Male Surgical Ward/Theatre

Hello all,

We are wrapping up our third week here in beautiful Mongu. For us (Matt & Shelly), we were able to spend this one split between helping with school health week at the save a life center (operated by the Zambia project), and at Lewanika General Hospital in the male surgical ward and OR (called simply ‘theatre’ here).

The school health week went off without a hitch. We were able to see over three hundred children (grades 4 through 10 on the first two days) during our time there. We helped conduct vision and ear exams, collected heights and weights, and calculated BMI’s to assess for adequate nutrition. It was great to get to interact with the children, and likewise work alongside our colleagues from the save a life center.

The following two days we started our mornings in the male surgical ward. There we familiarized ourselves with the daily routines of the unit. We helped the nursing staff with vitals, assessments, and daily cleaning duties (“damp dusting”) before joining in on the clinical officers “rounds” of the patients.

In the afternoon, we made our way to the OR (“Theatre”) where we changed into theatre scrubs, shoes, and masks, and were welcomed into the surgical theatre by the incredibly friendly staff.

Our first case on Thursday was a caesarian birth (“ceaser”), and was of particular significance for us both as it was the first birth we had witnessed. As it was a high risk delivery, we both mentally prepared for what we might need to do if resuscitation of the neonate was necessary. We recalled the afternoon we had spent in pre-departure training where we had reviewed the indications, and subsequent interventions, necessary to revive an infant.

As it turned out, our pre-departure training couldn’t have been more applicable, as immediately after delivery, the Doctor turned to Shelly and said simply, “you will resuscitate this one”. In a flurry, the limp child was carried to the warmer and over the next 10 minutes we worked alongside a nurse and anesthesiologist to successfully revive the baby. We both felt time seemed to run slowly and all else in the peripheral environment fade to the background as we dried, suctioned, stimulated, and ventilated. For both of us, this day undoubtedly marked one of the highlights of our trip.

The next day, we similarly started our morning off in the Male surgical ward, and then returned to the theatre. We started our day off by watching the amputation of a leg, then were able to watch a gynecological procedure during which the power to the building cut out and we were forced to help light the surgeons field with the light from our iphones. Later that afternoon (power restored), Matt was allowed the opportunity to “scrub in” on the final procedure of the day, helping the surgeon by handing tools, retracting, and preparing the sterile field amongst other things.

For us both, we were reminded of how the “right” way of doing things, is often a subjective term as we witnessed our colleagues this week operate in exceptional competence, despite things looking different than they would in Canada.

This next week we are off to a rural community where we will be setting up a clinic for several days before ending our time here.

All the best to you all,

Matt & Shelly

It's not all elephants and sun-downers on the Zambezi

Hello it’s Madison here!

I am calling this blog post “It’s not all elephants and sun-downers on the Zambezi” because although this trip has been life changing and filled with moments that I will hold close to my heart forever…there are days here when it is just hard. We are across the globe, surrounded by new things, new people, new food, and all while trying to get through our final practicum of our nursing degree. Sounds easy doesn’t it!?

During this past week I have faced some of my hardest moments. When asked what was wrong I would reply “I am over the honeymoon phase”, this meaning that I am over a month into being away from home, I miss my family (mostly my dog…sorry mom and dad), I miss westernized food, I miss not sharing a bed with someone (although I love my roommate Julia…you sleep talk), and I am missing familiarity. Even doing laundry by hand and making a cup of coffee that took 10 minutes to boil feels like the biggest task at times. I am missing simplicity (and yes when I think of simplicity I am picturing my Keurig coffee maker at home). Now these things may seem small (and really, they are), especially considering I am in Africa where I am surrounded by people in poverty, people struggling with severe illness, and people facing many barriers in their lives such as access to food, clean water, healthcare, and the list goes on. But I have been put into a completely new world, where I don’t fully understand anything. I am a Mukuwa (the term they use here for white people) who is a little lost in Mongu.

I grappled all week with my “low” feelings and spent my time wondering why I was feeling this way. I kept thinking something was wrong with me… I am in my favourite place in the world so why was I feeling like this? One word that comes to mind is exhaustion. We are always “on” here. We must greet each person in our passing appropriately (I haven’t quite mastered whether it’s a clap and a bow, a hand shake, or none of the above), we must try and learn a new language (so far, I have learned “hello, I am fine” in Lozi), we must be culturally aware and culturally safe at all times (my highlight from this week of what not to do is tell someone you’re married just to get out of being asked to marry someone’s son) and always being on showcase (by this I mean being looked at 24/7 and getting called MUKUWA right, front, and center) just because I am CLEARLY not from here. In the honeymoon phase, this was all new and exciting– and some of them still are, but the more I hear the word Mukuwa, I just want to shout, “MY NAME IS MADISON”. Of course, I don’t do this, I smile and wave and join in on their laughter.

Going through all of these small things really do add up and while I am dealing with the things that I miss from home such as my morning routine, my beloved dog Twix, my morning cup of joe…I am also working with sick babies, children, and adults. I see things each day that I wish I could change and I see people that I wish I could save…but I can’t. That itself is enough to throw me out of whack! My heart is full here, but it is definitely heavy, and each day is bringing new challenges. I think I can speak for everyone when I say that we are trying our best to keep a smile on our face even though we want to cry because of something we just saw at practicum or on the street, and that we are doing our best to stay positive, to embrace each and every moment, we are doing our best to adapt and fit in… we are doing our best and that’s all we can do but some days are harder than others.

           I keep telling myself “it’s okay to feel low, but you can’t stay low forever”.  Although it is easy to get caught up in the negative things we are seeing, I am pleased to say that it is incredibly easy to be uplifted here. The culture, the people, the beautiful surroundings are what keep me going. I was face timing my dad one night this week, and I started to tear up (who knows for what reason this time). I went outside to the street to get some fresh air.  I walked a little bit down the street, said hello to a few people, and saw this stunningly beautiful woman walking down the street with water on her head and a baby on her back.  For a moment I forgot my dad was on facetime until I heard him say “You just changed…the moment you walked onto that dirt road and greeted your neighbors and those driving by, you changed. You look so much happier”. Zambia is my home away from home. I have made new routines, I have learned to enjoy instant coffee that took 10 minutes to make, a part of the Lozi culture will always be in me (so if you see me in Canada clapping and bowing to you at your feet this is why), and I will always be a Mukuwa. When I go home to Canada (which is coming up quick) I am going to miss these things just like I missed home in Canada. And now to finish this incredibly lengthy and personal blog I will finish it off with a cheesy but TRUE quote “every day may not be good, but there is something good in everyday”

Now I must go run and get my clothes that I hand washed off of the clothesline because its pouring rain…

All my love, From my Zambian home to my Canadian home

Madison

6 thing I have learned so far in Mongu..

6 things I (Julia) have learned so far in Mongu:

1.   That using your brain and knowledge are both extremely important, especially when in a healthcare environment with limited resources. I have been challenged to change my healthcare mind-set from very technology focused to critical thinking focused while being here, because often times the equipment you need is not available. Because what do you do when you don’t have another ambu-bag and you need it? What do you do when you don’t have an IV pump, or a tourniquet, or tape, or normal saline? You need use your critical thinking skills, nursing knowledge, and a bit of creativity in order to work with what you have. I have experienced these kinds of situations many times here in Mongu.

2.   That Zambia time is much different then Canadian time. In Zambia the people revolve time around their lives, whereas in Canada, we revolve our lives around time. They are all much more relaxed about time here, and because of this people understand that sometimes it is okay to be late, because if you are late it means you got caught up doing something else important in your life. This is very different for me, but I think us in Canada could all learn a thing or two from Zambia time. I also learned that if you actually want a taxi to pick you up on time here, you must specifically tell them “7:30am Canadian time.”

3.   That it is acceptable to swerve all over the road while driving to dodge all the massive pot holes, people, and obstacles on the road. It is also acceptable for the cab driver to blast cool gangster rap music in all situations, including when dropping us off at the hospital in the morning.

4.   That everyone needs to dance a little bit more. Dancing is a big part of the culture here, and we have all had many opportunities to dance while we were here. Whether it be spontaneous dance parties with children on our road, or dancing with a group of nuns and pastors at Liseli Lodge, or having the ladies at the Zambia Project teach us their moves. That being said, I have also learned that Zambian people are great dancers, and that they definitely have a thing or two to teach to us “mukuas” about dancing.

5.   That it is very possible to carry large and heavy objects on your head and walk far distances while balancing them. Many women here carry VERY large objects on their heads, all the while having to also carry their baby at the same time. I am continuously impressed and amazed at how these women manage to do this.

6.   That the same place can be heartbreaking, but also beautiful at the same time. I have seen many difficult things here, things that I have heard about but have never experienced before I arrived in Zambia. For example, one of the hardest things I have seen are the ill children – many who are small and hungry and have swollen bellies, many with serious illnesses, and many with torn clothing and rotten teeth. These children have broken my heart. But I have also seen the passion and dedication of certain individuals, healthcare workers and organizations that are trying to help these children. I have seen their successes and the differences they are making. I have seen the beauty in the people who are trying to make a change, and the beauty in the children who are growing and healing and recovering. I have found that many of my experiences here in Mongu have also had this same contrast.

- Julia Roth

3 weeks gone by...

Three weeks now, three weeks just moving through this foreign land, this foreign space, trying to make sense of emotions, thoughts, context, constantly musing, asking why.... why do I think this or that?  Why was that done like that?  Is it correct, the best way?  What is the best way?  Do I know what’s best?... And it goes on like that, sometimes in conversation with others, sometimes alone, in silence, my own quiet reflection.  

I enjoy the morning best, 0500h, only the call of roosters and sounds of insects outside, and I sit and drink my coffee.  The rest of the day is noisy - not in a bad way, just noise and movement - roommates getting ready, preparing food, chatting; the lodge staff working to cut grass (by hand with a machete), do laundry (line dry), sweep the grounds, make repairs, and so forth.  Once we head out for the day, there is talking and music, jostling against one another as we ride in a taxi or minibus down the road full of pot holes.  And there are people, people along every road, walking or sitting, moving or waiting, greeting one another, carrying heavy loads balanced on heads or teetering on bicycles, tiny babes tied securely to backs, and children running and playing - moving along just like I am.  And there is shouting, lovely children shouting, shouting to get our attention, and waving.  They yell “makua” - white man - and “How are you?”, to which “fine” is the best answer.  We wave and beam at one another as we move in the noise, adding to its volume and content.  And the language is sound too, low and softly spoken.  I’m trying it, to speak the language.  It is difficult, and I carry my list of words and phrases, practicing, listening for familiar words in nearby conversations.  This endeavour, however small and poorly pronounced, is sincere and has created simple, small flashes of connection, openness - a shared smile and a laugh.

It helps me to keep trying, when I don’t feel like trying, and it helps me get through the noise, shifting the unfamiliar to something familiar, creating a shared space.

Adia