Sefula Rural Health Centre

Muzuile cwani! - this means good morning in Lozi, one of the many languages spoken here in Mongu. As we have begun to settle into life here in a different country, we have learnt many things along the way. Things such as basic Lozi phrases, how to fit 16 people into a mini bus, where the best spots are in town to watch the sunset, when to run outside and pull your clothes off the laundry line before it starts pouring rain, how to cook rice one hundred different ways, and where to buy the best avocados (hint: the ladies outside the hospital sell beautiful avocados that are the size of your hand!). Of course we still make mistakes - like pronouncing someone's name wrong in the out-patient department (OPD) and having everyone laugh - but hey, we are still learning and if people are going to be stuck waiting in OPD, they can at least get a chuckle out of our Canadian accents and horrible mispronunciation!

Hi! Amanda and Shelly here and last week we were placed at Sefula Rural Health Centre. Our experience at Sefula was unique because the centre is based on an integrated health system, meaning everyone is seen through OPD before being triaged and seen by a Clinical Officer and/or admitted to one of the wards. With the process of admission, it is also mandatory that all patients are tested for HIV and malaria with each visit. On our first day at Sefula, we were given a quick tour around the small clinic - which housed a female ward, male ward, maternity ward, treatment room, a room for male circumcisions to be preformed, a few counselling rooms, and a lab. The centre was very clean and well kept and the staff were very welcoming. After our tour, we were taken to OPD which is what we know in Canada as the Emergency Department.

The OPD was a small room with benches lined against three walls, full of people already waiting. A table was placed in the centre of the room which had a pile of little notebooks stacked haphazardly on the top. Out the door we could see people lining up, patiently waiting for their name to be called. We were given a blood pressure cuff and two thermometers and told to start triaging. I (Amanda) grabbed the first book and read out the name, or what I thought was their name... A roar of laughter erupted and a patient came over to me. She looked at the name scrawled on the book and called it out for me in her beautiful accent that I felt I could never replicate. I looked at her, grateful and thought "oh boy, here we go..."

Throughout the week, Shelly and I had the opportunity to work in OPD, the treatment room, and the clinic. The clinic is run by registered nurses and allows people to access health care based on a particular topic for each day of the week. For example, Mondays are reserved for antenatal health visits for expecting mothers in the village. Tuesdays are reserved for postnatal health visits for mom and baby, as well as provision of Option B+ which is antiretroviral medication for mothers with HIV. Wednesdays are for teaching about family planning and provision of free birth control for women. Thursdays are the "Under Five Clinic" for children under 5 years of age in the community to receive health check ups and vaccinations. And lastly, Fridays are reserved for male circumcision.

The Under Five Clinic was a fun day for both of us. We began the morning by weighing the babies by a scale hung from the large strong branch of a tree out in front of the clinic. Once weighed, the mothers and their children would line up inside and wait for their turn to be called up to receive vaccinations. As I (Amanda) helped with the paperwork, Shelly distracted the children with puppets and colouring books as they patiently waited their turn under the hot African sun. One interaction that struck me (Amanda) was when one mother had walked kilometres to get to the clinic so her child could receive his first dose of the BCG vaccine (this vaccinates against Tuberculosis), only to be turned away simply because the clinic was out of stock for the BCG vaccine. The look of disappointment on this mother's face as she turned and walked out of the clinic was one I can't forget. And as I sat there, I remember feeling so helpless in that moment. 

On another note, Shelly had the opportunity to spend a morning in labour and delivery with al abouring mother. I (Shelly) found it interesting how many women from the village piled into the clinic to offer their supports. The mothers in Zambia remain silent during the labor and deliveries - very different from what we're used to seeing back home. The birth was thankfully uncomplicated for both mom and baby. A short 6 hours after delivery and this first time mom, her baby, and an entourage of women from the village set off on foot to walk back to their village. This kind of support from the villages is unlike anything we would ever see in Canada and it was encouraging to know that this new mother had many supports around her despite the challenges of living far away from easy access to health care.

Sefula Rural Health Centre has truly been a unique experience that has caused Shelly and I (Amanda) to consider issues in health care that we had not considered before. We have learnt so much this past week and we are very grateful to the staff at Sefula for their help and guidance. Their passion for nursing is seen in the work that they do for every patient that walks through their doors. Keep up the great work Sefula!

Amanda and Shelly