Yesterday was our first day emersed in the Lusaka hospital for our clinical experience. Many of us felt nervous, and unsure how to help, but as the day progress I think we all began to feel more comfortable where we stood. The Lusaka hospital is huge, but we divided into a few groups and each had an instructor nearby to watch over us. I was assigned to pediatrics, and spent thee first part of the day on the malnutrition ward, and the second part at the Maternal Child Health clinic.
The malnutrition ward is very hard for me to put into words. Imagine a large room with rows of metal cribs, babies crying, families chattering, crowding, heat, smells, bugs crawling on the flors, flies around the children and their bits of food... witnessing children carried into the ward that look to thin it astounds me that they are still breathing.... watching a babe lay limp and her eyes roll back while her mother changed her diaper, because she had no strength left... a small boy brought in with ribs not only showing through the skin but actually protruding, he was so thin. There must have been 30 or so families brining their malnourished children to the wrd for treatment, even though the ward was already full. It is hard to even imagine. Some of the children are frequent patients, as they begin to become nourished in the hospital they go back home where there is no food for them, and arrive back on the ward months later. These children usually suffer from a disease or condition that contributes to the malabsorption of food, such as HIV/AIDs, TB, or other parasitic illnesses. Children most acute are kept closest to the nurses, and are fed by nasogastric tubes (inserted through the nose, these tubes lead to the stomach and allow high-caloric feeds to be directly passed to the stomach). The feeds were made from sour milk, sugar, mineral/vitamin powder, water, and oil -- a mixture made up by the nurses every 12 hours. These sickest babes are too exhausted to eat anymore. The next row of cots has children who are starting to have more energy to eat, and the remanding two rows of cots the children are starting to eat and play again, almost ready to go home.
The majority of my day was spent in public health, helping immunize healthier babies, and make rounds on the pediatric wards to teach mothers the importance of vaccinating their children. I could not help with much of the teaching, since all was spoken in a Zambian dialect, but i was able to give injections to the babes brought into the clinic. About half the mothers bringing their babies in were younger than 20. The nurses in this clinic were extremly welcoming and happy to have me along with them, and we had an opportunity to sit and discuss some of the differences between Canadian and Zambian health care. They laughed and could not believe that in Canada, men and women are on the same ward and even in the same rooms! They had me repeat this to doctors that came in, to see their reactions. The also were shocked that I had never seen a case of TB or malaria in Canada. These are two very prevelent diseases here.
All in all it was a good day, despite the sweltering heat and surprises along the way. As we all came together at the end of the day, it seemed that everyone saw unbelievable sights and had new experiences. This is only the beginning of our journey here as nurses...
This Thursday we will be travelling to Mongu, our resting place for the next 5 weeks or so, and we will try to keep you readers as updated as we can on the sights we see here. Love and miss you all back home,