SMH ultrasound technologist Sarah Schneider teaches midwives in the Philippines
In September, Sarah Schneider, an ultrasound technologist at the Sheridan Memorial Hospital Women’s Clinic, spent 10 days volunteering in the Philippines, where she provided hands-on ultrasound training to local midwives.
The journey to Linapacan
After a journey that took her from Sheridan to Denver, then San Francisco and Manila, followed by a short flight and a four-hour boat ride, Schneider finally arrived in Linapacan, a remote island municipality in the eastern Philippines.
Healthcare challenges in Linapacan
With a population of about 16,000 people spread across 10 islands, Linapacan faces significant healthcare challenges. Among one of the poorest municipalities in the country, Linapacan has limited access to running water, intermittent electricity and no roads linking the islands. The area is served by just two doctors and a single main clinic responsible for the healthcare needs of all its residents. For complicated childbirth cases, reaching the nearest hospital requires a five-hour journey by boat.
“They have amazingly trained midwives on the island,” Schneider noted. “But they lack the tools needed to diagnose some complications that could come up during pregnancy and childbirth.”
The role of Life Matters International
Schneider traveled with Dr. Stefan Haller, executive director of Life Matters International. The San Francisco-based nonprofit is dedicated to reducing preventable maternal deaths by promoting disease prevention and establishing sustainable, equitable and technology-driven healthcare systems in rural and underserved communities in the Philippines, including Linapacan. Life Matters International conducts one-to-two week missions multiple times a year, training midwives in these areas to effectively utilize ultrasound technology.
Answering the call to volunteer
Although she had considered volunteering in the past, it was a post from Life Matters International seeking volunteers in an online sonographer group inspired Schneider to take the leap.
Meeting the Midwives of Linapacan
After arriving in San Miguel, one of the main villages on the largest island in Linapacan, Schneider and Dr. Haller met with two midwives who had previously been trained in ultrasound by Life Matters International, as well as a community liaison who helped the group navigate the area and communicate with residents who couldn’t speak English.
Hands-on training with new ultrasound technology
Life Matters International had secured a stationary ultrasound machine for the main clinic and birthing center in San Miguel, as well as a portable, battery-powered ultrasound machine. Traveling between the islands by boat, Schneider and her team, alongside 14 midwives from Linapacan and local doctors, used the portable ultrasound at urgent care clinics in other villages across the municipality to provide vital services to women throughout the area.
Schneider was responsible for providing hands-on training to the midwives on operating ultrasound machines and identifying potential complications that could arise during pregnancy and childbirth. As patients arrived at the main birthing center and other clinics, Schneider guided the midwives through the process, encouraging them to operate the ultrasound machines themselves instead of observing her.
The impact of ultrasound training on the community
During her 10 days in Linapacan, Schneider encountered a diverse array of individuals and medical conditions. One significant case involved the midwives discovering a complete placenta previa—a condition where the placenta blocks the cervix during the later months of pregnancy, potentially leading to severe bleeding—using their new ultrasound machines, which likely would not have been identified without the technology.
The timely diagnosis enabled the woman to be quickly transported to a hospital in Manila, where she delivered her baby via C-section. Both mother and baby were healthy; had she delivered at the birthing center in Linapacan without a surgeon or obstetrician present, the outcome could have been dire.
The cultural impact of ultrasound technology
Interestingly, not all patients examined by the ultrasound machines turned out to be pregnant. Some individuals, lacking access to pregnancy tests, believed they were three or four months along, but ultrasounds revealed otherwise. In these cases, patients were referred for further medical care to investigate their symptoms.
Schneider also recalled a day when an older woman stood on the fringes of the crowd in the birthing center. It took a moment for the team to realize this woman was an elder from one of the island’s indigenous tribes. Traditionally, these women acted as midwives, assisting their community in delivering babies, and they typically did not seek government healthcare. However, this elder was drawn to the birthing center out of curiosity about the ultrasound technology. Initially standoffish, she gradually moved closer and became more engaged, eventually interacting and talking with the midwives.
A lasting connection with Linapacan’s midwives and residents
For many patients, Schneider observed that learning how far along they were in their pregnancy, discovering the gender of their baby or even finding out they were having twins when they hadn’t known before became significant bonding experiences with the midwives, and this connection fostered greater participation in the healthcare system.
“Not only is ultrasound a great tool to catch potential issues, but it also allows midwives to bond with their patients,” she explained. “Many patients hadn’t seen a midwife before; they came in because they were curious about the new technology or wanted to find out if their baby was a boy or a girl. Many wouldn’t have come in otherwise.”
Reflection: The difference between Linapacan and Sheridan
When asked how her experience influenced her view of her role at Sheridan Memorial Hospital and its significance in Wyoming, Schneider remarked that the objectives of ultrasounds in Sheridan are significantly different from those in Linapacan.
“The things we’re looking for are so different,” Schneider explained. “Here in Sheridan, we’re looking for tiny abnormalities so these babies can go to a hospital to be taken care of. In Linapacan, we’re looking for issues that must be caught to prevent the mother or baby from dying during childbirth.”
Kindness and Community: Lessons from Linapacan
Reflecting on her time in Linapacan, Schneider emphasized the kindness and pride of the residents in their community.
“They treated me with so much kindness, and they were so welcoming. The children really stood out to me because they rarely leave the island, so for many, I was the first girl they had seen with blonde hair. They would come up to me, say hi, giggle, and were just so sweet. They are the kindest, most respectful people, and it’s not just towards me; it’s how they treat each other as well,” she said.
Schneider also praised the midwives of Linapacan and expressed her hope that her time and expertise would support the healthcare system there.
“The midwives are excellent at their jobs. They work in a place where they can’t just transfer a patient to surgery if there’s an emergency, and they’re amazing. The ultrasound machines and training will be another resource to help them catch issues earlier.”
Looking forward: Plans for future volunteer work
Schneider hopes to return to Linapacan next September to attend the graduation of the midwives she trained. She also plans to visit another Philippine community, Lubang, for the first time to begin training midwives in ultrasound there. Ultimately, she aims to make volunteering a yearly or semi-annual experience.
Encouragement for other healthcare professionals
Schneider encourages other healthcare professionals who are considering volunteer work like hers to take the leap.
“Absolutely do it. It’s very rewarding, and I feel like I learned more from the residents of Linapacan than they did from me,” she said.