Sunday 15 April 2018

Pharmacy Off a Tailgate


We - Tanner, Matt, Adia and Shelly - had the great pleasure and privilege of spending our last week of nursing practice helping to set up a remote outreach clinic in the village of Ngundi.  Four full days, we worked with a group of amazing individuals from Village of Hope:  Dr. Nilene, Megan (occupational therapist) and 4 amazing translators Muzo, Miselo, Jeremiah, and Musiwalike. We we would like to sincerely thank them all for providing us with this opportunity, teaching us and supporting us, and making us feel like welcome friends.

The day before we left, we worked with Dr. Nilene for a few hours organizing medications and supplies to ensure we had enough. On the day of departure, the sun was shining as we packed the two trucks with all of our gear, food, and medical supplies.  As we prepared to leave, the rain started, and we drove through an epic storm - thunder and lightning directly overhead, torrential rain (we have no idea how Megan and Dr. Nilene could see to keep driving), then hail, and wind.  The mattresses on the roof of the trucks were thoroughly soaked, and we stopped to adjust the plastic cover - perfectly timed to see a car pulled over on the side of the road with a cow in the trunk (alive, seemingly very comfortable).  We all shared a good laugh and continued.  What was supposed to be a 2 hour drive turned into 5 hours due to some difficulty finding the correct turn-off.  Fortunately, we found a man to guide us, but this meant Tanner was left behind at this man’s house while he rode with us to the village... Tanner was happy to stay and interact with the family, quietly hoping we would, in fact, return to pick him up eventually, which we did 30 minutes later. 


The rain had stopped, and the camp site was perfect - close to the Zambezi river, with large trees surrounding a sandy clearing.  Some men from the village had constructed a shelter that very day, so we had a large shaded area under which to set up the clinic, and a toilet (flat boards with a hole cut into them over a pit, surrounded by a privacy screen made of branches) had been made for our stay.  We set up camp as the light faded, hanging the mattresses to dry, and a delicious dinner of spaghetti was shared.  The night sky was unlike anything the four of us had seen before, no lights from surrounding towns to compete with the stars, and the Milky Way was clear and brilliant.




A welcome addition to our team, while we were setting up camp on day one, was an abandoned kitten who found us at our campfire, trying to stay warm. It appeared to have a broken leg and was full of burrs. We quickly adopted it into our camp family. It got bathed in the morning. Adia spent over an hour cutting out all the burrs from its fur and Megan the OT worked on rehabbing its paw. The next day we noticed it had 3 large bot fly larvae (looked like large maggots) buried into its leg, it took 4 of us holding the cat and Nilene with the tweezers, but we successfully removed the larvae from its leg. Over the four days, we became very attached to the sweetest and most adorable cat we had ever met. It was initially unclear if the cat had an owner, but at our departure we were given permission from the villagers to take her with us. Megan adopted her, and further intends to use her as a therapy cat for her OT patients. We named it Kwena - meaning crocodile.



Day one of the clinic went well, but slow, rising at 0600h to start the fire to boil water for coffee and oatmeal.  We started the clinic at 0800h, setting up four stations - one for screening (name, weight, vitals), one for waiting, and two for people to be assessed and given medication.  The four of us felt a bit unsure - the tropical diseases/various ailments and their signs and symptoms unfamiliar to us in practice - so we initially relied heavily on Dr. Nilene’s advice and guidance, along with the help of our fantastic translators.  We served over 80 patients in that first day, packing up the clinic around 1730h.  Another amazing dinner nourished our tired bodies and brains, and we visited under the stars before going to bed (on nice dry mattresses!).

Day two and three of the clinic went much more smoothly.  We felt more connected as a team, working together with Dr. Nilene, Muzo, Miselo, Jeremiah, and Musiwalike, everyone more comfortable with their roles and the flow of the clinic.  We served over 100 patients on days two and three, doing many malaria and HIV tests, giving out medications, creams, and syrups for a range of ailments - from sand worms under the skin, fungal infections, respiratory infections, dehydration, malnutrition, and pain (headache, stomach upset, toothache and sore backs).  Those we could not help with the supplies on hand, we referred to local clinics for further tests and resources, hoping they had the means to get there soon.  Most people had travelled on foot (one elderly couple was even brought by canoe!) over long distances, many with babies tied to their backs or with small children, and many had been ill for weeks or months before, so just getting to our clinic was a challenge, let alone travelling further to get more treatment.

We were all in awe of the people, resilient and patient, sitting on mats on the ground, waiting for hours to see us, never drinking or eating anything, or using the bathroom.  The reality of the state of dehydration that many people must endure here was exemplified by one older patient who collapsed during screening on the afternoon of the second day.  Tanner was manning the screening station, and called for extra help, and Dr. Nilene, Matt and Shelly quickly joined and assessed her. She was confused with a low body temperature, irregular and fast heart beat, low blood pressure, skin tenting and profuse sweating.  An IV was started to give her a litre of normal saline and she was monitored closely while we prepared to take her to the nearest hospital in one of our trucks.  We heard the next day that she was well, and home again.

On the evenings of day two and three, after more delicious and nourishing meals of traditional shima with cooked veggies and meat stews, we enjoyed more amazing star-filled skies, fireflies, and the gracious hospitality of our hosts from Ngundi village. We attended two wonderful bonfires, with singing, dancing, laughing and sharing of stories. The leader, Maurice,  shared one story about a hippo capsizing him and his friend’s boat, and then hunting them for hours while they hid in the reeds on the bank of the Zambezi River.  He shared this story as a warning to be careful, since a hippo had walked past our camp (between the camp and our bathroom - not more than 10m away) on the first night!  Maurice also expressed his and the people’s gratitude to us for coming and providing the care and resources of our clinic, and we were all humbled and happy, giving our thanks in return.  It was lovely, and we felt very privileged to be welcomed into their village to host the clinic (while also feeling a new-found-terror of hippos).

      Apart from the long days and the initial feelings of uncertainty on day one, we all had an amazing experience, and we are incredibly grateful and thankful for the opportunity to learn and grow in a setting where, though their is suffering, their are shining bright stars - in the sky and in the hearts of each individual person who share their lived experience with us.


From Africa With Love,

Matt, Adia, Shelly, Tanner 

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