Friday, April 11, 2014

Where there is no doctor

     This week we were placed at the Save a Life Center and worked with an amazing team at the center as well with the rest of the village of hope community. Our adventure started with our cab running out of gas and breaking down. We ended up calling Jess and Jackie to help us. In that moment we felt a little scared because it was dark, only had an approximate idea of where we were, out of control, and we had a crowd starting to form with the attention of trying to get the car going. We were reassured and know that we weren’t in danger, but it was not a good feeling.
     We got settled at the village of hope and started our our first day at the clinic the next morning. It was a little nerve racking of the idea of us seeing patients and decided on the treatment. We know how to document and assess, come up with recommendations, but making the call of treatment was intimidating,  not to mention the language barrier. It was a great experience in the end because of the growth in trusting our gut and the knowledge that we now know we do actually have. At times we would feel frustrated as we thought , I am trained canadian med/surg nurse that is trying to catch up on tropical medicine. We relied on Ivy for not only translating,  but also for her experience with tropical medicine and the culture. We have greater respect for walk in clinics and appreciate the role of the nurse practitioner and doctors more now because of this experience.  As a team we would discuss and turn to our resources to support us.  This experience really pushed us out of our comfort zone.  Come to think of it, most of this experience in Zambia has pushed us out of our comfort zone.  But this diagnosing and prescribing business was something completely foreign for us.  As UBCO nursing students, our Scope of Practice has been so deeply embedded in our education, that we almost felt as if we were breaking rules by diagnosing and prescribing all by ourselves! But armed with our books and our own experience, we made it through the day feeling proud of ourselves.  Reflecting back, we think that the stretch to our comfort zone will make us better nurses in the end.  It's ignorant to think that the RN's scope is static. The scope of the registered nurse is constantly changing and expanding, and I feel as if Save a Life gave us the opportunity to have a sneak peek into the future of our chosen careers.  

     We also had the opportunity to teach a mom and baby class!  As part of Save A Life's child malnourishment program, the caregivers participate in weekly education sessions with their children.  The staff really gave us a lot of freedom in creating our milestones (gross motor and fine motor skills) class. Our favourite moment from the sessions was seeing the mothers and children bonding. It was an opportunity to celebrate the success and the development of their child. We also were able to work with Ivy and continue to build on our partnership.

     One of our most valuable experiences this week was seeing these moms and babies in their own homes.  Going on the home visits was also great opportunity to see the hidden communities within Mongu. We started by slipping between two shops and suddenly, we entered a part of Mongu that we never knew existed! Through the sun and sand, we trekked through the communities. Our first home visit was in a one room hut. The walls were made of weaved reed mats; there was a carpet on top of the plastic sheet, a few pieces of furniture, and clean dishes. A simple chitenge (similar to a sarong) divided the rooms. The baby looked well and more or less the same since we last saw this child in our class.  One of our biggest learning experiences here was that this baby was clean, happy, and healthy in this one room hut with his loving mother.  A baby is a simple creature with minimal material needs.  At first, this hut may have looked like a sagging lean-to, but to the baby and his mother, it was home sweet home. This was a good visit.  After our visit, mom and babe walked with us for a great distance on our way to our next home visit. As we walked, the inequity between the communities became obvious.  Some live in huts of sticks and clay, some of bricks and sometimes a combination of the two.
     As we reached this second home, we sat on a little bench. Behind us was a child who had not been to the center for two weeks, and why we were concerned. She hadn’t come to the center because the mother was not feeling well. She had three children. This was a moment where it truly looked like your classic World Vision commercial. We thought we had seen poverty, but this was on a different level.  The Save a Life staff had been suspecting that maybe the mother was having to choose which child is to receive the minimal amount of food. The child on the program sat outside the door with flies around her face and we think she may have had diarrhea. The child beside us was sitting on the floor and playing with a match box. The oldest child was in and out, interested to see us. No one was very clean and it was as though you could see the stress on the mother’s face. We thought back on the times we've ever thought, ‘we have to take care of the people in our own backyard first.'  While the poverty in Canada is prevalent and worthy of attention, sitting in that home gave us a real look into poverty and the living conditions of billions of people worldwide. The people we visited really are looking for the basic human needs to be met. A safe shelter, food to feed their family, safe drinking water, be able to receive medical care and support when facing diseases such as HIV and malaria for example. You can see in these moments how it is so important to support the women and girl children and help to empower them.  For example, when the mother was asked why she hadn't brought her child in for her weekly weigh in, she said that she had been ill for 2 weeks now and was feeling dizzy when she walked.  Now consider that the clinic was a 2 hour walk from her hut and she had 3 children under 5. Two are unable to walk.  How was she supposed to bring her daughter in to be weighed?  Who would care for her other children? When would she get medical attention herself if she was barely able to jwalk? As easy as it would be to blame this mother for "neglecting" her children, we learned this week how important it is to consider the context from which our clients are coming.
    This week has pushed us in more ways than one and wasn’t the easiest this week. In order to grow and change we need to be pushed and get outside that comfort zone. We are grateful for this week because of development in ourselves we have seen because of it. It made our weekend at the saffari something celebrate and reflect on how far we have come since first landing in Lusaka that afternoon.
Looking forward to seeing what opportunities arrive next and where this journey takes us.

Aileen and Darien.

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