21 September 2011

1st Day of Work = Children's Clinic Day! (and election update)

Today had the potential of being a very good day or a very bad day.  Either way, after waking up this morning I had a feeling that this day was going to define the next month of my life.  Would work be fun?  Would we be safe at the clinic?  Who won the election?  Would there be political turmoil?

It started out badly. 

In so many ways.

I don’t know if you’ve ever tried mixed fruit yogurt.  That’s what we have here.  It’s decently tasty I suppose.  But Frances had the brilliant idea of topping the yogurt with corn flakes.  I thought I’d mix them in.  But all they did was get soggy and taste like they were mixed with bad milk. 

Lesson learned.

We took our 500ml water bottles that were half frozen and half water down to the clinic with us.  Our supervisor gave us another (bigger) frozen water bottle to take so we could re-fill our bottles.  But they stayed mostly frozen all day despite the heat. (it’s in the upper 90s during the day here)  Our big water bottle never melted.  And we never had to pee. 

Which means we didn’t have to use the squatty “toilets.”

Which is nice, but also probably means that we were dehydrated. 

Not ideal.

We arrived at Mushili Health Center and were greeted by the lab technician, who introduced us to the CHT: Community Health Technician, the man who runs the under 5 children’s clinic.  We were going to work with him today for and help him with the children’s clinic.

We entered a packed room with children strapped to the backs of their mothers, quiet and peaceful except that it was hot.

Each child had a health card, similar to vaccination cards mothers in the United States carry around from doctor’s visit to doctor’s visit when their children get vaccinated.  Their health records were stacked on the table in order of arrival. 

Frances and I sat at the front of the room and were scrutinized by the mothers and the children sitting there.  Precious children!!

The CHT was working on getting the vaccinations ready, so he told us we could go and work with the nurse practitioner (NP) on the other side of the clinic and he would come get us when he was ready.

We walked into her office as she was finishing with a patient.  She had another worker bring chairs for us to sit on, even though we insisted that we could stand.  In America we rarely have the option to sit as students.  But she stopped seeing patients until we got chairs. 

We saw the NP finish with a patient, talking mostly in one of the local languages that we did not understand.  She rubbed the child’s belly, opened its hand, and looked at the eyes.  She recommended water mixed with 2 tsp sugar and ½ tsp salt.  Then she sat down and wrote in the record book, handed the book to the mother, and they left.  When the next patient walked in, she looked at us and said, “See the patient.” 



I looked at Frances.  The mother did not speak English at all.  We were given no instructions. 

Frances, the brave one, examined the child and asked the NP some questions as I stood there dumbfounded.  The NP appeared put-out when Frances asked her to ask the mother questions.  What are the child’s symptoms?  Any vomiting?  Bloody Diarrhea?  Fever?

Then Frances told the NP what she thought was wrong and what to do.  But the nurse handed her the medical record (everyone here carries around their own composition book and hands it to the doctor/ NP to write in) and said “Fill it out.”

Um.  How?

Maybe you should teach us first?? 

Frances and I are educated.  If we were in America we could write up a patient with no problems.  It would change a bit depending on the style of the clinic, but we would feel decently comfortable writing a note. 

However, this is Africa.  We don’t write in composition books.  We don’t know the required elements of the exam.  There’s not space to write it all!  We don’t know what we’re doing here! 

A little direction might help…this might just be a long day…

Frances wrote a basic note after glancing at the other notes in the composition book.  Thankfully, our Community Health Technician that we were working with came in to save the day!  He pulled us into the children’s clinic!

Did I mention how much I LOVE African children?!

I got to hold them (briefly) while we put them on the scale to weigh them.  Well, it is more like we tied them into slings made of cloth like we were shipping them in a stork’s beak and hung them from a UNICEF labeled scale. 

It made me wish a stork would bring me a little child in its beak!

I mean, not really. 

Not yet.

We weighed all the children.  Each month they come in for a visit and get weighed to monitor their growth.  If they don’t grow, the CHT talks with the mother about why and educates her.   Sweet! 

The children’s health cards had a place to record their vaccinations.  They get OPV, which is Oral Polio Vaccine, at birth.  They also get BCG, to protect against TB.  We don’t give either of these vaccines in America.  The children also get OPV again at 6 weeks, 10 weeks, and 14 weeks.  They get a combination of TDP (tetanus, diphtheria, and pertussis) and Hep B and Hib all in one vaccine following the above vaccine schedule.  We give all those in the United States, but they’re in separate shots.  I’m not sure why.  Maybe they’re testing it out here first.

The health cards also have a place to record growth similar to American children’s growth charts.  And a place to record number of de-wormings the children get, unlike anything we have in America.

The kids were SO well behaved and SO cute!  I loved doing children’s clinic today!!

Apparently we get to do Children’s Clinics on Mondays too, only we get to travel around to remote villages and help people who have no access to the clinic in town!





During lunch I saw a tornado and yelled to Frances to look!  It was picking up sticks and dust.  Oh!  But Frances looked around and no one else was very affected by it, so she didn’t get excited either.  Lame.

We also met a man named Gift who is going to be a missionary in Malawi.  He was very passionate about Jesus.

Back at the compound we went on a walk with some of the missionary students and we watched some children play soccer.  I worked on my ZSL (which we learned is 94% similar to ASL because we met some missionaries who work at a deaf orphanage in Luanshya (Lew-wants-ya) and they told us how similar it was.  They also invited us to come hang out with their kids sometime, which we’re stoked about!!)

We had some leftovers for dinner.  We saved them in our fridge and heated them up in our microwave.  Neither of which I thought we’d have.  Crazy.


Frances and I feel like celebrities.  Everywhere we go people stare at us and wave to us.  So cute!

The votes haven’t been counted in the election yet.  People get their thumb painted black so they can’t vote twice. 

High tech. 

We’ve gotten about 8 different emails from the US State Department and International SOS about staying out of sight.  The opposition party (Sata, the man who isn’t in office) has already threatened to put up road blocks and stop and plunder cars on the road in their main region, the copperbelt (where we are).  We’re not too worried about it, but I’m praying we stay safe and out of the way, especially since we stick out and we usually travel in a car.  But we’re off the main paved roads, so we should be ok. 

Please continue praying for the country.

And our safety.

Thank you!


  1. Sounds like quite an adventure thus far. Glad to hear you've settled in.

    From a Public Health perspective, I think the reason that they give all the vaccines at once is because they can't be assured that they'll ever see that child again, and there is no negative interaction between the vaccines, so they want to make sure that the child is as well-protected as possible before the mother takes him/her away from the hospital. A working mother that had to walk 10 kilometers to get to the clinic might not take another day away from the farm to get an "unnecessary" shot for her child, especially if the first visit made the child better. In the U.S. there aren't as many access issues, so mothers are encouraged to bring their child in multiple times in order to get a routine check-up as well as the booster shot. OPV can't be given all at once or else they'd probably do that one too. I could be wrong about that, but I know from my coursework that services tend to get lumped together in rural Africa to create more of a "one-stop shop".

    Can't wait to hear more about your Monday site visits.

    What's the local language? Do you know the word for "crazy white girls" yet? :-)

    Praying for safety and peace. Take care.


  2. Kim Boling, PA-C23 September, 2011 15:44

    Wow.... what an adventure. Wish I could be there to experience it with you. Love your writing, praying for you, look forward to hearing more.... PA power!!! :)