20 September 2011
Insights and Inabilities
[picture of the river where they baptize people]
I’m not sure where to start to describe life here. Should I give you details? An amusing story? What if I throw an array of pictures at you?
[toms in the dirt with a child’s footprint]
I was going to put some cheesy comment like “I wear my TOMS while practicing medicine in Africa so less footprints will look like this” but I figured you, my blog followers, wouldn’t really think that was cute.
There’s this juxtaposition in my life. Between the medicine that I know, and what I can practically use here. Between the skills I have, and the limited resources there are to carry out those skills.
Improvisation only goes so far.
[George Forman grill]
The juxtaposition of the family sized George Forman grill in the kitchen, and the hut next door that is smaller than the living room of our guest house. Of the yucky pear I picked up this morning for breakfast, and made myself eat all of because, after all, “there are starving children in Africa,” and for now, they could be right outside my door. (I feel, at times, like a princess here in our guest house. I can’t stand it, but at the same time it’s comforting to have a microwave and a refrigerator. My head has no idea how to make the two sides meet: comfort and compassion.)
What are you supposed to think when you walk by people who are washing their clothes in a bucket, then laying them out to dry when you’re living in a “palace” next door with a washing machine?? I wonder what they think of this place.
Monday, 19th of September, 7 am, Zambia, Africa.
It’s bright outside. The light that streams through my large, curtained window tells me it’s time to get up and get ready for the day.
That and the constant beep from my alarm clock.
After brushing my teeth, being careful not to use the tap water that’s from a deep well on the property because it just might not be clean enough, and not nearly as clean as our boiled and then filtered water, I got dressed and grabbed my Bible. I made instant coffee.
Isn’t there supposed to be amazing coffee in Africa? All I’ve ever had here is instant. One day I’ll work on changing that.
We read and then read some more. We had no idea what our agenda for the day was supposed to be. We were waiting for our supervisor to come get us.
She came around 9am, we decided to go into town, take our supplies to the clinic, and then return for a hike. We were joined by Henry, our supervisor’s “son”/assistant/ Bible student.
And guy from the mission doing temporary night watchman/ fixit/ work who had just cut his hand open on a machine. It was continuing to bleed profusely after applying constant pressure, and we just happened to bring suture material with us. We didn’t have any gloves or needle drivers, so we decided to go down to the clinic to sew him up.
So, we drove the 10 kilometers from the mission to Mushili Health Center in a rustic (the most descriptive and polite word I could have used to describe) red truck. Some of the guys were in the bed of the truck with my luggage that held all of our supplies.
We arrived at the clinic and were introduced.
We talked about our schedule in English, but it wasn’t really American English, so we had trouble keeping up. “You’re ok with 09 hours?” Was the question. “Well, sure, that’s not a bad shift,” we replied. “Ok, and Thursday we are 10 hours.” Again, not bad we thought. “And we usually finish around 16 hours every day, depending on patients. Some days we are done at 13 hours and other days maybe later.”
It took us forever to realize we weren’t talking about 9 or 14 hour shifts, but starting at 9:00 and finishing at 4:00.
Then we gave them all the supplies we brought. They were incredibly grateful for most of it. Some of it couldn’t be used, so we’ll take it to the big hospital to be used there. We wish we could have contacted someone and figure out what would be most useful. But TIA. (This Is Africa, a phrase I’ve heard a million times in by Peace Corps workers and Missionaries, mostly meaning things work really differently here…)
The nurse was called over to attend to a birth, because she was the only nurse on for the day. We rushed behind her to get our first look at medicine in Zambia.
Medicine should, logically, not be defined by borders of a country. It should be a universal thing. If Coca-Cola is sold all over the globe, naturally people should practice ethical, world-class healthcare all over the globe too. The medicine we’re taught should work everywhere, not just America. (Right?)
The juxtaposition between a birth in Dallas, America and a birth in Luanshya (pronounced “Lew wants ya), Zambia:
Large hospital in an urban city, built over 20 years ago, storage rooms full of clean sheets and blankets, sterile gloves and gowns and hats and booties and tools, skilled nurses checking in, doctors/residents/midwives attending the delivery, someone to tend to the baby when it comes out, fancy little clips for the umbilical cord, hats and booties for the baby, and suture kits on hand to care for the mother, beeping fetal heart rate monitors, blood pressure cufs, mothers screaming in pain or silenced by an epidural.
Small clinic in a rural village, built several months ago, sheets and blankets from the mother’s home if they are wealthy enough to afford them, sterile gloves but no gowns or hats or booties and tools that are cleaned with Jik(hydrogen chloride), a single skilled nurse that is working at the clinic AND attending deliveries, tending to the mother AND the newborn, ripped pieces of cloth to tie off the umbilical cord, self-supplied baby hats and maxi pads if the mother had a bleeding tear, no wires, monitors, or blood pressure cuffs, no screaming, silenced by the toughness that the people here seem to be born with.
The baby came out the same way, a healthy baby girl. They used oxytosin: IV before birth to help increase contractions and IM after birth to help the uterus clamp down. I dropped 2 drops of OPV (Oral Polio Vaccine) into the newborn’s mouth.
Different, but similar. The process works the same way, except with some improvisation and juggling.
After the delivery we tried to sew up our friend from the mission compound, but we were told he was going to be “referred out” to another hospital. Ok, then. But this morning, he came to our door and we found out he didn’t get stitches. Just a gauze wrap. We would have stitched him in America. Frustrating. He could have definitely used the stitches. And we could have given them to him.
After a homemade lunch of toasted pb&j, we sat down for a nap before our adventure. We were worn out mentally and physically.
We’re not sure if the exhaustion was due to a long morning dealing with so many differences in healthcare or if it is due to the jet lag or the fact that we’re so much higher above sea level (around the same elevation as Denver). Maybe it’s a combination.
Our next adventure began at 3 pm, towards the direction of Kafutu River (small hippo river). Frances, newly educated after one of her safari trips, learned that hippos are the most deadly animals. We had also learned over dinner last night that they flatulate out their mouths.
None of us wanted to see a hippo.
We walked past a mill for cornmeal. We have yet to eat Nshima, the local dish that we keep hearing about. We saw many goats. I inquired about stacks of rocks that seemed to mark some people’s driveways. Our tour guide Henry (our supervisor’s “son”/ assistant/ student) told me a story about the root that they crushed up here and made into a drink. Fresh, it was delicious. But some people let it ferment and it turns into a beer-like substance. Literal root beer. And the rocks marked that the people living there had some to share.
On our walk we met a few people that Henry knew. Each time we were invited in to sit on their couch. Sitting on the couch was a big deal. It was THE way to properly greet a guest. Sit on their couch and leave a dusty impression of your skirt behind?
While sitting on a couch we met a 2 year old who stared at us. We were the first white people they had seen.
We also came across a river (the opening picture of the blog post) that is used to baptize people. During the baptisms, local villagers ride up and down the river in the boat to scare off the alligators. Thankfully we don’t have to do that in America.
We came across a bridge and 3 little children scampered across it coming in our direction. When reaching our side they put out their hands and stared at us in awe. We shook their hands and said hi. I dug in my bag and handed them a candy to share. Their eyes got huge and precious. They had the biggest smiles!
Then Frances and I timidly crossed the “bridge.”
We didn’t have too hard a time crossing, except I nearly fell in after Frances got to the other side and started cheering. I cheered along with her, lost my balance, and was only caught by a random twig on the side of the river. Thank you Lord!
We also saw the oldest church in Zambia.
[100 year old church picture]
Each night so far we’ve had dinner with the other missionaries. I am enjoying finding out more about the people here. There is a couple from the United States that has lived here over 10 years. They spend a lot of time with the people, teaching in the mission’s Bible school, teaching deaf education classes, and organizing the clinic. There’s also a 73 year old Westpoint graduate who is helping with a lot of tasks around the mission compound. I let him borrow my headlamp so he could clean out a big huge container that looks like it would fit on the back of a 14 wheeler.
Dinner is delicious, but it’s so cushy and American. We ate blueberry/peach cobbler for desert last night after eating spaghetti and meatballs. I loved it, but I felt so bad eating it after watching small children run around with pot-bellies from what is likely to be a protein deficient diet. My heart breaks. Another juxtaposition I’m faced with.