Just when you think it can't possibly get hotter...

it starts raining, and the mercury drops a good couple of degrees. Today I immediately threw on my swimsuit and almost ran (as much as you can in 90 degree/100% humidity) outside where I alternately sat in torrential tropical downpour and then in the pool. The downside of the rain is the oppressive humidity which follows it.

I’m not sure what I expected from the way Vanuatu looks. It appeared idyllic from the air. Seriously green, palm trees, impossibly blue water, all the tourist brochure stuff, unsealed dirt roads skirting the coast but the drive from the airport revealed dwellings which could be described as shanties. Little huts constructed of corrugated iron and palm leaves which are often clustered around other little huts with long crowded washing lines strung about. Scrawny looking dogs who stand around looking tired in a few places, and the men here seem to either stand around in small groups on the side of the street or wander about. All the women seem to work in long impossibly flowery tropical print dresses and flip flops - they have quick smiles and seem to (correctly) assume I speak English. I discovered that not everyone does though, after a funny encounter with a little girl in the supermarket when I spied an unoccupied basket on the floor. I asked her immediately, unthinking, if it was taken. I may as well have descended from another planet for the look she gave me. I realized very quickly that no, the kids don’t speak English. I asked another man who looked on chuckling, and he kindly translated for me. I was expecting bislama to be the predominant language spoken here, but I’m surprised to find that I hear French spoken just as often, it’s helpful as I really know no bislama, but my French is passable. I hear many of the midwives are francophone so, that should be helpful.Next time I think I'll just ask in french.

The trip to the market was memorable for being 4.00pm on New Years Eve. The place was packed with people, imagine Black Friday sales at Walmart, but at a Safeway, buying supplies for parties. The lines at all 4 checkouts were 10 to 30 people long. The party item of choice seemed to be cans of air with a (very loud) horn attached, but more about that later. There truly is almost everything you could need in there, lots of familiar foods with outrageous prices and local stuff which was more reasonable. The French influence here translates to insanely good French bread (50vt for a batard/baguette). I’m informed that there is a tiny corner shop across the road which sells fresh bread daily and assorted canned goods. Which I’ll have to check out. It was nice to see lots of local tropical fruit and veg. Masses of bananas, and my all time favorite fresh passionfruit (5 for about $1) and the hugest avocadoes I’ve ever seen. Some were bigger I swear than my head. I spied a few avocado trees on my walk home which were heavy with fruit as well so I expect that they will feature prominently in my diet while I’m here.

Ni-Van’s celebrate NYE as much as New Yorkers. I was warned when I checked in that it would be “noisy” and boy was she not wrong. My little cabin seemed too be surrounded by parties, loud island music (kinda a cross between reggaeton and low budget electronica), screams (yeah, real screams - not a nice sound, really), whoops resembling those of howler monkeys, incessant canned air horn honks (the children I assume?), and then later (towards dawn) the dulcet tones of dogs fighting and myriad cock crows. I think one area off to the left of my house still hasn’t stopped its party and as I write it’s 7.00am. Update: the party seems to have moved to a series of car/trucks which are driving about – or more careening, really – past, yelling, honking those damn air horns and generally encouraging everyone to continue the party at all costs. It’s now 4pm. These folks have serious party stamina!

I’m staying at a small "resort" hotel just by the hospital. It’s a cluster of 6 studio apartments and 4 or so of larger apartments. It has a nice pool and a BBQ area. It’s comfy, but my apartment isn’t air conditioned. I suspect it will take me quite a while to get used to the heat. I’m torn by my desire to seek out some air conditioning especially at night. I know though that I’ll be more reluctant to venture out by myself if I have a cool refuge. I confess I find it pretty intimidating to wander about as a solo (visibly pregnant) female foreigner, in a country which is so clearly socially dominated by men, but I notice that there are local women about on their own. I’m conscious also that women are modest with their dress, I’ve not seen any pants worn by women at all, and skirts and dresses fall at least to past the knee. Good thing I’ve never been a short shorts kinda gal. I suspect also that my pregnant belly may deflect some unwanted attention.

Hopefully some of these nights we’ll get some more rain and some cool breezes both of which were absent last night) and in the meantime I’ll throw myself into the pool periodically, and continue to drink loads of cold water. Today (Friday) is New Years Day, and everything is closed, I plan on sticking close to home, recovering a bit from yesterday’s travel, and reviewing some midwifery material. I think I’ll go up to the hospital on Monday morning for my first shift. That leaves Saturday for a good trip to the market for some food shopping and Sunday for some wandering around and finding my feet.

Seems I have excellent internet access though, which only occasionally necessitates a wander out to the pool area where the modem is nailed to the wall. The breeze is nice out here tonight though, off Erekor lagoon.

I'm here.

Updates...

Turns out the counter agents at United are a bunch of idiots, well one in particular actually. He managed to put my bags on the correct plane initially, but then saw fit to assume which airlines I'd be flying onward from LA. Fortunately I had that agonizingly long layover during which I had to extricate baggage from Air Nui (New Caledonian Air), and get it to Air Pacific (Fiji). No small task, but accomplished with about 45 minutes to spare.

The layover in Fiji gave me a lovely taste of what I'm in for in Vanuatu weather-wise. It was about 5 am when we landed there and it was about 30 degrees c and humidity like I haven't felt since living in Townsville. NZ by comparison is cool. Weather in the 20's, chilly at night, but the sun is Southern Hemisphere HOT. The boys are toasting up to a lovely shade of brown, Ryan persists in getting RED every day and complaining bitterly about it at night. Lots of swimming, playing on wild NZ playground equipment which would be deemed MUCH too dangerous in the States, and yesterday we wandered around the Sea Lion colonies here at Kaikoura - Miles of stunning blue water beaches on one side and towering mountains (complete with a touch of snow) only a few short miles away on the other. It's lovely.

Earlier this week we enjoyed the hospitality of lovely M, her partner T and baby Noemi and midwife/preceptor Sue. It was so nice to finally meet her (will update blog roll accordingly - terrible omission). They were kind enough to hook me up with my 2nd trimester ultrasound which was, suffice to say, considerably less expensive here than it would have been in the States ($65ish versus $300-odd). I'm not sure if it was a combination also of NZ's less litigious attitude, or excellent scanners which seemed so much better than any I've had before, but we scored a rockin' ultrasonographer who was happy to talk me through the whole scan, pointing out the findings I was most interested in (4 chamber heart, all outflow tracts lovely, kidneys, diaphragm, etc. etc.). It was fun watching her chase this new little person around. While we hadn't quite decided to discover the gender, it was all rendered moot within about 2 minutes when he decided to point his bum right at the transducer beam and well, all mystery was swiftly lost. I should note that this scan also served to determine that there is but one fetus in residence which makes me very happy indeed.

So with that sorted I give you the obligatory creepy ultrasound pic of wee baby #3. It seems I am destined to be mother to legion sons.
Internet access sufficient to update blog is spotty here in NZ, and quite expensive... You may not hear from me again till I land in Vanuatu. Happy Christmas, Hanukkah, Solstice, Kwanzaa - hope you and your families are warm and safe, and your tables full of delicious things this holiday. Here comes 2009!

Catch you on the flipside.
Xx L

Give me your tired and huddled masses...

I gotta say, that LAX is about the weirdest place on the face of the earth. I can remember the first time I ever visited the States on a family holiday - I was about 13, my parents bribed my younger brother and I with a trip to Disneyland so they could then subject us to every major church and art gallery in western Europe... I can remember stumbling off the plane here in LA, staggered both by the thick smoggy air (I'd never actually seen smog prior) and the sheer size of everything and the throngs of people. Back then (1991?) LAX was a good deal grubbier, and seemed to be inhabited by hordes of aggressive Hare Krishna devotees all determined to "gift" me - and I assume everyone else with copies of a large book. I'd never encountered the "here's a present, now you must give me a donation" technique of fundraising. How good a target I appeared as an incredibly naive Australian tween, still rather eludes me, but they tried anyway.

Every time I'm back in LA I'm struck by just what an extraordinary place the Tom Bradley International terminal is. It's massive, it's packed with every possible nationality of traveller in every manner of national dress. I've been sitting here (I can't check in for another 2 hrs) watching people, and it continues to be just a kaleidoscope of people. Interestingly the first man who spoke to me this afternoon after I arrived was a south asian Indian?) guy thrusting yet another text at me, and, with nothing to identify me as such asking urgently "Are you an Australian or New Zealander?" I'm really not sure what it was that tipped him off. I rather thought that after almost 9 years living here that I'd have less Australian-ness about me - especially when you consider that I didn't actually open my mouth (an almost immediate give-away). I didn't stick around to find out which group he was recruiting for...

Anyhoo. After two days of what is quite honestly, a pretty grueling exam, I'm now headed south. In something like 20hrs I'll get back to my family who are currently enjoying NZ's beautiful Bay of Islands and then we'll head south for three weeks of R and R. Before the real adventure begins.

Fingers crossed my bag tranfers as it should from Seattle, all the way to Auckland else I'll be royally screwed.

Countdown

Have been (blessedly) off call for some three days now, and have been a perpetual motion machine ever since. Have finally accumulated some 20kg (~40lbs) of supplies to take with me thanks in large part to the gracious donations of assorted Seattle midwifery practices, friends and preceptors. Vila Hospital has the following coming their way, assuming I don't slip a disc in the process...

• 200 disposable chux pads (we get to use 1/2 a chux for each birth - I'm used to using between 10 and 20 per birth so I expect I will get to love those rationed items dearly...)
• 12 boxes (1800) non sterile nitrile gloves. Always in short supply I'm told.
• 200 pairs of sterile gloves
• About a gallon of alcohol based hand sanitizer.
• A big pile of hand towels (all now permanently marked with "Property of VGH" on the advice of former pacific midwife-adventurer Emily. I guess they have a tendency to "walk" otherwise)
• About a dozen bars of antibacterial soap (more to be purchased in NZ)
• Several large bottles of lidocaine - students have found at various times that there wasn't enough lido for all the repairs that are reported to go on. I tend to think that you can never have too much, so I've brought a bunch with me.
• A bag of tubes of Erythromycin eye ointment - I've since been informed that they don't use it, but perhaps it'll come in handy anyway to some baby somewhere!
• A handful of (slightly out of date) amnihooks thanks to a lovely nurse at a hospital which shall remain nameless.
• A handful of digital thermometers (which read in celcius - note to self, must brush up on conversions...)
• Oh yeah and a small fortune in suture material, mostly 3.0 and 4.0 synthetic. I'm reliably informed that every lac, no matter how small is routinely sutured with 0.0 (aka what I imagine looks and feels like heavy gauge fishing line). Besides the fact that I'm not sure I could adequately knot that sort of suture, I hope that the 3.0 and 4.0 will make more women a bit more comfortable.

For myself Husband (sweet man) has gifted me an electronic book which will allow me to take 800 books with me without actually carrying them all around. Sometimes this technology is a wonderful thing. :) I also have packed 5 knitting projects (two UFO's -un-finished objects - and three lovely new projects for baby all in yarns which honestly, are too luscious for babies altogether. There will be an "Absolutley no puking allowed" clause cited before each garment is ever worn. How effective this plan actually ends up being, remains to be seen. In any event I plan on much knitting, much reading and oh yeah, much blogging.

I'm frantically preparing for my final practical exam - the dreaded ACE (Advanced Clinical Examination) as well as completing the rough draft of my Senior Paper which, inexplicably is due NOW. Husband and boys leave for NZ tomorrow morning, as I head to school for a couple of days.

I'll be on a 10.30 ish flight to LAX/FIJI/AUK on Wednesday next.

Thanks all for your support and encouragement. Stay tuned!

Headed South

In a few short days I will be off call here in Leafy Corner (phew) and will prepare to take my final practical examinations at school and head south for a few well earned weeks vacation with my family in beautiful New Zealand. Not quite my homeland, but almost, as that's where my Dad hails from.

From there at the end of December I will head for the tiny island nation of Vanuatu, where I will be working as a volunteer midwife at Vila General Hospital, Port Vila for several weeks. It promises to be a fascinating, difficult, exhilarating, lovely time. I'm wildly excited and intermittently terrified. Most students who travel to Vanuatu from my school and others (Seattle's Bastyr University students send their ND/LM students there too) travel in at least pairs. I find myself headed south solo this time. Off to adventure on my own. As I have in the past I expect that this new blog, my first open blog since I took my first Mama Mid(wife) Madness into a slightly more sheltered space for a bit, will become a repository for my experiences in Vanuatu.

I hope this blog will serve a few purposes beside my own selfish need to empty my brain at the end of a shift. I hope that it can shed some light on the practicalities and the intensity of these clinical experiences for students at my school and others who plan on undertaking overseas placements (presently almost the only way for Direct Entry Midwifery students to gain hands-on, in-hospital experience). I hope also that it will serve to enlighten those who wonder about the many and varied ways that student midwives (and their programs) hunt out clinical experience on their way to state licensing or credentialing through NARM here in the US. As I explained to a lovely doc during a quiet moment at a transport the other day: We can't get this experience (of managing several births at once, or in quick succession) in hospitals here in the States, and super high volume homebirth practices are rare here, so we sometimes decide to go abroad at the end of our training to hone our skills while helping understaffed, under-resourced hospital staff and the women and babies they serve.

There exists some debate among the midwifery community about the ethics of (comparatively) wealthy (predominantly white) American women traveling to poor nations to work with communities there. I'm still not entirely clear on how exactly I feel about this issue. I can only submit that I feel like I can help these women and their babies get good care, and lighten the burden of the in-country midwives, if only for a while. I really hope that that can be a force for a balance of good at the end of the day. I'm sure this will be a subject much thought about (and thus written about) along the way. I know that some midwives, midwifery students and others object strenuously to this.

I should say at the outset that I'm not going to engage in any debate, especially the nastiness which so many midwife bloggers have come to expect from certain quarters. I doubt highly that I'll have any energy for it at the end of the day/shift. I expect that I'll occasionally disable comments to some posts. Comments, encouragement and questions will be most gratefully received. Please remember that I'm a student, I'm learning and I expect parts of this journey to be intense and hard. If past experience blogging is any indicator, we can all safely assume that occasionally I will speak(write) rashly. Be patient with me.

Thanks for reading.

I expect to begin blogging in earnest on the first of 2009. Come on back then to see what I'm up to!