Saturday, Jan. 7

We woke up to another beautiful sunny morning. It may be the rainy season, but it’s not rained on us since we arrived in Zambia. We may appreciate the dry weather but we are learning that it can cause dire consequences for the people who live here if their crops don’t receive adequate rain.

We had breakfast porridge this morning—reminiscent of grits but incredibly smooth. The girls were all in their scrubs, ready to go right over to the hospital to observe on rounds. As I sat there, the only one not in uniform, I felt even more privileged to be part of this experience. These are women who, in a few months will be working as nurses. They can be fun-loving college students one moment, but when they walked into the hospital there was a change in their demeanor. Professional.

The team was divided up—some to the male ward, some to the female ward, others to maternity, and pediatrics.

The doctor in the male ward is Zambian and could speak Tonga which meant that he could communicate well with his patients. He also spoke English and really engaged the girls in conversation—explaining the patients’ issues and asking questions about what they know. Each patient he introduced by name and would say, “he is two days old in the ward” or 1 day old depending on when he was admitted.

As I have said, I am not a nurse, so I do not understand more than a bit of what we saw but I can tell you a little:

There was a young boy with a heart condition whose face was very swollen and had difficulty breathing. Two women I assume were his mother and grandmother sat at his bedside helping him eat a little breakfast. A teenage boy had a fractured femur—he had been kicked by an ox. Several older men were admitted for congestive heart failure. Others had diabetic wounds on their feet. One man had been readmitted—weeks ago he had been treated for an ulcer on his leg which seemed to be doing well. Today the doctor was very concerned because the leg looked very bad. He was ordering a biopsy to check for cancer.

The ward itself was filled with close to thirty beds—they were not all full, but the room seemed crowded as we went from bed to bed.

After checking in with the patient, the doctor would call the nurse over to give instructions, “Sister!”

Halfway through rounds, I left the male ward to go to the female ward at the other end of the hospital. Rounds were just getting started. The two Dutch medical students (both women) who were in charge had to wait for the Zambian nurse to arrive so that she could do translation for them. Clearly it is an obstacle to treat patients who speak a different language. The nurse was busy and the doctors had to wait often for her to come to the bed to aid in communication.

Resources are limited—not all medications one would normally prescribe for a certain condition are available. Diagnostic equipment is extremely limited. X-rays, blood work are done but not as frequently for follow up as in the States. Internet access is inconsistent, and so researching is also difficult although there is a medical library on the compound that is pretty up to date.

Speaking of x-rays, there was a woman on the ward who had a very puzzling chest x-ray—the Dutch med students pondered and pondered, and even invited Katie and Erica to see if they could make any sense of it. We hope to find out later this week what they finally learned about the patient.

There were two new admits who were able to be seen this morning. Since rounds are not done every day, it was to their advantage that they arrived this morning!

Half of us got back to the dining room for lunch and we started eating, wondering where the others were. They arrived a while later, breathless and excited—they had been present to assist with a birth! A wee little boy under four pounds who seemed to be doing fine by the time they left. In fact, the mother was dressing and preparing to take herself home. It was her fifth child. She had hoped for a little girl, and so perhaps years from now his older brothers will tease him about how he came home from the hospital in a little girl’s dress.

An afternoon walk led us out to a little market where most of us were able to buy chitanges—the fabric wraps that women here wear to protect their clothing from the dirt and dust. The shop owner assured us that if we come back next week he will have many, many more to choose from.

We’ve had a few power outages, but usually it is just a very short time until the generators kick in and the lights are back on. We learn to keep our flashlights handy in the evenings.