Celebrating National Midwifery Week

Birth has been in the news a lot lately. Stories on the rising c-section rate and Duchess Kate giving birth to a future heir to the throne of England are just two examples. This week we once again recognize and celebrate the work midwives are doing around the US. Over 300,000 babies (7% of all births in the US) were "caught" by midwives in the US in 2011 (the last year for which we have statistics). Did you know that midwives provide more than just care for pregnant women?

Last year, the American College of Nurse Midwives launched Our Moment of Truth, to help women know their options and to know more about the care midwives provide. You can head over to the web page here. There you can read about the care midwives provide through the lifespan, from caring for teenagers to caring for women all the way through menopause. They also bust a few myths about midwives. Last but not least, there is a place to read stories of midwives in action from others just like you. You can also share your own story.

Sexual Violence Towards Women in Asia.

More than one in ten men surveyed in six Asian countries said they had raped a woman who was not their partner and that figure rose to nearly one in four when wives and girlfriends were included among victims.

That was the lead to a recent story in The Economist about violence against women in Asia, including Indonesia. The Lancet recently completed a study into the subject and the statistics paint a distressing picture for women living in Asia.

The culture has to change around the world and especially in these countries when only 55% of the men stated they felt guilty and less than 25% were sent to prison for their crimes. I wish I had the answer on how to prevent these horrible crimes or at least punish the perpetrators. The sad reality is though, that as a health care provider for women, more often than not I will be dealing with the aftermath. So instead I will be focusing on how to help them heal.  

Pictures of Bottles in Coffins

For several days now I have seen this graphic popping up on my Facebook feed and in several of the blogs that I follow. It is creating quite the storm and getting lots of negative feedback. I completely understand how many in the developed world would find this offensive. I would be the first to tell women I am working with in the US, that while I recommend breastfeeding, I know that is not possible for some women. I think it is important to support them in whatever they decide and for them to not feel any guilt over choosing not to or not being able to.

What I think is being overlooked though in all the negative feedback is that the statistic is from the WORLD Health Organization (i.e. an organization that predominately works with people in the developing world). Now I have not had the time to find and research that specific statistic but other statistics show a similar story. For example, they show us that 4 million children die each year around the world, the majority of them in the developing world. It is estimated that 1.3 of those children could be saved each year with exclusive breastfeeding for the first 6 months and partial breastfeeding (solid food added) through the first year. In fact, they are also discovering in the developing world, in places like Ghana and Nepal that initiating breastfeeding in that first day and especially in the first hour is critical to a baby's survival. In fact, 20% more babies survive if they breastfeed in that first hour of life.

Here in Indonesia there are entire store aisles that are devoted to baby milk formula. There are billboards, advertisements on Facebook (in fact there is one on my feed right now from Enfagrow), and brochures with free samples at lots of health care facilities. They show happy, Einstein-like, musical virtuoso kids that sleep during long road trips and through the night. Not a bad thing if you have enough money to afford the very expensive formula and have clean water to mix it with, but that is rare in many homes across Indonesia and other places in the developing world. Instead they make the formula stretch by only putting a small percentage of the recommended amount in the bottle and make it with unclean water. So the baby slowly loses weight because they are not getting enough calories and then they get sick from the water. In little ones they can quickly get dehydrated and then they die. In places like Indonesia, too counter those magic pictures of formula fed babies they need graphics like the one above.

This week is World Breastfeeding Week and I think this week and every week of the year we need help each mother make the decision that is right for her and her baby. It is important she know the facts and the risks for where she is living. Then we need to support her in that decision and make sure she has the resources she needs!

The logo for this year's World Breastfeeding Week (August 1st-7th)

Back to Work

Well it didn’t even take a week before the questions while I was out and about began and the phone started ringing with questions. The news has spread quickly (not that I was trying to keep it a secret) that I am nurse and midwife. It started with simple things like a rash -- of course it had to be a dermatology question, definitely not my specialty :) I have to admit though after a year "off" from nursing, it is good to be using those skills again! 

This afternoon it was a missionary’s kid who had gotten hit in the head with a swing and had a head laceration. I told them I would be happy to go to the clinic/hospital with them but didn’t have the supplies here to do any suturing. Their response – oh don’t worry we have all of that. So in they walk to the house with this huge bag packed with all sorts of medical equipment including suturing kits and IV fluids. I guess it pays to be prepared when you are serving overseas! Thankfully the laceration wasn’t long or too deep and had mostly stopped bleeding on its own. So we found some superglue and sealed it up.

It pays to be prepared! 

Serving in Indonesia, you would expect that most of my patients would be Indonesians and they are but providing care to expats and missionaries also takes up some of my time. Being sick is never fun and can be a bit scary, especially in a foreign country where you don’t know the system or the doctors. There are some great doctors in Indonesia and there are also some not so great ones. The problem is in knowing whom you can trust.

Thankfully one of my friends, a nurse I worked with at Bethesda Hospital several years ago, anticipated this need. She is currently in the US for a couple of months on home assignment but she is normally one of those who gets these problems and questions. When I arrived there was a present in my room from her. I opened it up to discover these…

They are Indonesian drug books. In the back they list all the medications by their brand name (the name they are in the US) along with a list of the generic names (not the same as the US) they are called in Indonesia, with page numbers. It allows you to look medications up and get dosage information and warnings specific to Indonesia. There is also an online version and I have already bookmarked it on my phone.

Hopefully, most of the needs I will encounter here away from the hospital will be few and not too serious. Thankfully, I am also living with my teammate who is a doctor, although he is frequently at the hospital or doing other traveling, like he was today.

Celebrating Moms and Midwives

I find it fitting that we celebrate International Day of the Midwife and Mother's Day just a week apart. I could quote statistics until I am blue in the face but the tagline for this year's International Day of the Midwife sums it up perfectly.

As my departure nears (just waiting on my visa now) it is exciting to think and plan about how I will be serving the women of Indonesia. I have missed catching babies!

This weekend we are celebrating Mother's Day. I can think of no better way to celebrate than to share just a few of the pictures I have of Indonesian moms and their kids...

More Than Just a Number

I spend a lot of time on this blog talking about the numbers, including this blog post and this one too. The number of women that die due to complications of pregnancy and birth. The number of children that die too young. The people of Indonesia though are much more than a number to me.

For awhile now I have followed the work of Micah Bournes, a powerful spoken word artist. I came across this video recently and it touched my heart.

Is Justice Worth It? feat. Micah Bournes from World Relief on Vimeo.

The statement that caught my attention was this, "It is one thing to wonder if someone else is worth fighting for." So many ask me why I am going to serve long-term in Indonesia. In many ways it is hard question to answer but maybe it is because they are more than a number to me and worth fighting for. While my role in Indonesia is not one that seeks to bring justice, it is one that seeks to bring relief from suffering. In many ways they are a similar task. In both you tend to lose as many if not more than are saved (or at least some days it feels that way). In both it is a never-ending battle. In both the answer to the question, "is it worth your time?" is a resounding yes. The key is in identifying with that someone else. When you see their face, hear their voice, and hold their hand during their suffering they become much more than a number.

I remember the first time this really sunk in. It was December 26th, 2004. I had been in Indonesia almost 2 years. Our first cell phone tower had been finished earlier that month and we were all excited about having cell phones that connected us with the outside world. That morning all the phones started ringing with phone calls and text messages. They told us there had been an earthquake and tsunami in Aceh, Indonesia. We turned on the one TV we had hooked up to a satellite and watched the images streaming in. I could understand what the people were saying and watching them suffer brought me to knees. It reminded me of the morning of Sept 11th, 2001, when I was also brought to my knees with grief for the American people.

That morning in 2004 I realized that in those two years of serving I had come to know and love Indonesia and her people. It brought new purpose into my work and life there. Whether I was in clinic or the hospital I learned to not just focus on the physical needs but see the patients as people and listen to their struggles and their joys. I could fill a blog post with pictures. Pictures of people who are more than a number to me. Some lived and some died. Some are of us laughing and some bring me to tears. All of them, their family, and their friends are worth being there for. 

Here are some videos and stories from Indonesia during the earthquake and tsunami. You can hear them speaking Indonesian but it is also subtitled in English.

Birth Photos from Around the World

I came across this photo slide show of birth in several places around the world recently on the New York Times web page. It has some beautiful and amazing photos! There is also an article from the photographer with more information about the photos that you can read here. 

International Women's Day

It is that time of year once again, where where we celebrate and recognize women around the world! This year the theme from the United Nations is,  “A promise is a promise: Time for action to end violence against women.” One of the ways the day is being celebrated is through the release of a new song. In the song, 25 singers and musicians from over 20 countries come together in a unified voice. You can listen to it here:

One of my favorite books about women is Half the Sky: Turning Oppression into Opportunity for Women Worldwide by Nicholas D. Kristof and Sheryl WuDunn. This fabulous book tells the story of several women around the world facing struggles and how they are turned into opportunities. For example there is a Cambodian teenager who is trapped in sex slavery who escapes and becomes a business owner, which supported family. Or there is the Ethiopian woman who struggles with devastating injuries during childbirth who goes on to become a surgeon. It is a great read -- informative and challenging!

Violence against Women in Indonesia

This post is a follow-up to the V-Day: One Million Rising post from a couple of weeks ago. In that post, I talked a bit about violence against women and how I have become more familiar with the topic. I mentioned that there are a number of ways women experience violence, one of which is rape.

There was a recent editorial written in the Jakarta Post Newspaper by an American woman living in Indonesia. She was highlighting several recent incidents in Indonesia that had happened to young women (really just girls) living there.

• First, was an 11-year-old from a family of Jakarta whose father confessed to raping her. She was found to have the same sexually transmitted disease as her father. The girl passed away from an inflammation of the brain.

• Second came the report of a 13-year-old who had been married to a 39-year-old in a Balinese Hindu ceremony. She became pregnant but the baby was born premature and died. 

• Then there was an incident in the fall of last year where Facebook was used to lure a 14-year-old. She was gang-raped and they planned to traffic her but due to media attention she was released. You can read more of the story here. 

Incidents like this occur across Indonesia on a regular basis. They happen across islands and people groups. One of the biggest risk factor is poverty. For some poverty drives families to marry off their young daughters. Sometimes they are sent away to work where they are risk for human trafficking and abuse. Others are lured by promises of cell phones, new clothes, or fees for school into a trap.

I recently came across this video on YouTube which highlights the risk young women are at and simple interventions that can help save them. I thought it was worth sharing...

V-Day: One Billion Rising

Did you know that 1 in 3 women will experience violence in their lifetime? That means over 1 billion women will be impacted by violence. That statistic shocks me but does not surprise me.

I remember when I first visited Indonesia in 2000 and I went on a village health day trip. While were were there doing prenatal care, giving immunizations to the kids etc and a young woman was brought to us. She had wounds around her wrists and ankles. She was catatonic - awake but unresponsive to us and the world around us. We were asked to bring her back to the hospital and see if we could help her. I didn't really understand what was going on until it was explained to me. The young woman had gone to work as a house maid in neighboring Malaysia. While there she had been kept captive and abused. That was really the first time I heard about human trafficking. Since then I have become much more familiar with violence against women, whether that is human trafficking, rape, domestic abuse etc.

For the last 15 years Valentine's Day has also been called V-Day. V-Day's mission is simple. It demands that violence against women and girls must end. So today, February 14th, 2013, V-Day's 15th Anniversary, they are inviting one billion women and those who love them to walk out, DANCE, RISE UP, AND DEMAND an end to this violence. They are events happening around the world in person and throughout social media like Facebook and Twitter. You can find a lot more information here. You can also watch this YouTube video.