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