Thursday, February 2, 2012

Challenges at Lewanika

Well here we are at week two in practice! The safari was definitely a nice break from cold showers and cooking. With buffets 3 times a day, animals trekking though our camp, a swimming pool and glam suites it was a enjoyable time for all of us. On our safari drives some of the animals we saw were: lions, elephants, wart hogs, hippos, crocodiles, impalas and many more! It was quite the surreal experience. However we were all a little glad to be home in Mongu once we got back. And hey! We had hot water!
                  This week we are working on the male ward. It is quite different then the clinic and much different from home as well. Unlike Kelowna where the wards are divided into medical and surgical, our wards here are divided by gender. The male ward is semi split down the middle with surgical patients on one side and medical on the other. However with lack of space some may be mixed, and unfortunately some may be on a mattress on the floor. The day usually starts with us going on rounds with the doctor. The doctors have been especially good to involve us in their rounds, testing our previous knowledge and sharing some of their own. The most common things seen on the wards thus far have been BPH, HIV or RVD, Pulmonary TB and various fractures. Yesterday we had 4 casualties from a motor vehicle accident come from 4 hours away. From broken femurs to compression of the spine these poor patients travelled 4h to get to us, only to have to be transferred to Lusaka due to lack of resources. In Canada we also have patients transferred for a higher level of care, or to a specialist, however they are normally airlifted. The patients here were going to be travelling 8 hours in a bus (not ambulance) with only one nurse and no life sustaining medical equipment. It is things like this that make appreciate what we have at home. 
                   Today was especially hard for the pair of us. At home, we expect to see most of our palliative care patients in their late 70's and 80's, but in Mongu, it is rare to see anyone over the age of 50 on the ward. This speaks volumes to the low life expectancy in Zambia. Many of the end-stage HIV patients on the ward are under 40, with large families at home. We will never get used to the suffering these patients are facing. From extreme malnourishment to raging infection and excruciating pain with no medication, it has made us appreciate the comforts we enjoy back in Canada, even at the end stages of life. Losing a 17 or 25 year old boy (chart said both) to possibly End stage HIV. Unable to truly get closure because cause of death was never confirmed due to lack in diagnostic abilities. Almost losing an 8 year old child to malaria that Julet brought to the hospital from a clinic 15 minutes away because of lack of resources. We both helped transport the child to OPD (the equivalent to Emerg) via blanket and 4 strong makuwas (white girls). Once there, we had to get the attention of the busy doctors (harder than it sounds), and try to stabilize the boy. With a raging fever, we poured our bottles of ice water from lunch over his seizing body, hoping to bring down his temperature. We also had to use an ambubag to help him breath. Scrounging for the resources that would be at our fingertips at home, we were finally able to stabilize the little boy with help from the pediatricians and nurses. It was a hard day, but it is days like this that remind us of why we are here. At the end of the day, we were reminded that along with hardship there is still beauty. When we went to go get Michelle and Cara from maternity, we saw a new grandmother so happy celebrating the birth of her grandchild that she started singing and dancing at the bedside. It almost bringing tears to our eyes, and it was that little joy that we needed to get through the day.
                  We miss everyone from home and hope you are all enjoying the snow and cold weather, while we are getting tanned (and burnt) and melting in the heat when our power is out.

Brit and Steph

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