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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

Luck of the draw

Hello everyone! I can't believe that in a few short days we will all be leaving Mongu and continuing on with our travels. I've learned more from this practicum then any regular university class could have taught me. I often look back to the night before our first day of clinical in Mongu. We were all having dinner together when one of my instructors made a toast and said "if this experience doesn't change your life it will change the way you look at your life." Three weeks later I can confidently say it has.

I spent this week on the Children's Ward with Ali, Kristen Merkley, and Avneet. Those of you that know me know that pediatrics is an area of interest for myself and I was very excited to have this learning experience in a new country. Having worked as an employed student nurse on the pediatric floor in Penticton over the summer I have had a small amount of experience in this area. However, looking back I don't think anything could have prepared me for the week that I had. In Canada we are fortunate to fly the really sick acute kids to our children's hospital in Vancouver where there are several doctors, tools, and machines that are specific to certain pediatric conditions. In Mongu, they are forced to work with what they have. This has been a constant theme in my past experiences at the hospital here, but this week it really hit me.

We were only a few minutes into the doctors medical rounds when a new bed with a twelve year old boy was moved from a different room into the acute bay. He was diagnosed with malaria and sepsis. It was roughly about two minutes into me looking through his bedside chart when I realized something was very wrong. The doctor had begun CPR, and a medication was pushed through his IV. The full equipment that would have been used in a code in Canada was not there. I couldn't help but feel frustrated, useless, and confused as I tried to comfort his mother. With the language barrier I wondered if what I was doing was helping or making things worse. All I wanted was for this mother to get closure and spend her last few moments with her son. I didn't know how to give her that and this was one of the worst feelings I have felt as a nursing student. I try not to always compare the hospitals back home to here but when this boy passed away a part of me couldn't help but wonder, would the outcome have been different if we were in Canada?

Before coming to Africa I had heard many conversations and debates about bringing supplies or helping out in other countries. Common questions have been "why would you want to help another country when your own country still struggles?" My answer has never been more clear to me than after this day. We all live in the same world, we are the same people. Land and water are the only things that separate us. As confusing as this day was and as hard as it is to make sense of a situation like this, there is one thing that makes perfect sense. We are so lucky to be born in Canada where there are many resources, opportunities for education, and huge advancements with the health care system we have. Unfortunately, this boy wasn't as lucky. We had the luck of the draw being born in Canada and the only difference between them and us is luck. 

Kristal