Saying Goodbye

Last week was another amazing experience at Lewanika Hospital. We celebrated valentines day with all the kids on the children ward, covered in stickers, smiles all around from everyone. Wednesday we taught at the nursing school, it was a learning experience for both us Canadian nursing students and the Zambian students. Friday I spent an amazing day scrubbing in into the Operating Theater. In Canada we have all had a chance to see a surgery, but to actually be apart of it and be in there covered in blood handing tools to the Doctor is such an adrenaline rush.  Especially in a sense of urgency as the patient is having a seizure and needs an emergency c section. The next surgery we perform without power, running off the back up battery. However mid-surgery the back up generator fails and we are stuck performing surgery under a lamp someone is holding up over the doctors heads. Only in a third world country would this ever happen and I loved every minute of it. Not knowing when the power is going to turn back on, sweating in a 50 degree OR, it was a perfect way to end my experience in Zambia. I feel like I have experienced it all; maternity, pediatrics, female/male wards, code situations, community life in the safari villages, Operating theater and unfortunately death. However it is safe to say that I have grown from this experience immensely and I feel like a stronger person. I am sad to say goodbye to Mongu, but I know it won't be the last time I will see this place. It feels that we just hopped off the plane in Africa, but now we are saying our goodbyes to the friends we have made, and saying goodbye to the place that has been our home for so long. Thank you Mongu, for an amazing experience and the wonderful people that I will never forget.

-Sam

Good Bye Mongu

We can’t believe that our time in Mongu is already up. It has been a truly amazing and unforgettable experience. We look back and remember our excitement as we got off the plane and felt that first wave of humidity. But now this wonderful place feels like home. We have fallen into routine, gotten to know the locals, tried to learn some Lozi (without much success), and can wake up without sweat because our bodies have finally adapted to the climate.

Mongu has left a lasting impression. The thunderstorms were memorable and amazing, although frightening to Susie. The sunsets were breathtaking, especially when viewed over the floodplains. The random and scheduled power outages were a bit inconvenient, but we made it work. Even if we showered by head lamp or played cards with 6 flashlights shining on the table. Our time here has shown us that the life of networking, internet, and electricity is not a necessity in life. We have learned to live without it and it has been a lesson we are thankful for.

Our nursing experiences here that have left lasting memories in our minds and hearts. From Mutoya camp, to Lewanika hospital, teaching, and delivering babies; we have had experiences that have been meaningful to us. There have been moments of heartache, tears, and frustration. We have had to help each other debrief about the things we have seen and remind eachother that we aren’t here to change the world but to live in each moment and do the best that we can.  We have grown as individuals and this experience has helped transform our nursing practice to one that is more culturally sensitive, empathetic, and resourceful.

At the beginning of this journey neither of us really knew the other students coming with us, but after having spent this time together and experiencing laughter, tears, and similar stories, we have made lasting relationships and we will truly miss the close community we have developed. 

Now we are saying good-bye: To Mongu, to the welcoming Lozi people, to the wonderful doctors, nurses, and nursing students that we had the pleasure of working with over the last few weeks.  To the staff at Mutoya camp. To our instructors. and to each other. The other day it hit us that we were leaving when we had to say goodbye to our favourite chef, Lloyd. He cooked for us again this weekend and we will always remember how he filled our bellies with the best Mongu rice, eggs, and green leafy thing that we still don’t know the name of. So good bye Mongu, you will be forever in our hearts.

Susie and Rachel

just another week in mongu!

We wrote this post last week but has a little trouble with the internet so are only putting it up now, anyway enjoy!

Michelle and I were together again this week on the male ward. This ward consists of anyone who is male and over the age of 16. Needless to say we saw a lot of varying illnesses and disease. The week was a good one and we both learned so much. It was a big change from maternity and all of the cute babies. We tried to dedicate our time to a few of the patients each day as the nursing students were focusing on their practical exam. In doing this we hope that we were able to make a small difference for at least a few of the patients that needed it most. There was one man in particular who we spent some time with where we really had to get out or comfort zone to provide care. Although it was hard for us at times, it was worth it to know that we did everything that we were able to. Other than that, we were able to do rounds with the doctors which was a great learning experience every time! We got to see many things that neither of us had ever seen before and may never see again. I enjoyed my time on the male ward, it was challenging but think it was nice to have to use a lot of the skills that we know the best.

While not at the hospital, we have spent our days tanning, playing cards, reading and even spending time at the local restaurants. We got to experience our first Zambian concert, Maki 2, which was a great time... the people here really know how to show you a good time! Another exciting thing this week was Zambia vs. Ivory Coast in the Africa Cup of Nations. It was so nice to see the excitement in the people and their pride in the country they live in. It was like the olympics all over again, and the best part is that they won!

This week I am on the post-natal ward taking care of more babies and Michelle is enjoying her time at ART (HIV clinic). Its crazy to think that we will be leaving so soon, we have really just started to settle in. We are excited for what our last week has to bring and are getting even more excited to spend some time in Livingstone soon. I think we can both agree that we are going to miss this place!

Write soon,
Cara and Michelle

P.S. Happy Belated Valentines Day!

Times up!

I can't believe the end is here. It feels like just yesterday we were arriving in Mongu, eager to see what was to come.  I feel as though we were just getting comfortable in our practice here so it's sad that it's over for now. Each week came with its challenges and frustrations but in reflecting upon them I feel they only made me further understand the importance of doing the best you can as a nurse. No matter where you may be the hospital, a clinic, or a tree taking the time to look and really asses each patient is as important as giving them the medication that is ordered.When you ask the right questions and make it your responsibility to provide the best care for each patient, you can advocate for them especially when they can not do it for themselves. I believe it is our duty as nurses to do this, and if I was to share anything about what i have learned here to nurses and aspiring nurses out there it would be the importance of Advocating for your patients.
Toni B

The Last Supper

I feel like we have done more on our last week here than we did throughout the entire trip.  We made a bucket list last weekend of things that needed to be done before we leave- most of if seemed out of reach but we managed to finished everything except for going to watch another sunset and we only missed that because it was cloudy every night at that time (we'll get it in Livingstone).  Our final weekend was definitely a perfect ending to our trip.  We went to the community health worker graduation on Friday afternoon- which was excellent.  They were so excited to be finished and there was really good snacks!  Friday night we had a BBQ at our house, a retirement party for Fay.  The people here make heating coals look really easy but it took us an hour to get all of them hot enough to cook.  It was really cool because all of us wore our Shenyangs (fabric skirts however it may be spelled) they looked cute but were hard to dance in (not enough leg room!).  I think the best part of the evening was when we gave one of our guests a bicycle.  I have never seen anyone so happy- the picture we got of him on the bike should an add for the bike company- I don't think they could ever find anyone else who looks that excited to be on the "Zambike."
Saturday morning we went to the markets and searched high and low for cow bone bracelets it took us three different markets- but eventually we all found one!  Later some of us went to Limulunga and hiked a "mountain" (definitely not like the mountains at home).  It was a beautiful view of the town and flood plains- some of us even did yoga poses on the cement pole located at the top of the mountain.  It was the only night that the power was out past 730 at night so we were all cooking with our headlamps on.  I wish there was some good pictures of it- but everyone's cameras were so good that it looked like the lights were on.  We then went to Oasis for a dance party- we almost should have just stayed and danced at home because we took up most of the dance floor but it was good to get out.  Being at the bars here is almost like being at the bars at home- they both have women hiding smoking in the bathrooms- fights- street meat- and people buying you drinks (except here they ask to buy you a drink and take your money and get it!).  Sunday we went to one of the local orphanages for a few hours and played with the kids.  It was really fun- but I had forgotten how exhausting it is to play with a large group of kids!
Just a heads up- I have been using hyphens as comas throughout this blog because the coma key does not work (just a little taste of Africa).
Talk to you soon!
Melissa

There are good things too...

Steph and I thought we should bring a little more sunshine to the blog. It is so easy for us to focus on the difficult things here rather than the things we love. Here are just some of the unforgettable things we have experienced so far!

- The beautiful African sunsets
- Lightning storms every night (and getting soaked while doing our workouts during a downpour)
- OK restaurant and its fantastic samosas everyday after clinical (Usually more than one. We can get a samosa and a coke for just over a dollar)
- The time we spent at a village in Limulunga singing Lozi songs and "dancing"
- Getting laughed at every time we went to Oasis because we can't dance like the Lozi's can
- "They are finished"- The response we got the day after Zambia won the Africa Cup and we tried EVERYWHERE to find Zambian themed shetenges.
- The pleasant surprise of having the power left on after winning the African Cup of nations so that everyone could celebrate. We were so excited to have the power on, we rushed to the internet cafe, only to find a sign on the door saying "Closed- out celebrating"
- How amused the children are with bubbles and stickers
- Sitting in a concrete room at Matoya with our only entertainment being spider fights
- Being able to stomach any kind of bug that comes our way (Steph flushed a scorpion down the toilet- we were so proud)
- The look on Lloyd's face when we presented him with his very own bike. He was happier than any kid I have seen on Christmas.
- Lloyd's restaurant in the Black Market- best chicken and nshima in town
- How every restaurant sells wedding cakes (1-5 tiers, price negotiable). However when we go to order one they say "We don't have".
- The standard menu that every single restaurant has. I think they order the menu's in bulk. It has every food you can imagine... but when it comes down to it "We don't have". Nothing but samosas, nshima and chicken.
- Going to OK restaurant, asking... when do you have pizza, what day? (apparently saturday). we went back on a saturday and not only heard "we don't have", but also, "the man who makes the pizza is sick today" (he was sick last week, too!)
- walking down the street feeling like a celebrity- everyone knows the makuwas in town
- Fitting 7 of us into a compact car on our way to go dancing at Oasis- 2 in the front seat, 4 in the back and Steph sprawled across us.
- The Zambian carwash- Cars, a stream, and buckets.
- How every single cab that drives by us yells "SHOPRITE"... like all we do is shop for food.
- Zambian pronunciations of our names- especially Britain (Brittany) and Jafulie (Stephanie), Caro (Cara), and Rrrrrrrrandi (Randi)
- Shetenge Sunday's and FINALLY finding our white Lozi bracelets 2 days before we leave. Mongu must have gotten a big shipment in.
- PURPLE MIRINDA pop- a cross between cream soda and grape
- The lady at the canteen at Lewanika hospital who wanted us to meet her entire family!
- Z-beats... Don't worry you will all hear them when we are home! (MACKY 2- we even went to the concert)
- Carrying each other in traditional Zambian fashion in shetenges on our backs.. just because we can
- Trying to think of what in the world we can use all these shetenges for when we get home.
- How friendly every single person is. You can not walk down the street without getting stopped and asked "how are you", then how grateful they are that we have come to their town
- Squeezing 20 of us into the back of a flatbed truck to go to the orphanage, and having the tailgate fall open every time we went over bumps- So many potholes (don't worry mom, we all made it there in one piece).
 - The 24 wonderful ladies (and 4 instructors) we got to share this experience with. We always had a shoulder to cry on, an ear to vent to, and people to laugh with.

There are so many other things we love about Zambia, and we can not believe we are leaving Mongu tomorrow. The people and the culture have made such an impact on all of us, and we will all leave a little piece of our hearts in Mongu.

Also, very excited to see you all when we get home!
xoxo,
Randi and Steph

When a Child Smiles

There are many sad things to be seen, and heartbreaking stories to be told here in Mongu; many injustices and unfair happenings. Every day since being here I have experienced a small part of this heartache, by hearing or being a part of someone’s story. This sorrow, however, I have learned is not nearly as powerful as the sound of a child’s laugh, or the precious sight of a chubby-cheeked grin. These moments leave me recharged, and completely captivate every part of my being. When I can sneak one of these smiles out of a hurting child, for that moment the burden I carry of people’s suffering is relieved; it makes every difficult experience I’ve had since being here somehow seem worth it. When a child laughs, all the sounds of pain and loss within the hospital are silenced. In a corrupt and impure world, it is refreshing to witness the innocence of a child’s happiness, even if it is within the confined walls of a hospital ward. In moments of frustration and sadness, it is easy to forget that there are good things in this world; there are joyous moments to be found within difficult times of hardship. There are no words to explain what a hug from a child feels like here.  When a tiny pair of arms binds tightly around my shoulders, or I feel their fingers wrap around mine, my heart swells and I become the patient. I am the adult, the nurse, the one who is supposed to comfort and reassure THEM, yet they hold a power that could effortlessly heal the world of its pain. There is a lot to be learned from the children here on the pediatric ward. Many of their lives are filled with anguish, hunger and a suffering most of us will never understand, yet they are able to appreciate and find joy in the simplest of things, such as a stream of bubbles from a wand. I’d like to think that I have made an impact on some of these children’s lives these past few days in the Pediatric unit. If I can give them half of the happiness that they have given me, I will have been a part of doing something great in this world.

Fallon

Friends remind me, It’s okay to be weak

 There have been many times that I question: Why did I even bother coming? People don’t get better and death is inevitable.  I am trying to remember that without us, this would all be happening and probably with less compassion and attention.  The life expectancy of Zambian people is far from changing, but what is important is that during their short lives, illness, and final hours, they experience compassion, love, sympathy, and respect. I think for some it will be the first time in their lives. I know our presence is invaluable to them. We never actually know how meaningful our actions are, perhaps the families saw how much we cared and were so touched that they better dealt with grief, or maybe we have inspired someone here to be a more compassionate nurse. So I am going to embrace the joy, embrace the sadness, let myself feel everything and let myself be human.

Knowing it’s okay to be weak, it’s okay to feel helpless, and it’s okay to feel sorrow. These things make me stronger and wiser and enhance all the things I am now. These experiences will not make experiences down the road trivial; they will just remind me that regardless of what I am going through, I will survive.

This experience has given me a life-check to truly remember what is important. Not the material things, but how lucky we are to be born in Canada and not in grueling poverty. We have premium healthcare even when we think we don’t.  We have the opportunity to be anything we want. We don’t have to fight for our lives everyday and we have everything we need at our fingertips.

I am learning many lessons that I will never forget. This experience has been invaluable and I am so thankful for every single moment of it.

Susie

All in the day of a Lozi Woman

 This week we have had the opportunity to experience the wonder and beauty of a new life. We have seen 7 births so far each being a completely different experience than we are used to at home. Women are not given any pain medication; it is not even an option. Husbands/partners are not permitted in the birthing room. Women are not allowed to make any noise, and if they do they are shushed or swatted on the head. Childbirth seems like it is just part of another day for a Lozi woman. 8:00 wake up. 10:00 deliver baby. But back home at 1600 in time to make dinner for the rest of the family. One woman came in for her fifth pregnancy. She delivered in 10 minutes, got up, walked back to bed and was probably gone by supper time.

These experiences were in stark contrast to what we have seen at home. Women have epidurals, husbands or other family members are almost always there for support, and the women are allowed to yell, scream, or curse as loudly as they want. The faces of the women here are stoic, calm, and seem confident. They seem to know exactly what to do when it is time for the babe to be born.  

Another thing we have noticed is that each woman comes with her own bag or suitcase filled with all the supplies she will need for childbirth: a plastic sheet, towels, sheets, clothes, cotton pads and sterile gloves. The midwife explained that women are instructed to bring these as the hospital may not always be able to supply what is needed.

We both had the chance to be part of birthing the babies this week. It was a wonderful and unique experience each time. We were so thankful to be able to hold the baby’s head and guide it into the world, truly giving us a personal and front-row seat to the miracle of life. It’s an experience that we will never be able to duplicate back in Canada but it was a privilege to be able to experience in rural Africa.

Rachel and Susie

"What does it mean when you eat lots and doze?" Monde, Liyoyelo Orphanage

     This week Steph and I were in Limulunga, which is located about 16 kilometers outside of town.  It was a lucky morning because we found a 3 pin cab to the clinic (like 60 cents).  It was also probably the quickest cab ride we've had since we arrived here, I had almost forgot what it feels like to go fast (most of our cab drivers don't drive over 40km/h!).  We worked in the Out Patient Department at the Limulunga Rural Health Clinic.  There we assisted the clinic's nurse Edith with triaging, diagnosing, deciding prescriptions and follow-up education.  Monday was a day almost completely dedicated to Malaria.  Everyone who walked in presented with fever, coughing, loss of appetite, night sweats, and headache.  By the end of the day we were experts in diagnosing and prescribing.  In the last hour of our day, Steph and I went with Edith to help admit a sick patient to the female ward (which is just a 3 bed room).  It was a very sad admission because this patient was severely dehydrated and was unable to hold down any fluids.  When she was unable to be cannulated (IV initiation) with the equipment present at the clinic Steph and I advocated that it was necessary for her to travel to the Lewinika General Hospital so that she could receive adequate care.  After a long debate with the family, we were not successful in convincing them to take her to the hospital and she died the next morning.  We found the families excuses and priorities very upsetting, but I guess we just don't completely understand their cultural beliefs.
     On Tuesday (Valentine's Day!) Steph and I went to a preschool in Limulunga and taught parents basic first aid.  We taught wound and burn care, care of fractures, sprains, and bruises, what to do when someone is drowning (they really liked throwing the rope and getting to the ground to pull the victim to shore!), what to do when someone is choking and the importance of oral and personal hygiene.  The parents were eager to learn and seemed satisfied with the knowledge they gained from us.  An example of this was a grandmother raising her hand to thank us for being there because she now knows how to properly treat burns (she was cracking a raw egg on them previously).  For our Valentine's Day we celebrated by going down to the harbour market to shop (always!) and out for dinner at Nalumba 2.  The market was really fun, there was a youth dance concert going on and some of the young girls were shaking it like crazy!  At dinner we ordered a couple bottles of wine to celebrate the day and the server looked at us like we were insane, I'm guessing people don't order wine often here.
     Wednesday we went to immigration, which surprisingly went very smoothly.  The commissioner was telling all of us that he was going to take us in a boat and throw us in the Zambezi River, so fortunately we're all still here.
     Thursday after work Steph and I taught nutrition at the Liyoyelo Orphanage in Limulunga.  Although we were told that they "really wanted to have this topic presented", they weren't too interested in the topic.  Since the nutritional talk was pretty dry, I'm really glad we stayed to dance with them after.  It showed all of the kids in a new light.  Steph and I also received a lot of "friend requests" from the kids, not on Facebook, but tiny pieces of paper which we have both kept.  After the orphange we walked to the Lozi King's Limulunga Palace, we can definitely see why he prefers this palace, it's much bigger than his flood plain palace.  While we were there we stopped in the museum.  It was an interesting assortment of historical paraphernalia, our favourite being the cooking pot "to cook human flesh" and the amulet "for winning court cases and also for sympathy from opponents."  While at the museum we heard music coming from behind the building, when we went back there it was a sand pit surrounded by wooded planks with women dancing to tribal drums.  We definitely got to see Barotse culture at it's finest.
   On our final day in Limulunga we gave our nurse Edith a thank you gift for being so wonderful to us.  Although she was the only worker in the clinic, had a woman in labour and at least 60 patients waiting to be seen her only response was "I am so happy!" and she kissed the gifts.  It's safe to say that we now have a Zambian pen-pal.
We're super excited to head off to Livingstone next week, but really sad to leave the house that has now become our home.
Talk to you soon!
Melissa and Steph

My defining moment in Africa

Cross-posted from Joel in Zambia

February 16

Hi all!

I just got back from the most amazing experience. When I think back to my time spent in Zambia, this will be what I recall.

On Sunday, we ate our "last instant noodles" while we waited for Lihana to come and pick us up. Toni, Sylvia, Esther, and I didn't quite know what to expect. We knew that Lihana ran a clinic in Matoya and that she was South African. That's it. It was a bit of a mystery trip: only four people could go, it occured once and only during the fourth week, and the details of the trip shifted from a two hour walkabout to a ten minute walk.

After working around her dead car battery, Lihana arrived at our house to pick us up. We quickly met Nasilele and Alinan (our translators), Lloyd (an evangelist and restauranteur), and Graeme and Tara (an Irishman and a young South African who were taking us to our bushcamp).

Sylvia and I hopped into Graeme's truck and pulled onto the road to Limulunga. We drove and drove and then drove until we, literally, ran out of road. The street crumbled away into dirt and the dirt eventually gave way to a narrow, carved out path winding through the trees. Although we hadn't planned on arriving in the dark, the sun set anyway.

Graeme successfully navigated us through the swerving and bumpy paths until we arrived into a village. We pulled over briefly for some introductions to be exchanged and then got back in for a much shorter drive. An open wooden structure appeared in the headlights and we drove up to it. Next to it, there was a clearing where we were to set up our tents.

It's kind of an odd situation to drive off into the middle of.. somewhere.. with a group of strangers and set up camp where you will live together for a few days. Although you know that you'll all be friends soon enough, you can't help but wonder what you're doing.

Because of Lihana's advice, I tried to smooth out the sand before setting up my tent. I finally put it together only to be relocated to another tent. With an ill-fitting fly. And a brick for a peg. Undeterred, I plopped all my things into it.

Before long, dinner was ready. Mince and vegetables on rice. We were pretty hungry by then and it was delicious and satisfying. We spent some time around the fire and went to bed.

The next day, we woke up around 0630, ready for our first clinic. Under the rising sun, we could finally see where we were. To the left of the tents was a latrine hidden in the trees. To its right, a barrier for bathing.

Out of the woods was the wooden structure and to its left, our semi-circle of tents. Finally, ahead, was a beautiful vista. Long grasses leading out into an endless plain. A modest soccer field to the right and unseen villages in either direction.

After breakfast, we grabbed our six stools, our "pharmacy" (a box of medicines), and our many books and things. We turned left onto the sandy path and walked down past a village. At the next village was a couple of houses. One of the houses was vacated by a woman and her children just for our clinic. She moved elsewhere so that we could see people there.

We moved her few pieces of furniture around to create two different clinical areas. A couch for two nurses and a few stools for the translator and clients, and a two armchairs with a few stools for the rest. Then, we emptied our medications onto a table and we were open for business.

Lloyd and Lihana introduced us and Ali led the people that had gathered around in song. Lloyd then preached for a while and then the clinic was open!

The days went like this: Patients would stream in, we would take their name, gender, age, and complaints. Complete an assessment, jot down our impressions, and prescribe medications. Hop up, gather the pills and solutions, and instruct the patients on how to take them. Up they go and in come some more patients.

It was incredibly busy. In the three days (and a couple of hours) we managed to see nearly 200 patients. We would begin at 0900 and would work solidly until 1700 or later with about an hour break in the middle. Each day, we went back to bushcamp exhausted.

We diagnosed many skin diseases, eye problems, dental issues, muscle aches, angina, and really everything under the sun. After diagnosing, we would have to figure out what to give for it. The books we had were incredibly useful and we were confident about what medications we gave out.

In the evenings, we would get to eat delicious meals (even the nshima wasn't too bad!). Then we would sit around the fire and chat for hours. I quickly came to like Lihana, Lloyd, Nasilele, and Ali. They are all wonderful people who seem like they were born just to help others.

On Wednesday, we managed to run out of patients early and took the opportunity to continue down the path and visit villages. As we walked, we were treated to many neat things. We visited a family preparing cassava and Sylvia and Toni got the chance to try pounding it. Another lady invited us into her home for a tour and she showed us the traditional percussion anklets that girls wear when they start puberty (and then did a little jig for us!)

Further down, we watched an older man as he skillfully put together a grass mat. We walked as far as we could go and visited each village. Everybody was so kind to us and would smile and wave at us as we passed. We shook hands with almost every adult we encountered (Metozi shwani! Metozi hunday. Encha!). Some of the people that we met had previously been in the clinic and so we were able to provide some follow-up care.

On our way back, somebody gave us a big bag of maize (soon to be roasted!), someone else gave us several sugar canes, and Lihana and Nasilele bought a couple of grass mats. Everyone smiled and waved at us some more as we headed back to the village to care for some more people that had arrived.

That evening, our neighbours had caught wind that we were having a bonfire with singing and dancing. Right on cue, as the sun set, people arrived at our camp ready to enjoy the fire with us. We laughed and sang and had a wonderful time under the stars (and there are a lot of stars here!).

The next day, we packed up our things and walked back to the clinic for the last time. We gave care to everybody that showed up and then closed up the house.

Several people came to camp to see us off and I have to say that I was actually quite sad to leave. Everyone had been so kind to us and were very welcoming. We drove off that afternoon and came back to Malingwa.

Overall, it was a phenomenal experience. Lihana gave us lots of independence and we had plenty of opportunity for critical thinking. I really enjoyed meeting the people of Mawekulipe (MAH-way-ku-LEEP-eh). I learned so much during my time there and felt priviledged to provide them with care.

Truly, this has been my most defining time in Africa.

- Joel

Ready, set, oh no!

Well here we end our week at mukombi. Our first day started off with a bang as we missed our bus (thought it left at 8 not 720!) and then spent 20 min chasing it in our taxi. When we finally accepted that we weren't going to catch it we turned around only to find a different bus going in our direction. Exceptionally lucky for us this bus didn't charge us! Relieved and on the bus, we could finally relax knowing we were going to make it. That was until we met up with our other bus as a tree obstructed the road! It felt like we were never going to get to mukambi. However our bus in shining armor carried on. And went around our original bus and around the tree and we were back on track. Once we arrived back at mukambi we dove straight into our especially comfortable beds and waited for lunch. We had made it! Monday we went to see the nurse and headmaster in Chunga to arrange our week. Next we went to the Mukambi school to talk to the headmaster about teaching at his school also. Everyone was very receptive to us coming to teach and test. Tues we taught HIV and safe sex education for 12-15 year olds then hygiene and malaria education for grades 2-4, wednesday taught woman's health in the morning to the community women. When we arrived at 8 no one was there. At 9 the head master sent every child in the school (about 40)down to get there mothers and they werent allowed to come back with out them. After that we had about 30 mothers attend our session. In the afternoon we went to Chunga, a near by compound, where we taught HIV and AIDS education to grade 9s. Thursday we did HIV testing in Chunga and Friday children's HIV testing in MuKambi. It was a very busy week! We also watched the Ghana vs Zambia soccer game on Wednesday. What an experience that was. With a 1-0 win over Ghana and our fellow students working in Ghana we couldn't help but to be proud of our fellow Zambian team! Our time here has been amazing. Anywhere from the food to the animals, we have enjoyed every bit of our experience at Mukambi Lodge. Mongu this week for the final week where has the time gone. Missing everyone from home Brit and Amy

Haunting Sound

Last week I spent my time on the female ward. It was by far the most difficult week of my nursing practice yet. Monday morning usually begins with frantically trying to orient myself to the ward and trying to determine who the most acute patients are. This can prove to be difficult when many of the patients have no previous charting we can read and many times have no diagnosis written. The nursing shift handover is a far cry from the 30 minutes we take at home to review everything there is to know about our patients from history, to lab diagnostics to how well they slept throughout the night. As I was going from bed to bed, doing a quick assessment of my patients, I noticed a number of Zambian nursing students collecting around a patients bedside. I rushed over to see what the problem was and the patient had no pulse. I asked one of the students to get me an ambubag and another to go find me a doctor STAT. I became a little frustrated as they sauntered across the ward to get supplies with no real sense of urgency. When I finally received an ambubag, the doctor showed up shortly after and we began compressions and bagging the the patient. We were still waiting on suction, which the students had to retrieve from another ward. Since the patients airway was not clear, the air from the ambubag was unable to fill her lungs. Backboards are non-existent at Lewanika so the chest compressions were very ineffective as the body just sinks further into the bed. After about 8 minutes, the doctor called the death. This marked my first code blue. I was immediately overcome with emotion, and headed outside to find one my colleagues to debrief. This was only the very beginning of the long week that was ahead.
The next day again, very early in the morning there was a very unstable woman who was bleeding copious amounts from her mouth and nose. I made it a priority to move her to the acute bay beside the nursing station. As I was doing a head to toe assessment she had no radial pulse in her arm, and using my stethoscope I noted her apical pulse to be slow and very irregular. I called over the doctor who happened to be doing his morning rounds and we transferred the patient to one of the two beds in the critical care unit. Amanda and I spent the morning gaining multiple IV accesses, obtaining blood samples and administering emergency medications to the patient. I took the blood samples to the lab and when I returned her heart rate had dropped to 40 and again, we began CPR. We were fortunate to have a doctor from Kelowna present to help guide us and help with the code. But again, regardless of everything we did to try and save her throughout the morning, the code was unsuccessful. I was sitting, beginning to chart what had happened throughout the morning when I heard the family wailing. I can not begin to describe the haunting sound. The loud cries, the screams, the prayers. It is a sound we have all heard far too often in Zambia. This sound marks the end.. it is something I know that none of us will ever be able to forget. As I sit outside crying, I can feel the stares of passerby's and hear people whispering about the "makuah" in the corner, for it is not normal for nurses to cry, unusual for them to show emotion.
Okay I have made it through Tuesday...
 Wednesday was a really good day- no emergent situations, no death. A well needed, quiet day on the ward
Thursday things went back downhill. In acute bed one was an end stage HIV patient with septicemia. She was not expected to make it through Wednesday night and by 830 Wednesday morning, she had no pulse. It was hard to refrain from doing CPR. Unless we have a Do Not Resuscitate order in Canada, we attempt CPR. Of course there is no such paperwork here. So I sat with the 40 year old patient and her mother, as she watched her child die. I must say, although the death of someone so young was tragic, I knew in my heart that she could finally be at peace. I helped her mother wrap a shetenge around her waist and then sat and comforted her as she grieved the loss of her child.
This Is Africa... the days when we could pull a cord on the wall and have 10 people run to our aid during a code remind us just how lucky we are. Here, we can only do the best we can with the scarce resources we have. After the last week, I can truly say that this experience has changed me. It had opened my eyes, broke my heart and at times made me feel completely and utterly hopeless. It is hard to see the good things in a place filled with so much tragedy. But it is the little things, like the birth of healthy babies, the unmistakable joy in a child's eye when you blow bubbles for them, and the people who have survived surgeries against all odds that I have to remind myself of, and hold on to.

Happy Valentines Day everyone!
Thanks for listening...
Randi

17:03

Just last night we were caught up in the contagious joy of the nation, celebrating as Zambia won the African cup for the first time. People were on their knees praying, tears of pride streaming down their faces; families were dressed in the colors of the Zambian flag, singing and dancing; cab drivers drove up and down the streets honking, and cheering from out their windows. Just last night, we too shared that excitement. Earlier today we delivered a healthy baby girl, and felt elated when we heard that loud, robust cry of a new life. These moments of joy were short lived though, quickly replaced by a hardship that neither of us have­­ experienced before: the loss of a child, an innocent life. That seems to be how it works here, each wave of fulfillment and happiness is quickly followed by a ­­­tragic sight or sound that leaves us slumped over, fighting for air and to regain our own thoughts.

17:03-the time we called the code, and stopped resuscitating his tiny, limp body. We stood there stunned, eyes blurry and hearts racing, as we peeled off the tape holding his I.V and NG tube in place. We closed his eyes and placed his hands over his chest before covering him with a sheet, like we do with our adult patients who die at home. It didn’t seem right. His body looked too tiny, and his eyes still looked so full of life, it felt wrong to close them.

Fallon: I ran into the room after I heard Sam yelling my name, not sure how or what to prepare myself for. There he was, our little 2 ½ year old boy, lying limp and lifeless on the bed, his mother sobbing against the wall. I have never seen a dead child before, and the sight is something I don’t see myself ever forgetting. It took me a moment to get myself together, and to force my eyes off of his hauntingly white lips. Here we go I remembered thinking, Just Sam and myself, running our own code with no doctor or crash cart. We took turns between chest compressions and giving him air, with breaks of frantically feeling for pulses. Nothing. I remember how his chest felt beneath my gloveless hands; I could feel his ribs cracking beneath the strength of my fingers with every push. His skin was still warm, and the heat of his body felt like hope. “Come on, come on, come on” I remember Sam saying, through the muffled haze of the other sounds in the room. The doctor finally came fifteen minutes later, and gave us the orders to stop. I remember feeling torn between my own exhaustion and the obligation I felt to keep trying. This is somebody’s child, I can’t give up. I gave one final breath of air, his last, before removing the mask from his face and stepping back. Time of Death: 17:03. I immediately wished I left the mask on his face, because it let me forget the whiteness of his lips beneath it. I could feel my adrenaline wearing off, and my “game face” disappearing beneath my own sweat and tears. I went into the hallway and leaned against the wall, trying to make sense of what just happened. I felt my knees give out beneath me, as I slid down the wall taking comfort on the dirty floor of the hospital next to the wailing mother. Again, I found myself in a situation with no words to offer, and we sit together, the 3 of us, without words for nearly an hour. Pain and brokenness is a universal language, so words weren’t needed anyway. I felt numbness, and caught myself just staring at the floor, with blurred vision and no thoughts. These periods of detachment were frequently broken up by a burst of tears brought on by the mother`s piercing cry and rocking next to me. I wiped my tears from my cheeks, and realized that my hands were stained with the odour of the child’s skin. This smell of milk formula and sweat made me feel nauseated, and I felt an overwhelming need to wash my hands of it. I remembered there was no running water at the hospital today, so I tried to scrub them with the hand sanitizer in my pocket. The strong scent of the alcohol was not even enough to rid my hands of the smell.  I remember thinking that all I wanted was to do was wash my hands…to splash some cold water on my face, and to not smell and feel the burden of a dead child lingering on my fingers.  The grandmother walked by us with a great look of sadness, interrupting this thought. She said “thank you” in Lozi to Sam and I. Thank you? For what? We couldn’t save your grandson, why are you thanking us?  I suddenly felt a need to get up and go back to the child, and found myself walking back to the room before rationalizing my own need for closure. There he was on the bed, his tiny body wrapped tightly in a blanket, his face covered: a sight more haunting than his lips.

Sam: Last night we celebrated. We were lifted up onto tables, we danced, we hugged, we cheered and we sang. Zambia had won the Afcon cup for soccer for the first time in history. Faces painted, donning the Zambian colors, we were there in the heart of Mongu celebrating with locals. It felt like the Vancouver 2010 Olympics, words cannot describe the atmosphere. And now less than 24 hours after, it’s hard to remember those feelings, in fact it’s hard to feel anything at all. We had just witnessed a birth that morning, a moment of excitement for a new life.  Nearly 40min later we were mourning. We were sitting at the nursing station when I heard the cry of a mother. I ran to the bedside, the frail 2.5 year old was motionless, no palpable pulse, respirations or response. I yelled for Fallon for help. We grabbed an ambubag and Fallon started bagging as I initiated compressions, switching back and forth when we got exhausted. Seconds felt like hours as we waited for oxygen supplies to come and for the doctor to arrive. Thumping deep into the chest of this tiny boy was gut wrenching. But 15 min later we heard the words, “1703 time of death”. Even though we knew it was doomed from the start we still held on for that small glimpse of hope, but then it vanishes and no words can describe how you feel. Nothing can come out of your mouth to sooth this grieving family, and you hear the noise of the wails that haunt you in your dreams, reminding you of death. The mother leaves the room hysterically, and I don’t want to close my eyes because his face is all I can see now. His tiny, pale, innocent face. Only 2.5 years old, his life ahead of him, was now over. I know people don’t cry here but in Canada we cry. So we sat on the dirty floor of the hospital hallway with the parents. We sat as they cried and as we cried. We sat and held their hands, we sat in silence; we sat until we could no longer feel anything at all. I remember looking over at the mom and Fallon, both of their eyes fixated on the same blank wall ahead of them. A feeling of numbness, shock and sadness had overcome us all. No one said anything. People walked by us, their children in their hands and I felt so angry that this family had just lost theirs. Thunder, lightning and rain seem to have their cue here as we could hear the rain pounding on the roof. What had been the happiest day of many Zambians lives, was this family’s worst. It is hard sometimes to think positively when everything you see is overshadowed by tragedy, disease and death. But all in all it makes you stronger, even when you feel like you’re broken and can never be fixed.

Still looking forward to writing a happy blog. Stay tuned…coming soon?

Sam and Fallon

Another Week at Lewanika General Hospital

I spent my third week of practicum on the Children’s ward in the Lewanika General Hospital. I was most excited for this ward because spending time with children is something I love! If I can make one child a day smile, forget about their health condition for a moment, or show them compassion they may not see at home, my goal is accomplished. I spent the majority of my time in the PEM room for children who are severely malnourished. I cared for the same 6 children for the majority of the week which I appreciated because I enjoy getting to know my patients and their families. Making these relationships and bonds with my patients is something I have learned to be difficult when their health conditions begin to deteriorate. Many people say to not get attached to your patients, don’t bring your work home with you, etc. However for myself, I know I am one to do no such thing. With children especially, I think about how they will do overnight until I can see them again in the morning, I wonder how they will do when they go home, what kind of home life they have, and what more can be done for them.

In the PEM room I became particularly interested in one case. I spent the majority of my hours with a little 2 year old boy who was malnourished, along with various burns and large areas of his body that were excoriated and infected. He could not talk or even make noise when he cried because of all the sores in his mouth. His breathing was never quite at ease and there was so much I wanted to do for him that I could not do, due to the lack of resources, supplies and short staffed doctors and nurses.

            Although there were many things I could not do and could not find out about the boys condition from the father due to the language barrier, I did everything I could think of to improve this boy’s condition and make his hospital experience more enjoyable. To accomplish this, I made sure that the boy received his full feeds on time, whether that meant feeding him through a syringe myself or monitoring the father while he did the feed. I completed thorough oral hygiene daily with the boy, and bathed him in a small tub 1-2 times during my shift to help clean and heal his wounds. All these simple and small tasks are something that in my eyes should come naturally to a parent. However in this particular case, the father had no parenting skills, and was not fit to care for this child. Unfortunately for the child, his father was the only family he had as his mother passed shortly after he was born. Because this child was in such great need of care and compassion, I knew he would be someone I would not be able to leave alone.

            On my fourth day working on the Children’s ward, I arrived to work to find out that my little man had passed away just a few short hours before I arrived. I was heartbroken to find this out, and even more disheartened when I was told that the father did not even spend the night with him because he went out drinking to watch the soccer match instead.

My little man who should have walked out of the hospital a happy and healthy two year old was instead rolled away on a stretcher to the hospitals morgue. A death that could have been preventable if proper care was given around-the- clock, if antibiotics were initiated earlier, or if everything that should have been done for this boy was done early and done right. I can think of so many things that could’ve, would’ve, should’ve been done, but at the end of the day you have to accept what life decides. I am a strong believer in “Everything happens for a reason” but on days like these the word ‘why’ seems to continuously cross my mind. 

Natalie xox

An Afternoon at Sefula Secondary School

February 9, 2012

Two days ago, Amanda, Julet, Denee, Esther, Sylvia, and Joel visited a school in a nearby town to speak about the importance of post-secondary education and the benefits of nursing.

Our trip was put into motion during our first week in Mongu. While picking up our new ZamBikes, Amanda serendipitously met a woman by the name of Chi-Chi. Seeing a group of Makuwas in Mongu isn’t a terribly common sight and so Chi-Chi was curious. Amanda explained that we are a group of nursing students from Canada and that we were staying for a few weeks. Chi-Chi, as it would turn out, is a guidance counselor at a secondary school and so she asked Amanda if she would bring a group of us to her school to speak to her students.

A few weeks passed before Chi-Chi contacted Amanda again. Details were set and, before we knew it, we were whisked away in the back of a van. Rocking (slamming) back and forth, we zipped along the pockmarked road on our way to the school.

Prior to arriving, Chi-Chi explained that this was the oldest school built in Western province. For an ancient school, we were surprised by how well-kept it was and the stunning location in which it was situated.

We stepped out of the van and Chi-Chi ushered us into the staff room. She set out to gather the students and to prepare the lecture hall. As we sat alone, we began to wonder exactly what we were getting into. Amanda had implied that she had been invited to speak and that we were going to support her. Chi-Chi, however, had other ideas.

She returned to the staff room soon after and inquired about our lecture plan. Although we were planning on having a casual conversation with the students, Chi-Chi wanted to have set introductions, speaking points, and conclusions. Hesitantly, we all signed up for topics while secretly shooting daggers at Amanda.

Satisfied with the plan, Chi-Chi took us over to the lecture hall. A dull roar of voices could be heard more and more with each step and we quickly realized that we would be speaking to more than just a class. The doors opened up and some hundred students became visible. Amanda! What have you gotten us into?

Our group took to the stage and sat down in front of our (very large) audience. Chi-Chi took some time to introduce us and sat down. It was all us now.

Before going any further, I should probably mention the heat. And the sweat. Even with the windows and doors open, the ventilation was next to nil. We sat in front of our audience, glistening, with sweat dripping down in places never before thought possible.

Denee stood before the group to explain the importance of post-secondary education. (“Anyone can… dig a hole. But nobody can take your education from you!”)

Next, each of us stood up and shared how we had all found our way into nursing. Joel then spoke about post-secondary education and how to apply internationally.

A question-answer period followed in which the boys asked questions (Chi-Chi: “Girls! Ask a question! This looks very bad on you!”). Julet, disturbed by the girls’ lack of questions invited (told) all of the grade 12 girls to approach the stage (“Education before babies! Education before babies!).

Before we knew it, the talk was over and the students stormed the stage to hear their heartbeats with our stethoscopes. The students were very engaged and brought up many good questions. We took plenty of snaps (photographs) and the students were excited to see their faces on our cameras.

        And with that, we headed out to the van and traveled back to Mongu.

        Although it was an after work experience, it ended up being entirely worth it. We were exhausted upon arriving but were pumped up by the students’ enthusiasm and the very idea that they had stayed late from school to hear from us.

        We had a fantastic time at this school and we hope that this opens up new possibilities for next year’s group.

By Joel, Esther, Sylvia, Amanda, Denee, and Julet