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Saturday, January 25, 2014

“Madam, you need to step out of the delivery room – you are too soft.”

 I am not sure that I have ever been called “soft” if my life (except for maybe my waistline).  But I was judged harshly and labeled severely by two nurses last night in a labor and delivery room at a local hospital in Swaziland.

It all started at 7:30AM when I dropped off one of the young woman who lives at the Kibbutz at the bus stop to go and have her last prenatal appointment before her expected due date of February 3rd.  For the sake of privacy I will call her the Girl. I was heading north to deal with a very serious family situation with one of our new children and the Girl was heading south to her appointment.  Almost five hours later I was finished my run around and was heading home when I got the call.  My Girl was in labor!  I was traveling with my longstanding partner in adventure, Susan Page, and so we dropped off the first baby at home and headed south to see how the Girl was doing.  The rest of the blog is a likely poor attempt to explain what childbirth in a local hospital in Swaziland looks like. 

I promise you that I would rather not relive it in order to write it, but to honor the Girl and all the other women who have given birth here and will in the future I will put pen to paper (or fingers to keys) and share my experience with you.  They are heroes.

First let me say that this was a nice hospital. It is government run, but is clean, tidy and reasonably new.  Women in labor either walk to or are dropped at the front gate and picked up a day after the baby has arrived.  No one is encouraged (or allowed) to stay with them, walk with them or wipe their brow.  They are on the long and painful path of the unknown, alone.

The women are told to go find their post-delivery bed and put their bag of clothes on the bed.  They then take off their street clothes and wrap a cloth around their naked body, usually a piece of Swazi cloth or a flag-like material.  Then they wait. As labor comes on they move from the hallway to the floor.  From the bathroom (with no toilet paper, soap or doors that lock for privacy) to the outside entrance area where there are bushes with freshly washed underwear hanging to dry.  Vomiting ensues and the pain continues.  There is nothing for the pain and no chance of avoiding the inevitable – the natural delivery of a baby with no epidural or other reprieve.

When the mother feels like she is in full labor she walks down to the “Labour Ward” and lies on one of four beds, her “private area” facing towards the entrance of the main hallway (with no door on it) and waits for the nurse to come and do a pelvic exam to see how far she has dilated.  Until the baby is ready to “crown” she must stay out of the labor ward except to be checked.  When she enters for her examination she is given a disposable sheet to so that she does not dirty the heavy plastic cover on the bed and is reminded to keep that with her at all times as she will only get one of them.  Several times yesterday I found my head spinning when I walked down that hall and glanced in that room, only to see women spread-eagled with nurses determining their fate (or expected time of their baby’s arrival).  Not something I need to see again.

With hours of pain and agony behind us, we thought for sure that the baby was ready to come only to find that the mother had only dilated 3 cm. We were back to the hallway to watch these young women writhe in pain while we white people measure the length of contraction on our iPhones.  Surreal.  I digress.

When it looks like the woman (or Girl) is about to pass out from the pain or asks you to have a C-Section because she can’t stand the pain any more, it is time to go in to the Delivery room.

The Girl asked me if I would go with her in to the Delivery Room.  Why? Because the other women who live at Project Canaan told her that if you scream or cry out at all, the nurses will beat you. She thought that if I were there maybe they would not do that to her.   Against my better judgment I agreed. 

PG Rating on the rest of today’s blog.

I followed her in to a stark white room with three delivery beds, all facing directly down the hallway for the world to view all that was going on (!). She went to the far bed, which provided the most privacy.  She removed her cloth and crawled up on the table, butt naked.  There was another naked women on the bed next to her who looked dead (she was not).  I am not sure what stage of labor she was in, but I suspected from the gurney waiting outside the room that she was waiting for a doctor to arrive to head to the operating room for a C-Section. Doctors don’t deliver babies here, nurses do all that work.  Well, the pregnant women do all the work, really.

The Girl handed the nurses the cloth she had been carrying around with drops on it from prior examinations. She lay on the hard plastic bed, again, totally naked and the nurses showed her how she was to pull up on her own legs when she felt a contraction coming.  There were no stirrups.  She looked at me and was terrified. She said, “Auntie, I can’t do this!”

I assured her that she could do it and that it was almost over.  The baby would be here in minutes and she would be ok. I rubbed her arm, held her hand and squeezed tight as she took her first attempt at pushing the baby out.  It was then that I was asked to leave the delivery room.

“Madam, you need to leave the delivery room,” the nurses said.

“Why?” I asked with surprise.  I was doing a great job of keeping the Girl calm and hopeful.

“Because you are too soft,” both nurses said at once.

What?  ME too soft?  I quickly backed up against the wall and held my ground explaining that I had promised her that I would be there for her.  And then I said,
“And if I leave her, you will beat her.”

They laughed out loud, totally agreeing that my accusation was correct. Then pointed to the hallway where I was to wait. Timing was good and another contraction came along so we all focused back on the pregnant one. They told the Girl to pull up and hold her legs and could see that the head was there.  Without giving me a chance to look away they took the end of a scalpel (i.e. a razor blade with no holder), did the episiotomy and then told her to push again. 

Up until that point I was so overwhelmed by everything going on that I failed to question why one of the nurses was standing up on a stool beside the table.  I looked at her and saw that she was there to push down on the Girl’s belly and help push the baby out. She pushed with both hands, and all her might, but the baby wasn’t coming.  They paused.  I stayed quiet and the Girl and I looked at each other. The next contraction came, and the same thing was repeated over and over again.  After some time the baby come slipping out (with a long skinny head from the birth canal) and we saw that he was a perfect baby boy. That was a surprise because the ultrasound told us to expect a girl.

The worst was over, the placenta was delivered and I stepped out of the room with the baby just in time to miss the stitching up of the Girl.  All of this was done with no pain medication or anesthesia.  She didn’t scream, or cry out even once.  And as I write this I am still amazed at the fortitude and courage of this terrified 17-year old girl.  

The plan was and is for this baby to live at the El Roi Baby Home. The child was conceived by rape and the Girl wants nothing to do with the baby.  She moved to the Kibbutz to avoid gossip and hopes to leave us once she has healed so that she can go back to school.  We named the baby “Jerry” in honor of Captain Jerry Coffee who is visiting us this week (his wife is Susan Page, who was with me through this life-changing event).  Jerry is a loving, caring, kind man and a hero to us all.

Yesterday was another tough day in Swaziland, but much easier for me than all of the women around the country having babies.  I have never liked being called names, but being “too soft” to a young girl in active labor is a name that I can and will live with. 

My prayer today is that a spirit of compassion will wash over this nation so that we can all look at each other softly and help one other rather than just “doing our job” and getting it done.  I hope that I can be the first to make that change in other parts of my own life. 

Live from Swaziland … Baby #50 has arrived!


PS - the total cost for labor and delivery of little Jerry was $3 USD.

Saturday, January 18, 2014

A day in the life in Swaziland: HIV, DNA, birth control and of course a pit latrine baby

Yesterday was a fairly typical day.  I start by making a plan that requires me to drive to town and spend an hour or so to do what needs to be done.  At the END of the day I drive home, emotionally, spiritually and mentally exhausted and then have a laugh as I tell Ian about all that happened.

There are several parts of the day that I can’t share with you yet, but will another time.  But for now I will give you a blow by blow of the day.

·      Left Project Canaan at 7:30AM with three women from the Kibbutz, two babies from the Kibbutz and an El Roi Baby (and a volunteer from the US named Lynn)
·      Dropped two of the ladies off at a clinic in Manzini to get birth control shots.  Learned that they have to have shots for three months in a row before they can get the ten year “implant”.
·      Learned that the reason that “my girls” want birth control EVEN THOUGH they have sworn off men is because there is so much sexual abuse and rape here.  Better safe than sorry (and my Compassion Purse funds it).
·      Went to Social Welfare office to meet an 18-year old woman and hear her terrible sorry of being kidnapped and into a forced-marriage (not uncommon here). She married a police officer, who beats her regularily and last week used his hand cuffs to tie her and then beat her. She wants to get a restraining order and go back to school so we were being asked to help work this through complicated situation.  We agreed to help in some areas, but insisted that she be tested for HIV so that she at least knows her status while we working out other things.  We went to clinic with her and sadly, she learned that she is HIV positive.  I hugged her and told her that she can live a full live being HIV positive, but that she will need to make some lifestyle changes and go to clinic on a regular basis. It was a very sad moment in the day.   We are still helping her with her crisis.
·      Went to a private clinic where they do DNA testing.  One of our Kibbutz women is adamant that a certain man is the father of her two youngest children.  The man claims he is not the father and will not help with payment for the babies.  Social Welfare insisted that he raise the $250 US to do a DNA test on the eldest of the two (to start).  We all met at the DNA lab for testing and my Kibbutz lady was so adamant about the truth that she paid the extra $100 US to have the little baby tested too, even though that baby lives at the El Roi Baby Home now.  We will know the truth for sure in 4-5 weeks. This is not something that is important to me or to the baby being with us, but it is important to her and she wants me to know that I can trust her … and so it is important to me now. Oh, I didn’t mention that the man brought his new wife with him to the DNA testing lab? The same wife who was pregnant at the same time as my girl was? Awkward.
·      Went to RFM Hospital to meet up with Futhi from the Kibbutz who’s baby was rushed to emergency room the night before because she was having great difficulty breathing (and lots of vomiting).  This is the same baby who is severely disabled and HIV positive so we must take extra care with her.  She was diagnosed with pneumonia and almost admitted to the hospital, but we were able to get her home because Kenny could give her the antibiotic injections here on the farm. Oh, that is if we could find them somewhere. Turns out all the pharmacy’s in Swaziland are out of that prescription.  Would deal with that one on Saturday.

·      While at RFM Hospital we were approached by a woman, whose 13-year old son had been in the hospital for a long time, and had just been discharged, but she didn’t have enough money (around $13 USD) to pay his bill so he was made to stay in the hospital until she could pay.  We walked her to the Social Workers office where she could seek assistance. 
·      While at the Social Workers office we were asked again when we were going to take the baby who had been dropped in a pit latrine two weeks earlier and had been discharged a week ago, but who was still there.  I explained that we were waiting for the proper paper work from another government department, but that it was being delayed, again.  The Social Worker was very concerned about the baby getting a hospital infection, which is what happened last November while waiting for paper work and that baby died.  This is a frustrating situation and one that we are praying for a miracle about.
·      While going and checking on the pit latrine baby and making sure that the diapers and formula that we took the week before were still enough, I was approached by another lady who had a 3 lb premature baby in the NICU ward.  A nurse told her about the El Roi Baby Home and she begged us to take her child so that he won’t die when he goes home.  Again, I walked the lady to the Social Worker office and explained that she must speak with her, not with me. We can only help through the proper channels. Stay tuned for more on that one.
·      Went back and picked up the three women who were getting their birth control sorted and the three children they had with them, loaded up Futhi and sick baby.
·      Learned on the way home that my Kibbutz girls spent all their money at Christmas so they have no food from now until payday on Jan 31st.  Had a little talk about budgeting for Christmas 2014 (!).  Stopped at another store to buy them bread then called Anthony to have some maize, vegetables and Manna Pack dropped off at the Kibbutz to tie them over.  SO thankful for Manna Pack and compassion purse funds!
·      Dropped baby off at El Roi, three women and two babies at Kibbutz and then got home after 5PM.

This photo isn't relevant to anything in this blog, but its really cute :)
Have I mentioned lately that I love my life?  And my babies?  And my Kibbutz girls?  I really, really do.

Live from Swaziland … tomorrow is another day, and I get to visit Nomsa.


Saturday, January 11, 2014

What does pure joy look like?

As we kick off a new year together I thought I would keep this blog short and sweet. Based on the past 24 hours I think next week’s blog is going to be long and heavy, so today, a treat … a few photos that bring me joy and make my heart sing. 

I hope you enjoy them too.

The toddlers pretending to take a spin around the farm. 
It's hard to get a photo of Caleb smiling, but this one is a winner!

Baby Debs

Those crazy kids!  Emmanuel and Caleb racing down the hallway.

New puppies "Georgia" and "Tai" :)

My family.

Live from Swaziland … I am going out to walk the new puppies.


Saturday, January 4, 2014

Not a good way to start the New Year, or maybe it was the best way?

Our family in enjoying a much needed, long overdue holiday, together on the beach in Durban, South Africa.  Each day starts with a view of the Indian Ocean and ends with a delicious meal, Cribbage games and watching Scandal Season 2 together.  The reason we can go away worry free is because we have such an incredible team of people living and serving at Project Canaan.  They only contact us when there is something that we need to know or that they know we would want to know.  That is how the day started.

Today, my first FaceBook message was from Kenny VanWinkle. He and Amber graciously offered to live in our house while we are away taking care of chickens, dogs and security.  Kenny’s message to me read something like this:

Hey Janine. Hope your vacation is going great. We had a couple of visitors last night. Came out of the bedroom and there was a 3.5 foot long snake coming out of the pantry. Chased it and cornered it under the stove. At the same time saw another one come from under a chair in the living room and go down the hallway. Called Denis and we killed the one under the stove. Not sure what kind of snake it was. Kinda looks like a Puff Adder, but it hissed at me really loud, and it long and skinny. Haven't found the other one yet. And we have looked like crazy. Just curious if you guys have had this problem before. We haven't left any doors or windows open. Anyway just wanted to let you know what's going on. We are still searching for the second intruder. Other than that all is well. Pretty sure I lost a few years off my life last night! Haha”

I know lots of you (Beth, Penny etc) hate when I talk about snakes, but I have a point. I will get to it.

After that I was looking through friends FaceBook posts and saw this photo from Brooke Sleeper of little Esther’s foot with a hookworm working its way through her skin.  We try to get the Aunties to make the children wear shoes, but heck, its Africa.  Everyone is in bare feet, right?  I wonder how many other people have hookworms making tracts that no one sees? Probably many.  I was able to contact Brooke to find out what she was going to do and she said that Esther’s foot is very itchy and after 3 days of treatment the worm(s) will die.  YUCK!!  Again, I have a point to why I am telling you this, and will get to it.

After reading my morning news, we got up and headed to the lobby at 5:45AM where we were getting a car to take us Deep Sea Fishing. We were all so excited for another great Maxwell family adventure. One of our favorites from the past was White Water Rafting down the Great Zambizi River in Zimbabwe. Maybe today would be even better than that?  We arrived at the chartered boat, hopped in and off we went. Simple.  I had packed lunches, water, cold drinks, lots of sunscreen and cameras.  It would be a perfect day (other than how it had started).  But I knew I had forgotten something. What was it?

It wasn’t until we left the harbor and we headed in to the open water that I remembered what I forgot, but it was too late. You see, I get really, really, REALLY motion sick.  And it started.  We had traveled out in the Indian Ocean about 2.5 miles and then stopped. We were all handled fishing rods and told to drop the lines to the bottom. Immediately fish were on Chloe’s and my line and up we successfully caught 8” fish. I did that once, and then things started to spin.  I moved in to the shade and sat down in the breeze. I was in a full body sweat. My head was sweating and even my upper lip and I knew I wasn’t going to make it.  I moved to the front of the boat to get more breeze and see the shoreline and tried to regroup.  What was I thinking? This was my idea to go Deep Sea Fishing!  How could I have forgotten such an important thing!

I didn’t want to tell Ian how sick I was getting for fear of ruining this great adventure.  It turns out we were only fishing for bait at that stop and soon we were heading back out to the open sea.  The swells were high as we crashed into and over each wave.  After 15 minutes of debating if I could call a helicopter to be evacuated or if I could just jump in the water and sink or swim (didn’t care which at that point), I went to the skipper and asked how much farther were were going.  He said, “Only another 9 miles out to sea”. I panicked.

He, and my family saw my panic and he gave me a anti-nausea pill.  Chloe was looking “green around the gills” too and so she took one too.  Fast-forwarding to the end of this terrible morning, by 7:30AM I was begging God to take me home.  Spencer and Ian were reeling in big Dorado fish (Mahi Mahi), I was power puking off the side of the boat and Chloe was curled up in the fetal position trying to “find her happy place.”   

The adventure was to last until 2PM, but we were back on shore by 10:08AM, much to my joy (and thanks to the understanding men in our family).  Oh my, my, my we were SO SICK.  But we have some great fish to show for it and will be eating it at dinner tonight (if I ever get this blog posted).

Near the end of the day I got a message on my phone from a Child Protection Police officer. He message read, “Good afternoon Janine.  We have yet another discovery of a dumped baby who has been rushed to the hospital.  Do you sill have space at the El Roi Baby Home?”

My reply was, “Yes, we hope to always have room for babies that you find dumped”. 

We are awaiting the details of this newborn baby, our first of 2014.

So, how do the snakes in our house, the hookworm in Esther’s foot, the adventure at sea and a newborn baby possibly all fit together?  It’s easy.  If we were too afraid of snakes to have said “yes” to this calling (and I HATE SNAKES!), I wouldn’t have had the privilege of receiving the phone message about a dumped baby. While I am totally grossed out by Esther’s hookworm (and may have wanted to cut my own foot off), we have an awesome Nurse Practitioner who said “yes” to the calling on her life and she can treat Esther and do another “teaching” on the importance of wearing shoes outside (oh, and we have shoes for all of them – we are blessed).  If we had said “no” to God’s calling on our life we wouldn’t have had the amazing opportunity to drive to Durban, stay on the beach and go Deep Sea Fishing in the Indian Ocean.  Sick or not sick, I got to be a part of a really cool adventure that our family will not soon forget.  And, at the end of the day, I got a message about a baby whose day was much worse than mine, and yet I could be a part of making his/her day better.

It’s January 2014 and we all are starting a new year.  I pray that you will not let your fears, your phobias or your excuses rob you of the huge blessings that the Lord has in store for you because you are thinking about saying “no” to what HE is asking you to do.  Today was a great day in my life – not an easy one, but another great one. I am so very thankful that we said “yes”.  You will be too.

Live from South Africa … it’s Saturday evening and time to eat Mahi Mahi.