travelling mercies

A lot of our management team was away this week, so I had the privilege of attending the organizational meeting for the local measles vaccination campaign that will happen next month.  It was an interesting meeting as we try to sort through logistics of getting vaccines that need to be refrigerated out to rural health clinics without power, much less refrigerators, often 40-50 miles away down roads that take several hours to traverse.  We also have to try to recruit staff for the administration of the vaccine, even when we don't have staff to run the hospital or local clinics.
Anyway, as many Zambian meetings do, this one started an hour late and ran over into the lunch hour.  I am still without my motorbike and so was walking back the 3 miles from town back to the hospital, and was a little hungry.  As I walked through the charred stubble that is most of our fields, trying to avoid the clouds of dust that get whipped around by our cold season winds, with my stomach rumbling a bit, I couldn't help but think again about all of our patients who often have to walk or bike those miles when sick, or in labor, or anemic, or with HIV wasting.  Many of our HIV patients are around 60-80lbs.  A few months ago, I took care of a woman who had been referred to us by Mufumbwe hospital, a local district hospital even more rural than us without a doctor that works there.  She was too sick for them to take care of, so they wanted to send her to us.  However, they didn't have transport available, so she was discharged from the hospital, placed on the back of a bicycle, and forced to cycle for three days to reach us with her family.  Keep in mind that this was a woman who was too sick to stay there.  Anyway, they made it to us, and eventually recovered.  That's in contrast to the women who our student nurses took care of at a local clinic, pregnant and with malaria, but there was no malaria medications at the clinic, the ambulance was broken down, and she died before it could be fixed and come and get her.  In keeping with local custom, the husband cut out the baby from the dead woman so that it could be buried separately.