Got to meet my first baby named after me last week -- a lady I did a
C-section on about a month ago. Unfortunately, I couldn't find my
camera and she was headed back to the village, so there's no pictures,
but you can rest assured that he was very handsome at one month. :) No
one names their babies before they are born -- or even for several days
afterwards, for that matter -- so there's some opportunity to make
suggestions if they are interested. We spend a lot of our call doing
obstetrics here; with the average family size around 7-9 people, you can
imagine how busy that can get at times. It's more fun when there's
these personal connections, though. Does anyone else want me to be
suggesting their names to potential mothers?
Monday, June 16, 2008
Tuesday, June 03, 2008
comfort zones
Hello to all! It's been too long since I've been in touch from Mukinge! I admit that I've been playing a little bit of hooky over the past few months as I took some time out to visit with my parents and see some beautiful animals in Botswana. Those times are really hard to express well in an email -- the scale is just too big to get across with pictures or words. There's a comfort, or peace, to put it better, in time spent looking into a red sunset with your family as the tower of giraffes gracefully graze in the distance.
I've found my role at the hospital changing a little bit over the past few months as I try to get involved more with the local communities doing education and mobile clinics. In April as the result of brainstorming with the district health nutritionist, our nurses on the malnutrition ward, and some of the doctors, we decided to put together a community-based malnutrition project aiming to address barriers to growing protein-rich foods, and then to provide seed for protein-rich foods like beans and peanuts to the families that successfully completed the educational part of the program. So far we've had a lot of interest from the local community and we have had close to 300 families sign up -- could be quite a challenge providing food for that many families come October! Right now, we still don't know where the funds will come from to provide seed for that many people, but we are confident that we will be able to provide. It's been a stretch for me to do something like that without having all my 'ducks in a row' before I get started, but I've been changing what I feel comfortable with in the knowledge that we will be cared for, like we've been cared for 50 years. I don't really like the phrase 'out of my comfort zone' -- it seems overused these days, and maybe not all that applicable to a place like Africa where the entire continent is sort of one big 'uncomfortable zone' as you face issues of malaria and overwork and problems with things like water and electricity. But I've consistently found that the places where I need to be working are often just a little bit outside what I think I 'should' be doing. Gracefully, I also find that when I arrive at those places, they are just the place where I am supposed to be.
Last week I substituted for our executive director, Mr. Fumpa, in the hospital's mobile eye clinic. I drove off for two days to what was perhaps the center of the dust universe to see people complaining of 'smoke' and 'darkness' in their vision. After two days of peering through dust and smoke myself (it's now burning season in Zambia, when they burn all the fields) I could sympathize well with them and their vision problems. These community experiences have been a change for what's comfortable for me as well -- doing work in the hospital -- as I face life without the comforts of electricity or running water or the comfort of people who can help translate for me if I'm getting stuck with my Kaonde. One of the things weighing on me as I begin to contemplate what will happen after I leave is the general discomfort of needing to leave the programs behind in the hands of the local people, who may or may not be able to carry on after I've left. I'm starting to face the reality of my leaving more and more and am doing my best to encourage and identify local people to provide the impetus that most of these programs will continue to need. So much of development aid these days is focused on 'sustainability', which is a concept that falls well short of the mark in places as poor as rural Zambia. You often need outside resources to overcome barriers like transportation and communication that we take for granted at home. I think what we need is 'sustained interest' from the rest of the world, which is perhaps a concept that's even trickier than sustainability.
There's a lot more going on the hospital that I could tell you about -- the fruits of some of the seeds that we planted last year are coming ripe: a new restaurant, a rehab of the admin block, the new nursing student dormitory, a HIV counseling center, internet access in the hospital, completing the construction of two more staff houses, beginning on our apartment complex, and so forth. We've seen some miraculous recoveries that have had the docs scratching their heads and wondering how that person pulled through. I have enjoyed seeing the basketball/tennis court put to good use almost every single day by the local youths and kids of the community -- makes the effort worth it. My current goal is to find an ice cream machine for our new restaurant (a person can dream, huh?). And as always at Mukinge, for every up there is a down -- this week we had a 14 year old boy die from cancer after traveling 4 days to get to the hospital. I had a 1 year old boy die under my hands while doing my eye clinics because there were no IV cannulas to transfuse the patients with severe malaria at the clinic where we were at. And despite our overall infrastructure progress we've continued to have issues -- the telephone system is down, the electrical transformer is about to go and causing electrical fluctuations which have caused the burnout of two water pumps, leaving us with a tenuous water supply. Funds that we've raised have lost value as the dollar becomes weaker and the price of oil continues to rise, making transport in the rural areas even more expensive.
You all have been so generous with your support, emails, and finances to the hospital while I've been here, and I wanted to say thank you once again. My current goals are to be finishing up around 6 months from now and spend some time in the states working and thinking about my future, so hopefully I can catch up with all come next Christmas season!
All the best,
Matt
I've found my role at the hospital changing a little bit over the past few months as I try to get involved more with the local communities doing education and mobile clinics. In April as the result of brainstorming with the district health nutritionist, our nurses on the malnutrition ward, and some of the doctors, we decided to put together a community-based malnutrition project aiming to address barriers to growing protein-rich foods, and then to provide seed for protein-rich foods like beans and peanuts to the families that successfully completed the educational part of the program. So far we've had a lot of interest from the local community and we have had close to 300 families sign up -- could be quite a challenge providing food for that many families come October! Right now, we still don't know where the funds will come from to provide seed for that many people, but we are confident that we will be able to provide. It's been a stretch for me to do something like that without having all my 'ducks in a row' before I get started, but I've been changing what I feel comfortable with in the knowledge that we will be cared for, like we've been cared for 50 years. I don't really like the phrase 'out of my comfort zone' -- it seems overused these days, and maybe not all that applicable to a place like Africa where the entire continent is sort of one big 'uncomfortable zone' as you face issues of malaria and overwork and problems with things like water and electricity. But I've consistently found that the places where I need to be working are often just a little bit outside what I think I 'should' be doing. Gracefully, I also find that when I arrive at those places, they are just the place where I am supposed to be.
Last week I substituted for our executive director, Mr. Fumpa, in the hospital's mobile eye clinic. I drove off for two days to what was perhaps the center of the dust universe to see people complaining of 'smoke' and 'darkness' in their vision. After two days of peering through dust and smoke myself (it's now burning season in Zambia, when they burn all the fields) I could sympathize well with them and their vision problems. These community experiences have been a change for what's comfortable for me as well -- doing work in the hospital -- as I face life without the comforts of electricity or running water or the comfort of people who can help translate for me if I'm getting stuck with my Kaonde. One of the things weighing on me as I begin to contemplate what will happen after I leave is the general discomfort of needing to leave the programs behind in the hands of the local people, who may or may not be able to carry on after I've left. I'm starting to face the reality of my leaving more and more and am doing my best to encourage and identify local people to provide the impetus that most of these programs will continue to need. So much of development aid these days is focused on 'sustainability', which is a concept that falls well short of the mark in places as poor as rural Zambia. You often need outside resources to overcome barriers like transportation and communication that we take for granted at home. I think what we need is 'sustained interest' from the rest of the world, which is perhaps a concept that's even trickier than sustainability.
There's a lot more going on the hospital that I could tell you about -- the fruits of some of the seeds that we planted last year are coming ripe: a new restaurant, a rehab of the admin block, the new nursing student dormitory, a HIV counseling center, internet access in the hospital, completing the construction of two more staff houses, beginning on our apartment complex, and so forth. We've seen some miraculous recoveries that have had the docs scratching their heads and wondering how that person pulled through. I have enjoyed seeing the basketball/tennis court put to good use almost every single day by the local youths and kids of the community -- makes the effort worth it. My current goal is to find an ice cream machine for our new restaurant (a person can dream, huh?). And as always at Mukinge, for every up there is a down -- this week we had a 14 year old boy die from cancer after traveling 4 days to get to the hospital. I had a 1 year old boy die under my hands while doing my eye clinics because there were no IV cannulas to transfuse the patients with severe malaria at the clinic where we were at. And despite our overall infrastructure progress we've continued to have issues -- the telephone system is down, the electrical transformer is about to go and causing electrical fluctuations which have caused the burnout of two water pumps, leaving us with a tenuous water supply. Funds that we've raised have lost value as the dollar becomes weaker and the price of oil continues to rise, making transport in the rural areas even more expensive.
You all have been so generous with your support, emails, and finances to the hospital while I've been here, and I wanted to say thank you once again. My current goals are to be finishing up around 6 months from now and spend some time in the states working and thinking about my future, so hopefully I can catch up with all come next Christmas season!
All the best,
Matt
the problem of pain
I was the substitute eye doctor last week as I covered for our executive
director when he got called away into town for a meeting. We ended up
seeing around 200 patients in the two days that we went out into the
community clinics, and most of the time there wasn't much help in
translating, so I was amazed at how 200 people could really pretty much
manage to sum up their complaints in about 5 ways: 1) my eyes hurt, 2)
my eyes feel like there is dust in them, 3) I can only see smoke and
blackness, 4) I can see far away but I get a headache when I read, and
5) People in the distance are blurry but when they get closer I can see
them okay. Maybe that was limited some by my language skills, but
honestly, that managed to sum up close to 190 patients (the other 10
were more fun -- my favorite was the 10 year old girl who was brought in
because she couldn't see when it was dark at night, but when they turned
the lights on she could see okay -- exactly what's the problem there?).
Most people when they present to the hospital don't even describe what's
wrong, they just name the body part -- ie "What's wrong?" "Eyes." (as
if I couldn't have guessed since they were coming to the EYE clinic).
Sometimes this gets pretty funny as you get a list of body parts from
some of the older patients, like learning anatomy: "How are you
today?" "Eyes, neck, chest, stomach, back, legs, arms, head." And when
you see them the next day, it's the same: "How are you feeling today?"
"Eyes." This can be frustrating when you're trying to work out whether
they feel better or worse.
It's funny that the vocabulary to express problems is so limited,
however. At home we're taught to elicit all the parts of someone's pain
-- is it stabbing? burning? like shocks? crampy? and so forth -- but
here there's really just one word for pain and it pretty much sums up
everything. Complaining is not so much of a right. I wonder if like
the Eskimos with their 82-odd words for snow if our vocabulary points
out our fixation on pain in the states, and also being pain-free, where
here the expectation is that pain is part of life, not something to be
dwelt upon.
director when he got called away into town for a meeting. We ended up
seeing around 200 patients in the two days that we went out into the
community clinics, and most of the time there wasn't much help in
translating, so I was amazed at how 200 people could really pretty much
manage to sum up their complaints in about 5 ways: 1) my eyes hurt, 2)
my eyes feel like there is dust in them, 3) I can only see smoke and
blackness, 4) I can see far away but I get a headache when I read, and
5) People in the distance are blurry but when they get closer I can see
them okay. Maybe that was limited some by my language skills, but
honestly, that managed to sum up close to 190 patients (the other 10
were more fun -- my favorite was the 10 year old girl who was brought in
because she couldn't see when it was dark at night, but when they turned
the lights on she could see okay -- exactly what's the problem there?).
Most people when they present to the hospital don't even describe what's
wrong, they just name the body part -- ie "What's wrong?" "Eyes." (as
if I couldn't have guessed since they were coming to the EYE clinic).
Sometimes this gets pretty funny as you get a list of body parts from
some of the older patients, like learning anatomy: "How are you
today?" "Eyes, neck, chest, stomach, back, legs, arms, head." And when
you see them the next day, it's the same: "How are you feeling today?"
"Eyes." This can be frustrating when you're trying to work out whether
they feel better or worse.
It's funny that the vocabulary to express problems is so limited,
however. At home we're taught to elicit all the parts of someone's pain
-- is it stabbing? burning? like shocks? crampy? and so forth -- but
here there's really just one word for pain and it pretty much sums up
everything. Complaining is not so much of a right. I wonder if like
the Eskimos with their 82-odd words for snow if our vocabulary points
out our fixation on pain in the states, and also being pain-free, where
here the expectation is that pain is part of life, not something to be
dwelt upon.
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