Week 5: Choma and Classes

This week team B was back in Zimba which meant my team was in Choma for Monday and Tuesday. Monday I spent the morning at Martin Hospice center. We got there around 7:30 and sat with the staff for their morning devotions. After devotions we donned gowns over our clothing and helped the nurses with the cleaning of each room and making and changing on bed linens. After the cleaning was done we had tea at 10. I had the opportunity to go to Choma General Hospital with one of the nurses to get some medicine for some of the patients at the hospice. We were there for a little while and got to see the ART clinic that was packed with patients waiting to be seen and get their medicine. When we I got back to the hospice from the hospital, I helped Pam with one of the patients who wasn’t feeling well. I took her outside in her wheel chair for a little bit and then took her back inside to her room before we left at 12:30. That day I also met two of the teachers who work in Kara house behind the hospice. Kara house is a place for vulnerable children to come to receive extra help with school, nutrition supplements, and counseling services. Many of the children who come there are HIV positive and are receiving treatment. I did not have much time this week to interact with the children but I did get to meet a few of them. Most of them will come after they finish school for the day. In the afternoon I had some free time to work on homework and relax.

Tuesday I went to Dr. Jain’s clinic. In the morning I stayed busy with taking vital signs and checking on Alyssa. She became very ill the Saturday before and was admitted to Dr. Jain’s in the middle of the night on Saturday. She was being treated for malaria and dehydration. Tuesday she was finally able to return home with us when we left at 11:30. We were all very excited to have her back at home with us, and she was glad too. She rested the rest of the day. After lunch I went back to Dr. Jain’s. There were not many patients in the afternoon, so Dr. Jain took us into his office and told us stories about interesting cases he’s had and a little bit about his life. Tuesday evening the team from Zimba returned and we all had dinner. After dinner we had post conference where we all had a chance to talk about what we’ve been learning and seeing in our clinical.

Wednesday morning my team of 8 had the opportunity to go to the pediatric ART clinic at Choma General Hospital. The other team of 8 had been able to go the week before so I was glad that we too had the chance to go and help. I helped take vital signs and got to sit in with the doctor for a little while as he checked up on the patients. The rest of the day I worked on homework and did some relaxing.

Thursday I woke up feeling really achy like I had worked out the day before and was really sore, but I hadn’t worked out or done anything to make me sore. I also felt really hot and sweatier than usual. I didn’t think too much of it and went to class in the morning at 9. After an hour and a half of lecture I was really not feeling well and was really tired. I decided to tell Pam and she had me go back over to the guest house and take my temperature. It was 100.8 and I was feeling really hot and had a headache by then. Pam and Lisa decided I should go to Dr. Jain’s to be tested for malaria. Lisa took me over and they took a blood smear to look for the parasite in my blood. They found it and Dr. Jain gave me coartem to take for three days. I went back to the guest house and drank lots of water and rested for the rest of the day. After I got back my roommate Lauren was not feeling well either. She was diagnosed with malaria too and started the medicine not long after me.

Friday was another day of class but I did not go since I was still feeling unwell. I rested most of the day, making sure to drink lots of water.

Saturday was my last day of meds and I finished them up at dinner. After finishing the coartem I was feeling much better. My fever was down and my headache was gone. My body still felt kind of sore and I was still very tired but I did feel better than the previous couple days. In the afternoon on Saturday, I felt well enough to go with the group to St. Mulumba’s school for disabled children. That afternoon there was a group of Japanese young people from Lusaka who had come to share their cultural with the children. They performed a dance for the children and had different learning stations in the classrooms that included Japanese calligraphy and Japanese toys. It was a nice break to get out of the house after being inside sick for a couple days.

Sunday morning I decided to go to church but after the singing was done and before the preaching I walked back with Alyssa. I realized I wasn’t yet feeling the best and did not think I would be able to make it sitting through another hour or more of preaching when I felt like I might fall over already. So I came back and rested until everyone else got back for lunch. I did a little homework on Sunday. I was feeling really behind after missing several days while I was sick. But I don’t think I got through too much as I was still feeling pretty tired.

Week 5 Photos

Two more pictures! These are from Zimba :)

This is one of the little girls i took care of on the Peds Ward.

The Hospital sign for Zimba Mission.

Week 4: Zimba and Chikankata

Starting week 4 off on Monday, I left with 7 other girls at around 7:00 am to travel to Zimba Mission Hospital where we would be spending two days. Monday I volunteered to spend the day in the Maternity and Peds Wards, hoping that i would be able to see a birth. The group last week i think was able to see one or two births while they were at Zimba. However, there were no births and no women even in the Maternity Ward waiting to deliver. So i spent the day with Marianna in Peds. (Marianna has been my partner each time we've gone to Zimba because the 8 of us split into 4 pairs and then work in different areas each week.) So in the morning when we first arrived, our whole group had a tour of the hospital and of the different areas where we would be getting to work and observe. Around 9:30 Marianna and I started in Peds with the nurse that was working that day. She was doing her meds at 10 so we got to help pass out the tablets and we drew up one injection each to give to two children. After meds at 10 Marianna and I looked at some of the charts for the children and talked with the nurse a little bit about how long she has worked there and what types of things she has seen in her time as a nurse. The rest of the time Marianna and I just stayed pretty much in the ward talking with the children and checking on them. There were several babies who were sick with pneumonia and one girl who had burns all over her legs. At 1 we went back up to the guest house where we would be staying and had lunch. Then we had some time before we were to go back to to hospital at 2 so i took a short nap. The rooms in the guest house each had an air conditioning unit! so that made it very nice and cool in the rooms. At 2 Marianna and i went back to the peds unit and just hung out with the kids and talked to some of the mothers who were there to care for their child. At 4 we helped the nurse pass meds again and then around 4:30 we ended for the day and went back to the guest house to relax before dinner. Dinner was at 6 and we had some really good chicken. During dinner we had started a conversation about experiences with broken bones and other medical things so that continued after dinner too. Then we all shared what we would want our last meal to be. We talked about some other stuff for quite a while and then we all went to bed around 11 i think. Marianna and I were on call that night in case there were any births at the hospital they were to call us and we could go down to watch. I slept with the phone but there were no calls. :(

Tuesday we got up and had breakfast at the guest house and then were down to the hospital around 8. Marianna and I spent all morning in the Maternal Health Clinic. It was similar to the clinic we went to at Siachetema where we sat in on an antenatal clinic for the pregnant woman. At this meeting however, there were special guests from Lusaka who came to talk with the mothers and fathers who came to the meeting. They were from the Mothers 2 Mothers Program which is a program that seeks to help mothers prevent transmitting HIV to their babies. The room for the meeting was not all that big and in no time it was packed with women who had come to learn. Marianna and I were on the side of the room and we sat there for probably an hour or so before they meeting actually started. I believe it went for at least 2 hours. And it was all in Tonga except for a few things that some of the people from Lusaka were unsure how to communicate in Tonga so they would say a little in English and the women that worked at Zimba would interrupt into Tonga for the women and men present. So it was long time to sit there. But it was interesting. After the teaching was finished, the staff started the assessments on the women. Marianna took blood pressures and I got all of their current weights and recorded them in their books. Then i helped one of the nurses with counting out pills for the women that they would get after being assessed by the midwife. The pills were an iron supplement and folic acid. After counting pills for a little bit I asked the nurse midwife if Marianna and I could come in and watch her as she did the assessments. She was very willing to let us come in and learn. She let us watch as she did one assessment and talked us through it and then the next few that she had she let Marianna and I do. I felt like i learned a lot and the midwife was so helpful and willing to answer all of our questions. So it was nice to be able to do something after sitting in the meeting part for so long. We went back up for lunch with the other girls and then at 2 when we came back to the hospital, Marianna and i went to spend some time in the lab. Some of the other girls had gotten to do blood draws and blood smears for malaria but there was not much going on then. So i copied down numbers in a book after running complete blood counts of different vials of blood and just talked with the lab technicians. We left around 4 to come back to Choma so that we would be sure to get back for dinner.

Wednesday morning the other 8 went to Choma General Hospital to help with the pediatric anti-retroviral clinic and the 8 of us who stayed at the guest house either did homework or helped some of the WHIZ staff with data entry. I went over and helped Ms. Peggy with data entry for 3 hours until lunch time. Then after lunch our whole team left to go to Chikankata where we would spend a few days observing in the hospital there. It was a long drive to get there and it was after dark when we did arrive. I think it was around 7:30 when we got there. We got our stuff into our rooms and then we had dinner around 8. I shared a room with Janna. The beds were nice and pretty comfortable. It was kind of strange sleeping there but i did get some good rest.

Thursday and Friday we spent at the hospital moving between different wards. On Thursday i was in the Maternity Ward with Alyssa and Alissa. i was hoping again to see a birth. There were several women who were there waiting to give birth but the nurses said some of them it would be a couple days at least. We all took a tour in the morning of the hospital and when we went to the maternity ward there was a woman in labor. But when Alyssa, Alissa and i got back there we found she had had her baby a half hour ago :(. So we hung out with the nurses there and we got to see the delivery room and the ward. The nurse that showed us around was very helpful and answered all of our questions. The hospital also has a special room called the Prem Unit. It would be probably the closest thing to a NICU here. They had three incubators and 5 premies there at the moment. One had gained enough weight that he did not need to be in the incubator and there was one set of twins that shared an incubator. Seeing that room for the premature babies and watching the nurses give the feedings through the NG tubes was one of my favorite things of my time at Chikankata. To save some length i'm going to do some summarizing of the rest of the time there. Basically i waited around all day to see a birth and missed another one by mins when i went down to get lunch. Then after dinner i went back up with 4 other girls and we waited for 2 or 3 hours for a woman who was in labor but she never advanced far enough while we were there and we could not stay there any later. We did see one baby who had stopped breathing be resuscitated by the nurses. We found out later the next morning that that same baby had not made it through the night. That was hard for me to realize that i had been there and i felt like if i had just been there and checked on the baby more often it might have lived. But my experience just from that one day and couple hours at night in the Prem Unit really helped me to see that God has placed premies and their families on my heart and that i want to be there to help care for them. Which i had thought before i wanted to work in a NICU but i had never really had any experience and to be in that unit with those babies just felt right. So i'm interested to see where God takes me and what he has planned for me after i graduate!

So that was that and then on Friday i spent half the morning in the ICU and the other half i was in the outpatient department with one of the doctors just observing her as she saw patients. She was really good about talking with me in English and explaining what was going with each patient. We left after lunch around 2 to come back to Choma. We got back and had dinner here in Choma and then had a free evening to relax. Saturday we had a guest speaker come and talk with us from 9-11 and then had free time the rest of the day to do homework. And then Sunday was Church.

My pictures this week are all from Chikankata and i don't really have a whole lot but i'll share what i have!

Week 4 Photos

Week 3 photos

Got them loaded :)

Week 3 Photos

Week 3

On Sunday of this week are team traveled to Jembo where there is a Bible college and a secondary school. Mike and Cindy Helvie are missionaries at Jembo, teaching different classes at the Bible college. We spent the morning with them at their house and had lunch with them. At 2:00 there was a revival service for the youth attending the secondary school. My team got to go to the service and sing a couple songs for the group of students. There were also several students from the school who sang in small groups. I really enjoyed the message as well. After the service we got to see the dorms where the students live. Liz, a 10th grade student at the school, showed me all around the girls dorms. It was not what i was expecting. A lot different than dorms in the states. There was really just one really long room with bunk bed after bunk bed lined up next to each other. There were probably around 50 girls in the one dorm i went in. All of the students asked when we would be back. I had to tell them that i didn't know if we would be able to come back.

Monday Team B, made up of half of the group, went to Zimba to spend two days working at the mission hospital there. Our time spent at Zimba will all be dedicated to fulfilling the hours required for our Transcultural Practicum. Each group will get to go three times and we will rotate the weeks that we go. I am in Team A so this week i stayed in Choma. On Monday I went to Dr. Jain's clinic in the afternoon. I went with three other girls and we did not have to be over there until 2:00 so I decided to take that day to skip breakfast and sleep in. I think i got up around 10:00 and then did a little homework before lunch. After lunch i went over to Dr. Jain's. Dr. Jain is an Indian doctor who has lived here and worked in Zambia for many years. His wife is also a doctor and they work together at their clinic to treat and care for the people who come to them. Mostly that afternoon i just had a tour of the clinic and got to see the doctor talk with a couple patients. The office closes at 4:30 so i was only there for about 2 and a half hours. One thing that was interesting and that i learned was how to use a mercury blood pressure cuff. It was really hard to read and see the mercury as it went down the tube, but i got to practice using it a couple times.

Tuesday is when I finally got to go out and do the food distribution with WHIZ. We were scheduled to go a week earlier, but the mill that was grinding the corn into mealy meal did not have enough corn to fill the order that WHIZ had placed. But today they finally got it, so we set out with about 500 bags of mealy meal and 500 heads of cabbage to distribute food to the community trusts that WHIZ supports. We left about 9:00 in the morning. One thing that was a huge praise was God getting us through a government check point just outside of Choma. Before we had even gotten to our first village we were stopped at a check point and told we could not go on because the truck that was carrying the food did not have a fire extinguisher. We could have been there an indefinite amount of time waiting til we were told we could go on, but our group prayed and that God would let us get through the check point. The driver of the truck went and talked with the officer in charge and basically got down on his knees and begged him to to let us go. We were there only about 20 mins before they let us go. The driver had told the officer in charge that we were carrying USAID food that we had to get delivered today which i think helped some, but i know that God worked to let us get through that check point to distribute the food. We traveled to 4 or 5 different trusts that day giving out bags of mealy meal and heads of cabbage. At each trust we gave the food to one of the community committee members who took responsibility of the food and who would make sure the food was delivered to the right people. A bag of mealy meal and a head of cabbage were left with the committee member for each family that was caring for a vulnerable person. So at one trust we left 9 bags and heads of cabbage while at another trust we left close to 90 bags and heads of cabbage. I really enjoyed that day and got to play with and hold some children. Our team worked well together too to unload the food from the truck and formed an assembly line to pass the food down the line to the place where we were stacking it up. It was a long day with lots of travel. The furthest village we went to we were told we were close to Lusaka which is a good 4 or 5 hours from here. I don't know how close we actually were though but it did take us a while to get back to Choma from that last village.

Wednesday the team from Zimba was back and they got to go on food distribution that day. My team got to go to Choma General Hospital and meet with the director and have a tour of the hospital. It was a good experience to get to see what different hospitals here in Zambia are like and what each offers and doesn't offer. Wednesday my group was also able to go to Martin hospice in Choma and have a tour. On the weeks that I am not in Zimba, my team will take turns going to Dr. Jain's clinic and Martin Hospice on Mondays and Tuesdays. One thing i learned about the hospice here is that it is very different than what i think of when i think of hospice in the U.S. Here the hospice has 12 beds, 6 for men and 6 for women. The hospice cares for people who have HIV/AIDS. Their goal is to help people who have AIDS get well enough so that they can get their strength back and be able to go back home. Hospice also works with the hospital and ART clinic to get the medicines that those people need to help control their AIDS. After our visit to Martin Hospice, we were able to go to a village near our compound and pass out tootsie rolls and play with the children. We went with Dave and many of the children knew him already. There was one girl named Ethel who just smiled and went around to each of us girls giving us hugs.

Thursday was a really cool day! We all went to a rural health clinic in Siachetema. We spent all day there. The main thing that i got to do was sit in on the antenatal education and assessment clinic. About 15 or 20 women came to the meeting. A couple girls from our group lead the education and really just talked with the women about what they already knew about what they should be doing during their pregnancy to keep themselves and their babies healthy. Then after the education each of us students got to go in with one pregnant woman and do a head to toe assessment on her and then feel for the position of the baby and listen for the fetal heart rate. It was hard for me to find the fetal heart rate with the small metal tool they used but the nurse was very good at finding the FHR and then showing me where to listen so i could hear it also. The other thing that was going on at Siachetema was the outpatient department where people came with all sorts of complaints to see the doctor's who were there. I was able to stand in with Dr. Joan Jones as she listened and assessed patients who came to see her. Two cases that were very interesting to me were both children. One was a 10 month old baby who had been sick for 7 months. This was really hard for me to comprehend but the mother had brought the baby to the clinic several times all with the same complaint of a persistent cough. The first thing that i noticed about that baby was the lack of energy and movement. The baby just sat on the mother's lap and didn't move much at all. It was such a stark contrast to another baby who came in with his mother who was about that same age. That baby was active and smiling, laughing and banging his hands on the desk. That baby that was sick was referred to a hospital where they would be able to do more tests to try to figure out how to treat and care for the baby. Since it was a small rural clinic any person who comes with a more severe problem will be referred to a hospital for further evaluation. The other child had a large skin lesion covering the calf of his right leg. The boy was not very old and his father told the doctor that it had started about a month ago and just kept getting big. Dr. Jones was not sure about it and referred the boy to a hospital, but she thought it could have been some kind of fungal infection.

Friday was a day devoted to class and homework. Saturday was Kirk and my 2 year anniversary and Sunday was Kirk's 20th birthday. I wasn't sure if i would be able to talk to Kirk on those days but i did have a few minutes each day so that was a real blessing and encouragement to me. I'll include some pictures now from this week! Enjoy!

Ok...so it's taking awhile to load so i will try to get them up later today!

Week 2

So it has been awhile since i have written.....almost 3 weeks (sorry!). I've decided to write a post for each of the past 3 weeks and summarize briefly my highlights from each week in hopes to catch y'all up. Enjoy :)

Last time i mentioned that we had a turkey friend here on the compound. Well, a few days after that post we all got to see Fred, one of the guys who works on the compound, cut the turkey's head off. A lot of the girls took pictures of it and a few took videos. I must say that it was interesting to watch. We will all get to enjoy that turkey plus one other turkey on October 24th which is Zambia's national Independence Day!

On the 22nd for my history class we all went to the museum of history in Choma and to the Zambia Library Service in Choma. The museum was small, not like the museums we have in the States. There were several big boards that covered history of Zambia from when the British arrived and colonized Zambia to when Zambia received its independence from Britain in 1964. There were several display cases that had various artifacts from different tribes in Zambia and described what all of the traditional items that were used were. The display cases talked about traditional life for women and men in a tribe and about such things as childbirth, farming, and celebrations. We spent just about a half hour to forty-five minutes at the library in Choma. I was very interested to see the library and to be able to compare it to the libraries we have in the States. The first thing i noticed was the size of the library. There was one main larger room that had several bookshelves. Most of the books looked old and had been well worn. Off of the main room there were a couple smaller rooms. One room that i found interesting was a room dedicated to literature on HIV/AIDS. There were a few signs that listed the rules for the library. The one i found most interesting was that no sleeping or dozing is allowed in the library.

On September 24th, our team traveled to Arise School. This school is a school that was opened in the community of Choma by a pastor's wife. This woman had previously worked as an educator for the government but decided to open a school for orphans and other vulnerable children who could not afford to buy the uniform and supplies necessary to attend the government schools. In Zambia school is "free" but the children must have a uniform and supplies to be allowed to attend. Many orphans do not have the money to buy these things and cannot go to school. The Arise school has 7 volunteer teachers and has grades 1-7 offered for the children. There are about 250 students who attend this school. The woman in charge told us that they will not turn away a child who is vulnerable and in need of schooling. This was an encouragement that these children have a place to come to receive an education but also discouraging for the fact that there are so few teachers and supplies for the teachers and children. Only the teachers have books and they copy down the chapters onto a chalkboard for the children to copy down in their notebooks.

The 25th was to be a trip to the market place for a history field trip, however, when we got to the market to shop and ask some questions of the women who work there we were told by the market chairperson that we would not be allowed to ask questions that day because the committee members first had to meet and agree that it was okay for us to ask questions. So instead we had class for a little while and then in the afternoon we were able to go to a village and play with the children there for an hour or so. It was so good to be out with the children and see the smiles on their faces.

Lastly for this week, on the 26th, we had a guest speaker come who talked to us about much of the traditional beliefs and practices among Zambians. I learned a lot from the speaker and as he talked with us, he related how the practices and beliefs could influence the health care of the people. That was important for us as nursing students to know as we begin our time of working and caring for the people of Zambia!

(I am not including class time in my highlights but I am attending class sessions! :) )

Click on the picture below for more pics!

Week 2 Photos