Amy Osborne: Overseas Midwife

‘If we have no peace, it is because we have forgotten that we belong to each other’ – Mother Teresa

Amy in the Philippines

Vancouver native, Amy, has been trained at the National College of Midwifery for her Associates Degree in Midwifery. She then went to UBC for her Bachelor of Science in Animal Biology, and is now completing her second year at Saint James School of Medicine.  Amy has traveled to Australia, Japan, Korea, Thailand, the Philippines, Afghanistan, Uzbekistan, Sudan, Kenya, France, Switzerland, Peru, the Caribbean, the U.S. (including Alaska), and Mexico. She has spent time working in the Philippines, Afghanistan, Darfur and New Orleans after Hurricane Katrina. Amy has done over 500 births, with her record shift delivering 10 babies in 24 hours!  Her goals are to return to Africa to work in fistula repairs, work with MSF (aka Doctors without Borders) again, set up clinics in developing countries and train locals in safe deliveries, to go where she’s needed when she’s needed and to live out her life verse (Isaiah 58: 6-14).

Amy is too humble (see the end where I have post all the quotes that are her ‘signature to every email and you will see!) to say she’s a trouper, but she truly is a servant to her calling. Please read and be moved, but note that what follows contains some content that may be difficult (but real) to read.  So, if you are reading this and are supposed to be ‘working on that report’, you may want to wait for an ‘alone moment’.

 Amy in the Philippines

Loaded Bow: So, you were trained as a midwife in El Paso, Texas and then decided to go to the Philippines. How did you choose to start your career there?

Amy: The school where I trained as a midwife was set up so that the students did their school and book-work in El Paso andthen their practicum in a free maternity center that the school had set up in one of the worst slums in the Philippines. It was a pretty amazing place to train as a midwife. There is a strong Catholic influence there so it’s a culture where birth control is rarely practiced and the women have pregnancy after pregnancy. For us, this meant that we were able to get the experience we needed in a much shorter time than it would take in North America. It also meant that we would see rare complications due to the sheer number of deliveries we attended. For the women there, it meant that they were often high-risk pregnancies. The pregnancies were too close together, which is hard on a healthy body never-mind a malnourished body.  

Frequent pregnancies result in the death of 60,000 mothers and children each year in the Philippines. Pregnancy and delivery complications comprise the 6th leading cause of death of women of childbearing age. 63% of women are considered to be at high health risk…. In fact, 50% of pregnant women in the Philippines have anemia and 45% suffer from malnutrition.”

Many of these women were dying unnecessarily, simply because they were delivering with untrained birth attendants and they couldn’t afford to go to the hospital if a complication arose. Our clinics served two purposes. We were learning how to save lives during deliveries, and the women were provided with a safe, clean place to deliver their babies.

LB: In the Philippines you were working in clinics with a group of midwives. How did experience in the Philippines change you/your perspective?

A:  My experience in the Philippines played a huge part in who I became, where I’ve gone and the things I’ve done as a midwife. I started there as a student who knew next to nothing and by the time I finished (I did 4 trips there over 6 years, to 3 different islandsand clinics) I was setting up a new clinic from scratch with 2 other midwives. From the beginning our clinics were run and staffed by really young women who, due to circumstance, ended up running these maternity centers and midwifery schools in these crazy, impoverished, drug and violence plagued neighbourhoods. It could have gone either way and thankfully it went the way of a group of young women realizing that they really could do absolutely anything. It wasn’t easy- at times it was a nightmare- but we stuck together and we stuck it out. The girls who went into that experience came out as women who continue to amaze me with their strength, courage, dedication, brilliance and beauty. One day the cebubians are going to change the world.

Amy in the Philippines

LB: How do you make a living as a midwife overseas?

A:  That depends on the organization you go overseas with and where they send you. In the Philippines I went with a small organization that required you to pay for all of your own expenses (which was good because it meant that all of people’s donations went directly to running the clinics). Thankfully I had inherited money and could afford to volunteer there. Some of the girls on my team had worked and saved money to go and others had people at home who believed in what we were doing over there and supported them financially.

When I went to Afghanistan I went with a larger organization that was able to pay for all of my expenses, plus provide a living allowance, “danger” pay (because of where I was being sent) and a generous stipend. Because there wasn’t much to spend money on there, I was able to save most of what I made while I was over there.

The organization that I went to Darfur with paid for my expenses and also provided a living allowance anda stipendbutit was much smaller. Again, because there was nothing to buy there, I saved up most of it. I liked going with the organization that didn’t pay much because it meant that the people there were there because they really cared, not because it was a good living. There was a doctor on my team who was approached by another organization who offered to multiply his current salary by 10 and he turned them down. I went to New Orleans to work in the shelters after Hurricane Katrina and the organization I went with was small and could only provide us with part of our airfare. Thankfully my family and friends were all wanting to do something to help the people of New Orleans and enough donations came pouring in to send me and two other midwife friends. We were able to go provide care for the pregnant women in the shelters.

LB: How did you deal with some of the harsh conditions you saw overseas?

A: Not very well? Seeing some of the things that I’ve seen overseas has come very close to sending me over the edge. When I was in the Philippines my leader never let me accompany our patients to the hospital if there was a complication and they had to be transported. She was afraid that I would see how badly the doctors and nurses treated our patients (all of whom were very poor) and lose my shit on them. She was right to not send me. One of the only times I went I took a poor, young couple, 9 months pregnant with their first child, in for an ultrasound because I couldn’t find the baby’s heartbeat. The technician walked in, found the heart on the screen and said “It’s not beating. It’s dead”, then turned around and walked away. She didn’t even LOOK at my patient. Thankfully I was so concerned about the couple and how they were taking the news that I didn’t have time to react to the technician. I might have hit her.

Another time a friend of mine went to the home of a patient to check on her son who was at home with his father. She found the one-year-old boy tied up, beaten so badly both of his eyes were swollen shut, with his entire body covered in whip marks and cigarette burns. She picked him up and took him home and refused to give him back. We ended up keeping him in our baby-home while our organization fought his parents to keep him. Once his parents lost custody he was put up for adoption and eventually was adopted by a family. That was the best way I ever saw someone deal with the harsh conditions we saw: to say to someone “You suck as a parent, so now you don’t get to be one”, take their child away and find a better family for it. Frankly, it should happen more often. On my last trip to the Phils I went with a friend who was volunteering at a charity medical “outreach”.

This was the first time I saw the rich treat the poor like they didn’t care if they lived or died. My friend had forbid me to do or say anything while we were there, and it wouldn’t have helped anyways. At one point I asked a nurse if she could at least wipe the pool of blood off the table before putting the next boy on it, and then I had to walk away because I knew I wasn’t going to be able to sit by quietly anymore. If it hadn’t been for the amazing friends I always had on my teams in the Philippines, I would have lost my mind a thousand times over. We took turns- sometimes you were the one having the breakdown and sometimes you were the one holding someone else together.

Amy in Afghanistan

 In Afghanistan it was even worse. It wasn’t so much an economical hierarchy as it was a gender issue. The women had no rights. They were barely human- a 5-year-old boy in our kindergarten loved one of the girls in his class so much he was already saving his money to “buy” her.

I had a patient there who was a young girl who needed surgery to save her life (A brutal story, actually. Be glad I’m not telling it). Her parents were dead so her older brother owned her. He forbid her to have the surgery. I went to him and begged him to let her have it. He said no. I told him she was going to die if he didn’t let her. He said no. I told my translator to not translate for me for a minute and then told him exactly what I thought of him. The only reason I lived to tell the story is because I did it in English and in a pleasant tone so he had no idea what I was saying. I had to be careful there because even if the men couldn’t do anything to me if I stood up to them, they could take it out on the women in their families. The only reason I survived there with my sanity somewhat (and I do mean somewhat) intact is because I had a group of girls on my team who I was really close to. They were a lifeline – a lot like my friends in the Philippines were.

Being a woman on our team in Afghanistan meant that our entire experience there was very different than the men’s. We had no freedom whatsoever and the guys couldn’t relate. They would wear what they wanted, do what they wanted, go where they wanted. We needed armed guards or male escorts or someone to drive us any time we stepped foot out of the compound. We were also doing very different jobs there and had different interactions with the people and the culture. We didn’t come to the dinner table at the end of the day and share stories equally because it was a bit hard to say something like “Gee, that sucks that you didn’t get to dig your well as deeply today as you had hoped. My day sucked too. I had a baby die in my arms and then tried to get a rape victim sewn back together so her husband wouldn’t murder her on their wedding night for not bleeding on the sheets. Can you please pass the salt?”

So the girls on the team stuck together. We snuck alcohol into the country and would have nights where we hid in the basement, smoked cigars and drank. I also started writing about a lot of my experiences over there in order to give my family and friends an idea as to what I was experiencing, and that was therapeutic. I also came home from there and went into therapy for a couple of years.

Darfur held more harsh conditions, though I don’t know if harsh is a strong enough word to describe the things I saw. On my first day seeing patients there I had a 6-year-old rape victim come in. I went home afterwards, lay on my bed, pulled my pillow over my head and thought “What the F**K have I gotten myself into?” What an appropriate welcome. I told myself that at least it couldn’t get any worse, right? Wrong – it always managed to get worse.

How did I deal with it? I didn’t, really. I still haven’t. It’s probably a good thing that alcohol is illegal in Sudan, otherwise it’s a strong possibility that I would have come home as a raging alcoholic. One night, I was so desperate to stop feeling that if someone had handed me a syringe full of heroin I would have injected myself with it. To this day I don’t let myself think about Darfur almost at all. On the days when I do think about it- if I’m writing an article or preparing for a talk- I usually vomit. Maybe that will change if/when the world finally lives up to its empty promise of “never again” and puts an end to the horrors that we are all letting go on.

Babies in Afghanistan

LB: What are the most difficult parts about being a midwife overseas?

A:  Other than the horrific things you see and deal with? The hardest part, aside from the things you witness and experience, is how much witnessing and experiencing those things changes you- and not for the better. I was different when I came back from the Philippines after my first year there, but after a year or so I felt like I was pretty much back to normal. It was a shock to the system but not permanent. Afghanistan really, really changed me. I came back from there an utterly different person. I was completely hardened, jaded and numb. I’ll never forget sitting across the table from one of my best friends and him looking at me incredulously after I had basically just told him that I didn’t give a shit about anyone or anything anymore and him saying “Who ARE you? You aren’t the Amy I know and love”. To this day I can’t hear the Beatles song “Looking Through You” and not remember that conversation. Darfur had it’s own altering effect on me. When I first got home from there I couldn’t talk. My best friend came with me down to the Oregon Coast and left me to my silence until a week and a half later when I slowly started to talk again. I read a book while I was in Darfur that was really eye-opening. It was an MSF book and there was a chapter that talks about the way people are when they come home from an experience like that. It was the first time I ever heard that it was normal to arrive home and be rageful and awful and hurtful and confused. I think when you’re overseas doing this kind of work you don’t have time to process any of it. You don’t have the time or you don’t have the strength or the energy. So you go home and all of a sudden it all hits you all at once. I have so much rage since being in Darfur I have nowhere to aim it. I feel it towards the entire world for letting what’s happening there continue. Unfortunately, since I can’t take it out on the entire world, when I do let it out it’s often on the people closest to me. Last month I was visiting an old friend I was in the Philippines with and I hadn’t seen since getting back from Darfur. We had been really, really close friends in the Philippines and loved each other to bits. After spending a few days together I asked her “If you met me now, would you still love me as much as you did when we first met in the Philippines?” She hesitated (which pretty much said it all) then told me that I had sacrificed part of myself for the people in Darfur and I was different but that she understood why. I wish I wasn’t this new, angry, serious version of myself, but I don’t know how to go back. How do you just un-know and un-see and un-hear all of the things that you’ve known and seen and heard? It basically comes back to something my friend once told me “Amy, considering the choices you make in life, you just have to accept that you are going to spend the rest of your life in therapy.”

LB: What is it like working with doctors?

A:  That completely depends on the doctor. I’ve worked with doctors who are humble and respectful and treat midwives as colleagues andI have worked with doctors who are arrogant and disrespectful andwhotreat midwives like the enemy. I’ve worked withtwo European doctors who both have a lot of respect for midwives and their capabilities- possibly due to the fact that in Europe the mindset isn’t that birth is a scary medical procedure. In Afghanistan I worked with an American doctor who was happy to take my word for it when complications arose during deliveries. She had last delivered a baby 25 years previously when she did a 6-week rotation as a medical student. Her famous expression was “I’m a rheumatologist. What do I know?” On the other side of the spectrum, I worked with a doctor in Afghanistan who took offense when I was allowed to be trained in a medical procedure that she wanted to be trained in as well. When she said “I’m a DOCTOR and she’s only a midwife” I had to bite my tongue. This was the same woman who had nearly let a baby die during a delivery because she didn’t know how to do neonatal resuscitation and who I finally pushed out of the way and took over from.

Amy in Afghanistan

LB: What made you want to become a doctor?

A:  I had a lot of reasons for going to medical school and an equal number of reasons for not going. There were a few events that played an important part in my decision to go but most of it all came down to one reason- I want to be able to do more overseas. When the tsunami hit in 2004 I wanted to go with the medical teams that were being deployed. I spoke to someone from an NGO who told me that, as a midwife, my skills were pretty specific and they would take doctors and nurses, whose skills were more general, before they would take me. She had a valid point (though midwives have a lot of the same training as nurses do) and that same reasoning was going to limit what I was chosen to do overseas.

Another motivator was a patient that I loved in the Philippines. She died a slow, agonizing death and it killed me to watch someone so lovely and so kind and so gentle-spirited die because she hadn’t had the money for the simple healthcare that would have prevented her from getting that sick to begin with. In the end it was a dental cavity that cost her life and took her from her husband and children. I’ve seen too many people (especially babies) die or become permanently disabled simply because they have been denied one of their basic human rights: healthcare. I want to be on the front-lines fighting injustice like this. To quote Gandhi, I want to “be the change I wish to see in the world”.

Amy in Darfur

LB: I understand you are an advocate of boycotting Nestle and educating people about the damage they have done and are doing in the third world. Can you tell us a bit about this topic and why it matters?

 A: You might not want to get me started on Nestle…I’m a bit of a zealot …According to UNICEF: “Marketing practices that undermine breastfeeding are potentially hazardous wherever they are pursued: in the developing world, WHO estimates that some 1.5 million children die each year because they are not adequately breastfed.” Babies who are bottle-fed are more prone to illness, no matter what country they are in. This is simply because they are missing out on the antibodies that are present in their mother’s breast-milk. Babies who are bottle-fed in certain countries are at an astronomically higher risk of illness and death. This is because of the lack of clean water, the inability to sterilize the bottles and/or the family’s poverty leads them to over-dilute the formula. These three factors can lead to fatal cases of diarrhea, dehydration or starvation.

Nestle is one of the most aggressive marketers of baby formula and consistently finds ways to undermine breastfeeding in favour of infant formula. Their employees stand in the aisles of supermarkets in the Philippines, dressed professionally, convincing people that it is better for their baby to be bottle-fed. Their employees “befriend” hospitals, doctors clinics and maternity centers and their staff (take them out bowling, for dinner, bring gifts, etc) in order to have the staff wear Nestle labels on their scrubs and/or put up posters. In Afghanistan they were the only company to sell infant formula and they had managed to brainwash the women so well that I had to fight them tooth and nail to breastfeed. Often they would use most of the family income to buy the formula and their other children would go hungry as a result. The ones who couldn’t afford the Nestle formula were so convinced that their breast-milk was bad for their babies that they would give them chewed up cookies and sugar-water instead. Want to guess how long those babies lived? I can’t even count how many babies I’ve seen being buried because they were given Nestle formula instead of their mother’s breast-milk. Nestle is evil. They know that their efforts to improve their profits cost babies their lives. And they do it anyways. My sister says, “At the end of the day you only have yourself to face. At the end of your life, that is another matter altogether”. I agree.

Here is a great anti-Nestle site that has all of the facts.  

QUOTES Amy lives by:

If you are humble, nothing will touch you, neither praise nor disgrace, because you know what you are” – Mother Teresa

“I don’t know what your destiny will be, but one thing I know: the ones among you who will be truly happy are those who have sought and found how to serve others” -Dr. Albert Schweitzer

“There is one right I would not grant anyone. Andthat is the right to be indifferent.”- Elie Weisel

“Be kinder than necessary, for everyone is fighting some kindof battle” -John Watson

“If we have no peace, it is because we have forgotten that we belong to each other” – Mother Teresa

“Spiritual people inspire me. Religious people frighten me” – ?

“Great spirits have always encountered violent opposition from mediocre minds” – Albert Einstein

“Well-behaved women seldom make history” -Laurel Thatcher Ulrich

“It would be better to be born without arms than to go through life with no guts” -The Bridge to Terebithia

zoe+loadedbow

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21 Responses to “Amy Osborne: Overseas Midwife”

  1. Thanks, Amy. I am humbled that my quote meant enough to you to remember and to use. I think it is a fabulous article about a fabulous young woman, and I am not in the least bit biased.

  2. Beautiful. Not too brutal…just real. Thanks for being the change we all want to see in the world. Cebubians WILL make it happen!

  3. Once again I am reminded why I am considered honored to be among your circle of friends…I’m so excited to continue working with you in your unique role as G.E!

  4. My heart breaks more for you than any story you talked about. It sounds like the weight of the world has been placed on your shoulders. May you find the ability, while being an instrument of love, to somehow transfer all of this pain off of your shoulders onto His. With much love and prayers.

  5. fantastic interview ames.

  6. I’m humbled by reading what you have experienced in your life. I’m also shocked by the activities of Nestle in the Phillipines. I was under the impression that legislation had been passed to stop that blatant advertising! Did I dream it!!!!!!!!!!!

  7. Emily Gemmell Says:

    Hi Ames — Thanks for telling your stories — It makes me remember what I want — read this last night and thought of you “Only to the extent that we expose ourselves over and over to annihilation can that which is indestructible be found in us.” Love you.

  8. Emily Gemmell Says:

    Thanks for telling your stories — It makes me remember what I want — read this last night and thought of you “Only to the extent that we expose ourselves over and over to annihilation can that which is indestructible be found in us.” Love you.

  9. Annemieke Says:

    Inspiring Ames. You are an amazing chick and will always be dearly admired for what you do and for bringing awareness into the lives of us who love you, and who maybe don’t carry that kind of perservering strength and selflessness to actually make such critical changes happen. you truly are some kinda angel

  10. Hey Libby, yeah, unfortunately you might as well have dreamed it. No matter how much legislature is passed regarding the marketing of baby formula, Nestle finds a way around it, or targets countries where there isn’t the money to fight it, or simply finds a new way to market it that hasn’t been around long enough for it to have been legislated against yet. And they are expanding their awesomeness- google “Nestle Boycott” and you will find a plethora of articles about their new activities. They are fairly ingenious. If only they used their power for good rather than evil….

  11. Amy, you have a remarkable ability to tell stories which i’m sure are exceptionally difficult to share. i hope you realize the profoundly positive impact you have made on those around you and those you’ve encountered overseas.

  12. Wow, that brought tears to my eyes and makes me miss you so much! I have not forgotten who you are, God has broken your heart for the things that break His heart! Don’t loose sight of that, even when darkness falls! You are such a special woman, and have a rare ability to care for the least of these! Look upon yourself for a moment and imagine looking down and seeing all the brokness and compassion you feel for those people suffering around the world, and for just one second see it through God’s eyes and know how much more he is broken for you and how much he loves you! You are not alone in this, even though I know there are days where you feel abandoned in it. I love you to death and I am proud of you! You have stood against the norm and given your life to serve those less fortunate then you. You are stronger then you realize. It was hard for you to leave some of those places, feeling hopeless for change, but the truth is you are changing things, with out even realizing it. You make an impact on everyone you meet. You are going to school for a good cause, it is not in vain and the more you know, the more you can make an impact in the future. It is not our jobs to change the whole world. We just can’t do it. But I do believe we can make a difference one person at a time, and as we do that it is our hope that it spreads and people will begin to do the same. Just be yourself and love you! Seriously, you have one of the biggest hearts I have even known…but you know it is crazy because you and I are similar in that it is so great that we are broken for so many people who most people could just walk past and not even blink an eye, yet it really sucks to be someone like you or I, because we take that brokeness and if we are not careful it can affect of everyday lives in a negative way and it really hurts. We try too hard to cary the burden on our own, when it was never our burden to cary in the first place. We have to beable to lay it down at the end of the day to let God carry it for us, or we will not stay well enough to continue this for the long run. Love you and thanks for sharing with us!

  13. Amy, you continue to inspire me and I wish I could help you feel better….I miss you lots
    xo

  14. My life has forever been change since the Philippines… and i will forever be thankful to God for that! So thankful you are obeying what He has called you to do my dear sister Amy… i love you, my heart is with you!

  15. ames- your life is well lived, b/c you love extravagantly. You give everything to serve, you’re a living sacrifice. I’m challenged & humbled by you, and so thankful for your life crashing into mine.

  16. Amy is a caring heart. She is always willing to help and she is a person I can count on. Strong , encouraging, independent , intelligent woman are just a few words to describe her. I can not forget how much fun and happiness Amy brings where ever she goes. Amy- Continue with your success 🙂

  17. Amy- thank you for writing what you did about your experiences. I couldn’t stop reading it tonight. It brought back so many memories. You have amazing ability to see the needs of others and meet them in a practical way- that is a gift from God. Events like you have seen and experienced will never go away, I sure wish they would. Love, you are remarkable and the God who created you and lives in you is so alive in you. It is evident in all you do- that is the very reason why you’re so passionate about all you do. Love you friend.

  18. Hello,

    I was searching the web for opportunities to help pregnant women overseas when I found this blog. I am not a trained midwife but I am currently applying to medical school to become an ob/gyn. I desperately want to serve in this capacity and have five years of hospital experience. If you or anyone has information that would help me acheive this goal, please, please contact me at draya16@hotmail.com

    Thank you,

    Andrea

  19. I loved what I saw of your site…
    you are doing what my heart’s desire is to do. I did some basic midwifery training for a year with my organization and am now wanting to get back out overseas to do midwifery. All of my training was in India, Sudan and Indonesia. I’d love to hear more from you. Is there opportunity to work with you or do you have some clinics you might recommend to a new midwife still learning to volunteer at???
    Thanks for sharing your stories. I just randomly found you on goggle 🙂
    Blessings!!!

  20. shari daniels Says:

    Amy, I have been a miwife for 37 years and have worked all over the world but never with an organization. Would love to know what organizations are out there and how to help them. Please contact me via e mail. Thanks and thank you for sharing. G-d Bless. Shari

  21. Hi Amy first I want to say you are a very special person. I breifly spoke with you at ETSU about save Dufar. I have a passion for this cause and I want to help. I have began my letters to President Obama, and Oprah Winfrey. In the mean time if you can think of any thing else I can do please let me know. I am also on face book. I am a student at Walter State Community College I am majoring in Nursing. I would love to do mission work someday. Thank you For all you do ! Tammy Bell

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