It's time

Time is a valuable commodity. More valuable than almost any living person can fathom. We want more of it, yet waste so much of it. It's been two years since I met Amelia. I've had two years to process and conceptualise what I saw, felt, did and didn't do. It's time to write about her life from a different perspective. One that has had the time afforded to it that her life didn't. I have had two years of explaining my 'Amelia' tattoo in a very sheltered way in an effort to contain my profound sense of loss and deep saddness. I have choked back too many tears to prevent others from feeling a sample of grief that the raw entierty of her story brings. I have chosen to keep my original blog post and add to it.

My neonatal death experience toll is at one. Not something I would wish upon anyone. 

I had the pleasure of seeing a woman deliver naturally a breech (bum first) presenting baby. She was planned for a Caesar, but between mum and bub, they decided to forgo it. The baby was a mere 29 weeks. In Australia, with good NICU care, that's a very viable baby. In Nepal, the youngest baby in NICU (in regards to weeks from conception to birth) was 31 weeks. Two weeks makes a lot of difference! 29 weeks here is incredibly fragile. The doctors gave her a 50% chance of survival. That's a big statistic so I'll assume that's her chance if she had the best care possible in NICU for several moths. Her birth was marked with uncertainty and fear of the unknown.

I had hopes and assumptions that this baby would end up in NICU. To see someone die when there was every chance of them living is beyond painful and frustrating. Four days later I found out that the baby girl was alive, but not in NICU. Both mum and bub were on the postnatal ward. What I learnt after that changed my world.

Babies aren't made to leave the womb at 29 weeks and survive on their own. I was told that the baby was not receiving care because the family couldn't afford it. I asked a nurse if the baby was a boy, would they beg, borrow and steal money to keep him alive. Her answer was honest and unforgettable. She had shame written all over her face as she nodded and quietly said yes without looking me in the eyes. Treatment in hospital is not free like it is in Australia. You are required to pay for your care, however there is a well known fund for those who cannot afford care. In the instance where you cannot afford care, you receive it for free. This beautiful, premature baby required care. Not only did the family refuse to pay for that care, they also refused free care. 

Unfortunately, the mother was 19 and the men in the family make the decisions. I learnt that when babies are not wanted by the family, the mother is starved with the aim to prevent her breastfeeding, thus starving her child. That is what happened in this case.

It was only days later when I was looking through the birth records book that I saw NND, meaning Neonatal Death, in red pen next to that babies birth details. I had heard doctors mumble "Passed" when doing morning rounds one day. No more, no less. I'm sure that baby was a trooper. She fought for every moment she had a chance at holding. She didn't even have a name. 

I can't comprehend the amount of guilt I felt at the time and continue to feel. I contemplated fleeing the country to come home with her to ensure she had the chance at life she deserved. I imagined the legal loop holes I'd need to jump through to make it happen. I thought about being a 20 year old mother, forgoing my own dreams for her needs. I was too late. I have cried more tears for her than I have for any other human. I am committed to sharing her story in its raw, unjust nature. I also apologise to anyone with whom I have shared this story with and not detailed it in full. I selfishly struggle to repeat what was an upsetting experience. So

RIP baby Amelia. Thankyou for being my first breech birth and unfortunately my first 'neonatal death'. Thankyou for fighting. You gave me so much and I have a lot to thank you for. I have so much admiration and love for you baby girl. Happy birthday xx

My habitual grossness

Its true when people say you need to learn to love yourself, because you are the only constant thing you'll have through out your life. My time in Nepal taught me alot of things and I appreciate every lesson an experience. However, it forced one lesson upon me. At home, its hard to learn to love yourself as you are. You are constantly compared either by yourself or others. Despite the fact you are the best version of yourself, there always seems to be someone who appears to live your life better. You are surrounded by similar people.

Nepal thrusted upon me the notion of washing once a week, not wearing makeup, spending 60 seconds flat on my hair daily, not washing my hair for 7 days, hairy legs, baggy eyes, epic regrowth and wearing trackies and thermals out to dinner. None of that was terribly acceptable prior to me leaving Aus. I'm not sure when it kicked in, but sometime around the 5-6 week mark it became liberating to have marriage proposals and general attention despite the fact I thought I looked disgusting. It definitely kicked in when I cam home 48 hours ago. Mainly because I wasn't in a hurry to change how I looked. I'll admit to hastily getting out of the trackies and thermals I'd been wearing for 3 days because I looked 100% homeless in them. But, I still went out to the shops that first afternoon with dirty hair, unshowered, no make up on, my usual grossness. It felt freaking liberating. Sometimes thats all you need- to feel liberated. Thankyou Nepal.

I'm happy to say though that I now shower daily, despite it feeling like an absolute chore and my solid list of excuses holding me back such as "It takes too long", " I just dont have time", "Its too much effort". I clearly haven't fully rehabilitated yet, but know that I am doing well.

The day dreams come true

I can't begin to describe how amazing my last 24 hours in Pokhara were. But, I'll try my best to do so. 

I woke up and couldn't help but shake my heads. When did it get to be the 20th February 2012? When did it get to be my last day in Pokhara? I didn't have plans. I've grown not to have plans in Nepal. I just knew I wanted to buy some pants and get a scrumptious, fresh apple juice from my favourite cafe near the lake. I had 9 hours to complete my task. I think I could manage. 

After buying all my bits and bobs, I sat down for my apple juice and met one of the loveliest blokes around. It's a tad unfortunate that the tourists here aren't that friendly to each other, but e was a dime a dozen! It gets lonely eating on your own and I was so thankful to have a fabulous Aussie to chill with. 

I had spent my morning thinking about a conversation with a local Tibetan guy a few days earlier. He was telling me about a local midwife who looks after a whole village. At the time I couldn't help but think if I had more time, I'd love to meet her and try and get some details in case I came back. After finishing my apple juice I walked home for the last time, shedding a tear because locals were smiling at me. I was accepted. I made it my mission to leave some kind of a note for this guy to contact me in regards to the midwife. Boy is God good. 

I walked into the camp and he was sitting outside his uncles shop. Already winning. Asked him if I could give him my details so he could send me the midwives details. No probs. He upped me. "Want to go visit her?" Royal flush. 

Not even an hour later I was on the back of his bike riding 45mins out into the beautiful country side of Pokhara. It was too far away from where I was staying to be able to travel this distance everyday. I doubted. It was beautiful though. Winding up a very steep mountain and feeling the chill in the air, we arrived. Five meters one side, mountain goes down, five meters on the other side, mountain goes down. I am literally perched at the top of the world. I am in love!

I am filled in that there are three midwives who look after a village with a population of 10,000 people. It's estimated that there are 312 pregnant women at any one time. They aren't backyard midwives. They work at a small health post run by the government. If the women need further attention, they go by ambulance to hospital. Otherwise, they deliver at the top of the world at the health post. The midwives are on call and work in a threadbare work place. I'm flat on my back. This is home! I have a 90 day visa, I can stay for another month no problems. 

I had the chance to ask the main midwife what they need in hope that I can gather some funds and send stuff to them every so often. Although the health post is government funded, the funding is slow and pathetic. They need everything, from baby clothes and blankets, a cot, gauze, sterile gloves, umbilical cord clamps, equipment, a heater (imagine laboring at the top of a mountain, at midnight, in winter, being naked and only having a few coals for heating!!), everything. I can help. 

Next, there is a guest house fifty meters down the road. Someone get me a cup of tea, I'm home. To top it off, fill out a simple form, post it to an office in Kathmandu, get approved (relatively simple) and your free to volunteer. Oh man. Just when I thought this trip was over, with no idea of where to go next doing what I've dreamt of doing, this comes along. God is good. Beyond good. Faithful. 

I can't be more glad that I took that chance. I'm in awe. 

The day dreams come true

I can't begin to describe how amazing my last 24 hours in Pokhara were. But, I'll try my best to do so. 

I woke up and couldn't help but shake my heads. When did it get to be the 20th February 2012? When did it get to be my last day in Pokhara? I didn't have plans. I've grown not to have plans in Nepal. I just knew I wanted to buy some pants and get a scrumptious, fresh apple juice from my favourite cafe near the lake. I had 9 hours to complete my task. I think I could manage. 

After buying all my bits and bobs, I sat down for my apple juice and met one of the loveliest blokes around. It's a tad unfortunate that the tourists here aren't that friendly to each other, but e was a dime a dozen! It gets lonely eating on your own and I was so thankful to have a fabulous Aussie to chill with. 

I had spent my morning thinking about a conversation with a local Tibetan guy a few days earlier. He was telling me about a local midwife who looks after a whole village. At the time I couldn't help but think if I had more time, I'd love to meet her and try and get some details in case I came back. After finishing my apple juice I walked home for the last time, shedding a tear because locals were smiling at me. I was accepted. I made it my mission to leave some kind of a note for this guy to contact me in regards to the midwife. Boy is God good. 

I walked into the camp and he was sitting outside his uncles shop. Already winning. Asked him if I could give him my details so he could send me the midwives details. No probs. He upped me. "Want to go visit her?" Royal flush. 

Not even an hour later I was on the back of his bike riding 45mins out into the beautiful country side of Pokhara. It was too far away from where I was staying to be able to travel this distance everyday. I doubted. It was beautiful though. Winding up a very steep mountain and feeling the chill in the air, we arrived. Five meters one side, mountain goes down, five meters on the other side, mountain goes down. I am literally perched at the top of the world. I am in love!

I am filled in that there are three midwives who look after a village with a population of 10,000 people. It's estimated that there are 312 pregnant women at any one time. They aren't backyard midwives. They work at a small health post run by the government. If the women need further attention, they go by ambulance to hospital. Otherwise, they deliver at the top of the world at the health post. The midwives are on call and work in a threadbare work place. I'm flat on my back. This is home! I have a 90 day visa, I can stay for another month no problems. 

I had the chance to ask the main midwife what they need in hope that I can gather some funds and send stuff to them every so often. Although the health post is government funded, the funding is slow and pathetic. They need everything, from baby clothes and blankets, a cot, gauze, sterile gloves, umbilical cord clamps, equipment, a heater (imagine laboring at the top of a mountain, at midnight, in winter, being naked and only having a few coals for heating!!), everything. I can help. 

Next, there is a guest house fifty meters down the road. Someone get me a cup of tea, I'm home. To top it off, fill out a simple form, post it to an office in Kathmandu, get approved (relatively simple) and your free to volunteer. Oh man. Just when I thought this trip was over, with no idea of where to go next doing what I've dreamt of doing, this comes along. God is good. Beyond good. Faithful. 

I can't be more glad that I took that chance. I'm in awe. 

To miss or not to miss

I can't help but write a list of things I'll miss and things I won't miss. It seems appropriate to give you some context to my time here. 

I won't miss the noise- bus horns, car horns, scooter horns, bike horns, bloody horns, the praying with drums and cymbals, the dogs barking, the alarms, the doors banging, people spitting. Everywhere. 

I won't miss my bed. My knees, hips, pelvic bone, neck and shoulders hate me for sleeping here every night. I won't miss the carpet 'mattress' that has unleashed endless amounts of bruises on me. I also won't miss the glowing Buddha above my bed. 

I won't miss the feeling of numb feet inflicted upon me courtesy of the squat toilets. I won't miss being able to have a front row seat at my own waste disposals show. I won't miss the compulsion to steal extra sheets of toilet paper when at restaurants to use at home. I pray that doesn't stick with me. 

I won't miss being stared at, honked at, yelled at, or come at by Nepali guys. I'll take being invisible any day! Although I have discovered an antidote. Whack on a pair of sunnies and headphones. Walking down the street like this with people staring at you makes you feel like your in a film clip. 30 minutes a day is an appropriate dose. 

I won't miss my weekly hair and body wash. The concept of a daily shower as routine, as opposed to a weekly wash as a  privilege, feels so foreign. 

I won't miss dal bhat. Not. At. All. 
I won't miss vegetables and two minute noodles for breakfast. I won't miss any Nepali foods made from refined white flour. 

I won't miss the need for my nose to constantly filter the horrid air I breathe 24/7. I owe it a holiday. 

I won't miss the close calls I have with necking myself on the clothesline in the backyard. 

I will miss sharing every piece of land here with the cows and buffalo. I'll miss seeing them stop traffic or just poo in front of me. They are a great reality check. 

I'll miss having and sharing a double bed. Dutch ovening someone else is much more fun than inflicting your own horrors on yourself. 

I will miss being with women every day. I'll miss being apart of their lives during a season they'll never forget. I'll miss the smiles of the women and their families as their faith in me grows. I'll miss all the newborn cuddles and the chance to pray for minute old babies. That they will find and love God, be healthy and happy, and do good in this world. 

I also need to thank a few special people. First an fore-mostly, Thankyou to my steri strips for rescuing me from the terrifying need to go to hospital here. I can't thank you enough. Thankyou cheap travel pillow. You've been a nightly companion when I only expected you to be there for me on the plane. You've gone above and beyond your duty. Thankyou to my 14 pairs of undies. If you weren't such a large team I would've had to double wear you more often. You and I are both better because of your great existence. 

The moments that matter

Now that my time at the hospital has ended, I feel I can choose a favorite memory. Like all experiences in life, they never turn out how you expect and the ones that you assume won't be profound, in fact are. 

It had been weeks of tirelessly working at being accepted and welcomed by Nepali people. Day after day my efforts of being warm, caring, gentle and helpful seemed as though they had amounted to nothing. In a world where language counts for so much, I was struggling. It took 3 weeks until I had made friends with the nurses, 4 for the doctors and forever with the patients. It felt like I was wasting my time. Attitude is everything though, so I decided that I would eventually be rewarded and paid back in full. Indeed I was. 

It's a blessing to have two favorite memories. Both happened without any initiation by myself. I was given a few moments break from working at being accepted. 

It seemed like any other morning. I checked the patient bed list board. It was a full house. I wandered the corridors to see who was an old or new face. Then, like every other day I wandered down to delivery. I sheepishly opened the door, not knowing who was or wasn't in there. I wasn't having a particularly good morning. I was beginning to grow tired of all the effort and the lack of return. I had no idea what awaited me. As I lifted my head, this petite, worn, sun beaten woman (who was the mother of a labouring woman) quickly stepped towards me, smiled warmly and joyfully from ear to ear, and very respectfully bowed and said "namaste". That was it. In all her simple glory, she noticed, respected and welcomed me. 

Another memory I can't forget was the day I saw three natural deliveries, one after the other like some crazy production line. The first woman had delivered and it was a matter of minutes until the second delivered. It was frustrating watching two very inexperienced interns attempt to deliver her baby of the second woman. She was given an episiotomy and still struggled. Fundal pressure was applied, along with a strong hand to her face. She was so strong and determined. She gave birth to a baby boy. 

I was watching the first woman, who also had an episiotomy, be stitched up. It had been around 45 minutes since she received her poorly administered local an aesthetic and it was wearing off fast. I could see her face crease and body flinch. The last time I had attempted to comfort a woman in that room, I had eyes burning holes into the back of my head and ended up getting kicked out of the way. Not what I would call positive reinforcement. I have learnt to tread carefully the fine line between working with the staff how they want me to and meeting the needs of the women. In this case I couldn't watch her be alone in pain. I stood by her and calmed her for ten minutes, sweeping my hand over her head and holding her hand. My poor attempt at Nepalese meant I was only able to tell her how good she was doing and that she was finished. I genuinely don't care if I'm hated for being emotionally supportive. Those women were and are amazing, and in that moment they needed assistance to prove it. I was in the right spot at the right time, and was presented with the privilege of assisting them in doing so. I can't and won't take that for granted. 

Just as the first woman was finished being stitched up, the second woman was part way through her stitches. She appeared much like the subtle face of bravery before her- creased face with an open hand reaching out. She didn't need me, but she needed something. It was beautiful. She let her guard down and I saw her pain, but she was still so strong. Once again, my terrible Nepali could barely covey the fact that she was strong and that I was proud of her. I couldn't help but wonder if she has ever heard words like that before. 

The intern stitching up the second woman gave me permission to let go of her hand and watch the delivery of the third woman who had just been wheeled in. I tried to explain the concept of too many chiefs and not enough Indians. I left only for a few moments to prepare for the baby- turn on the warmer, gather gauze pads to wipe her with, find a measuring tape etc. But I knew the local was wearing off and her pain was increasing. I stayed, because in that moment, she needed me more than I needed myself, my agenda and to be another spectator at a birth. Few people have my respect quite like Nepali women. 

It truly is a beautiful thing to be what you are needed, at the time when you are needed. 

The best kind of first

I will forever and very fondly remember this year of my life as the year I delivered my first baby! I so wish that I had a life changing and thrilling birth story to share, and although each birth is different, nothing was wildly exciting. 

She was an average Nepalese woman who laboured quietly. Something that immediately earns my respect mainly because I don't think I ever could. It was her first pregnancy and first birth. She had two bozo interns looking after her, assuming they would deliver. When it took them 5 minutes and a third year nursing poster to decide that 'Station: 0' meant halfway between station -2 and +2, I knew I had to do this delivery. And do the delivery I did!!

She crowned, I told her to push in my dodgy Nepali, I looked her in the eye and with the warmest smile possible, I told her she was doing really well and she could do it. Then we had a baby. Welcome to the world princess. I'm proud to say I caught you. At the end I was able to tell the mum how proud I was of her. I later wondered if anyone had ever said something like that to her before. I know one thing for sure. After 5 weeks of being at the hospital, it feels good to know that at least one woman was given support that was more than just perineal!