Updated... finally!

May 18, 2008
Today was an amazing day! As always, we went to church and enjoyed the strength of the ward. But, afterwards we had a great opportunity to go sing at the Psychiatric Hospital of Guayaquil. It was truly an unforgettable experience. If there is one thing this country does far better than us, it is taking care of the mentally ill. We arrived and met with the nuns and then were split into two groups. Our group was the lucky one... we sang longer than the other group and to the women and the children. The hospital is divided into salas that consist of inside sleeping quarters and an outside, fenced in area where the patients can freely roam. It is very well kept and beautiful. The patients are well taken care of and the staff is kind, gentle and loving... a stark contrast to the majority of psychiatric facilities in the States.

In each sala we were greeted with hugs and kisses from each patient. Many of them were abandoned and were thrilled to have a visitor enter their world. As we sang songs to the patients the Spirit was so strong as we sang to the beautiful patients. They were thrilled to hear about their Lord and a peace overcame them as we sang. One of the salas we visited was specifically children. It was heartbreaking to know most of these children would lose their family along the years. We sang, "I am a Child of God," and "Families Can be Together Forever," and tears welled in my eyes knowing their difficult future ahead. Yet, they were completely happy. Kisses, claps and smiles filled each room. What a beautiful people.

May 19, 2008
What a wonderful day! I was able to visit Sotomayer Hospital again (the Maternity Hospital) where I helped with labor support in the room for high risk patients. It was an amazing experience to see these women give birth in stressful conditions with no pain relief or prior teaching. I was able to teach relaxation techniques, give counterpressure and provide support for the women in the room. I specifically helped with three births.

At first it was very overwhelming. A few of the women were in terrible pain and very afraid. The hospital does not allow anyone in the room while they labor. Women lie naked on the tables filled with patients and labor together and then are wheeled into another room where they have to switch tables as the are crowning to be delivered. There is no pain medication and very little monitoring. Needlesstosay, this is a very different experience than I had at the epidural capital, UVRMC. The high risk room where I was stationed was a little different--much smaller and each woman had an old monitor. In addition, my women did not have to switch beds. However, the added stress of having a high risk delivery (pre-term, stillbirth, pre-eclampsia, etc.) made the experience all the more frightening.

The patients were so grateful for the support we gave. One of the patients was wheeled in later in my shift and saw that I was finishing helping during a delivery. She motioned for me to come over and asked if I would please stay with her. She was very scared. Her baby was going to be delivered quite early (she was 29 weeks along) and she had driven 3 hours to get to the hospital. She was only 19, but this was her second baby (very common for this country). I promised her I would do all I could to help her. Immediately, we bonded. I started her IV and prepared her with some brief relaxation teaching. Then, I turned her on her left side and applied counter pressure to her lower back with each contraction. When she was ready to deliver, I assisted her into the position and helped the doctor dress. I held her hand and reminded her the God would give her strength. With each push she wrapped her arms around my neck and squeezed me with all she had. We breathed together and cried together when her baby was rushed out of the room. I don't know if her baby lived. It was born with a tracheo-esophogeal fistual. Basically its digestive system and breathing system was linked together... incompatible with life if radical medical interventions are not taken. I didn't get a picture with her in all the rush of things, but I will never forget her sweet face as we talked about trusting the will of the Lord.
After the hospital, a few of us rushed over to another CPR class. We taught a group of school teachers and were in the newspaper the next day! It is a neat thought to think that a life might be saved for the teaching I have done.

May 20, 2008
Today I spent another day in the maternity hospital. This time I didn't get to go into the labor room but spent and hour in the nursery and the rest of the time teaching in the salas about umbilical cord care. It was so fun to hold and bathe the little babies. They can't afford wipes here so when I changed the diapers, I had to undress the baby and rinse it off in the basin. It is amazing what we take for granted in the States.

Afterwards, a small group of us went out to the community where we met with the auxiliaries (like CNAs or PCTs) and held a 3 hour class. I was the team leader and helped arrange education on Vital Signs, First Aid, Safety and Security in the Community, and CPR. It was lots of fun and my Spanish is definitely improving with all this teaching I have been doing.
We drove straight from the community to a Stake Center in South Guayaquil (the dangerous part) where we had another Stake Health Fair. (Of course, we made a quick pit stop at a local McDonald's for a five minute dinner). Again, me and two other girls taught about Nutrition and Exercise. I continue to be amazed at how much these people want to learn and are willing to change. They are genuinely concerned about their health.

At each health fair we take the blood pressures of all those who come to the class. As usual, I took the blood pressure of a woman in her late 30's. Although I was shocked at the reading... 210/100. She was literally a walking stroke. I asked one of the girls to double check my reading and I immediately went and got one of my instructors from the other class. After the class was completed, we pulled the woman aside and asked if she had a history of high blood pressure. She explained that she knew her blood pressure was high but she could not afford the medication. She had been having headaches and nosebleeds a lot and knew that she should take the medication, but her family needed to eat. We explained that she should see her bishop for help and meet with a doctor either tonight in the ER or first thing tomorrow morning.

After meeting with her my instructor and I found the Stake President. We explained the situation and made sure we had done the right thing in referring her to her bishop for help. He was so concerned for the woman and wanted to meet with her immediately. I raced out to find her before she left, I hadn't even gotten her name. Luckily, I found as she was walking out the front gate. The President met with us and told her that her medical expenses would be covered, that she needed to be a mother for her two kids. Her eyes filled with tears and the utter relief was clear. She hugged me and told me she would love me forever for the help.

A few moments later another women asked me if I would please take her blood pressure because she was having bad headaches. Sure enough, it was 185/95... another potential stroke patient. The Stake President saw me take the reading and immediately asked if it was dangerous. I gave him the usual schpeal and his eyes welled up with tears... it was his mom. He had no idea that she was in danger of having a stroke. He was so grateful that we were here helping him help in ways he couldn't. The entire trip was worth those moments... lives potentially saved by a simple blood pressure reading. It is amazing how the Lord guides us to bless each other's lives.

May 21, 2008
Today was dreadful. All that McDonald's finally caught up with me... I got food poisoning and was throwing up all last night. I couldn't much get out of bed except to expel what was left in my body.

Haha! Watching Seinfield I couldn't help but get a kick out of this line...
"Who goes to South America? You go there, you come back with things taped to your large intestines!"

I concur.

May 22, 2008
Today I finally got out of bed and headed to clinical at the Gilbert Pediatrics Hospital. I had clinical twice before (once being sick). I banked on a quick recovery and was wrong. After about two hours of clinical... which at Gilbert consists of standing and watching whatever you can see over the herds of staff... I began to feel really nauseated. I walked out into the hall... having no idea what was about to happen. Luckily, I had the sense to sit down... originally to prevent barfing. The next thing I remember I was being shaken by a team of doctors. My ears were ringing and I couldn't hear a thing they were saying but their faces were so close I could lick them. I was so confused until finally I heard... "Do you speaka eSanish?" In my just-out-words, I managed to say, "Si."

I was forced to spend the rest of the clinical day in a wheelchair. Remember... this is a children's hospital. Thus, I was confined to a wheelchair that was tiny toon size. That will teach you not to pass out a clinical! All in all though, it was fun to joke with the little kids who were in the same size wheelchair as me as I passed out another round of presents. And, my hot wheel skills thoroughly improved.

That afternoon, we were scheduled to meet with a local nursing school to discuss the experiences we were having and compare it to the experiences of Nursing School in the States. Of course, we were dropped off at the wrong University. So, we walked for 30 minutes to find the correct University. By the time we got there I was exhausted and feeling sick. I was already dehydrated. Sherri (the main lady) took me to the air conditioned heath center on campus to lie down for a moment.

As soon as I laid down a student was in to take my blood pressure (which was fine). Then, the nurse came in to assess me. She didn't believe me that I wasn't in pain. I repeated explained to her the situation... I had passed out earlier, yesterday I was throwing up a lot, I was just hot and tired and needed to lay down for a few minutes... but, more needed to be done. She raised her finger in the air and exclaimed (all in Spanish of course, but for your sake I will translate this)...
"She needs las gotas (the drops)!"

Worriedly, I asked, "What are las gotas?"

"Las Gotas!" She exclaimed again, this time annoyed.

Confused, I asked, "Well, do las gotas have a name?"

"Yes, Las Gotas!" She was becoming far more irritated with me than I had imagined she would.
I motioned to see the bottle to look at the name. For the first time in my life I was actually hoping for the JACHO mandated label. Of course not, though. It was a plain dropper bottle with the word, "Emergencia" (Emergency) scribble across the side. Oh great, I thought. Las Gotas are going to get the best of me. There was no one else in the room to help me out with this one, so I used the line we hear all the time in nursing school...

"Well, I am actually taking a few other medications, and I don't want this one to negatively interact with them. So, I actually do not want Las Gotas, but, thank you."

That was it! She had had it with me. She inched closer to me and said, "I don't care. Either you open your mouth, or I will open it for you."

Evidently, patient autonomy does not play a role in the heath care of Ecuador. I received three drops of las gotas. Now, I don't know if it is due to the lengthening of time, or las gotas, but I am feeling significantly better.

That night we went to the beautiful temple of Ecuador again. I so enjoyed it. I felt as though I was returning home and was comforted to be inside the house of the Lord.

May 23, 2008
Today was the our last day in Guayaquil. It was filled with packing, a lunch sponsored by the Junta (the charity hospitals we have been working in) and a pool party at David's cousin's house. I am excited to move on the Quito for a little bit of tourism! It has truly been a great experience here. I have learned so much about gratitude. Although I have been rather ill for the majority of the trip (those darn intestinal bugs got me good), I am grateful for this experience and wouldn't trade it for the world. Often, the world is not a happy place... but, the people still live happily.

10 Things I Discovered I am Grateful for:
1. Clean, running water... this is not something we have to think about in the States, but it kills people here.
2. The Medical System in the States... sure it still sinks sometimes... but, at least we can get adequate care. Although we might not be able to afford the ER visit, at least it will probably save our life.
3. Pain Management... I am so glad my mom did not have to suffer in pain while she had the neck problems. Culturally, we accepted she was allowed the opportunity to take whatever pain medication necessary to feel better.
4. A Loving Husband... I am so grateful my husband loves me and is faithful to me. How difficult it was to witness the pain, fear and abuse suffered by so many of these women.
5. The Crappy Economy in the States... hey, at least my home has a floor, roof and windows (even without screens). I have a job that meets my needs. I can get an education at a great university. I can eat a balanced diet. I will not die, because I have been given much.
6. Bug repellent and sun tan lotion... I probably will not get malaria, because I can afford to wear bug repellent each day.
7. Good old American food... Oh my skinny body needs some good food.
8. Enforced Traffic Laws... it is amazing what I have lived to see! Here, the lines painted on the roads are mere suggestions.
9. Contact with the outside world... It is amazing how difficult it is to live without cell phones, computers, internet, etc..
10. The United States of America... people, we have it good. Sure, there are things to change, but do it with gratitude, not whining. We have a country that can change.

10 Things Ecuador Can Teach Us...
1. Resourcefulness... that's right, use that rubber glove as a tourniquet. Go ahead, fill that bucket with water to be used for traction.
2. Happiness is Not Dependent on Money... I saw more smiles here than I see in the States. Sometimes, being poor is a blessing.
3. People Don't Bite... we really ought to say, "Hi," to that person on the elevator. Sit next to someone new at church, smile at a stranger... what is life without friends?
4. Invest Our Time in Learning Another Language... Far more people here speak English than those who speak Spanish in the US. We are an ethnocentric people in the US. Opportunities are becoming global, we need to participate!
5. Love the Land You Live In... Every person I met immediately asked, "So, how do you like my beautiful country!" They are proud of the beauty around them. We need to learn to appreciate our land as they appreciate theirs.

I am happy to be on the tail end of my journey. I am so grateful for my parents in providing this opportunity and for my husband in letting me go! I miss you all so much! Talk to you soon!

May 23, 2008
I finally arrived in Quito for the touristy stuff. I am excited to be here. It is much different than Guayaquil. Much nicer... much more beautiful. I am excited to get home, but will enjoy these last few days. I will post pictures later. Love you all!