The journey back and some thoughts

Alfred dropped us off at the airport and our overnight flight to Amsterdam was uneventful and we had about 2 ½ hours at the airport. I purchased some cookies and candy for the kids at home. Then thought about all the little things we miss from Zambia such as:

1)     The beautiful blue skies – everyday! (This at the University of Zambia)

2)     The crisp cool nights – with temperatures dropping as soon as the sun sets around 6pm

3)     The smiles of almost every Zambian we met!

4)     The warm welcome that everyone gave us

5)     The Zambian handshake we learned from Sammy

6)     The Zambian handshake/curtsy we learned from Chisomo

7)     The long, long time our toilet took to fill back up after a flush (at Palmwood)

8)     The funny water pipe sounds we heard as the toilet kept filling up

9)     The bougainvillea flowers carefully left for us by the hotel staff on the towels

10)  The beautiful vegetation and flowers – various colors of bougainvillea, as well as other bright red flowering trees etc.

11)  The juxtaposition of fancy malls and grocery stores with prices that are the same as the US and people who make $1 per day to survive

12)  The government bureaucracy – handled with a charming smile as always

13)  The babies at the orphanage who were so stoic and did not cry

14)  The roads ranging from well paved ones to ones full of potholes, to the unpaved ones that we drove on for many kilometers making dust clouds

15)  The big bus Dr. Weaver showed up driving (and all her help)!

16)  The Kamwala shopping center alleys!

17)  Bartering at the Kabwata cultural village and buying two for the price they asked for one item

18)   John Mwakatala our wonderful safari guide and his story and his lovely family

19)  The village people we visited with and their simple lives – happy with what little they have (a few hens here)

20)  The graceful giraffes that we saw up close

21)  The many people we saw waiting at the clinics and hospitals – full waiting rooms

22)  The brightly colored chitenge we saw the ladies wearing

23)  The people such as Dr. Somwe, Dr. Matafwali, Chisomo, Alfred, Dr. Froeschl (and many others) trying to make a difference to the lives of people in Zambia

24)  The daily dose of eggs for breakfast we had at Palmwood Lodge

25)  The incredible work that the Special Hope Network and Cheshire Homes are doing for children with disabilities in Zambia

26)   The ability to buy talk time for cell phones just about anywhere, even from a vendor on the street!

27)  The need for lots and lots of kwacha since credit cards are rarely accepted anywhere (the only store we found that accepted credit cards)

28)  The school children in their school uniforms always around

29)  The power cut and sitting in candlelight at the lodge

30)  The nshima that is the staple food of Zambians

31)  The impala that we saw so many of

32)  The rich African art we saw at Chaminuka

33) The beautiful Zambian sunsets

34)  The huge termite mounds we also saw at Chaminuka

35)  The miles and miles of Zambian scrub land as we drove through the country

36)  The “compounds” – tightly packed together and overcrowded with people, next to more upscale neighborhoods

37)  Chisomo – all her help during our stay

38) Alfred and Beit Cure Hospital for getting this whole project started

The double decker plane at Amsterdam – (our Chicago – Amsterdam – Chicago flights were on these)

I could keep going, but, we have now reached home after the long journey – back in West Lafayette.

and will keep you posted as we go through the next steps of formalizing this into a student program next year! Thanks to all who have followed the blog and for all who posted comments.

Zambia Day 9: The last day

Our last day in Zambia – for this trip, but we have so much to look forward to for next year!!!! Last breakfast at the Palmwood Lodge: we ended up having a treat as they had crepes with honey and watermelon! Most previous breakfasts had included eggs and toast! 

We also noticed weaver bird nests on the tree right outside our room at the lodge (what poor observers we have been the past 9 days!) 

 Palmwood staff who helped us:

Martin

Irene

Brenda

 We missed Linda who checked us in when we arrived at midnight and for the next few days, and the chef who cooked most of our meals at the lodge.

Today was the first cloudy day we had during our whole time in Zambia! We have had beautiful blue skies and sunshine every day so far!

Chisomo picked us up at 9:30 am because Alfred has clinic on Thursdays. YES! We were able to sleep in on our last day here! Our first stop was at the Pediatric Center for Excellence (PCOE) which is funded by the US Centers for Disease Control (CDC). This center caters to children from birth to 18 who are either HIV positive or who were born to a mother who is HIV positive, but are themselves negative. They provide free care, counseling and medications as well as specialty services such as physical, occupational and speech therapy that are not available much anywhere else in the country. We walked through their developmental intervention clinic where the therapies are provided, their counseling areas, their enrollment area etc. We met with the Director of the Center Dr. Kankasa who is a pediatrician. It is a very well maintained facility, as long as they can maintain the CDC funding!

And the center was officially opened by Hillary Clinton!

We then walked across to the Community Based Intervention Association (CBIA) which offers physical therapy services as well as training in PT to parents and teachers, and also provides outreach services in rural areas.

Their area was also well-equipped and maintained.

Funny street sign: “robots” refers to the red traffic light!

That was the end of the work for the morning – a short day!! We then went to Kamwala Shopping Center to buy “chitenge” fabric which is a local Zambian fabric and outfit. The ladies wear the fabric in bright colors and designs around their waists, and for special occasions they may wear a chitenge suit which has a matching top. This was quite an experience!!! We entered the small market into another world of very narrow alleys with tiny shops selling all kinds of things ranging from produce to shoes to fabric! Reminded me very much of the Mysore market in India!!

Narrow alleys

Chitenge fabric

Shops on the street

Then we drove past the state house which is the residence of the President of Zambia Michael Sata – his picture is prominent in many places in town – in all government buildings which included UTH buildings as well as the schools we visited yesterday etc. etc.

Nice roundabout – there are many in the city and the fish eagle here is the national bird of Zambia.

We stopped for our last lunch with Chisomo at a Lebanese restaurant called Mezza.

Chisomo and me at lunch:

A very large order of fries! We ordered 2 and got 2 giant bowls of them!!

Mezza: the Lebanese restaurant:

Back at the hotel: Jenn wearing her chitenge!

And me:

Jenn’s last run at the hotel:

My last blog from the hotel – to be posted from the airport hopefully.

We checked out of the hotel and met with Alfred and the ENT surgeon Dr. Uta Froeschl for our final dinner and planning meeting. We had a good dinner as well as some time talking about plans for next year’s trip! Given all that we have seen and discussed, there is SO MUCH to do, but we were all in agreement that we should keep the first trip simple and manageable so that it is a success and then take steps to keep improving each year. So now our travels come to an end but the serious planning begins. We are at the airport in Lusaka, but when we return: First step: proposal to the study abroad office to get the course approved for next year. Although the travels are ending we hope to keep updating the blog as needed as we take the next steps in getting the course planned and set up for next year. Stay tuned!!!

Zambia Day 8, Lusaka:

Alfred arrived to pick us up at 8am at the lodge. We set off for our day’s meetings – first to pick up a letter of permission to visit the ENT area at UTH, and with that in hand to actually visit “Clinic 6” which is ENT and Audiology. Permission is required since it is a government hospital, and it is important to follow the rules and regulations!

We briefly met the three physicians there who were all busy with patients (and the hallway was full of waiting patients). We also met the 2 nurses they have, who have been trained to do audiometric tests. They do not dispense hearing aids but refer them to Beit Cure Hospital to Alfred or to the Speech and Hearing Center at UTH – more about that later.

UTH Audio booths: Ellen – one of the nurses trained to do audiometry

Note the equipment – one GSI 16 and 2 even older Beltone audiometers. We also noted one broken GSI 33 on the floor as well as some other older audiometer.

 We then dropped off a letter at the Pediatric Center of Excellence (PCOE) that we will visit tomorrow and then went to the Curriculum Development Center (CDC) to request permission to visit the schools for the deaf. This is a branch of the Ministry of Education, and we waited almost 45 minutes after which Alfred finally returned with a Ministry employee who accompanied us on our school visits.

 First we went to the primary school which is in the UTH campus. We observed an excellent teacher who was hearing-impaired, but verbal and signing teaching kids math and English. All kids have hearing loss and use sign only. None use hearing aids. All were participating well in class!

 We wanted to visit the UTH Speech and Hearing Center, but it was closed and there was nobody available there. It is the only other center in Lusaka other than Beit Cure where hearing aids are dispensed and we were hoping to see their facilities, but that was not to be….

 Next we went to Lusaka High School and met with the Head Teacher and visited their 2 classes of boys with hearing loss (grades 8 and 9). We learned that the boys used to get regular follow-ups but that has not been happening lately, and the teacher was interested in getting that service back. Again, none of the boys wore hearing aids and all used sign only. From what we understand from Alfred there are cases where kids with less severe hearing losses are sometimes placed in schools for the deaf due to the lack of services available.  Also that deaf kids have a very difficult time finding employment.

 Lusaka High School:

 

Lusaka High School grounds:

Our next stop was back at Beit Cure where we finally gave Alfred the items we had taken for him – immittance tips, ear lights, text books etc. Hopefully they will all be put to good use to provide some small help to the people of Zambia! We also met the German ENT surgeon he works with Dr. Uta Froeschl.

 ENT/Audiology at Beit Cure:

We also looked at the housing available for students at Beit Cure.

Potential housing at Beit Cure:

We met back up with Chisomo – and she was wearing the PASO tee shirt we had given her!!!

Jenn, Chisomo in PASO tee, me:

After a really late lunch with Alfred and Chisomo (today it was after 2pm, but typically, Zambians appear to eat lunch after 1 or 1:30pm), Chisomo took us to visit another housing option for the students next year. We were unable to take pictures as the rooms were currently occupied.

We also went back to the Kabwata Cultural Village to purchase a few last gifts and then headed back to the hotel. Along the way:

Mosque:

Old apartment building:

As in many cities, and in developing countries, we see the old and the new, the ramshackle and the spotless, the poor and the wealthy as well as the clean and the dirty – in Lusaka.

 Back at the hotel – our second time to find our fresh towels laid out on the bed with bougainvillea flowers on them – these grow abundantly in vibrant colors everywhere!

Flowers on towel:

We had our last dinner at the hotel tonight. Tomorrow we leave – we can’t believe our trip is lamost over!!!

A final note – there are 2 posts today – yesterday’s and today’s activities – enjoy and we hope to have one final entry before we leave tomorrow!

Zambia Day 7: Return from Kalomo

We had a good night at the house in the Namwianga mission compound. The mission appears to be well funded and the buildings all look relatively new and well-maintained. After breakfast with the 20+ group from Harding University, we went to visit the Haven (the orphanage where their students work). There are three separate Haven houses – one for babies on formula, one for toddlers and one for medically fragile babies who are HIV positive or have tested positive for TB.

One of the Haven houses:

Harding faculty Dr. Dan Tullios, Alfred Mwamba, Jenn, me and Dr. Beckie Weaver:

 Water tank: these dot the countryside – water is not necessarily always readily available – again a la India 

Alfred and baby:

We visited many of the babies at the orphanage. The Haven was very well kept and maintained, and well-equipped and the babies each had a crib with their names listed. There were several twins! These are babies who have either one or both parents who have passed on, or are too ill to care for them. One thing I did notice – despite the lerge number of babies, there was little crying. In fact I did not hear a single baby cry – just a couple of whimpers. For the sake of privacy, we are not posting any pictures with the baby’s face.

Jenn and baby:

 Haven inside

We observed some of the Harding students working with the babies on oral stimulation for swallowing, as well as some language enrichment groups doing circle time and singing songs with the toddlers. We have learned so much from this trip to Kalomo – it was worth the long drive over the 2 days and we owe Alfred and Dr. Weaver many many thanks!!You can see their class blog at http://hizpath2012.wordpress.com/

We also visited the Rural Health Center run within the mission compound and Alfred discussed the primary ear care services available there – which are basically non-existent. Ear infections, both bacterial and fungal are a huge problem and seeing draining “pus” from ears is very common. The treatment used at the centre: gentamycin drops – which with repeated treatments can of course be ototoxic. Alfred discussed with them how one of their medical professionals may go up to Lusaka to receive training in primary ear care and also examined the ears of a couple of babies at the Haven before we left. From these discussions we learned a lot about the lack of specialty care available for common ear diseases that we would treat very easily in Western countries.

We left Kalomo around 11:30am for the 5-hour drive back to Lusaka. One thing of note regadring the drive – the highway was really quite good!!! So although certain roads within Lusaka are quite poorly maintained, the highway was great!

One mission I had on the way back was to try and get a picture of cows along the road. I missed many times and here is the best I could do! 🙂

Another excitement during the journey was that we had an oncoming wehicle carrying a large load that passed us and just before it did, a chair fell out of the vehicle into the middle of the road! Fortunately, it did not cause anyone any harm and we were able to avoid it.

Back to Lusaka – the city:

And vendors on the street: they sell anything from fruit and veggies, to clothing and trinkets, to even talk time for cell phones (cards)!!

Town:

We got back to the Palmwood Lodge to a different room, but when we tried one of our adapters to charge the laptop, we could not make it fit!!! We were quite upset and asked for our old room back because it had a power strip with different kinds of outlets. The receptionist Lindiwe was very sweet and checked out the other room and said that she understood the problem, and shifted us back to our old Room #25 – “home sweet home” I guess! 🙂 Later we found out from Alfred that the way to put in a 2-pin plug to fit the 3-pin outlet is to push in the top pin with a pencil!! Warning: Don’t try this at home – outlets here are turned on with a switch and there is no power on when using the pencil in the outlet!! 🙂

Jenn and I decided to venture out to Manda Hill mall in the evening. So our lodge had given us a reliable cab driver’s number and we called him to get there. We wandered a little and checked out prices for groceries and food (somewhat in preparation for our visit next year in case we decide to have food in the place where we decide to stay). We had dinner at a small Indian restaurant: Curry in a Hurry! 🙂

Tomorrow we have a few more meetings and we are almost to the end of our trip!

Zambia Day 6: Kalomo

Today is a travel day to Kalomo. We had breakfast at the lodge and then checked out. We ran into John and were able to say goodbye to him. 

Breakfast at the lodge:

Today we go about 5 hours south of Lusaka to a rural town called Kalomo to visit the Harding in Zambia Speech-pathology (HIZPATH) program. We hope to learn a lot from them as this is their 4th year in Zambia with SLP students.

Sammy arrived to pick us up around 9:15. We reached Lusaka around 10:30 or so and went to Sheeba’s (Alfred’s wife) store and waited a little bit for Alfred who was at the barber! Anyway, it was great to see him after 8 years. His daughter (Naku) is 3 and looks real cute (we saw a picture). Anyway, we set out for Kalomo around 11am, and Chisomo was ill and decided not to come. We chatted with Alfred about plans for next year, the number of students, the accommodations etc.

Traffic along the way includes people in the back of a truck a la India 🙂

 

Well kept and watered wheat fields along the way

 

 

Countryside:

Baskets and pottery along the way:

We stopped for a restroom break at Mazabuka at a mission centre, but the nuns were out for lunch so we did not meet anyone. This is a place where Alfred comes for Outreach clinic days though. It was about 2 hours from Lusaka.

 

Another hour later we stopped at another little town and bought some fruit from the roadside to eat for lunch. There were tasty little bananas similar to ones we get in India. We also bought some oranges and some little bags of roasted peanuts.

 

We reached Kalomo around 4pm and met Dr. Beckie Weaver (Dean of the College at Harding University) driving a big old bus at the little post office in rural little town Kalomo!

Post-office:

We followed her for 7km down an unpaved road and she stopped several times to pick up folks who needed a ride. The Namwianga mission compound turned out to be a very large and well established affair. Their buildings all looked new and well kept.

We sat and chatted with her for a while and then ate an early supper with their 18 students + 5 faculty. We then walked over to the house where we would spend the night and Beckie told us stories and chatted for almost 3 hours – I made lots of notes!! This is her 5th trip to Zambia, the 4th with students. The house has several rooms and there are 5 girls staying there. We learned of rules and regulations, visa issues, etc. etc. – lots of good information!! Tomorrow we visit the orphanage where they work (The Haven) and then head back to Lusaka. It is cold in the house – probably because it is concrete block and the floors are all concrete! Jenn decided to have a shower, and although there is a water heater in the bathroom, apparently the water turns from steaming hot to cold very quickly!! I guess I’ll have that experience in the morning!

 The internet signal is very weak here so I was unable to connect to the internet to post this blog. So, here it is one day late – enjoy!

Zambia Day 5: Chaminuka

We had a little hiccup early this morning, but it ended up being a great day again!

The hiccup: I was up sick in the wee hours of the morning – I think from eating too much good food!! But, we had decided to sleep in a bit and our first activity – a visit to the village within the park was scheduled for 10am for which I was ready to go! In fact we had a short walk around the lodge before that.

Cool eagle sculpture on the grounds (one of the 1000 works of African art collection they have!):

 Papaya tree with fruit (and they also had a vegetable garden) in the lodge:

 On the way out we drove by the lions’ area, and there they were!!! So, although we did not get a good view yesterday, they were majestically waiting for us, making it a great start to the day!

(Mom and Dad) Lioness and lion:

 

The cub!:

Father and son!:

We then had a guided tour of one of the villages with our favorite guide John Mwakatala. We sat with two different families in the village and chatted with them. They grow maize and a few other vegetables (okra, bananas, papaya), some of the men work at the lodge, and we met several young children. Unfortunately, there is a school nearby, but it is private and costs K15,000 (about $3) per month, which they cannot afford – so the kids do not go to school. Government schools are free to children until 7^th grade, but the government school is 4 km away and too far for them to take the kids. Each family had some hens and there were also a couple of dogs. Water is drawn from a shallow well, but it appeared to be pretty dirty, and toilets are holes dug in the earth.

Village house: made of mud, the kitchen hut is thatched; the house has a metal sheet roof held down by rocks.

 Kitchen (note the charcoal stove at the entrance):

 Water well:

 Cluster of village houses:

 Maize farm:

 

Chicken and maize:                

 

Tomatoes for sale in the village:

An unexpected treat we had was running into John’s family! We met his wife and two young children returning from church. His son who is 3 has started school and the school fees are deducted from his salary at the lodge. John finished high school, and then trained to be a park ranger which requires on the job training and then an exam to get certified. He spouts out names of all the various plant, animal and bird species around very fluidly and has been a great guide for us!  

 Another treat as we walked back from the village – we saw 2 ostriches!! So, although we had the safari yesterday, the park is such that you may run into animals at any time, which is pretty cool!!

Our next activity – a horseback riding tour! Although Jenn has some experience riding, this was my first time on a horse (although I have had a > 1 hour camel ride before). Jenn rode Beauty and I rode Edward who was somewhat skittish in the beginning as he wanted to keep trying to munch some grass, but once we set off in single file, with me safely in the middle between our guide in front and Jenn in the rear, I managed without any mishap, constantly talking to Edward to make sure he remained my friend!

 

Our last planned activity was a boat ride on the Chitoka Lake which is one of 4 lakes in the park.

 

Francis was our boat captain and took us for a spin around the lake pointing out various birds.

Francis:

Birds: (name forgotten)

 Weaver bird nests:

 

We also saw some large water monitor lizards:

and some very pretty lilies and a bushbuck wandering at the edge of the lake (missed the pic as he bounded off too quickly!)

End of boat ride (with Francis):

 And another beautiful sunset!

 And so ends our time at Chaminuka. Tomorrow we travel about 6 hours south of Lusaka to visit another program – but that will be the next blog!

Also, a child of mine pointed out to me that it is difficult to comment because of restrictions, so I have removed those and this should make it easier for anyone to post comments. We hope to hear from you!

Zambia Day 4: Chaminuka Nature Reserve

Saturday!!! No work today, but time to play :). So you get a very different kind of blog today! We left the Palmwood Lodge around 9:30 am with Sammy who turned out to be Alfred’s wife’s uncle. He drove us to Chaminuka, which took a little under 1 hour. We passed the Lusaka airport and after that we were on a unpaved road for probably about 15 km until we reached the park.

Unpaved road with dust clouds:

Going to town to sell wood (walk several miles):

 

We saw a herd of deer soon after we entered the park (impala).

 

A stroke of luck!! We hopped out of the vehicle and a safari was just leaving. The front desk said our room was not quite ready but we could go on the safari – so we hopped into the jeep with some folks from Australia and went on a 2-hour safari with John the guide, Moses his trainee and Abraham the driver! There is a pride of 4 lions in the park and they are in a restricted area. We saw them through a fence, but the scrub was too tall and we did not get a good view. We also saw a hyena, again in a restricted area, who posed for us quite nicely!

 

As our guide John pointed out to us, we saw some Homo sapiens next! 🙂

We saw a herd of zebras from afar – quite clearly since the white and black was easy to spot among the brush – BUT they were very skittish and quickly disappeared before we could get any closer :(. We also saw a water monitor lizard which looked like a long iguana-like reptile scurry across the path in front of us.

And then we came upon 3 giraffes having a “bachelor party”! They looked so serene munching away happily and did not mind our being there at all! There are 17 giraffes in the park and a bit later on in the drive we spotted about 4 more of them.

Giraffe hide-and-seek!

 

We saw several kinds of antelopes including tsessebe, impala, bushbuck, blue wildebeest, Lichtenstein hartebeest etc.  I’m sure some of these names are not accurate – BUT I did not make notes during the safari as I have been doing at all our meetings this past week!! We were really glad to sit back and enjoy the ride and not have to take notes!

 

 

We saw more deer and there are also 300 species of birds in the park and we spotted a few. There is a family of three elephants in the park (mom, dad and baby who is 6 years old). They are semi-tame and therefore we called the keeper to see where they are and then found them – eating of course! An elephant eats 150 kg of leaves each day and then leaves droppings of about 100 kg – i.e. a very ineffective digestive system someone commented in the jeep!

End of safari: with John, our guide, Abraham, the driver and Moses the trainee park ranger.

Back to the lodge and we checked in: the reception area had a great African art collection – some for sale.

Our room – the Mwenge (which is the name of a tree). Each room has a name rather than number and there was the Eland room, Bushbuck room etc. The pic does not do justice to it! The rooms are scattered around the grounds like little bungalows…

 

Interesting art work around the grounds:

The rooms are very nice and we were told lunch was at 1:00 so we arrived promptly! It was a beautiful buffet by the swimming pool with lots of varieties of vegetables and salad – it put Colombia to shame!! There was a great cauliflower dish, one with eggplant, a slaw with local greens, and of course dessert as well as various cheeses made in the park at the cheese factory there.

 

After lunch we arranged to go on a bush walk. John was our guide again and we took a 1-hour walk through the scrub. He pointed out various spoor to us, as well as interesting trees and bird calls which he reproduced very well!!

Water monitor lizard spoor:

The path we walked:

We saw a giant nest of a hammerkopf (spelling?), spoor of water monitors, as well as giraffe and elephant etc., and lots and lots of termite mounds. It was a lovely walk!

Huge nest:

 

Termite mounds:

With John, our bush walk guide:

After the walk we visited the cheese factory within the park. They have 160 cows, 43 of them milking currently, and although we were disappointed that we did not get to tour the factory to see the cheese being made, we got to do some serious cheese tasting with wine! There were various kinds of cheeses for us to taste (feta, gouda, Cheshire, Swiss, and our favorite: gouda with cumin). This is the only cheese factory in Zambia I think.

 The Kaposhi cheese “cave” (Isaac helped us with the cheese tasting):

One of the cows waiting to be milked (the cows were brought over from Holland!):

 

Jenn was happy to be able to go out for a run around the park (she has been using the treadmill at Palmwood, unable to run outside), while I decided to work on the blog! This is certainly restful after the very hectic three days we have had!

We saw a beautiful orange sky as the sun set behind our room.

After a bit of relaxation reading about Chaminuka in our room, we went to dinner. So, it is a 10,000 acre park which belongs to Andrew and Danae Sardanis. It was their home from 1978 – 1998, before they decided to open it to the public. The grounds are beautiful, the lodge full of African art and artifacts, and they set up the game reserve by bringing in some of the animals (e.g. the deer and antelope existed there, but they brought in giraffe and elephants). Anyway, it is a gorgeous place, and outshines many museums with the very large collection on display throughout.

 

Dinner was indoors since the evening was chilly, and next to our table sat an older couple whom we had also seen being served at lunch time. He asked us how long we were staying and when we asked him the same he responded “I live here; I’m the owner”! Of course since we had just read about him we jumped up and chatted with them for a bit and they were so gracious and took a picture with us! Mr. Sardanis came to Zambia in the1950s and was involved in the country’s independence from the British. For more about his story see http://www.travelzambiamag.com/index.php?option=com_content&task=view&id=2428&Itemid=47

 

Tomorrow we have more fun to come – hope you will be back to read tomorrow’s adventures! And we would love to hear from you – so please post your comments – we really look forward to them!

Lusaka Day 3

We had a very interesting day today and got a view of a different set of challenges in Zambia – read on!

Our day started with an insight into Zambian government bureaucracy! We were to tour areas at the University Teaching Hospital (UTH) – a government institution. Before we could do so, we had to have a letter of approval from the Managing Director (MD) of the institution, which had been requested by our host Alfred about 2 weeks ago. SO – we went to the Managing Director’s office to get the letter and were directed to the Public Relations office to pick up the letter. In that office was a lady nonchalantly reading a newspaper, who made no effort to help us other than ask us to be seated. After some time of waiting a gentleman came in and he made a thorough search of the in- and out-boxes and said there was no sign of any letter. Chisomo actually had received an e-mail approval, but had been instructed to pick-up an amended letter. So, she showed him the printed e-mail she had. Still he was not satisfied and trotted off again to the MD’s office again, but did finally return with a signed e-mail, stating that the unsigned e-mail that she had was worthless. Anyway, we finally had what we needed in hand, about ½ hour late for our first appointment of the day!

UTH:

 

Lots of people waiting outside the hospital:

Next stop: Pediatric Neurology Clinic. There were patients waiting outside and within one small room were three neurologists seeing three different patients all at the same time. The fourth, the head of the department was there too, but left soon, leaving me wondering whether there may be times when there are 4 patients being examined all at the same time in that small space?! HIPAA regulations clearly are very different in Zambia! We started to hear the history of a 7 year old girl who has been experiencing episodes where her eyes roll back in her head and are glassy and she falls. The doctor had a file and was getting her history, but then the mother said that the girl had had her very first episode when she was only 3 weeks old! And there were no records in her file to indicate so…..and so it goes – a 7 year old with a longstanding history of neurologic problems, with very poor prior records to help the physician currently examining her.

We had to leave the Neurology clinic to get to our next appointment with Dr. Somwe – head of the Pediatrics Department. He is another one of the wonderful people we have met in Zambia so far. He is a passionate individual who is extremely knowledgeable and cares deeply about children, and wants to do whatever he can to improve the lives of children in Zambia. He spoke to us about challenges in Zambia – for example, their hospital is so busy and understaffed that they do not have sufficient staff to do baby check-ups at the hospital. Babies born in Zambia have follow-up appointments at local clinics at 6 weeks, 10 weeks and 14 weeks when they get weighed and get immunizations. The next “jab” is at 9 months he explained and a lot of babies are lost at that time and do not return for check-ups. How, when we cannot even do baby-checks at the hospital can we even think about screening them for hearing loss he exclaimed! He is trying to make change happen, but the system is difficult and collaboration and team work which he sees as very important in good health care is very much lacking. He also said they use aminoglycoside antibiotics liberally, without thought of the consequences, and that outer ear malformations are not explored further to determine whether there is any underlying sensorineural hearing loss. We also learned that the specialists in Zambia do not necessarily have the training that we would think they do – for example the neurologists are neurologists because they had a special interest in that area and chose to follow it, rather than receiving additional training in that area as they do in the US. We really liked Dr. Somwe and he was so open to collaborating with us to see if any positive change can be effected for Zambian children.

Pediatrics:

 

With Dr. Somwe:

Next we had a tour of the school for children with special needs at UTH. We walked through classrooms ranging from pre-school to the “16+” room which focuses on skill development and saw children with a wide variety of impairments (intellectual handicaps, autism, Down syndrome, hearing loss, etc.) all grouped together in classes. And the classes have to follow the same curriculum (which is set by the government) as regular schools. In the 16+ room we did see older kids learning to weave rugs and some of them doing a fine job! There is also a school for the deaf on campus, but the head teacher was out and we only had a glimpse of kids horsing around in the hallway.

UTH Special School:

 

Next, we went to Beit Cure Hospital to meet the Medical Director, Dr. Georgio Lastroni. He is a very energetic, charismatic, and pragmatic person, who seems perfect for the position as director of a non-profit hospital. He was very clear as to the vision of their hospital and the need for fundraising and donations to keep their work going.

 Fruit vendor on the street on the way – it is common to see them selling newspapers in the morning, and also tomatoes, oranges, and today we also saw avocados.

On the way to lunch – images of school children and their living spaces:

And interesting modes of transportation (a la India!)

Lunch was at the Mint Lounge (another great choice by Chisomo) with a 10 year old boy with a cochlear implant and his mother. Their story: he received hearing aids at about age 3, and the parents have been set on using oral language with him. About 10 months ago he went to India to get his CI (no – they are not possible in Zambia). They lived in India for 8 months after his implantation and received intensive therapy, but since their return, his mother says that he is making less progress because of the lack of speech therapy in Zambia. They have recently started with Chisomo – who is pretty much the only speech therapist in the country! And they plan to go back to India for 2 months in the fall to get therapy again. What a challenge for a family to have half the family in another strange country getting surgery and therapy while the other half remains at home. And Liam was such a bright child and so extremely social.

Our last stop of the day was at Cheshire Homes which is a facility for children with physical disabilities. This was a very impressive facility run by nuns and we met briefly with Sr. Marjorie who was on her way out the door when we dropped in! She was so kind to give us a few moments and we learned that they take in kids from all over Zambia with physical disabilities and the kids and mothers stay with them if needed, as long as needed. Children get free surgery at Beit Cure (or another one that provides free care), and then stay at Cheshire Homes free until they get the needed rehabilitation before they leave. During their stay they also continue their education and the nuns work to get them incorporated back into society. After three days of visits to so many places, I was almost moved to tears by all that we have seen and this remarkable nun who is running such a wonderful facility!

Cheshire Homes

 

Chisomo dropped us back to the hotel where we experienced another Zambian challenge – the hotel had been out of power since about 11am. Fortunately, the laptop was charged and we could use it but because of no power we also had no water and as it grew darker, we were provided 2 candles in our room and also requested a bucket of water to freshen up after the long day and fill up the toilet tank! We were exhausted and just enjoyed the quiet and darkness for a bit.

Dinner at the lodge was on – and with the use of a generator the kitchen and dining room had power – so we actually did not have to eat in the dark as I had feared! For dinner we had a nice pasta with greens and vegies on the side. I have certainly had a MUCH better dining experience in Zambia than I did in Colombia as a vegetarian!!!  Also, we tried the Zambian staple called “nshima”. It is made of milled corn that is stirred and stirred and ends up as a heavy smooth paste which is typically served in a football shape. It has no particular taste of its own, but with the accompanying tomato sauce, we ate some! It is the typical Zambian staple, and some families with low income are restricted to eating nshima 3 times a day.

 

After dinner we went back to the room to pack by candlelight! We are going to Chaminuka tomorrow for the weekend and are excited to have a break from all the meetings and enjoy a safari! We were so busy packing in the dark, we did not even know the power was back until Linda (from the reception desk) came to let us know! And with the power the water was back also – hurrah for Zambia!!!!

 

Lusaka Day 2

Sorry the breakfast at the lodge pic did not make it on the last entry – here it is!

Beware – today’s entry is a long one!

Today’s schedule included meetings with the Medical Director of Beit Cure Hospital, faculty and administrators at the University of Zambia (UNZA) and Audiology clinic observation at Beit Cure. We learned the importance of being flexible and going with the flow as the schedule had to be changed in the middle of the morning. Due to the schedule change, we also ended up having a wonderful afternoon of “play” after a good morning’s work! And, we owe Chisomo a huge debt of gratitude as she drove us around all day again, for a second day in a row!

 We had an early start today and were ready to go at 7:30am. However, the Medical Director of Beit Cure Hospital had already started surgery in the OR and we were unable to meet him as scheduled at 8am. So, we went on to the Audiology clinic for observation. Since Alfred, the only audiologist in the country of Zambia is away attending a conference; the clinic was being run by two nurses (Evelyn and Charity) and a technician (Patson). Patients are seen on a walk-in basis and come from all over Zambia often travelling many miles to Lusaka and sometimes having to stay several weeks to complete treatment. 

Jenn, Evelyn, Charity, Patson, Lata

We were able to observe/participate in clinic for about  1 hour-here is a summary:

The first patient I saw with Charity was a young lady who had had a fungal infection in her ears and was back for her second follow-up appointment. Happily the fungus had cleared and she was asked to come back in a month to ensure that everything remained OK. We learned that fungal infections are very common in Zambia.

I also observed an older lady getting her hearing tested. She had a bilateral mild to moderate high frequency sensorineural hearing loss. Recommendations: to come back for an annual assessment and consider amplification if she had communication difficulties. A somewhat different recommendation that what might be recommended in the US, but quite consistent with what I have seen in other developing countries.

The booth – inside

The third (and last) patient I observed was a 5 year old girl who had been referred by the University Teaching Hospital (UTH – affiliated with the University of Zambia) for grommets and adenoidectomy due to adenoid hypertrophy. Her story is what is important to understand some of the challenges of health care in Zambia. The family lives about 6 hours away from Lusaka by bus. The mother and child traveled to Lusaka on May 27^th. They saw the physician at UTH last week and he referred them to Beit Cure since there is an ENT surgeon available there (there are 5 in the whole country). She came on Tuesday but was asked to return today (Thursday), because the audiology clinic has outreach services on Tuesdays and are not available at the hospital. After the tests today she was asked to return next week since the ENT surgeon is attending a conference. My guess is that next week she will see the ENT and then be asked to return again for surgery. SO – the mother and child have been away from home, leaving her older sister and rest of the family, for 3 weeks or more, staying with relatives in Lusaka, just to get treatment for her otitis media with effusion.  So, although services at Beit Cure are free, many poor families are unable to do this and thus lack access to medical care due to distance and inability to travel. Also, this leads to families often waiting until the problem is quite severe before even thinking about seeking medical care.

The booth – tester side

Jenn also saw three patients with Evelyn.  The first was a 9 year old boy with profound hearing loss (wears power BTE hearing aids) with fungus in both ears.  The nurse suctioned the ears and prescribed drops for 1 week and then recommended that the boy return in 2 weeks for a check.

The next patient was a 16 year old boy with hearing aids, one was lost 1 year ago and the other was not working.  His last appointment was in December and he had fungus at that time.  No fungus today, but impacted wax.  It was very dry so drops were prescribed and he will come back for suction in 2 weeks.  He also will have an audio and hopefully get new hearing aids.

The last patient was a 9 year old girl who had impacted wax and fungus in one ear.  The nurse attempted suction, but the child was so uncomfortable the nurse was unable to finish.  The patient was prescribed drops and will come back in 1 week to attempt suction again.

SO – hearing aids are provided free to poor children and adults, but only BTEs. Earmolds are made right there in the Audiology clinic by Patson. Paying patients can choose to get custom devices, but these are ordered from Siemens South Africa.

Our afternoon appointment was moved up to 11:30, so we rushed from the hospital to the UNZA campus. 

We were a few minutes early, so we wandered around campus. Jenn was challenged to a game of checkers by a young man (Ken) and boldly took it on!!

First we met with Dr. Beatrice Matafwali (one of only three women on the University faculty with a PhD)! She is the head of the Department of Education and was a delightful person to talk to! We discussed the goals of our program including trying to meet some of the needs of Zambia in terms of audiology services, as well as possible collaboration between Purdue students with UNZA students. Dr. Matafwali spoke about some of their challenges and brainstormed ideas with us and also gave us a tour of their assessment center. We also met with the Dean of the College of Education Dr. Oswell Chakulimba. Both were very positive about a collaboration between Purdue and UNZA and Dr. Chakulimba expressed interest in formalizing a memo of understanding between the two institutions! This was an extremely positive outcome from today’s meetings and we are excited at all the possibilities!

The boys dormitory

 

The Education building where we had our meetings

Since we completed the afternoon meetings in the morning, we then went to lunch. Chisomo picked a really special place called Sugar Bush. It is a bit of a drive outside the city, but is a restaurant with a Zambian craft shop also.

The countryside on the way to the restaurant

Sugar Bush

Garden outside Sugar Bush

Organic vegetable garden outside Sugar Bush

Lunch! (Chisomo and Jenn)

Lunch was great and then we went shopping!!!! Of course, we count this as “scoping out good shopping places for the students who will accompany us next year”!! We went to two regular stores beside each other. First to Africolor – where they sell local goods including fabrics and clothing made of “chitenge” fabric – a local quilted fabric, as well as some pottery, etc. This was the first store in Lusaka which accepted a credit card!!! We were so excited 🙂

Next door was the store “Ntizo” which means “heavy” in Swahili. This was a very interesting place – they scour and find boat wrecks as well as buy old boats (called dhows) that can no longer be used from Tanzania and make cool furniture as well as artsy stuff from it!! A very interesting story! Notice the beautiful old wood chandelier!

 And then, we went to the Kabwata Cultural Village – this was a GREAT place for bargain shopping. There were local vendors selling their wares in small huts ranging from bags, beads and jewelry, wood carvings, etc. etc. And in this place you bargained and negotiated prices down to about half what they asked for the item. We had a very successful shopping experience, both at the more upscale stores as well as at the cultural village where we patted ourselves on the back for our bargaining skills!

 

After a brief return to the hotel, while I worked on the blog and Jenn ran on the treadmill, we decided to try our first outing by ourselves J We took a taxi to a mall nearby and checked it out. There were several restaurants and a movie theater and a casino! We thought it would be a good place for the students to hang out.

And finally, we bought a small gift for Chisomo for all her help (and it was her birthday today!). BUT – we had no gift bag or wrapping paper. I learned how creative Jenn is by the bow she made out of colored plastic shopping bags!!!

More tomorrow!

Lusaka Day 1

Breakfast at the Lodge:

 

And then we waited for Charity from Beit Cure Hospital (http://cure.org/hospitals/zambia/) who was supposed to pick us up to take us to the hospital. While we waited we met Donald who is from the UK and stays at our Lodge. He helped us set up our local cell phone while we waited and told us of interesting places to go. He has been living in Zambia for 4 years. While waiting we also saw an unusual sight at a hotel – a lady drying peanuts in the sun! Zambians use peanuts in their cooking a fair bit!

The grounds of the lodge – look like a beautiful park

 

When his driver arrived, he was kind enough to drop us off at the hospital. There we found Charity (Business Manager of the hospital) who told us that Chisomo (our other host) had her car battery die that morning – hence the delay in picking us up! Anyway, Charity gave us a tour of the hospital. They are a specialty hospital primarily providing neurosurgery, orthopedic surgery and ENT/audiology services, mostly free to needy children.  So, basically they are a non-profit, but they have a “private wing” for paying patients with 16 beds. And Chisomo had a wonderful welcome gift bag for each of us with candy and Zambian bracelets and earrings! We were really touched by the thoughtful gifts!!

Charity (standing) and Chisomo

As part of the tour we also saw the rooms they have where we could possibly stay when we come next year – functional rooms in almost a small house with an equipped kitchen and dining room. The hospital is on 43 acres with several red brick buildings with green roofs.

Lunch: in “The Deli” – a brand new restaurant with Panera style soups and sandwiches. Very nice!

Then we visited CFB Medical Center – this is a fee for service hospital (unlike Beit Cure) and provides mostly primary care and maternity services with some special services. We gathered information on their costs and services. In case we need services, this is where we might go to get medical care. It was a very different experience from hospitals in the US. The hospitals are much smaller hospitals here with only 30 beds or so. They were clean and functional, but not fancy.

Our final visit of the day was to the Special Hope Network (http://www.specialhopenetwork.com ). This is a non-profit which works with children with intellectual disabilities and their mothers providing basic physical, occupational and communication therapy services, and training local Zambians to do this as well as the mothers of the children. This was the most moving visit of the day – here were three westerners who have moved to Zambia permanently and work in the “compounds” (the overcrowded settlements where the poor live with some of the poorest people in Zambia.

With translator at Special Hope Network (mothers and kids in the background)

Our next stop: to get an internet “dongle” which is a USB stick that you plug into your computer and purchase internet access with (really needed that to continue the blog since the hotel did not have Wifi)! SO – we Chisomo took us to a rather modern mall where we got the dongle as well as some Zambian kwachas (FYI 1 USD = ~ k5300) and some bottled water and fruit. Then back to the lodge where the chef had prepared some special vegetable stir fry and stir fried rice for us! The people are extremely friendly and everyone has a warm and welcoming smile for us! It is a great place to be!

Grocery store – not much different from the US!

The first escalator in Zambia – at the Manda Vila Mall