby girl after 3 boys and 10 years without a full term pregnancy. The baby is still recovering from a postpartal infection most likely received as a result of premature rupture of membranes.

My next transport, unfortunately, was my continuity. Remember Macaria? I delivered her baby boy early last year at MMC. Well, when I found out she was preggo again, we met and I had the pleasure of taking her again as my patient. However, she shared that her husband was moving to Macau before her baby was due and he would be working there for 2 years. Heartbroken and fearful, Macaria decided she would sacrifice his presence at her birth for a hopeful future of financial security (many families from the Phils do this). I personally do not recommend this and I could tell that Macaria was struggling with him leaving.

Her prenatal was last Tuesday and my peer, Tiara, and I got to spend a long time praying for her that Jesus would bring her peace and wisdom. She is pictured above. We also prayed that she would have boldness to tell her bana how she felt about him leaving. She stated that he planned on leaving Sunday and she really wanted him to be there for the birth. At 33 weeks, I explained that it was just too early for her baby to come safely and to just hang on for another 4 weeks.

Well, 2:30 am that night/Wednesday morning, I got a text from her. "Ma'am, daghang dugo sa gawas...sige busog. Balik sa MMC?" Her labor had started, she was bleeding and contractions were coming every 3 minutes. We raced to MMC. Sure enough, she was 8 cm dilated and her baby was quite small. Premature. We transported and within 3 hours, her baby came out barely breathing. The baby was moved to the nursery and briefly incubated when he started to pink up and breathe without assistance. Miracle.

When I visited her in the hospital at 11 am Wednesday morning, she still had not seen her baby at all, had not been able to breastfeed and had no idea what the status of her baby was. Her husband had gone home to get some supplies and was still planning on moving to Macau for work. Macaria, scared and alone seemed grateful that he had been able to see the baby briefly before leaving, but knew the road ahead would be rough. Please pray for Macaria as she parents two young boys alone for the next two years. Because her baby John Carl, was premature, he may have difficulty in lung development and may be predisposed to lung infections. Please pray for his safety and total healing. Thank you. She and baby John Carl are still currently in the hospital.
Here is that Tuesday prenatal day...and there I am teaching the patients about labor and delivery....with my three visual aids...Tiara, Willow and Ate Melody. :)

Thursday began the first of many Bible Studies! An-An and I arrived in the prenatal room at 3:15 pm with boiled eggs and pandesal (bread), pens, papers and prizes. We prayed for 15 minutes and asked the Lord to bring whoever He desired to the Bible Study. We prayed that those that He had handpicked would come with willing and excited hearts....and then we waited. And waited. Start time was 3:30 pm. At 3:45 pm, we decided to head downstairs and see if maybe someone was waiting outside....yup, one lone patient....she was waiting for a friend to go with her...we told her she was the only one...embarrassed and slightly annoyed, she lumbered upstairs...then one more patient trailed in. We were four. An-An and I shared how blessed we were that they had come and gave them lots of food.

First An-An shared her testimony...how she met Jesus, how He has given her peace amidst heartache and how she has found joy being in His presence. Then it was my turn....I shared from beginning to end...lots of details and areas in which Jesus is still changing me. Then we asked them (I will keep them anonymous) if they had ever seen Jesus work in their lives....that's when the Spirit of God fell.

As the two patients began to tell of years and years of abuse from family members, bitterness, fear, and sleepless nights, they began to see God's hand in their lives....He had removed them from the situations of abuse in miraculous ways and gave them incredible stories of survival. They began to understand how Christ impacted their lives without them even recognizing it at the time. The joy on their faces was incomparable. An-An and I shared that going through trials and recognizing God's hand on us through those times prepares us to be an encouragement to others struggling in the same areas and that we have a purpose to proclaim the glory of God because we have SEEN it with our own eyes! They got it. We had an amazing time of prayer and we talked about ways of stopping the cycle of abuse in our own families. It was rad.

Upon reflection, An-An shared with me that she had never seen a Filipina open up about their life so freely before. She was encouraged and suggested we open the Bible Study up for any and every patient that comes to MMC. So we'll see how many come this Thursday! We're diving into the Word this week, WAHOO! And here we are...just us four. :)

The weekend came and Tim, Promise and I got to witness the death of our Thanksgiving Turkey. A few of my peers, Jenna and Kinshasa, bought a wild, Filipino turkey from the local meat market and decided to slaughter it on their front porch. We attended the ritual and cheered for joy knowing that this evening, he will be gracing our bellies. :) Happy Canadian Thanksgiving!

And finally, this morning, I had the privilege of delivering my 57th baby. Ter came in fully dilated at 10 am and at 10:49 am, she powerfully pushed her baby out. I mean...stubbornly! She did not want any help or any instructions...she was focused and determined. Despite my warnings of slowing down, she popped her baby's head out slicker than snot and this was a BIG baby. A 7 1/2 pound baby girl came flying out creating a first degree tear in her momma. She is a beautiful baby...healthy, strong and stubborn like her mom. I sutured the tear and with the help of a new friend, Maria, got Ter to the postpartum area in time for shift change. Both momma and baby are well. Beautiful baby, Jammy and momma, Ter. :)

Well, Tim, Promise and I are headed to the orange house to have Canadian Thanksgiving with the other Canadian midwives....I was able to pump out three pies...kalabasa (squash similar to pumpkin), raspberry (from a very expensive can!) and dutch apple (made with fuji apples...it's all we got here!), but I am sure they will be grand! WAHOOO!

Blessings to you all on this very Happy Thanksgiving! Thanks be to God!

"When it rains....

it pours"....and so it has. As many of you know, the Philippine Islands have been hit hard by brutal typhoons the last two weeks and one is currently on the way. The President in Manila has considered the country in a state of disaster. Like you, we have only heard and seen pictures and testimonials of the terror of the typhoons. In the clinic, I have had many patients concerned for family members they have been unable to contact. Thankfully, Davao City and the island of Mindanao has been spared receiving only heavy rain and wind. A few lower-lying parts of the city have flooded, but very little. The devastation has been limited to the island of Luzon so far.

As we receive news from internet, newspapers, and friends, we are very aware of the need for intense prayer for our neighbors in Manila, but also in Indonesia, Vietnam and Taiwan. Please pray, too. Thank you.

This week it has been "raining" in the clinic, too....babies, that is. I was looking at my calendar this morning and counted 8 deliveries in 3 weeks. That's a record for me! Eight babies, eight mommas, and 40 baby checks over the next 6 weeks. This week alone I had the privilege of delivering 3 babies, 2 on one shift. What a zoo! One delivery in particular blessed my socks off.

I had met Teche about 3 weeks ago in prenatals and noticed that she had been Jes' patient (a former student) and Jes couldn't continue caring for her because she had to return to her homeland...so I debated whether or not to take her as a continuity. I decided against it concerned I would inconvenience Promise and Tim if she decided to deliver in the middle of the night. Well....on her due date, October 1, I just happened to be working day shift and she walked in. We saw each other and burst into loud hellos and laughter! Her smile is priceless....we hugged and thanked Jesus for allowing us to be together on her special day! I've never had such an amazing greeting from a patient....and I got to be her midwife. I was so honored.

Teche labored AMAZINGLY....her bana at her side, she smiled the whole time telling me all the things she needed to do to get the baby out. And she was right. She had delivered her other two babies at MMC, so this was old hat to her, so I just monitored and enjoyed her company. Meanwhile, I got another labor....three baby checks....and another patient pushing...ha ha ha...my fellow midwives all had labors, births or both! We were insanely busy, but loving every minute...there was never a moment where we were short or frustrated....just driven and busy.

Teche continued to labor...then the smile left her face with the wave of a heavy contraction...but she started to have intense pain in her lower abdomen. She had a UTI and I knew she had only been able to pee a bit here and there. I told her that before her baby could come, she would have to pee. She laughed at me and explained to me exactly why she would have to do that..."To make room for the baby's head and so that I do not have to get catheterized". Yup. She'd done this before. I found out later that she had studied nursing and completed a program here in the Philippines just as she found out she was pregnant with her first baby!

After peeing like a champ (believe me, it's hard when you're near the pushing stage!!), she wanted to push....just like that, a beautiful 6 lb. baby girl, Lois Ariel, arrived. Beautiful. Healthy.
Here they be!

Then another labor came in....between the postpartum checks and bathing of babies, fundal checks, another baby was born...and another. Then a patient I was sharing with my supervisor (depending on who was busier) wanted to push. She was 7 cm, but really wanting to push. Jean was in so much back pain she was crying out in frustration and fear. Her first baby, she labored with intense concentration, trying to follow my instructions to breathe instead of pushing.

We finally had to take her to the CR (washroom) to take a shower/half bath to get her mind off pushing. It worked...10 minutes after taking a bath, her baby's head dropped just behind her pubic bone and her bag of waters was visible. YEAH! Jean pushed her baby out slowly...there wasn't much room for her baby to come out of! And yet, she controlled her pushing and our eyes met, we breathed together 7 deep breaths and her baby came....beautiful 5 lb 15 oz. baby boy. And here is Jean, baby Kent, and her hilarious bana. He cheered out loud and did a lap around the birth room when the baby arrived. :) Five babies born in 4 hours.

Wednesday also brought me a wonderful patient. Claire came in wearing a huge smile and a huge personality. Delivering her baby without a boyfriend or partner, Claire was not at all shy about her situation and loved having another baby. I was a little caught off guard by her transparency. She had several friends coming in and out wanting to help, but chose her close friend and neighbor to be there for the birth. Baby Rafael was born sporting his umbilical cord around his neck and spilling meconium everywhere, but super healthy despite. And there they are!

I later found out that Claire's neighbor has been married 7 years and has never been pregnant. That's huge here. And I can relate to the disappointment and frustration of desiring a child...

I had an awesome opportunity to share how after 6 years of marriage and 8 years of being told that having a baby would be an impossibility, God did the impossible...Promise was born. I shared that God hears our prayers and for me, God gave me a child in His precious timing. It was not my timing and it required me laying down my deep desire to have children and just be obedient to what God asked of me, but when I gave the desire to Him, He fulfilled it. Not only that, but I knew that I was pregnant as a result of His grace and mercy, not of my own striving (like in vitro or trying to plan it). It was not planned...but it was God's plan. She looked astounded and alarmed. I offered to pray with her regarding her desire and exhorted her for being her friend's support during labor....I know the pain one feels when seeing another's joy. She excitedly agreed for me to pray.

We prayed for God's perfect timing and that He would show her areas of her like that she could work on during this season of waiting and that if He asked for her to give up her desire for children, that God would give her courage and strength and that He would give her a new vision and new hope for the future. It was cool.

Meanwhile, Tim and Toti have been working on several different projects, but Tim will post all that info tomorrow. He's great and he has been extremely attentive with Promise while I've been at work. As a result, Promise has grown quite attached to her playmate, Daddy. I have to say, He DOES light up a room. :)

Okay, I am tired and that's enough for now, eh?

Thank you all for your prayers after last week's stink week...this week was better for me, but I realize just how many of you are going through the poo, too. Praying for you.

Next week begins our patient Bible Study. An-An and I are nervous, but we anticipate the Lord showing up and doing what He does....we serve an awesome, loving Savior.

Be blessed.