Children's Ward - Ella & Michaela

We (Ella and Michaela) spent last week on the Children’s Ward at Lewanika General Hospital. We learned a lot from our Zambian colleagues and were able to gain insight into their daily routine on the ward. Our day started off with morning rounds with the doctors, where we learned about several different conditions such as malaria, TB, fractures and malnutrition. We worked alongside the nursing students assisting with procedures and tasks throughout the day. We typically ended our shift doing play therapy with the children. Our wonderful friends who had previously worked on the ward the week prior had initiated play therapy with the children, so they were excited with anticipation of playing with bubbles and colouring! There are many children on the ward who were too weak to leave bed or had traction placed on a broken limb and needed interactive play therapy at their bedsides. Bubbles were a great way to get all the children bright eyed, and even had the parents laughing. The children were also very eager to colour. Some smaller children needed demonstrations, but once they started they loved it. Once all the pictures were coloured, they were hung on the walls above the children’s beds! It is incredible getting to see the children laugh and play following the stresses of morning rounds.

      One of the most memorable, yet challenging experiences we encountered on the ward was working in the PEM unit (protein, energy, malnutrition). It’s a small room with 6 or so beds, a few heaters, and several malnourished babies and children. We are very grateful to have had the opportunity to collaborate with several experienced doctors and nutritionists who taught us the effects of malnutrition and the management of acute cases. Unfortunately, many of these children are malnourished due to limited resources or family health issues. We found these cases to be difficult, because neither of us have seen anything similar back home. We were keen to use play therapy with these children, chat with the mommas, and even give special attention to the little ones who were more ill.

While being on the ward we noticed that the children here in Mongu are very brave. During the doctors’ rounds, there are several dressing changes and other treatments that need to be done. Many older children endure these procedures showing little signs of pain, despite the lack of analgesia given due to shortage of resources. Although we encountered some challenging situations, we were proud to have been able to provide comfort and distractions through presence and play therapy.

              We were lucky enough to work along side the nursing students from Lewanika School of Nursing. It was also their first week on the unit, and we were able to learn together and from each other. We felt very welcomed on the ward by the students and staff. They were all enthusiastic to answer any questions we had and give us help if we needed. Overall, our week on the children’s ward was a unique experience and we are grateful for these learning opportunities.

A week at the Zambia Project!

Hello Everyone! Julia and Sam here.

This past week, we were lucky enough to be placed at the Zambia Project. The Zambia Project consists of the Save a Life Center, a walk-in clinic, an orphanage, and an elementary school for vulnerable children. We both spent Tuesday and Wednesday at the Save a Life Center, which is a feeding program for severely malnourished babies and children in the area. When a malnourished child is admitted into this program, they are brought in once per week by their mother or guardian so that they can be weighed and assessed. The mothers are then provided enough food to properly feed their children for the week. The child’s weight gain and health status are monitored weekly for the 6-month duration of this program, and mothers are provided with education on how to properly feed and care for their children during this time. The Zambia Project also does home visits for certain children in order to assess their home environment and monitor their progress. We were lucky enough to be able to participate in multiple home visits, and we also helped out in the walk-in clinic by assessing patients with the physician, doing vital signs, and doing malaria tests.

Julia – I thoroughly enjoyed my time and learning at the Zambia Project and found it to be a very eye-opening experience. Although I had a hard time seeing so many young children very sick and malnourished, I was happy to see the positive difference that this feeding program is making by improving the nutritional and health status of so many children. My time at the Zambia Project also helped me to realize and reflect on the many reasons behind why these children are malnourished and helped me to examine the social determinants of health that are affecting these families. Some of the contributing factors I witnessed were little or no source of income, parental illness, lack of parental education regarding nutrition, and lack of access to a variety of food. Some children were malnourished due to another underlying health factor, such as a disability or another illness such as HIV. On Tuesday and Wednesday, I had the opportunity to participate in the feeding program, and involved weighing children, rationing the food to the parents, and of course lots of play therapy with the kiddies, which I loved.

On Wednesday and Thursday, we had the opportunity to visit the homes of many children on the feeding program in order to assess their home situation. I found these experiences to be very valuable for my learning, as they really provided me with a first-hand look at the challenges these families are facing. Most of the homes I visited were made of sticks and mud, had no electricity, and consisted of one bed where the whole family slept. During our home visits, we ensured that the child was being fed properly with the food that has been rationed to them, and we also inspected the cleanliness of the house and the presence of a mosquito net. We also found ourselves having to advocate for a particular child in order to get her to the hospital so that she could receive medical treatment. I am very grateful that we were welcomed into these homes, and for the support of the community health worker that was guiding us through these home visits. I loved working with the passionate and knowledgeable staff at the Zambia Project, and believe this organization is making a big difference in the lives of many malnourished children in Mongu.

Sam - This clinical placement has opened up my eyes so much. I am so thankful for the new things I have learned and the experiences I have had. I really enjoyed interacting and playing with the children while their mothers/caregivers were learning the lesson for the day. When interacting with the children I was surprised about how evident it was to see the difference between the children who have been on the feeding program for a while and those ones who are more new to the program. The newer children who were more malnourished acted less energetic and didn’t talk or interact as much. After talking to the staff at the Zambia Project, they stated that it was common that the children who were almost finished the program were the ones who were the more energetic, couldn’t sit still, and were acting like a “normal” child. Seeing this first-hand really highlighted the importance of good nutrition in children.

Another aspect I enjoyed was going on home visits. Participating in these made me realize the number of obstacles these families must overcome to feed their children. For example, some of these families have to travel (usually by foot) far distances get food, they may not have enough money to buy food, they may not have access to clean water and may have a lack of education in regard to nutrition. While visiting with one mother, we found out that her top goal was to move somewhere where there was access to electricity so that she could cook for her child at any time of the day, especially at night when the child is hungry. I never put much thought into how easy we have it in Canada to keep our children nourished. Now thinking about it, making your child something to eat quickly at night without electricity would be such a struggle. You would have to find the supplies in the dark, try an start a fire, keep it going long enough for it to cook the food and then safely put out the fire. In Canada, if your child is hungry, you can just quickly warm up a bottle of milk or food in the microwave in less than 1 minute. I really enjoyed this clinical placement, and it has made me rethink and become more aware of the things we take for granted in Canada.

Days for Girls (DFG) Kits – Finally!

Ella, Erin, Lauren and Kelsey here,

We are writing to update on the Days for Girls (DFG) kits – we know our chapter in Kelowna has been patiently waiting to hear about where the kits have made their impact! The four of us have been working on this project since September and are very grateful that we get to see this project through in Zambia.

Starting on Tuesday this week, Lauren headed to our first site at Limulunga Primary School to meet with the head master and deputy. The purpose of this visit was to ensure our teaching was in line with the school’s values and also to gain an idea of the students learning needs and how we should best relay all the important feminine and sexual health content to the girls. The head master and the staff at this school are amazing, the head master and deputy were very excited to choose 50 of the most vulnerable girls whom to which we could work with the following morning. Lauren had an amazing meeting and quickly began organizing material before the three of us finished our practicums for the day.

Wednesday morning, Adia, Mallory, Diva, Claire, Jessica and ourselves brought our large suitcase and headed to the school at 0900. We had another nice meeting with the headmaster and then got to meet all the amazing girls! We split into 7 stations and rotated small groups of girls through each topic. These topics included: puberty, sex-ed, menstrual cycle, how to care for and wash the kits, HIV/STIs, consent, and empowerment. Starting with a chant we jumped right into it. The girls were so attentive and engaged, this was so cool to experience. Although there was a lot of content to cover, they were amazing listeners and asked challenging but great questions. The teachers helped distribute the kits at the end to 52 girls (thankfully we brought two extra!). At the end, one of the students stood up to express their gratitude and appreciation to not only us but the women back in Canada who worked so hard all year to make this happen. This was a very emotional and humbling moment for all of us.

Wednesday evening, we were off to meet with a rural girl’s football (soccer) club, to hand out another 52 kits! Lauren had been in contact with the girl’s football coach over the past couple weeks and after waiting for the rain to clear, he did an amazing job facilitating the entire evening. This experience was quite different than the morning: instead of the classroom we taught on grass and soil, many of the girls did not speak English or attend school, and we were reaching a broader age group who faced many challenges. Luckily for us, two of the assistant coaches could speak both English and the native language, Silozi, and did a wonderful job translating the important information many of the girls had never heard of prior to this evening. This group also asked a lot of tough but meaningful and important questions and we worked with the assistant coaches to provide the best answers we could. Again, we ended the session with the same empowerment chant but this time we got to learn it in Lozi as well. 

We left this day with sore throats and full hearts. We feel ridiculously privileged and excited that we were able to work with the wonderful girls and women we met at both sites. We are looking forward to where the next 196 kits will take us.

Before we sign off, we want to extend a MASSIVE thank you to our wonderful DFG chapter back in Kelowna. We are thinking of you often and this project would not be possible without all of you and your hard work.

WE ARE WOMEN! WE ARE STRONG! IT'S OK TO SAY NO! MY BODY IS MINE!

Until our next visit,



Erin, Ella, Lauren and Kelsey 

Male surgical/ Theatre - Maddy + Tanner

Hello All,

It’s Madison and Tanner here, another week has passed here in Mongu and it feels like just yesterday we were reflecting and blogging about our previous week here.

This week we were placed on the surgical ward and in the operating room (theatre). We worked closely with many doctors, clinical officers, nurses and nursing students who all provided us with different learning opportunities.

We would start every morning “damp dusting” which consisted of us cleaning the ward with wet gauze as this was their means of infection control. Afterwards we would participate in rounds with the doctor and clinical officer students where we were drilled on medical information and sent home with homework for the questions we could not answer. This was an amazing opportunity to learn although intimidating at times. We participated in dressing changes, many on ward procedures and learned how to make use of limited resources in a highly acute environment. We admired their creativity although it was challenging for us at times coming from a place with an abundance of specialized medical supplies and diagnostic testing equipment. The ward is often out of regularly used supplies, the diagnostic equipment often breaks down and the blood bank is frequently dry. These were some issues that we have not come across in our Canadian practice which made it hard for us to wrap our head around.

A highlight of this week was our time spent in the operating theatre. We would head there every day after lunch and observed many procedures including a tumor removal, ORIF of the ulna, 2 ceasars (c-sections) and abdominal surgeries. We weren’t under the impression we would get to see any babies be born but were very excited when one of the clinical officers invited us into his theatre to watch our first births. Tanner was standing at the bedside with the ambu bag in hand eager to resuscitate where as Madison was standing with the mom sharing happy tears and welcoming her new baby girl. All the surgeries went smoothly although there were some close calls but the very talented staff pulled through and taught us while doing so.

As we reflect on the last week we have realized how much we have learned, both in and out of the hospital. We have had the opportunity of being a part of some individuals toughest days and some of their best days (seeing two healthy baby girls join us in this world). We only have 2 more weeks of our final practicum and bachelors degree and what a journey it has been!

Thanks for reading and stay tuned for next weeks post! Tanner will be at Sefula rural health clinic while also doing 2 days of child health at one of the local schools. Madison will be placed at Limulunga rural health clinic working with people of all ages and all different backgrounds unsure of what will walk through the door.

Sending love from Mongu,

Madison and Tanner

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