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!
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.
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!
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!!!!