Someone grab a flashlight!

March 23

I'm standing next to the table, shrouded in a dark green surgical gown that practically drowns me, mask, head covering, sterile gloves.....I stare down at my hands, one pulling the uterus back on top of the abdomen and the other disappearing inside the woman. Outside the rain is coming down in torrents. Inside, Dr. Fam starts yelling over the roar of the weather, "Somebody get me a torch! A flashlight! I can't see." We are in the midst of a cesarean section and the power has gone out....again. It is my first full day in Nigeria, and this is one of the last positions I expected to find myself in.

But a familiar position.

My eyes gaze fondly at the small cramped operating theatre, memories coming back from 5 years ago when I stood often in a similar room in Tchad. I remember doing surgery on a man with ruptured bowel, the patient kept trying to strangle me from the side and we couldn't get his intestines to fit back in him. I remember spending hours in the middle of the night, painstakingly helping the surgeon put in hundreds of tiny stitches to re-create a mangled hand on a woman. I remember pulling babies out of many uteri.

Mind back to the present, the power has come back on. Dr. Fam and I continue to stimulate the uterus trying to get it to contract down. The uterus is still soft and there are little bleeders everywhere not wanting to stop despite all his suturing. This mom came to the hospital with obstructed labor. The story I heard is that she first went to a "mission house," which is a place run by local churches offering help for pretty much anything. From what I've been told, these places don't seem to be as great as their name suggests. They "help" people with medical problems, much like a traditional healer, despite having no medical training and often do more harm than good. They chain up psychiatric patients and try to beat the devil out of them. Kind of scary, and sad that it is under the name of the church.

Anyway, it had been relayed to us that this woman had actually delivered the head at the mission house, but the baby wouldn't deliver any further, so they actually pushed the head back in! When she came to the hospital, we were still finishing a different cesarean that Lisa and I helped with resuscitating the baby. So with the main operating room tied up (that woman was hemorrhaging badly), we prepared the second, less used OR with Dr. Fam who came in to do the second surgery. I thought I would just be observing...we had come to teach neonatal resuscitation and this would be a good chance to see how they do things and get ideas for what material we should focus on. But maybe because it was the weekend and less staff were around, or because in these areas of Africa, an extra pair hands can always be used, but Lisa and I were quickly pulled in. Lisa got ready to help receive the baby and I scrubbed in to help Dr. Fam.

With the first cut into the uterus, pure brown amniotic fluid came pouring out. Meconium everywhere. The baby was big, floppy, and quiet. He'd been in distress for quite a while. I suctioned the mouth and nose, clamped the cord, Dr. Fam cut, and then quickly handed him off to Lisa and the nurse anesthetist. They ended up suctioning a bunch of bloody meconium out of his lungs and successfully resuscitated him after a bit of work. I didn't know much of what was going on with the baby as we continued with the mom.

The surgery took forever for a cesarean. Partly because she kept bleeding and we didn't want to close her up until it was under control, and partly because the power kept going out. But I had a great time hanging out with Dr. Fam! He told me about all the other countries he has worked as a surgeon and the difference in people & cultures. Then we compared notes with places that I've worked. Every 10 minutes or so, the power would go out again, it would get dark, and we'd try to remember where the bleeding was and put pressure on it until someone could grab a flashlight so that he could continue suturing. 

So great to be back in Africa in surgery!

Fundraising

I had planned on holding off starting my fundraising for the Philippines until after I return from Nigeria so as not to confuse the two trips. However, I found out that I need to be ready to buy my ticket to the Philippines very soon if I want to get the group rate. So with no further ado....

I am wishing to secure as much as possible of my tuition and expenses before I leave in August and would like to invite all of YOU to be a part of this journey with me. Newlife International School of Midwifery is unique in that while I am going to school in a sense, I am also working as a volunteer missionary in their free maternity clinic and other outreaches they do in the surrounding community. All tuition that I pay, goes towards funding Mercy Maternity Clinic, the largest charity-based birthing center in the Philippines. They serve almost 20,000 patients annually (prenatal exams) and over 19,000 babies have been delivered in the last 16 years.

I have added up all my expenses and the total is very daunting!

$36,680

One good note is that this is only about half the total tuition of the other stateside midwifery schools I had looked at. And that is ONLY tuition at those schools....not to mention living costs.

This total includes ALL my expenses that I can think of over the next two years. The school offers free room and board, free meals, and free preceptor/clinical fees.

Here it is broken down:

Tuition - $22,380

National College of Midwifery Admin Fee - $3100

Airfare - $800-1200

Visa/Immigration - $800-1000

Books - $600

Midwifery Supplies - $500

Overseas Health Insurance - $3500
Extra Living Expenses - $150/month = $3600
NARM Exam for Midwife Certification - $1000

If you would like to help sponsor me, I've created a donate link through paypal. It is on the "Donate" page at the top of the blog. Some have asked about supporting me monthly while I'm gone. If you would like to do that, please email me at sarah.sexton06@gmail.com and I would be happy to set that up as well.

Thank you so much!
Sarah

Counting Down the Days...

Two weeks from today, I'll be arriving in Nigeria! How fantastic it will be to step out of the plane and breathe in the deep, dry African air again.

It will be a short trip, just 10 days, but very busy I'm sure, teaching neonatal resuscitation at the Ile-Ife Adventist Hospital. While I was in Tchad, at the Bere Adventist Hospital, I heard little bits and pieces about the other African Adventist hospitals around the region. So it will be neat to go there in person, the 3rd hospital I've been to, after also spending some time at the Koza Adventist Hospital in Cameroon.

I've been asking my co-workers to start saving baby Ambu bags that they would normally throw away in our hospital.

I am also so excited to work with Lisa again, who is organizing the trip. Our years together in high school, go down in history....at least our personal history :) It seems so long ago already. What is neat, is that I can remember tromping through the back woods together in the mountains, talking for hours about both our desires to work overseas. We would talk about starting a clinic or an orphanage, dreaming big dreams, never quite sure if they would come true. So when Lisa called me up last Fall, describing her plans and asking if I would want to be involved, I got so excited to realize that even after years of not seeing each other, we've both ended up with some of the same passions and finally making one of those dreams come true of working internationally together. 

Are you sure?

Yesterday I received the exciting news that I will be heading to the Philippines for the next 2 years! I've been accepted to Newlife International school of Midwifery in Davao City on the southern island of Mindanao. I let out a little yelp when I read the email at work. As the news spread among my coworkers, many were curiously confused as to why I would choose to go to the Philippines for education. I've tried to explain my passion for working in underdeveloped countries, but it doesn't make much sense to them. Their favorite interest in traveling out of the country is to go on Disney cruises in the Bahamas. And why would I choose training that isn't at the most professional and highest level I could in the great United States? They were all very congratulatory, but also intrigued.

The biggest surprise to me was when I broke the news to my boss. She was excited for me, but then said, "Sarah, before you make any decisions, Kim and I want to talk to you."

Later in the afternoon I was called to her office and was a bit intimidated to see our nurse manager, our assistant nurse manager, and two other administrators waiting to talk to me. They sat me down and one quickly blurted out, "We think you should be a nurse practitioner!"

I was a little taken aback, and just answered with a surprised, "Oh!"

They went on very kindly to tell me how smart they think I am and how much potential I have, and want to be sure I know all the options available to me.

I told them I was very flattered that they would care so much to say something and that they think so highly of me, but want on to describe my passion for maternal and infant health and becoming a midwife. I explained the difference in working in an international setting and how physician assistants and nurse practitioners aren't always a recognized profession in other countries.

They still interjected more comments, "But you would be a fantastic nurse practitioner!" "It would give you so many more variable skills if you trained as a nurse." "You would always have job options."

So I explained more about why I want to train as a direct-entry midwife and become a CPM (Certified Professional Midwife) instead of going through nursing and becoming a nurse-midwife. I talked about working in rural areas in other countries, what I've seen and the needs that are there. I explained my desire to teach women in these areas to have basic midwife skills and how this school in the Philippines is so greatly aligned with all of my goals.

In the end, I don't know if they truly understood me. It was so very sweet of them to care so much and they were very encouraging, but I think I disappointed them a bit. They did tell me they were impressed that I would choose a life of such service, but they make it sound like I'm sacrificing so much, whereas I see it as what I enjoy more than anything else. I just wish it wasn't all about being successful and professional. To them, it sounds like a dinky little midwife school in the Philippines. To me, I see a fantastic opportunity to learn and serve at the same time at a school that highly values many of the things I value. It is a fully accredited program through the US that offers me a degree and prepares me to register as a CPM.

I am trying to not be disheartened by the fact that people think I'm choosing the wrong path. I truly have extensively thought through my options over the last few years as people have asked me why I'm not going to medical school, or PA school, or becoming a nurse. I have seen God leading me this direction and I'm jumping in with both feet!

What do you do with your TIME?

I'm passing on a blog post that really spoke to my heart. I hope it speaks to you too.

http://aplacecalledsimplicity.blogspot.com/2013/02/was-god-just-kidding.html

Becoming a Midwife

This is a long overdue update on what has happened regarding my search and applications for midwife school. Many knew that I was applying to a school in Portland, Oregon and was supposed to hear in January whether I got accepted. I felt that my chances were good, my interview went great, I way over-fulfilled their prerequisites and optional classes...So I was really HOPING to receive a letter of acceptance, but was also ok with a rejection letter. What I was NOT expecting was a letter saying that they were no longer considering my application and were throwing it out because they think I "falsified" information on my application. Crazy. I was rather shocked when I pulled the letter out of the mailbox and read it. It included statements on how they think I purposely tried to lie and mislead them about what I've done and accomplished. It felt very insulting.

So I had a couple days of awfulness. Trying to sort through what happened. Realizing that I would not be moving soon back to Oregon. I wrote an email to the school trying to clarify things and hoped to receive some kind of response back, but it has been a month and I've heard nothing. I know there are good people at that school, I don't want to down on it, but whatever happened in their assessment of me and my application feels very wrong. Through the whole process over the last 6 months I've always had positive responses from them, so what bothers me the most is that they never communicated with me and just jumped to the conclusion that I was lying to them and didn't even tell me till the point that I was hoping for an acceptance letter. Even when I flew out for an interview in person, it was all very encouraging and positive. I can't help if they choose not to believe me.

Good things come, though, from something that seems negative.

I started searching for schools again and found a Christian-based midwifery school that is in the Philippines! I was a little wary at first, but after checking it out and finding that it is fully accredited through the US and offers degrees, I got more excited about it. The program is specifically for training midwives to work in underdeveloped countries which is right where my heart is. So I've just finished my application for that school...and seeing where it takes me! I'm trusting that where God wants me, it will happen.

"According to the United Nations Population Fund (UNFPA) State of the World’s Midwifery Report, Up to 3.6 million deaths could be avoided each year in 58 developing countries if midwifery services are upgraded.

The study, The State of the World’s Midwifery 2011, estimates that an additional 112,000 midwives need to be deployed in 38 countries to meet their target to achieve 95 per cent coverage of births by skilled attendants by 2015, as required under the Millennium Development Goals (MDGs). Globally, 350,000 midwives are still lacking, it says.

The report, launched at the Triennial Congress of the International Confederation of Midwives (ICM) Durban, South Africa, says if adequate facilities were accessible to deal with complications at their onset, many deaths could be averted: 61 per cent of all maternal deaths; 49 per cent of all stillbirths; and three in every five newborn deaths.

The report adds that if midwives are in place and can refer the most severe complications to specialized care, up to 90 per cent of maternal deaths could be prevented."

Midwife International "The Global Call for Midwives"

Happy Holidays!

2012

Hard to believe it's over already. When I look back, there was a lot of heartache, but growth along with it. Funny how those two are always connected.

I started working at University of TN Medical Center one year ago. The long 12-hour shifts really make the weeks fly by! I work in the Neonatal ICU, a large 67-bed ward for babies. Many friends have asked me, "What do you actually do there?" I try to explain it as part tech, part secretary. I help run the front desk, dealing a lot with the parents and families of the babies, which can be a bit exciting at times. New babies always seem to come with family drama, custody issues, etc. I've seen some of the strangest things...many young teenage moms, drug babies, crazy relationships within families.

Another main part of my job is processing all the doctors' orders off the charts. We haven't gone to the computer-entry system yet for the physicians, so they still write all their orders out and then we enter them into the computer, order lab tests & xrays, and call physicians in a myriad of specialties to come consult our babies. I really like doing this because I have been able to learn so much by reading through the process of treating our babies. Away from the desk, I help the nurses hang their IV fluids and TPN, and help feed a baby now and then when it gets busy. I enjoy having a job that really involves so many different things. I run all over the hospital at times, picking things up and dropping things off, trying to figure out answers for the nurses and doctors. I keep my ears open, trying to pick up on anything happening around the unit because my job is a constant stream of questions from people, "Can you fix this? Can you find this? Can you order this? Help me!" Fun, fun :) I LOVE when it's busy!
~~~~~ While working in the hospital and having these 2 years off from college, it has really been a good reflection time for me to really understand what I'm interested in doing. In all my time overseas in other countries, I've seen a lot of need in women's and children's health. I've seen a lot of births go awry and emergencies unattended because of the distance from medical care and lack of skilled birth attendants. One of the Millennium Development Goals by the United Nations, is to reduce the maternal mortality rate, especially in Southern Asia and Sub-Saharan Africa where giving birth is very risky. According to the 2011 State of the World’s Midwifery Report by the UNFPA, approximately 350,000 women die while pregnant or giving birth every year— almost 1,000 a day. Of these women, 99 percent die in developing countries.

This is something I've become passionate about and have made the decision to become trained as a midwife! I have applied to a couple of direct-entry midwifery schools in the last few months and am currently waiting to hear from a school in Portland, OR that I interviewed at in November. My real dream is to be able to not only practice as a midwife, but also to teach basic midwifery skills to women in these remote areas of underdeveloped countries so that they could help the women in their villages.
~~~~~ I am also looking forward to a chance to step back into Africa this March. I'm going to Nigeria with my friend Lisa Hulse, to teach Neonatal Resuscitation at the Ile-Ife SDA Hospital. Lisa and I were high school friends, and it is so neat to end up with similar interests wanting to see things happen in the area of maternal and neonatal health. And it's Africa! I will be updating my blog with more as we work on fundraising and preparing for the trip.

It has been hard being alone in Tennessee away from so many friends and family, especially hard not getting to spend the holidays with any of them. But it has also been good, pushing me past my comfort zone. I have a great group of friends here that have dinner together each week and have a wonderful roommate, Pamela, who I moved in with in September. And of course, Mowgli, my great little travel companion, posing above with our Christmas tree that he enjoyed terrorizing :)

"One day spent in your house, this beautiful place of worship, beats thousands spent on Greek island beaches. I'd rather scrub floors in the house of my God than be honored as a guest in the palace of sin. All sunshine and sovereign is God, generous in gifts and glory. He doesn't scrimp with his traveling companions. It's smooth sailing all the way with God." - Psalm 84: 10-12

God would make a great traveling companion. Travel! Not a day goes by that I don't have an ache and longing to travel more. But like David says in this Psalm, even the Greek island beaches can't hold a candle to what's to come in our life with God.