Trial and Triumph…and Appreciation

Trial and triumph.

My first blog post ever, and also my first week as an ALSO teacher (actually I’m currently an “instructor candidate”, so not even official yet.)  While I’m talking about firsts, it’s also my first time in Guatemala, and I’m having a great time.

I have been so inspired by my colleagues both from the U.S. and here in Guatemala.  At the core we have a group of people who are passionate about women’s health/maternity care and who are all working together to share information and to improve outcomes.   Our first session was with the Comedronas (midwives) who provide care in rural areas with information passed down from generation to generation.  The ones who came to the course Mercedes organized are the ones who are especially eager to learn and improve.   We hear that 25% or so in the field don’t practice basic sanitation practices like hand washing.  This omission leads to higher rates of infection and sepsis and women at risk for critical illness.  This basic education is a priority for our colleagues as well.   Many of the GPs here also do deliveries (often home deliveries) – I had a great time learning about their management and when they refer. 

The OB/GYN specialists here in the hospitals work hard with long hours and limited resources.    They have a 40% cesarean section rate, which is likely because higher risk people end up in the hospital/and also that there is limited access for other options.  Our ALSO workshop on vacuum deliveries was very well received and doctors are very interested in this way to avoid some cesarean deliveries but for one problem – very few hospitals have access to the vacuum devices.    They are hopeful that the Minister of Health will continue to learn about the needs for the doctors and hospitals so funding will be improved.  We are also hoping that a protocol for amnioinfusion (putting fluid back up in the uterus when there is a cord being squeezed with contractions) might help decrease the c/s rate as well. 

Yesterday we taught the first ALSO instructor’s course in the past 7-8 years.  I’m currently watching one of the OB/GYN residents who took the course yesterday give a lecture on bleeding in pregnancy as an instructor candidate.  She’s rocking it.   They do the ALSO course very frequently here, but we have a different perspective as we are using many of the techniques being taught and can provide practical knowledge.  Ultimately the program is self-sustaining, with an occasional bolus of updates and new energy. 

Many of the instructors in our group have taught in several other countries (including the US) and are adapting to this curriculum with ease.  Many are faculty at our Kaiser program, or for Audra at Touro, and all of us teach residents on the labor deck.  It’s pretty amazing seeing what people have already done and their ideas for the future -- all with an inclusive and collaborative approach. 

I can’t help but think as well about the great amount of need that we have at home in the U.S. too.  The fact that we have so many resources and are such a wealthy country and STILL have Moms and children that are hungry and that have trouble accessing safety and care – well, we need to keep trying to improve.  I’m hoping to take some of this energy and use it in ways that count at home as well.  I challenge everyone to pick one thing to do to help improve the life of someone else – whether it’s keeping watch on an elderly neighbor, picking up medications for someone sick at home, bringing extra food/produce to a food bank, or writing your legislators to support a social program that you believe in.  And for everyone who does so much already – thank you for making this world a better place.   You inspire and humble me. 

Rebecca Darsey

PS: For my son Bryce – here is a bridge – I don’t think I can find you a roller coaster.  Love, Mom.

And from Audra Lehman:

Appreciations for my Team

Sarah J: Our den mother and the force behind this whole venture. An incredibly capable woman who makes things happen, and makes them happen to the highest standards. She’s always on: planning, monitoring, checking in and offering support (massages!) and feedback. Also, photographing continually! Improvising on the spot, she keeps the big picture and the littlest details in mind all the time.

Isabella: I couldn’t wish for a travelling companion with more warmth, intelligence, humor and grace. In addition to the nurturing attention she shows each of us, her dynamic translation is that kind that you always hope for: she has the medical knowledge and cultural awareness combined with such a strong commitment to making sure that students really get it. 

Sarah M: A perfect example of “don’t judge a book by its cover”. She’s an elegant, blond haired, blue-eyed surgeon who grew up all over Asia! Tough as nails, but lovely and kind at every step, I want her not only as my OB consult, but style consult too.

Candace: What a delight! She’s the only one among us that is still in her residency training, although her level of maturity and ability belie that status. She’s strong and smart, a problem solver with a passion for education. She’s “no drama”, but plenty of fun.

Rebecca: Steady and positive, always in good cheer and making heroic efforts to communicate in Spanish. I really admire that no matter how hard it is for her to be away from her little boy at home, she has traveled far because of her commitment to keeping women and children safe here, too.

Alison: My roommate, and that couldn’t be more perfect. Our neighbors say they hear us laughing at night. We have so many shared values and interests despite our completely different backgrounds; we could talk pretty much endlessly. And best of all, she sings me a beautiful lullaby at night.

Mercedes and Julio and Eva Marie: Our amazing hosts. Endlessly gracious, patient and attentive, it’s been truly precious to get to know these special people. I harbor a small fantasy of returning to study with Dra. Mercedes, then cover her service so she can have a vacation! I hope to stay in touch with this family and see how little Eva carries forward her amazing family tradition of love and service to community.

Audra invited edits to her post above--the only edit I have is to share my appreciation for Audra:

Audra is a born educator.  She is fun, smart, warm and dynamic, and she knows how to win an audience.  Committed to effective teaching, she incorporates various methods to engage learners and ensure a quality experience.  And…the woman can dance!  And sing!  She showed courage by joining an all KP-team, and she makes our team complete!  Hopeful this trip will be the first of many…thankful…sj