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 27th. 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
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!!!