Postnatal Unit

This week Ella and I (Amanda) had the opportunity to work in the Postnatal Unit and SCUB (Special Baby Care Unit) at Lewanika General Hospital. The morning of our first day was filled with excitement and anticipation as we patiently awaited the familiar sight of Santos' blue mini bus to pull into the parking lot and take us to the hospital. Once on the bus, Ella and I briefly reviewed maternal and neonatal assessments with one another, scribbling notes in our notebooks as the bus navigated the many potholes in the road.

When we arrived on the ward, we were warmly welcomed by all of the staff on the Postnatal Unit. Ella and I were very grateful to be working alongside other nursing students, midwives, and doctors on this unit! We also appreciated being able to exchange knowledge and gain insight about each other's health care systems.

One difference that we noticed between our health care systems is the difference in length of stay for postpartum mothers and babies in the hospital after delivery. In Canada, we typically monitor mothers for 24-48 hours on the Postpartum Unit after delivery, whereas at Lewanika, mothers can decide to be discharged in as little as 6 hours. Ella and I (Amanda) were very curious as to why some mothers didn't chose to stay on the postnatal unit after birth so we asked the nurses. What we discovered was something that made me (Amanda) pause and reflect on for the following days after. The reason was this: mothers might choose to leave right after birth to get back home to their families and continue with the tasks of homemaking and/or helping out with small family businesses. As a result of the high turnover on the Postnatal Unit, we learnt a lot about the discharge teaching provided to mothers, which included topics such as newborn care, breast feeding, and family planning.

Another challenging, yet unique experience that Ella and I (Amanda) quickly discovered about nursing in another country, was putting aside our "Canadian" routines and allowing the nurses at Lewanika to show us their roles and responsibilities as nurses working in Zambia. For example, we noticed that in some ways the pace on the Postnatal Unit is much slower than what we are used to in Canada. Often times we would arrive on the ward, ready to hit the ground running with maternal and neonatal assessments, but instead, find the nurses tending to housekeeping duties such as damp dusting the ward and counting inventory. It took us a bit of time to get used to this routine but what we found is that this way of beginning the shift actually allowed mothers and their babies time to rest in the morning and it provided them with space to bond with their baby. Around 8 am the nurses join the doctors in completing rounds (assessments) and then the nurses follow thru on providing the ordered care and discharges. The nurses then gather the mothers that are being discharged and complete health education together as a big group.

Although the ward was a slower pace than what we are used to, it gave us the opportunity to ask many questions and learn from our Zambian colleagues. We learnt a lot about their vaccination schedule for children and how they adjust when the hospital supply of vaccines is low (something that unfortunately happens within a context of limited resources). In addition, we learnt about the most common sexually transmitted infections (STIs), how they are transmitted, and how they are treated. In fact, we discovered that advocacy for male circumcision after birth, as well as in adulthood, to reduce the transmission of disease is highly promoted at Lewanika General Hospital.

All in all, Ella and I (Amanda) valued this incredible experience and the opportunity to deepen our understanding and knowledge of maternal health in Zambia, and what that means in comparison to our health care system in Canada.

To conclude our first official week in Mongu, many of us gathered together for World Tuberculosis (TB) Day this Saturday to participate in a march to Mongu District Hospital in celebration of Zambia's many efforts to reduce the transmission and spread of TB. On the way, we attracted many children who wanted to hold our hands and march alongside us and the nursing students of Lewanika General Hospital. Once at Mongu District Hospital, we listened to speeches made by various leaders and professionals in the community and had the pleasure of being entertained by many talented performers and dancers. It was an honour and a privilege to be invited to take part in this event.

It is safe to say that having a nursing practicum in Mongu has been an incredible experience thus far and we are both looking forward to what is yet to come!

Ella and Amanda