Take-home message from the trip

From Dr. Kristi Meyer:

With our time in Zambia drawing to a close, Dr. Carey has been asking the students to start thinking about their take-home message from the trip. What one interaction or experience or thought will stick with them the most as they leave Zambia and head back to their final year of nursing school at Wisconsin Lutheran College? And what will they do with that take-home message?

I’ve been thinking about my take-home message as well. As the only non-health care member of the trip, my experience has been a little different than everyone else’s. I haven’t spent time in the clinics of Lusaka. I haven’t interacted with the patients who came for care for HIV testing. I haven’t had conversations with the Zambian health care workers and seen how the conditions here are different from back in the United States.

2014-05-Zambia-Student-activitiesInstead, my trip has been focused on education. I took students out to two different Lutheran schools in Lusaka and supervised presentations on oral hygiene, fire safety, and water sanitation. I watched the students present to the Seminary wives, the women who will serve alongside their husbands in the field in the near future. And perhaps most poignantly, I sat in on the students’ presentations on HIV and associated issues at the rural clinic at Mwembezhi. I have been so impressed by our nursing students over the course of our two weeks here. They have done a wonderful job with all of these health education presentations, despite working through cultural and language issues.

As a consequence of my role on this trip, my take-home message is education. In our daily debriefings, there are certainly positive stories to be shared. But the overarching theme comes back to the need for better health care in Zambia. That’s where education comes in. I firmly believe that education is the key to improving the health care system in Zambia. More education is needed for the clinical officers, the nurses and community health workers, the midwives and traditional birth attendants, and most of all the patients. With education comes knowledge, and with knowledge comes change.

And that’s where I hope our students realize the impact they have had through this trip. From their stories, I can tell they’ve learned a lot and have had some wonderful conversations in their clinical settings. But because they are still students, their primary role in these settings has been to observe. In contrast, they have been actively doing and teaching in their health education presentations. They have been imparting valuable information to the students and community members. They have been making a difference by sharing their knowledge.

Because we are “mzungus,” we stand out here. We are an anomaly. We are something different for the population to experience, something out of the norm in their everyday life. Maybe they will go home and tell their family members and friends about us. Maybe they will also share some of the health education lessons they learned from us.

What will I do with my take-home message? I’ll continue to encourage our students to be educators as well as nurses. I’ll do my best to share my experiences from this trip and talk about what I heard and saw here. Most importantly, however, I’ll pray for the people here that we presented to. I’ll pray that our messages were heard and understood. I’ll pray for the physical and spiritual health of all the people we interacted with over the course of our two weeks here. And if even one Zambian has a better health care experience because of something we said and did, then our trip will have been worth it. Through God’s grace, we will have made a difference.

At Chelston Clinic

From Hailey, a Wisconsin Lutheran College nursing student:

Today I was at Chelston Clinic, which is about a 30-minute walk from the Lutheran seminary in Lusaka. I spent the morning in the HIV testing area. One patient that came in was an 8-year-old boy. He was brought in by his mother to be tested for HIV. His mom is HIV positive, but the boy had not yet been tested.

I went in with a volunteer into a room with the mother and son. The volunteer explained HIV as an enemy soldier in the body. She also talked about ways someone could get the enemy soldiers (i.e., methods of transmitting HIV). She explained to him that we were going to test his blood to see if he had the enemy soldiers.

We then went to go test the boy’s blood. They used two tests to determine if he was HIV positive. We had to wait 10-15 minutes to get the test results.

The volunteer and I took the mother and son into a private room to give them the results. It turns out that this boy is HIV positive. It broke my heart to hear this. This innocent boy will have to spend the rest of his life on antiretroviral therapy. Going to Chelston Clinic was definitely an eye-opening experience.

An unexpected walk

From Becca, a Wisconsin Lutheran College nursing student:

On Thursday, everyone left the Lutheran Seminary in Lusaka by 6:30 a.m. to depart for a rural clinic in Mwembezhi. Our two-hour bus ride was short compared to the drive last weekend to Livingstone. The last leg of our journey consisted of traveling on a dirt road and villagers stopping and waving at the bus full of “mzungus” (white people).

When we arrived at the clinic, there were more than 50 people gathered outside underneath mango trees waiting to be seen and receiving health education from the community health workers. It was “under five” day at the clinic, so the majority of the patients were women and their children under five years old.

Julia, Sarah, Courtney, and I provided health education to the patients on fire safety. Since women in the rural areas of Africa typically cook meals over a fire, they and their children are at risk for respiratory issues and burns. During our presentation, we had the privilege of working with an interactive interpreter who translated our presentation into Tonga, the local language. At the end, we demonstrated “stop, drop, and roll” – what to do if they were on fire. Everyone watching was surprised that nursing students from America were rolling around in the dirt!

The patients were responsive to our teaching, asked questions, and even thanked us for showing them how to stop, drop, and roll – a new concept for them. Overall, I think our health education in our two days at Mwembezhi – covering the topics of water sanitation, fire safety, oral hygiene, and HIV/AIDS – left an impact on the community.

After the clinic day was over, we loaded up on our bus to head for our lodging in Kamamba, a village about 3 km or 1.8 miles from the clinic. Our driver, Fasty, couldn’t get the bus to start. Whoa-oh. We all piled out and decided that our best shot was a push start. I personally don’t think you can bond any better with your fellow nursing students than sweating and pushing a bus on a dirt road in Zambia.

Unfortunately, our muscles did not start our bus. It turned out that it needed its battery changed. So we threw on our backpacks and pillows and began our 3 km walk to Kamamba. I loved our walk! We passed fields of cotton and maize (corn) and had the amazing opportunity to watch an African sunset out in the bush. Groups of children began following the trail of white people. We were pretty popular by the time we reached Kamamba, safe and sound!

ART clinic in Mwembezhi

From Ashley, a Wisconsin Lutheran College nursing student:

On Thursday, our group traveled to Mwembezhi. I went to the ART (antiretroviral therapy) clinic for HIV patients with Alissa and Alex. I was shocked at how differently things were done compared not only to America, but also to the other ART clinics I’ve been to here in Zambia.

The room was a square with cement benches lining the walls. All the patients came to sit on the benches while the clinical officer sat on the bench closest to the door. The patients would wait quietly until it was their turn, but they could see and hear everything the clinical officer was saying to the other patients – no HIPPA privacy!

After doing a very brief assessment, the clinical officer wrote out prescriptions for medications. He let Alissa, Alex, and me write out a few and then he would sign them. Overall it was a very interesting and eye-opening experience.

Later that night at our lodgings back at Kamamba, Kayla, Alex, and I ventured out to the chimbuzi, or “bathroom,” literally a hole in the ground inside a small concrete building. Alex and I were very cautious, so Kayla volunteered to go first. After walking into the first chimbuzi “stall,” we heard Kayla scream and then she ran out. There was a massive spider in the chimbuzi! Then she went into all the other sections and found many more spiders. After deciding against going to the bathroom in the bushes, she finally got the courage to enter the least intimidating chimbuzi. While she was I there, Alex and I sang songs to her for comfort.

After a lot of convincing, I went into the chimbuzi, with more songs of comfort to ease my fears. That was definitely my most terrifying experience here in Zambia, but I’m glad I have such great friends to sing me songs throughout the experience.

Basic necessities

From Amanda, a Wisconsin Lutheran College nursing student:

On Thursday, our group traveled to the Mwembezhi Health Clinic, about 100 kilometers or 60 miles from Lusaka. Katie and I started out in the ART room (antiretroviral therapy room), where medications were being given out to new HIV patients. New patients were given a two-week supply. Over the course of a year, they slowly work their way up to being dispensed a three-month supply. This allows the clinic workers to more closely track drug compliance with new patients.

The worker handing out the medications was actually a part of the cleaning staff but was trained to help out with the ARTs. She seemed to really care about the patients and made sure to have a positive interaction with each of them. When patients who were just beginning ART came in, she made sure to thoroughly educate the patient on the medication.

She stressed taking the medications at the same time every day, but this appeared to be a problem for one of the patients. Katie and I figured out that this patient did not have access to a watch, clock, radio, or anything that would tell her what time it was. The health worker said that she could go buy a watch for five kwacha (about $1), but I am not sure if that will actually happen. It is astonishing to think that in this day and age, there are individuals who do not have access to so many things we consider basic necessities. Clearly, the need is real.

Welcome message

A welcome message to the Wisconsin Lutheran College nursing group, from Community Health Worker chairman, Mr. Munyati:

HONOUR: Delegate leader from the USA, Chairman NHC Mr. Makusa, Clinic Officer Mr. Kalekwa, USA students, Traditional Birth Attendants, Community Health Workers, Members of staff. Oh, I just say you are all welcome to Mwembezhi Lutheran Clinic. For the interest of our visitors, Mwembezhi means “a shepherd.” And for sure Mwembezhi clinic has been shepherding this area in devotion and good health.

This missionary work in Africa, Zambia in particular has been marvelous. We have been healthy simply because of the health centre the mission brought to this place some good years ago.

Choosing to come to Mwembezhi health centre is a blessing. There are many countries you would have wanted to go, but thank God you opted to come to this pace.

Zambia is one of the democratic countries of Africa which enjoys peace. But we are in war and this war is poverty, HIV/AIDS, maternal birth rates, and good sanitation. Many residents do not manage to have just a dollar for their daily food. Hence the contribution from USA such as drugs, funds, and resource personnel has been working very much in our country and in our local community. We salute your tender help you are rendering to us.

The hospitality of Mwembezhi clinic in the area has brought a lot of challenges. Many patients or clients opt to come to this centre. As a result we are facing this problem of transport, read more here canadianpharmacyon.com.

We have suggested to build a guest house that will be hosting visitors like you. When we finish such a house we humbly request the mission work in USA to be sending nurses or students for their field work to let us lighten the burden of resource personnel we are facing.

Thanks very much. May The Lord bless you.

Health education in Mwembezhi

From Jaimie, a Wisconsin Lutheran College nursing student:

Today in Mwembezhi, we did some health education with the people who live in the area. One group taught fire safety. They already knew that raw eggs were good for burns, and they really got a kick out of the “stop, drop, and roll” method.

My group taught about oral hygiene. We wanted to make sure they knew the importance of a healthy mouth and brushing teeth. They didn’t understand the word “floss,” but they did get the concept of flossing.

Overall, the crowd was great! They participated and asked a number of questions. I am so glad we were able to impart some of our knowledge to the people of Mwembezhi.

At the Seminary

From Courtney, a Wisconsin Lutheran College nursing student:

There are many connections made in the WELS. I was playing with the Seminary children today when a Seminary student named Bismark came up to me and asked if I knew Pastor Dan Kroll, who had once been a missionary here in Africa.

This student was from Malawi, and Pastor Kroll had encouraged Bismark to attend the Seminary and become a pastor. ?Bismark is now graduating from the Seminary on Friday, and will move with his family to serve as a vicar and then a pastor. ?It was inspiring to hear how one missionary encouraged a man from Malawi to be a pastor… and I have confidence that he will be an excellent one.

Home-based care

From Katie, a Wisconsin Lutheran College nursing student:

Today I had the wonderful opportunity to partake in home-based care (HBC) with Paul and Jaimie. I was uncertain of what to expect, yet anxious to see what was in store for this gorgeous sunny day in Lusaka.

When we arrived in the Chamba township, I immediately became humbled. As we walked to the patients’ homes, rocks, broken glass, and garbage covered the dusty dirt roads. At times, the soft breeze brought a strange odor. Barefoot children chased each other while roosters trailed around pecking for food. Bright colored pants and shirts hung out to dry at several homes.

I found it quite entertaining when the children pointed to Jaimie and me yelling, “Mzungu!” (white person). ?As we were walking, some children even followed us around, amazed at seeing white people.

The thing that moved me the most during my time doing HBC, though, was giving a female patient her Piggly Wiggly tote bag filled with toothbrushes, floss, pens, encouraging cards, and a small toy. Up until that point, she was quite despondent and clearly appeared ill. As soon as she held her bag, happiness and gratefulness quickly overcame her. She tightly clutched the bag to her chest as she expressed her gratitude. Seeing her ear-to-ear grin and appreciation warmed my heart and gave me goosebumps.

I can honestly say that today’s clinical has had the most impact on my heart and mind. ?I am so thankful to God for all the blessings he has showered upon me. ?Being immersed in Zambian culture on a more personal and intimate level has definitely made me more appreciative of my own life and how good I truly have it.

At the Linda Compound

From Courtney and Hailey, Wisconsin Lutheran College nursing students:

On Thursday, we drove with Paul to the Linda Compound on the outskirts of Lusaka. ?Our main mission was to host a free blood pressure clinic in the Lutheran church parking lot to screen residents for high blood pressure. We set a record for attendees with 43!

This record was possible due to the help of several community volunteers: Patricia, Jane, and Beatrice. ?These volunteers aid people in their community who need medical attention through a home health program. They do not get reimbursed for their help. They use their community influence to convince residents to get their blood pressure tested. This screening was a wonderful way to reach out to the members of the community for physical aid that could potentially lead to spiritual aid as well.