ten and a half months ago. In a lot of ways, things haven't changed much
since I was here then; it's still hot, and full of mosquitoes, and I am
fully expecting to have another night spent sitting up and swatting bugs against
the wall. This has been made more challenging since the last time I was
here by the addition of regular power outages, so that you are
trying to swat bugs by sounds and feel alone, which is a distinctly
dicier proposition.
Despite similarities, a lot of things are really different than before, too. My computer is now full of beautiful pictures and also with emails about water pumps and visiting medical students. There is now a separate Zambia folder with funding proposals, memorandum,
minutes from various meetings, and medical protocols.
In a moment of pique last week as my insomnia kicked in and my frustration level was
high, I made a list of all the things I'd had to learn while I've been
here for 10 months. At the time I was mad because I'd been forced to learn so much in such a short period of time; now I'm feeling kind of proud of myself. Here's the abbreviated list:
How to plant and fertilize maize and a garden
WHO recommendations for malnutrition, setting up a malnutrition
protocol, components of mineral supplementation, whether commercial
mineral supplies are adequate for human consumption, price of skim milk
powder, how to purchase and deliver milk powder, where to buy peanuts,
soy, how long peanuts can be stored, where to find containers for peanuts
Basic Kaonde
How to deworm a cat
Where to hire someone to shovel off the tennis court
How to get out of trouble when you're over your head in a C-section
Dosing and monitoring of chemotherapy for cancer, HIV drugs
African vernacular songs on the piano
How to distill water, where to find distilled water for lab and OR use
(the air conditioner, rainwater)
How to sterilize surgical instruments
How to fix a tire on a motorbike
Tennis forehands
A variety of medical conditions: Madura foot, eosinophilic folliculitis,
lymphoblastic lymphoma, leprosy, nephrotic syndrome, acute rheumatic
fever, cerebral malaria, ecclampsia, uterine rupture, snake bite,
organophosphate poisoning, tropical ulcer, pin placement for skeletal
traction, typhoid fever, skin grafting, hydrocoele repair, ultrasound
diagnosis of DVT, VSD, and ectopic pregnancy
30 or so African choruses
How to dispose of medical waste
How to make nshima
Charitable organization legal proceedings
About 200 people's names
The Evangelical Church of Zambia organization and the hospitals' role
with ECZ
How to set up a computer network (well, how to fail to set up a computer network, really)
ER medicine for my ER boards
What SIM stands for, who runs SIM, how to get things done through SIM,
how to request funding from SIM, how to recruit personnel via SIM, old
SIM projects that have been conducted at Mukinge, SIM future goals for
the hospital
Pharmacy ordering systems, contacts of about 5 pharmacy delivery
suppliers in Zambia, methods of delivery, goods received vouchers
Where to find sources of lab supplies, drugs, and stores in Zambia.
The government supplier of pharmaceuticals system, ordering timetables
What is an electrical transformer, how much voltage requirement is
needed to run a hospital
How to dig a VIP toilet
Mukinge history of severe illnesses, malnutrition, malaria, history of
relationships with the local health board
Antibiotic resistance patterns for Mukinge for the last 6 years
How to put someone on the Zambian government payroll, how to find out
how many people they expect us to have on staff
Installing and troubleshooting cellphone modems, wireless cards, and
internet access on 10 different computers
It's a long list, and I edited out a fair number of things. It feels like almost everything on that list I had to figure out on my own when I got here because of the lack of long-term docs to do a
proper handoff. Like I said before, I was peeved at the time I wrote the list because I was feeling that it was unfair to have to study for my boards on top of the rest of the
things that were going on. But now, I'm kind of just proud of myself for
managing all those things. Who knows what the next 14 months will bring?
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