I got a chance to meet the baby named after me last weekend when we went
out to visit my host family from the village. I don't really know why I
enjoy the fact so much that there's another kid running around out there
with my name -- it's not exactly as if Matthew is an uncommon name --
but it still makes me smile. As you can see from the picture here, he's
off to a healthy (read: fat) start! As we do more of our malnutrition
outreach, I'm grateful for the kids that do at least start out fat --
they've got a leg up on the rocky road of subsistence farming ahead of them.
Sunday, July 20, 2008
the namesake, part II
Friday, July 18, 2008
Three kinds of English
Theoretically the schoolkids, Mabel, and I all speak English, but the number of differences between Irish-, Zambian- and American-English have been pretty amazing. From Mabel I've learned that rubbers are erasers, wool is yarn, lollipop sticks mean popsicle sticks, joined up writing is the same as cursive writing, and that anorak is a preferred term for jacket. Apparently people often refer to children as "pets" in Ireland; the schoolkids seemed to think Mabel was a "wee bit" funny for calling them animals in the beginning but they seem to have become accustomed to it.
For the first few hours in the school I thought I was having an easier time understanding the children than I was listening to Mabel until one of our young ladies asked, "Auntie Hilary, may I go to the room?" Now, we have two small rooms connected to the back of the classroom which we sometimes use for small group instruction, plus a few of the grade 3 students travel back and forth between our classroom and the grade 1 classroom since we're a little short on desk space, so I wasn't entirely sure which room this child wanted to go to. "The room?" I queried. "Yes, auntie, may I go to the room?" "Which room?" I asked. The somewhat frustrated child then quietly informed me, "Auntie, I need to go to the toilet." Ah yes, the roo m.
Lately I've started teaching the kids and Mabel how to say short phrases in Spanish. Maybe we'll all be able to understand each other soon :-). Hasta la vista, Hilary
Multiplication mission
Mathematics, or "maths" as people in Zambia refer to the subject, seems to be a bit of a challenge for many people in the country. One of the expatriate nurses shared with me that many of the Zambian nurses struggle with mathematical concepts, and this has caused some difficulty when it comes to administering the proper dosage of medication and other job responsibilities. In the classroom it's been frustrating watching the children calculate problems like "24 x 4" as "24 + 24 + 24 + 24" when they're supposed to be practicing their multiplication skills. It seems like they never learned their multiplication times tables, or at least the information never really sank in. So we have now embarked upon a "multiplication mission" for the next few weeks, focusing on memorizing the times tables. Many educators and others in the United States say that it's not necessary to spend much time memorizing mathematical facts since we have such tremendous access to technology, but I haven't seen a single calculator in our classroom and am fairly certain that most of the kids aren't using one at home, let alone other more advanced forms of technology. Plus, it seems to me that medical staff and other professionals don't exactly have time in the middle of a busy workday to find a calculator or a cell phone to determine the answer to a simple ma thematical problem. So, everyone, nine times four equals …? Mathematically yours, Hilary
Monday, July 14, 2008
Zambian schoolhouse
Hi, everyone! For those of you who are regular or occasional readers of Matt's "Notes from the bush" blog and may not know me, I'm a friend of Matt's and fellow parishioner from Colorado who's working at Mukinge Hill Academy about half a mile down the road from Mukinge Hospital for the next few weeks. Matt agreed to have me as a "guest blogger" for the time that I'll be here, so hopefully this will give everyone a grander perspective on what life in this part of Zambia is like.
Mukinge Hill Academy hosts about 70 students in grades 1-5 (British system of education), and many of the staff members at Matt's hospital choose to send their children to this academy. There are two classrooms in the building, with grade 1 in the first classroom and grades 3-5 in the other, while the grade 2 students and teacher meet in a room at the church across the road. At this current point in time, the regular headmistress/grades 3-5 teacher is on "home assignment" in the United Kingdom, so a lovely woman named Mabel from Ireland, myself until the end of this current school term, and the regular Zambian classroom assistants are handling affairs until Janet returns. I'm working mostly with the older children although we do combine all the students for some activities such as preparing for an upcoming concert/sports day.
Mukinge Hill Academy hosts about 70 students in grades 1-5 (British system of education), and many of the staff members at Matt's hospital choose to send their children to this academy. There are two classrooms in the building, with grade 1 in the first classroom and grades 3-5 in the other, while the grade 2 students and teacher meet in a room at the church across the road. At this current point in time, the regular headmistress/grades 3-5 teacher is on "home assignment" in the United Kingdom, so a lovely woman named Mabel from Ireland, myself until the end of this current school term, and the regular Zambian classroom assistants are handling affairs until Janet returns. I'm working mostly with the older children although we do combine all the students for some activities such as preparing for an upcoming concert/sports day.
I had seen the school last year when Tay and I had visited Matt during the summer of 2007, but working in it definitely provides a different experience. I'm still in the process of learning the children's names; David, Victor, and Success have been easy enough to pronounce and spell, but Chikumbutso, Kameya, and Kaumba make me think a little more. I had taught for several years in southern California before moving to Colorado a few years ago to begin a PhD program in education at the University of Denver and thought I'd seen a variety of educational arrangements in schools, but the format at Mukinge Hill Academy is new for me. The day normally begins around 7:45 am (the actual start time depends on when the keys arrive and with whom :-)), and the children typically begin working on individual workbooks in the areas of English, math, science, social studies, and word building. The students are basically using a home school curriculum, as it has been difficult to find teachers to serve in this part of Zambia and it was decided many years ago that a curriculum which encouraged students to function independently would be a good approach.
Anyway, the schedule itself is not terribly complicated: the students bring their goal sheets to Mabel and me at the beginning of the day for a checkover, spend most of the morning engaged with their workbooks, individually check in with me, Mabel, and the other assistants in the room as they finish each assignment, and take tests when they come to the end of a particular academic unit which Mabel and I then grade that same day. The students have an early-morning break, then continue the process of working on their individual assignments along with the continual checking and grading, have a late-morning break, then do something like art, religious education, or PE in the early afternoon until the end of the school day. There are other breaks during the week for assemblies and Kikaonde (language) lessons and occasional field trips, but that's the general idea.
Anyone who has ever worked with children knows that kids are an endless source of entertainment and creativity, and the children in Zambia are certainly no exception. For our art session on Friday, I told the kids that we were going to make friendship bracelets as do many children in the United States. The idea was to make a simple bracelet with two plastic "charms" or beads on it, but in no time the kids had moved on to friendship necklaces and triple wrap bracelets, along with extras to give to family members. It's all about sharing the love :-). We spent the afternoon practicing relay races, potato sack races, and three-legged races for the upcoming sports day and concert (more on this in the near future). Lots of love to all, Hilary Burg (aka "Auntie Hilary," as the children call me :-))
Saturday, July 12, 2008
Guest Blogger
Hi there everyone -- for the next month or so, there will be some guest
blogging from Hilary Burg about life in the local elementary school,
Mukinge Hill Academy, where she's working for the month of July. So you
can check out blogs about about the local education scene as well!
We'll try to be fairly obvious about who's doing the blogging....
blogging from Hilary Burg about life in the local elementary school,
Mukinge Hill Academy, where she's working for the month of July. So you
can check out blogs about about the local education scene as well!
We'll try to be fairly obvious about who's doing the blogging....
Monday, July 07, 2008
4th of July, Zambia style
We celebrated July 4th this week along with the rest of you in America.
It's a pleasure to be able to get back to my boyhood days of playing
with dangerous fireworks. Firework season is in December in preparation
for New Years', so it's slim pickings these days. However, I've become
more resourceful after 18 months here, so I got my chess playing contact
from the BOMA to rustle around in the shop where he works and he
uncovered two stacks of fireworks buried beneath the cartons of mchuzi
mix and Colgate toothpaste. Zambia fireworks inspire even more
nervousness that the ones I remember from childhood that would chase you
around the yard emitting green sparks: the two cartons of fireworks that
we could find had a fuse that was about 2mm long (okay, maybe that's an
exaggeration -- it was really 1mm) and were shaped suspiciously like
bullets wrapped in paper. Not knowing exactly what to expect, we found
a fairly long stick with a live coal on the end from our bonfire and had
a go -- and were rewarded with a very satisfying amount of explosion and
flashing lights shooting up into the nearby tree. Despite the fact that
we've had no rain since April, there was not even one extra fire. And
nobody's eye got put out, so I guess we met the definition of 'fun and
games'.
It's a pleasure to be able to get back to my boyhood days of playing
with dangerous fireworks. Firework season is in December in preparation
for New Years', so it's slim pickings these days. However, I've become
more resourceful after 18 months here, so I got my chess playing contact
from the BOMA to rustle around in the shop where he works and he
uncovered two stacks of fireworks buried beneath the cartons of mchuzi
mix and Colgate toothpaste. Zambia fireworks inspire even more
nervousness that the ones I remember from childhood that would chase you
around the yard emitting green sparks: the two cartons of fireworks that
we could find had a fuse that was about 2mm long (okay, maybe that's an
exaggeration -- it was really 1mm) and were shaped suspiciously like
bullets wrapped in paper. Not knowing exactly what to expect, we found
a fairly long stick with a live coal on the end from our bonfire and had
a go -- and were rewarded with a very satisfying amount of explosion and
flashing lights shooting up into the nearby tree. Despite the fact that
we've had no rain since April, there was not even one extra fire. And
nobody's eye got put out, so I guess we met the definition of 'fun and
games'.
snake attack
Probably the number one question that I get asked by people interested
in coming to visit is "what about the snakes". I've had some close
encounters with snakes since I've been here -- the time I went to the
pool to find a 6-7 foot spitting cobra swimming in the deep end; the
time I was riding my motor bike and a HUGE snake appeared out of the
grass about 10 yards in front of me -- its head had disappeared in the
grass on one side of the road before the tail appeared on the other
side; the four snakes I found on my doorstep in two weeks last
December. Remarkably, though, even if you get bitten, most people do
pretty well -- they get a big huge swollen leg that takes about a month
to go away, but there's not a lot of lasting damage.
in coming to visit is "what about the snakes". I've had some close
encounters with snakes since I've been here -- the time I went to the
pool to find a 6-7 foot spitting cobra swimming in the deep end; the
time I was riding my motor bike and a HUGE snake appeared out of the
grass about 10 yards in front of me -- its head had disappeared in the
grass on one side of the road before the tail appeared on the other
side; the four snakes I found on my doorstep in two weeks last
December. Remarkably, though, even if you get bitten, most people do
pretty well -- they get a big huge swollen leg that takes about a month
to go away, but there's not a lot of lasting damage.
Issues of expired drugs, unfamiliar diagnoses, and fatal diseases come
up routinely in the hospital and are part of what makes the medicine
here so challenging. This past week, we had the first severe case of
snake bite I've seen in the hospital -- a guy who was bitten 24 hours
previously and sent from one of our referring hospitals. Usually with
these severe cases of neuro toxins you expect them to die within just a
few minutes; why this man had such a delayed presentation I don't really
know (it was a 'green snake with a black head' -- more descriptive than
the usual at least, if someone wants to take a stab at identifying it).
But when he arrived at the hospital he was barely breathing and the
muscles all over his body were twitching uncontrollably. He was rapidly
accumulating fluid in his lungs because his muscles were so weak, and I
knew we didn't have much time.
Unfortunately, time was not the only thing in short supply; we have very
little snake anti-venom in the hospital, because it's expensive for us
to stock. Usually to treat a severe case of snakebite you need around
10-15 vials of anti-venom. I knew we had a hidden stash in the bottom
of the pharmacy refrigerator -- it was expired from 2004, but I had
resisted throwing it away in the hopes that it could still be useful.
Anti-venom is made from horses serum, and can be potentially dangerous
or even fatal to give if the horse serum reacts with your body. So I'm
contemplating giving a potentially dangerous drug which when it's good
can be trouble -- my batch, though, was 4 years out of date and slippery
from the mold from the bottom of the refrigerator. I've never given
this drug, or even seen anyone give it to a patient. And there's always
the chance that my diagnosis of neurotoxic snake bite could be wrong as
well, since I've never seen one of those, either.
I was surprised by our pharmacist, who reported that we had 18 of these
expired vials, about 10 more than I remembered having on hand. The man
was clearly dying, so I called in the other docs who agreed with me and
we started with 8 vials. They helped a little bit, but he was still
twitching like an electrocuted fish, so we ended up continuing to give
and give extra vials, nervously noting his wheezing with some of the
doses as he reacted to the medicine he was given. At vial #16, his
twitching finally stopped, and we ended up giving the full 18 vials to
him to make sure his symptoms didn't come back.
The next day, he's sitting up in bed, smiling, and saying he's feeling
much better! And he went home the next day after that with a slightly
swollen leg but not much the worse for wear. He also met with the
chaplains and decided to dedicate his life to God on the day he was
discharged. I can't help but think that it was unusual for him to take
24 hours to develop symptoms, to arrive at the hospital at just the
right time (an hour later he would likely have been dead), to need 18
vials to get better which just happened to be the amount that we had,
left over from some order back in 2002 or 2003, and that maybe there had
been a plan for him made a long time ago that was difficult to see until
he came.
babies in the grass
I had my first opportunity to deliver a baby on the side of the road
about a week ago -- this is an opportunity that everyone who works at
the hospital seems to get to enjoy at some point during their stay. I
was sitting in the maternity ward when the phone call from the girls
school came, saying someone was giving birth on the side of the road
about a kilometer away. The maternity nurse and I looked at each other,
and I offered to drive her out to the place on the back of my scooter,
so we hopped on board and zoomed at 20 kph down our rutted, dusty road
to the place where she was supposed to be. We found her sitting up in
the grass with a blanket pulled over her head and the baby on the dirt
at her feet. At this point, a small crowd had gathered, and I think she
was pretty embarrassed, so she wouldn't answer us or look out from
underneath the sheet. So we recruited about 7 women who had gathered
around to make a barrier by spreading out their skirts (the outer skirt,
not the inner one -- this isn't one of those risque stories) like a
fabric wall, at which point the young mother peeped out from underneath
her blanket and we were able to get the baby and her cleaned up. She
even agreed to be taken back to the hospital to sew up some small tears
(on the back of the motorbike, mind you -- people have to be tough here
to sit on the back of a motorcycle 20 minutes after giving birth)!
about a week ago -- this is an opportunity that everyone who works at
the hospital seems to get to enjoy at some point during their stay. I
was sitting in the maternity ward when the phone call from the girls
school came, saying someone was giving birth on the side of the road
about a kilometer away. The maternity nurse and I looked at each other,
and I offered to drive her out to the place on the back of my scooter,
so we hopped on board and zoomed at 20 kph down our rutted, dusty road
to the place where she was supposed to be. We found her sitting up in
the grass with a blanket pulled over her head and the baby on the dirt
at her feet. At this point, a small crowd had gathered, and I think she
was pretty embarrassed, so she wouldn't answer us or look out from
underneath the sheet. So we recruited about 7 women who had gathered
around to make a barrier by spreading out their skirts (the outer skirt,
not the inner one -- this isn't one of those risque stories) like a
fabric wall, at which point the young mother peeped out from underneath
her blanket and we were able to get the baby and her cleaned up. She
even agreed to be taken back to the hospital to sew up some small tears
(on the back of the motorbike, mind you -- people have to be tough here
to sit on the back of a motorcycle 20 minutes after giving birth)!
Fortunately, everyone did well and went home the next day.
Wednesday, July 02, 2008
the english cut
There's too many puns to be made on 'the first cut', but suffice it to
say that after mom and dad brought me a pair of electric clippers one of
the fun things we've been doing is offering free haircuts to the men on
male ward while they are in the hospital. I thought that maybe we'd get
one or two guys who wanted to get a shave, but it never fails that when
we do it the entire ward files up for a haircut and we're surrounded
with piles of curly hair next to the laundry lines outside. Usually I
leave the job to our capable ward assistants (Mr. Bazelel Munguya
pictured here) but I had a go at it today. The first person asked me
for an 'english cut', which I later found out was not to be confused
with an 'english bobee cut'. Actually, in my opinion pretty much any
haircut that I give is by definition an 'english cut', or at least a cut
in english. However, the actual english cut consists of shaving on the
sides and leaving it infinitesimally longer on the top (by about 1 mm
longer according to the clippers). I think I have a picture from
Livingstone last year that may illustrate the topic...coming next....
top right
So I think the actual english cut would be the top right. Perhaps with
a little practice I can manage the '$' in the back of the hair soon,
though?
Monday, June 16, 2008
the namesake
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?
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?
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.
Monday, May 26, 2008
Bupe
Bupe means 'gift' in Kaonde, which is somewhat appropriate as she's now become quite adept at finding little gifts for herself from our soft-hearted staff on peds 2, the malnutrition ward. Bupe and her family have basically moved to Mukinge over the past year as they've spent more time in the hospital than at home; one of the difficulties with treating malnutrition is that the children often require 1-2 months in the hospital to get better, but then the family can't do the farming at home, so they don't plant their crops and the cycle continues.
Families like Bupe's are part of the reason that we're doing our community intervention to reach families at home, teach them about farming for protein-rich foods (beans and peanuts and soy beans) and hopefully break the cycle before they get to the hospital. We're moving forward -- we've got around 230 families so far, and hope to be able to provide seed for all those families in October.
Projects like this make me worried, although they are good, because of the amount of control that you have to turn over to the community and families and overworked hospital staff now and after I go as well. But the opportunity outweighs the risks, and we're hoping for some miraculous changes in the years to come!
Thursday, May 22, 2008
back again
Blogging is bad when it's too introspective; I've had a hard time find
things worth blogging about the past few weeks after getting back from
vacation with my family. I've started thinking about where I'll be in
December and what life will look like after two years at Mukinge, but at
the same time I seem to find my responsibilities here continuing to
expand -- now spearheading our nutrition outreach, filling in for Jairos
in the mobile eye clinics, helping to orient pharmacists and lab
technicians, neither of which I have much of a clue about -- and so
forth. It's been a relief to have a full complement of doctors around
to take some of the burden of clinical work from me, but it's changed my
day-to-day routine quite a bit. Today and tomorrow we will go to the
villages to teach the community about nutrition, how to make a balanced
diet for their children, and suspend dozens of screaming children from
our scales as we monitor malnutrition in the various areas.
things worth blogging about the past few weeks after getting back from
vacation with my family. I've started thinking about where I'll be in
December and what life will look like after two years at Mukinge, but at
the same time I seem to find my responsibilities here continuing to
expand -- now spearheading our nutrition outreach, filling in for Jairos
in the mobile eye clinics, helping to orient pharmacists and lab
technicians, neither of which I have much of a clue about -- and so
forth. It's been a relief to have a full complement of doctors around
to take some of the burden of clinical work from me, but it's changed my
day-to-day routine quite a bit. Today and tomorrow we will go to the
villages to teach the community about nutrition, how to make a balanced
diet for their children, and suspend dozens of screaming children from
our scales as we monitor malnutrition in the various areas.
Thursday, April 24, 2008
traveling man
This month has been a little bit unusual for me as I take a little
detour from my usual duties of doctoring, seeing patients in the
hospital, doing surgeries, teaching, etc. I've spent most days this
month away from the inpatient duties as we've been going out into the
community to get the community buy-in for nutrition outreaches and
educational programs (more to come soon), I was doing the music for our
SIM retreat, and now am going to head off for a little break with my
folks down to Botswana. Tomorrow I'm off with our executive director to
visit one of our referral hospitals to examine some monetary issues and
get perspective on the medical care they give there. It's good to leave
the hospital because it gives perspective on why I'm working there, but
it always brings up some guilty feelings as you know the people who are
left behind have to work harder to cover for your absence. No decisions
get made in that independent vacuum that we like to fool ourselves into
thinking exists in America; we can do what we like and the only one it
affects is us. That's an unusual perspective compared to most of the
majority world and one that most Zambians have a hard time understanding.
detour from my usual duties of doctoring, seeing patients in the
hospital, doing surgeries, teaching, etc. I've spent most days this
month away from the inpatient duties as we've been going out into the
community to get the community buy-in for nutrition outreaches and
educational programs (more to come soon), I was doing the music for our
SIM retreat, and now am going to head off for a little break with my
folks down to Botswana. Tomorrow I'm off with our executive director to
visit one of our referral hospitals to examine some monetary issues and
get perspective on the medical care they give there. It's good to leave
the hospital because it gives perspective on why I'm working there, but
it always brings up some guilty feelings as you know the people who are
left behind have to work harder to cover for your absence. No decisions
get made in that independent vacuum that we like to fool ourselves into
thinking exists in America; we can do what we like and the only one it
affects is us. That's an unusual perspective compared to most of the
majority world and one that most Zambians have a hard time understanding.
Wednesday, April 09, 2008
Zamcowboys
Had an unexpected encounter with my visiting neighbor the other day who
styles himself as the 'only Zambian cowboy'. We were able to swap
horseback riding stories (me: trail riding experiences at camp, him:
working in a stable in Lusaka), compared cowboy boots, and discussed the
merits of straw versus felt cowboy hats (me: pro-straw hats in hot
climates; him: pro-felt hat durability). I have to say, I figured when
I came to Mukinge that I would encounter some different cultures, but I
fully did not expect to encounter Texan culture half a world away. He's
gone back to Lusaka now to finish his course in lab technology, at which
point I am completely sure he will be the only Zambian Cowboy Lab Tech
in the country.
styles himself as the 'only Zambian cowboy'. We were able to swap
horseback riding stories (me: trail riding experiences at camp, him:
working in a stable in Lusaka), compared cowboy boots, and discussed the
merits of straw versus felt cowboy hats (me: pro-straw hats in hot
climates; him: pro-felt hat durability). I have to say, I figured when
I came to Mukinge that I would encounter some different cultures, but I
fully did not expect to encounter Texan culture half a world away. He's
gone back to Lusaka now to finish his course in lab technology, at which
point I am completely sure he will be the only Zambian Cowboy Lab Tech
in the country.
Thursday, April 03, 2008
Mukinge...and one string
I was reading about and anecdote this week about Paganini giving a
concert where first one, then two, then three of his strings on his
violin broke. He reportedly finished the concert, and then played the
encore on the single remaining string.
Whether the story is true or not, it resonated with what we do here at
the hospital; despite no phones, our water coming and going and often
full of black sludge, intermittent electricity, overflowing toilets,
lack of funding, absence of IV's and syringes and tape and so forth, we
continue to play our concert for the people around us, and hopefully
most days it still sounds, perhaps not Paganini-esque, but like a simple
song of love and care for the people in the hospital, their families,
friends, and relatives. I'm constantly touched when a patient
unexpectedly reminds me that they can hear that song too, even on days
when I feel like the concert has to grind to a halt because too many
strings are broken.
So, here's to Mukinge....on one string!
concert where first one, then two, then three of his strings on his
violin broke. He reportedly finished the concert, and then played the
encore on the single remaining string.
Whether the story is true or not, it resonated with what we do here at
the hospital; despite no phones, our water coming and going and often
full of black sludge, intermittent electricity, overflowing toilets,
lack of funding, absence of IV's and syringes and tape and so forth, we
continue to play our concert for the people around us, and hopefully
most days it still sounds, perhaps not Paganini-esque, but like a simple
song of love and care for the people in the hospital, their families,
friends, and relatives. I'm constantly touched when a patient
unexpectedly reminds me that they can hear that song too, even on days
when I feel like the concert has to grind to a halt because too many
strings are broken.
So, here's to Mukinge....on one string!
the three 'selfs'
I've been reading a lot about cross-cultural relationships and service
recently. One of the new watchwords for any overseas mission are the
three 'selfs': self-governing, self-sustaining, and self-propagating.
These principles I think came about as an attempt to learn from previous
mistakes (yes, it can actually happen!) of neo-colonialism and
superiority complexes often brought in the past (and still brought some
by visitors, aid relief, and so forth) with devastating consequences.
Despite how things turned out, no one had a vision to come to Africa and
create dependency, unsustainable solutions, and destroy the local fabric
of society. I think these three 'selfs' provide important safeguards to
ensure that those models of developmental change don't happen again.
I can't help but remain uncomfortable with the three 'self' model,
however, on some fundamental levels. One comes from the nationals
themselves, some of whom have viewed this movement as an abandonment
that they neither asked for or particularly wanted. Is a forced
abandonment such a good thing? On many levels, it ignores the reality
of the economy of poverty in many of the places where these ministries
work. When a family subsists on 1-2 dollars/day, it is ludicrous to
expect any ministry to that area to ever be 'self-sustaining' without
significant economic and infrastructural changes occurring first. This
simple fact is obvious to the nationals who live and work in these
areas, but in an emphasis on 'self-sustaining' and 'self-propagating'
these concerns are swept aside. Jeffrey Sachs makes the point that
poverty has a threshold below which all interventions eventually lead to
nought because they lack the necessary impetus to grow. If that
threshold level has not been reached, a premature transition to
self-sufficiency will result in the ultimate destruction of the services
and ministry in the area. One could ask that very question of the
hospital where I work -- in the rural areas in our province there is
currently ONE Zambian doctor working in the whole province (at our
hospital already, I might add). Most of our patients total income for
the year will likely be between 200-300,000K (around 90-100 USD). Is
that a situation where the local populace can be expected to support a
hospital?
Although perhaps well-intentioned, I feel that the three-self principles
are an attempt to provide a somewhat easy solution to what is a
difficult problem, requiring humility and sensitivity -- how to be
willing to put yourself at the disposal of your Zambian/national
colleagues and trusting them to spend you wisely. How risky is that --
to open your own resources, money, time, professional gifts, and let
someone else in the community decide how they will be spent instead of
you deciding yourself? Such a concept is almost anathema to someone
from the individualistic cultures of the West where donations should be
ear-marked, reported on, and tightly controlled even after the money has
been given. Such a concept leaves you vulnerable to the people from the
other culture perhaps using more of your resources than you intended
them to, or spending them on different priorities, or even perhaps
'wasting' them, at least from your perspective.
I think that kind of partnership, however, is the one that we are
modeled in the Bible (see the Corinthians giving to the Jerusalem
church, for example), and is one that ultimately shows love and trust
for each other in ways that the 'self' model misses.
Self-sustainability is not a realistic goal; even self-propagation is
almost impossible to contemplate. I think we need to abandon that
thinking and instead look for a servant-partnership role for overseas
missions. I think we have a responsibility to continue to be involved
and supportive to the same levels that we were before, even if we are
not 'in charge' in places like Mukinge anymore. I hope that people
haven't chosen to leave places like Mukinge because that was too hard --
a statement something like 'if I can't be in charge of my things, then I
think I'll just take them and go somewhere where I can'. I don't think
that was the case in the past, but the fact remains that Mukinge (and
many other places like it) have been slowly abandoned by their brothers
and sisters in the West.
recently. One of the new watchwords for any overseas mission are the
three 'selfs': self-governing, self-sustaining, and self-propagating.
These principles I think came about as an attempt to learn from previous
mistakes (yes, it can actually happen!) of neo-colonialism and
superiority complexes often brought in the past (and still brought some
by visitors, aid relief, and so forth) with devastating consequences.
Despite how things turned out, no one had a vision to come to Africa and
create dependency, unsustainable solutions, and destroy the local fabric
of society. I think these three 'selfs' provide important safeguards to
ensure that those models of developmental change don't happen again.
I can't help but remain uncomfortable with the three 'self' model,
however, on some fundamental levels. One comes from the nationals
themselves, some of whom have viewed this movement as an abandonment
that they neither asked for or particularly wanted. Is a forced
abandonment such a good thing? On many levels, it ignores the reality
of the economy of poverty in many of the places where these ministries
work. When a family subsists on 1-2 dollars/day, it is ludicrous to
expect any ministry to that area to ever be 'self-sustaining' without
significant economic and infrastructural changes occurring first. This
simple fact is obvious to the nationals who live and work in these
areas, but in an emphasis on 'self-sustaining' and 'self-propagating'
these concerns are swept aside. Jeffrey Sachs makes the point that
poverty has a threshold below which all interventions eventually lead to
nought because they lack the necessary impetus to grow. If that
threshold level has not been reached, a premature transition to
self-sufficiency will result in the ultimate destruction of the services
and ministry in the area. One could ask that very question of the
hospital where I work -- in the rural areas in our province there is
currently ONE Zambian doctor working in the whole province (at our
hospital already, I might add). Most of our patients total income for
the year will likely be between 200-300,000K (around 90-100 USD). Is
that a situation where the local populace can be expected to support a
hospital?
Although perhaps well-intentioned, I feel that the three-self principles
are an attempt to provide a somewhat easy solution to what is a
difficult problem, requiring humility and sensitivity -- how to be
willing to put yourself at the disposal of your Zambian/national
colleagues and trusting them to spend you wisely. How risky is that --
to open your own resources, money, time, professional gifts, and let
someone else in the community decide how they will be spent instead of
you deciding yourself? Such a concept is almost anathema to someone
from the individualistic cultures of the West where donations should be
ear-marked, reported on, and tightly controlled even after the money has
been given. Such a concept leaves you vulnerable to the people from the
other culture perhaps using more of your resources than you intended
them to, or spending them on different priorities, or even perhaps
'wasting' them, at least from your perspective.
I think that kind of partnership, however, is the one that we are
modeled in the Bible (see the Corinthians giving to the Jerusalem
church, for example), and is one that ultimately shows love and trust
for each other in ways that the 'self' model misses.
Self-sustainability is not a realistic goal; even self-propagation is
almost impossible to contemplate. I think we need to abandon that
thinking and instead look for a servant-partnership role for overseas
missions. I think we have a responsibility to continue to be involved
and supportive to the same levels that we were before, even if we are
not 'in charge' in places like Mukinge anymore. I hope that people
haven't chosen to leave places like Mukinge because that was too hard --
a statement something like 'if I can't be in charge of my things, then I
think I'll just take them and go somewhere where I can'. I don't think
that was the case in the past, but the fact remains that Mukinge (and
many other places like it) have been slowly abandoned by their brothers
and sisters in the West.
Tuesday, March 25, 2008
petty theft
I've become increasingly challenged recently by how I should be handling
theft from my home. The week I left Denver to start to come out here I
had a garage sale where people came by at 6am to steal my stuff before I
could get up; maybe that was preparation for what I've seen out here.
There's a fair amount of it; I've had 4 pairs of shoes, socks, a cell
phone, a water purifier, bungee cords, cement, wire, sprinklers,
shovels, hoes, candles, knives, sunglasses, books, DVDs, and bananas
stolen from my place over the past few months. Most of the stuff was
gifts, or extra things, and I have tried to maintain an attitude of
'enforced generosity -- I probably should have given that stuff away
anyway' to those donations to someone's pocketbook or feet. As Gwen,
who's lived here all her life, points out, people here are very poor.
And she's right, they are. I have an abundance of things, especially in
comparison to the villagers, and most of the things that have been
stolen have not been essentials. But it can be difficult when you're
expecting a phone call to find that your cell phone has been stolen
(especially now that there is no other way of communicating here at
Mukinge with the internet and landline phone systems not working), or to
go play basketball to find your shoes have been stolen so you have to
play barefoot, or to strap something on your bike to find your bungee
cords have been stolen so you have to make 2 trips to carry the things
you needed, or to water the garden to find your sprinkler missing so you
have to water by hand. And it's frustrating when you know they won't
have the batteries to run the purifier, or the charger to recharge the
cell phone, so those things will become useless to them in about a week
as well, doing no one any profit at all. At least I can be comforted
that my shoes, or knives, or candles are probably going to good use
somewhere. So I range between annoyance to acceptance and back again,
and try to hold possessions a little bit more loosely, and try to
remember in between thefts to continue to be generous to people who come
asking for help or money.
theft from my home. The week I left Denver to start to come out here I
had a garage sale where people came by at 6am to steal my stuff before I
could get up; maybe that was preparation for what I've seen out here.
There's a fair amount of it; I've had 4 pairs of shoes, socks, a cell
phone, a water purifier, bungee cords, cement, wire, sprinklers,
shovels, hoes, candles, knives, sunglasses, books, DVDs, and bananas
stolen from my place over the past few months. Most of the stuff was
gifts, or extra things, and I have tried to maintain an attitude of
'enforced generosity -- I probably should have given that stuff away
anyway' to those donations to someone's pocketbook or feet. As Gwen,
who's lived here all her life, points out, people here are very poor.
And she's right, they are. I have an abundance of things, especially in
comparison to the villagers, and most of the things that have been
stolen have not been essentials. But it can be difficult when you're
expecting a phone call to find that your cell phone has been stolen
(especially now that there is no other way of communicating here at
Mukinge with the internet and landline phone systems not working), or to
go play basketball to find your shoes have been stolen so you have to
play barefoot, or to strap something on your bike to find your bungee
cords have been stolen so you have to make 2 trips to carry the things
you needed, or to water the garden to find your sprinkler missing so you
have to water by hand. And it's frustrating when you know they won't
have the batteries to run the purifier, or the charger to recharge the
cell phone, so those things will become useless to them in about a week
as well, doing no one any profit at all. At least I can be comforted
that my shoes, or knives, or candles are probably going to good use
somewhere. So I range between annoyance to acceptance and back again,
and try to hold possessions a little bit more loosely, and try to
remember in between thefts to continue to be generous to people who come
asking for help or money.
cash flow
I find myself in relative penury this past few weeks, although I wince
even as I write that as I look at the people around who are truly in
need while I sit here writing on my laptop with my collection of DVD's
and books in the other room, a freezer full of donated coffee from
overseas, and a pile of blankets on my floor to be given away. That
being said, I've been down to about $10 of cash for about 2 weeks, which
has forced me to make some interesting sacrifices (do I really need
butter on my toast? does the scooter really need to have its chain
repaired? what can I make for Easter dinner out of some potatoes and
evaporated milk?) and also forced me to have some hard conversations
with people when they come asking for assistance, loans, etc. which is
pretty common. I tend to respond to the needs that I have laid in front
of me, which when combined with extra expense for the labor on the
tennis court and lack of transport to the capital from whence all money
flows has put me in a bind.
I'm reminded that 'blessed are the poor' (not that I'm one of the poor,
as is very clear to me here) as per Ms. Hellwig:
- the poor know they are in urgent need of redemption
- the poor know not only their dependence on God but also their
interdependence on other people
- the poor rest their security on people, not things
- the poor have no exaggerated sense of their own importance
- the poor can distinguish between luxuries and necessities
- the poor can wait, because they have acquired patience in waiting for
needs to be filled
- the fears of the poor are more realistic and less exaggerated
- to the poor, the gospel sounds like good news and not like a threat
or scolding
These things are brought home to me right now in ways that I don't
usually feel in the states.
even as I write that as I look at the people around who are truly in
need while I sit here writing on my laptop with my collection of DVD's
and books in the other room, a freezer full of donated coffee from
overseas, and a pile of blankets on my floor to be given away. That
being said, I've been down to about $10 of cash for about 2 weeks, which
has forced me to make some interesting sacrifices (do I really need
butter on my toast? does the scooter really need to have its chain
repaired? what can I make for Easter dinner out of some potatoes and
evaporated milk?) and also forced me to have some hard conversations
with people when they come asking for assistance, loans, etc. which is
pretty common. I tend to respond to the needs that I have laid in front
of me, which when combined with extra expense for the labor on the
tennis court and lack of transport to the capital from whence all money
flows has put me in a bind.
I'm reminded that 'blessed are the poor' (not that I'm one of the poor,
as is very clear to me here) as per Ms. Hellwig:
- the poor know they are in urgent need of redemption
- the poor know not only their dependence on God but also their
interdependence on other people
- the poor rest their security on people, not things
- the poor have no exaggerated sense of their own importance
- the poor can distinguish between luxuries and necessities
- the poor can wait, because they have acquired patience in waiting for
needs to be filled
- the fears of the poor are more realistic and less exaggerated
- to the poor, the gospel sounds like good news and not like a threat
or scolding
These things are brought home to me right now in ways that I don't
usually feel in the states.
Wednesday, March 19, 2008
isn't it ironic
Who would have thought that perhaps one of the least sporty guys in
high-school would be the driving force to construct a tennis and
basketball court in a African town? It's been a bit silly, and a bit
frustrating, and not exactly NBA or Wimbelton standards (although it's
close to a clay court -- eat your heart out, Roland Garros) but it was
finally finished this weekend and christened with a rousing game of
tennis followed by a pickup game of H-O-R-S-E. I'm hoping that it
brings people together and provides some extra life to the community
here. It was really fun to see the kids shrieking in pleasure and
chasing tennis balls around the grass.
Tuesday, March 04, 2008
Lenten updates
Hey there from Kaonde-land!
It's been a good couple of months for us here at Mukinge, made possible by the fruition of some of the plans that we put together at the beginning of the last year. Since the last time I wrote back around Christmas time, we've begun construction on the new nursing dormitory, rehabilitation of the administration block, repair of two of the staff houses, construction of a garage for our hospital vehicles, and building of the new HIV counseling center. At the same time, the weather has caused some problems as we've had issues with lightning resulting in the burnout of our phone system, intermittent power surges, the downfall of our internet system, so we've been back to communicating by written notes carried by hand around the hospital. It feels pretty good to not be at the mercy of the phone sometimes while on call, I must admit, despite the inefficiency of the current system. As I remind myself on a daily basis, however, efficiency is not the goal here, but rather the relationships that you cultivate.
We're also in a transition period for staffing as two of our docs have left. We have been lucky to enjoy the presence of a Canadian surgeon to help ease the transition and the hospital hasn't been too busy recently, so we've been managing well. We are still facing some shortages at the end of the year when my term finishes at the hospital, especially in regards to surgical coverage and nursing supervisors/teachers. If you know people interested in coming, let us know!
Mostly, though, I feel grateful for the progress that we've been able to achieve over the past year. We've bought 7 oxygen concentrators for the hospital, upgraded our maternity care with ultrasounds and fetal monitors, increased our available staff housing by a total of 10 units, began much needed rehabs of different parts of the hospital, and so forth. You have been generous to help the work go forward here, not to mention the many care packages, encouraging emails, prayers, and postcards I have received over the year. We are continuing to look forward to exciting projects in the next few months, especially with a nutrition project that is currently in the planning stages to increase our community presence, provide much needed seed to local farmers to grow protein-rich foods like beans and peanuts, and provide education to the area. I am also trying to raise enough funds to purchase a much needed anesthesia machine which costs around $28,000. Seems like a big goal, but we'll see what we can do. We've managed maybe a third of the cost so far!
Despite the comings and goings of people here on the station (mostly goings), I continue to try to strengthen my friendships with my Zambian colleagues, even despite some cultural issues. We had a good cultural awareness seminar this past weekend which was pretty amusing as I continued to see in black and white how far away I am in my cultural expectations from Zambian culture. I think across 12 of 13 different cultural attitudes that we quizzed ourselves on, I and the typical Zambian were exactly on opposite ends of the spectrum. It actually amazes me that I am able to get any work done at all without immense frustrations on both sides, and it's shown me how much I am able to adjust despite ingrained cultural ideas. It also makes you realize how much unspoken grace you are being shown by the people who work with that you are probably unconsciously offending right and left. I had the opportunity to work at a nearby mission hospital in January and came away with a profound sense of gratitude for the more graceful way that we have dealt with those cross-cultural issues here at Mukinge over the years.
Thanks to you all. If I can give any more details on work or things at the hospital, let me know. We've recently been in the process of updating our website, so you might google 'Mukinge' and see what you get these days! Don't forget to check the blog at www.mattcotham.blogspot.com.
Best to you all,
Matt
the smell of progress
I'm surrounded by the smell of progress these days, but progress in
Africa isn't such a great smell all the time. One of my aromatherapy
candles quit quickly and the other was stolen from my coffee table,
leaving behind the tangy ammoniac smell of partially cured goat hide on
my new stool mixed with the turpentine of the varnish on the door which
I commissioned to serve as a basketball backboard. I'm inordinately
proud of this altered dwarf-sized door (short and fat) which may
represent the first major work I have ever knowingly ordered from
anyone, but the smell of varnish is particularly overpowering,
especially when I'm laying on my concrete floor already partially
overcome by the paint fumes of the Brilliant Green for the tennis court
that shredded 6 pairs of gloves and made my hands look like the
Incredible Hulk. I've been trying to scrub off this green hue with my
recent purchase of soap from the BOMA (the grocery store burned down
last month, remember, so everything's local purchases these days) which
is colored black and smells like cough drops. There's little more
disheartening than trying to scrub off green paint with black lather,
which leaves behind a disgusting black soap ring around the bathtub and
a smell of pharmacies without much improvement in the green cracks of my
knuckles or fingernails. But progress is progress, the dead-goat smell
is fading, and the tennis court is (mostly) rain-proof and ready for the
re-inaugural match next weekend.
Africa isn't such a great smell all the time. One of my aromatherapy
candles quit quickly and the other was stolen from my coffee table,
leaving behind the tangy ammoniac smell of partially cured goat hide on
my new stool mixed with the turpentine of the varnish on the door which
I commissioned to serve as a basketball backboard. I'm inordinately
proud of this altered dwarf-sized door (short and fat) which may
represent the first major work I have ever knowingly ordered from
anyone, but the smell of varnish is particularly overpowering,
especially when I'm laying on my concrete floor already partially
overcome by the paint fumes of the Brilliant Green for the tennis court
that shredded 6 pairs of gloves and made my hands look like the
Incredible Hulk. I've been trying to scrub off this green hue with my
recent purchase of soap from the BOMA (the grocery store burned down
last month, remember, so everything's local purchases these days) which
is colored black and smells like cough drops. There's little more
disheartening than trying to scrub off green paint with black lather,
which leaves behind a disgusting black soap ring around the bathtub and
a smell of pharmacies without much improvement in the green cracks of my
knuckles or fingernails. But progress is progress, the dead-goat smell
is fading, and the tennis court is (mostly) rain-proof and ready for the
re-inaugural match next weekend.
Subscribe to:
Posts (Atom)
