Monday, March 23, 2009
Tuesday, March 17, 2009
Monday, March 16, 2009
I've composed a list of what I've missed from life in the States followed by a list of what I'll miss about Macha, Zambia.
What I've Missed in the States:
Talking with my family members on the phone and in person
The NCHS FACS department
Sitting on the love seat by the window while reading
Resources within easy reach
Milk and ice cream
The variety of food and groceries available
The Mount/Wilkens/Gilmore Dinner Club
My dance classes
Having a house to ourselves
Our washing machine
Spending time with U.S. friends
Afternoon walks and talks with Bekah
What I'll Miss About Macha:
Riding bike down a dirt road and path early in the morning on the way to school
Priscilla's nchima and relish
Visits at the homes of other ex-Pats in Macha
Hearing my students say in unison: "Good morning, Mrs. Hess!"
Laughing and chatting with Beverly
The warmth and friendliness of the people in Macha
Seeing women carrying babies on their backs
The beautiful night sky - I've never seen anything like it here!
My students who would randomly stop by the house in the afternoons
Eating lunch with Dan every day
The calm, peaceful, relaxing pace of life
The singing of the students at Macha Girls Secondary School
It's been good for me to reflect and create these lists. Hope you enjoyed reading them!
Sunday, March 15, 2009
Today is the day we leave Africa. In many ways it feels as though we've already left. Nonetheless we know we have not yet arrived at home. It remains to be seen how this experience has affected and changed us. Although we are very ready to be home, there is some apprehension about the transitions ahead. Perhaps that is a good sign, evidence that we were really here and engaged in life.
Leaving Macha seemed a bit unreal, as though, after a couple of days we'd surely find ourselves on a bumpy ride up the Macha road once more. Even though our time there was only about six weeks we had grown used to being there. As we were preparing to leave many friends asked us when we would be coming back. One friend taught us a Tonga phrase appropriate for this transition: "Akabwenene taabuli kuswangana." Loosely it means, "Those we have met we will meet again."
Thursday, March 12, 2009
Wednesday, March 11, 2009
Monday, March 9, 2009
Friday, March 6, 2009
Monday, March 2, 2009
Wednesday evening I was called to assist with a C-section at 1:30 in the morning. Because the woman was somewhat unstable it took a while. The baby (2nd twin) was not alive when delivered, but the mother eventually recovered and has been doing fine. I went back to bed around 4am.
Later in the week a team, led by the British orthopaedic surgeon Allan Norrish (Cure International), came to evaluate and treat the patients we thought could most benefit from such a specialist. Thursday afternoon they saw at least 50 patients and scheduled ten relatively major operations and about the same number of minor procedures for the next day. Some were asked to travel to Lusaka where they would undergo free hip replacements or other procedures. On Friday more patients were added to the list as needs arose (e.g. patients from OPD) and a fairly solid 14 hours were spent in the operating theatre. (The day also included a laparotomy and bowel resection by Dr. Spurrier for a man with necrotic bowel and a symphysiotomy for a woman in labor whose pelvis was too small for the baby's head). It was a busy end to a busy week, but I felt like I saw and learned a lot. I'll try to post some pictures soon.
Sunday, March 1, 2009
During the rainy season there are often shortages of food. They have outlived the previous harvest. The number of children we see here at the hospital with severe protein energy malnutrition (PEM) is disheartening. It's even worse if you hear that the fathers are well fed, or that the mother believes maize porridge is enough for children (never mind that the family has beans, groundnuts or even chicken). Money and years have been spent on rural nutrition education, and yet marasmic children are still brought to the hospital. But what good is nutrition education if there truly just isn't enough?
Today, on Sunday morning rounds, I saw a patient admitted two days ago for PEM and gastroenteritis (namely, bloody diarrhea). When I saw it this morning at 9:00 the child seemed no worse than at Dr. Thuma's evaluation yesterday. It was now getting fluids (ReSoMal) via a naso-gastric (NG) tube instead of the initial IV fluids and had been started on the hospital's severe PEM protocol. I didn't think there was much else to do at the moment. However, upon returning less than two hours later to evaluate a different patient, the nurse asked me to review this child. She said, "It seems to be collapsing." The child was not breathing. There was no pulse. I felt helpless.
The child may have died because of some electrolyte abnormalities caused by the infusion of IV fluids. You could also blame the pathogen causing the bloody gastroenteritis. But the bottom line is, this child died hungry.