Monday, March 28, 2016

New Life in Lewanika General Hospital

This week, we experienced what it is like to care for new moms and babies here in Mongu. We were privileged to learn alongside Zambian student nurses and glean knowledge from the more experienced student midwives.

During our month-long maternity practicum in Canada, we were taught the importance of time efficiency and thorough maternal and child assessments. The average hospital stay in Canada is 24-48 hours for a new mom after a typical healthy delivery, whereas in Zambia, it is only 8 hours. Because of the quick turnover, we got to do many newborn assessments to ensure the babies had proper reflexes and were healthy enough to go home. However, it was a challenge for us the learn that Zambian clinical prioritization is different from what we are used to in Canada. Instead of doing assessments and checking in with moms and babies first thing in the morning, the staff here "damp dust" or wipe down the window sills and beds before starting vitals signs at 09:30.  The pace was much slower than the maternity ward at home; however, it left us with many opportunities to ask questions of the student midwives. We learned more about breastfeeding and preterm baby development and care. We valued these learning opportunities as they helped us deepen our understanding of maternity care both at home and globally.

On our last shift in the post natal ward, we walked in after lunch to a newborn baby having a seizure.  It was a tricky process for the staff to figure out what was going on with the baby, as many of the diagnostic tools that we would use in Canada are not available here. For example, when an infant has a seizure, one of the first questions we would ask is: do they have low blood sugar? We then would perform a simple test using a glucometer to see if we need to treat for hypoglycemia. At Lewanika General Hospital there is no access to glucometers, so the way to test for hypoglycemia is simply by giving the baby an IV sugar compound and observing how the baby responds. We watched as the healthcare team relied on critical thinking to stop the seizure and determine the cause of the baby's "fit."

After three weeks of travel, practicum, and adaptation to new surroundings, we were able to travel as a larger group to Livingstone, a city in Southern Province and home of the famous Victoria Falls. We spent four days enjoying the sights and activities that the area provided. Highlights for us included spending time taking in the sheer size and grandeur of the falls, getting soaked by its spray, and being taken by a guide into the water above the falls mere meters from the edge. It was wonderful to enjoy some of the incredible natural beauty unique to this country.

We are now exhausted from wonderful travel and are gearing up for another week of clinical. We look forward to many more learning experiences as our time comes to a close.

Until next time,
Julianne and Laura

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