florence

This past week was our last week of clinicals, and I am completely done with clinicals for nursing school!!!!! That is exciting! I tried to make the most of my last two days of being in the hospital. 

Monday I spent in the Pediatrics ward. It started out pretty slow, but ended up filling up by later morning.  The ward, just like the Male and Female wards, is split up by the medical patients and the surgical patients.  Medications are only given out twice a day, and so the only thing for us to do was talk with the kids and their parents.  It’s a pretty fun job, even though it is hard to communicate with some of the Tonga-speaking people.  The children all seemed to be relatively stable, so I worked my way through the ward looking at their charts and x-rays.  There are so many broken bones here! Maybe it just seems like more, because the children stay in the hospital for a few days with their injury.  One little boy, about 2 years of age, was there because his friend got hold of an ax and accidently hit his hand with it.  He had the nastiest gash on his hand, and is truly lucky he didn’t lose his entire hand.  I hope it heals well, because it was awfully deep.  You don’t typically see 2 yr olds coming in with injuries from an ax!  I’ve also noticed many children come back with problems from their broken bone.  For instance a deep infection starts in the bone, or ulcers form on the skin where they might have had surgery- lots of nasty things!

One little girl, who is almost 3, was admitted in the morning.  She was absolutely beautiful, but was breathing much too quickly.  Her mother brought her in because she had a couple times at home where she would start coughing, would have trouble breathing, would start foaming at the mouth, stop breathing briefly, and then would all of sudden start again.  It was terrifying for her to watch her do this.  Shortly after her initial assessment, she had one of those episodes.  She was breathing at 90 breaths per minute, and had hardly any air movement in her right lung.  Once she started getting worked up, she was trying everything she could to keep breathing, and she was only able to for a minute or so, and then she quit breathing for us.  At our assessment I asked if we could put some oxygen on her to help her out.  They kind of passed it off, because they really only use oxygen when absolutely needed (which it was!).  When she quit breathing, they then thought it was time for the O2.  We started bagging her to keep her oxygenated.  It took several minutes, but she eventually started breathing again and came to.  She was extremely tired afterwards and just wanted to be held by her mama.  When she first started her whole episode she was continually yelling “help me, mama” in Tonga.  It about killed me!

The next day I came in to see how she had done through the night, and she had had a few more episodes.  She had also had a 40 minute seizure with one of them, probably because of not getting an adequate supply of oxygen.  While there, one of our students- Joe - questioned the doctor about her needing more care than they could provide for her.  He convinced the Doc to transfer her out to Livingstone.  She was transferred by ambulance with a nurse who could care for her if it happened again.  We found out the day after that, that she passed away during one of her episodes because they did not facilitate her breathing and she never started again on her own.  After spending time with the little girl and the mom, it was devastating.  The only thing that was found on her x-ray was that she had aspirated something that was caught in her right bronchi.  While this is a serious thing, it could be easily fixed in the states.  I think suctioning her would have worked, but they don’t have the resources to do it.  It was so sad because she had been totally fine a few days before until she choked when eating lunch.  Anyway, another sad story to add to the rest, but I think some of these stories have impacted me most. 

On a much happier note, my heart has been stolen by a 2 ½ year old little girl named Florence.  I hadn’t spent much time with her until these past couple weeks, but I connected with her quickly.  She was kind of shy at first, and we spent quite a bit of time reading a book about farm animals.  She is particularly fond of chickens, and we pointed every one of them out several times.  Some of the animals were foreign to her since the book is from the States and our farm animals look a bit different.  She sticks pretty close to me.  The other day I was holding two babies and had absolutely no more room on my lap for even her small self.  But, she found room- on my ankles.  I had my legs out in front of my and she was frustrated she couldn’t fit on me and proceeded to plop down on my lower legs.  She also loves to so “NO” whenever I try to get her to do something. I play along with her saying “yes” and it becomes quite the little game.  She giggles and giggles and says “again” at anything she enjoys- spinning, being thrown up in the air, etc. 

A few of the other students have also really connected with the kids and were very interested in sponsoring the children if at all possible.  After they met with the head director and biggest supporter of Children’s Nest Orphanage Homes (http://www.childrens-nest.org/english/index.html), they were very impressed with this sponsorship program.  He spoke with them for over an hour all about it, and needless to say, many of us are walking away sponsors!  It has been awesome getting to know the kids personally and then being able to pick up their sponsorship.  This program uses 95% of the sponsorship money directly on the child.  That’s pretty unreal, even compared with Compassion International.  As of tomorrow I will be Florence’s sponsor.  Mr. Fisher, the Director, was thrilled we are as excited as he is, and says that we will be the first American sponsors this program has.  Most are German.  They also highly encourage you coming to visit your child.  I’m not opposed : )

This is Florence, 2 1/2, on the left and her sister Deborah, 5.  Oh, and Dixon is peeking through!

Doro and Selena excited about the baloons we brought them.



This is the picture I was trying to create with Selena to my left, and babies Christopher and Grace on my lap, with Florence sitting on my lower legs.  My hands were full!



Another one I wouldn't mind bringing home- Christopher. He is 11 mo. old and is just starting to be interested in walking.  He is also very fun!

Poor Britt is stuck in the middle. I NEVER wear my hair down going to the orphanage. Bad idea!

The church I attended a couple Sundays ago. The whole church- love this picture! Notice the white people? This is the WY group that was here a couple weeks ago now.



Christine and I with our work of art. This is the poster that went along with our teaching in the hospital. The nurses loved it!



Innovative! A plastic lawn chair + metal frame + large wheels = wheelchair!

Only ONE week left. I don’t know how I feel about that.  I know I’ll cry saying goodbye to all the kids at the orphanage, but I know I’ll be happy to be home too.  As we have spent more time here, I can see myself coming back more and more.  It has started feeling like home, and I know I will miss it.  We had a party today to thank all the staff that has served us in Choma at our guesthouse.  We served them tacos; a completely new food for all of them!  None of them knew how to eat it, so we showed them how to wrap it before eating it and told them what is customarily put in it.  They all said it was good, but they would say that whether or not they liked it!  We honestly all feel like they are our Zambian family.  They all want us to come back and marry Zambian men.  Gift-giving is a very important thing in this culture, especially when you are thanking someone or are grateful.  We have all received two gifts from the staff.  Ms Mukonde was the one of the ones we received gifts from and she said “my feelings go with you in these gifts.”  She has said we are part of her family because she has feelings for us.  I love the way they word things!   Tomorrow we plan on having another small party for the staff we are closest to, and we plan on giving out gifts as well.  So, the goodbyes are starting and it’s not easy!  However, I am ready to see everyone at home again. 

We leave Choma Saturday morning for Livingstone (which I am SO excited for- different foods, AC, tourism, and shopping here we come!), so be thinking of us as we are hugging our children goodbye.  It will be hard!!! See you all very, very soon…

life and death

This is how report is given in Zimba each day!



Me with the children at the orphanage this week.  One of the kids was asking to take some "photos" with my camera.  I wasn't quite ready, but I still like how you can see the diapers hanging out on the line after a washing!



It has been too long since I have written last, and SO much has happened over the last week and a half!! I’ll try to give you a good picture of what I’ve done and seen, but I’ll still try to be brief!

Last week we were in Zimba, about 2 hours away from Choma.  There is a small mission hospital that we spent several days at.  I was really impressed with this hospital, mostly because they had more resources and it was cleaner than the others we have been in.  The staff is extremely limited there.  To give you an idea, the Clinical Officer or “House Supervisor” did not only have that responsibility but she also took on the Maternity Ward and Pediatric Units all by herself.  You could say she is a busy woman.  All of the staff was more than thrilled we were there, because we help ease their load immensely.  Almost every one of the nurses works EVERY SINGLE DAY of the week, sometimes with one day off.  It’s incredibly taxing, and I have no idea how they do it stretched so thin all the time.  Also, the hospital has built homes for the nurses right behind the hospital.  They are very nice, but I would never feel like I had left work- behind the hospital, living among your co-workers.  Despite those circumstances, the nursing staff is still very dedicated and conveys a servant’s heart.  God must have given these people ten times the patience and endurance as the rest of us!

I started out my first clinical day working in a family planning clinic.  They have an open clinic every day at the hospital for women to come get free birth control injections.  Depending on the medication, they only have to come once every two to three months.  Quite a few women take advantage of this, but not every woman tells their husbands that they come.  You can see some cases where the woman has delivered 6 children, and the husband wants to have more, but the mother is tired and overwhelmed as it is.  So, she keeps it a secret and continues to not get pregnant.  That was something I found very interesting! Counseling also goes on too, but not while I was there.  It is a neat program, and I think pretty effective.

The next clinical day was my favorite!! I went to the outpatient ward where I helped take the vital signs of over 100 people waiting out in the intense heat to see a doctor.  Some had spent the night outside from waiting the day before.  When the doctor is ready to go home, he has to tell the patients they have to wait until the next day until they can be seen, unless it’s an emergency.   The doctors put in incredibly long hours along with the nurses, and if they could literally spend the rest of their days stuck in the office seeing a continuous line of patients if they didn’t cut themselves off from their work.  During part of my time, I stepped in to ask the doctor if I could listen while he saw patients.  He was thrilled we were there and was more than happy to have us sit in.  He was one of the best doctors and teachers.  Dr. Miyanda would translate the patient’s complaints to us and then ask us what we thought might be going on.  As we guessed, he would steer us in the right direction of making the diagnosis he thought it might be.  We stayed and talked his ear off for a few hours during his time in the clinic, and he joked around with us, saying that we were bad luck.  He is a surgeon, and his list of surgery patients was growing quickly.  By the time we left, he had a list of 13 patients needing surgery the next day! Oh, and Dr. Miyanda was on holiday.  He was not supposed to be working, but knew the need and came to work on his vacation.  He truly loves his job!  The next day, the three of us who had followed him in outpatient, followed him in surgery. 

The next day proved to provide the same experience.  He used each surgery as a lesson, and we each got to scrub in on an inguinal hernia repair.  Hernias are extremely common here- mostly inguinal and umbilical hernias.  Four of his surgeries were for hernias, and all seven of the surgeries we were able to see involved the reproductive system.  I’m not sure why, but there seems to be lots of complications and problems with these systems!  Dr. Miyanda has only practiced 2 years so far, and he showed us that last year he performed around 700 surgeries.  I was impressed!

My last day at Zimba was spent in the female ward.  I followed Dr. Patrick around and saw many things.  The ward was pretty full with sick women.  Many had HIV and were in the end stages of fighting with the disease.  Some had heart problems, TB, terrible ascites, miscarriages, and other things.  I was able to perform my first blood draws, which I thought were a bigger deal than they are! They are much easier than IV starts, but similar.  The one woman who had the incredibly bad ascites was breathing with a lot of difficulty, because fluid was up around her lungs.  She was so bad that Dr. Patrick stuck her twice with needles in her lower abdomen to simply allow the cavity to drain.  It was unlike anything I’ve seen before and I’m pretty sure I stood there with my mouth open for a while.  Yellow fluid (she had a TB infection, making it yellow instead of clear) started coming out in a pretty steady flow.  It seemed like such a simple procedure, but really the doctor has to be very careful to not stick the gut or other organs when inserting the needles.  By the time I left she had drained off about a liter and a half- and she had a long way to go!  Instead of pulling the fluids out like I have heard they do at home, the fluids drain by gravity- so it takes much longer.  Since the woman had been admitted, this was the fourth time this procedure had been done on her! 

Later that afternoon I went back to the hospital, because I heard twins were going to be born.  I was hoping to help assist in their delivery, and I thought it would be great seeing twins born naturally as opposed to a c-section like they often are in the states.  It took a few hours before the mom was ready to push, but once she got started, she went fast.  Before I had my gloves on, one baby was half delivered.  About 2 minutes later, I was being given the second baby boy.  Both did wonderfully, and were both head-down.  I got to help with the initial transition phase of the boys and it was great!  About 3 minutes after the mom had delivered, the nurse asked the patient to get up so she could start cleaning the bed.  The patient was compliant but about fainted when she stood up.  I caught her and eased her down on a nearby stool.  The nurse told me to find her a drink while she started the clean-up.  Each woman has a list of items she is supposed to bring in with her when she delivers.  It includes the cleaner used to wipe up the delivery mess.  It helps the hospital save on cost, since they already provide free services for everything else.  It was all very neat to see.

After our week at clinical, we had planned on going to an orphanage for the day, but the night before a big windstorm had blown through, taking down many power lines.  We lost power, and water was limited.  One girl started to get pretty sick, and the absence of water was doing her no good.  By morning we were completely out of water, except for a couple cases of bottled water.  We decided we had to skip the orphanage and come back early to Choma, where they still had power.  It was nice to be able to get a good amount of homework done!

This week we have spent our time at Choma General Hospital.  It’s been a good experience so far, and I already feel like I have met a good number of the staff members.  This hospital is owned by the government, and therefore they have more resources than the other mission hospitals we have been at.  This is partly because the Presidential elections were last month and, ironically, the hospitals resources become plentiful each time around the elections!  So funny! 

More to come tomorrow on this blog! I am tired and have a big teaching presentation in the morning….

This is the little girl I would bring home in a second!!  This is Sarah, wearing Katana's headband.

The first day we went to the hospital, I went to the dental clinic.  This is the first hospital that has offered this service, and they stay busy. At the clinic, many tooth extractions are performed on a daily basis.  It is the most common thing performed in the clinic.  Patients wait to see the specialists until their tooth is very bad.  Eurom, the dental specialist, said that many times the tooth can still be saved, but extracting the tooth is a quarter the cost of preserving the tooth.  Therefore, patients have their teeth pulled as their means of treatment.  Eurom is frustrated by this, but said there is little that can be done about it.  Unlike most areas in the hospital, the dental clinic charges patients for all procedures.  This is one of the main sources of income for the hospital, even though not many are able to afford it.  I was surprised to see each patient who was getting a tooth extracted being numbed first.  Eurom said the patient wouldn’t be able to sit still otherwise, which makes perfect sense.  I also saw an abscessed tooth and a little boy who fell and knocked his front tooth out in addition to many tooth extraction procedures.

For our leadership and management course we each have to each find something to teach on in clinical practice.  Choma General has recently received 3 new infant isolettes, but they do not know how to use them yet.  So, Christine and I decided to teach the staff about this.  We spent the next two days on the Maternity Ward, spending time reading about the isolettes and asking the nurses questions about what they already know of them.  They have a couple of old isolettes, however, have been very neglected.  Yesterday we were asked if we would clean the old ones.  Supposedly they are washed every week, but there is no way!  The isolette I cleaned had dead cockroaches in it, tons of bug poop, and a thick layer of red dust! It was soo grimy and disgusting.  We spent the next hour each cleaning one.  It was much better, and we narrowed down the topics we should speak about for our presentation of the new isolettes- safety & cautions, how to clean them properly, and the neonatal criteria for benefitting from an isolette.  Another thing, they rarely ever use the isolettes they do have, when they have so many babies who would benefit from it.  Currently there is a baby who was born at 27 weeks of gestation who is just staying with the mom.  That baby needs the more controlled environment of the isolette to help grow and stay healthy.  But, there is another mother on the ward who is in grade 12 of her schooling, and has exams to take while being in the hospital.  She is taking the exams in the room where the isolettes are, and therefore the nurses won’t put the babies in there with her.  It doesn’t make any sense to me.  But the exam seems to be more important than helping this very immature baby.  Mrs. Mukonde, our Zambian leader of the trip, was having a fit.  She is a retired nurse and has a much more westernized way of thinking.  So, hopefully Christine and I can have some impact with our teaching! We bought pastries from the bakery to take in, and we’re hoping that will draw in the midwives and nursing staff!

The day before on the maternity ward, Christine and I saw two c-sections.  The first mother who came in, had PIH, pregnancy induced hypertension.  The doctor told Christine and I he wanted to give us a lecture.  We followed him in to the room where the mother was, and he proceeded to tell us all about this risk factor and the possible complications.  He said the baby doesn’t receive adequate oxygen and nutrients during pregnancy when the mom has this, and you can usually expect the baby to be smaller and immature.  He decided this mother needed a c-section and the two of us were able to go in the theater to watch it.  Dr. Moonga is a wonderful surgeon, and had the baby out 58 seconds after his initial cut!  He has years of experience and also loves to teach while he works.  We were impressed with his work, and after the delivery of this woman’s fourth boy being born (she wanted a girl so badly!) we headed back to the ward.  When we got there, another woman had been driven in from a rural village with lots of problems.  The woman herself has spina bifida, and has a very deformed back with a prominent hump.  She is unable to lie on her back flat.  Olivia was also having severe pains in her abdomen.  A fetal heart rate couldn’t be found and Christine was sent to go get Dr. Moonga so he could quickly see this woman.  Her baby was also laying sideways, which is not conducive to labor! As soon as he arrived, he thought she had placenta abruption, a serious complication.  She was also given an emergency c-section.  The girl was only twenty, and because of her back deformity, was not given spinal anesthesia like the other mother, but just ketamine.  Ketamine put her to sleep and will help her forget everything that happens during the surgery- so she will be able to feel everything : ( She was crying out for her “mama” like crazy because she was so scared.  One of the girls held her hand as she went to sleep.  As soon as Dr. Moonga opened her, so much blood and fluid came out.  This woman probably weighed 90 lbs pregnant.  She had enormous blood clots, and the doctor’s thoughts about placenta abruption were true.  The baby was born a stillborn at 28 weeks.  The baby girl had probably been gone for about a week.  The mother continued to lose lots of blood, and the nursing staff was giving her fluids.  She needed blood, but it takes 2 weeks to receive it from Lusaka! 

So yesterday when Christine and I came back to the ward, we found out that the baby boy born from the first c-section had passed away.  He had been in respiratory distress when I saw him, but by the time I left the nurses had put oxygen on him.  I thought he would be fine after the help of the O2.  He should not have died and I took it pretty hard! The family was all around the ward after burying him that morning.  They were incredibly somber and it was so hard to see them grieve.  Christine and I also learned that the mother from the 2^nd c-section passed away four hours after surgery.  I was not so surprised, but it felt like another blow.  3 of the 4 patients we had worked with, the moms and their unborn babies, had died.  That same afternoon, another woman came to the hospital with her baby who was bleeding through the nose.  Although I wasn’t involved in the care of that baby, that child also passed away.  The air was very heavy in the maternity ward.  I overheard one of the nurses telling the mother of the first c- section that “the Lord giveth and take away.”  She was right, but it was hard to see so much death in one day. 

Although all that went on this week, I spent some time at the orphanage and had the best time with the kids.  I took dum-dum suckers, two nerf balls, and a soccer ball for them.  The suckers were a hit as usual, and we gave the soccer ball to the couple older boys who live in the orphanage.  They loved it and started playing right away.  I also gave these two boys the nerf balls, and they both felt like they had been given the world.  The held the kids a lot, and they showed me their garden once again.  We sat on the swings, and they showed me how they can hang upside down from the tree.  The kids were wonderful and I am starting to realize it will be hard to say goodbye to them in a few weeks!  So, I have captured many of the kids to remember them by. 

Two weeks of clinicals makes for one long post! I’ll try not to do that again : ) But, I also wanted to share one of the highlights of the whole trip so far that happened this week.  THE RAINS FINALLY CAME!!! We were all like little kids again, we were so excited.  We had been worshipping after a meeting, and then it started pouring.  So we ran outside in the rain and soaked it up.  It was finally cool! We started singing our worship songs outside and had a prayer for the next 15 minutes out in the thunderstorm.  It was wonderful and much needed by all of us.  We were completely soaked and trembling.  But it felt so good to be cold for a change.  It felt like a huge blessing!

We all saw some of the hardest things this week we have experienced so far at clinicals, but we continue to feel God’s presence here. 

Our soaked selves after a night in the rain!

The girls Yvonne and Doro.  Each child has their own bean plant, and they each made their own sign to label them.  They are very proud of them! You can see part of the rest of their garden in the back.

These are busy kids!

Here is the soccer ball we gave away.  This is Talent kicking it to Michael.  Talent loved this picture of himself when I showed it to him. I think I'll have to print it out to give to him!

clinicals and adventures in the sky

Whew! This week has been very full, mostly with lots and lots of time spent in the hospital. It has been wonderful though and I think each of us saw amazing things.  But, we also were able to do some fun and adventuresome things as well.  We just arrived back in Choma this afternoon, and I think it’s safe to say we are all exhausted.

Here is a recap of my week—

Monday we spent listening to lectures about malaria from a very passionate doctor.  He knows a whole lot about mosquitoes!! He works in a malaria research institute that’s part of the hospital.  We saw where they breed mosquitoes to do testing, saw the mice which the mosquitoes feed off of, and the traps that are used to catch “wild” mosquitoes that are tested.  Things have improved over the years.  The researchers used to have to use themselves as bait at night to catch mosquitoes, and would even stick their arms in the mosquito cages to allow the mosquitoes to feed every few days.  Talk about self-sacrifice!  The workers were constantly getting malaria!  Luckily the system has changed since.

Tuesday Dana and I followed around the Nursing Officer of the Hospital, equivalent to a House Supervisor.  Miriam was awesome to work with, and to say I was impressed with her would be an understatement.  I wasn’t expecting much, just because of different cultural norms and the way I had seen nurses work within the hospital.  However, she challenged the nurses who came in to give report and questioned some of the care that was given.  She is very organized and obviously respected by everyone.  The hospital is extremely understaffed (almost always just 1 nurse for a whole unit), and Miriam knows each staff member’s name including the nursing students who are doing clinicals at the hospital.  While I was following Miriam, she gave Dana and I the task of updating the statistics of the hospital for the last 3 months.  The most common diagnosis were things we do not see in the states on a regular basis- such as tuberculosis, epilepsy (they have an incredibly high rate of this but I’m not sure why), meningitis, and dehydration.

One sad case Miriam was working through this week was about a woman who was admitted with burns covering 60% of her body.  Her 2 year old son was also admitted with severe burns, and she was 8 months pregnant.  She went in to labor shortly after she was admitted due to all the stress, and gave birth to a stillborn baby.  Her 2 yo died shortly after as well.  Her home was set on fire and boarded up from the outside, most likely from her husband’s girlfriend.  It was incredibly sad, and it seemed like the bad news wouldn’t end for her.  When I was there seeing her, they still hadn’t told her that her son passed away- and it had been at least 1 day since it happened!  The woman was incredibly beautiful.  She was one of the prettiest Zambian women I have seen so far.  She does have an incredible support system though.  She had about 50 visitors, and her mother never left her side.  Thankfully, Zambian police are investigating the situation, and the girlfriend is in jail.  Their system is different- the offender is considered guilty unless proven otherwise.  This woman needs prayer.  Her life has turned upside down in a matter of a few days. 

Another awful thing I saw was some very emaciated adults, all of whom are HIV +.  They were actively dying and were suffering from wasting syndrome.  I was rounding on many women with the same illness performing vital signs.  I went to one woman and got my stethoscope out to listen to her heart rate, but my stethoscope was sitting on top of her ribs.  I couldn’t hear anything because not one part of her chest cavity was smooth enough.  That was a first, and it bothered me so much!

Amidst all this sadness is happiness as well! I was able to help assist in a delivery this week.  I would have caught the baby myself, but the baby was breech and a nurse needed to help the mom deliver the baby- naturally.  It was very interesting to see, and is something that rarely happens in the states.  The baby boy transitioned well and was very handsome!  About 3 minutes after delivery, the mom stood up and dressed.  She finished dressing and starting walking to the postpartum side.  I still can’t get over it!  The women are supposed to continue lying down for an hour, according to their policy, but they never do.  She was up and out of there! 

Last night I went in to work a couple hours in the male ward.  I had been there earlier in the day with Laura and really enjoyed talking with some of the Zambian nursing students.  We talked about dating and relationships, and it was so funny to hear what they think about it.  They were asking if I would ever marry a black man, why am I not married, and they were concerned I would confuse guys with my relationship status because of a ring I wear on my right hand.  We talked with them for an hour and had a ball.  One of the girls wants to meet Laura’s brother.  Her friend said, “What if he doesn’t like you?” She responded, “Oh, I will make him love me.”  We told her his name, and she said she loved him already.  The Zambian women would love to marry American men, because they are more faithful in marriages.  It’s not a big deal for married Zambian men to have girlfriends.  Their wives even know about it sometimes.  It is a huge problem, and is one of the major factors of the HIV/AIDS epidemic here.  Jessica was pretty serious about wanting to meet Laura’s brother.  It was pretty funny! But anyway, when I was working last night, a 21 yo male came in with a compound fracture in his calf.  I was able to help admit him, and between a couple of us we started an IV, irrigated his wound, and got him settled in for the night.  The night shift nurses are very lazy.  They work 7 nights in a row, and then have 7 nights off.  So, they are always tired, and are allowed to sleep at night.  Andrea and I were pretty much given free reign with this man.  I think we did very well!

As for our adventures, we climbed a water tower in Macha yesterday, and today we got to ride in a prop plane!  The water tower was terrifying.  I don’t like heights all that much, and climbing a perfectly vertical ladder to the top was not my favorite.  We are estimating it was about 5 stories high.  However, the view at the top was a-mazing!  We could see the hospital where we were all 3 weeks, and the different surrounding villages.  Check out the pictures! I’m glad I did it, but I don’t think I ever need to do it again : )

The prop plane was by far my favorite.  It was like a roller coaster ride.  I had never been in a plane that small before, and it feels much differently.  Our pilot was a German missionary.  He was a hoot, and had a blast taking us up.  He dipped up and down a lot, and turned the plane from side to side, where we were looking straight down.  He enjoys his job!  It was awesome and only totaled about $6.  Can’t beat that!

Everyone on the team continues to do well.  We experienced some rough stuff this past week, and we all had our weak moments handling it all.  We have had good discussions about what we are seeing, and it always helps to talk it through.  There were many more stories I could tell, both good and bad!  I am trying to record them all so I don’t forget.  The experience is priceless and I am trying to take advantage of it all.  I received surprise gifts and letters this week from home and that was so fun.  My chocolate supply is now abundant, and I am one happy girl.  Reading the letters gave me a great taste of home too!  I loved it!  I am continuing to stock up on plenty of souvenirs.  Everything is so cheap, and there are so many things I want to remember!  We are down to 30 days, and I am trying to soak it up.  Time has gone quickly, but I know I will be ready for home too! 

I am including lots of pictures this week! Enjoy--



I helped this beautiful baby girl's mom labor!



This is where all deliveries happen. Notice the only privacy between beds are shower curtains!

16 year old Rachael and her new baby girl (same baby as the 1st)! This is the mom I helped labor last week that ended up needing a c-section.  She was a trooper!

 

I can't remember if I have mentioned how each person greets one another after church. Exiting the service, you go down the line shaking hands with each person, and then join the line to shake hands with the people behind you.  I love this tradition! This is Bud going down the line!



Here you can get an idea of how many people it can be. I would say this was about 2/3 of the people last Sunday. It takes a while : )

This 3 yo guy is a favorite of everyone who works in Peds.  He broke one of his femurs and will be in traction for 4 weeks! He is very squirmy and quite animated!

This is a little boy in the malnourished area of the Peds ward. Look at how skinny his upper arm is- one of the biggest indicators of malnutrition in children.  His name is Blessed.

Dana and I at the top of the tower. Check out that view!

The monster- 90 rungs of steepness to the top.

They were obviously a little more comfortable than I was.  They were getting their picture so it looked like they were falling down backwards!

Our group for the flight! The 2 girls next to me are from the Netherlands, and are also studying abroad.  We have run in to them several times this week.

bugs and stuff

Our home away from home in Choma.

This week, our team has continued staying in Choma, traveling to Macha’s Hospital Monday, Wednesday, and Friday.  This week has not disappointed us in what we have been able to see and be a part of.  Monday I was on the Maternity ward, and my goal was to either deliver two babies, or twins! Haha!  When we (Sarahlyn, Liz, and I) arrived on the ward, three mothers were in labor, two with live babies, and another who they thought would deliver a stillborn baby.  The mother came in a couple days prior, saying she had not felt her baby move for a while.  The nurses were unable to find a fetal heart rate, and concluded that the baby had most likely died.  However, the nurses do not tell the mother when they suspect a stillborn baby.  Death is hardly talked about.  Also, the midwife never says, “It’s a boy!”  Instead the midwife holds the baby up for the mom to see, and the mother announces the sex of the baby.  This is one of the ways they check the neurological state of the mother after giving birth! Anyway, I was excited about there being three women in active labor, but I was informed we had to go to a special lecture being given on malaria.  I was so disappointed I had to attend when I knew what I might miss out on.  The other girls had never even seen a birth, so I let them stay so they might have that opportunity.  After just 1 ½ hours, I came back and ALL three of the mothers had delivered!  I was shocked and frustrated I missed it all.  Liz was able to help with the delivery of one baby boy, just until they realized his cord was wrapped around his neck; at that point, the midwife took over!  Sarahlyn was able to deliver the other two babies, one being the stillborn, and the other a very healthy little girl.  They loved their experiences, although the stillborn baby put a damper on the day.  That mother saw her baby, and looked away pretty quickly.  No bonding is supposed to be allowed in these kinds of events.  They quickly hid the baby in a closet.  The girls said the mother started shaking with emotion.  Poor girl!

After lunch on Monday, I came back to the labour suite to find a 16 year old who was 4 cm dilated.  I was able to help her labor for a while and I loved it!  She hardly understood English at all, so communicating was a bit of a challenge.  We demonstrated how to breathe through her pain, and after several times, she caught on.  She even started doing it on her own, and seemed to understand what we were helping her with. When contractions would begin, she would reach her hand out for us to hold. She did not have anyone else there with her, and we were her support- much different than in the states!! I was also was able to check her a few times (sorry if that’s too much!) to see her progress.  She did not progress much while I was with, but it is also her first child.  The poor girl was also sick.  One of my instructors seemed to think that she had malaria, and she was so hot and sick to her stomach.  But, she was not hooked up to a single machine!  We used a fetoscope to listen to the baby’s heart rate, and even listened with a Doppler, but that was the only “technology” used.  I had to leave before my patient was able to deliver, and I hated that, but it was still a good day.  She probably delivered that evening, and may have even gone home that same day.  Most women are discharged 4 hours after delivery, as long as mom and baby are both stable.  They often walk home for miles with their baby on their back, and then resume chores.  It is amazing!

Wednesday I went to the A.R.T. (Anti-Retroviral Treatment) clinic with Laura.  I wasn’t all that excited about this part of my clinicals, but I ended up really enjoying it.  I started off with Agatha, a nurse, who counts the number of pills each HIV + patient gets.  By counting the pills, they are able to tell the patient’s adherence to their medication.  If they are not adherent, they cannot receive more pills until they go to counseling.  It is a great program, and so many people benefit from it.  I also sat in with a clinician who assesses each patient who comes in.  The patients are asked if they have any pain or other complaints.  Quite a few shared at least one thing either as a side effect of their medication or a symptom of the disease process.  I was very impressed with how healthy the people looked who came in.  The clinic was extremely busy with patients, and none of them “looked” like they had HIV from the outside.  However, many did describe pains associated with the disease.  In the male ward, there were plenty of men who had wasting syndrome who were quite literally skin and bones.  They are men who have lived with the disease for a long time, and it is finally taking its toll on their body.  Often times, they don’t have the energy or immune system to fight off much of anything at this point and pass away.  So, I was able to see a clear picture of how this disease can look like on both sides of the spectrum. 

I was thinking yesterday, that there are so many little things I haven’t talked about in Zambia yet, like food, creatures, and other things.  So, I thought I would give you a picture of some of the normal, everyday things we see or run into.  First of all there are so many spiders, lizards, grasshoppers, mosquitoes, flies, and cockroaches.  There are also so many more cats and dogs here than I expected, which has been great being the pet lover I am.  But seriously, the cockroaches are everywhere, including the kitchen.  We all try to avoid the kitchen at night, because they all come out.  Judy, one of the leaders of our trip, and I spent about 45 minutes a couple nights ago rewashing all the silverware we eat on every day.  We doused it in boiling water, and then put it away in Tupperware containers that are cockroach proof!  Before, you would open the drawer and cockroaches would literally run across the fork you were about to pick up.  SO disgusting!  This is one part of Africa I don’t think I could ever get used to.  Thankfully our cook, Mrs. Bota, loves the new Tupperware and is all for it.  Mrs. Bota is a wonderful lady and a great cook!!  Everything we eat is made from scratch and most of our meat is extremely fresh.  A couple days ago one of the helpers at the house was carrying in 2 chickens.  That night we ate fried chicken and it was soo good!  Mrs. Bota cooks more American meals for us 6 of the 7 days each week.  We have a macaroni-type meal, chicken salad, fried chicken, beef stew, fish, and chicken stir-fry are the main meals.  Cabbage is the main vegetable eaten here, besides corn, and there is always rice or nshima.  Our team also goes through Peanut butter like nobody’s business.  It’s pretty unreal how fast we go through a supersized container of it!  Mrs. Bota also enjoys making treats for us once in a while like peanut-butter cookies or banana bread.  It all tastes a little bit differently, but we all really enjoy the food.  I don’t think anyone has lost weight!

We have also pass monkeys each time we are coming to or from clinical.  I have yet to get one on camera yet.  I’ll have to try again tomorrow!  Also, the transportation here is a hoot.  Each time we leave in our land cruisers, we pass several trucks that are full to the brim.  People sit outside of windows and stand up in the back of the truck.  There are sometimes probably 30 people in one truck (they have longer beds here).  Several we have seen recently have goats and pigs in the stuffed in the bottom of the truck, and then they have built a second level to the truck bed that holds people and luggage.  It is the weirdest thing.  The trucks are always dragging and never move very fast.  I shared on Facebook last week that we saw a man on a bike that had a goat strapped on the back of the bike.  I’m sure he was going to sell it.  It was a pretty funny sight!  One more I have to share-- one of the male patients had a cat and three kittens under his hospital bed.  I have no idea why, but it seemed a little out of place to me.  I am still surprised when I see these things, even 5 weeks later!

Life here in Zambia has continued to be eye-opening and I feel like I have really settled in here.  Everyone remains healthy, and our team continues to become closer.  I have made some great friends who will remain friends long after we leave!  I have started to become homesick, but I am confident this is where I am supposed to be.  I am excited about the next few Sundays.  We volunteered to sing a couple songs at church, and before we knew it, they gave us 45 minutes in the middle of the service to not only sing, but preach!  One of the girls is preparing a short sermon, and we had choir practice today in preparation for Sunday.  We are going to sing “Oh Happy Day” from Sister Act II, “Down to the River to Pray,” and a hymn we haven’t decided on yet.  We plan on acting “Oh Happy Day” out just as much as it is in the movie.  I think it will be pretty fun and it will definitely be a hit!  Thank you for your continued support and prayers.  They are still being felt and answered this far away! 

P.S. I will try posting more pics later- the internet is not cooperating!

This past week I also went to the orphanage to paint nails! It was a big hit! This is Colo painting my nails!