The day it got cold.

Friday

I answered the door to a cool blast of air and the housekeeper in a jacket and ski cap.  It’s cold?  Yes, she said as she gave me a look (which I probably just imagined) that said “do you think I would be in a ski cap if it wasn’t cold?”

Frances didn’t believe me.

Fine.

We arrived at clinic for ART (anti-retroviral therapy) day.  It never fails, that a baby is born on ART day.  So there’s no one to see patients because the Nurse Midwife is in the maternity wing of clinic.

Which means Frances and I are in charge of outpatient clinic.

The morning was bad.  Frances was in charge of actually seeing the patients, which is the worst job as you have to sit with a translator who treats you like an idiot because it’s been 3 weeks and you’re not fluent in Lamba and Bimba yet.

 I was in charge of passing out pills, which was great when it was actually pills, but not great when I had to make eye drops out of penicillin.  Thanks for writing for that Frances.  And thanks for laughing as I asked Maureen for instructions and she went on a 10 minute explanation, which I lost half of because your face was turning red and your eyes started watering. 

So I got Festina to help me with it, which worked out wonderfully. 

{Frances is cracking up, face turning red and eyes watering, as she writes the blog paragraph about her evil, self-centered version of the story… maybe you should check it out: www.francesinafrica.blogspot.com }

I found the ORS (Oral Rehydration Salts) produced by the WHO (World Health Organization).  I thought it was worthy of a picture because I think it’s brilliantly designed to rehydrate children without having to stick an IV in them.

[ORS]

The doctor for ART clinic never showed up, so the nurse midwife had to see those patients.  We were really looking forward to working with the ART doctor.  We helped the nurse midwife by putting 60 pills of bactrim in each of 50 baggies.  I got really good at counting to 60 by 3s.  Only they call it co-trimoxazole or septra here.  Same thing.

We took a walk at lunch to the King’s Highway guest house.  It was a very fancy place to stay with a fun gift shop.  I liked some of the necklaces to give as gifts, but they only had one of each kind, which isn’t fun.  The only thing they had more than one of was small wooden spoons.  Which might make an interesting gift, but I’m not sure if it would have been useful.  Or maybe more useful.

Either way, Frances and I have been told that the hostel we found to stay in (for only $22/ night!) has a great market right next door that sells all kinds of fun stuff.  AND they support the orphanage next door on the other side.  Could we have found a cooler place to stay??

I think not.

Especially since we’ve already been invited to watch a football (soccer) game at the orphanage on Sunday.  Futball?  Orphans?  Coolest part of Zambia. 

It beats out the pink toilet paper. 

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After our walk and tour of the Kings Guesthouse we still had time to kill so we lost at solitaire about 15 times.

How does that happen?

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The baby was still in the process of being born, so Frances and I ran outpatient clinic in the afternoon too.

We ran it together but with no translator.

Frances pulled out her paper with Bimba/Lamba words on it.  We’re getting good at “How old are you?” and “What’s the problem” in Bimba, only I like asking it in English so we get an answer in English.  We had the words for cough, stomach ache, sneeze, fever, and a few others.

We got good at pantomiming vomiting.  With sound effects.

We only got laughed at as much as we normally do, which I would call a success.

We ran a lot of malaria tests.  A lot of things here aren’t as frightening as Malaria.  And now that the first rains have come, the mosquitoes are breeding like rabbits.  We had two positive tests in the afternoon.  Malaria is easy.  Coartem comes in convenient pill packages that are already counted out for you.  It’s a lot harder when someone has a fever and bodyaches and the RDT (rapid detection test, which isn’t a specific name, but the test is for malaria) is negative.  What do we do??

In America, we’d assume it was a virus if it had been less than 7 days and tell the person to come back, and just treat it symptomatically.  Here they throw an antibiotic at everyone.  Everything is still resistant to penicillin, so I guess it’s ok.  And when we’re running their clinic I feel like we’re supposed to give antibiotics too.  Only I don’t really like to.

But when in Rome, you should act like the Romans, right??

I'm not here long enough to rebuild Rome.

Our favorite patient was the one who had abdominal pain, slight fever, and spoke no English.  He shook his head “no” to all of our other questions, so we got a RDT on him.  Why not?

It would have been really easy if it was positive. 

Or if we could read chicken scratch.  They keep telling us our handwriting is so good.  And I think it’s just because they’ve only had people write illegibly here.

Turns out, when you have 2 people look really closely at his only other visit to the clinic, you can read that his RPR (I’m not sure what it stands for, but it’s the test for syphilis) was “mildly reactive” and they treated him for it, telling him to come back in 2 weeks for a second shot.

Which was today.

I wish we had figured that out before we pricked his finger for the malaria test.  But honestly, I don’t feel too bad about it.  You can add “unnecessary tests” to the things you get for sleeping around.

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After work, when it was time to “knock off” for the day (at “14 hours”), we asked Pule about the cases we were unsure about, a man with a snake bite and a 2 year old with diarrhea and abdominal pain, but a negative RDT.  Pule gave us advice and told us how we did a good job this afternoon.   Which was the first time since we got here that we heard we were actually doing a good job.

Then we started “footing” ourselves home. 

People think it’s so funny that Masungus (we learned it’s an S in the middle and not a Z) would “foot” home.  All the way to Kafulafuta (10K).  We think it’s funny that that’s abnormal to them.

We got asked if we wanted a lift 4 or 5 times on the way home.  And we didn’t even do the “flapping hand up and down” motion everyone does here that means they want a ride. 

Our favorite was when pastor Lawawa slowed down and offered us a ride in his car.  That already had 3 people in the front seat and 3 people in the back.  Where are we supposed to sit??

But we told him we wanted to “foot” home. 

Thankfully, he let us.

About an hour into our walk, which we figure was half way judging by our pace and the fact that it took us 2 hours last week, Joseph (the politician/ pastor/ small business owner/ wife to Mary) was driving a farm truck home, and told us “silly girls” that we had been African long enough and that we were supposed to climb in the back and ride home. 

We were getting hungry, so we did. 

And we were concerned that our supervisor would be driving up in her truck and not be happy that we were “footing” ourselves home.  She doesn’t like to worry about us.

Frances and I got our photo taken.  It’s blurry, but you get the picture.

[farm truck]

We made veggie burgers, which we’re huge fans of.  We also made vegetables.  We also had peach sweet tea.  Fabulous.

We had a new flavor of Hit cookie for desert: hazelnut.  It might be my favorite.  It’s a hazelnut cookie with hazelnut frosting in the middle.  But it’s not too overwhelmingly hazelnutty.  Really, all Hit cookies are perfection.  They’re one of the best things we’ve eaten here.

Frances wanted to watch a movie, but we’re going to watch it tomorrow since the Aggies don’t play until 7pm US time, which is 2 in the morning here and we’ll need our beauty sleep.

But don’t worry Ags, we’re wearing our maroon chitengues to clinic tomorrow, so we’ll be supporting you in spirit.  I’ll even wear it to sleep if you promise it’ll help us beat Tech!

Which would be a small sacrifice because I tried sleeping in it when it got cold in the middle of the night last night and it severely restricted my leg room. 

But it would be worth it.