Gone Fishing

Monday Morning….The Course is about to start. There is anxiety and uncertainty wafting in the air. We, the foreigners who came to share our knowledge and learn from our colleagues are ready to teach Essential Surgical Skills. “Where is Bill?” Bill comes running into the room sputtering words that sound similar to a word salad…. “There is a man with a fishing spear in his back and I think he has a pneumo and I am going to operate……Glynn you are coming to intubate, Lianne you are scrubbing.”

That was it. It was decided. The man would have surgery to remove the spear and insert a chest tube to relieve the pressure caused by the pneumothorax (air trapped in his chest that compresses his lung).

We left the course, not quite sure what to expect. Bill, chest tube in hand was determined to do this…This would be Mongu’s first official chest tube insertion.

Bill, Glynn, and myself got ready. We discussed with the team what we would do and what everyone’s roll was. We prepared a water seal container with a suction canister, ringer’s lactate, and tape…pretty much a pleurovac right? (sorry for those non-medical people, just imagine a really home made system).

Bill and I scrubbed in for surgery. Bill ready to insert the tube took a long time to explain every action to the doctors and nurses. He is a fantastic teacher! The tube goes in and a large amount of air is released….The patient goes under and we remove the spear….

Let’s talk about this spear for a minute. This man comes from a town an hour away from Mongu. He had a few drinks with his friends and decided to play fight…The fight got out of control and he over powered his mate. The “friend” was so mad he went home and got a fishing spear. Needless to say we have a patient with a 5 prong, barbed fishing spear in his back.



Having a good look at the spear

The patient turned out to be an incredible opportunity to teach both doctors and nurses. Normally the patient would not have had a tube inserted and may have died from respiratory distress. With the new skills the doctors and nurses have learned we are certain we will be seeing more chest tubes in Mongu!

First Day Back in Mongu

Lianne, Jess, and Mr. Mumbuwa

First morning back in Mongu just started like any other day, waking to the sounds of Sister Christina already out in the garden. Man did I ever miss that woman! Our house feels like we never left it, Lianne and I even get to sleep in our old rooms.
The weather is hot, even at night! Thank goodness for our fans.....

I will never EVER forget our first day back in Mongu. Never in my life have I had a reunion like this before! Everywhere we went; from the hospital, to the school, to the only restaurant in town (Oasis) it was just one big reunion!! All of our old friends and acquaintances came to greet us....word is out that the 'Two Canadian Nurses" are back in town. Now a Zambian greeting isn't like a typical Canadian one. Zambians are full of big hugs and squeals of delight, excitement and always lots of laughter!

Just to walk around the hospital and School of Nursing felt like I was in a parade. I think the greatest feeling was to see our nursing students that we taught last year who have since gone on to graduate, and are now finally working in the hospital as real nurses!


With our nursing students

In one day I think we managed to reconnect with pretty much everyone we had met in the time we spent living in Mongu. From Max (our old taxi driver), to Prince Angola (the gardener), to Mr. Mumbuwa (our teaching colleague and closest friend)…it was just so exciting to see every single one of them. I don’t think we fully had realized the impact we made on the people here, until we returned. Everyone just kept saying how much they had missed us and were so excited that we came back.


Lianne, Dr. Liywalii, Jessica

I have realized the importance of returning to a place where you begin a project. It says to the people here that we are serious and committed to them. In Africa, many groups or NGO’s will start work in an area only to end up pulling out shortly after. It is so wonderful that OkaZHI has chosen to remain working in Western Province, and area that is often forgotten by even their own government. I feel so lucky that our team is back again this year, and will continue to come again and again!!!!

The Road to Mongu

There has got to be a word that is bigger than nostalgia. That is what we felt when we rented our car and took off from the airport. We were jetlagged, exhausted, but exhilarated by the familiar surrounding and sounds on Zambia. I took off from the airport in our Toyota Condor loaded to the max with surgical equipment, luggage, and a team of enthusiastic Canadians. The left hand side of the road felt all too comfortable.

We had very thorough meetings Tuesday followed by fabulous Indian food in Lusaka. On Wednesday we loaded our car with even more luggage, equipment and people (6 people and approximately 900lbs of gear). As we hit the road we made sure to stop by Game and Shoprite for the necessary picnic gear. We left a little late, not a surprise. The team made an executive decision that we didn’t need to worry about filling up the car as ¾ of a tank of petrol would most likely get us to Mongu…..right? Besides, Zambia has a petrol shortage right now and it would take over 4 hours at a pump to get even 10 Liters of fuel. Many cars have parked in a line and will stay that way for a week or so until more petrol comes…

We passed the only gas station en route to Kaoma, the next town on the way to Mongu. Kaoma is about 2/3 of the way from Lusaka on the way to Mongu. We stopped for a picnic in the park….did Mubita say to stop on the other side of the river after the park? Probably, as we were swarmed by hundreds of tse tse flies!! Either way the picnic was grand. We enjoyed avocado, tomato, biltong, cheese, bread, olives, chips and of course wine. Driving through the park we saw warthogs, marabou storks, puku, impala, and monkeys. Not bad for a Wednesday drive.

Jessica behind the wheel we are about 5 km from Kaoma…Everyone is a little tired, and the Jones’s keep falling asleep. Bam Bang…..and the car is on the other side of the road. We hit the mother of all potholes and have not 1, but 2 flat tires. Everyone works in a calm manner and action happens immediately. Cam and I hitch to Kaoma to find a new tire while Bill and the gang replace one of the tires with a spare ( ironically enough we hitch with an empty jerry can to get more fuel but barely have room in the back of the pickup as we are sitting on

2 barrels of petrol).

One of two busted tires!!

The first tire shop didn’t have our size, the second shop was being run by a drunk…things weren’t looking good. We had about 30 minutes of daylight left. I called our friend in Mongu asking him to see if he could ship a tire to us. Then I thought maybe I could take the bus to Mongu and cab back……Luckily mama Africa always pulls through. A bystander watching the white girl had called his friend to help. Two guys pull up in a van and start asking questions. It sounded like they knew what they were talking about so I stuffed them into their van and made them drive out to our car to look at the tire.

When we arrived the police were there as well as a group of village children. We got the measurements and headed back to find a tire. Fate would have it that we had to go back to that drunk tire dealer to find one. We get the rim on and now we need to pump it with air. The tire was not making a seal so the mechanic decided to put toilet paper around the edges of the rim with water to create a seal….I’m not a mechanic but I don’t know how trusty TP is? Regardless the power went out and there was no way to pump the tire. I grabbed popcorn, Cam and I watched in disbelief as the mechanics attempted to get our tire together. Finally we put a tube in and inflated it with the compressor attached to the engine of a truck nearby….

Meanwhile, Bill was keeping guard on our van by doing perimeter circles with a tire iron in hand. The children had helped him remove the bolts of the tire and were rewarded with our leftover fruit from lunch. If anything this experience was a good ice breaker in team building skills.



Bill and Glynn changing the tire

Back in Kaoma, Cam and I had a tire! We decided to push it a little further and ask our mechanic (who was quite sick of us and all the questions by this point) if it was possible to get petrol. The first “backyard shed filling station” was too expensive. The next place we went we ended up buying 10 L as it was getting quite late. We paid 35 dollars for 10L of petrol….yes $3.50 dollar per liter!! And thank goodness, because we later learned we would not have made it without it!

3 hours later we had a tire and were on the road again. When we saw the “welcome to Mongu” sign we were beyond relieved. We had made it back home!



Bliss with 2 flat tires

Back in Zambia...and it Feels SO Good!

Lianne, Bill, Joan and Jess at Heathrow Airport

Well we are back on Zambian soil and it doesn't even feel like we left! Right now it is 5 AM of Day 2...and I am wide awake. I am never up at this time, but thanks to jet lag here I am this morning. Our plane ride to Zam was looong, except we did end up meeting two guys in the middle of Heathrow airport who will be working in Mongu. They are from Seattle and it just so happens that they will be taking over Tyler's construction project out in Limulunga. What a small world to actually meet them in one of the world's biggest airports, but these Zambian connections just continue.

I don't think I have ever been so excited for a trip in my whole life! But it really is because I get to return back to a place that I love and miss so so much. And now we are coming back with Dr. Bill Nelems, who is truly the reason why we are back in Zambia. This time we are also bringing with us Joan Bassett-Smith, who is the former Director of Nursing at UBCO. She was also a professor of ours when we were wee little nursing students and has spent over 10 years working on nursing education projects in Ghana. She really gets Africa. Which is why it is so exciting to bring her with us back to Zambia!


We arrive after 24 hrs of sleepless travel at 0600 to Lusaka Airport. The rains have come already this year..so to our surprise it is quite cool! I know once we head to Mongu it will be much hotter. Bill has planned quite the full day for us already. We give Margaret a call at University Teaching Hospital and she is already waiting for us in her office. So off we get our rental car, Lianne starts the drive (good thing she is used to working night shifts and can go off little sleep..cause pretty sure she hadn't slept in about 2 days). Lusaka traffic sure hasn't changed much, expcept right now in Zambia there is a HUGE petrol shortage..the lineups for gas are unreal!!!!!! We are already making backup plans with jerry cans for our trip to Mongu. (don't worry Dad)

We set off to meet with Margaret, the Assistant Dean for the School of Medicine at the University Teaching Hospital (UTH) in Lusaka (the biggest and only tertiary hospital in the whole country) I know we have talked about her before on the blog but she truly in an amazing women. Began her career as a nurse, married the best Lozi (our friend Mubita), had 4 children...and somewhere in there managed to get her Master's and PhD. She has really been a driving force for improving nursing education here in this country. We are honoured to be able to call her a friend and colleague. It was neat to connect her with Joan Bassett-Smith..hopefully this is the start of us writing grants to help fund a nursing skills lab here at UTH. While we are at UTH we are approached by the Director of Surgery, Dr. Labib..and then Dean Mula stops by to say hello. Word is out that we are doing a surgical skills course in Mongu!!!! They all request us to run the surgical skills course at UTH. Feels good to know we get to deliver this course first in Mongu, but it is huge that the biggest hospital in the country is already asking us to come and work with them!


Mobita, Lianne, Cam, Glynn, Dr. Chifumbe Chintu (Bill's classmate at U of T)

Looks like we have a lot of work to do, I don't need to come home...right????? :)

Jessica

Viva Mongu!

Jessica, Bill, and Lianne at World of Hearts Charity Dinner

Since our return to Canada we have constantly been thinking about Zambia. How do we get back? What can be doing from here to help over there? How can we raise awareness within our own community? ANSWER: OkaZHI (Okanagan Zambia Health Initiative). This is a group creating an action plan with strategies for improving the health of Zambians. Our founding member Dr. Bill Nelems has truly been an inspiration to us, and has pulled together an amazing team of people.

OkaZHI Foundation Advisory and Management Committee:
• Nicole Arnt, President-Global Nursing Citizens
• Jessica Barker, RN
• Joan Bassett- Smith, PhD, RN, Associate Professor UBC-O
• Felour Behrouzi, RN
• Prof. Joan Bottorff, PhD, RN, FCAHS
• Dr. Linda Hawker, Family Practice
• Dr. Glynn Jones, Family Practice
• Lianne Jones, RN
• Fay Karp, RN, Associate Professor UBC-O
• Dr. Tom Kinahan, Urology
• Muriel Kranabetter, RN, Associate Professor UBC-O
• Gene Krupa, PhD
• Dr. Kim Lefevre, Neurosurgery
• Dr. Tim Murphy, Family Practice
• Dr. Bill Nelems, General and Thoracic Surgery
• Rebeccah Nelems, Chair
• Dr. Gary O’Connor, Orthopaedic Surgery
• Carole Robinson, RN, PhD, Associate Professor UBC-O

Ok looking at this …we often wonder how did we make the cut? That is quite the impressive list! We are a dynamic group that is dedicated and passionate about improving the health of the people of Western Province, Zambia.
It is funny to look back on our blog entries…and realize how much we have grown since last year. Our last entry even says ‘Don’t worry Mongu, We’ll be back.’ It turns out we really are!!! Never in a million years would we have guess that we would be back in Mongu in 9 short months!

The up coming journey starts on October 18th as we fly to Zambia with Joan and Bill. We will be meeting Glynn and his son Cameron in Lusaka prior to our departure to Mongu. Joining us at a later date will be Gary and Dr. Bob Taylor from the Canadian Network for International Surgery (www.cnis.ca). Together we will run the Essential Surgical Skills (ESS) course for our Zambian colleagues at Lewanika General Hospital in Mongu! This is a week long course designed for clinicians in low-income regions of the world and teaches a standard set of life saving surgical skills for medical urgencies that such clinicians face on a frequent basis. This course has been taught in Ethiopia, Uganda, Malawi, Mozambique, Mali, Rwanda…and now Zambia!


Lozi girls in the traditional outfit for Western Province

Words can’t even describe how exciting it is for us to return to a place where we once called home. We get to see our Mongu family once again! The most amazing thing is that we are going back to help build and empower the health care professionals at Lewanika General Hospital. It is a way to give back to the people of Mongu and Western Province for taking such good care of us for those 6 months we lived there.

Mongu get ready, Lianne and Jessica are back!