My favorite day in Africa so far

It was a Wednesday, Feb 10, 2010, the third day of clinical for us at the Lewanika General Hospital. I went to clinical, just like I had for the two days prior. Upon arrival at the hospital it was determined that one of us could go to the Maternal Child Health Clinic if we wanted. I, always one for trying new things, volunteered to go. The day began in the Out Patient’s Department (OPD), and I worked with a nurse who was substituting for a clinical officer ( like a physician assistant). the nurse would gather pertinent information – such as the patient’s chief complaints/symptoms, and do an assessment to the best of her ability. She would then explain to me what her impression or diagnosis was of the patient’s condition. She could then order antibiotics, analgesics, anti-inflammatory medications, and other lab tests or blood work, which was surprising to me how much responsibility and autonomy that she has, as in Canada RN’s typically do not practice in this kind of role. In western society we often rely on technology before we make any assessments or decisions. We saw a variety of conditions that morning, everything from Respiratory Tract Infections, to possible malaria, possible HIV and STIs as well as other ailments. A lot of this work was done using basic pen and paper and a stethoscope, as well as the nurses hands for tools. After some time in this clinic I was shuffled over to an antenatal clinic, where we recorded a history of pregnant mothers, and entered this information by hand onto a paper logbook “record”. I had the nurse be with me to translate the local Lozi language to English. Moving without a break we went to the antenatal clinic where we performed head to toe physical assessments. Again, no technology was used in performing these, I admired the skills that these nurses have in doing this kind of work. After this I went to an area where they were testing for STI’s and HIV via smears on slides. The nurses never cease to amaze me at how multi-talented, and multi-functional they are, continuously working without breaks and doing double shifts. They are a wealth of information and I have already learned so much from being there on just that one day. I left the hospital that day feeling like my purpose for being here had really started, that I was going to make a difference in the world, half a world away from home. Stay tuned!!

-Sherise

Nurses’ On the Move

Late Monday evening we received a phone call from a hospital employee informing us of a potentially serious mass casualty accident on the main highway. A charter bus full of passengers from Lusaka had dodged something on the road and flipped on its side. We were asked to come and help out with the situation. A vehicle was sent out immediately to pick us up and take us to wherever they needed us (either the scene of the accident or to the hospital). Immediately after the phone call, all of us sprung into action gathering medical supplies and preparing for a potentially tragic scene. Sidenote: of course while all of this was going on, the power was turned off as part of a nightly routine, usually between 1800-2200. Needless to say, we were frantically running about the house yelling out “fill all your pockets with gloves”, “bring your headlamps and goggles”, “where are all the CPR masks?”, “bring the fluorescent pink duct tape for triaging”, “drench yourself with Deet- the Mosquitoes are out!” as well as many others. The bus picked us up quickly which came to us as surprise considering it’s Africa and NOTHING here comes quickly or on time. So there we were on the bus- ready to go - wearing headlamps, goggles, massive amounts of Deet, CPR mask out and ready (with a quick review on how to use it) and adrenalin pumping through our veins. We were prepared for the worst and ready to take action! We were taken to the Lewanika General Hospital where we found what seemed like the entire Lewanika General Hospital staff and nursing students waiting outside for the arrival of the bus casualties. After a short while bus arrived and thankfully the patients coming off the bus were much less critical than anticipated. However, there were a few patients who required immediate attention. We were able to help by performing basic assessments, dressing wounds and assisting the physicians with suturing of major wounds. It was a beneficial learning experience for all of us and we were very thankful that it was not what we were expecting.

We want to thank everyone for joining us on our African adventure. This weekend we will be travelling to Kafue National Park where we will embark on a three-day Safari. So stay tuned, we will have lots to share.

The Crew

Zambian-Canadian Nurses’ Bash

Well, as you might have guessed… we have had the wonderful privilege of attending a Zambian-Canadian Nurses’ Bash put on by some of our dear friends at Lewanika General Hospital. The bash took place at a local safari spot (Kassima Safari) which was complete with sandy beaches, loud music, volleyball nets, refreshments, a braiie (bbq), and of course… dancing!!!! Maybe we are getting a bit carried away in saying it was a sandy beach – as there was a ‘swim at your own risk’ sign next to the swamp-like stream on the edge of the flood plains. Ronald (our host) came prepared with delicious crackling wine, plenty of Mosi (local brew) and a local dj. The day was extremely fun. We spent most of our time on the scorching hot volleyball court with the locals or out on the sand dancing to the Zambian music. Sherise also gave us a private salsa lesson which we failed at miserably but it was fun nonetheless (and entertaining for some- especially Fay!). Elizabeth and Lindsey were our all-star football (soccer) players and even locals commented on their stealthy moves. Mary was our volleyball extraordinaire (surprise, surprise;) and was probably the best player out of everyone on the court, including the men…. much to their dismay. The rest of us lounged in the scorching sun, enjoyed the refreshments, and mingled with the locals. It was a fantastic day and we owe many thanks to our excellent host and wonderful driver (aka – Snoop Doggs Brotha) as well as all the other people who made the day so great! Zambian-Canadian Nurses’ Bash was a HUGE success!

Back in the Saddle Again

It has been some years since I worked on a paediatric ward (I am adopting the African way of vagueness about time and years) and I am delighted to share with you that some things stay with nurses the way bike riding comes back to us all. Sick children have some things in common, no matter where you are. I remember lab values; the feel of dehydration; the look of a very sick child. The wonderful young Dr. Sam Miti on the children’s ward patiently tutors us about tropical illnesses that affect Zambian kids. He enjoys the interchange with me and the students and we love him. The children here are bombarded by many health problems. Their little bodies must fight Maleria,TB, HIV, malnutrition and dehydration due to a plethora of gastric bugs. Many of our kids on the ward are being cared for by a grandmother as their parents have died of HIV. 10 kids, of our thirty patients, are fighting some form of malnutrition. Their solemn eyes peer out of old faces and smiles are a rare gift. Several of our kids have fractures, particularly of arms, falling from Mango tree, from father’s shoulders, roof tops and all manner of high places. Also, several cases of osteomyelitis (bone infections). Sadly we have 8 children who have HIV and are here because they have related (opportunistic) infections/conditions such as TB, pneumonia, malnutrition.

As all kids, for the most part they get better fast. The small crying face sports a smile today and tomorrow screams with laughter at the Makuwa nurse playing peek-a-boo. The tiny fist unfurls, the eyes shine, the rash subsides. We have triplet boys, two chubby faces, bright eyes that follow me, ready to smile upon any eye contact from me. The third brother (last one out), has the baggy pant look of malnourishment, a large head, and a big cough. I fall in love at first sight with his big brown eyes and his reluctantly given smiles. The Doctor agrees that my man’s head is very large and perhaps we need to send him to Lusaka. This would be a huge ordeal and expense for the family and Mom would have to tote brothers with him. They are all treated for pneumonia and my boyfriend also is malnourished so is on special feedings.

One small lovely babe does not make it through a severe malarial crisis. Nothing to do but to weep. It is sudden and harsh, like many things in this land of extremes.
The ward nurse tells me that is it obvious that I have a passion for nursing kids. I am so glad it shows! The kids and the staff welcome our funny ways and concerned attitudes. Their smiles are also sudden and beautiful, like many things in this land of extremes.

Respectfully,
Sister Fay

One week and a light years from home...

Pick up at the airport: Flat deck truck, 22 bags, 22 carry on and 11 tired but hopeful faces. Add a tropical deluge like none other except maybe when Noah built his arc, 30 minutes to the nurse’s hostel. Our driver sweetly said “ they are now baptised by Zambia, so belong to us” and ...you get the picture?

Home in Lusaka: same faces, very wet, same bags, very wet, 7 rooms. Bathroom...not wet!? Spirits high and a dinner out brings smiles...you get the picture?

A quiet space: Shopping with all 13 of us...herding cats? Tried all banks...some money woes, but nothing we can’t solve. Then to a cafe called Zebra Crossing. Looks like a small piece of Africa on safari. Grass thatched shade. Great food and cold beer, served by lovely people in a courtyard filled with African art and a wonderful gift shop. Even had a cat attack... a Tabby attacked a small duckling that was enjoying a walk with Madame Duck... you get the picture?

Bus ride: same baggage, same faces, add what seemed like 200 Zambian men trying to guide, sell and help, tropical deluge interspersed with sun and a mature bus, a rousing sermon to set the stage....you get the picture?
Arriving at first stop on the trip to Mongu....all 13 out in search of bathroom. All 13 suddenly developing well trained bladders after bathroom facilities failed to pass inspection....you get the picture!

Finally, Mongu and one more hassle with 24 bags, 22 carry on, various bags acquired in Lusaka ( think food ) and 13 tired but spirited nurses. Jess womaning the phone and pick up appears along with Sister Stella who was on our bus! Home at last! Showers (not from the sky) are warm, house is great, kitchen well and equipped. Smiles all round...you get the picture?

Our first crisis, one of us must go home to support a sick family member. All of you who have had anything to do with supporting and raising these young women should take a bow. They all used their skills and love to support and organize each other to get our friend home. They are caring, lovely people who continue to send support to their colleague...you know this picture.

13 nurses: Welcomed warmly by Dr. Silumesii, the Executive Director of Lewanika General Hospital. Met the Acting Director of Nursing and were toured around the Lewanika Hospital that will be our practice site for the next five weeks. 10 pairs of big eyes, questioning looks, worried brows. If captions were to appear above heads, some would say “what am I doing here?” ...they have painted this picture.

Mid week: Party at our house to say good bye to some friends. We were elected to host because we are a party on our own and we have a great living room. As our Irish friend said, “looks like an excellent place for a Hooley (sp?)”. So, tired but valiant, we make Chili, and make nice and had a good send off...played Scatagories...you’ve seen this picture.
Wards: We are part of the scenery now, children on the ward greet us with smiles, student nurses look forward to interacting with us, and all watch us with the curiosity and love reserved for an eccentric aunt who brings gifts and exotic behaviours when she visits. We have had our moments, sad things have happened, tears shed, but we kept going back. We leave the children’s ward on Friday and as I look back I see three Canadian students receiving waves, shy smiles and handshakes from a ward full of kids and parents, all of them sporting happy face stickers on their cheeks...you should see this picture!
We have completed our first 10 days in Zambia and have many pictures caught in our minds...each different and each to be visited and reflected upon. Slowly, we are making inroads with our Zambian colleagues...respect is growing on both sides. We are teaching and learning each day.

Jess and I have met with many of our usual support team. Dr. Margaret Maimbolwa greeted us in her usual warm and helpful manner. Dr.Elenor Msidi, with the Zambian Nursing Council, guided me through the registration process and I now proudly can say I am registered in Zambia. We continue to meet with various officials regarding our practicum and OKAZHI initiatives.

From the land of forever skies, big lightening, extreme living...I hope you get our pictures!
Love to all, Fay

Home Again!

I think it is finally time that I introduce myself. My name is Jessica and I have had the pleasure of bringing these ten lovely ladies to a place I hold very close to my heart…Mongu, Zambia. I have been working in Zambia since 2008, and have a passion for nursing in Africa. This passion came to me three years ago, when I took the same path as these students and went to Ghana, West Africa for my 4th year final practicum at UBCO School of Nursing. Since graduating from UBCO in 2007, I have followed that passion and found myself teaching nursing in rural Zambia.

In 2008 myself and another colleague, Lianne Jones (who also just so happens to have that same passion for Africa!) taught at Lewanika School of Nursing for 6 months. The school is located in Mongu, the capital of Zambia’s Western Province. Although we were presented with many challenges, I had the privilege of meeting and working with a number of wonderful Zambians. My nursing students were bright and eager to learn, and my teaching colleagues taught me the principles of what it means to be a great teacher.

I returned back to Zambia in October of 09, with a team of surgeons and nurses from Kelowna. Together we have formed an organization called the Okanagan-Zambia Health Initiative-OkaZHI (http://www.okazhi.org/) Our mandate it to continue working in Western Province, Zambia and we will return twice every year to bring education to local Zambian nurses and doctors. I think of the UBCO nursing students as representatives of OkaZHI, and maybe one day they can return back to Mongu and help us to continue our education!

Every time I come back to Zambia it feels more and more like I am returning home. I think I can now officially call Mongu my second home! I love that I can share my second home with these ten wonderful nursing students. Zambia is also known as ‘The Real Africa’, and after traveling around many African countries…I can honestly say it is the ‘Real’ Africa! So far I think they really are getting a taste of the real Africa. I feel privileged to have the opportunity to guide these students through their own life changing experiences.

Jessica

A message from Mongu

I can hardly believe that I have only been in Mongu for over a week, it feels like this is my new home. Everyone has been so incredibly welcoming and so kind; whether I am sitting in the back yard, biking through town, or working at the hospital every person stops to shake my hand and welcome me to Zambia. It is such a great feeling. Speaking of working at the hospital, this week my group (Elizabeth, Sherise and myself) were on the Children's ward. It was an incredible experience and I wish I could stay there for the duration! Each morning when we walk on the ward the children sit up in bed, smile and start waving - they are always so excited to see the "Makuwa's!" I have learnt so much from the doctors, nurses and students on this ward. We work very closely with the staff and this has made for a very postive learning experience. The daily routine of the ward is such a contrast to what I am used to, and the severity of disease and illness is like nothing I could ever have imagined. The incidence of severe malnutrition, malaria, and HIV is astonishing and it is so heart renching to see such young children so sick. It has made me truly realize how fortunate and blessed we are in Canada, and how much we have. It has made me come to know what life is really all about and what truly matters. There are many people here who have so little, and yet the smiles on their faces could not get any bigger.

As you will read below, we went to the Orphange on Sunday and were joined by over 200 children. When we arrived they were singing the most beautiful songs - it brought tears to my eyes. We started off by singing and dancing with them, and then we spilt into groups and did beading, painting, skipping, soccer, red rover, and bubbles! It was so joyous to see the children so happy and having so much fun. The couple who run the orphanage told us that it is rare that the children seem so happy, and they were so thankful for our presence. The children glommed onto us - I could easily have brought at least half a dozen home!

All is all everything is going really well. I am having so much fun, learning tons, and crying lots.
Sending all my love to my family and friends back home.
Mary

MONGU thus far.

First of all I would like to start off by saying that I have already been deeply humbled by my experiences here in Zambia. We often take for granted everything we live, breathe, know, and expect back in Canada. I believe this is something that will resonate with me forever.

Even in Africa, we are truly spoiled with our beautiful, newly reno’d guesthouse directly across from some of Zambia’s largest flood plains, and our brand, spanking new ZAMBIKES! It is a blessing to be able to come home to such a safe, peaceful environment where we can debrief and relax in the hot African sunshine. Our new home is a small paradise in a world of heartache and need. Outside the gate of the guesthouse, the Mongu community is in dire need, yet despite the turmoil that surrounds them, the people of Mongu maintain big smiles, warm appreciation, faith in God, and hope. Their resilience inspires me.

On Sunday, we had the opportunity to visit an orphanage in Mandanga that is run by Mrs. Kababa, the librarian at Lewanika School of Nursing, and her husband, Mr. Kababa. Nearly two hundred ecstatic children greeted us. They were singing and dancing their little hearts out. We laughed, sang, danced, played, and cried. I have never been so moved. This day was beyond anything I could have ever expected.

Monday was our first day of work at Lewanika General Hospital, and we have split into three groups of three. Kirsten, Jamie and I have started working on the female ward this week. When we arrived for our first day, there was just one nurse to twenty-five patients, as the second nurse was ill that day. I cannot begin to explain the conditions that the nurses have to work in, and I realize now how much I will learn from their adaptability as nurses.

Now as the sun sets over the breathtaking flood plains across the road, it is as though nothing else matters in this moment. This moment passes, and the world carries on.

-Lindsay Courtice

“Be the change you wish to see in the world” –Gandhi

TIA

I'm sure many of you have heard the phrase TIA- it means THIS IS AFRICA and it is a phrase we are becoming very familiar with. The African Life is very different from what we are used to in Canada. Many of the things that are soo easily accessible to us in Canada (running water, medical supplies, washers and dryers!!!!!!, food etc etc) are practicallly nonexistent in Zambia. We have gained such an appreciation for what we have at home especially after witnessing what the people of Zambia live without. The people here use the phrase TIA to signify what African life is like - you basically make due with what you have and that's all you can do! As we said before, we are coming to learn this VERY quickly.

We have found one of our greatest challenges has been practicing in the Lewanika Hospital here in Mongu. There are next to no medical supplies and very little resources for people to access, not to mention an overall lack of healthcare professionals. We have come to realize that there is a vast amount of education needed here for the staff and patients, particularly with the recurrent medical conditions they are exposed to everyday (Tuberculosis, HIV, Malaria, Meningitis, Malnutrition and the list goes on). There is also a severe lack of funding for the hospital to train and retain health care professionals. It is truly a system in need.

On a brighter note, we are learning so much from our experiences at the hospital. Each of us have been stationed in different areas throughout the hospital. Mainly, outpatient (sort of like emergency), maternity, medical/surgical units, pediatrics, ART (HIV clinic) and the operating theater (aka - operating room). The staff and students have been very welcoming and supportive of us. We are soooo grateful for them and all their hospitality. We have also had Jess and Fay to guide and support us through this huge transition which has been unbelievably helpful. We could not possibly thank them enough for all the support, mentorship, and love they have bestowed upon us.

We are sorry we have not put up pictures yet, we are having technical difficulties with internet connections. So, stay tuned and pictures are shortly to follow!

Again- we would like to send our thoughts and love to our 'tenth' student who left us early in our journey. We are always thinking of you B.C. and wishing you and your family well. xoxo 'Your long lost Lozi's!'

Makuwa

Sherisse and the Zambikes!!

We titled this entry Makuwa because we hear it about 500 times a day. It means ‘white person’ in the Losi language and everywhere we go people shout it out…it is hilarious! We have safely arrived in Mongu. The 8 hour bus ride was what we expected. Along the way we saw elephants, wild boars, antelope, and Mary is 80% sure she saw a Rhino but the bus was moving to fast to be sure and Fay is convinced it was a unicorn…haha. We have now settled nicely into our lovely new home at the Cheshire guest house. It is beautiful. We are fortunate enough to have our own kitchen area to cook in. Kirsten, Jamie and Lindsey C made Chilli for our first meal! We all share a room with 1 or 2 other people, and each room is even equipped with it’s own bathroom – we feel so thankful for the living accommodations we have been provided with.

Yesterday we picked up our bikes from the bus station and rode them all through town back to our place. The bikes are called Zambikes and they were made just outside of Lusaka by a good friend of Jessica’s. Zambikes moto is ‘building bikes for change’ and they are committed to making this company a sustainable one for Zambians. We purchased the bikes with the money we fundraised over the last few years. They will be our major source of transportation while we are here and when we leave we plan to donate them to locals in the community. As if 12 Makuwa’s weren’t bright enough to draw attention in this small town, the bikes are florescent yellow and are always accompanied by a trail of African children running behind us.

We had a tour of the hospital where we will be spending most of our time working over the next 5 weeks. The experience was very eye opening once again. The conditions are much less then ideal, the staff to patient ratio is about 2 nurses to 40 patients, and sometimes they run with only 1 nurse. Despite the conditions, the hospital director along with all the staff and students were extremely welcoming and so pleased to have us there. We went to the lecture room where the students were being taught, and the way in which we were welcomed brought tears to our eyes. Every single person shook each of our hands and said “you are welcome.” Among all of us there is a very overwhelming feeling. We are nervous and scared to work in such a challenging environment but the support we have already been shown is very reassuring. By talking with the nurses here we have come to realize that we both share a desire to learn from each other and share our knowledge. We start on Monday at the hospital and we will keep you posted on how it is going!

Among health care challenges we are coming across others as well. Here are some to name a few: we are washing clothing by hands which takes a very long time, especially because it is rainy season and very humid, therefore nothing will dry, we are lacking coffee which is a nurses lifeline, we share our corridors with some very strange creatures – frogs, cockroaches, very large spiders, geckos, all sorts of crazy flying insects, but surprisingly and thankfully very few mosquitoes. All in all we have come to learn to cohabitate with the local flora and fauna.

Last night we sampled the local restaurant and pub/dance floor/night club. It was fantastic. One of the highlights was definitely the 6000 Kwatcha (local currency) Mosi AKA $1.25 beer. The food was great, so far we have had lots of western type foods, however last night we branched out (thanks to Lindsay Redl) and tried some Nsheima. It is basically a ground maise made into dumplings and you dip it into various sauces, last night it was a spinach concoction with small nuts in it. We then headed over to the dance floor, and perhaps we will just say that was quite the experience in itself. Our Makuwa moves were not warmly received at the Oasis dance club – apparently Canadians can’t dance. Needless to say we were given lessons!

On a sad note, one of our nurses has had to go back home due to a family emergency. We want her to know that we are thinking of her and are sending her and her family all of our love and support. We miss you B.C. and are thinking of you often.

That’s all for now, we hope this finds you all well. We will be in touch!

We are not in Kansas anymore Dorothy:

Checking in with the heaviest bags BA has ever seen and having the audacity to ask them to waive the charge on our extra bags they told us that our second bags would cost $50.00 each. Finally, after much chatting they waived the fees and began weighing each bag in.
All bags open in front of various checkouts as we took this out of there and put that back. Finally, they charged us $120.00 and begged us to move on. Still took two of us to move Jess’s hockey bag that is half the size of New York.
All asleep as I strolled the plane somewhere over the Atlantic.
Tired but excited all but Jess and I caught the train to London. Talk of plays and sights.
Jess and Fay meet the Ghana group whose plane has been delayed. They look tired but undaunted. I just look tired.
We are off to Zambia with three seats each so sleep regenerates us.
Are met at Zambia’s airport by Benjamin and an experienced looking green Nissan. We pile our luggage (which seems to have reproduced) into the back and into the front, along with Jessica, myself and the driver. Jess is perched on the center and has to shift so Ben can! I feel obligated to hang on to the door as I have visions of Jess and I flinging out on to the street. AH yes, we are here.
Our driver is terrific and we accomplish our errands quickly.
It is green and lush; trees sporting their finest flowers and the crops are flourishing. The city is busy and Benjamin takes us safely to the Zambike farm where Jess and I will stay until the students arrive. Lovely big house and best of all a bed.
I am struck once again by the welcome from Zambians. Benjamin talks with us about his life and we about ours. He finds guidance in his life from his deep faith and can recite many verses from the bible, which he uses daily to guide all his decisions and make sense of his life. It is not something we are used to at home, but natural and comfortable here as is done without judgement or preaching.
I awoke to strange bird songs and the sound of a torrential rain storm. No we are not in Kansas anymore.

Fay

Welcome to Zambia

Our arrival... after days, months and even years of anticipation we have finally made it to Zambia. Stepping off the plane was a surreal and exciting experience. The Zambian heat and humidity were in full force as soon as we stepped on Zambian soil. We were warmly welcomed by Fay and Jessica not long after we landed. The drive to our accomadations was interesting to say the least;)

We are staying at the University Teaching Hospital in Lusaka (the capital) and were given a grand tour by a third year nursing student. The environment and working conditions of the hospital have made us greatly appreciate our healthcare system and how lucky we are to have such amazing facilities. Despite the poor working conditions, the Zambian people have been exceedingly friendly and always have bright smiles to welcome us with.

We are staying in Lusaka for one more day and tomorrow we take a grand and prestigious bus ride to Mongu. Apparently, the journey will be comprised of 8 hours of bumpy roads, sweaty people, less than optimal toilets and a group of eager nurses.

So that's all for now, we'll keep you posted on our adventures throughout Zambia.