zambia

Zambia//Day 17

Posted on by cminnett12

June 22nd (Friday)

            Last day of our “work week” as we get to rest over the weekend, unless there is something emergent that we can help with. I was able to plaster another child’s club foot essentially on my own, except this baby was very wriggly and Jack and JR were assisting me in hanging onto his leg and keeping his foot in the correct position. It is called the Ponsetti treatment that JR has learned and implemented here when treating children with club feet.

I was then able to observe an abscess being drained from the top of someone’s great toe, it was fascinating and disgusting all at the same time. Then a boy came in the same age as my brother Caleb (he looked to be about 14 but on his ticket it said his birth year was 2000). This boy had a dislocated shoulder. It was actually a bit difficult to notice as the shoulder only looked slightly forward compared to the other one, also the boy couldn’t move it very well so he had quite a decreased range of motion. So they gave him strong pain meds to prep him for putting it back into place. JR then instructed one of the clinical officers how to do it. They used a certain method that Dr. McAdam prefers at Chitokoloki. He tried with no success. He tried a few times, then JR tried herself but it didn’t go in, then Dr. Lipsi gave it a shot using a different method and nothing happened. So then we left the boy laying on the stretcher with traction created by a weight hanging off the tensor bandage and let gravity help pull it out of its incorrect position and then it just had to be put in correctly. So we left him like that with a family member and went for lunch at the Spiechinger’s.

It was a lovely lunch, we had different kinds of pot pies–chicken and beef and both were delicious. Afterwards Kate asked if we could babysit Owen for the afternoon so she could help Mwansa with the clinic. So Nicole took charge of Owen and her and Fiona walked to our house with him and I went up to Kariba to see what was happening with the boy who had the dislocated shoulder. I got there in time to see Dr. Lipsi and Tiffany attempting again to put it back in, to no avail. So they decided they should take some more x-rays to see if that would help to see what’s happening.

I then helped Kate with a little boy. She was plastering his wrist as he had come in with a fracture. He was maybe a little bigger than Owen. He sat still and was very good to let us do our thing. He had big eyes that looked a little teary-eyed and just had a little frown/straight face. He was very cute! After that I decided to go back to the house.

We played with Owen for a little while and he is so full of energy. We then (Nicole, Owen, and I) walked back to Owen’s house. We met Mwansa along the way and walked with her a bit. We got to JR’s just as Kate was coming on the four wheeler to come get Owen. He was so excited to see his mama though! It was so cute.

Nicole and our fave little man, OWEN!
Our staple meal in Zambia ❤

We went to JR’s house later that evening for a get-together. We watched Cinderella and had snacks and Tiffany’s birthday cake. Mwana and Owen’s antics kept us all very entertained. After our evening was concluded we returned home and went to bed.//

Zambia//Day 16

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June 21st (Thursday)

           Another theatre day is upon us. We did ward rounds first. After we got done in the ICU Nicole and I took an elderly lady to the minor theatre to remove her old dressing on her leg stump so that Dr. Lipsi could redress it. The nursing staff had taped it too tight all the way around which could cut off circulation if you aren’t careful.

During this time the girl in the emergency room -Patricia, started to crash, thankfully JR and Tiffany were in the room and someone apparently went to the ICU and simply shouted “Dr. Mwansa, COME!” So they performed a resuscitation and used the defibrillator and shocked her as well as used the last of the adenosine. She was successfully brought back. Throughout the rest of the time during ward rounds Fiona was bagging the patient while I provided periods of relief. It was then tea time and we passed the ambu-bag to the assigned nurse.

After tea I scrubbed in as the fourth assist during the debulking of a tumour that a woman had on her neck. I didn’t do too much but I had a good view of everything that was happening during surgery. We went back to the Annex for our lunch.

After lunch we returned to the hospital for a few more procedures. Nicole scrubbed in for a BTL and then there were two cervical biopsies performed by Dr. Mwansa. The BTL patient’s reaction on ketamine was entertaining. We used ketamine quite often as the medication of choice for conscious sedation. The patient’s reaction to the ketamine was to sing and sing loudly! It was amusing, however, she had a nice voice.

I then went to relieve Fiona in the emergency room to continue bagging the girl. The first lady who had a cervical biopsy was being wheeled on a bed to recover in one of the wards. As she was passing by the emergency room I could hear her shouting “HALLELUJAH! And PRAISE THE LORD!” I was told later that the second woman was calling the nurses, Fiona, and Nicole “little children” and laughing.

After the procedures were finished we returned to our house and went for a walk by the river to take pictures of the sunset on the shortest day of the year, (it is their winter months).

We then began supper preparations when we returned. We made omelettes and potato wedges. I also cooked up some beef for the next day. Tiffany sent us a message asking if we had eaten supper or not. We answered saying that we were making some and she was welcome to join us. She replied saying that wasn’t her meaning, she was thinking she could make nshima (but apparently we eat too early). She did accept the invite and had supper with us and joined in playing some games, of which, Fiona and Tiffany were quite competitive when it came to Dutch Blitz in particular. Tiffany also regaled us with crazy missionary medical and non-medical stories. It was a really fun night!//

Zambia//Day 15

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June 20th (Wednesday)

           Another clinic day today. We were so busy (the three of us anyways), there is always a long line to be seen by the doctors at clinic. We went to Dorothy’s again for lunch. She had been planning to have just the men that are here to help with maintenance/construction of a roof and installation of a water pump. However, they ended up going to another area for a few days, then Dorothy decided to have us three girls, Phil Granger, Tiffany, Dr. Lipsi, Mwansa, Allison and Mel.

It was a good lunch and it began with Dorothy showing us what her worker, Sarah, had almost swept up what was underneath the chair at the dining table. It was a black and white banded snake. It was quite small and had been put in an empty jam jar. We looked at it and set it to the side after determining by looking in the snake book that it was a kind of garter snake–poisonous but not known to be fatal.

When Allison came we passed the jar saying we thought you might want to see it. She took it and wrinkled up her nose at the sight of it–she really doesn’t like snakes, so she quickly try to get rid of it. Mwansa also didn’t love having it on the table and it became the centrepiece.

A little later while we were discussing snake and crocodile stories Mwansa yelled and jerked in her chair and Nicole yelled “what is it?”, Mel and I flinched. All this happened at once. As we have been talking about snakes, Mwansa had felt something touch her leg (which we discovered it was just the cat’s tail), Mwansa apologized. Tiffany then scared Allison when we were putting things away in the kitchen.

After lunch, us girls came back to the Annex and rested/read, we went for a walk by the river, then had supper, and went to the last English gospel meeting of the series. Allison and Tiffany had to leave the meeting early as there was an emergency at the hospital. Mel and us girls walked over as we were curious and Mel needed Allison’s house keys.

There was a little girl who had come in earlier that had been seizing and was positive for malaria after being tested. She came in as she was vomiting blood. It became emergent when she was unable to breathe on her own anymore and became paralyzed. We then were suspecting that perhaps she was bitten by a snake, but we couldn’t find a definitive bite mark. After she was stable we returned home for the night.//

Zambia//Day 14

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June 19th (Tuesday)

           I had to be over to Dorothy’s to go out with her around 7:15am. We didn’t end up leaving until 8:00am, so we had a later start. We went through Kolundola, Nymibia, Sowfuku, MatuWanki, and Impidi.

I was assisting Dorothy by taking blood pressures (we never really got out of the Isuzu truck.) I suppose it’s safer that way, but Dorothy will honk the horn when the children are crowding too close. I would take BPs from the left side (the passenger side in Zambia -like UK driving) and have the patients put their arm through the window. I was essentially a “drive-thru blood pressure check”. I tried using what Luvale I have learned so far to converse with the people. I made the children laugh when I spoke to them, they would try the few English phrases they knew (“Hi, how are you?”) and I would answer them in English and they would all die laughing. When we got to Sowfuku there was a man there in his late 30s and he introduced himself to me (he could speak English). He then turned and introduced his 3 younger male friends. He told me that they wanted to meet me and ask some questions, how old was I? Where was I from? Did I have a baby at home? Did I have a husband? They were very interested in learning about me to see if I was a single *white woman. As white women are usually more well off in their opinion, so we were told that some men may approach us or offer marriage.

Dorothy handed her patients their meds and would talk to people about their concerns or if they needed rides or if they wanted her to purchase corn (maize), beans or peanuts. While we were out she traded 5 baby bundles for chickens for the hospital kitchen. The chickens went in the back with the patients, other travellers, and Patrick. Dorothy told me she sometimes gets home with some chickens that are squashed by some of the people’s loads if they aren’t careful with packing.//

Zambia//Day 13

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June 18th (Monday)

           Today is clinic day, which usually means it’s a lot of work for the doctors and the more senior (missionary) nurses to see patients at clinic. For us, we tend to do small tasks that we are able, but it is difficult to be helpful as we don’t know the language and that is crucial to figure out what the issues are for these patients. We went up to the hospital at 7:30am for ward rounds (we are adjusting fine to “Zambian time”). Ward rounds tend to be longer these days with several (two or three) doctors to discuss the cases along with the missionary nurses. We had tea, and there was birthday cake at tea break for Dorothy’s 71st birthday.

After tea Nicole and I observed an I&D (incision and drainage) of an abscess on a woman’s cheek. Dr. Lipsi injected a local anaesthetic but it wasn’t really working; at least, the patient was in quite a bit of pain when he was packing the wound. Jack actually had to hold the woman’s arms down.

About that time when we finished it was time to go to lunch at Dorothy’s house. We had chicken and it was quite good aside from a few pieces that were slightly overdone. Tom from Unionville Gospel hall and Dorothy were going back-and-forth with teasing, dry humor, quick witty remarks… That could be taken as offensive. Let’s just say the meal was quite entertaining! I’ve never had to hold in so much laughter and surprise during a meal!

We returned to Kariba and observed a rather painful procedure on a man who underwent a urethral dilatation where Dr. Lipsi essentially inserted metal rods with a slightly curved end increasing in size (I think he inserted about six). The man received local aesthetic, however, he was experiencing a lot of pain. After the dilatation Dr. Lipsi inserted a catheter.

We also observed an LP (lumbar puncture) on a younger man who couldn’t see and he is experiencing paralysis so they sent it to the lab in Zambezi to see if they could get answers.

We had Tiffany over for supper. We ate leftovers from the day before and made more naan bread. We talked for a while and then she went home to catch up on sleep that she missed over the weekend. The three of us then played some games in the evening, read our books, and then went to bed. The next morning I would be going with Dorothy to see her chronic patients and it is an all-day affair.//

Zambia//Day 12

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June 17th (Sunday)

           Today was also a relaxing day. Fiona wanted to go up and watch an abscess be drained for a pregnant woman. Dr. Lipsey was going to do it early in the morning before the meeting at 9am. I also got a bit more sleep than usual – I’m getting used to the roosters (besides they crow all day long it seems). When Fiona came back we were finishing our breakfast (which is banana bread that we made the morning before, so good!)

I think we are getting better at singing in Lunda and Luvale, but extremely long words do pose a challenge at times. Today the ministry was given by visitor from Unionville Gospel hall, it was nice to have it in English, but watching the translator was pretty funny. Sometimes he would speak much longer than a simple translation. Ha ha, Dorothy said “he’s preaching a whole sermon in between!”

When we came back to the house we began to make lunch: chilli and homemade naan bread. It was so delicious! I’m impressed with our cooking every time and happy that we can make good meals for ourselves. We think we should have Dorothy over to show her we can do better than PB&J sandwiches.

We also went to the Sunday school at the colony, which was nice; the little boys have so much energy! The rest of our evening was spent reading, relaxing, and playing games. And we can’t forget listening to my Spotify playlists.//

Zambia//Day 11

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June 16th (Saturday)

           Today was a nice relaxing day for me. I slept in a little bit as did Nicole. Although, Fiona did walk up to Kariba to join ward rounds. She returned later that morning and we are planning on having Tiffany over and making nshima. Then have others over to play games after supper. However, there was something that suddenly came up and she had to go to Zambezi to meet her brother there.

Nicole and Fiona went to the hospital in the afternoon after we had lunch at Dorothy’s to participate/watch a leg amputation. I stayed at our house and fit in a video chat with my mum. I also cleaned/tidied the house and baked brownies. I was just starting to prepare supper: honey mustard chicken, rice, and cabbage when the girls came back.

After supper we played some games, just the three of us. It was nice to have a fairly relaxing day as we know looking at the week ahead we will be busy enough and you never know when there could be an emergency. Also the girls have no self-control when it comes to brownies, so, note to self. Also, Dorothy whipped up a lunch for us (I think Sara had the day off) as Dorothy said it’s just a simple meal, that was quick. She had KD, sausages with mustard on top, boiled broccoli, and baked beans. It was good, but a strange assortment of food.//

Zambia//Day 10

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June 15th (Friday)

           Today was fairly quiet at the hospital; ward rounds took longer than normal and it was like we were a crowd moving from patient to patient. We then assisted with three OGD’s (oesophago-gastro-duodenoscopy) after tea. Also, I should mention that while we were in the paediatric ward we noticed, actually JR noticed, that the mother of the patient with malaria also had a baby who was wearing a necklace. It was actually a charmer that the witch doctor charms to apparently protect the baby. The mother actually turned the necklace around to hide the little charm, hoping we wouldn’t notice. JR went and got scissors and cut it off from around the baby’s neck. Tiffany said that they would never willingly take it off and now the mother probably isn’t too happy with us as she will likely have to go to extra lengths to get another one. But the people know that the “white people” (at the hospital especially) don’t like the charms because it is a Christian hospital and the witch doctors perform dangerous procedures that will apparently “help”.

During the second OGD, Kayumbo said that the patient was doing very well, and I wanted to test out the words in Luvale I have been learning. So I said “chamwaza” which means very good and is like an encouragement/praise. Kayumbo was surprised and shocked as he looked at me. I pulled out my piece of paper from my pocket and told him I had written down some words and was practicing. He laughed and asked me who my teacher was, I said Tiffany and Joffrey taught us some words, mostly Luvale and some Lunda.

Later during the procedure there was a flurry of activity and you could tell one of the patients must be crashing. We heard it was the man from ICU, Isaiah, which unfortunately wasn’t too surprising as he didn’t look very well during rounds. Tiffany came into the theatre looking for something and Fiona and Nicole were just watching the OGD while I was the one assisting with the mouthguard, to hold it in place. They asked if Tiffany needed more hands and she said “sure, come along.” So Fiona and Nicole assisted with a few rounds of CPR on the man in the ICU. But the team was unsuccessful in the resuscitation. He had so much contamination inside of him (from the surgery I assisted with earlier in the week) that sepsis had set in and he had a very high fever, was tachycardic, and his BP had dropped dramatically. After that was over they return to see us finishing the last OGD (where we took biopsies of a tumour in the stomach.)

It was then lunchtime and we were invited to the Spiechineger’s house for a meal of naan, rice, and a delicious meat and bean mixture. Dr. Vincent and Dr. Lipsi were there, as well as Allison and Mel. We then went home and relaxed for the afternoon then went to the English meeting.

Afterwards we went home and saw we had a message inviting us back to the Spiechinger’s house for a girl’s movie night. We walked over admiring the African stars and we all decided to watch Kung-Fu Panda. There was the three of us, Mwansa, JR, Allison, Mel, Kate, Tiffany, and sometimes Joey (to do the set up). We ate some snacks then we returned home when the movie was over and tried to sing a few songs in Lunda and Luvale for the fun of it. Looking forward to sleeping in tomorrow!//

Zambia//Day 9

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June 14th (Thursday)

           Today Fiona and I went with Dorothy, Tiffany, and Joffrey to hand out praziquantel to school children at three different schools. Lwitadi, Chizozu, and Kanyanzi. We rode in the back of the truck and I was able to get the full experience of the African back roads today. (They also drive on the left in Zambia.) The praziquantel we were giving out is to treat schistosomiasis, a parasite they get from standing water (bathing or washing in it) and it destroys people’s lives and will eventually kill you. It is a highly prevalent disease in this area. I enjoyed seeing all the cute little school children (some REALLY didn’t want to take the medication).

In between schools we (Fiona and I) were trying to learn some Luvale and Lunda words that would be helpful to know and be able to communicate better. We went to a market close by where they were vendors. While there Dorothy bought us Fanta and Coca-Cola to drink for lunch and I also bought a chitengi there for 45 kwacha (Tiffany bought it as I didn’t have kwacha and I’ll pay her back with US dollars). Throughout the day we had given some people rides to and from different places along the way. We returned to the one school to get the afternoon class and there we had the beef and cheese sandwiches Dorothy made, fresh tangerines, and pop. Also, at that school I went to the bathroom in the pit. Let’s just say it was a true African experience…

On the return back to Chitokoloki there was a section of the road that Dorothy hit going at a good speed and there was a very significant pothole that sent Tiffany and I flying in the back of the truck while Fiona managed to hang on and if there wasn’t a crack in our seat before, there certainly was now!

Right near the end of our trip we picked up a man and woman who had quite heavy loads and a bike. We put the bike in the back and Fiona and I switched to the front passenger seat and Joffrey sat in the back with the couple, Tiffany, and the bike. We got back to Dorothy’s and her and Tiffany spoke of possible dates to hand out more praziquantel.

Fiona and I went back to our house (just next-door) and Nicole hadn’t returned home yet. So we started on supper (sidekicks pasta and back bacon) – it was quite tasty and quick to make. Nicole got home about half hour after us and reported that she had a busy day at theater. There was a BTL, amputation, and two other surgeries she participated in as the scrub nurse handing instruments to the surgeons. Also, she said a young boy came in who was not very responsive, he had apparently drank and basically overdosed on alcohol (he was maybe only four years old). By the time we had our supper it was late and we were much too tired to go to the English gospel meeting tonight. We hope tomorrow will be a little less tiring and not quite as long. Also, Thomas made up our beds with new sheets, so I’m looking forward to that.//

Zambia//Day 8

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June 13th (Wednesday)

           We went to the old hospital this morning for a teaching session to get updates on HIV protocols and stats. Which for the most part was interesting but some of it went over my head. At that point, after the session, we met the reinforcements that arrived on the same plane as our luggage the evening before. (YAY! FINALLY WE HAVE OUR CLOTHES!) We met Dr. Lipsi and Dr. Vincent. They are going to be doing surgeries which will be a nice relief for Dr. Mwansa. She stayed home to rest today and hopefully feel better.

This morning I attended ward rounds and then we had tea. Afterwards I went to the under-5 clinic. After watching for a while they asked if I wanted to give the vaccines. So I finished administering the vaccines for the rest of the many children… and unfortunately made many babies cry. Nicole joined me for the last two patients and I got her to do the vaccine administration as well. We then returned to Kariba and helped with clinic until lunchtime. Nicole scrubbed in for an exploratory laparotomy and biopsy of a pelvic cyst/tumour. We helped with clinic some more and came back for supper at our house and then attended the English gospel meeting on Luke that Gordon is doing. When we got home for the night I unpacked my suitcase and tidied my things. On for tomorrow is a trip to village schools to administer praziquantel with Dorothy.//