Yes, today was busy, but different than we expected. We were at the Centro de Salud in San Bartolome today - an area with one of the highest fetal and maternal mortality rates in the country - or so we were told before. The last time we went, we saw about 30 or 40 pre-natal patients and everything was peaceful ("tranquilo" is the word they use here).
This time, we arrived and apparently caught them off guard. The nurse, Heidy, our contact there, had forgotten to tell everyone we were coming. And she was on a call. Just before we got there, a local midwife had called and told them they had a mom in a bit of trouble, so off went Heidy in the ambulance. She returned shortly after we arrived to say that the baby had been born before they got there but didn't make it. We should have known that today wasn't going to be good.
We only had four patients to start, not really a problem for us - short days are nice. But Heidi gets the very first patient on the table, starts the ultrasound, and says "You've got to be kidding me!" Another mole - maybe. It's either a mole or a miscarriage, but looks more like a mole. If it is, that's three in four months. DANG! Dad was actually there with Mom, another instance of a caring dad (way to go, guys!), but even Dad doesn't speak a tremendous amount of Spanish.
So we explained to them, through an interpreter, what is going on and that they'll have to go to the hospital in Quiche for evaluation, blood tests, etc., then probably a surgery to fix the problem. It's very difficult to explain to people who've been pregnant ten times that this particular pregnancy is different - it's not a baby in there, but a tumor. Most have never heard of this problem and it's sometimes hard to convince them, but they did great. They went home to pack some things and waited for us on the road back to Quiche. We brought them here to the hospital and helped them get their labs done in town. More on that in a minute.
The second mom's baby was fine. However, the last time she had a baby, her uterus ruptured and they had to do a C-section. That means she needs a C-section this time, too, at least that's her best option here in Guatemala. (Dr. Yeomans could probably deliver her, but he doesn't work here!) The problem is that she didn't get any good dating early in her pregnancy and once you get close, the American measurements we have aren't quite as accurate as they are early. (American babies are normally much bigger...) So this lady lives at least an hour's drive from a hospital and she can't exactly schedule a C-section because her dating isn't too good. (If they take the baby and it's too early, its chances aren't the same here as they are in the U.S.) But she promised to head to the hospital as soon as her labor starts. Pray that everything works out okay there.
The third mom's baby was not fine. The first thing you look for on ultrasound is a head, which is normally shaped like, well, a head. This one looked more like a squished spaghetti-o. And the spine was bent up like a staple. And by measuring the femur, it was only about 15 week size. Mom has been pregnant for seven months. In other words, we're going to need a surgery here to take the baby out (it's been dead for some time). So she was going to go home, get her husband and return for a ride to the hospital. She never showed back up. So please pray for her, too, that she decides to come here. Luckily, before she left, we counselled her that that's what she needed to do. Hopefully all she missed was a ride, not the point of the conversation.
Baby number four was fine, thank God, and it was early in her pregnancy, too, so she should be able to get excellent pre-natal care at the Centro de Salud. We've been so impressed with the folks out there. They don't have a lot of equipment, but they really do care and they work very hard to provide the best health care they can, which is a whole lot better than was there a year ago!
As we were waiting for Mom #3 to return, three more moms came in and we checked them out, too. Fortunately, all was well with them. One thing we noticed, though, was that these moms do tend to have lost more kids than moms we see in other places. When we first started here, we expected to see lots of G10 P5's (G is how many times you've been pregnant, P is how many living children you have.) However, for the most part, it's pretty unusual for a mom to have lost more than one, and it's actually more common for all of a woman's kids to be alive. Sick, maybe. Malnourished, maybe. But alive.
In San Bartolome, however, at least based on our small sample size today, the average was more like two kids lost per mom. Very sad. Our hope is that we can help, even if it's just a little tiny bit, the great folks that are working there to improve those numbers.
Okay, more on Mom #1. We picked them up on the side of the road on our way back to Quiche and brought them here to the hospital and got their labs taken. We said all that, right? The labs won't be back until tomorrow afternoon, but apparently the doctor on call agreed with Heidi's assessment and wanted Mom to stay. The problem is that she already has a half dozen or so kids at home - and is nursing. Mom and Dad came to our door this afternoon and said that they have to go home and take care of their kids tonight, but that they'll be back in the morning. Pray for that to go okay, too. If it's a molar pregnancy, she really needs to be in a hospital.
When we got home, we had no electricity. So Matt went down to the hospital to work on that while Heidi was taking the family to the lab. When we've split up in the past, things haven't gone so well, but there's a first time for everything. Today, surprisingly, was it. Everything went fine - we got the power on and the labs taken. Gracias a Dios!
We also got a chance to go check on Lesly, the Down's Syndrome girl we told you about last week that we brought here because she was so malnourished. Bad news. She looks even worse now. She has lost even more weight and her eyes are so sunken into her head that she barely looks like a baby. Skin is just hanging around her entire body - her neck, her wrists, her legs, her arms. It's very sad. The nurse told us that she has diarrhea and is on antibiotics. She also said she's seen them look this bad and make it, but I doubt that Las Vegas would put very good odds on her. Please pray for her, too.
We did get to go open a new bank account tonight with Jacob. Remember that our other bank folded. The new account is good news, I think. Normally things are very difficult here, but we were only there for about ten minutes and probably five of that was just shooting the breeze with Jacob.
Oh, and we got the green truck to Martin, our mechanic friend here in town. (Remember that it died on Heidi last week.) Hopefully it'll be something very simple (and cheap) and we'll have it back in time for Paul and Lindsey to use it while we're in the U.S. over Christmas. It seems weird to ask for prayers for a truck after all this other stuff, but while you're praying, toss in our truck, too, if you would!
Tomorrow is supposed to be a bonifide day off. We'll let you know how that goes!
Oh, pictures. These two girls here are the daughters of the cleaning lady at the Centro de Salud. They were SO cute and friendly, we just had to play with them and take their picture. And, of course, one with Mom, too. (Note the toddler she's carrying on her back while she's working! Sometimes he plays with the two girls, sometimes Mom has him.)
