Mexico, Mercados, and Meditation

My mom keeps pleading with me to not go to Mexico. What I think she doesn't understand is that there is really no difference between here and just over the border in my sister town called Progresso. I went to the market this weekend and asked my friend, what exactly the difference was between here and across the border, as I couldn't imagine any. "Basically just the pharmaceuticals." Touche.

At the market everyone was packed around us closely, jabbering in "Tex-Mex." People laid out tables selling everything you could possibly imagine--and I mean everything: live chickens and puppies, fresh fruits and vegetables of all kinds, music, DVDs, kitchen and household appliances, clothing: new and used, mechanic tools, cleaning products, furniture, school supplies, cowboy boots: buy some or just get yours shined, toiletries and over the counter medications, and probably anything else you can imagine. Some tables appeared to literally be selling garbage.

And who'd have guessed; my favorite part was the food (see my Peru entries detailing my reckless consumption of all street food all the time). At this market there were Tamales; Elote: big kernals of corn usually served with mayo, lime, and chili; Hochatas: a yummy and very sweet drink made with rice milk, sugar, and cinnamon; "Chitos" which are cheetoes covered in nacho cheese; enchilladas; breakfast tacos; fried potatoes on a stick with ketchup, mayo, and lime; big styrofoam cups of fruit sprinkled with chili; Aguas frescas: juice with fresh fruit, water, sugar, and sometimes some kind of flavoring or koolaide; Raspas: the snowcones I talked about earlier; and all kinds of little sweets.


The markets by far are my favorite thing ever.

Yesterday we had a big rain, which was incredibly refreshing. I had hoped that the drop in barometric pressure would have some babies dropping too! But alas, no births. We've got women due, but the midwife is going out of town for a few weeks this week, so I'm going to Dallas on Tuesday and hoping I won't miss out on too much excitement here.
Though actually, my trip to Dallas will be all about avoiding excitement. I will be doing a 10 day Vipassana meditation program. It's at a meditation center outside Dallas that offers free meditation programs in striving to make the world a more peaceful place. I am looking forward to the challenge and the opportunity to re-center myself. No talking, reading, or writing for 10 days. I'm carpooling with 4 other people from Austin, so it will be interesting to see how we react in the 4 hour ride back together.

Keep on breathing!
xoxo, Rachel

The Art of Living

Gratitude down in the Valley

Idealistic as I am, I may find myself unhappy at times with the care at the clinic, but in the last week I have become especially appreciative of the care we give.

While the WHO recommends no more than a 10-15% C-Section rate, the US's average is around 30%. That is generally appalling enough for me. But here in the Valley, the rate is 40%, with one major hospital at 44%. This is complete lunacy in my mind, and yet, there are some things to consider... Generally the C-Section rate is so high because of the fear-based practice that OBs have been driven to practice because of the high rate of litigation. By fear-based practice, I mean that OBs do a lot of preemptive C-Sections and use a lot of medications "just in case" which in invariably end up necessitating a C-Section because the drugs put the baby or mother into medical distress. Of course the "Just in case" more often than not does more harm than good, but it at least it looks like the doctor was trying "just in case" they get sued.

So, number #1, I am very pleased to report that at Holy Family the C-Section rate is about 4%. I could go on and on about why this is, but I'll simply say that we don't mess with nature.
Point #2: As if OBs didn't have enough to worry about with getting sued, I learned on Tuesday of an OB that was actually murdered by the father--involved in the drug rings--of a mother who had died in childbirth. Woah! Since we are not interfering with the body's innate wisdom and are not using unnecessary medications and procedures it is much much much less likely for a bad outcome to occur with the mother or baby...It's not that our patients aren't suspected of being involved with the drug crowds, simply that I am confident that our care is at least safe, and that it probably won't result in my getting killed by a drug lord!

My other piece of gratitude I have here is for the patients, who all have interesting backgrounds, to say the least. A mother gave birth recently who had come from El Salvador. She had had a baby there and like in most developing countries (well and in the backward hospitals here in the Valley as well), they still take the baby away from the mother immediately upon delivery to go to the nursery. She was later told that her baby had died and was not allowed to see him. She suspected that the baby had been stolen and she never heard another thing. Because of this awful experience her delivery was hard. She likely had a lot of subconscious fear and anger, and for this reason, she did not want to push. She was crying and trying to find a way out of pushing her baby into the world, but eventually, of course, out he came. It was beautiful watching her with her baby who went immediately up on her chest. I'm happy that I got to know this patient during her care, and happy that she had a place to have her baby that was safe.
Like most patients, she was ready to go home a few hours after the birth. The only problem: she didn't have a car seat. And she didn't have money to buy one. Thankfully we had one to loan her. And Thank god for our amazing bodies that provide for us so well...at least with breastfeeding she won't have to buy anything for him for a little while... (we also loaded her up with donated clothes and diapers).

Eeep! I am continually reminded of how lucky and privileged I have been all my life. More to come about all the impressive and inspiring people I have met down here... The bilingual hairdressers who can't read or write because they never went to school, the migrant farmers, the factory workers, and the "swimmers."

Clowning in Peru take 2

This August I will be meeting up again with Patch Adams and Clowns in Iquitos, Peru to paint houses, bring cheer to impoverished Belen, and Clown at the hospitals, nursing homes, orphanages, and in the streets. We will be teaching classes, doing health screening, and working with street kids.

I can't wait!

The "tuition" for the program is about $1,000 (which will pay for paint for the houses, materials for projects, and some scholarships for kids to attend school. It does NOT include my flight to Peru). I am hoping to raise at least half of the tuition through small donations.

If you're interested in pledging a little something toward the cause, visit my Clowning Mission Fund. The way this site works is if the goal is not met, nobody pays.

See Gesundheit Iquitos for more information on the Belen Clowning Project. It's truly awe-inspiring.

Thanks for being part of my journey, either through a contribution or simply by being a reader and being there alongside me.

un abrazote, Rachel

Feliz Dia de las Madres!

Happy Mothers day! It's a big deal here, with mariachi serenades, people selling roses in the streets, "Dia de las madres" specials everywhere and congrats to the moms on local business signs.

I celebrated my mother earth/ocean by visiting good ol' South Padre Island. It's only an hour away and with nothing else to do by myself in a quiet clinic, I may as well spend my Sunday on the beach. Unfortunately I laid out a little too long and am looking like the famous Gulf of Mexico shrimp. Of course I also called my Mama and Grandma today.

Mexicans tend to take any chance they can to celebrate, so I'm hoping we get to do something for National Nurses week which is just wrapping up (May 6-12). When I was in Peru, they celebrated the day of the Patron Saint of Nurses while I was living with a family. What I thought might be a minimal holiday (and maybe it is, but that didn't diminish the scale of celebration), turned out to be a feast of fireworks, music, late-night partying, and festive food and drink.

A random mama factoid: Women here during pregnancy often wear a safety pin with or without a key on it over their belly button to protect their unborn child from lunar eclipses, which according to lore: eat parts of babies and can cause birth defects.

Together now (you know the tune): "Let's talk about sex Holy Family..."

A patient asked me the other day if she could give an STD to her kids.... Ma'am, I sure hope you wouldn't give it to your kids...

I had a frustrating day with

• 1 positive Chlamydia test, which I had to explain in Spanish: an awful injustice for the patient I felt (considering my modest language skills)
  
• 6 pregnancy tests (we usually get one every other day or so), all of whom were in their early 20s/teens
  
• 2 people ask me for birth control, which we are not allowed to discuss in this Catholic institution.
  

It's very hard for me to see these people coming in with STDs, teens worried about being pregnant, and others coming for information from healthcare providers and not being able to help them because of the clinic's religious affiliation. It's funny because I had the simliar sentiments of distaste in the hospital, but opposite.

I wanted to be more natural in the hospital, and here, though I think natural family planning is great for planning a pregnancy, and great maybe for prevention if you're in a committed relationship, but it's a little too idealistic if you're worried about preventing diseases and avoiding pregnancy in the general population. It's incredibly frustrating for me as a healthcare provider when a girl tells me she had unprotected sex the night before and knowing other options (specifically preventive onces), I can only talk cervical mucous and last menstrual period with her.

So, renegade that I am, I did a big No-No... I didn't say anything to her inside the clinic, but I ran after her to her car when she left. My heart was pounding and I was sweating and felt myself anxiously look around, as if I was trying to push dope on her. I blurted out some information on Emergency Contraception and IUDs, to which she very happily wrote down everything I told her and gave me several hugs. It felt really good to help her, and it sucked that I had to be so "rebellious" to do it.
Where the hell am I?
I keep trying to push judgment aside, and figure that if I can do what I know is right and learn from all the other unique experiences here--learning about normal non-medicalized pregnancy, natural birth and breastfeeding, etc--it's so worth the experience. And beyond that, the work got me down here to see this part of the country, which I would have probably never known...and that alone seems worth it! I do recommend to all my Yankee friends to come on down, not only to Texas which is in itself a whole nother world, but deeper south to the border, where everything transforms again, and you find yourself in another culture warp.

Oh, and I don't want to leave out the little tidbit I learned yesterday, which is that around here it's a common practice for men to poke holes in condoms to "trap" their girlfriends. Yep, that's right, impregnate them so they have to stay forever! Honestly, I was just surprised they were even using condoms since unprotected sex, starting around age 12 or 13 seems to be the norm here. Argh! You see my frustration in not being able to offer these women a little education?! IUDs for everyone I say! Or as one of my nursing professors used to joke, birth control in the water! (OK, not really, but seriously...we've got some issues to confront here, and some education to get out there!)

Today, I'm heading south along the border, as far south as you can go here: To South Padre Island. Hallelujah!

un beso, Rachel

PS I never actually thought of myself as a Yankee until I came here. People actually use this term, and when they talk about "going north" they usually mean to Dallas or Oklahoma.

Feliz Cinco de Mayo!

Too bad nobody really celebrates it here nor in Mexico. The holiday has basically been commandeered by Americans as a drinking holiday and misunderstood by many to be Mexico's independence day. In reality, their independence day is the 16th of September (not nearly as catchy), and the 5th of May commemorates the victory of a battle against the French in Puebla (a town just a couple hours from me). A year after the battle in Puebla, they actually lost to the French.
haha. Ohh well!
The interesting thing though is that America has also adopted it as a sort of Mexican-American cultural-awareness/heritage day, which is pretty rad.

To celebrate, I am eating fresh bananas and papaya from the trees in the yard. Mmm, que rico!

Mi mente esta MELTING

Well, it's 8pm and it's still 90 degrees. I can literally feel my flesh burning, even without the sun. Today I took the clinic car to do a post-natal home visit 30 min away. I forgot that the car had no air conditioning and when I arrived I was drenched in sweat. Thankfully, Tex/Mex hospitality provided the gift of an icy cup of sweet tea upon entering the house. I drove around for an hour afterwards, looking for a coffee shop to sit and enjoy the air-conditioning.
Unfortunately with the heat expanding the space in between synapses in my brain, thoughts were few and far between and I never did find it. Luckily for me, there are plenty of stops along the road to find tasty "Raspas:" shave ice (with real or corn-syrupy juice) topped with pineapple, mango, banana, or would you believe pickles?? I went for the Tamarind, and it immediately brought me back to life...for about 30 min until the heat penetrated again.



I wanted to share also, a classic Tex-Mex interaction, spoken by the woman who preceded me in line and the Raspa vendor: "Dame four larges" "Que flavor?" "De este Strawberry y Tamarindo." "Seis bucks."
haha, I love it