Monday, July 19, 2010

PUTU'S PLACENTA


 Dayu, our pregnant cook, carrying her offering to the temple

(In January 2010, Phil and I spent three weeks in Bangkok, Thailand.  We went for Phil's annual medical check-ups and to renew our visas for Indonesia .  Toward the end the visit became quite traumatic. See my February 17, 2010 post. "You Never Know," on my other blog at http://ezinbali.blogspot.com)
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Shortly after our return from Bangkok, I'm resting on the couch, when my phone rings. I've not been well. I'm still reeling from three weeks of breathing Bangkok's heavily polluted air and from my unexpected hospitalization at Bumrungrad Hospital.  Now back in Bali, exhausted, facing a backlog of work, and having the runs for the second day, it's all I can do to keep myself together.

I pick up the phone, hoping it's Pak Layar, the electrician, telling me what time he's coming over to fix the air conditioner in the upper bedroom suite. The stupid appliance, made in China, has been acting up for the third time this month and the California couple occupying the room are threatening to leave for a better hotel. But it's not Pak Layar on the line, it's Dayu, our beloved cook. She is in the hospital. Finally. We've all been waiting for her call. This is her first baby and she is past due.

“Dayu, how are you, sweetie?” I ask.
 “Not so good.” she answers in a little voice. “It hurts.”
 “Aw, I know. Is your mother with you?”
 “No, she is preparing offerings for me and the baby.”
 “What about your husband? Is Ketut there helping you?”
 “No,” she whimpers, “I'm alone.”

Oh my god, her first baby and she’s all by herself. Shit.

“Where are you, Dayu?”
Gianyar Hospital.”
I don't really want to, but I ask her anyway.  “Do you want me to come and be with you?”
“Yes, please.” she cries.

Oh god, I don't want to go out there. It's a 30 minute drive and who knows how long her labor will be. Plus, I've got the runs, damn it. It's a public hospital.  You don't ever want to have to use a public hospital's restroom in a Third World country. But I love Dayu and she needs me.

I turn to Phil for medical advice.
“Phil, how much Immodium do I need to take to stop the diarrhea right now?”
I never take allopathic medicines, preferring herbal treatments..
“Two pills will do it.” he says.

Suamba, our driver, picks me up. Traffic is thankfully very light and we pull up into the hospital's parking lot in less than 20 minutes. At the far end of the parking lot is the hospital's temple. A woman is making offerings of frangipani flowers, incense, rice, and an assortment of sweets wrapped in banana leaves. We recognize her as Dayu's mother, and Suamba and I walk over to join her. She is just finishing up. We watch her say her final prayers in front of the Ganesha statue at the main entrance of the hospital and then follow her to the birthing room, wending our way through various buildings that are connected by covered walkways..

At some point we pass by what looks like a ward, overflowing with patients with various ailments. Some lie on narrow cots, surrounded by family members. Some are covered in bandages. Some are attached to IV lines. Others look like they're still awaiting treatment. No doctors or nurses in sight. The room is semi-dark and smells of endless waiting and mute resignation.

When we finally arrive at the entrance to the birthing room, we find the doors closed and the hallway crowded with the patients' families, sitting or sleeping on the floor.  We learn that Dayu shares the birthing room with three other women, two of whom have just entered the last stages of labor, which is why the families have been told to leave the birthing room. I'm happy to find Ketut sitting on the left side of the open hallway with Dayu's sister Komang.  There is nothing else for me to do but to join everyone else on the floor. It's a tiled floor, cool but hard, and of questionable cleanliness.

I make myself as comfortable as I can, envious of the Balinese ability to spend half their lives sitting on tile floors with nothing to lean up against, or kneeling during endless ceremonies on the equally hard floors of the temple. I once witnessed a crowd of men, women and children kneel motionless on the concrete floor of a temple courtyard -- hands in prayer against forehead, flower between middle fingers -- all the while being pummeled by heavy rain. The Balinese know how to endure.

The Balinese also like their food.  It doesn't take long before I'm offered some of their goodies wrapped in banana leaves. Shoot. Ordinarily I'm overjoyed to eat anything wrapped and steamed or roasted in banana leaves, but mindful of my diarrhea, I demur, saying, “Oh, I'm not hungry, I've just eaten.” I know that that is a lame excuse. In Bali you eat not just when you're hungry, you eat whenever there is food. So I'm left eyeing everyone eating the delicacies that Dayu herself had prepared this morning before she left for the hospital. Really?  She is beginning her labor and she prepares food for the family?

“Did Agung drive her?” I ask.
Agung, her uncle, is a kind and handsome man who owns a car.  Since he is fluent in English, he is much in demand as a driver and tour guide. I had asked him to take Dayu to the hospital at my expense when her time came.
 “No,” Ketut answers, “Agung was not available.”
 “Did you get a cab then?” I ask, thinking I would reimburse him for the fare.
 “No, we came by motorbike.”

Holy Jesus Mary Almighty, thirty minutes on the back of the motorbike while you're having labor pains! I can't believe it.  And yet, I can too. Balinese women are the most awesome women I have ever met. They are the construction workers, carrying stacks of bricks and concrete blocks on their heads from the road to the construction site and back, all day long. They pour concrete. They're up on the roof. They work the rice fields in burning heat, planting and harvesting. Village women working together, laughing, gossiping. They make us look like a bunch of pitiful worthless wimps. Dayu on the motorbike in labor...

Komang, Dayu's younger sister, starts massaging the sole of her mother's left foot. The mother sighs and lowers herself onto her side. They're talking quietly among themselves. Suamba and Ketut are also talking and laughing softly. Everybody is sitting here, waiting patiently, hanging out together. I find myself relaxing. Looking around me I can't help smiling.  I'm smiling because I'm sitting on the floor with a bunch of Balinese and I don't understand a word they're saying. I'm smiling because time does not exist, because I belong here and I don't belong, because I'm waiting for a baby, because I rushed here thinking that Dayu was alone but she is not, because I have lots to do and am doing nothing, because life is so strange, and because the Immodium pills worked.

One hour later, the doors open, and one husband is ushered into the birthing room. He soon reappears carrying a small bucket. Aha, the placenta. That reminds me. I turn to Ketut.
 “Have you decided what to do with the placenta?” I ask him.

Even though Ketut's family is Balinese with a long line of ancestors from the Karengasem district, his immediate family has settled on the island of Lombok, a 3-hour ferry ride away, where they run a palm sugar farm. The Balinese feel intimately tied to their land. The placenta represents the soul of the newborn baby and must be immediately buried with great ceremony in a designated spot on the father's land. Since Ketut does not own any land in Bali, he will have to find a way to bury the placenta on his father's land in Lombok as soon as possible after the baby’s birth.

Ketut has three choices:

1.      He can bury the placenta in an earthen pot and guard it with his life until the time mother and baby are allowed to travel with him to Lombok two months after the birth. The drawback: Someone who means them harm could steal the pot with the placenta in it and perform black magic. The baby's life would be in danger.

2.      He can put the placenta on ice, drive his motorbike to the harbor in Padangbai, and take the next ferry to Lombok. The drawback: The cost and the possibility of no ferries if the baby comes at night.

3.      Ketut could plastic-bag the placenta, strap it to his waist, swim out into the ocean, and drop it in deep water. Major risks are sharks, treacherous currents, weather conditions, ocean conditions, Ketut's untested swimming skills, and the possibility of the placenta being washed back to shore. Our indigenous healer, Jero Mangku Made Rata, had also added another caution. He said that a placenta dropped into the ocean would predispose the child to grow up as a restless wanderer, someone who would not honor his family and ancestors in Bali. That would drive a spear into the heart of a Balinese.

My question to Ketut: “What have you decided?” was a typical western-framed question. A decision about placentas is not made by one person, even if he is the father. Decisions are made by the whole family in consultation with their community priest. I knew that Ketut and Dayu had made the trek to Lombok earlier, specifically to address the placenta issue. As if my voice counted, I had stressed my intense opposition to the ocean swim option many times before. Dayu had agreed with me. So I am stunned now when Ketut answers that his family had decided on the ocean swim. I nearly jump out of my skin right then and there. I leap up, stare Ketut in his eyes, and threaten him and his whole family that if they stick with that decision, I will... I will what...?

Everyone in the hallway is watching me, this strange local lady.  She must be Javanese.  Javanese people are so uncivilized. They make scenes.  You see it on TV all the time.  Bad manners. 

I feel helpless. I'm outraged. Don't they know how many people drown in Bali's waters? I thought they were afraid of the ocean spirits. So why the hell do they want to risk Ketut's life? In my eyes I see him swimming at night, always at night. It just gives me the willies. It scares the shit out of me. So, is it about my own fear of swimming then? My nightmare of drifting in the ocean at night all by myself, lost, abandoned, predators lurking underneath? As Phil would say, “Beware of projecting.” Maybe it's okay. Maybe the baby will come during the day and Ketut will be fine.

“I will be... very... angry.” I finish lamely.
Then I ask, “How much is a ferry ride?”
“One hundred fifty thousand rupiah one way” Ketut answers. That’s only about $15, not much for me but a fortune for Ketut.
I pull out my wallet and count out three 100.000 rupiah bills and press them into Ketut's hand.
“Take the ferry.” I tell him, hoping that the money will persuade him and his family.

I lose track of how long we’re waiting outside, but at some point I decide I’ve finally had enough.  It does not look like any of us will be allowed inside the birthing room soon to be with Dayu.  It is getting late and I am getting stiff from sitting on the hard floor for so long.  Suamba and I take our leave.  We shake each person’s hand and bow with our hands in the “Om Shanti Shant Shanti Om” position.  I make Ketut promise to call me as soon as the baby is born, no matter what time of the day or night. 

Dayu’s labor turns out to be painfully long.  Little Putu is not born until a day and a half later.  When Phil and I finally visit Dayu in the hospital, we find Putu in another room asleep in a plastic box-like contraption that is supposed to pass for an incubator.  He had swallowed amniotic fluid during the birthing process which caused complications.

When I watch Dayu’s mother taking a bottle to feed him, I turn to Dayu to ask if she has put him to her breast yet.  She tells me that she tried but was unsuccessful. Because of the complications, she did not get to hold her baby until six hours after his birth.  When she tried breastfeeding him, she found that she did not have enough milk and that Putu did not want to suck.  She gave up because she was still so exhausted from the long labor.

I don’t know much about birthing and babies, but one thing I do know from personal experience is that you put your baby to your breast as soon as possible to get the milk flowing and to teach the baby to suck at your nipple.  None of it is particularly pleasant at first.  It actually hurts to get the milk flowing and sucking milk from a nipple demands more work from the baby than sucking it from a bottle.  When you are so exhausted, it is the last thing you want to have to do.

I encourage Dayu to go ahead and breastfeed Putu now.  There are no comfortable chairs in the room, but we find a plastic stool for Dayu to sit on.  She takes Putu out of the “incubator” and puts him to her breast.  Poor little thing just wants to sleep.  Plus, having been fed with a bottle already, he is not really motivated.  Dayu struggles. The room is hot.  She soon is covered with perspiration.  But she knows how important it is to breastfeed Putu and she is determined to do it.  Her mother wipes Dayu’s face and I am supporting her back, all the while cheering her and Putu on.
“Look how well your milk is coming.”
“See, it’s working.” 
“You can do it, little baby boy.” 
“Yeah, keep going, keep going.”
It’s hard work for Dayu and little Putu, but it’s working.  I’m so excited.

Before we leave I ask Dayu what Ketut did with the placenta.
“He took the ferry to Lombok.”  She smiles. 
The placenta has been buried safely on his family’s property with all the right ceremonies.
I heave a sigh of relief.
Dayu with baby Putu (4 months)

1 comment:

  1. It seems you have a lot of endurance too..sitting on that cold floor, handing out 100,000 rupias...worrying..waiting for a blessed event and a gorgeous baby.

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