Saturday, April 9, 2016

Until next time...

Hello all!

Rachel's Week in the Outpatient Department at LGH 

Spending 3 days in the OPD allowed me the opportunity to see many patient presentations- an experience similar to the Canadian ER though vastly different in terms of triage, treatment, and resources. It felt as though I saw anything and everything in a day, though each shift seemed to bring new lessons of trauma, abuse, violence, and suffering. Of course, there was positive change as well; a couple wishing to receive reproductive counselling, a mother with her sick child, or seeing granddaughters with their grandmothers. The simple shift from one patient to another was astounding and taught me a most certain sense of adaptability. In working with the Medical Officers, I saw it- they are there to do their jobs and to treat each patient as best as they can, though that adaptability is much easier said than done. Thirty minutes spent identifying a passed mother and her baby is intertwined with the concerns and questions of the other patients around you. There is never enough time, nor will there ever be. That's what we see at home and it's what we see here in Zambia. How can we best serve patients under such strict time constraints, completely outnumbered and short staffed? It's a question to be answered in both health systems. In realizing this, I was able to enjoy my time spent with the knowledgeable Medical Officers in order to treat each opportunity as a valuable experience, whether it be devastating or surprising. Being in Zambia, I feel that I have experienced so much yet have barely scratched the surface of what it means to be a nurse here. In contrasting my experience in the OPD with our Malnutrition Screening event, there were times of sadness in seeing patients who had little hope of surviving. There was also a feeling of positivity and hope after finding out that one of the patients that we referred from the screening clinic went to the Save A Life Centre to receive help the very next day. To me, knowing that our initiative made a difference for one patient was more than enough to make it worth it.

It's a genuine pleasure, working as a nurse. To find fulfilment in each day that I spent caring for patients is an absolute blessing that I wouldn't trade for the world. How awesome is it that I can say that? I have certainly found my passion and carry such pride in knowing that my fellow students represent the same. I will surely miss all those whom I have come to know throughout this trip though will carry the many lessons learned in Zambia for years to come.

Thank you for joining us on our amazing adventure! I miss you all!

Jackie and I will be continuing our travels through to Cape Town and to London before travelling throughout Europe for a few weeks. I can't wait to see you all upon my return to Canada!



Ending is just another word for new beginning

This was our final week at Lewanika General hospital on the labor and delivery ward. We are together yet again, and had the most wonderful week to conclude this final practicum as student nurses. 

(Priya) I want to pursue a career in maternity in the future so, being on the labor and delivery ward was very exciting and something I really looked forward too. This week I got to experience some very beautiful moments with nurses, families and of course lots of babies!! One our first day on the ward we were able to take part in a c-section delivery for surprise triplets! When we walked on the ward the understanding was that the mother in question was pregnant with one child and was going to give birth soon. We had the pleasure of working with the Czech Doctors and upon their arrival they assessed this mom. They were able to distinguish two separate fetal heart beats. After hearing the news, the mom was not as enthused as the staff and students were and it became apparent that the mom was not ready for two let alone one child. We found out that the second baby was in a different position than the other making a natural delivery difficult/impossible. The mom required an emergency c-section to be performed when the OR room was prepared. 

Since the patient was quite young, the patients mother provided consent for the surgery and I (Priya) performed a pre-operative checklist! Very quickly the patient was in the operating room and we were watching the doctors perform the c-section. After the first baby came out I got to perform assessments and care to the baby which was amazing and very interesting. With Priya attending to the first baby I (Jackie) was able to assess and take care of the second child. At one point I was tending to both children as Priya moved to check in on the mom in surgery. While I was busy with the babes at the baby warmer I hear Priya yell, "Jackie! There is a third baby!". It was very crazy, nobody expected this and everyone was surprised. 

(Jackie) Upon hearing that there was yet another baby I was of course very excited. However, a feeling of sadness also came along side my happiness. This mother was not prepared for a single child, let alone three. I could not help but feel for her and the situation she was now in. Over this, I felt sadness and could not help but feel empathy for her. The new mother's sister at only 2 months, had just become an aunt to three new babies. It was a bitter sweet moment for me and I could not help but cry out of joy as well as out of heartache.

We had to leave soon after the birth as the room we were in could not accommodate the needs of the three new babies. We carried the children over to the Post Natal ward where there was a bed waiting for them. Everyone along the way was surprised by the triplets and asking if they were all one birth. Many families were overjoyed by the three new faces on the ward, but in some you could see the struggle. The struggle of mixed emotions that I (Jackie) felt when they were born. 

(Priya) It was bittersweet though, imagining how difficult it was going to be for this young mother and 3 children especially when she did not know of the 2nd let alone the 3rd child she gave birth to.Knowing of this and the difficulty this mother may have for resources we provided her with extra baby packs with clothing, socks, hats and blankets she could use for the babies. All in all, it was an amazing, once in a lifetime experience!

(Jackie) The following day on my birthday I was able to deliver a baby boy! Priya and I were both very excited and still on an emotional high after delivering the triplets the day before. We worked with a midwife named Regina and she was phenomenal to work alongside. We fanned the mother and held her hand as she started to push. We really wanted to tend to the mothers needs during childbirth as understandably, so much attention is put on the babe during delivery. It was her first born and she was very nervous. At times she felt she was "going to die" and could not continue. However, despite her struggle she was able to deliver a baby boy. When she was ready the midwife turned to me and asked if I wanted to deliver the baby. I got right in there and started supporting the head as it emerged. I was able to check for the chord which was thankfully not of any danger to the baby. Once I delivered the head, I was able to assist in rotating the baby to deliver the first shoulder, followed by the second until the entire baby was out! I placed the babe on mom to promote skin to skin and keep the baby warm. When that baby let out its first cry it was like music to my ears. We warmed him with a towel and took him to the warmer to put on a cute little outfit and surprise mom after she had been tended to by the midwife. My heart was very full, and it was so wonderful to see a mother who felt truly blessed by the birth of her first child.
(Priya) My next highlight of the week was helping in the delivery of a baby boy! We had come on the ward in the morning and during rounds learnt there was a patient who was quite dilated in far into her labor so we followed this case into the delivery room. There was a nurse, nursing student and Jackie and I. We waited for a while before the mother was fully dilated and pushing. During the birth I (Priya) got to catch the babe and give it to mom for immediate skin to skin, as it was crying and healthy! I was so happy I was able to promote and get the mom and babe doing skin to skin as it is not seen much here. Mom was very happy and did so well during the birth, it was such an heart warming experience; watching a new life enter this world. After the delivery we got to assess and dress the baby, we had brought some baby packs and were very excited to dress up the little boy! When mom saw the baby she was very happy and so so thankful for our help, she was very sweet. These 2 experiences were definitely highlights of mine for this entire practicum! I learnt a lot from the midwives and nurses this week and am very thankful I got to be apart of these experiences!

We were able to work with wonderful nurses and midwives on the labour and delivery ward which truly enriched our experience there. There was so much leaning that took place, and we both left with a greater understanding of both labour and delivery but also, working hands on in a limited resource setting and making due with what was available to us. Labour and delivery was such a beautiful was of ending off this practicum. It is hard to believe it is already time to leave and know that this was our final practicum of our Bachelor of Science in Nursing degree. As we step forward into our future we will carry with us all that we have learned here in Zambia, and will continue to reflect on all that we have seen and experienced throughout our careers. This is not an ending for us, it is the start of a new beginning.

To everyone who has supported us throughout this journey, thank you.


Priya and Jackie

Kyle's Last Blog Post

      In this last week I feel like everything really came together. There's a certain sense of accomplishment in distributing supplies to different wards and taking part in the nutrition event. I think I'll always think about how Lewanika hospital is doing and how far they are progressing. I guess I'll always be able to get a small glimpse through this blog in future years. However, I don't think they'll be able to grasp how far the health care system has come. Just like I wasn't able to recognize progress when I first arrived.

    The medical ward was quite nice to see. It was refreshing to see nurses who charted on the data-action-response forms that we're so gung ho about. They also generally seemed very well trained,  professionally strict and disciplined.

The nutrition event was fun if slightly chaotic. The target population of children didn't seem to have any respect at all for our insistent pleas to return to class. The fact that we had the headmaster's consent to shoo them back to class didn't seem to give us any more validity either. It was interesting speaking with Sister Kathy (who runs our accommodation at Liseli lodge) about the education system here. She told me how dubious she is about the quality of the education system here. I wish I had more time to investigate this aspect of Zambian society more.

It's a weird feeling leaving Mongu. I'm happy to be finished my degree but it's daunting to think about working as a full time RN now.

All in all the trip was about a 9/10. Would do again.

Goodbye Mongu, Hello New Adventures

After 4 short weeks the Lumbe house became our (Robin, Taylor, Hayley, Montana, Hailey and Steph) second home. We spent our last week in Mongu on the Peds ward hanging mosquito nets above every child's bed, out in various rural clinics seeing patients who didn't have the means to get to LGH, in the OR theater watching various successful procedures and in the NICU with our fellow Zambian nurses and Czech Republic doctors.

The Lumbe house fostered a place for us to laugh until we cried, practice our dance moves and eat copious amounts of pickles. We are all sad to say goodbye to our new found Zam Fam, but excited at the same time to start our new journeys as part of the 2016 UBCO BSN graduating class.

Sincerely with love
The Lumbe House

This is not goodbye.

What a whirlwind adventure I have been on the past month. I vividly remember the day before I was about to hop on the plane; sitting in the living room, strategically packing my suitcase. Here I am today, one month later, thousands of miles away, doing the same thing. I never truly realized how much I love Africa until I pack to leave; the people, the culture, our surroundings- and yes, I have learnt to make those gigantic spiders my acquaintances.

The experiences I have been lucky enough to have over the weeks have certainly been ones I will never forget. The mornings full of instant coffee, the conversations we laugh at till our cheeks hurt, the continuous sweat dripping down our face and the exhausting hot clinical days. I can't believe our time has come to an end, it truly saddens me to leave this beautiful community and the people in it. So many life changing moments in such a little time. I came into this practicum expecting to change lives; not knowing how much they would actually change mine.  

With love from Mongu,

Reaching the Untouched Side of Zambia

This week our time was originally scheduled for Limalunga Clinic. Limalunga is the village where the King lives and is famous for the Koamboka ceremony that takes place annually.  Instead of staying at the clinic, we were fortunate enough to accompany two medical officers (Kuwabo, and Lucia) and a pharmacist (Henry) on excursions to rural villages. We were to bring supplies to the villages and to introduce a new TB charting protocol. We would drop off Henry at Mwanawina Rural Health Centre (named after King Lewanika) to distribute ART medications, and then return the next day to pick him up.

Over the course of the time we spent with Henry, Lucia, and  Kuwabo, we were able to experience a side of Zambia we had not yet seen. It was amazing to see how many people live out in these rural villages. Although they don't have much, they manage to function and live happy and healthy lives. However we quickly saw how this can change when they get sick. They most eye opening thing we saw was how far people need and are willing to travel to reach a clinic and gain medical attention. For example, we drove one patient from the clinic back to her village after she'd walked all that distance to get there, and it took us 45 minutes driving. We can't even imagine how many hours it would have taken her to walk. On our second day, we reached the clinic, and this time conducted some assessments on patients that were staying on the ward. We assessed one lady who was severely dehydrated and suffering from cryptococcal meningitis which is an opportunistic infection that is commonly seen alongside HIV. We ended up transporting her back to Mongu to admit her to Lewanika General Hospital. Normally, these patients travel by oxcart which can take many hours. Our drive back was about two hours. This just shows how long it can take to receive health care, even simple things such as blood work can take weeks, as there are no labs out in the rural areas.

We had a great week out on the road with our team. We learned so much from Lucia and Kuwabo while travelling to the clinics about rural life in Zambia. Henry also educated us about the different medications used to treat HIV. We are so thankful for their insight and guidance when assessing patients. They welcomed us with open arms and encouraged us to fully engage in their work. The most important lesson we learned was to take time to have fun, to take a break from the medical work in order to enjoy our opportunities and surroundings.

With any great road trip comes good music, and we had a fun time singing along to country, top 40 hits, and African gospel music.

- Hayley & Janeva