Monday, April 1, 2013
We Sing, We Pray, We Dust
I remember my reaction to the male ward, during the initial hospital tour, like it was yesterday. The patient beds so close together, the overwhelming pungent smell that overtook my nostrils, and the countless male patients, just skin and bone, that were laboured with every breath. I remember looking around at my fellow classmates and feeling reassured when their faces reflected my exact emotions. Later we spoke excitedly about starting work on every floor but unanimously the male ward was dreaded and secretly I prayed I would be placed anywhere but there. The minute the assignment sheet was posted and the words 'Nicole.M. - Male Ward' came into focus, my heart sank.
I am a firm believer that everything happens for a reason so I decided I would remain silent about my disappointment and head into the experience with an open mind.
I can proudly state that this past week Stephanie Simpson and I bravely tackled the ward. Miraculously, I can honestly say that I thoroughly enjoyed the experience and learned a lot about nursing in Africa and truthfully, about myself. Sometimes the best experiences can come from being pushed out of your comfort zone and this was definitely one of those times.
So there I was on my very first day on Male Ward looking around, just as overwhelmed as ever. Trying to get myself pumped up and positive I walked over to the Zambian nursing students and asked with as much enthusiasm as I could muster "So guys where do we start?". They all looked at me strangely and one replied, "Well Sister, first we sing, then we pray, then we dust". Sing? Pray? Dust? That's when I really recognized just how different nursing in Africa really is. After hearing that response I came to the realization that I may be completely out of my comfort zone but that I still have so much to offer. I have the power to be a role model to these nurses and to demonstrate what I feel is most important - providing patient centered care.
Zambians are very proud people and it is not always the easiest to tell if the nurses here are learning anything from us but deep down I know they notice the way we interact with the patients and take note.
One case in particular that stuck out this week was when Steph and I arrived on the ward to find a patient that was a local prisoner laying on a mattress on the floor covered from head to toe in his own feces. We have no idea how long he had been in that horrid condition. Of course Steph and I were apalled and I am sure the looks on our faces gave away our distaste. We hurriedly gathered a basin with water and gauze to clean the patient up.That was a profound moment as patients on the male ward are often left laying in their own filth, waiting for their family members to clean them; that is if they are lucky enough to find clean linen and supplies. Us demonstrating that we will provide compassionate care and treat any patient with dignity regardless of their status, prisoner or not, was enough. The nurse noticed what we were doing and quickly joined to help us. The cherry on top of that experience was when the patient that was barely conscious prior to the cleaning, looked up at me and gave me the hugest grin.
I now understand the impact our actions can have here but before we can take over with our Canadian nursing ways, we must learn to sing, pray, and dust.
- Nicole McComb
I am a firm believer that everything happens for a reason so I decided I would remain silent about my disappointment and head into the experience with an open mind.
I can proudly state that this past week Stephanie Simpson and I bravely tackled the ward. Miraculously, I can honestly say that I thoroughly enjoyed the experience and learned a lot about nursing in Africa and truthfully, about myself. Sometimes the best experiences can come from being pushed out of your comfort zone and this was definitely one of those times.
So there I was on my very first day on Male Ward looking around, just as overwhelmed as ever. Trying to get myself pumped up and positive I walked over to the Zambian nursing students and asked with as much enthusiasm as I could muster "So guys where do we start?". They all looked at me strangely and one replied, "Well Sister, first we sing, then we pray, then we dust". Sing? Pray? Dust? That's when I really recognized just how different nursing in Africa really is. After hearing that response I came to the realization that I may be completely out of my comfort zone but that I still have so much to offer. I have the power to be a role model to these nurses and to demonstrate what I feel is most important - providing patient centered care.
Zambians are very proud people and it is not always the easiest to tell if the nurses here are learning anything from us but deep down I know they notice the way we interact with the patients and take note.
One case in particular that stuck out this week was when Steph and I arrived on the ward to find a patient that was a local prisoner laying on a mattress on the floor covered from head to toe in his own feces. We have no idea how long he had been in that horrid condition. Of course Steph and I were apalled and I am sure the looks on our faces gave away our distaste. We hurriedly gathered a basin with water and gauze to clean the patient up.That was a profound moment as patients on the male ward are often left laying in their own filth, waiting for their family members to clean them; that is if they are lucky enough to find clean linen and supplies. Us demonstrating that we will provide compassionate care and treat any patient with dignity regardless of their status, prisoner or not, was enough. The nurse noticed what we were doing and quickly joined to help us. The cherry on top of that experience was when the patient that was barely conscious prior to the cleaning, looked up at me and gave me the hugest grin.
I now understand the impact our actions can have here but before we can take over with our Canadian nursing ways, we must learn to sing, pray, and dust.
- Nicole McComb
The Unseen Results - Mukambi
This week we (Marlee and Jenni) stayed at
Mukambi Safari Lodge, working daily with the surrounding communities of Mukambi
Compound and Chunga Village. Throughout
the five days, we were faced with many barriers, mostly being outsiders in a
small community. It has been a week of
smiles, laughs, frustration and realization.
We would like to share some of these memories of Mukambi and Chunga you
all!
Our week consisted of traveling to Chunga village to work at the Out Patient Department (emergency in Western terms), participating in the “Under 5” clinic, teaching grade 1, 8, and 9s at the Chunga boarding school, providing an information session at the Mukambi School for parents, and spending a day HIV testing. Each of these experiences showed us how different but more importantly how similar Canada and Africa truly are.
Teaching the grade 8 and 9 students at Chunga is definitely one of our most memorable moments. For those of you who know us, neither one of us are overly outspoken and are not ones to speak up in a group, so this was a challenge! As our discussions around hygiene and sexual health progressed the students became more involved… asking fairly complex questions. These questions ranged from “what is masturbation?” to “is a sexual relationship between a 15 and 16 year old advisable?” Masturbation in Zambia, especially in the smaller communities is frowned upon, and is not something that people here engage in. In addition, sex in general is not common topic around the Zambian dinner table. As we stood in front of 120 students and 4 teachers, we were at a loss for words and wanted to find the nearest exit. After a few seconds, which felt like an eternity we realized the purpose of our visit. The purpose being to spread valuable information about health, but more importantly, to have a clean slate, where they can ask any question they may not have been able to ask their parents, loved ones or teachers.
Our next adventure was teaching the parents of the Mukambi compound. We covered similar topics with the addition of Malaria, HIV, and basic first aid with the help of a translator because many people in the community only spoke Chitonga, the local language. Impromptu teaching about safe sex and specifically how to put on a condom was a popular topic (a bottle of water was the only demo prop we had – limited resources at its finest!). Even though we were able to pass on information about health, we ended this day feeling slightly disappointed as the response from the group was hard to read and we were unsure of their acceptance of us. But throughout the rest of the week, we began to gain trust with the community by simply putting up health posters or playing a game of net ball with the school children, we realized that if we were able to reach one person throughout the health teachings, good things will come of it.
With the stigma regarding HIV being highly prevalent in this community we were uncertain of the turnout we would have with the HIV clinic. After the days end, we tested 28 people and felt like it was a very successful day. This resulted in 28 people knowing their status, receiving information about preventing or living with HIV that we hope will be passed on to their families and loved ones.
Overall it was a great week at Mukambi. Through our background and environment, we have learned to be “doers” and want to see results of our actions or a change for the better, immediately. Whether it is with our looks, our careers, our education, we like to see the “fruits of our labour,” in a very timely fashion. This week has allowed us to realize that even though we may not have seen a direct result of our teachings, it does not mean that change did not happen or will not come. A simple demonstration of correct condom use, has the potential to protect one person from contracting an STI, having an unplanned pregnancy or receiving or passing on HIV. We may never know the direct results of our time at Mukambi, but we have come to see that education is truly the best medicine.
Our week consisted of traveling to Chunga village to work at the Out Patient Department (emergency in Western terms), participating in the “Under 5” clinic, teaching grade 1, 8, and 9s at the Chunga boarding school, providing an information session at the Mukambi School for parents, and spending a day HIV testing. Each of these experiences showed us how different but more importantly how similar Canada and Africa truly are.
Teaching the grade 8 and 9 students at Chunga is definitely one of our most memorable moments. For those of you who know us, neither one of us are overly outspoken and are not ones to speak up in a group, so this was a challenge! As our discussions around hygiene and sexual health progressed the students became more involved… asking fairly complex questions. These questions ranged from “what is masturbation?” to “is a sexual relationship between a 15 and 16 year old advisable?” Masturbation in Zambia, especially in the smaller communities is frowned upon, and is not something that people here engage in. In addition, sex in general is not common topic around the Zambian dinner table. As we stood in front of 120 students and 4 teachers, we were at a loss for words and wanted to find the nearest exit. After a few seconds, which felt like an eternity we realized the purpose of our visit. The purpose being to spread valuable information about health, but more importantly, to have a clean slate, where they can ask any question they may not have been able to ask their parents, loved ones or teachers.
Our next adventure was teaching the parents of the Mukambi compound. We covered similar topics with the addition of Malaria, HIV, and basic first aid with the help of a translator because many people in the community only spoke Chitonga, the local language. Impromptu teaching about safe sex and specifically how to put on a condom was a popular topic (a bottle of water was the only demo prop we had – limited resources at its finest!). Even though we were able to pass on information about health, we ended this day feeling slightly disappointed as the response from the group was hard to read and we were unsure of their acceptance of us. But throughout the rest of the week, we began to gain trust with the community by simply putting up health posters or playing a game of net ball with the school children, we realized that if we were able to reach one person throughout the health teachings, good things will come of it.
With the stigma regarding HIV being highly prevalent in this community we were uncertain of the turnout we would have with the HIV clinic. After the days end, we tested 28 people and felt like it was a very successful day. This resulted in 28 people knowing their status, receiving information about preventing or living with HIV that we hope will be passed on to their families and loved ones.
Overall it was a great week at Mukambi. Through our background and environment, we have learned to be “doers” and want to see results of our actions or a change for the better, immediately. Whether it is with our looks, our careers, our education, we like to see the “fruits of our labour,” in a very timely fashion. This week has allowed us to realize that even though we may not have seen a direct result of our teachings, it does not mean that change did not happen or will not come. A simple demonstration of correct condom use, has the potential to protect one person from contracting an STI, having an unplanned pregnancy or receiving or passing on HIV. We may never know the direct results of our time at Mukambi, but we have come to see that education is truly the best medicine.
Mission Impossible: The Untouchable.
Mission: Survive one clinical week on the Male Ward.
Details: In the face of lacking supplies, extreme nursing
workload, a language barrier, an unknown hospital political process, discouraged
critical thinking and an evil doctor, you must care for patients in every way
you can, and come out of it with your head still perched upon your sweat soaked
neck.
…mission accepted.
With so many
things stacked against them, it is a wonder that patients, family and nurses
alike make it out of there in one piece. The “supply room” is a spacious room,
but only because there is next to nothing in it. It contains just a few boxes
of IV fluid and some catheters on the floor along one wall. Even clean linen is
scarce. The number of patients fluctuates, but you can be assured that there
will be at least 40 patients (medical and surgical combined) on the ward with
only 3 nurses to attend to them. There are often many students on the floor
though, so they seem to manage in their own way. One of the most difficult
things to work with is the fact that the nurses here are not taught critical
thinking skills. These skills actually seem to be discouraged, and the only
purposes the nurses have are to clean and to follow doctors’ orders. Following
orders isn’t necessarily a bad thing, but there are often times when a patient
becomes quite sick suddenly and the nurses do not act because they do not have
a doctor there to give the orders they need. And no, they do not call the
doctor for help regularly. It was during these times that Nicole M and I were
really able to kick butt and get things done, using our critical thinking to do
what we could with what we had.
My stand out
moment this week was the care for a particular patient on the floor. We noticed
that his mattress had been moved to the floor overnight, so we went to check on
him. He was semi-conscious, naked and covered, from head to toe, in his own
feces. After a quick assessment we went to work cleaning him up and trying to
talk with him as he became more alert. The nurse we were with though didn’t
seem to want to come and help us even to just translate what he was trying to
say. After scrounging up some linen we were able to clean and cover him, and we
sat him up by leaning his mattress against his bed post, as he was too weak to
sit by himself. His mouth was also covered in sores and muck, so we cleaned out
his mouth with some of our supplies. It was then that he smiled at us. That
single moment has made my trip here so worth everything in so many ways. Later
that day when his guards came in they went to talk with the nurse. We heard
them talking, laughing and saying “makuwa” (white person) a few times. We asked
the nurse what they were talking about once the guards had left and though she didn’t
really answer that question she did tell us that he hadn’t eaten in 5 days. You
see, it is up to the family members to feed the patients, and he didn’t have
anyone in the hospital to see him. He also was unable to get food for himself.
The hospital provides one meal a day however, so we made sure to feed him when
they came around with the food. We also asked her to tell the nurses to feed
him when food comes, but who knows what will happen with that. I was really disgusted
at how much the stigma of being a prisoner affected the ability of the nurses
to care for this patient, but I hope that our actions were watched closely by the nurses (as I believe they were) and that they may take even just a moment to think about us and why we acted the way we did. Hopefully, these small thoughts will eventually turn into something a little more that can help the patients of the future.
Clinical week 3 of 5: Completed.
-------------------------------------------------------------Stephanie S
Living with HIV
This past week I had the opportunity to work in the ART Clinic-the Anti Retroviral Therapy clinic where people go for routine check ups and treatment for HIV. It was such an eye opening experience while I sat taking vital signs for 4 hours nonstop person after person filtering through the clinic. It is amazing that some days they can have up to 300 patients come through. What really caught my attention is that HIV has no stereotype here in Zambia, and I never would have thought that many of the people who came through the clinic were living with HIV. It made me realize that we have been in contact with many people during our stay here that are living with HIV without knowing it, and we have danced and laughed and shared some great times and made some wonderful memories with a lot of the people without ever thinking that they might have HIV. It is very easy to stereotype people anywhere in the world when it comes to diseases and that there are many people here as well as back home who are living with some kind of illness that we may not see on the outside. Here in Mongu HIV affects the young and the old, the rich and the poor and it reinforces the fact that as a nurse it is important that we are seeing the patients for who they are and not just their illness. It was a very interesting couple of days and I am thankful for the learning opportunity.
-SB
First Aid Teaching
This week we taught a first aid course at the "save a life" feeding centre. At first this week seemed like a lot of work and not a whole lot of fun. Now looking back at it it definatly was a lot of work but with that came a great amount of accomplishment and a tremendous amount of laughter and good times. We will forever have a new respect and appreciation for all of our teachers as it takes an amazing amount of prep time to teach lessons and a lot of energy while in the classroom.
Our class was filled with 12 Zambian students of various ages, backgrounds, and professions. Each one of them had their own story and reason for being in the class. Some were there because they were asked to be others were there because they wanted to know and teach their children all about first aid. Over the four days we taught first aid we developed friendships and were able to learn more about the culture and traditional beleifs these people have especially surrounding first aid treatments. We had some extra challenges teaching here in Africa. These included the language barrier and limited resources (as always is the case here). We tried our hardest to present the information in a fun and interactive way. Through hands on activities, posters, games, and scenario playing we were able to engage our students and develop a first aid program that fit with their needs.
On our last day we had a review and a practical quiz where we role played different scenarios and students had to demonstrate how they would respond. It was a lot of fun and giving out the certificates was a great ending !
Looking back at this experience we feel privileged to have been given the opportunity to teach. Not only was it a great review for our upcoming outreach trip it was also a challenge that was well worth the rewards!
---Anna & Amanda---
Subscribe to:
Posts (Atom)