From student to nurse

This experience has been like none I have ever had before. I grew up travelling and know what it is like to live in unfamiliar places. I knew coming to Zambia would be different, because for the first time I would be travelling, working, and living with a group. I am accustomed to travelling independently, and found having to navigate a busy schedule with unique group dynamics challenging at first. I enjoy my 'alone time' and, with the added responsibilities of leading group projects, have needed more of it than usual. I have realized that building relationships with others is essential for cultivating trust and teamwork. I have also come to appreciate that maintaining these relationships is often more important than being task orientated.

This experience is different from any other 'clinical experience' because it is not clinically based. I have come to learn that I enjoy medicine (my western view of medicine) and take comfort in my medical/ surgical practices back home. Within my first few days of practice I realized that my knowledge and skill doesn't have the same value in Zambia as it does in Canada. I felt frustrated with the care I was observing. Why does an emergency in Zambia look so different than an emergency in Canada? Is it the difference in resources, training or knowledge on potential adverse outcomes? Maybe all of the above or none of the above? Either way, I felt very out of place. I came to realize that what makes me a good nurse in Canada, does not necessarily make me a good nurse in Zambia. How could I make my time here meaningful and put my skills to work? I had to change my focus to a more upstream approach. Thankfully, I had the opportunity to prepare the preliminary steps in a needs assessment for a first responder program. This has been a fantastic learning opportunity for me, as well as a chance to try my hand at something new. I have personally observed a need for this program and I am excited to see where this project goes in the future.

Reflecting on my clinical experiences, having had the chance to work in both urban and rural settings, I have a newfound appreciation for the Canadian medical system. It makes me think . . . health care is a right to everyone and should be universal. How can I, as a nurse, help establish a strong and reliable health care system?

It is hard to believe that my time as a nursing student has come to an end. I am grateful for this experience and all of the lessons I have learned. My major take aways from this trip are as follows:

- Never underestimate the importance of building relationships and establishing trust.
- Building others up is vitally important.
- Just because it's not your way doesn't mean it's the only way.
- Challenges build character . . . enjoy the process.

Came as a Student, Left as a Nurse

It is so funny how everything works out, I have been genuinely planning on writing a final blog post about my last weeks here but I have been so busy in this little town in Western province I have struggled to find the time to sit down and type. However, today our bus to Livingstone, Zambia is a prompt 2 hrs late….and Maggie has so graciously let me borrow her laptop to write one last time from Mongu. 

I have had a lot of time to reflect while I have been here. Whether that has been during our mini bus rides to the hospital or nightly sunset walks down the road. During these times I have felt immense amounts of gratitude for this global health practicum. It is difficult to put our time here into words and the best way I have been able to explain it to friends and family back home is that coming on this final nursing practicum has kind of been like going off to summer camp…

Growing up I was very fortunate that my parents signed my sister and myself up for variety of overnight summer camps around the West Coast (shoutout Keats Camp and Camp Qwanoes). I was young, excited and ready for a week of adventures and activities. One week every summer we would wake up early, Mom and Dad would remind me not to forget my sleeping back again and I would hop on the ferry to go meet new friends from around the province. Similarly, leaving Canada, my parents reminded Ali and I not to forget our passports and they dropped us off at the YVR airport. Only difference this time instead of being off to Vancouver Island for one week, I was off to “Nursing Camp” for four.

At nursing camp, we were greeted by an entire town in which we were told we were “most welcome” by everyone we met in Mongu. We arrived to our “cabins”, picked “bunkmates” and awaited further instruction from our wonderful “camp counselors”. Like any other summer camp, nursing camp has had many activities. However, instead of sports such as archery or rock climbing, our daily activities included hospital shifts in a variety of different units. Instead of arts and crafts, we used bandaids and took vital signs.

Very similar to home, I have to say my favorite nursing camp extracurricular activity was football (soccer for all you Canadians back home). After our shifts, the group would walk to the streets with a ball to head up to one of the local pitches. The first time we walked out into the road with a brand new FIFA ball at my feet I was amazed to see at least 20 children run to the streets yelling “Makuwa has football!!” within 30 seconds of us appearing from outside the lodge gates. At a full sprint, I ran along Limulinga road, passing a ball around with our new little friends. I couldn’t help but notice when the children first introduced themselves to me, there was quite an obvious language barrier between us. We barely managed to share our names let alone explain what a small Canadian girl was doing in the streets of Mongu with a football. However, our language barrier was brief as I really realized for the first time in my life that the language of football is universal. We could barely tell each other our ages but we both knew how to call each other out for handballs, corner kicks and when the score was tied. We played lots of games throughout our four weeks, most of them on the side of the road. One game, 11 older boys invited us to play against them on their full sand field, complete with goal posts. Unfortunately, I had to tell my coach back home that these guys absolutely kicked our butts. They just seemed to float with such ease and grace on the sandy surface, while our team who was only used to playing on freshly cut grass looked like a clumsy group of elephants.

Lastly, like all amazing camp adventures, it is now time to begin the journey back home to Canada. For me, this will include a month of travels through South Africa and England before returning to Kelowna. I want to take a moment to thank our instructors for their patience and guidance through this practicum. They truly let us blossom over four short weeks into now officially….graduated nurses!! I also want to congratulate my now fellow colleagues (because that’s what you say apparently when you aren’t students anymore). I am so proud of the people I have shared this experience with. Together we have welcomed new life to this earth and I have also watched my dear friends hold the hands of those who have exited this world. Together, I feel we have grown stronger ties to this global community we are all so lucky to be apart of. Safe travels and best wishes to you all, you may now get some sleep without having to listen to my singing every morning.

Yours,

KT

My new little friend from across the road

First day of "Nursing Camp"

Getting beat very badly

11 v 11 (plus friends)

Soccer girls!

Peds crew

Leaving behind a piece of our hearts ❤

Hi everyone! Last week I was able to change things up and spend a few days at the Save a Life Centre. This was a great experience, as I was able to work in the clinic alongside the doctor. After watching her see a few patients, she switched seats with me and let me take the lead! Having autonomy felt great, and really tested my knowledge about the common illnesses we learned about. Fortunately, a lot of people came in with common things: sore muscles, menstraul cramps, common colds, the flu. These are easily treatable and the patients receive all medications free of charge. What a wonderful program to promote the health and wellbeing of these clients. This clinic also sees all of the school children for any apppintment they may need, as well as ensures each child receives an HIV test, has their BMI calculated (to screen for malnutrition), has routine ear cleanings, and as well routinely deworms the children.  I was able to get through many people in the clinic, and ended the day with one case that may stick with me for a while. A young girl, around my age, was potentially having an ectopic pregnancy and needed to be brought to the hospital. She looked terrified, and did not want to tell her mother she was pregnant. Many factors play into this situation, as in this culture being unmarried and engaging in sexual activities is discouraged. She asked if we could tell her mother, so we did. After explaining the seriousness of the situation, they said they were unable to go as they had no means of transportation. I spoke aside with the doctor, explaining that I would be leaving soon and they could come with me in the cab. After translating, the mother and daughter agreed to come, and I kept reassuring them that I would cover the cost (as well as give them kwacha to get home) and I was happy that they were going to be going to Lewanika General Hospital. They were very grateful for this, and I hope everyone is healthy and safe now. It felt great to be able to help pay for this family to get medical help, but all I could think was how many more times this happens and people go home because of finances, transportation, time, other kids to care for, etc... Unfortunately the poverty level is high, and paying 30-50 kwacha each way for a cab is not affordable for everyone. Sure, I was able to help one girl. But how can everyone have access to medical help in emergencies, despite where they live or their financial status?

During my time at Save a Life I was also able to go on one home visit with Nikki. Walking through the villages opened my eyes to how many people live in each home, and how many children there are! We were visiting a little girl who is new to the feeding program, and she has begun improving already. We delivered food to her mother for the week, that is adequate in nutrients to help promote her growth and bring her out of malnourishment. During this time I was able to hand out some handmade teddy bears from a family member in Canada, and the children absolutely loved them! It was nice to see such big and happy smiles. Toys and gifts are something we take for granted so often in Canada, especially children. Your favourite toy is gold until something new comes out! But here in Mongu, I see true appreciation for gifts. The children genuinely love to play and interact, and small things like bubbles and stickers make them so happy. I've seen some pretty creative handmade toys as well! Some of these kids have great engineering futures ahead of them!



I was able to spend one last day on Labour & Delivery, which feels like my home since we've been here. Unfortunately not much was going on, but the four of us (Steph, Kristen Merkley, Avneet & I) were able to assist in a delivery of a beautiful baby girl. It was a little questionable at first how well she was doing, but we had our emergency equipment prepared, and the second the cord was cut we were attending to the baby.

Well, it's time! We must leave Mongu and say our goodbyes. This experience has been far more than I ever expected it to be, and I cannot say enough how thankful I am for the group of girls we had, and of course our three lovely teachers (now colleagues!) that supported us each and every day. I met so many wonderful people here, from ladies in the market, to our fantastic and reliable cab drivers, to each individual I worked with on L&D and at Save a Life. Each individual taught me something different about life that I will always remember. It has been such a privilege to be welcomed into this community for the past month, and I hope that our presence had a positive reflection on everyone as well. I hope to return one day with OkaZhi - but first, student loans and graduation!
Congratulations my Zamfam - finally we are REGISTERED NURSES!!!

Much love to everyone,

Alana

It's A Boy

Hello, Kristen Monz here! I spent my final week at Lewanika General Hospital on the labour and delivery ward. I was looking forward to this placement the most, and was thrilled with how it went. On our first day on the small ward there was 12 Zambian nursing students there with us and although there were deliveries. I only got to watch from a doorway. I felt a little discouraged as I definitely was hoping for a more interactive week. By our second day there there were less students which meant more room for us! During the first delivery of our shift I observed and then asked if I could assist with delivering the placenta. The nurses had been a little quiet and I didn't want to be too pushy, but the nurse I was with seemed shocked and got a big smile on her face and said "you want to?!" Yes I sure did! For the next delivery she asked if any of us would like to conduct the delivery! Everyone else was hesitating, so I said I would love to if she helped! We were all ready to go when we realized that our patient went from 10cm dilated to 4cm. Sadly we brought her back to the ward and I began waiting for another! After waiting a couple hours with 10 minutes left in our shift they brought another woman into the labour room and left us with her to go finish her admission. Within minutes we noticed that she was crowning and Lexi ran for help, I jumped in and began doing what I was taught. Next thing we knew the head was on it's way out and Lexi was still tracking down a midwife, Cierra ran to help speed up the process. Now it was just me and the labouring mother to be. I began delivering the head and noticed the umbilical cord was wrapped around the infants neck. As soon as I got hold of the cord, in came Cierra, Lexi and the midwife. I began to unwrap the cord from around the infants neck and out came the rest of his body! It's a boy! We congratulated the mother on the delivery of her beautiful baby boy and then Lexi, Cierra and the midwife congratulated me! As excited as I was that I was able to be apart of such an amazing moment, I did have to consider what would have happened if we weren't in the room. Would the mother have delivered alone? There are no call bells or emergency buttons anywhere within the hospital like we have back home. Does this happen a lot? Also, what if it was a complicated delivery, would I have had to leave the labouring mother to seek out help? I am forever grateful that none of this happened, but these questions remain. Now our week is over and we have just completed our final day of clinical practice. I've been so consumed with sadness with leaving Mongu, I didn't even realize that leaving Mongu means we are leaving behind our titles as student nurses. We are officially new graduate nurses, and I couldn't think of a better way to celebrate than heading to Livingstone to see Victoria Falls! Our first five weeks here have flown by and I am so happy that I decided to challenge myself with this practicum. I have learned more than I could have imagined and have fallen in love with the beautiful town of Mongu. From our morning rides to LGH with Santos and his minibus to sundowners on the mesmerizing flood plains, I will miss it all! 
Kristen Monz

Santos' minivan

A proud me after conducting my first delivery

Goodbye Mongu

When I first pictured myself in Mongu, Zambia, I saw myself surrounded by mud huts and lions. I guess it goes without saying that my expectation was far from my reality. Instead, I was greeted by extremely wholehearted people, cooled off in my air conditioned room, heard Katy Perry blasting through the radio, danced at a club, visited the Safeway-like grocery store many times, and, so far,...no lions.
The healthcare system was also different than my expectations. I expected the hospital to be a place where people came to die paired with a complete lack of resources to deal with their health concerns. Instead, I saw people in the hospital being discharged, and although there was a very apparent lack of resources, the healthcare workers I worked with demonstrated extreme innovation and competence.  I was absolutely amazed how resourceful people can be in a low resource setting.
I learned many new nursing skills throughout my global health practicum that I would not have had the opportunity to learn if I were doing my practicum in Canada.  For instance, I helped diagnose illnesses, prescribe medications, and deliver babies. Being able to participate in these skills that only physicians do back in Canada has improved my knowledge of what other healthcare professionals go through during their days. Understanding their point of views will allow me to better relate to the physicians and other healthcare professionals back home.
Although this will be a great addition to my skill set, the most valuable knowledge I gained throughout my global health experience was better understanding privilege. I always knew I was lucky to have grown up receiving much more than my basic needs, but I had never actually stopped to think about it and reflect on it until this practicum.  For me, this topic was impossible to not think about every day of the practicum. I was impressed and humbled to see people living in what looked like awful poverty to me being able to live fulfilling and happy lives; however, I often felt embarrassed by my privilege. I felt sick at the site of people collecting water from dirty streams while on my way to buy bottled water or seeing children die from malaria when I knew I wouldn't run out of my $5 a day anti-malarial pill.  At the beginning of my practicum, I really struggled with this difference in privilege and the knowledge it had nothing more to do with than pure luck; however, as my practicum progressed, I realized feeling sorry for the people here wouldn't help. Instead, I decided to use the power I was given through privilege to continue working and advocating for improved global health.  Once this trip is over, I will be joining the Okazhi foundation.
  I am so happy I was able to do my global health practicum in Mongu. I am sad it is coming to an end already. The knowledge I've gained and the lessons I've learned have been truly invaluable.

Until next time,
Ali

New Beginnings, Endings, and Everything in Between

Well our time here in Mongu is coming to a close and I (Alexa) want to catch you up with what I have been up to for the past week. I was so glad to spend my last full week of clinical on the labour and delivery ward of Lewanika General Hospital. I don't think I have ever had my hand squeezed as tightly as by a labouring mother, but it was worth every minute.

I am impressed with the resiliency of the women here, as they labour without any pain medications and often without a support person in the room as is typical in Canada. I was happy to have the opportunity to act as a support person for some of these women by holding hands and rubbing backs. Of course, nothing beats seeing the tiny wrinkled face and first breaths of the newborn when it is over and seeing the smiles of the new mothers.

Cierra, Kristen, and I in the delivery room

On Monday, I spent the day with the Save a Life Centre doing home visits with one of the workers to check in on children with a history of malnutrition. Doing this granted me an inside look at the living conditions of some of the Mongu residents and the challenges that they face every day. I was relieved to hear that all of the children we visited were showing signs of improved health.

The view from the Save a Life Clinic

That brings us to today-our last day in Mongu and I have been doing a lot of reflecting on this experience. It has been hard. I have cried. I have wanted to scream with frustration from the lack of resources and occasionally I have craved the familiarity of the Canadian health care system. Every once in a while a moment comes along that makes dealing with those feelings worth it. In the first week when I found it upsetting to see a young boy so sick with malaria that he was unconscious, one of the workers at the Limulunga clinic gave me a Lozi name- Inonge, which means strong. When I saw very sick children on the children's ward and tried to help comfort a child as she screamed through her dressing change, I later got to play with the kids and make connections with them despite the language barrier. It is an emotional roller coaster of highs and lows trying to adjust to spending a prolonged period of time in a foreign country, but this experience has changed my view of the world, myself, and the things we take for granted in Canada.

I have met a lot of great people here and saying goodbye is hard. The time here went by so fast that sometimes it feels like we have only been here for a week, not a month and it makes me sad to think about leaving tomorrow to head to Livingstone to see Victoria Falls. I am very excited to see the falls and then continue on with my travels in Europe, but I will miss Mongu and the people I have met here more than I can express.

Thank you all for following along and sharing our journey.

-Alexa

The sunset over the Barotse Floodplain

Our Time Was Short, But Will Stay With Us Forever - Farewell, Mongu!

Wow!...

It's hard to believe that the end is already here! Today was bittersweet... we said good-bye to many of the Zambian colleagues we have grown to love and HELLO to the last day of a four year journey. That's right folks... WE ARE OFFICIALLY BSN GRADUATES (cap, gowns, and degrees coming June 9th)!!!!!

Jumping for joy as we complete the final day of our nursing degree!

This week was an amazing way to end our adventure. I (Maggie) spent the week at Sefula Clinic, a rural clinic that provides essential services to approximately 10,000 people living on the Southern outskirts of Mongu. During the week I worked in their OPD (the first point of contact where each patient describes their chief complaint, has vital signs taken, and is triaged), malaria and HIV screening rooms (tests are done on every patient), family planning clinic, and the ART clinic. I also assisted the physician with clinical examinations. Precious, one of the amazing nurses at Sefula who has stolen all of our hearts, also made sure to include us whenever there was anything happening in the labour and delivery ward. We were able to welcome one little man into this world just moments after he was born in the car on route to the clinic. We also had the chance to palpate fetal position and listen with a fetoscope for fetal heart rates. Last week Erin described some of the challenges that Sefula Clinic have to face, particularly the lack of running water. Despite these challenges, I was blown away by the care that the staff at Sefula provide to each and every patient. THANK-YOU for sharing your knowledge with me Sefula staff!!!!

I (Erin) spent most of my final week back in the operating theatre. On Monday, I worked alongside others to clean the operating rooms. As I cleaned and wiped dried blood off the operating tables, I found myself thinking about the patients who previously had lay there. What was their story - why were they there?... Did they recover okay?... What burden did this surgery place upon their families?... I took a few silent moments to honour and provide well wishes to those who trusted their lives with the surgeon, anesthetist, and operating room nurses.... As the week  progressed I was able to assist my Zambian colleagues with implementing a new Surgical Safety Checklist. Throughout the various surgeries, it was great to see the nurses taking the initiative to start the checklists!!! I also was asked to be the scrub nurse during a few cases (one was an emergency!). I was surprised at how flexible the surgeons are here in Mongu. If they asked me for a surgical tool, and I did not have it on my field they would politely ask me to chose something that may work. In addition, they were very patient when I would have difficulty understanding their accents (sorry!)...

Our favourite day this week was Thursday. We both joined the group and travelled to an outreach clinic about one hour via bus outside of Mongu. This was our final day of the research data collection we have been doing, and over sixty participants were sitting in the sand awaiting our arrival!...Part way through the day, we were both asked to assist Alexa & Kristen hand out Days For Girls https://www.daysforgirls.org/ kits to a local grade 8/9 class. Along with the kits we provided teaching about reproductive health including: anatomy, hygiene, menstruation, and contraception. Although these are sensitive topics not commonly mentioned, and the girls were extremely shy at first, you could tell they were genuinely interested. We also answered questions they had such as "what is HIV?". We found this particular question surprising... In our minds, we assumed girls of this age-group who may potentially be sexually active would be well informed about HIV. Especially because the infection rate is very high in Zambia compared to back home. Sharing this information with them was a privilege for us because it is such an important topic!!... BUT, one of the best parts of our time with the class, was the cheer we sang as a group at the end. Our classmates had previously led a Days for Girls teaching session the prior week, where the cheer was well received. We figured it would be great to keep it going... You can picture the unity and strength of many young women yelling... "We are Women... We are STRONG... It's OKAY to say NO!... And we will ALWAYS PROTECT OURSELVES!!!'... followed by cheers of excitement, high fives, and fist pumps into the air! - click on the link (https://www.youtube.com/watch?v=yCqZZiVLG58&feature=youtu.be), or "play" on the video below to see!

Thanks to everyone who has followed us along our incredible journey in Mongu. There have been too many amazing and impacting moments to write about, but we look forward to sharing more with you in person when we are back in Canada! To our Zambian colleagues, thank you for spending the time to teach and assist us with our growth as nurses. We will remember how you graciously welcomed us in all settings. And to the Lewanika School of Nursing Students, thank you for working alongside us, becoming our friends, and showing us the flood plains!

Until then,

Erin and Maggie

On the road out of Mongu - farewell!

Bittersweet goodbye

Hi everyone, Laura here! I am currently procrastinating packing my suitcase as it is our last day here in Mongu. This realization has brought up a whirlwind of feelings and emotions, so I thought I would share with you all the biggest things I learned over the last 4 weeks. Being in Africa, I have come to learn many things. Things about myself and also about the world around me. I feel very grateful to have been able to come to a new country to learn about the nursing profession while also learning and experiencing an entirely new culture.

I didn't come into this adventure with many expectations, in fact my mentality was based around the saying 'no expectations, no disappointments' and I think it really worked in my favour. I have loved every part of this trip. Everything ranging from the new clinical experiences, to learning how people on another continent live their lives. Being here has made me conscious of myself in relation to others and how it feels to be a minority which doesn't generally happen in my everyday life in Canada.

As much as I have loved and been so grateful for this experience, it was not without some challenges as well. There have been times where I have caught myself feeling almost ashamed of some of my privileges such as being able to comfortably afford a new pair of shoes once mine broke, or being able to easily go into town to buy bottled water whenever it was convenient for me. Realizing this has been very humbling for me and it's made me aware of the fact that in the Western world, we have a tendency to live way beyond our means. This trip has made me recognize that this is, in itself, what privilege means. I did nothing to earn the life full of resources that I have back in Canada, I just happened to be born there.

Leaving Mongu, the feelings I have are bittersweet. There are so many adventures and stories and memories that I cannot wait to take back home with me, and I hope that the people here learned as much from me as I did from them.

Insert inspiring title here

Hello everyone, Steph here! 

Somehow we're almost done our adventures here in Zambia. The past month has been a bit of a whirlwind of emotions. Getting used to Zambia wasn't as difficult as I thought it might be. One of the hardest parts for me was accepting the bugs. More specifically, the spiders and cockroaches. Massive spiders. Those of you who know me know that I don't handle spiders very well. So just take a minute to picture me dealing with the largest spiders I've ever seen... not my bravest moments. My saving grace has definitely been my mosquito net. That thing is tucked in on all edges 24/7. Too bad spiders, no cuddles for you. 

I also found the heat to be a bit of an adjustment. I of course knew it would be hot, like we're in Africa after all. But the humidity took me by surprise. I learned very quickly that nothing will ever be completely dry again, including myself. The longest I actually feel clean after a shower is about 5 minutes. Then the sweat so kindly returns. Yummm. 

I've also found that being white women (some of us very white), means that we always stand out. Always. Blending in is not a possibility for us. People stare, call out, and sometimes come right over and strike up a conversation. They don't mean it in a bad way at all, we're just new and exciting for them. It definitely makes me wonder if this is how other nationalities feel when they come to Canada. Do we stare that much..?  

The kids in particular like to come right up and say hi. Imagine a group of 10 kids running at you yelling "Makuwa! Makuwa! (this means white person) How are you?!" For some of them, I don't think they really even understand what they're saying, they just know that they're saying some English words. One thing I've learned about the kids here is that they LOVE getting their pictures taken. If you pull your phone out and point it, they will come over with the biggest and most genuine smiles I've ever seen. My heart has definitely been stolen by the kids here on more than one occasion. 

The hospital is also a whole new ball game. Unfortunately, the lack of supplies is the biggest barrier they seem to face on the wards. The simple task of hanging a bag of normal saline can turn into quite the adventure. No saline? Okay, how about ringers? Nope, okay.. so what exactly do we have? Although being low on supplies is extremely hard and frustrating, it's amazing to see how creative the doctors and nurses have become. I'll be standing there completely stumped and looking helpless and they'll come over and solve the problem within 30 seconds.  Smooth move Steph. On top of that, everyone is so willing to take the time to teach us. The doctors and nurses on the children's ward were particularly amazing. We spent hours with them some days just going around and seeing all of the patients. This was some of the best learning for me. Plus I got to spend my time looking after the cutest little munchkins. Big bonus. 

Unfortunately, Western Province (the province where Mongu lies), has some of the highest rates of HIV in all of Zambia. I found this interesting as Western Province has some of the lowest numbers of people. So why is the prevalence of HIV so high here? My best guess is that the many social determinants of health are playing a big role. When looking at all of the provinces in Zambia, Western Province has one of the highest rates of poverty. Interesting how that seems to have such an impact.

Of all the different diseases, HIV seems to be one of the most feared. For me, this is difficult to understand. There are countless other diseases that are much more painful and even fatal. With the treatments available today, HIV is no longer a death sentence. We as health care providers know that you can live a long and normal life as long as you're careful and take your meds correctly. Unfortunately, the people living here don't seem to have that same knowledge. The negative stigma that HIV carried in the past seems to still be stuck in this part of the world. With more time and education this will improve, but from what I've seen we still have a long way to go until HIV is actually understood and accepted. 

Anyway, that's all the time we have for tonight folks. Stay tuned for more thrilling and probably slightly repetitive blog posts! We love and miss you all back home. 

-Steph

The incubator unit

This last week Mckinnley returned to the Special Care Baby Unit (SCUB) and I (Brishen), joined her. I was weary of working in this care area because my experience with premature newborns was next to nothing. Surprisingly, I found I could fit there because I saw my contributions as a health care professional making a positive impact. For example, to keep discharge from a new ostomy contained and off of a fresh surgical site, I cut a hole in a tagaderm and fit a glove through it, attaching the device to my young patient as a make-shift ostomy bag. I never thought I would find myself working in a unit dedicated to infant care, however I enjoyed my short time there. I was lucky enough to have Mckinnley guidance and knowledge with me in the SCUB unit. 

I (Mckinnley) made the decision to return to the SCUB unit this week. After the events in my previous week in SCUB, I felt a commitment to the unit and its tiny patients (I also really love baby snuggles). Myself and Brishen were hesitant, although hopeful for our upcoming week. 

The additional time provided us the opportunity to take a critical look at the workings of the unit and our impact there. We found ourselves reflecting on how the lack of resources affected not only the availability of supplies and medicine, but also staffing ratios. We have seen small SCUB unit, and its adjoining kangaroo care room, to accommodate up to 14 newborns. In Canada we would have at least 5 nurses and numerous support staff to provide care for this patient load. The Zambian unit most often only has one nurse. This means that mothers are required to provide night and day feeding and care for their sick infants. 

With only one nurse on the unit (albeit a very knowledgeable one) she must choose how to allocate her time based on infant status. When there is several critically ill babies on the unit, where does the nurses time go? Should her time be allocated to the critically ill patients? or the patients that are more healthy and more likely to be discharged? While we always have to manage and prioritize our time in Canada, we are fortunate to have the resources to constantly monitor and provide complete care for all of our patients.

- Brishen and Mckinnley

Field Notes: Teamwork

  Hi everyone! Rylee here. The past 2 weeks we've all been busy busy busy doing research on atrial fibrillation, a heart condition, in and around Mongu. Carolyn and I have been working with Jessica, Fay, and our other UBCO instructors to help prepare for this research since September as our 4th year project. I've always been excited by our research topic, since I love all things cardiac. I've also been super excited to get to follow through with the project here on the ground, after having helped with the prep. But as far as the actual 'research' goes... a) I didn't know what to expect (because I've never been apart of research) and b) believe it or not, research class...was a wee bit dry. However with that said, I loved working with my classmates and helping my teachers at UBCO prepare for this. Little did I know, the fun had hardly begun! Now that we're here, we can finally see the pay off. Each Tuesday and Thursday for the past 2 weeks, I've been able to see my instructors and all the students hard work at play. It's been pretty cool. Not to say it's gone on without a hitch, but we made little tweaks that lead to improvements everyday. Never having been apart of research myself, Jess assures me this is a normal part of the process:)

     If it's not clear already, the research days have been one of my highlights while being here. It's been a unique experience with lots of collaboration; collaboration with my peers, my instructors, the Zambian nursing students, the Zambian nursing profs, doctors, clinical officers and the district ministers of health. Good thing I love teamwork! I love being part of a team working towards a common goal. Let me tell you, this exemplified team work. Each day our team was made of around 30 people, working together, helping each other out, trying to make each others lives easier. Not only were people fulfilling their roles in the research process, but I really liked when I saw everyone doing a little something extra. Whether that be people offering up their chair in the shade, or tossing their buddy a water, or sunscreen (some of us makuas have a little trouble in the sun sometimes) it was awesome to see. It's like these days were jam-packed with random acts of kindness and I hope everyone else felt what I saw. 

     Another part of the fun in research was getting to go into the communities and talk to the community members. Each day we went somewhere new and vastly different; some locations more rural and others right in the busy city. Each site was unique and valuable, both to the research and to my understanding and impression of Zambia. 

     I love what I learned about this team and these communities from the research days. As for what we set out to find about atrial fibrillation, I'm not sure yet. We'll have to wait and see!

Rylee

Homeward Bound

Well we're coming to the end of our time in Mongu and let me tell you, I have learned a lot. I think that coming to a country that is such a contrast to Canada has been one of the best decisions I have ever made. I have noticed that I am more aware of my surroundings and the people around me. It is so easy to get stuck in our Western bubble and ignore what is happening in the world. I think back to things that I would complain about in my life or at work and I truly understand the meaning of "First World Problems". We live in an age where technology and money seem to dictate our lives. It has been eye opening coming to a place where people don't rely on material things to be happy. Many people make less than 1000 kwacha a month (approximately $145 CAD). I have easily spent 1000 kwacha in a week thinking how nice it is that we can get our everyday necessities and luxuries for so cheap. But then I think about what $145 would get you in Canada for a month... Not a lot. When you think about it, 1000 kwacha does not leave a lot of wiggle room for extra things if you have to spend that money on water, food, and rent. However, I have observed that people in Zambia still find happiness with few things. They don't need the latest iPhone, a brand new car or fancy jewelry from their significant other to be happy. They find happiness in who they surround themselves with and their faith. It has made me realize that I was someone who heavily relied on my phone and laptop to function in my day to day. But in a place like Zambia you get the chance to put down the phone and just experience life. You get to see the joy, sadness, and frustration through the Zambian people's eyes. I feel so grateful that I was welcomed into this country with open arms and hearts. People here are so kind and generous. I have had so many people pass me on the street and smile or ask me how I am. Almost all the staff I have met at the hospital have been so curious about us and our lives in Canada. They are excited to share their knowledge and expertise with us. Many of the physicians and nurses challenge us to think in the context of a low resource facility and push us to see beyond our Western medicine lens. There were many times when we didn't have enough medications or supplies for all of our clients. Some of the clinics have only one physician and a few nurses to provide services to hundreds of people. When we are understaffed in Canada we often are quite bitter about the increased workload. But not once have I heard the healthcare professionals here complain. They work to provide the best possible care to those in need and they still manage to laugh and bring a sense of humour to their work lives. Seriously, some of the people we have worked with are hilarious (still not always sure whether they are laughing with us or at us) and I usually leave work feeling happy with the success of the day. But I also experienced many lows while being in Zambia. This included seeing my friends being upset about a day at clinical, experiencing the profound effect HIV has in Zambia and witnessing suffering in the clinics and hospitals. There were days where I cried and wondered whether I made the right choice to come. Some days I just wanted to be home with my friends and family. But I will never say I regret coming to Zambia. I think the biggest thing I have realized is that in every situation, good or bad, you can learn and grow. It may take days, months or years to find out what you learned but I think that looking back we will all see some sort of growth. Even as I reflect on my experiences, I see that I have changed. I have grown into some more aware of myself, my peers and the people around me. I am trying to listen more than I speak, learn more than I teach, give more than I receive and laugh more than I cry. Zambia has given me a wonderful gift; being present in the moment. It has given me the ability to put my phone down and experience life. Yes, taking photos to remember your time here is important, and using your phone is a convenient way to do this. But I think that being present in the moment so that you can give someone or something your full attention and time is more meaningful. This is something I will bring back to my life in Canada. Simply enjoying the fantastic people in my life, my rewarding career and the exciting things the future will bring. I am so proud of the work we have done here and the relationships we made. I am so grateful that we were given the opportunity to come to Zambia, as it is a trip I will always remember. We will be heading to Livingstone on Wednesday for a little fun, and then back to Terrace in Northern BC for me. Although the trip has been amazing I am looking forward to a little relaxation and time with my family. Thank you for following my blog posts, I appreciate all the love and support throughout this trip!

Cheers!
Jill Fuller