We spent 6 months volunteering in Mongu, Western Province, Zambia in 2008, where we taught nursing students at Lewanika School of Nursing. Since our return back to Canada we have joined a dedictated group of health care professionals to form OkaZHI-Okanagan Zambia Health Initiative.
Friday, September 19, 2008
Monday, September 15, 2008
More experiences from the HIV clinic....
The topic of HIV is continually on my mind. After traveling to another HIV ravaged country, Malawi, it just makes me realize how big the problem of HIV is all over Sub-Saharan Africa. The life expectancy of a Zambina is 39 years, there are many reasons why this number is so low…and one of them is HIV. It is interesting to note that you really don’t see much of it if you were just a tourist traveling through sub-saharan. It is once you start integrating yourself into the culture and seeing the everyday reality of a Zambian, does the shock of the reality of HIV really hit. The Zambians go to funerals ALL the time here. We always see groups of vehicles around town carrying friends and families to funerals. At night as I am going to sleep, I can hear the people living around us singing funeral songs and wailing. This has truly been a wake-up call for me.
This ‘wakeup call’ has just driven me to continue working at the HIV clinic. There is so much to know about HIV care, it is so complex! I have taken my usual attitude of just throwing myself into the madness at the clinic and asking as many questions as possible...so I can learn as much as possible about HIV care. And I am telling you that once the clinic opens its doors on Monday morning….it is overwhelmed with people each and every day. It is truly organized chaos in there, and so full of people that there is no room to even move. The clinic is constantly overcapacity, and just further emphasizes the epidemic this country is facing.
I have had a many memorable moments and then again some really sad ones too. Today I was looking at the lab results for one of my patients. They use what is called a CD4 count to monitor the level of HIV in the blood, and to see if the HIV medication is working properly. I could tell she was nervous about the results, and wondering if her CD4 count had increased. (The CD4 count should be increasing once a patient is started on medication) So I looked at the results, and told her that they had increased. She was so happy that she gave me the biggest hug right in front of the whole clinic. These are the moments that I enjoy most.
There have been many heartbreaking moments as well. Today I had to tell someone they were HIV positive for the first time. It is very much like delivering someone the news that they have cancer. Except here we know without a doubt that this disease will kill them, and much sooner than if they lived in Canada. It is so unfair. I looked at the test results and said to her, ‘you are positive’. Those few words just completely changed the course of her life. I saw it in her eyes..and it was a look I will never forget.
I will also never forget having a mom and young son come in who where both HIV positive. The mother had been non-compliant with her medication for various reasons. After three months of being non-compliant with HIV medications, patients have to be completely taken off the medication and are not allowed to return back to taking them. This is not to be cruel, but it is actually because the HIV virus has already had a chance to mutate and now the medications will no longer be effective in stopping the HIV virus from multiplying in their body. If someone stops taking their medications properly they are ‘just putting another nail in their coffin’ as a nurse at the clinic so bluntly put it. This situation occurred with the mother and son. Because the mother had not been taking her medications properly, she was not given anymore meds. Unfortunately so was her young son because she had not been giving him his medications properly. The nurses told me he had only been off his medications for one month, and they could already tell he was deteriorating. To me he looked so sick, and it was heartbreaking knowing that his quality of life could be improved with just these simple meds, but it was too late. So unfair that he really had no choice in the matter. It was hard for me to watch as a bystander, and not be able to jump in there and fix things…like I am so used to doing as a nurse!
Prevention messages like this can be seen all over Zambia
At times it is hard not to be overwhelmed by this disease. I always knew that HIV was a problem in the world, but to be honest it was never truly until nursing in Zambia that I realized…they aren’t lying when they say that millions of people are dying of AIDS in this world. I am embarrassed to admit it, but I don’t think I truly grasped the reality of HIV until it was staring me in the face. It was when I started physically touching these patients and caring for them that it hit me. Now it is my job to make everyone in the world gets it like I just got it.
Anyone want to help?
Jessica
Thursday, September 11, 2008
Malawi: The warm heart of Africa
Landlocked Malawi ranks among the world's most densely populated and least developed countries. Like many African countries, Malawi was once a British colony called Nyasaland. It became the independent nation of Malawi in 1964. When translated, the name Malawi means Lake of Stars. It is bordered by Tanzania, Mozambique and Zambia, and it is slightly smaller than Pennsylvania.
The economy of Malawi is predominately agricultural with about 85% of the population living in rural areas. Major agriculture products are tobacco, sugarcane, cotton, tea, corn, potatoes, cassava (tapioca), sorghum, pulses, groundnuts, Macadamia nuts; cattle, and goats. Agriculture accounts for more than one-third of GDP and 90% of export revenues. The performance of the tobacco sector is key to short-term growth as tobacco accounts for more than half of exports. The economy depends on substantial inflows of economic assistance from the IMF, the World Bank, and individual donor nations.
Tea Harvesting
Tobacco Harvesting
The government faces many challenges including developing a market economy, improving educational facilities, facing up to environmental problems, dealing with the rapidly growing problem of HIV/AIDS, and satisfying foreign donors that fiscal discipline is being tightened. The life expectancy of a Malawian is 43 years, which is comparable to Zambia. Estimates take into account the effects of excess mortality due to AIDS (the AIDS rate in Malawi is 14%, which is also quite comparable to Zambia….and really high!!); this can result in lower life expectancy, higher infant mortality, higher death rates, lower population growth rates, and changes in the distribution of population by age and sex than would otherwise be expected.
Wowee Malawi
We first had to bus from Mongu to Lusaka. Our high priority was to try a veggie burger at Steers, the local fastfood joint (seriously there is no where to eat in Mongu). We were excited to be in the big city and be able to blend in a bit more. Then we took another looooooong bus ride to Chipata in Eastern Province, Zambia. This bus ride was suppose to be 5 hours as promised by the bus operator. However it took us 15 hours! The bus left 2 hours late, broke down for 3 hours and we had to wait on the side of the road in the blistering sun for someone to drive the part to us from Lusaka. Then while we were driving, someone threw a rock at the window and smashed a window two seats up from us. It was like being in a war and a shot was fired and everyone hit the ground. But don’t worry moms, we are ok. The plan was to get to the capital of Malawi that day, but we spent the night in Chipata to avoid travelling at night.
The next trek was from Chipata to Lilongwe, the capital of Malawi. It goes as follows: cab to border, change money illegally inside cab, flirt with border guards, stamp passports, cab to the nearest town, grab a minibus, and finally off to Lilongwe…In the capital things were a little hectic as always. Jessica luckily made a friend on the bus who “helped” us get a cab to our hostel. He was a little upset when she wouldn’t kiss him, but what did he expect, they just met right? Ohhhhh Africa.
We spent two nights at a great hostel where we met some fun people and lounged by the pool. Our favorite ones were two guys from Israel, they would make us their traditional coffee at their campsite..on their little campstove. Has anyone ever had Israeli coffee before?? It is strong stuff! This was just the beginning of the many Israeli’s we would run into during this trip. We learned that the reason for meeting so many young Israeli’s is that they all must put in 3 years of Army service once they turn 18 (both men and women). Once they are out…they all just want to see the world and travel!
We took another bus to get to Mzuzu where we spent one night to avoid traveling in the dark. The next morning we mini bused to Nkhata Bay on Lake Malawi where, after 5 days of travelling long hours, we decided to spend an entire week just relaxing.
Our resort was beautiful. There was no room in the hostels when we got there, but the owner let us stay in a chalet for two nights at dorm price (4$). The chalet was so amazing that we ended up staying there all week (10$ a night thereafter). We had a private little beach, and the view of the lake was outstanding.
We met so many fun travelers from all over the world. We ate at unreal buffets where our plates were heaping with both comfort food and local dishes as well. The majority of our days were filled with swimming and sun bathing. However, we did frequent the markets in town and a few boat trips as well. It was free to borrow snorkel gear from the hostel so every morning we snorkeled and saw the glorious cichlids (over 850 species of cichlids in Lake Malawi) which is the fish found in the lake. Lianne went scuba diving and saw mama cichlids fight off predators and then all the babies would hide in her mouth when she felt threatened (up to 40 fish in her mouth!!).
The feel of Nkhata bay was extremely laid back. The place was filled with Rastafarians and mostly every night the place had live music. One thing we did notice was almost everyone smoked, which is quite different from Zambia as no one there does! This is probably because Malawi’s primary export is tobacco..so that means supply is plentiful for the locals.
We were very sad to leave Lake Malawi as we knew that we were leaving behind such a beautiful place. We also knew we had to make that loooooooooooong trek all the way back to Mongu.
Well we made it back, no break downs on the way back ..or rocks thrown at our bus! We stayed an extra day in Lusaka, to stock up on a few things from the big city that we can’t get in Mongu. We were so excited to go grocery shopping and get items that we are unable to find at our local grocery store (which I must say is lacking in many things!!) Our most exciting finds were hair conditioner, mustard, salad dressing, salsa and taco shells. In the big city we went out with friends who took us bowling and for sushi. Yes we had sushi in Africa, it was actually pretty good..but really expensive.
The last leg of our journey was the bus ride back to Mongu. Pretty cool that to get to Mongu we have to drive through one of the biggest game parks in Zambia. On this trip we saw zebras on the side of the road! (as well as the usual elephants, antelope, impalas, warthogs, etc) It was so nice to be in familiar territory again. We got off the bus station and instead of being hassled and ripped off by all the cab drivers just waiting for the tourist mizungus (white people)…we had our local trusty cab driver Max waiting for us! It feels so good to be home. It got HOT in Mongu in those two weeks that we were gone. We are worried because everyone keeps telling us that October is the hottest month. We are both already sleeping with no covers, and fans on continuously. We are going to be in big trouble once October hits!
We were also very excited to return back to Mongu because Cam had just returned from a trip back to Canada. He was waiting for us with so many care packages from home. It was really Christmas in September!!! Cam was also able to bring back much needed textbooks, and computer software that will go to help the school of nursing. Thank-you to everyone who sent stuff with Cam, it was the best Christmas ever.