Wednesday, March 10, 2010





I have never blogged before. I struggle enough sharing my inner most feelings with those that are closest to me so blogging terrifies me. I am not interested in writing for the sake of writing but to tell a story, paint a picture so those who read what I write have a sense of what I am experiencing. This may help explain why I am a terrible facebook friend and rarely email…or never email…I find that my words are clumsy and can misrepresent what I truly want to say. I want to capture how amazing this clinical experience has been for me but am afraid I will fall short. Although there have been many tears, I realize that my presence here has made a difference. A difference in the lives of patients, families and the nurses I have worked with. I have learnt so much about the human spirit and how resilient people can be. How much people can endure and still have hope. Hearing about HIV/AIDS in Africa is not comparable to seeing how it has torn apart families. Children should not be burying their parents and grandparents should not be burying their grandchildren.

HIV/AIDS is everywhere but poverty is what resonates within my soul. Poverty encompasses everything; it is the root of most problems as far as I can see.
Poverty is two boys sharing a pair of oversized sandals so they are able to jog with us down the road. Poverty is the 11 year girl down the street in the baby blue party dress that may have fit her two years ago that is so covered in dirt that I can’t imagine any amount of cleaning will ever return it to it’s original shade. Poverty is being unable to provide enough food for your family, having to bring your child to the hospital because they are so ill with malnutrition it is amazing they are still breathing. Poverty is the man who walks eight hours every two weeks to the feeding clinic to pick up four containers of formula for his 9-month-old twins. Poverty is a man hunched over a pothole, splashing handfuls of muddy rainwater over his naked body on the side of the road. Poverty is being unable to send your children to school because the school fees, books and uniforms are beyond your means. Poverty is here. It surrounds us. It overwhelms us. Despite what may appear to be a desperate situation, there is hope. Hope in the eyes of those we encounter and smiles that would melt your heart.


Pediatrics is my passion, yet the Lewanika Maternity Ward took my breath away. The strength of the women that come into the Maternity ward put me to shame. In the week I spent there I did not hear anything louder than a soft moan. There is no pain control whatsoever. It is not unusual to find a woman in the birthing room by herself minutes away from giving birth. I spent the week giving women back massages, cool cloths, words of encouragement, breathing with them, teaching them about caring for their babies. I delivered twins with Lana, which still brings tears to my eyes. I held the hand of a woman as she struggled to deliver her full term baby who would not be able to join us in this life. I fought back tears everyday and sometimes the pain and sadness was too much to contain. I sat on the floor of the hospital and cried with a woman who had just lost her 27 year old sister to AIDS, who lay motionless under the blanket, so thin you could hardly see her outline. I have learnt that touch transcends the spoken word and although we were unable to communicate verbally we were able to relate on different levels.

The room where patients have been referred to get testing is a small room with an old wooden desk. It is 0900 and there are people lined up waiting to be tested. We are out of reagent, which mean the tests cannot be done. I am left in the room to look around. The walls are covered in posters about family planning, condom use, encouragement about getting tested and decreasing the stigma associated with HIV/AIDS. The registry of patients sits open on the bed behind the desk. A total from January reads out 76 tested, 5 non reactive. Five out of 76 tested negative. The odds aren’t great when people come in. The reagent was found after all and the first patient comes in, a child and their mother. The nurse is speaking in Lozi and slips into English to introduce me. I clearly have not mastered the local language so I sit in the room and watch for any non-verbal cues that will give me a clue as to what is going on. The child sits there as the nurse pricks their finger. Certain words- like CD4, HIV, AIDS stand out among the Lozi. There are no tears or smiles when the test is over so I must wait until the nurse informs me. The child is negative.

The hospital is not only short on supplies like the reagent, but medications, glucometers, blood pressure cuffs, staff, water, …the list could go on. These are basic supplies that hospitals require. Last week, as I was leaving the hospital, three physicians were standing outside the Administration Building in their lab coats, each with an x-ray held up to the sunlight. This is Africa. Where they may not have all the equipment that we take for granted but they make due with what they have and are extraordinarily innovative and adaptable.

I have met so many amazing people, people who have committed years of their lives to help those that are less fortunate; I only hope I am capable of such selflessness. They are so inspirational. I am also grateful to have traveled with such an amazing group, each with their own strengths and gifts. I have learnt, I have taught, I have laughed, I have cried, and most important, I have changed.

I will be back.

Lindsay Redl

Monday, March 8, 2010

My Zambian Experience So Far....

Well, where do I start? I know I cannot possible put into words how amazing and life-changing this trip has been for me but I feel inspired and in a sense obligated to share my story with all of our friends and family members who have been travelling with us on this journey.

I have to be honest; when I first arrived in Mongu (our current home) I was overwhelmed and completely terrified! I was raised in a small town and have barely experienced ‘city life’. Up until this trip my idea of travelling was an all-inclusive trip to Mexico! So, an adventure into the heart and soul of Southern Africa was quite an adjustment. I would compare the experience as something like spending five hours in a hot sauna and then proceeding to do a polar bear dip into the Arctic Ocean... hint- it’s a bit of a shock! However, after spending five weeks in Zambia I can honestly say I do not know how I will be able to leave this place. The things that initially terrified me, I have now grown to love.
Some things I love about Africa:

I have met some of the most generous, caring, thoughtful, compassionate, and friendly people in the Western Province of Zambia. I have cultivated relationships that I will cherish forever. Every day I am warmly greeted with bright smiles and cheerful expressions. I had no idea how extensively the people of Mongu have valued our presence here! Everyone shows such respect and appreciation towards us – it is an extremely humbling feeling.

The landscape is incomparable to anything I have ever seen. We live right near beautiful and vast floodplains and the sunsets that highlight the plains can truly take your breath away. A medley of oranges, yellows, pinks and blues canvas the endless sky. For all those astronomers out there – come to Africa if you want to see how amazing the night sky can be. I had no idea so many stars existed! The Milky Way and Orion’s Belt are so profound, once again words cannot describe.
Song and dance are as essential to Zambian life as air and water. Both are integrated into a child’s life from a very young age. It is no wonder it seems as though every person here has an innate ability to sing and dance brilliantly. I used to think I had some pretty good moves on the dance floor... I now realize that my so-called talent pales in comparison to the people of Zambia. My friends have suffered as they have watched me try and groove with the locals. For the first little while, I thought I was doing a pretty good job- until I realized that the pointing and laughing usually started when I hit the dance floor!

Zambian artwork is another part of the culture that I have grown to love and appreciate. It’s easy to overlook a simple basket made out of straw. However, if you look closely you will see how intricate the details of a hand-woven basket can be. I imagine it takes not only an enormous amount of patience but also an ability to navigate the finest muscles of the hand to be able to craft such a simple yet beautiful piece of artistry. I also greatly enjoy the African paintings... maybe a little too much as they have certainly done a number on my bank account! Artists use radiant colour schemes which perfectly capture the Zambian culture (especially the landscapes!). I am so eager to share the artwork I have found with my friends and family back home.

A Final Note

Although Zambia has so many issues like poverty, widespread disease and other detrimental determinants of health... I can only think of it in a positive light. I have seen some of the most horrible things here, yet these things have not impacted my overall love and affection for Africa. It will always have a special place in my heart. I wish so badly my family and friends could be here to experience what I have had the privilege of experiencing. I will be forever grateful to those who made it possible for me to come here. Zambia has taught me so many things in just a few short weeks. Undoubtedly, the experience has changed me for the better and I will never forget it!

Jamie

A Time for Good-Byes...

Hello fellow bloggers, travellers and followers. It is now the end of our trip and an amazing experience. I feel that there are few words to describe the tremendous amount of knowledge I have learned and how much I have changed. I ended my experience on the maternity ward of which I have very little experience. The midwives, students and doctors were so welcoming to me. The teaching done was amazing to help me to feel more comfortable on the ward. I experienced my very first birth and it was so amazing to go through something like that and share that with the mothers. The feeling of being a part of a new life is so wonderful. The mothers are so excited to share with you their new baby and for you to hold them. To top of my experience it was my birthday and I couldn’t have asked for a better present, to see a brand new baby.

I couldn’t have done it without the help and support of the nurses there and my fellow students. It was such an amazing experience that I really wanted to be able to help out with one and be a part of a mothers life changing event. The next day (Wednesday March 3rd) a mother was in labour and with twins, something that I was very excited that I could potentially be a part of. Another student that I was working with was also with me. Lindsay delivered the first baby and then we switched spots and I was able to deliver the second baby. It was an absolutely speechless event to see that baby take its first breathe and hear her cry. The joy that I felt to hold that baby, weight it and wrap it was beautiful. I sat with the mother after the birth for only 5 mins and gave both her baby girls baby toques from Canada.

Overall, my experience has been absolutely wonderful I couldn’t have asked for anything more. The other students that I have worked with have been an amazing support system as well as the 3 leaders of our group. The friends I have met here are ones that I will never forget as well as the experiences they have shared with us. Thanks to all of those who followed our blog, supported us in the hospital and share the experiences with me. I couldn’t have done it without you.

Take care and see you all soon,
Lana

Abstract ART

The moments that have surprised me the most have been some of the hardest to explain and reflect upon. These interactions seem so simple and ordinary when you skim the surface, but if you just stop for the slightest of a second to think beyond the task at hand, pause to peer into the life of the individual before you, your world as you know it screeches to an alarming halt. In these moments my life seems so trivial and undeniably selfish. A pang of guilt creeps in and my heart screams in question, “WHY, WHY, WHY”!? Why have I been so lucky? Does every individual not deserve the reassurance that they will have food on the table for their family each day, that the drinking water will not make them devastatingly ill, or that they will live long enough to celebrate their 13th birthday.

During our last week at Lewanika General Hospital I was fortunate enough to spend time in the ART (Anti-Retroviral Therapy) clinic. The ART clinic is where individuals from Mongu and the surrounding communities come for HIV counseling, routine check-ups, CD4 counts, and medication alterations etc. The clinic is open Monday through Friday and each day at precisely 8:00 a.m. the crowd of approximately 250 rush in, each person scrambling to be first in line.

It is difficult to come face to face with so many people affected by HIV/AIDS at one time. To avoid the impact that HIV has on this world, more specifically southern sub-Sahara Africa, is beyond impossible. Looking into a child’s eyes and knowing whole-heartedly that they will not live long enough to see adulthood is one of the most helpless feelings I’ve ever experienced.

A moment that took me by surprise and literally knocked the wind right out of me happened while I was weighing a middle-aged man that had already been diagnosed with HIV for a few years now. He came in for a routine check-up and I was taking his vital signs before his assessment with the Clinical Officers. He wore an orange collared shirt, which was smudged with dirt, and a pair of dark dress pants, fraying around the ankles. His black dress shoes were unpolished and looked as though they had been to the top of Mount Everest and back. His face looked sunken and tired and he carried a slender tattered leather brief case, which held only his hospital patient record. The man removed his shoes to mount the scale; his body shook as he stood there and as I looked down at his feet I couldn’t help but notice the large holes in both his socks, exposing both his big toes and three others on each foot. I could tell that this man had dressed in his best to come to the hospital that day, my heart began to wrench and my eyes welled up with tears. I put my head down to catch my breath.

I will never be able to fully understand the reality of the situation here in Mongu or else where in this world for that matter because I am not personally living with the disease. Just to bear a glimpse of someone’s life who is living here with HIV was enough to leave me speechless. The complexity and severity of HIV as well as the multiple co-morbidities and poverty that plague Africa make living with HIV/AIDS incredibly difficult and at times impossible. HIV has left thousands upon thousands of children without families, grandparents are looking after grandchildren and siblings are looking after younger brothers and sisters, those of whom are also fighting to take care of themselves.

This experience has opened my eyes to pain and suffering well beyond my comprehension. The interest I hold in the fight against HIV has been officially sparked; I hope to be a positive agent in the care and reduction of stigma for individuals living with HIV/AIDS for as long as this disease is taking the lives of people on this earth.

Elizabeth

Sunday, March 7, 2010

Blessings in Disguise

As our four weeks at Lewanika Hospital have come to an end, we now have some time to reflect on what we’ve seen and what we’ve been a part of. As I look back, I remember the many surreal moments that will forever be embedded in my mind.

-Taking a break from doing vital signs all morning in the Anti-Retroviral Therapy Clinic just to look around and realize you are in a room of 250 men, women and children, all of who are HIV positive.
-Restraining a 2year old child that is not much larger than a newborn so a much needed IV can be inserted in his neck. Being fully aware that the efforts to save the child from cerebral malaria may render useless as the child is already to weak to cry.
-Becoming so overwhelmed by another’s suffering, you’re unable to hold back tears at her bedside.

And although these moments induced some great horror and sadness, each one has also been accompanied with learning, laughter and hope.

-Almost all of those 250 people greeted us warmly and they were grateful to be there so they could receive treatment that could extend their lives for many years.
-Although that small boy was too weak to cry, he has not too weak to smile. And even during the IV insertion he managed to look up and bless us with a smirk that can never be mimicked.
-Even with the difficulties of language barriers and cultural differences, nothing shows sincere empathy like tears. And the ability to communicate that so clearly to a patient is a gift.

I am proud of the work that my fellow students and I have done here. We are making an impact on the lives of the patients and on the learning of the nurses. In return they have also blessed us with some of their knowledge and expertise.

What I am most grateful for is to have been privileged enough to hold someone’s hand as they experience the most terrifying moments of their lives. Not many people have participated in something as fulfilling and amazing as that. I will never be the same person, nor the same nurse.

Vanessa

The Impact of Zambian Maternal Nursing

As we carry on with our Lewanika Hospital rotations I have found myself within the maternity unit. I was privileged with the opportunity to work in maternity this summer and therefore felt I had had some experience under my belt. Canadian maternal nursing I am familiar with, Zambian I am not.

The environment within the ward is a complete transition. Women labour in a two-bed room, lying on top of a plastic sheet. Technology is absent from this room and therefore the usual sound of the fetal heartbeat or a call bell is replaced by silence with the occasional deep breath or moan. The mother must provide linens, pads and diapers, and for one premature mother this meant scrounging up a pillowcase to wrap her newborn in. Epidurals and Demerol are not an option; in fact there is no form of analgesia provided to these mothers. With all of this into consideration, I have witnessed 5 births in two days and they have been some of the most peaceful experiences of my life! Although cesarean sections are an option, they are rarely employed and therefore mothers must be confident in their god given ability to give birth.

I feel as if in Canada women have forgotten about this ability. Planned cesarean sections and requested epidurals are frequently seen within our hospitals. Women rely on doctors to deliver their children, lacking confidence in their body’s ability to take control. I am not denying that these interventions are necessary and required at times but through my experiences here I have regained faith in our ability to give birth without these inventions.

Lots of love sent out to all my family and friends following this blog,
-Kirsten LeDuke

It is Almost Time to Leave Mongu


It is almost time to leave Mongu and as always it is busy. So many hands to shake, thank you to give, so many see you laters.

I am going to continue my very excellent adventure in Livingstone and maybe Botswana, and so I will not blog further.

I want you all to know that we all have struggled to deal with this experience. We have had ups and downs, laughs and tears, homesickness and moments of joy and I think none of us regrets any of it. These are some very fine women, and those of you who love them should be so proud of them. The hospital will miss the smiles, the questions, the laughter and the energy. I am so privileged to be part of this experience and I thank all of them for teaching me things I needed to learn.
I have one last picture that stays with me at the moment.

A baby on the back. I sit beside them and watch her expertly tuck the holding cloth around the baby as she switches him to the front and closes his jacket. She unconsciously sways as she switches him back...like mothers all over the world, a gentle shifting back and forth. She watches the children swinging, playing soccer and shrieking with laughter as they play with the nursing students. I offer to hold the baby, but he is shy and draws closer to her. She switches him around again and wipes his nose and tries to rock him to sleep. She expertly fixes him to her back and resumes rocking and watching. She smiles wistfully. She is 10.

Oh Africa, childhood can be short.

We are so privileged. Love to you all,
Fay

A Post Script from the edge of the Zambian Sky

On our last day...Lana came to see our old man and he gathered all of his 4 month old, 5 pound body and he smiled!!! His Grandma said it was the first time...and then, as if he discovered how good it felt, he continued to gleep at us all...his small serious face transformed...his eyes smiling, his whole body smiling. Now that is the way to end our stay. Oh Africa.

Children's Ward: Week 4


Our old man has fat cheeks! His Grandmother shows us pictures of her three daughters. Two of them have died in the last two years of HIV. She tells me that Old Man’s mom died two weeks after he was born. She wants me to see her daughter as she was when she was well. I sit beside her and admire the pictures and we hold on to each other. There are no words.

I give old man a toque knitted by a Grandmother in Kelowna. He looks adorable and has stopped looking quite so worried.

Our small finger pointer is better, but we find out she is HIV positive. We are all saddened, but she looks better and we gift her a smashing red velvet dress with red net flounces and she leaves the ward in style after a photo op with our students. We have all fallen in love with her.

We have two new cases of severe malnutrition...a five year old who looks 2 and a small girl who has a huge swollen abdomen, looks like she is 4, but is 10. She has a parasite that has damaged her liver permanently, and she is HIV positive. As Sam says, climbing a mountain is hard, but for her, it will be like climbing a mountain in a wheel chair. She loves the students and dispenses hugs all round.

Then there is Houdini...2 years old, in stripped sleeper with green pants over top. Also sports lime green flip flops which he “borrowed” from his neighbour. Any chance he gets he heads for the hills, chortling with glee as Mom and I give chase. He is lucky; he has an abscess which is so curable. He and I have the same dance style and occasional we entertain with a few chosen steps. Always leave them begging for more is our motto!

More good news. My boyfriend, Mr. Grumpy pants is not HIV positive. Sadly, he has forsaken me for the younger women, and dances with Lindsay C. and Jamie. His smiles are like gold.

We have a huge group of kids who are here to see a visiting orthopaedic surgeon. They have club feet, broken limbs, deformities of limbs and all hope for corrective surgery.

We also have several broken bones, bone infections, an eye injury, 2 kids who need circumcision, and 2 more burns.

We laugh, we cry and sometimes we pray. It is a hard place to grow up.
We are sad to be leaving...we finally are beginning to feel useful and we have made friends here. Each time in Africa I leave a piece of my heart. And these beautiful children...just like anywhere, their parents want the best and they just want to be kids.

Hug the next kid you see, and when I get home, I’ll teach you a few dance steps from Houdini and me,

I am a Dancing fool,
Fay

Childen's Ward: Week 3

One small baby girl raises her index finger and gravely points at my white face. She is dressed in a pink pinafore and red dress and solemnly follows my face as I try for a smile. There are no smiles today, smiles take energy! The Doctor gently explains that her wrinkled skin is “where the baby used to fit” in other words she is malnourished. As we examine her, her mother suddenly breaks down crying. This is so unusual, as the women are so silent and strong. Imagine not being able to feed your baby enough to keep her thriving. The mother shows courage in bringing her baby for care. We can offer momentary support and food and hope for better times for the family.

A grandmother greets me with a smile as I perch beside her. Her grandson is 4 months old, weighs 5 pounds and looks like he is 100 years old. He looks at me with old eyes, not even crying when we start an IV. I suddenly find tears filling my eyes. What kind of world has he experienced in his 4 months that would make him feel that crying is a waste of energy? Grandma and I share a look and I suddenly find tears rolling out the corners of my eyes. I pretend I have a cold and excuse myself to blow my nose and compose myself.

My grumpy pants 4 year old boyfriend (sorry Jo) who has been with us for 3 weeks and has not been won over by my scintillating personality, finally smiles! He has been treated for Malnutrition and TB and finally is turning the corner. Good to win some!
The little girl ( burns on chest and thighs) who has been painful and cranky...we round the corner and she is sitting up, eating a piece of bread the size of her head and grinning at us. Again, the smiles of all staff and parents say it all.
One of the nurses tells me that they missed us yesterday...they say it is so much more fun when we are there! The sweetest of praise is to be missed.

The play therapy toy box causes a stir and the kids hug each toy. It is hard to convince them that they can get them back tomorrow. The ward staff is amazed and delighted with the notion of play.

I close with a reminder to hug your kids and count your blessings. We feel blessed to be part of this hospital and the lives of our Zambian friends.

Love to you all. Fay

Things That Go Bump in the Night...or any other time!

·Small tree frogs with tiny delicate fingers and suction cup pads that sneak through doors and windows and cause screaming and shuffling and the call for gloves and a little help from friends.

·Thunderous, rolling, bed shaking claps of thunder that cause sitting straight up in bed, bewildered and shaking

·Large clicking beetles that look like they could carry a small child on their back( see small tree frogs for reaction)

·Barking dogs ...the guard tells us that all Mongu dogs are in heat at the moment. And apparently ours are no exception. I do think they are related, so we are slightly disapproving.

·Small and not so small flying ants that come like a plague of locus and disappear as quickly( see frogs for general reaction)

·Thumps of people jumping on furniture when any of the above happens!

·Shrieks of laughter when any of above occurs.

·Honking of horns when the bus, taxi, min bus arrives at the gate

·Sweet reedy singing voice of Mobebo, our guard as he works in the porch.

·Wailing of the women who are burying their dead

·The call of a wayward rooster who obviously does not wear a watch.

·Distant drumming

·Sunday morning praise singing

·Curses from those of us who try to exit our bed whilst becoming entangled in the mosquito net.

So it goes in Zambia. Hope all of you are sleeping well. Love to all and to all a good night,

Fay

Where All the Lights Are Bright

Mongu has a wonderful main street...at least I think it is the main street. Tarmac with sand on both sides.

Small adobe type stores, blue, pink, ochre and white; signage announcing their wares. Pep( a very small version of Woolworths), Dry Goods and Stationary...sells neither!, Mongue Shopping Center...sells green and red satin slips, African dresses, calculators, face cream, toothbrushes, batteries, random jewellery( I buy two pieces; we were looking for paper!), two things of eye makeup and assorted wonderful necessary items. The proprietor has a soft smile and asks us what we do, how long we are here and how we like Mongu. When we answer we love it his smile broadens and he says Praise God. I digress...

More random stores, some selling groceries, one selling shoes, live chickens and ice. Zambeef selling, what else, beef. People sit out front and stare at the white women. I sometimes feel like we are in a parade and I am the featured float. All interest is friendly, and I shall be quite disappointed when I get home and no one greets me or stares at me.

My favourite store front reads Real Last Judgement Barber.

The hardware might sell furniture and clothes and the clothing stores also carry ladies face cream, assorted tools and some dishes.

Many blue and white minibuses on the main street. Conductors calling out their destinations and the cost of the ride. “ Shop Rite, 2.5 “ and we load on. Always an adventure to ride...again everyone talks and visits and asks about our stay and blesses us.

Finally we come to the paper store, well really it is a grocery, but they sell paper, markers and they can get us flip charts. Off goes a person who returns in 5 minutes with the needed goods. By the time they return, we have shared stories, exchanged phone numbers and acquired a congenial but quite drunk guide who carries our wares to the taxi. Who needs the bright lights and big cities!

Ah Mongu. We love you.

Good shopping all, I’ll bring you some Mongu jewels and I send my love,
Fay

African Skies

·Fire in the setting sun, reflected on the flood plain, reflected on the other side of the sky, pink on black towering clouds, changing to neon pink, then clouding over to deflect light on rain, no words, heart flowing through my eyes...Oh Africa, Oh Zambia

·Orion above us, in the wrong place, so bright he should be in a book on Orion, a friend from B.C. skies. A pathway of light so bright that it takes us a while to recognize the Milky Way.

·A blue sky that stretches to tomorrow with marshmallow clouds hanging around the bottom. Changing suddenly to grey and black, heavy with rain, then again to bright lightening that comes from everywhere.

I wish you all could see it in all its guises, a gift too wonderful to describe, it is a feeling not a sky,

Look up everyone,
Fay