July 2nd (Monday)

Today we spent the morning in “The Mall” helping Ruth sort the packages that hadn’t yet been opened. We opened them and sorted the clothing into girls or boys and specific age ranges. We were all agreed that it would be fine if we never saw another reversible outfit again. They were all handmade and someone put a lot of time and effort into making them and sending them. However, they made them out fo the most interesting/questionable fabrics and patterns (most with very colourful frogs). It was also very difficult to figure out the sizes, gave us a good headache for sure!

We worked until 10am and then had a tea break. Ruth had freshly squeezed orange juice for us-absolutely delicious! She also had very good bran muffins with raisins and craisins which was very refreshing to have with the orange juice. We sat on the front porch of Ruth’s home with a beautiful view of the valley and Zambezi river below. We were joined by Ruth, Phil, Tom, and another local man helping install new kitchen cupboards in the Hanna’s home. Gordon and Garrett had left early in the morning to go to the Chingola area to see where the shipping containers arrive.

We finished going through all of the unopened boxes shortly after 1pm. Nicole and Fiona told me to go get my camera to take picture in the Mall. So I went back to our house to get it, Tom and Phil passed me on the four-wheeler saying I was going to be late for lunch… bu they didn’t realize that I wasn’t as we weren’t invited to lunch this Monday (Dorothy normally hosts lunch for visitors on Mondays). Earlier Dorothy made a point to find us and tell us that we were not to come to her house for lunch, hahaha, she said that she was just going to have the others this time. We definitely understood and were not offended, just amused.

So I took some pictures and we finished sorting the last box and took the few things we gathered from one of the containers earlier when Ruth was there as we asked if we could have a bit more food/cans to cook with. When we got back to the house we discovered/remembered that Monday and Tuesday are Zambian holidays and Thomas was not going to be working as evidence by the mountain of dishes still present on our counter, haha! We relaxed for a little while, then Nicole began to make peanut butter cookies.

Tiffany then sent Fiona a text saying that a patient had arrived and they were going to start surgery for a perforated bowel.She said that some of us could come, so we didn’t think that meant all 3 of us so Fiona and Nicole decided to go up and help out while I stayed and was going to make supper. (I made roast chicken, chickpea curry, rice, and coleslaw). After they left I washed the mountain of dishes that had piled up from our weekend and the fact that Thomas wasn’t working because of the holiday. That took me awhile and then I started on the supper. After I had pretty much finished supper I had gotten a text that Tiffany sent that said they would still be a little while. So I ate my supper and then decided to have a shower.

Fiona, Nicole, and Tiffany came through the door at 10:15pm (they left around 5pm…). I knew immediately that they had a crazy night by their facial expressions and also by the evidence of some dark fluid that had soaked the front of Nicole’s shirt, they looked exhausted. Nicole and Tiffany showered while I heated up the supper I had made while Fiona gave me the low down on what had happened: Apparently a man came in that had an abdominal stab wound that had perforated his bowel. How this happened was that this man had owed someone (he said his “friend”) about 5 kwacha (about 50 cents US) and the man couldn’t pay back the debt. He asked for more time and then the person who wanted his money back stabbed him. They had a lot of trouble inserting the NG tube (the man wasn’t cooperating) and also did not want them to insert the catheter either. So it took a long time just to prep the patient for surgery. The patient vomited partially digested nshima all over Tiffany, some went down her shirt, in her face, and in her hair. Nicole’s shirt was probably soaked in some sort of bodily fluid -likely blood, but perhaps iodine… The surgery itself went alright though. When he was waking up the ketamine made him aggressive, however, he also proposed to Nicole, several times. He was persistent.

So when they all sat down to eat supper they were grateful to be clean and they had high praise for the meal I had made for them. Around 10:30pm Tiffany went home to bed and the rest of us retired for the evening.//

July 1st (Sunday)

It’s the first day of July and Canada Day! It’s quite strange to be out of the country on Canada Day. It is a first for me to not be in Canada on July 1st, but I am very grateful to be here in Zambia and value the experiences gained that I never would have had if I stayed in Canada. It is also Sunday so we went to the church building just up the hill from the house. There was a definite increase in the amount of people (mostly additional women) as there was a women’s conference going on this weekend located at the colony here on the mission.

Once again it was a very enjoyable breaking of bread meeting. The majority of it is in another language, however, I can pray silently my thanksgiving to the Lord for the great sacrifice of His death on the cross as the others are doing so in their own language. Also, the songs are in another language but the tunes are usually the same and the words are phonetically spelled so we can sing along. The singing is wonderful here, I know God enjoys the joyful noise made to Him from Chitokoloki. After the meeting was over it is followed by a short break and then the gospel meeting is immediately afterwards.

We then went back to the house and had leftovers for lunch as we (Fiona and I especially) were starving. We again spent the afternoon outside and missed going to Sunday School but we don’t really get to do too much there anyways. Then in the evening we had supper and I made beaver tails to celebrate Canada Day and they turned out very well! We also put on any red and white or Canadian type clothes and had our own little celebration. Very thankful and proud to be born in and call Canada my home!//

June 30th (Saturday)

We were all very grateful to be able to sleep in a bit today. Yesterday was very busy. It was nice to have a slower morning. We had pancakes a la Nicole. Mwansa gave us some syrup so we definitely took advantage of that. We then took our books out to our back porch and sat in the sun soaking up the late morning warmth.

For lunch we made coleslaw and Nicole found a great homemade coleslaw dressing recipe online and it was simple to make and very good. We ate outside and Nicole and I also made salmon sandwiches. We joked that Fiona was eating cabbage for all meals of the day! But hey, I guess, ’tis the season, hahaha! We finished our afternoon outside and moved indoors for supper.

When Fiona came inside she discovered that her window had been broken and there was glass all over the bed (there was 2 small beds in her room and it was on the one she hadn’t been sleeping on) and there was glass on the floor and what looked to be bird poop on the bed and a small feather. At first glance it looked as if someone had thrown a rock except there was no rock and so with all of the bird evidence we figure a bird must have flown into the window. We did hear a loud bang when we were outside reading but didn’t think much of it. We never found the bird in the house so it must have flown out the way it had come in.

For supper we made a new variation of our fried cabbage, this time we added some chick peas and beets which gave it a nice bright colour and it was very tasty! We also made lemon meringue pie. We played some Mexican Train to finish off the evening and Fiona was finally able to call her parents. Also, I got a funny half leg burn and Nicole got a slight burn too haha.//

June 28th (Thursday)

Fiona and I got up and went to Kariba at 7:15am to attend the devotional that Gordon does with the staff every Tuesday and Thursday. Nicole went out with Dorothy to administer praziquantel. We joined ward rounds and were finishing in the ICU (the first ward) when Alison said she would get the patient ready for the ventral hernia repair. Dr. Lipsi then asked Fiona, Kennedy, and I whether we knew the difference between an incarcerated and a strangulated hernia. An incarcerated can be reduced and there is still good blood flow. But a strangulated hernia is an emergent situation and the blood supply is being cut off and the bowel is dying.

So, Fiona scrubbed in and was the scrub nurse and was responsible for all of the instruments. She did quite well for her first time. I have not yet been the scrub nurse. however, the next case that I assisted with was a BTL. I was Dr. Lipsi’s first assistant. That means I was holding the retractors as he positioned them, cutting the suture string, providing counter traction when he was using the scalpel and diathermy.

We finished those 2 cases and had a quick MUA (move under anaesthesia) -the same boy we had done it for a few days ago. We had to give his arm more traction and try and set the bones better and then re-apply the collar and cuff. When he was under ketamine he was quiet unlike others and his eyes were open and sadly one little tear slid down his cheek. As we finished the MUA Kate came in to look for an eye guard as Phil got some metal in his eye somehow while working on the roof at the duplex. Dr. Mwansa was able to remove the metal splinter alright. He was then told to wear an eye patch. Fiona and I decided that before going home for lunch we would check on the labouring woman in maternity that Tiffany had told us about. The woman was just young (only 18 years old) and this was her first child. We were in maternity ready to help and learn what the protocols are for monitoring the progression of labour. Fiona did a VE (vaginal exam) and we checked the fetal heart rate. After about 2 hours passed and there didn’t seem to be any progression the nurse/midwife called Kate. She and Tiffany came shortly after to assess the patient. Kate decided that a change in scenery would help so we went along to the theatre as it was quieter and not as many people hovering around where Kate could coach her. She was slowly making progress so after a half hours Kate called Mwansa. They decided they should give some oxytocin and maybe help things along with a vacuum or something.

Just then a doctor from the government who was inspecting things at the hospital came and they thought it best that because we weren’t licensed and just students that we should make ourselves scare until the doctor left. So we went to the tea room and waited 30 minutes. Tiffany came in to get something and we asked how the patient was doing. She said that the baby was born and all was well. We said to ourselves “OH, we just knew it!” As soon as we were going to leave we knew she was going to have her baby. All we wanted to do was observe our first natural delivery of a baby and we were waiting so long for this one, even skipping our lunch and missed it. But we did have a good laugh and there will be more babies born while we are here. So we collected our things and went back to our house. We were just relaxing and we were very hungry, we had some sweet potatoes I had cooked the other day to last us until 7pm as Alison had invited us over for supper.

Nicole got back around 6pm and Fiona and I both had showers before so Nicole fit in hers and we went over to join Kate, Owen, Tiffany, and Mwansa at Alison’s for a very delicious dinner of chicken with a chickpea curry sauce and rice with granadilla (passionfruit) juice. After we had supper we played a few rounds of Jenga and it was very fun, especially with a hyperactive Owen to watch out for around the precarious Jenga tower. Mwansa went home then as she wasn’t felling too well. The rest of us pulled the couch and coffee table close to the nice cozy fire going in the fireplace. Joey came to get Owen to put him to bed and we played several quite hilarious rounds of Uno (that we played with Monster High version of the cards, haha). It was about 10:30pm when we called it a night and returned home to go to sleep.//

June 27th (Wednesday)

This morning we headed off to the “Old Hospital” as there is usually a teaching session there on Wednesday mornings, however, there was no one to teach this Wednesday. So we then went to Kariba to join ward rounds. Except we had to clean up the tea room from all the baby bundle stuff from the day before. So we were able to skip out of ward rounds this time and clean up the tea room so that we could have it ready when we would break at 10am for tea.

But then as we finished that task we were informed that they were setting up for the bowel obstruction surgery. Fiona scrubbed in and set-up all the instruments (it was her first time so it was a bit challenging to differentiate them all). I was helping Jack doing the circulation nurse’s role. Nicole and I were also assisting Alison and Dr. Mwansa with anaesthesia while Dr. Lipsi performed the surgery with Kennedy, Queen, and Fiona. The surgery went through tea time so Nicole and I switched off with Alison to bag the patient while we went for a drink of water and some peanut butter cookies.

Later when the surgery ended it was roughly time for lunch and Dorothy had kindly invited us for another lunch with the visiting men and Alison came along as well because she’s home alone as Chris has gone to China to get some things and he is trying to organize a test flight he has to pass for some sort of additional inspection they changed for every 3 years to every year.

At lunch we heard some repeat funny Dorothy stories and some more of Dr. Lipsi’s fascinating stories of where he has lived and some of his experiences as a US military surgeon and as the son of a missionary in Brazil. He is very wise and experienced in many things and I have a deep respect for him as a person, a doctor, and as a fellow believer. He at times speaks slowly and very measured, you just need some patience because you will likely learn something interesting and valuable.

After lunch we returned to the hospital to see what we could assist with at the clinic. There wasn’t much going on so we returned to our house and had a more relaxing afternoon. We didn’t eat much for supper as we didn’t feel overly hungry since we had eaten our fill at Dorothy’s. We played some games to end our evening and I got in a quick video call to Caleb to wish him a happy graduation day and say that I missed him and wish I could have been able to attend his Gr. 12 Graduation.//

June 26th (Tuesday)

Today Nicole and I went up to hospital for the devotional at 7:15am and Fiona went with Dorothy to see her chronic patients around 8:00am. We began the day by going to outpatients to learn what they do there. We began by taking vitals for a patient and watching and RDT (rapid diagnostic test – it indicates malaria if positive) as well as observing what a clinical officer does when they assess people. He (the clinical officer) also quizzed us on what questions we should ask and got us to be involved by performing a chest exam. Tiffany then interrupted to ask if we wanted to see a hernia repair that Dr. Lipsi was going to do on a young boy. We both said yes and then followed her back to the theatre.

I scrubbed in a bit late but I became the third assistant. I was able to hold the retractors and clips while Dr. Lipsi worked. The next case was a young girl who had a burn to the elbow and they were going to perform a skin graft. It was kind of brutal and interesting to watch . Dr Lipsi used this tool that worked essentially like a potato peeler to get the skin from the leg. Kayumbo had to hold the girl down because even with dosing her several times with ketamine (conscious sedation) she was still wriggling against the pain. The case took a long while and we missed tea break and so we just took turns going to have a cookie and something to drink. When we were done and after the clean-up it was around 12:45 so Alison told us to just go ahead and have our lunch 15 minutes early. So we walked home and just quickly cooked some eggs and had naan bread. I also tried my quinoa packets, it was alright, it just wasn’t very fresh tasting and I didn’t want to have it again.

When we returned for the afternoon we didn’t get started right away as they were deciding whether to do the bowel obstruction surgery today or tomorrow, so they were reviewing the scan and assessing the patient who had arrived via ambulance. They decided to do it the next day so Nicole was scrubbed in and the patient that needed a LHR (left hernia repair) was next. They also did a MUA (move under anaesthesia) for a boy on the paediatric ward with a collar and cuff to adjust it to be more effective. Nicole was scrub nurse and I was the circulating nurse with Jack to perform the instrument counts.

The next patient I prepped and was able to put in an IV cannula myself! I was pretty happy about that. Also I watched Dr. Mwansa perform 2 cervical screens during the other surgery. Nicole also scrubbed for the last one as scrub nurse and I was again circulating nurse with Jack. The last surgery was a BTL (bilateral tubal ligation). Dr. Mwansa helped to get the patient prepped with LA (local anaesthetic) and accidentally got a needle stick so we looked at the patient’s ticket and there wasn’t a recent PTC (HIV test) done so she had to go find one to perform the test on the patient. This incident was a very good reminder that anyone can get a needle stick injury and we should be hyper-vigilant in not only protecting the patient but ourselves.

During the case Dr. Lipsi was teaching about John Huss and others from the protestant reformation. I know some of this topic but he had to give me a refresher. He seemed to be talking directly at me as he saw I was interested by the topic and information I suppose. It was fascinating stuff for sure. Later the finally found a PTC so Mwansa got the result for the patient and thankfully it was negative. After we finished the last case it was quite late (some time after 6:00pm and dark outside).

Nicole and I walked back to the house to start making supper and Fiona had not returned with Dorothy yet. We just made something simple -vegetable soup, ate the last of the naan bread and I boiled some sweet potatoes. Then we decided that we could make some peanut butter cookies. So Nicole made some and Fiona returned from her day trip and was able to have a meal of leftovers and we ate MANY of the peanut butter cookies, they were just SO good! It was like the brownie situation all over again but this time I joined in eating probably too many at once. We did leave a plate full for the next day. We then turned in for the night//

P.S. Fiona was very happy to have nshima 2 days in a row (she also was served a fresh big fish with it like Nicole had. I was the only one stuck with the small dried fish when going out with Dorothy).

June 25th (Monday)

Another Monday here in Africa is upon us as well as another clinic day. So we expect it to be a little slower. Sometimes that can be quite nice and you have to enjoy those days as other days you can be swamped with things that I have to be done.

We completed ward rounds and then it was tea time! One of my favourite times of the day. We weren’t very busy afterwards and it feels strange now that JR is gone for a few days and Mel has returned home. Jack, Nicole, and I gave Ponsetti style shoes to a baby who has completed the plasters part of the treatment for club feet.

We went to Dorothy’s house fo lunch as did the visiting men (Dr. Lipsi, Tom, Phil, and Garret). It was another interesting/amusing lunch when you have characters like Dorothy and Tom seated around the same table.

That afternoon we ventured into the baby bundle room and nearly got lost in all of the bags, clothes, blankets, etc. that is overflowing in abundance. We set some of the items out in the tea room and were able to complete many baby bundles for both girls and boys. We had a LOT of fun matching things and planning a colour scheme with all the cute baby items.

We returned home after 4pm and Tiffany had sent us a message asking if we wanted her to make nshima. We said that would be great and FINALLY tonight was the night. The nshima was good however, I think I would find it challenging to eat without the tasty relishes as I’m not used to it and find it bland by itself. We then played games until 10:30pm. Nicole and I dominated in Crokinole and lets just say I didn’t do as well in Dutch Blitz or Mexican Train this time around, haha//