My house, the hospital, the obstetric ward...

Thanks to everyone for being so patient. I've been trying to process through my time here thus far, trying to decide what to write about, what you might want to know.
Below are some words, pictures and a few slide shows.

Here I go. Whew.




It is my 20th day in Cusco, Peru. I live in a large house called CASA DEL CONDOR. I am participtaing in a program from the Matrona School (based in Asheville, NC). My main instructor is Whappio Diane Pilgrim, a lay midwife with a head of spiked grey hair and arm tattoos. She practices a very holistic, hands-off approach to midwifery, but she also makes us study the hell out of all the clinical and anatomical aspects of childbirth. We are also instructed by two local midwives, Sunday & Christine.


We live at the top of a very busy street. There is the constant sound and smell of diesel trucks, construction, and taxi traffic. At the bottom of the hill, in the middle of the street, is a giant column atop which sits the statue of a condor, one of the icons of Peru. Across from our house the sidewalk is lined with car washers. They stand there all day with their buckets waiting for taxis to stop and get washed. It is very easy to tell a taxi driver how to find my house, I just say "Donde llavan los taxis", or "Where they wash the taxis".



Living with 25 people is very wild. In a short time, because of the intense work we are doing, we have become a very tight group. I have held an amiga while she collapsed and sobbed in the yard after an 18 hour hospital shift during which the woman she`d been attending was suddenly carted away for an "emergency" cesarean. She could do nothing to prevent it, was unallowed to attend, and had to listen to the woman crying out for her all the way down the hall. I have taken care of housemates while they were extremely sick with altitude, and likewise had folks take care of me last week when I was very ill with some kind of strange upper respiratory bug. We all share clothes, and I think I have seen just about everybody naked.


About thirty minutes ago I left "counsel" or "circle", which is when the entire house is called to meet on a specific matter. This was a long one. We sat in circle for almost 4 hours. There had been a giant indiscretion. One woman had slept with the husband of another woman last week. The husband and wife are local Peruvians, and the wife attends our classes. She was not present today. There was so much gossip and tension that Whappio cancelled class and called a circle. There were a lot of tears and questions and discussion of character, integrity, self-discipline, etc. It is difficult to explain, but basically it is like family. Each persons actions can have repercussions for the entire family, can create inner tensions, and can affect the family's reputation in the community. So, this is what we met to discuss.





Now back to the basics. Our house has beautiful adobe handiwork, lots of plants, lots of different paint colors, many windows, decorations, altars, and no closets or storage space. We do our laundry in buckets outside. We have one small kitchen in our house. We drink only distilled water so as not to get parasites from the tap. We do not have an oven, only a tiny gas stove with two burners. Once a day, Abbey or Llana (fellow students) cook a meal for the entire house. There is a tiny, old Peruvian woman who comes and cleans the house Mon-Fri. This takes her about 4 hours as there are 7 bathrooms, as many bedrooms, and 3 common areas. I live in a room with 4 other women. We each have an uncomfortable lumpy mattress pallet on the floor.

The only hot water in the house comes from bath showers. And there are only two showers in the house with working hot water heaters. Ours is one of them, so we have a lot of wet foot traffic. In Peru, most houses do NOT have hot water. And if you do have it, the water is heated at the moment it passes thru an electric shower head. In order to get the water hot, you must keep the pressure very, very low so that the water has enough time to be heated as it passes thru. So, basically, I am showering in a warm trickle. And if I try to change the temp or pressure, when I touch the handle I complete the circuit and endure a low, consistent shock of electricity. Ugh.



Everyday we have class in the two common spaces. Classes are from 9am - 12pm, one hour for lunch, and then more class from 1-4pm. And sometimes there is class in the evening as well. The class subjects are: Quantum Midwifery, Clinical Skills (suturing, vaginal exams, palpation, etc), Medical Astrology, Egyptian Alchemy & Herbology, Qigong Technique for DMT Release, Fertility Awareness (family planning, ovulens, etc), Holistic Sexuality (cosmic orgasm, tantra, etc), Woundology, Rank, Power & Priviledge, and Mayan Massage. I realize this sounds like a bunch of metaphysical, hippie shit, but I promise all of it is based in biology, chemistry, ancient history, anatomy, quantum physics, the medical sciences and is corroborated by the empirical evidence of my teachers and classmates. And, yeah, we get "deep" and talk about our feelings, god, the universe, energy and the many other things that cannot be measured so easily by scientists.

AND... once a week it is mandatory that we attend a Birth Circle. I am very glad for these, as what we learn in class and what we are seeing and experiencing in public, Peruvian hospitals... well, these are very different things. On the one hand we are studying birth as a holy rite of passage, and then we go on a 12 hour hospital shift to see women rushed through their labors with pitocin, paid no attention by the staff, told to lay down and be quiet, routinely given episiotomies for no reason, stitched up for 2 hours with no pain medicine by obstetric students who have never sutured anything EVER, given cesareans because some doctor put his fist to her vagina and decided her pelvis was too small, cathaterized by a tube that touched the doctors clothing, the bedsheets, and even the floor before it was inserted roughly by an untrained hand, and a dead baby put in a bed pan and stuck on a shelf in the maintenance closet until someone could deal with it.


If you ever get really sick in Peru, I would suggest spending your life savings to get airlifted back to the states. Otherwise, there is a HIGH chance you will leave the hospital sicker than you arrived. In the maternity ward, all the women are given water to drink out of the same cup. This means, if the woman next to you has Hepatitis, it's your lucky day! There is only one technica (orderly) on staff at any time, and so this one woman must maintain the cleanliness of the entire obstetric ward, which is physically impossible. So, there are random open trashcans full of used gloves and masks floating in a pool of placentas, urine, feces and amniotic fluid. Sterility is virtually non-existent. Yes, the doctor will put on a sterile glove before a vaginal exam, but how many things will he/she then touch before the actual vagina? Lots. The technica does NOT wear gloves when she handles bodily fluids. Bedsheets are rarely changed, even if they are bloody. Many of the sinks have posters describing the importance of soap and hot water, but most of the sinks have neither soap or hot water.




BIRTH AT A PERUVIAN HOSPITAL

Here, as in the states, birth is not a natural rite of passage, it is an emergency. Laboring women are put on a timeline. After 4 centimeters, they are expected to dilate one centimeter every hour. If they do not, then they are given pitocin (a synthesized version of oxytocin), which produces faster, larger, and much more painful contractions... but does not necessarily dilate the cervix. If this does not work, her amniotic sac is forcibly broken. If this does not work her labor will be augmented with more pitocin, sometimes combined with a narcotic to help her relax. It would seem quite obvious to me that relaxing through a pitcocin induced contraction would be impossible, since your entire being lays in fear of how painful the next one will be.

Anyhow, so more narcotics, more pitocin, more narcotics, more pitocin. All during this, there are doctors and obstetrical students talking, laughing, listening to the radio, dancing, throwing things, watching TV, paying no attention to the laboring woman, yet in every way distracting her from concentrating on her labor. People lay their purses and charts on her bed. If she cries out or sobs she is told to calm down and breathe. Once in awhile she will receive a long, painful palpation or vaginal check from the doctor.

When she has reached 10cm, they consider her "complete". She is then moved to the delivery room, put on her back in stirrups and encouraged to push whether or not she actually has the urge. The doctor will generally have her gloved fingers inside the mother, moving all around the vagina. And generally someone is bearing down on the mothers stomach with their elbow. And the doctor and obstetric students are paying no attention to the mothers cries and whimpers and are laughing and gossipping with each other. Once the baby's head is in the vaginal canal, the mother's perinium is usually cut with sissors, and she pushes the baby out. Immediately, and while the umbilical cord is still pulsing with blood, the cord is clamped and cut, and about 20 seconds after she delivers her baby, the mother watches as the baby is taken away, oftentimes without even knowing if the baby was born a boy or girl, dead or alive.

After this, she will lie almost completely naked in stirrups in a room with no heat and several different obstetric students will take their turn sewing up her unnecessay episiotomy, taking out the stitches, and resewing it. They will start this suturing by administering lidocaine, but this will wear off about 30 minutes later. So, she will spend the next 90 minutes enduring what amounts to torture. At some point the doctor will take over and actually stitch her up for good. She will then be moved to the recovery room where there is a tiny old heater with on working coil. At some point she will be given her baby and can try to breast feed for awhile. Then she will be moved to the maternity ward to sleep.


If she did not deliver within 24 hours of her water being broken, she will be given a cesarean.

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I realize there are some burning questions which haven't been answered yet. I promise to attend to the following in my next post:

1) If the hospital sucks so bad, why are you there?!?!?!?

2) What is it exactly that you do at the hospital?

3) What weird stuff have you seen during births?

4) Have you taken San Pedro or Ayhuasca?

5) How are Peruvian men on the dancefloor?

In the meantime, here are some pictures of my travels in the Sacred Valley and in Cusco...