Aventuras de Yenni

a sewing lesson in female anatomy...

2008-12-21T15:35:00.000-08:00

tinctures, tinctures, tinctures!

2008-10-25T16:53:00.000-07:00

so i am back in guatemala teaching classes with the midwives. today we covered postpartum hemorrhage so we made tinctures and learned how to give injections (on oranges). soooo much fun!

hunting for shepherd's purse was seriously better than any easter egg hunt i have ever had.

eureka!

erin the acupuncturist from oakland is lovely and amazing. thank you for your help!

everyone busy at work.

¡ya!

michimegan

2008-10-25T15:54:00.000-07:00

last week i went to michigan to attend the annual MANA (midwives alliance of north america) conference and got to stay with my mejor amiga megan. it was a much needed break to reconnect with old midwife friends and recharge for my work down in guate. and michigan is gorgeous this time of year, who knew?

lake michigan
megancita
driving again....weird.

if you can't tell that is ricki lake and abby epstein getting down at the mana conference. if you don't know why ricki lake would be attending a midwives' conference you obviously still need to see her amazing documentary on maternity care in the US: The Business of Being Born. Netflix it!

more baby catching...

2008-10-15T08:44:00.000-07:00

This was an awesome birth I attended with Dominga, one of the midwives in my class. She taught me sooo much about traditional practices in Mayan midwifery. And the mama was such a trooper...17, first baby, 8-hour labor, not a single whimper. The women here are so stoic during labor it is truly incredible.

Me and baby Xela.

Warrior mama!

sunset san marcos style

2008-10-07T10:01:00.000-07:00

as much as i love rainy season in guatemala with all the thunder and lightning storms, i think i could get used to the dry season if all the sunsets look like this:

Juanita's Mom

2008-10-04T14:29:00.000-07:00

A few days ago I found out that my friend Juanita's mom had passed away at 40 years old from diabetes. Or to put it another way: she died from poverty. Juanita's family couldn't afford the insulin or proper patient care and education that her mom needed. I just can't tell you how the suffering in this country kills me sometimes. But the people here are so strong and have such faith. Yesterday I walked up to the cemetary with Juanita and her family to put fresh flowers on her mother's grave. It was so sweet the way the family tended to the grave and spoke about how they were relieved that their sister/mother/daughter was with God. Juanita had asked me to take pictures, which I happily obliged but the whole time I just felt so sad for this woman who had died too young.

Juanita

Nurse Hannah does Guatemala

2008-09-27T12:10:00.000-07:00

Nurse Hannah came to visit me for a week and took a bunch of photos of just about everywhere we went. So I thought I would share them with everyone so you all can get a better idea of my work, home, etc.

Clinicas Maya

The "waiting room"

My office where I do prenatals.

Mi casa

Kitchen

Living room

Bedroom

Hannah Banana in the boat on our way from San Marcos over to Santiago.

Posada de Santiago.

Hannah and I hanging with the acupuncturas at the pool.

Tuking it.

Hannah is always good at reminding me how important it is to cut loose. So here are the photos she took after we had a margarita at Casablanca. Apparently, it only takes one margarita and then I think I am a musician.

Don David and I having a moment.

¡Ramos!

2008-09-26T16:21:00.000-07:00

About 2 months ago I had a patient named Ramos, who was coming regularly for prenatal check-ups, ask me to deliver her baby. I explained to Ramos that I had a deal with the indigenous midwives here, where I would only attend births as an assistant. But Ramos was relentless and insisted at each visit that I catch her baby. I finally agreed on the condition that she would find a local midwife to come to the birth as well. The bargain was made. A week later I met Juana, a very popular midwife from San Pablo (where Ramos lives) and we talked about doing the birth together. It was a bit challenging to communicate with Juana because she doesn't speak Spanish but one of my student midwives Julia translated for us.
Ramos continued to come for prenatal citas up until her 37th week when she stopped showing up. I asked Julia why she thought Ramos hadn't come and she explained that it is customary for the women to stop traveling a month before the birth. Since the clinic is in the next town over, Julia said she wasn't surprised that Ramos had stopped coming. I thought this was totally hilarious given my experience with gringa patients who would come everyday for a prenatal check-up I'd let them. But the tuktuk (motorized rickshaw-like golfcarts that serve as the main form of transportation at the lake) rides can be pretty rough sometimes so I decided to pack up my things and go to Ramos' house for a home-visit. Ramos lives in a really cute place that is very "upscale" for San Pablo with its fenced in front yard and tiled floors. And for the next few weeks I continued to go to her house to check on her until her 39th week. At 39-weeks and 3-days my friend Hannah was coming to visit from the states so I went to do an exam to see how close Ramos might be to birthing. She definitely had some signs of progress but I thought it could be a few more days so I chanced it (for my midwife readers: she had a Bishop's Score of 4). I told Ramos to call me right away if she had ANY signs of labor....you all know where this is going, right? Yup, I got all the way to Guate and checked into my hotel when I got a phone call from Ramos's sister that she was in labor. It was 4:30pm when I got the phone call but apparently Ramos had been in labor since noon and now had contractions every 10 minutes. Every 10 minutes wouldn't be so bad, however the drive back to San Pablo is about 3 1/2 hours and the last shuttle had left at 4pm. So I called my friend Juan who has a private shuttle service to find out what he was up to. Turns out he was in Antigua so he said he would come right away. Juan showed up an hour later with Julia (my assistant and Juan's girlfriend). We headed home but there was a ton of traffic. Julia took this opportunity to lecture me about how crazy I had been to think I could go to the city with a patient so far along in dates. Finally at 9:30pm we arrived and Ramos looked completely exhausted. Juana had a glove on but she told Julia that she hadn't done a dilation check yet. Ramos asked me to check her so I quickly put on a pair of gloves. When I lifted Ramos' skirt (the midwives here deliver babies under the women's skirt) I saw the amniotic bag. I told Ramos to go ahead and push but she was having a very hard time. I checked the baby's head and realized the baby was posterior. I suggested to Ramos that we change her position but Juana did not like this idea and said Ramos should stay put. After a few more pushes without change I became more insistent and had Julia translate to Juana that I wanted Ramos to move onto her side. As soon as Ramos moved the baby came instantly. It was a baby girl who was born persitent posterior (face up) at 10:05pm and who was healthy as could be. The postpartum was just beautiful...the baby was an expert breastfeeder from the start and Ramos had no complications. About 30 minutes after the birth Ramos' two other sons came home to check out their new baby sister and it was just a precious scene. We weighed and measured the baby: 7lbs.7oz. and 17 inches long. And then a few hours later once everyone seemed to be doing well Julia and I went home.

Ramos and baby 1 hour postpartum.

Super blurry pic but here is Juana the Comadrona (who is sleeping in the corner about an hour after the birth) and the big brothers.

Big brothers: Alvaro and Jorge

More of Jorgito who I think might be the cutest 3 year old in all of Guatemala.

1 day postpartum visit...

Checking baby out.

Jorgito loves to listen to his own heartbeat.

Preshie Presh!

Julia and me with the baby girl who has yet to be named but who I have taken to calling Ramosita (Little Ramos).

reggae party at the posada

2008-09-08T15:02:00.000-07:00

Martin, Amanda and Little Emma

The mamas swapping secrets

La pareja

Los Dueños de la Posada de Santiago
David and Susie Q

Surunda and her new grandbaby

Guapos

a night in pana

2008-09-08T13:33:00.000-07:00

The three (and a half) amigos...

Traditional Guatemalan Pose

(Pretend like you're constipated)

Las Esposas

Comadrona Classes!

2008-09-01T11:47:00.000-07:00

As mentioned before, for the last 2 months I have been teaching classes every Sunday for a group of indigenous midwives from various pueblos on Lake Atitlan. These women are truly amazing and sooo much fun! From sharing stories of the countless births we have attended to learning how to take blood pressure or finding a pulse, we have been learning a lot from each other. As well as giggling a lot with each other! But a couple weeks ago my friend Megan Spelman, the ever so talented photo journalist, came to capture a Sunday afternoon at Clinicas Maya with the midwives. Here are her beautiful photos...

Rosita la bonita!

Isabel and Petronila studying hard.

Me and Alicia (a doula who has been helping me with the classes).

Giggles.

Tomando presion! (Blood pressure)...

Learning signs of anemia.

Feeling pulses.

Dominga!

2008-08-18T10:10:00.000-07:00

Here at the lake we are surrounded by three gigantic volcanoes and to prove how hardcore I could be I convinced my friends Megan, Viente, Lucia and Samuel to hike to the top. We were supposed to meet in San Pedro at 7am to begin the ascent but there were a few snafus since neither of our boats left on time. My comrades coming from Santiago somehow felt that this was my fault. So I have included photos of their impatient unhappy faces waiting for the boat. :)

When we finally met up there was talk about it being too late but we agreed to go anyway and began hiking at 9:00am. We were told the hike was about 5 hours long (3 hours straight up and 2 hours down) but Lucia was anxious to get going so the two of us ran ahead for the first 15 minutes... until the return of my giardia caught up to me. I tried to continue climbing but had to stop every few minutes to mark a new territory on the volcanoe. By this time we had made it to the first mirador (lookout point) and so I told them to go on ahead and that I was going to climb down. Of course, five minutes later I decided-- out of pure stubbornness and perhaps a bit of pride--to climb up behind them. Samuel had waited for me and was a great cheerleader for the next couple hours. When we finally reached the top there was a bunch of fog but I felt so victorious for making it that it didn't matter.
Not as hardcore as I'd hope with a time of 4-hours up and 2-hours down but how many hikers can say they climbed San Pedro with giardia? As they say around here, "Guatemala has a way of building intestinal fortitude."

prepping at dawn
"yenni, are you sure there's a boat at 6am because all the lancheros say the first lancha leaves at 7am."
waiting for a boat.
loaded up ready for the boat to leave.

el volcan de san pedro...

hiking volcanoe + giardi = miserable yenni
megan generously offering to document my torment!
not even half way up and we drank all the water we brought.

having made it a third of the way here is our view from the mirador.

samuel, vicente, lucia and the frenchie tagalong.
megan and lucia trying to convince me to keep going. me, ready to keel over.

when i finally made it to the top the fog had rolled in and here is my spectacular view, lol.

and the rest of the troupe?

as is custom with 2 españoles and one wanna be: siestando (napping).
lucia expressing her enthusiasm for the return.
down we go with our guide, pedro.

¡Eva!

2008-08-18T09:03:00.000-07:00

For the past 5 weeks I have been holding midwifery classes every Sunday afternoon. So far we have been working on understanding the circulatory system and listening to heartbeats, taking blood pressure, etc. All the women are doing great and I am so inspired by their dedication and enthusiasm for learning. But Eva is my gold star student. Despite the fact that Eva's coke bottle glasses are completely worthless (she can barely read anything smaller than 30 point font) she has been coming every Sunday as well as assisting me on Fridays in the clinic. Unlike the majority of the midwives in the group, Eva has not attended any births yet. When I asked Eva why she hadn't started delivering babies she told me that she had wanted to apprentice with the local midwives but they told her a real midwife doesn't have to study. Eva said she didn't feel comfortable going to births alone without understanding anything about the body so she was super excited about the opportunity to study with us at the clinic. And study she does! She takes home her handouts and comes back full of questions. And this week when I asked if anyone could summarize what we have been learning she explained the entire circulation process to the class of midwives! Now all we need to do is get her a consult for some new glasses.

I know it looks like I am holding her hostage but she's just SUPER camera shy.

Eva taking blood pressure!

lunch at Geydi's

2008-08-18T08:43:00.000-07:00

got to the clinic this morning and geydi (our receptionist) said she wanted to invite everyone to her house for lunch. we got there and she had made tamales, chicken soup, limonada and chocolate covered frozen bananas for dessert!

my favorite pukey cute pareja

2008-08-18T08:31:00.000-07:00

megan and my second favorite dog, birdie

what is a travel blog without a diarrhea story?

2008-08-01T20:01:00.000-07:00

I contracted giardi within the first couple of weeks of being in Guatemala, most likely eating street food at the fair. And being the naturally inclined midwife that I am, I tried to battle the parasites with massive amounts of garlic and grapefruit seed extract. But finally after the 5th stratight week of diarrhea I gave in and went to the hospital for antibiotics. Within hours I was sure that flagyl was a miracle cure! However, for the entire week that I took it, I couldn't poop. Finally on my last day of the pills I was desperate because I was supposed to go on a 4-day camping trip with the clinic staff. The drive was going to be 8 hours and I thought I would die of painful bloating if I wasn't able to go number 2 before we left. Normally I would go for a run but it was night and its not really safe for gringas to be out running late, so I did 600 jumping jacks instead...nothing. Then I did yoga for an hour afterward, still nothing. Then I got creative and tried the old fashion q-tip and olive oil trick only I didn't have q-tips so I had to settle for a chopstick (gross i know, but don't worry I threw it away). But that didn't work either. So I broke into the clinic's bodega and found an enema kit. I got it all ready went into the bathroom laid on the floor and, well, gave myself an enema. But just as I was about done I heard some people cracking up outside. I lifted my head and looked out my little bathroom window and there were three guys in their mid-twenties sitting on the balcony of the hotel next door literally rolling on the ground with laughter. Completely mortified but fully indisposed, my only option was to move to the toilet. You can imagine what happened next: 7 days without passing a BM plus a liter of warm water exploded out my derrière to the sound of uncontrolable chuckling. It was painful--in more ways than one--but hey I finally pooped! And luckily we left early for our trip the next morning and I haven't seen any of my peeping toms since.

semuc champey

2008-07-25T19:01:00.000-07:00

For the last four days I have been on an employee trip to Semuc Champey, a national park with beautiful swimming holes in Guatemala just outside of Coban. (We were fumigating the clinic to get rid of ants, spiders, scorpions, etc....so we took the opportunity to have a little fun). Neither I nor the rest of the clinic staff had ever been to the Alta Verapaz region so we hired a shuttle driver (who I later learned is a serious crush of one of our employees) bought a bunch of snacks at Hyperpais--Guatemalan Walmart-- and headed northeast. You should have seen the look on the doctor's face when the staff said we were going camping! Apparently he had never been before. Honestly, I myself was not sure how we were going to pull off camping in the rainy season either but we set off anyway...

Tono with Tino's cool shades.

When we finally arrived outside of Lankin we all went spelunking.

Here is the doctor carrying Mario since he kept slipping on all the bat dung.

Tono doing his best bat impersonation.

After the caves we drove into Lankin, a small town outside of Semuc Champey and it was pouring down rain. I asked the girls if they were sure that they still wanted to camp and they said they had brought all the equipment so we should at least try it out. The doctor gave me a look of desperation so I asked the girls if they could show me what equipment we had while we parked under a dry overhang. I climbed onto the roof of the shuttle with Miriam and she showed me a bunch of straw mats rolled up together. I asked where the tents were? But it turns out they had only brought 6 straw mats for 8 adults and 1 child. Needless to say we ended up all staying at a hotel. Since it was raining the girls and I played cards while the doctor and the boys went off to find cuba libres (rum and cokes with lime). Three hours later the boys were nowhere to be found so the girls and I went over to a comedor for dinner. Half way through dinner the boys show up completely wasted. The doctor was actually not too bad but the thing about indigenous Guatemalans is that they rarely drink because it is a total social taboo. So when I say wasted I mean, staggering can't walk, can't talk wasted. The girls and I left totally embarrassed and went back to the hotel to go to bed. As I was finishing brushing my teeth I saw Samuel, our gardener hunched over a box of aspirin. Suddenly I had to be nurse Jenny, luckily he had only taken 4 of the 10 pills but he was crying and talking about how I couldn't tell his baby girl that he had been drinking, blah, blah, blah. I tried to help him up to get him to bed but then Tino came over and tried to help and fell over. I swear it was like taking care of 14 year olds who had been drinking for the first time. But a half hour later I had them all tucked into bed and was able to go to sleep. The next morning when I woke up the guys all gave me sheepish smiles and we went to breakfast. Unfortunately, the rain had been so bad the night before that the road was washed out and we wouldn't be able to drive down to the swimming holes. After the night before though, I was determined to go so I suggested we walk because it was only 9K. They all thought I was crazy so I went alone for a much needed solo hike.

And just as I got there the whole crew showed up in a truck so we all went into the park together. Apparently the rain had caused some mudslides so the pristine blue swimming pools were full of rushing muddy water, which was a bummer. But I convinced the guys to hike up the mountain to the lookout point and it was still an incredible sight, even if the water wasn't clear.

Here's Tino being a total lunatic sitting on the ledge

Here's the doctor trying to convince Tino to get down, lol.
Drenched!
Samuel!

For the record, I am not mean, he wanted me to take this photo, haha.

Julia and the shuttle driver, aka the love birds.

meet the gang at clinicas maya

2008-07-25T18:39:00.000-07:00

geydi our receptionista and aspiring doctora.
vicente our male nurse--enough said.
Celestino, our naturopath.
Pierre, or "Doctor Pedro," our volunteer doc from france.
Miriam, our administrative extraordinaire.

happily reunited

2008-07-25T18:22:00.001-07:00

las esposas together again, falta johanna.

mis novios, andres and miguel who apparently asked after me all year long but said they didn't remember me when they finally saw me.

the traveling feria...

2008-07-25T17:49:00.000-07:00

Summertime in Atitlan means feria or "the fair" for those of you non-Spanish speakers. Here are photos from the parade in San Pedro...

The parade in San Marcos outside the clinic...

No parade in Guate is without its reina del lago!

I know, I know. A blog? But what can I do but follow orders...
And I quote: "Be a good white person in central america and make a blog." -Scott Reed