Today was our first full day at Beit Cure Hospital, which is actually our primary community partner. We reached there promptly at 9am as requested, to find the Audiology/ENT waiting room already full of people! Christi and I went in and met Dr. Uta in her office. Alfred was not in his office so I took a few minutes to walk all the students over to their respective rotations: Rachael and Alyssa to the kitchen, Kelly and Andrea to the laundry, Julia and Rachel to Physiotherapy and Amanda and Katie along with Christi to the children’s ward.
With me and Alfred in Audiology were Jessica and Breanne, and in ENT with Dr. Uta and ENT nurse Charity were Alexis and Kaitlyn. The first person I saw when I walked in was one of the UNZA students in Special Education who we had met on the day we visited campus last week. He had lost his hearing in 1998 at the age of 19 after a bout of malaria which was treated with quinine – a medication that can be toxic to the ear. On that day I had asked him if he had been tested and he said not since 1998 when he had been told that there was nothing that could be done to help him. So I had told him we would be at the hospital and asked him to come for an assessment. I guess I was really hoping that he had some hearing and could be helped – but I was wrong. Precious one of the audio technicians had already assessed him and when I looked at his audiogram it was clear that a hearing aid would not be useful. I felt awful that he had come here upon my recommendation but there was nothing I could do to help. We talked for a few minutes with me writing notes to him – my lack of knowledge of sign language is frustrating at moments like this – and he asked about a cochlear implant. I had to tell him that they were not available in Zambia but that I knew a family that had taken their son to India to get an implant. He asked about anyone who could sponsor him for this as it would be very expensive and I had to tell him that I did not know but would try to find out. It was very sad and reminded me of the teacher I had met last year at the Deaf Bible Baptist School with an identical story. Two smart young men, who in the right circumstances would have had every opportunity to be able to hear and continue to use the spoken language they already had, but given their circumstances have no other option but to use sign language. Life is just so unfair, that some people have so much and others have so little available to them. I did later talk to Alfred about this and asked if he knew of any avenues for help – we will have to discuss this more. But – even if an implant is obtained, who helps with the follow-up care? The re-programming, the repairs if needed, etc. etc. – it is not an easy situation and I wish I could do something…..
After that I got busy with patients! Breanne was in the new booth with Alfred while I was with Jessica in the older booth that we had used last year. Precious, the new audio technician was with us for some of the time also, especially in the beginning as we got going. Between 10 – 1:45pm Jessica and I saw 11 patients with a wide variety of problems:
- A 48-year old man who complained of “echoes” in his ear but had normal hearing
- A 65-year old lady from N’Gombe compound who has had a history of chronic ear disease and is now being referred for a hearing aid. Again I spoke with Alfred to see if she was interested since we have hearing aids available for her. We hope that she returns tomorrow for the fitting
- A 37-year old lady who got hearing aids 4 years ago – but had a conductive hearing loss – again likely subsequent to ear disease
- A 1-year old for tympanometry – he got normal results. But , a funny story about this: Both Jessica and I looked at his paperwork and saw the date of birth which read –/–/13. I said “This is an older gentleman” (thinking it was 1913) and somehow Jessica agreed and went out calling for “Mr. ——“ only to have a mother bring in her small child born in 2013 for the test!! It was funny moment in a busy morning!
- A 20-year old young lady and another 20-year old young man – both with perforated eardrums from chronic ear disease
- An adult who complained of his left ear being “blocked” who turned out to have a unilateral sensorineural hearing loss. We later found out that Dr. Uta did refer him for a CT scan to evaluate his auditory structures
- Two 20-year olds with unilateral profound hearing losses – it is sad to see so many individual with profound hearing losses for which we have no help to offer
- And finally a 4-year old and a 7-year old for tympanograms
In the middle of the morning my local phone rang and I answered it to find it was the second UNZA student I had met who had complained of hearing loss, asking if she could come to the hospital. Of course I said yes and she was the last patient we saw. She was one of the patient’s with the profound hearing loss in one ear, and although she knew of the hearing loss since childhood, she was crestfallen when we had to tell her that there was not anything we could do to help her other than to ask her to monitor her good ear.
Jessica did a fantastic job and was ready to try anything including tympanograms on the kids and counseling of patients! She got better at using the computerized Aurical audiometer as the morning progressed and put up with my quizzing as she was testing patients! We were the last ones to get to lunch – it was nice to see Elijah in the kitchen briefly and I got my rice, beans and cabbage served by our kitchen volunteers Katie and and Amanda and had a quick lunch.
Rabecca (Jessica’s UNZA buddy) stopped to say hello wearing her Purdue shirt!!! She had come to the hospital to see a family member and met up with Jessica – it is so nice to see the student buddies getting along together and having so many similarities in their lives despite being half way across the world from each other.
After lunch, the afternoon was rather quiet with an empty waiting room! There were a few patients for Dr. Uta and a couple for Alfred. I asked Patson if he needed any help and he gave us the job of testing and sorting donated hearing aids, which we readily started.
Once the students were doing that I had the opportunity to walk over to the ward. I walked through and saw Rachel and Julia sitting at the bedside of 2 girls who were coloring. I also stopped and chatted with a little girl and her mother. The baby (1 year old) was sitting up on her bed, dressed all pretty in a pink dress, tights and shoes. But her bulging head told the story of hydrocephalus – she is scheduled for surgery tomorrow. I stayed and chatted for several minutes – it is hard to see so many kids who are sick and have disabilities that are quite severe. Even after so many years of being a clinician, it affects me and helps me realize how very very fortunate I am to have my children.
Other students all wrapped up and came to Audiology/ENT and we waited till Dr. Uta finished with her last patient before we left around 4:30pm.
Back to the lodge and students were craving wifi in the front of the lodge as soon as we returned – even before picking up their room keys!
A short break and we met at 6pm to go to the Arcades for dinner again – the students all prefer this mall to Manda Hill for food! Christi and I stopped at the Chinese restaurant there (a new one which was not there last year). The menu did not look good (weird pictures and misspellings galore), but we decided to be brave and try it out. The food was actually much better than the appearance of the menu and it was a nice change! We stopped in SPAR again and took a few minutes to get cash and pick up some breakfast food for the students. Katie had mentioned that she had eaten a cheese scone that was delicious, so we picked up some of those and some croissants that we hope they will enjoy. So we were the last to the bus – LATE – but told them that we were sorry but we had been doing a “good deed”.
Back to the lodge, quick pit stop and then to Christi’s room for our pow-wow.
Tonight’s reflections included two incidents that the students involved handled really well and we are so proud of them for it!
- One involved a patient telling the student “You need to learn the local language”
- The other involved a patient who fainted in the Physiotherapy room and the caregiver said that she had fainted because the white people (students) had scared her
We had a discussion about these incidents and once again – kudos to the students who handled themselves professionally through these incidents so early in their budding professional careers!
- Over my three visits to Zambia, I have only encountered the most warm and friendly people, and so this was a new experience for me to hear about, deal with and discuss….
Other students had many positive things to share:
- The students in the children’s ward really enjoyed the time spent with the kids
- Students with Dr. Uta appreciated her having them look in ears through her microscope and also spoke about how she cared for her HIV positive patients reminding them about regular tests
- The students in the kitchen really enjoyed interacting with the staff there and learned to cook some Zambian food
- They discussed the power outages during the morning: so the power went out twice this morning affecting Audiology and Laundry the most! Our computerized audiometer had to be shut down both times when the power went out while Laundry had to be stopped and the students chatted with the staff
- They discussed the interesting cases seen in Audiology – very different from the cases seen at our clinic at Purdue University
At the end of the pow-wow we got a round of applause from the students when we produced the scones and croissants! I was surprised that they were SO appreciative of such a small thing that we did.
Tomorrow will be our last work day and it is hard to believe that two weeks of my third trip to Zambia are almost to the end!