card playing....shhhh

I haven't read anything prohibiting me from playing cards on the
station, although I have restrained my urges to try to swindle people
out of money by gambling. :) Nevertheless, a simple game of gin rummy
with one of my Zambian brothers last night was pretty amusing. Our
western ideas of taking turns and waiting in line are not common here in
Zambia. When you go to the grocery store, while they are totalling up
your amount, they will often attend to several other customers who barge
in with their purchases, whether a big order or just a child wanting to
buy 5 pieces of candy. Needless to say, trying to play a card game
without the concept of turns becomes a tricky prospect. I'd discard a
queen (or a Q, to a Zambian) , and he'd take the card whether it was his
turn or not. He'd then proceed to take another turn, because that
didn't count as a turn. This was the natural and right way to do
things, and although we took several breaks to explain the concept of
turns, it never really sank in. It's funny the different emotions you
go through, but you eventually end up laughing at the absurdity of it
all, and it becomes a license to have a free-for-all playing the game.
It challenges a very basic cultural assumption of my concepts of
fairness and respect and fun.
I've noticed the same thing when trying to teach people to play tennis
here; tennis in Zambia is mostly a game of hitting the ball as hard as
you can if it will go over the net. Hitting the ball within the lines,
or serving the ball, or keeping score become very secondary goals and
not usually adhered to by the kids or even the adults that play.

hope deferred

As some of you know, this weekend was supposed to be the launching of
the new satellite internet here at Mukinge. Well, the team arrived on
Thursday, but was not the team we expected. The team that came arrived
in order to survey the local people outside Mukinge what they thought of
the internet, but they forgot to actually bring the parts that would
allow the internet to be functioning here. Likewise, they didn't bring
the technical people to help set it up. So after surveying people, they
flew back to Lusaka and brought back the parts required; however, they
forgot the software to install the run the server. So we're still back
where we began, although maybe we'll have another flight next week that
will help clear this up a bit. After waiting six months after when they
said it would be installed, I guess another week or two won't make that
much difference. Don't call me on Skype quite yet, though.

So long, sucker

So long, sucker, originally uploaded by mattcotham.

This has been my temporary bridge to sanity for the past two months as I

have given up on my phone ever working properly and the vagaries of

dial-up internet. This pint-size package plugs into my computer and

allows me to talk to all of you, at least briefly and with a minimum of

pictures.

BUT.....The awaited promised day is soon to arrive, where I can call

home using Skype, and get pictures, and watch edited Lost episodes on

abc.com -- the VSAT! The satellite dish has been delivered, the

installation team has been scheduled to arrive on Thursday, and

hopefully by next Monday, without too many snafus, we'll be in

business. Updates to follow....

African yard sale

I had the opportunity to participate in my first yard sale in Africa
this weekend. Two of the missionaries who have been here for a few
years are moving back to New Zealand in a month, so this weekend was the
cleaning out of their house and selling off of all those useful things
which aren't worth the cost of shipping -- furniture, sheets, dishes, etc.
Muzungu yard sales are a much anticipated tradition here at Mukinge,
mostly because shopping experiences are so limited so it's a chance to
get some stuff that's different from the usual things you can buy.
There are tales of sales of people climbing over fences to get in early,
clawing through bushes, and hiring bouncers for crowd control at
previous events. It's more like opening day for tickets for Star Wards
than a yard sale.
This weekend was a tamer version, however, with people lining up only 2
hours before the event, and only about half the hospital staff skipping
out of work to come. Despite that, the stuff was mostly gone in 30
minutes, and by the end of the sale everything was completely gone
except for a few videos left behind; a striking difference to my yard
sale in Denver where the men came by to steal my golf clubs in the early
morning hours but I still had over half my things leftover after two
days of sale. Total raised for the local orphanage from the sale
yesterday: around 3 million Kwacha, which roughly translates into around
$750.
I will admit to not being immune to the pleasures of the yard sale; my
purchases were a lavender shower curtain to go with the pink and peach
ones that I already own, a waste basket (been looking for 2 months for
one), and a sprinkler to replace the one that got stolen last week. Not
a bad haul.

experimental chemotherapy

I've got a man on the ward these days who presented with a large growth
on his testes; like most people here, he waited until it got really big
and started bleeding until he came into to see us. There's a few
elements of community education that I'd really like to see emphasized,
but one of them would definitely be the idea that presenting earlier for
unexplained masses is a really good idea. Like the guy in the bed next
to him, who has a mass that's at least 8 inches across eroding through
the skin, pushing his cheek out and his ear closed. Or the guy in the
bed next to him, who's got a big fleshy mass in the back of his throat
which is gradually cutting off his windpipe.
We do have limited chemotherapy, and our reading said that this could
likely be Burkitt's lymphoma in his groin, so we decided to give
chemotherapy a go. Chemo is really specialized at home, with good
reason, as these drugs are pretty evil -- one turns you so toxic that
you have to even wipe their nose with gloves for 24 hours (that one's a
derivative of mustard gas from WWI) and when you pull them up in
syringes they are thick and have these weirdly beautiful and
deadly-looking oranges and reds, so it feels like injecting some strange
type of jello into his veins.
So I put on my gloves, and pulled up my array of orange and red-filled
syringes, and ran through with him about how he'd lose his hair. I
transferred the guy three beds down to the TB ward so he could cough
over there while we were waiting to determine if he had TB or not. So
we gave the meds, and now we wait and see if there will be any shrinkage
of the tumor. This is fairly experimental, however, because we don't
really know what we're treating (the chemo doctors at home won't treat
anything until it's been examined by a pathologist); so we weigh the
options and take our best guess. We'll see how he does.

Emailing: tennis partners

Emailing: tennis partners, originally uploaded by mattcotham.

These are the Griffiths, my tennis partners. You can see the somewhat

rehabilitated tennis court in the background. Construction is still

ongoing....

Transport trouble

One of the constant demands and problems for people here is transport --
with distances that range up to 70 kilometers and no regular public
transportation, even no people with a car that live out that direction,
people have to cobble together whatever means of transport they can find
-- bicycles, finding a ride with the mining trucks, various people going
around or good samaritans willing to give them a ride. Today we had a
case that highlighted that for me: we are the referral hospital for two
district hospitals that don't have a surgeon or higher care. An HIV
woman was admitted to one of these hospitals with severe diarrhea a week
ago; they decided that they needed us to treat her more aggressively, so
they wanted to send her on. They have been having troubles with their
ambulance, so they sent her on a Bethlehem-like journey on the back of a
bicycle for a three-day journey to arrive here today, weak, dehydrated,
and very ill. Now this is mostly just plain negligence to transport a
very sick person that way, but it also highlights the difficult
decisions that they have to make without a working ambulance and without
other options.

Our welcome sign

Our welcome sign, originally uploaded by mattcotham.

I think this speaks for itself. I especially like the phoenix-like

depiction of the chicken on the left being transformed into the serving

platter.

My email spot

My email spot, originally uploaded by mattcotham.

I currently am emailing using a 'cell-phone modem', which is basically a

cell-phone that plugs into my computer and allows me to connect to the

internet. I don't get good cell coverage in my apartment, so my current

system is to go outside and sit in my pink lawn chair (also known as a

'lazy-man chair') with my laptop on my knees, my hoodie on, and the cat

gnawing at my toes while I watch the sunset or contemplate the mass of

lettuce that I'm about to harvest from my garden next week (what I'm

going to do with 35 heads of lettuce, I'm not quite sure; gotta work on

having my gardener space out the planting a bit). Occasionally I get

treated to sunsets like this (taken by one of the visiting docs) or the

incredible night sky filled with billions and billions of stars, to

quote Carl Sagan. Next photo project -- picture of the stars.



One downside from having so much natural exposure is the fact that my

malaria risk has gone up immensely as I sit outside at dusk while

emailing and get bit by the mosquitos. That should tail off here as the

rainy seasons have ended. I think it's a good trade-off anyway.

Success!

Success!, originally uploaded by mattcotham.

This man came in after he had tried to commit suicide by slashing open

his throat. Psychiatric care is one of the things that I really

struggle with here in Zambia, partially because my language skills are

still rudimentary, partially because we have only basic medications to

treat people with, and partially because the follow-up is done by

untrained personnel, if at all. Who knows if this man will do okay at

his house or not. When he arrived on early Sunday morning a week ago,

he had cut most of the way across his windpipe, so that he was breathing

out of the hole in his throat. I was called out of bed to see someone

who 'had a cut on his neck"; I asked if it could wait until I was to

come in to the hospital a few hours later and they said I should come

see him now, and we went to the OR where I put a breathing tube down the

hole and tried to sew up his trachea around it. He unfortunately had

cut through the larynx, above the vocal cords, so he kept draining

saliva down through the wound; however, as the wound healed up this got

to be less, and we finally took him back to the theater where we put a

tube down his throat from above and sewed up the external hole. And he

is doing great, able to talk, swallow his saliva, and looks much

better. We've been praying pretty hard for him here, and the surgeon

says that people he worked with say that they've never had a patient

with a tracheostomy survive in Africa, so he's a testament to the grace

of God. I'll put the follow-up picture next.

Plastic surgery extravaganza

Plastic surgery extravaganza, originally uploaded by mattcotham.

This past week we had a marathon plastic surgery clinic. Generally once

or twice a year a visiting Serbian plastic surgeon flies out to see us.

To prepare, we send out letters about 1-2 months in advance asking

people to come to the hospital to see him; we generally get about 60-70%

of people to actually come. These people start coming to the hospital

on Wednesday, where they get admitted, and the surgeon flies in on

Thursday, operates Thursday and Friday, and then leaves on Saturday. We

generally finish operating at around 8-9pm on Thursday and Friday, so

it's a long day for the staff.

This kid, Goodson, was scheduled to have a bilateral cleft lip and

palate repair; he got there on Thursday and was scheduled for surgery on

Friday but started running a fever and having bloody diarrhea. We had

to cancel his surgery on Friday because he was too sick to go under

anesthesia, and we prayed for him at prayer meeting in the morning (we

have daily prayers at 10:15 every day). Sure enough, the next day his

fever was gone, his diarrhea had gotten better, and we squeezed in his

surgery before the surgeon had to go. This is how he looked today!

Next week we do the same thing with a visiting orthopedic surgeon. This

is pretty much the only way to get surgical sub-specialty care out here,

and we still feel the need for urology and ENT follow-up for patients

that right now have nowhere to go.

Speaking of surgeons, our current surgeon is scheduled to leave in

January of next year and no replacement has been found; if you know

someone who might be willing to come, let us know!

Tracheostomy part 2

Tracheostomy part 2, originally uploaded by mattcotham.

Looking good!

legends of the fall

May has begun to bring about some change in Zambia.  After 5 months of hot, sticky, wet weather and rain, we've entered the fall, with cooling temps (down to the 50's at night) and beautiful, sunny days.  The grass is starting to turn brown after 3 weeks of dry weather.  I'm now the proud owner of a somewhat crooked shower and a 2 month old cat with really bad breath.  I also enjoy a large amount of pink furniture, with a pink lawn chair and shower curtain.  And after only 6 months here, it is starting to feel more and more like home. 

The hospital continues on much as usual.  Our fortunate budgets for the past few months have ended, so we had to make some hard choices this month at the finance meeting and still budgeted over 5,000,000 Kwacha (about 1,250 USD) more than what we expect to receive.  Our usual budget is around 17,000 USD/month, from which we pay the salaries of around 150 employees, buy drugs, lab reagents, postage and paper, IV fluids, gloves, tape, plaster of paris, etc.  We're trusting that the additional funds will come from somewhere.  It's a bit of a step for me to do that sort of thing, being the son of two accountants, but it's been a good experience for me.  I've personally settled in a bit better to my role as the manager of clinical services, with the educational responsibilities and meetings that that entails.  I've still been covering the pediatrics and TB wards, with a little help out in the radiology and anesthesia realms.  It keeps me interested, and I even had a few cases that were vaguely ER related this past month -- heart block, a man who cut through his windpipe with a sickle, insecticide poisoning -- which helped me feel somewhat competent, as opposed to all those malnutrition cases that I see on pediatrics.

I had a much more traditional 'missionary' month, with preaching in the local church two Sundays ago, various Easter responsibilities, and leading worship for the SIM retreat.  All were somewhat stretching experiences for me but went on reasonably well.  Our missionary staff has grown closer here on the station, and we thank you for your prayers.  We still will likely need some docs starting in February 2008, so you can starting asking your friends and neighbors if they want to come out!  At the same time that I was a more traditional missionary, I also enjoyed my first taste of tourist Zambia, with a 2 day stop-over at a nice hotel coming back from retreat, and a few purchases at the local curio shop.  We've also resurrected the local tennis court here at the station, and although it could use a little work, the only points I win are when the ball takes a funny hop off the cracks, so I'm not pushing too hard to get it fixed.

I've enjoyed hearing from each of you.  Communication has improved immensely since I bought a cell-phone modem which uses cellular technology to get on the internet.  You should check out the blog if you haven't recently -- it's a veritable multimedia experience (www.mattcotham.blogspot.com).  It's been good to be in better touch, although it still routinely takes me around an hour a day to download my messages, so don't expect 24/7 responses.  Next step: satellite internet, supposedly coming for the second stage of set-up in 2 weeks.

A few pieces of news which may be of interest to you donors back home:  thanks to the hard work of one of my college friends, Leslie Park, we are in the process of creating a non-profit organization in the states which will forward all funds directly to the hospital, with a small fee taken out to support the local church (2.5%).  Hopefully for anyone who's not donated through the usual SIM channels because of high administration fees, this will be a vehicle to ensure that your funds get straight to the hospital where they can help the most.  We expect to have this up and running by the next month or two.

Also, after some discussion with the management of the hospital, we are also contemplating converting one of the wards into a more intensive-care area, where sicker patients could get closer nursing care.  This will involve remodelling part of a ward, installing an oxygen system, buying some equipment, and so forth.   I'm therefore going to send all my donations made to my account at WMM to this purpose, unless you specifically ask me to send it somewhere else.  We're hoping to raise around 30,000 USD to get this done.  We're already making good progress towards the goal, thank you for all your contributions!

Miss all of you.  Would love to hear about your travels (especially those who have made it to Africa since I've been out here!) life events (lots of new babies out there) and other things going on.  I am relaxing the email restriction on photos sent to me since I've got a better connection these days, so a few cute pictures of babies or other things wouldn't be amiss.

Talk to you all soon,

Matt

illustration2

illustration2, originally uploaded by mattcotham.

illustration

illustration, originally uploaded by mattcotham.

Thought this might illustrate my previous blog on child safety. This is

Linus, who fell in the fire after a seizure and burned the right side of

her face. She's a beautiful girl.

grocery shopping

grocery shopping, originally uploaded by mattcotham.

This is the local grocery store; there's a bigger collection about 3

miles away, in case you're out of luck at this one. Fortunately, this

one stocks a good supply of the basics -- candy, flour, and toilet paper

-- so in an emergency you can get fixed up.

Look out Roger Federer

The inaugural tennis match of 2007 came off without a hitch as we found
the tennis net buried in the back of the musty housing container,
nestled between two wasps nests and a hopelessly tangled amount of
clothes hangers. We even found some cans of tennis balls that were
still pressurized from the 1990's; there must have been some serious
tennis players here in the past. After blatantly ignoring the
instructions taped to the cable, we managed to get it strung up and had
our first (sort of) game of tennis, where I lost 3-1. The tennis was a
true African experience, starting off with about 8 people on the court,
wildly swinging rackets and hitting the balls into the surrounding
brush. We still need to fix the fences at the ends of the court, but
fortunately several of the crowd of children stuck around to help
retrieve balls in between their time dribbling the basketball around me
while I tried to hit the ball back to John. Today I must have been
asked by 15 people if I played tennis; I guess news travels fast here at
Mukinge. Next up: wash off the court so you can see the lines well; I'm
currently looking for a hose long enough to stretch from the nearest
house. After that, I think we need to build one of those high chairs so
we can have a proper line judge -- you all know how competitive I am.

child safety

I must admit, I've made a little fun of the over proliferation of child
safety restraints and laws in the US -- I can still remember sliding
around the backseat of our old yellow Buick when I was a kid and the lap
belts were too big to hold me down. And yet I managed to escape serious
head injuries. However, I'm hit by the amount of negligence/accidental
injuries suffered by children here -- hot porridge burns down their
front, crush injuries from putting their fingers in the maize pounder,
broken arms from picking fruit from trees. Obviously children are
expected to grow up faster here -- marriage in the teens, working the
fields when 7-8 years old -- but there's also some room for the
regulations which keep kids safe. On the other hand, it's nice the
freedom that kids have to be kids here as well. I'm sure there's
probably a middle ground somewhere.

poor choices

poor choices, originally uploaded by mattcotham.

This was attempt number three at climbing to the top of the screen door

-- I let him find his own way down this time. He hasn't climbed up

again....

hmm...sterile

hmm...sterile, originally uploaded by mattcotham.

No wonder our post-op infection rate is so high....check out that

spider. Like a lot of the stuff in the theater, no idea what this is

actually the lid to, which is probably why it hasn't been used since

1999. There's a definite reluctance to throw anything away, though,

since you never know when you might need it. You could almost employ

someone full-time just to sort through equipment and repair things that

are broken. I never realized how important the biomedical maintenance

side of things was until I got out here. Our resident, surgeon, David,

has made it his mission to sort through all this stuff in the year he's

here, since we haven't had a permanent surgeon for several years here at

the hospital. David's a very optimistic person. :)

Naphthali

Naphthali, originally uploaded by mattcotham.

One of the pleasures of working here is the chance to get to know a few

of your patients a little better. At home, in the ER, you maybe get to

spend a few hours with someone, usually at a pretty traumatic time;

here we have some kids who are in traction for 6 weeks since we don't

really have the capability to do internal fixation of long bone

fractures. So Napthali has been hanging out with us for the past month

-- his time is up on Monday, and he looks like he'll be fine. We have a

variety of things to help keep the kids at least a little entertained,

but nothing beats having your picture taken.

Gary

Gary, originally uploaded by mattcotham.

I had written about Gary earlier and tried to send the photo through

(see blog 1/9/07) but I wasn't able at that time. Here it is. Updates

on Gary; he seemed to respond to chemotherapy briefly, but quickly

relapsed and had increasing growth of his tumor. He went home about 2

months ago after we had to break the news to him that he wouldn't make

it and there was nothing we could do for him. We haven't heard anything

since. We've got a new boy on the ward who likely has a similar tumor

to Gary; we started chemotherapy today and are hoping for the best.

I'll send pictures soon.

M&M

M&M is a medical term for conferences where you discuss patients that
had bad outcomes (usually death, about the worst outcome you could think
of) and it's something that I was dreading having to do in the
hospital. It is one of those things where it is very easy to feel
defensive and attacked, especially if you were involved in the care of
the patient who turned out badly. Certainly most American residents
have very negative memories of standing up in front of a room of 50-100
people and explaining why they made a mistake, or things didn't go
well. We're required (as I found out in our most recent
inspection/visit) to have these conferences every month, so I started up
with them last month, fearing that people would be upset and defensive
and unwilling to share. What I've found, however, is that it's been a
really good forum for the senior clinical staff to come together and
discuss issues and how we can improve on patient care, with everyone
putting in a bit to the discussion. One of the really nice things about
working in a small hospital is that it's a small group of people;
although this has its downsides, overall, everyone can feel involved and
have a say in what is going on, which is very nice. And we can continue
to improve the care we give to people here at the hospital.

the face of poverty

the face of poverty, originally uploaded by mattcotham.

I've been working on the malnutrition ward for the past several months,

and have treated scores of children who look like this because they

don't get enough protein in their diet to make the necessary parts of

their blood. I find that figuring out exactly what caused their

malnutrition can sometimes be a tricky thing, since often it's

complicated by occult tuberculosis or HIV. TB was on the way to being

eradicated in the world even 20 years ago, until HIV came along and the

numbers for TB exploded. Now we see a fair amount of TB in people who

aren't even HIV positive because of the resurgence in the HIV population.

This child looked like a normal kid after about 2 weeks on our

high-energy protein diet, which the nurses make on the malnutrition ward

from peanuts and soy beans and sugar. I wish I'd take an after picture

to show you as well....

tennis, anyone?

Just so no one thinks I'm suffering too much here, we had our spiritual
life retreat this past week, where the mission organization that I came
out with got together and shared notes and generally enjoyed
themselves. Of course, my participation came at the expense of two of
the other docs who had to stay behind to man the hospital. That
not-withstanding, I overcame my guilt and enjoyed a few games of tennis,
even though I hadn't played since I was a kid. In fact, I think the
last time I may have played was in a mother-son tournament where we
managed to get some kind of trophy, a feat I can only imagine was
possible if my mom hit all the balls at the other kid.
Here back at Mukinge, I'm starting on rehabilitating the tennis court,
and buying some paint to repaint the lines. Now all we need is some
fencing. I'll send you some pictures of our beautiful pool as well if
this new photo blogging works out okay.....

photos galore

photos galore, originally uploaded by mattcotham.

We will try one more time to flesh out the blog with a little

photographic evidence. This is a photo of the night-time assault on the

beehive next door, dripping molten honey and charred honeycomb as sleepy

bees tried to figure out what was going on. If this is successful, I'll

update a few of the other ones.

Staff Appreciation Day

Staff Appreciation Day went off this Thursday, and was an adventure.
You try to delegate things to other people, but things often require a
fair amount of improvisation here in Zambia. Case in point: I wanted to
have Cokes for the staff at the party on Thursday. In order to get
Cokes here, you have to have a bottle to deposit. So I tried to
delegate the rounding up of 200 Coke bottles to one of our staff
members, was assured that I'd have the crates by lunch time, and then of
course they don't show up. So I scrounge around myself, find seven
crates, only to find that the transport I'd arranged to carry them was
full of people it had offered a lift to the town, so I had to arrange
for a different car. Then I get to the BOMA to find out that there's a
national shortage of Cokes (American imperialists, watch out! Your hold
is slipping). After a brief moment of panic that an atomic bomb had
been dropped on Atlanta, I went for plan B -- buying juice. But you
can't buy disposable cups in Kasempa. So I considered having everyone
bring a cup, but then spied some bottles of orange drink in the corner,
bought them, and got them back just in time.

the gas man

Heard that phrase on an old episode of M*A*S*H referring to the
anesthetist; no one here ever seems to get it but I'm going to keep
using that bit of slang until they catch on. Maybe I'll stage a M*A*S*H
marathon to help it sink in. I've been brainstorming about ideas to
help improve and maintain staff morale over the past few weeks, and this
week saw the fruition of two of those plans: Staff Appreciation Week and
participating in the anesthesia call pool. For several years there's
just been two people doing all the anesthesia call in the hsopital, and
they were getting stretched pretty thin, so I volunteered to fall in the
schedule with them to help. So I had a crash course in spinal
anesthetic, reversal agents for paralyzing agents, and infant
resuscitation and started this week. It's been interesting, and a
learning opportunity, but it's probably the closest thing I can do
that's close to ER here, so I've enjoyed it, despite the little extra
lack of sleep it's given me. It's been all C-sections and one
amputation, but the sections have been a little scary since twice the
baby came out not breathing, so I had to try to revive the baby and take
care of the mom at the same time. For various reasons, our labor nurses
here are not trained in neonatal resuscitation, so you end up having to
do both things at the same time, which can be tricky, especially if both
are sick. Trying to make sure that training takes place is one of the
things that I want to make sure happens before I leave.

making a house a home

March was a month of nesting for me, as I tried to make my apartment a
little bit more comfortable for my stay here. This is a mixed bag, as
every convenience entails a certain amount of inconvience. But I
decided to embark on three projects: a telephone line, a shower, and a
cat. I know many of you must be thinking what's the deal with this guy
and the cats, but rest assured the tale has come to an end this month.
First up: the telephone line. I made three visits to the telephone
company, the first two during which the only man who sells telephone
service was missing because he was depositing his paycheck. The third
was more successful, although hampered by my lack of a copy for my
passport. I finally managed to track down the only copier machine in
town, which was low on toner, but when turned up to the darkest setting
could produce a barely legible picture of my passport. I think I could
still deny it in a court of law, however. Armed with my ghostly
reflection of my post-call passport picture from a Walgreens in Denver,
I was able to plunk down my $30 to try to get a line installed. Things
seemed like they were going well, the only service vehicle visited from
the nearby city only a week later, and a hole was drilled in my wall and
a line installed. Unlike home, a line doesn't include things like the
box that you plug your phone into, so it was just a bare wire sitting on
the floor for another week until one of my compatriots made a visit to
the capital and bought me a phone and a 'jack point', that magic box
that allows you to talk. Unfortunately, even though it's a 'new' line,
the cable they hooked into is one of the oldest cables around, and
there's too much noise to call out on the line, or connect to email. I
take a perverse pleasure calling them on my phone line, which they can
barely understand me on, and asking them to come fix it. Unfortunately,
the truck hasn't come back from Solwezi since I bought my phone box, so
we're still at square one, or perhaps square two, since I now have a
line, just one that doesn't work.
Second project: a cat. Actually two, or three, depending on how you
look at it; I caught two kittens, one for me and one for my family in
the village to catch mice. I had placed a bounty on the cats with the
nursing students, a system which resulted in my being called three times
while at dinner at another person's house to inform me that the students
had caught two 2-day old kittens for me. At 2 days old, kittens are
barely able to stand up, much less take care of themselves, so i
returned them to the mother and went back in two weeks. At that point,
they were more capable but also more wild, so I managed to trap them
behind one of the filthy toilets on the closed TB ward and bring them
home. Some of the kids were envious of my cute hissing and spitting
cats, so we went back and caught the third one the next day. Since then
I've had the joys of little kitten claws in my skin, effort of
house-training (concrete floors are beautifully easy to clean) and
trying to tame them and get them to come out from under the
refrigerator. Today I delivered one to the village, so one remains,
Kisela, who looks like she's going to be a good cat. She even wags her
tail and has taken to coming to sleep on top of me at night, which is
okay for now but not that good for my sleep patterns overall.
Third project: a shower. I bought the pieces necessary for a shower
installation, and after five days had progressed to two pipes sticking
out of my wall, pouring water unfettered into my bathtub. This state of
the union has remained for the past week and a half while they try to
replace the faulty part that was bought in the first place, although we
have managed to staunch the flow of water by screwing on two garden taps
to the end of the pipes. Maybe before I leave Zambia I will be able to
enjoy a shower. Until then, we're still stuck with baths.

burning the bees

Wish I could you post the pictures for this -- we've had a huge beehive
gradually growing for the past few months. This week we had people
running in terror as the bees unleashed their vengeance on the local
community outside the hospital. This, coupled with the advent of spikes
next to the wall in front of the hospital (current tires destroyed
count: 3) made it an unpleasant place to be. Perhaps to offset the
negative vibes from the spikes, we hired people from the forestry
service to burn out the bees. A first attempt with a 10 foot ladder was
unsuccessful; armed with a 50 foot ladder, a bamboo pole with
gasoline-soaked rags, and a lighter, the second attempt yielded a fiery
rain of bees, honey, and bark from about 100 feet up one of the local
trees. Unfortunately, it didn't yield the queen, so the bee renaissance
has begun, and a third attempt has been scheduled sometime in the weeks
to come.