Life's Little Miracles.....

Did I ever think I would see her again? Never in a million years!

It has been almost 3 years now since I started working in Zambia. In 2008 Jessica and I arrived in Zambia with no idea that our passion for international development would guide us to where we are today. Three years later and we are now board members of a growing non-governmental organization that has thick roots in the heart of Mongu. If you asked me back then if I would be dedicating a large part of my life to this type of work, I don’t know if I could have imagined what we have become today. I am extremely proud of the hard work and energy that we have created as group and this next story is the reality of the outcomes of our love and passion.

In 2008 Jessica and I taught at Lewanika School of Nursing for 7 months. During that time I focused my lectures and clinical practice in Maternity and Pediatrics. Whilst on the labor ward my students notified me of a baby that had been born at 28 weeks gestation...This beautiful child had been dealt an unfavorable hand of cards. She was premature at 28 weeks (normal is 40), she weighed only 900 grams (about 2 lbs), her mother had passed away during labor of a post partum hemorrhage, and she was born near a hospital that didn’t have the equipment needed to sustain such a fragile life.

When I first spotted this little child all I felt was gut rotting guilt knowing that the chances of survival were next to none. I told myself to create space; don’t become attached because the outcome of the situation had a poor prognosis. The baby’s survival rates in a first world country would be slim let alone a hospital where almost no interventions took place.

It is obvious as to where this story is going. With daily visits to the maternity ward and creating an action plan with the maternity nurses the baby, my baby, ended up surviving and thriving. I would come to the ward with the students and Bertha the friendly midwife would say, “Limpo how is your baby today?” As my 7 months came to an end in Mongu it was time to say goodbye to baby Limpo as we called her. By this time she was over 2000 grams and feeding quite well. I often wondered what would come of her and what fate had in store for her down the road.

Since 2007 Jessica and I have both been back to work in Mongu 5 times! Cumulative we have spent over a year in Zambia....which goes to show you how passionate we are aboue our second home! Together with members of OkaZHI we have taught over 3 nursing courses, 3 surgical courses, 1 medical course and a handful of seminars, medical rounds, and mentorships. As well, we have helped UBCO bring nursing students to Mongu as part of their 4th year practical placement. This was a vision that Jess and I had when we first went to Zambia and she made it happen in 2009! Currently Jessica has accepted a position at UBCO working as a clinical instructor and would love to see UBCO nursing students in Mongu for the 3rd year in a row! I am extremely proud of all the hard work and dedication she has put into this project.

In July of this year (2011) I went to Zambia as part of an Evaluation team. The team consisted of Dr. Bill Nelems and Cameron Jones. We traveled to all the rural communities surround Mongu in Western Province to visit our Zambian medical and nursing colleagues who took part in OkaZHI courses since 2007. It was such a privilege and honor to be welcomed by so many into their communities and places of work. The entire trip was a huge success and illustrated our dedication to have Zambian voices have a say as to how our organization should operate within Western Province.

The most rewarding experience in the entire 3 years I have worked in Zambia occurred on the 2^nd day of that trip. It brings tears to my eyes thinking about the rush of emotion that overtook me. The three of us had traveled via Shalom Bus to Kaoma about 2 hours East of Mongu. We were planning on meeting Dr. Silumesii there and conduct a few interviews. While staying with the Chesire Home Sisters I found a few children who stuck to me like glue…Before I knew it I had 5 curious faces in my room looking at pictures and listening to music on my bed. I showed them a picture of Baby Limpo and asked if she was at the orphanage that was attached to our lodging. I grabbed Bill and Cam and we went to talk to the Sister in charge. She looked at the picture I had and I explained her story. A few shared words in Lozi between the Sister and a younger girl occurred then the Sister looked at me and said, “her name is Masualeti.” I felt this surge of energy and joy but also a sense of despair and sadness. The small girl comes over to me and hands me Masualeti who was sleeping at the time. She grabbed my arms and continued to sleep in my grasp. Tears start to pour down my cheeks as I was holding this little miracle that I had the privilege to take part in her care in her most fragile state.

Above: a group from the orphanage look at the picture of Masualeti as an infant

Masualeti sleeping, I'm a bit teary!

That day I thought over and over to myself how our actions, however minute they may be, can have a larger impact than we may ever know. I would like to think that I helped Masualeti become the beautiful 3 year old child she is today. In all likelihood, I think it is more probably that Masualeti is the one who has impacted and helped me become the woman I want to be.

Lianne

Evaluation Trip 2011

To Find out more about our latest evaluation trip have a peek at Bill's blog!! His words are inspiring and well constructed in this beautiful piece!

http://billnelems.hubpages.com/hub/-Do-you-mean-that-you-came-all-the-way-from-Canada-to-do-this-evaluation-in-Kalabo-Justin-Theatre-Nurse

Lianne

OkaZHI - A Friend In Deed!

Dr. Andrew Silumesii, Executive Director of Lewanika Hospital shares his experience working with OkaZI….

A common adage goes ‘a friend in need is a friend indeed’. The wis

dom therein underscores the gratitude we owe the people that come our way to give a helping hand in times when we need help the most (and perhaps when we least expect it). Such is our gratitude to the Okanagan-Zambia Health Initiative (Oka

ZHI)!

It goes without saying that the health care system in Zambia, l

ike in many other countries in Africa, faces many challenges. Prominent among these are shortages of human resources, inadequate financial resources and infrastructure and an increasing disease burden. Granted, human resources constraints are alarming and have reached crisis proportions in terms of the staf

f-patient ratios, but there is also growing recognition of the need to build capacity in the current health workforce, that is, enhancing their knowledge and skills so that they are able to provide health care more efficiently, effectively, safely, competently and confidently. This is what OkaZHI is already helping to achieve in Western Province, Zambia.

Here is how it all started:

One morning in April 2008, a tall and slender gentleman, presumably in his mid-60s walked into my office unannounced. Aside his strikingly smart looks – clad in a navy blue tie, white shirt with a variegated neck-tie and neat grey trousers – I was intrigued by his warm personality; his sense of humour was conta

gious. His name was Bill Nelems, a thoracic surgeon from Canada. ‘What on earth has brought him here?’ I wondered.

Bill began his discourse by tracing his roots back to Africa, his birthplace, and e

xplained that he spent part of his childhood in Zambia where his father worked in the mines. He went on to say that Profesor Chifumbe Chintu (fondly known as the ‘father of Paediatrics in Zambia’ by the Zambian medical fraternity), was an old classmate of his at the University of Toronto’s School of Medicine.

This time Bill was back in Africa, because he and his colleagues back in Canada felt the need to contribute to the improvement of healthcare in Zambia. And I came to learn that Bill was directed to Western Province by Dr Margaret Maimbolwa, assistant dean at the University of Zambia’s School of Medicine, because she felt the need was greatest there.

That first encounter with Dr Nelems set the stage for the collaboration that was to develop between us and our Canadian counterparts. This is a partnership that we have come to cherish greatly, and one that has added so much value to our work as we strive to provide health care to the people of Western Province. Space may fail me to chronicle all that has so far transpired in our collaboration, but I must hasten to state that the main story really begins a little later in 2008 with the coming to Lewanika School of Nursing of two registered nurses, Jessica and Lianne, to come to teach there for six months. Accompanying them was Cameron, a science graduate who came to help the stud

ents with computers. Jessica and Lianne made a great contribution to the training of our nurses during that time, but more importantly they established the strong bonds of friendship between us and our Canadian counterparts that will last a lifetime.

Another major milestone in our collaboration was the bringing to W

Dr. Andrew Silumesii with Bill Nelems and Gary O'Connor from OkaZHI

Western Province of the Essential Surgical Skills (ESS) course in October 2009, in partnership with the Canadian Network for International Surgery (CNIS). This was a program in which over 20 health staff from around Western Province comprising mainly of doctors, Medical Licentiates and Clinical Officers were trained. Alongside the surgical training, a nursing component was also offered to our nursing staff.

The ESS course proved to be of great benefit to our doctors and Clinical Officers serving in some of the remotest parts of the province. In this light, we envision Lewanika General Hospital becoming an epicentre of continuing medical education in Western Province. All these courses have been based on the locally identified needs.

In March 2010, OkaZHI facilitated the placement of nine nursing students from the University of British Columbia-Okanagan School of Nursing at Lewanika General Hospital, where they worked alongside our staff for 4 weeks during which there was a rich exchange of knowledge, skills and experiences. Their time at Lewanika was very positive and it is hoped that each year we will continue to have a placement of students for several years to come. During this visit, a Collective Review of Practice at Lewanika General Hospital and Lewanika School of Nursing was undertaken and its recommendations have formally been adopted as a plan of action aimed at improving clinical practice and standards of care.

Our experiences with OkaZHI have been very positive. We see great opportunities for the improvement of health care in Western province through this partnership. We value the unwavering commitment of OkaZHI to this cause and the mutual trust and respect exhibited in this collaboration. OkaZHI is proving to be a friend indeed!

By: Dr. Andrew Silumesii

Team Work on So Many Levels!

After reading Jessica’s last blog I got a little teary. It is so true; we are travel mates for life! As in any dynamic duo we have our ups and downs our quarrels and our successes. When it comes down to it, we have a beautiful relationship that I am so grateful....it’s hard to find a good friend, travel partner, and business colleague in one!

This summer I worked in Inuvik, NWT right near Santa’s house in the Arctic Circle. While I was there I did a few road trips and travels. My friends that I traveled with were a lot of fun, but they weren’t Jessica. They were patient, but they weren’t Jessica. They let me have my music loud, but they weren’t Jessica. Finding a good travel partner is like having a great dancing partner....they flow and bend together, and that’s the great relationship that we have! I am so very thankful for you Black Mamba! (Jessica’s snake name....we all need a snake name right?).

Last night was an OkaZHI fundraiser and social event at UBCO. I have to give my team so much credit for pulling it off and it was a great success! Currently we are planning our next trip to Zambia which is in approximately 2 weeks....The amount of planning, preparation, and course development that is going on right now is enough for everyone to be working full time just on OkaZHI work alone! In spite of this we were able to pull off a very successful event with over 100 participants. I am so grateful for our braai’ing team, our fantastic servers and volunteers from UBCO nursing school, and our OkaZHI members for their incredible social skills!

It was neat for me to have 2 special members in the audience. My Mom and Dad came from Prince George and were able to attend their first OkaZHI event. I have to admit that I was a little nervous to present in front of them, even though I have presented many times before. I was glad they were finally able to meet members of our team that have been such a huge support!

On that note, let me talk about the OkaZHI team. How is it that we have found a group that works so well together? We all have a very strong work ethic that is paired quite nicely with our sense of laughter. I love that we are able to work together to brain storm solutions to a problem...I love that we are able to meet 5, 6, 7 times a month and not be sick of each other....I love that we are able to exuberate that same sense of laughter that I see in our Zambian colleagues. I love our passion. We have all given so much of ourselves in so many ways but all for a common goal. Can you imagine if the rest of the world had the same sense of collegiality; it would be a different world!

Two weeks....Can you believe we are back at it again? I cannot wait to see our friends and family in Lusaka, Mongu, and surrounding areas. We have been blessed to have a fantastic hardworking team on the ground in Zambia as well! This will be our biggest team to go to Mongu which means 15 times the fun....So watch out Mongu here we come!

Reflections from Home...

The Dynamic Duo enjoying life out on the road

Now that I have had some down time at home in Canada, I have been able to take the time to read through our old blogs. WOW have we ever come a long way, and WOW have we ever been on a wild ride. Coming back home gives me the chance to take a step back and truly reflect on the affects that my African journey has had on my life. Just to think it was only two short years ago we began our work in Zambia. And it was really only just over 3 years ago that I touched down on African soil for the very first time.

There is just something about being on the road and experiencing new things that charges me on life. I’ve been able to experience history, soak up the culture, and see some of the most beautiful places in the world. I’ve have had to nurse and teach in some of the most extreme conditions and push myself to my so called ‘limits’. Through those times I have experienced my own personal lows, yet also have felt my own personal highs. When I get home and it comes time to describe my latest trip to family and friends, I can never quite seem to explain everything I saw, the people I met, or how I felt at the time. I know all my travels are something I won't ever properly be able to explain. There are words and then there are life experiences, and sometimes those words can never quite do justice to the feeling you had inside while you were there experiencing it for yourself.

With each trip back I feel myself growing further and further away from my old life. Traveling really is all about finding yourself and gaining new perspectives. Personally I’ve grown as much in the past 3 years than I did in my first 24 years on this planet. Sometimes it is hard for people to understand why I travel and choose to work abroad. In my travels I’ve had amazing experiences with people and landscapes. This is what keeps me motivated to travel and nurse abroad, and it is what keeps me out on the road. I miss the road, and I constantly miss the adventure. I need this continuous new outlook on life that traveling brings.

With one of our mentors Fay Karp

I know I won’t be able to keep up this pace for the rest of my life. But for now this means seizing whatever opportunity comes my way and altering my decisions so that I can be out on the road a few months of the year. If fully believe if you really want something bad enough, you will make the proper sacrifices to get there. Lianne and I are the perfect example. For this traveling duo ‘sacrifices’ have meant giving up houses, cars, an income, and potential long-term relationships. While we are away everyone’s life back home still moves forward and we do miss out on our friends and family members’ own life changing events…babies don’t seem to wait for Auntie Jessica and Auntie Lianne to get home! We have been continuously supported by our colleagues, families and friends, and without them would never have been able to achieve a quarter of what we have already.

As our adventures continue, I count myself very lucky to have found the perfect travel mate. Being out on the road with Lianne just makes my trips that much better. When it comes down to it we couldn't be more opposite, but do we ever work well together. In the end we really do balance each other out. I don't know how many times we have been lost, stuck on the side of the road, or huddled in our near flooded tent… in these situations she always has the ability to make me laugh. Life out on the road can be stressful at times....say when you are lost driving around the streets of Maputo!...or say after the chain has fallen off your bike 10 times in one day! We most certainly have taken that frustration out on each other. But the best part is always about thirty minutes later we laugh at how silly that was and how sorry we are to have let it get to us. Now that is an important quality in a travel partner.

Stuck on the side of the road with a flat in Botswana

After 4X4ing (in a rental car) through the mud in Mozambique

Really these past couple of years have only been a launchpad for the future, just prepping us for what is to come. Our organization, Okanagan –Zambia Health Initiative is growing fast, and I have never been more proud of the work we are doing in Western Province. I count my Zambian colleagues as some of my closest friends, and I can’t wait to head back ‘home’ to see them in October. Together we will improve health for the people of Western Province, I have no doubt.

Home Sweet Home in Mongu

With our good friend-Dr. Francis Liywalii

Our greatest challenge will always be how do we top this? How is it that each adventure just keeps getting better and better? One day I know I will probably be tired of the road, but one thing is for certain..I haven’t had that feeling yet. Traveling isn't like a light switch that you can just flick off, it's in you..it becomes part of you. One day I hope to say that ‘I’ve seen the world’, but that day isn’t here yet. In fact, I think it is only just beginning.

Just another African sunset...

“Adventure is a path. Real adventure – self-determined, self-motivated, often risky – forces you to have firsthand encounters with the world. The world the way it is, not the way you imagine it. Your body will collide with the earth and you will bear witness. In this way you will be compelled to grapple with the limitless kindness and bottomless cruelty of humankind – and perhaps realize that you yourself are capable of both. This will change you. Nothing will ever again be black-and-white.” – Mark Jenkins

Thank-you Africa for opening my eyes and shaping me into the person I am today.

-JESSICA

Why I Heart ZAMBIA (April 16th, 2010)

We have spent the last two weeks navigating our way through Zambia, and biking my way through has given me a whole new appreciation for this country. Although I have in the past driven all of the roads we have biked across, doing this trip has allowed me to see, hear and feel the heart of Zambia just that much more. Biking allows you the freedom to stop along the way and to integrate with the people. Again, I find myself continually appreciating how friendly the Zambians are…they are the reason why I am here. I have also been able to appreciate the different terrain this country has to offer. In Mongu we are immersed by the Zambezi flood plain and the sand of Western Province…in Eastern Province we got to see the lush, forest filled hills, and in the south it is the farms and sugar plantations that line the route where we cycled. What a beautiful place. Now ok back to cycling those hills of eastern province, they are really hilly! Most times the muscles in my legs sure didn’t appreciate those hills, but sure was a great way to train!

I have enjoyed my time with the other 60 riders on the Tour D’Afrique. Even though we have only been with them 2 weeks it already feels like we are one big family. There is nothing like 60 people all camping together in a bush camp…on the side of the road in Africa…with no running water…no bathrooms…to unite us together! The TDA riders are an eclectic bunch, from many different countries and all walks of life. But it doesn’t matter who you are, or where you come from because ALL of our bike shorts smell bad. If that doesn’t bring you together, than what does in life..right?!

I will never forget our last day of riding as we cruised into Livingstone. We had just spent the last 20 kms on pretty terrible gravel roads. I was having a hard time trying to navigate the dirt and gravel with my small road bike tires. My arms were sore from trying to keep myself stable on my bike, and my hands were cramping from clutching my handle bars so tight and trying not to fall off my bike. I kept thinking to myself ‘Why haven’t paved this road already! Then we came to the crest of the hill, and all of a sudden we are overlooking the town of Livingstone. I look up to see the beautiful mist of Victoria Falls, my motivation to just keep going! There is a reason why Vic Falls is called in the local language ‘The Smoke That Thunders’…the smoke is really thundering right now. Right now in Zambia the rainy season has just peaked, which means the waters of Vic Falls are the highest they are going to be all year. What a perfect way to finish off our bike trip, I will never forget that sight. Also yet another bonus was we hit the smooth pavement, no more gravel roads to navigate through!

Overall I am so proud of myself and my other two musketeers, Lianne and Bill. We have biked long and hard, and done better than we all could have ever expected. (especially after not having been on a bike until last year). Overall my personal lesson learned is that I can really do whatever I put my mind to. Out there on the road I had a few down times when I didn’t think my legs muscles could push myself along anymore. I just kept telling myself to keep going…and I did! The other, more overlying motivation to do this bike ride was for one thing, the Lozi people of Western Province. The more time I spend in Mongu and in Western Province, the more I feel at home. I love being able to nurse in a hospital filled with doctors and nurses with whom I respect. Nothing makes me more proud than to do this bike ride for them. In honour of our tribe living in Western Province, I wore my white Lozi bracelet the whole time while biking. Whenever I had a tough time out on the road, I looked down at my Lozi bracelet and said to myself ‘this is the reason why I am here, these are the people for why I am riding my bike across Zambia..keep pedaling!’ And I did.

Jessica

Oh The Places You'll Go (April 16th, 2010)

I think our experience as a part of Tour D’Afrique has been described by my two friends who have a beautiful vernacular, and therefore I will try to describe the experience from a humorous standpoint.

Firstly I would like to ask who thought I would be able to ride over 1000km in the African Sun??? Exactly…I didn’t either! But we all did it, and we did it gracefully. This time in Africa I have learned many things, but one of the most inspirational being the power of believing in oneself. The three of us really really wanted this bike ride and we trained and we rode hard….and the payout was the completion of a very difficult event. It goes to show that you really can do anything if you put your mind to it.

Secondly, I would love to express my passion for nursing. How we linked nursing with riding your bike across an African country is still mind boggling, but it has been done! I’ve enjoyed spending my time with the two nurses on the tour and learning the art of fluid replacement, rash management, and sadle soreology…..which I may or may not have been a patient of the later ailment.

Looking back it is hard to believe it is over. What is even more surprising is how much I am going to miss it. Who in their right mind would miss waking up at 5 am, packing up the tent again, and applying cream to a very sore bottom only to get on your bicycle to ride over 150km in the hot African sun? I do…and it makes me want to do it over again!

One of the finer memories from this trip was the noises you would hear at night…they were pretty much the typical African sounds, dogs barking, people dancing and playing music, and those darn roosters crowing all night. But wait….don’t those roosters belong to the tour staff?? On a few occasions the local staff who drove the support vehicles bought roosters to eat. However, they often took a few days to prepare the meals and riders patience would slowly be pushed as the roosters kept us up at all hours of the night.

Another favorite memory of mine was day 3 without running water…Not that bad, I know. But 3 days of riding your bike and producing more sweat than you ever have in your life and knowing you have to share a tent, that is a little more challenging. We were quite good at using the sun to “sterilize” your clothes and baby wipes to shower with. But on day 3 we stayed at a camp with a water pump. I will never forget the sheer joy on peoples face as people took turns inching themselves under the water pump for a shot of fresh skin sans salt!

On a serious note, I will truly miss the amazing food. Who would not love 4 solid meals a day with the portion sizes enough to feed a mother pregnant with triplets? The best part was the guilt free feeling that was accompanied by a hard day of riding. I am currently working on shrinking my stomach back down for my return home.

So in closing I want to express how much I have enjoyed the members of Tour D’Afrique, my fellow riders, and my two closest friends Bill and Jessica. I feel quite sad to know that this trip has come to an end, but on the positive side I am left with new outdoor enthusiast friends, stronger relations with my existing colleagues, and a deeper love for Zambia and it’s beautiful people.

I love biking. I love Zambia. I love these times of my life!

Kilimanjaro next year team?

Lianne

The Beginning (April 12th, 2010)

Sometimes I have to ask myself why I decide to do the things I do. In the months and weeks spent getting ready for this bike ride, I most certainly have had the ‘What was I thinking?!!” thought more than just a few times. Probably one of the main reasons for this thought is because until a year ago, I had not been on a bike in over 15 years. Now here we are riding over 1000 kms in just only 8 days, across Zambia. Although we were training in Mongu during the two months leading up to this bike ride, I don’t think anything can really prepare you for a bike ride like this. The days of riding are long, averaging about 150 kms/day, this is a pretty intimidating number for someone like me who has never ridden more than 30-40 kms in one day. (Never mind 5 consecutive days in a row!) Also yet another challenge is the fact that we are after all in Africa, which just in itself can be a challenging experience.

To decide to ride your bike across Zambia is certainly not something I would ever have guessed that I would be doing in my life! But here I am. It is certainly not something that I would ever have done on my own, so thank goodness for my other halves in this, Lianne and Bill. Over the past couple years I have been so proud of all the accomplishments we have been able to achieve with our work in Zambia. I am also amazed at all the things I have been able to do and see all over this continent. There is no way that I would have been able to achieve these wonderful things without Lianne and Bill, we really are like the ‘Three Musketeers’. I couldn’t ask for any two better people to be embarking on such a challenging journey. The best part about the three of us is that you just never know what we are going to do next….and now here we are at it again, with the ‘Three Musketeers’ riding our bikes across Zambia!



In the days leading up to joining the Tour D’Afrique in Malawi my feelings of nervousness and apprehension began to increase as the reality set in that I would soon be riding my bike across Zambia. The same thought just kept rolling in my head…. ‘Can I really can do this?!’ As we hopped on our bikes the first morning and rode out of Lilongwe, I was excited and feeling positive. Then we hit the first hill just outside of town, and my legs were already hurting! That was just the beginning of the mental game I had to play with myself on this trip. I just kept telling myself over and over to push it, and keep pedalling. Positive thoughts and words of wisdom from family and friends back home also helped too!


It didn’t take us long to get into the biking routine out on the road. By this time the Tour D’Afrique and all the riders (who have been here since Cairo, Egypt) are a well oiled machine. The day starts early at 0500, waking up and getting yourself and your tent all packed up. The sun is still not up at that point, so as you look across to the fields, schools, or churches where we are camping along the way, all you see is a dance of headlamps as everyone is packing up for the day. I call them the Tour D’Afrique fireflies! Now normally I am not a morning person, but being on the TDA makes you a morning person. The faster you get out on your bike, the faster you get to the next camp. It also means you get to escape the burning afternoon African sun.
There is no better way to experience a country by riding your bike through it. The TDA offers that chance, and has been the best part to joining this tour. Ok to tell you the truth some of my favourite memories have come from the times when take a rest on the road during our day of cycling. The ‘Three Musketeers’ have been known to stop once or twice at a ‘coke stop’. A coke stop is a TDA created term, by definition it is a local pub or rest stop in one of the villages along the way. Sometimes the cokes are cold, other times not so much…but this is Africa right?! Sometimes it just feels like I am just trying to pedal myself from one coke stop to the other….but I’m ok with it! We have even been known to take a few minutes on the side of the road for an afternoon nap. Together we share our energy bars, and remind each other to keep up on our H2O intake. We take off our sweaty helmets, lie down in the grass and give our bums much needed rest. (those saddle sores don’t take long to develop!) Although I do enjoy the days on the bike, nothing is more satisfying than seeing the orange flagging tape that signifies we have reached the next camp. Another of cycling done! The routine continues when we reach camp, and out comes the tent to be set-up…again. Dinner comes courtesy of our wonderful cook, James and then it is off to bed. Our early mornings mean that when the day of riding is done, we are all in bed at 7pm. I fall asleep so fast, barely even noticing the fact that I have no pillow. This is the time when I reminded how I don’t need much more than a backpack, a tent, and a bike to be happy in this world!

Jessica

Thoughts from Mongu...Written March 15th, 2010

This time around I have been in Mongu since February and have been continuing my training for the bike ride on the ground here. I am glad to have had some time to acclimatize…it is hot! Biking in Africa has been an experience. But I would not have expected anything less! From my time spent living and travelling here, I have realized that doing anything in Africa is always an experience. That is the beauty of this continent.

Six weeks ago I came with fellow teachers, Fay and Lianne, and with nine nursing students from the University of British Columbia-Okanagan, and helped guide them through a clinical placement at Lewanika General Hospital, our local hospital here in Mongu. With funds raised by the students they were all able to purchase ZamBikes to use around town. I will never forget the first day we all went down to the bus station to pick up our ZamBikes. The bikes are quite flashy looking compared to any other bike you usually see on the road here. First, they are brand new (compared to most of the other rickety bikes you see on the roads here) and the other is that they are painted a very bright yellow! We were quite the talk of the town riding those bikes home from the bus station that day. I don’t think Mongu had ever seen a sight quite like it…imagine ten Makuwa’s (the Lozi name for white person) riding through the streets of Mongu all together on bright yellow bikes! It is uncommon in Mongu to see even just ten young female Makuwa’s all standing together, never mind them all riding bright yellow bikes together.



ZamBikes in the Lusaka bus station..on their way to Mongu!

Biking through the roads in Mongu can be a bit dangerous at times (sorry Mom!). The taxis and minibuses drive so fast, barely paying attention to the mass amount of people walking and biking up and down the roads. The roads are also slowly falling away, leaving jagged edges and potholes in the pavement. This means you have to avoid these dangers all at once! The other thing about Mongu is the sand.
Any Zambian can tell you that Mongu is famous for three things…fish…rice…and the sand! This is a very sandy place, and riding or driving around in it reminds me a lot of navigating through snow. You can see how this would be an added challenge; because you are constantly having to swerve your bike tires around so you don’t get stuck!

Lianne and I have been working in Mongu since 2008, and from the beginning we were one of the few female ‘Makuwas’ in town. This means we usually always have people coming up to us to introduce themselves; we can’t help but stand out! But the beauty of it all is even if we’ve met someone just once…they always seem to remember it and now us means we are friends for life! (Just yet another reason why I love Africa) I am constantly amazed at how many people remember my name; even I only shook their hand once. This has also been reflected in my biking experiences here. It seems that every time I hop on my bike and start biking anywhere in town, I have multiple people coming up and saying hello or wanting to carry on full conversations! I can be biking on any road, and will often hear Jezzzzzzzka! Jezzzzka! (That is how they pronounce my name here). Each time I hear my name being called I never know who it is going to be…. maybe it is one of my taxi drivers, maybe it is a lady from the market, or maybe it is a patient’s family member, who knows who it will be next time?

I think my favourite thing about biking in Mongu is that it brings you so much closer to the people and their lives here in this town. You can see the sights, hear the sounds and smell the smells just that much more. My favourite time to bike is around 6pm, when I am out on the road alongside everyone heading home from work. (Most are usually walking or biking home since they can‘t afford vehicles). This is always good time for conversation with the locals, and they are often shouting out a Hello! Or Kimanzibwani! (Lozi saying for Good Evening).
Dusk comes as the sun begins to set; the women are setting the fires in preparation for bathing the children and cooking nshima (the local dish). There is an air of peace and calm, and I get to soak it all in.

This is only just the beginning!

Jessica

bicycle diaries

When I was a kid I enjoyed going for strolls around the block on my banana seated Strawberry Shortcake bike. It was a way for me to occupy my time and spend quality time with my friends and neighbours.

Now that I am almost 25 years old the face of biking has changed for me…or has it? I enjoy taking my bicycle for a stroll down by the river having the air whip at my hair and the beautiful scenery all around me as I take my bike down a new path on the search for a new adventure. When I look back and relate my experience of biking as a child on the banana seat to me on my much smaller seat now, I see the same excitement and joy, the same yearning to find a new adventure!

The beautiful thing about biking is how practical yet versatile it can be. It can fit almost any lifestyle. I enjoy biking to work – it is economic, cuts down on transmissions, and fits with my hippy side of life. I enjoy the exercise – it creates endorphins after a stressful day and helps with the guilty feelings you may feel after eating those Timbits. I enjoy the rush – downhill biking allows me to feel the rush as I manoeuvre my bike through trees and up and down ramps. I enjoy the challenge – pushing myself to bike from Lilongwe, Malawi to Victoria Falls is something I never doubted biking could do, but something I never saw myself caring out. Once again, biking is taking me on a new adventure.

I was recently training for this bike ride in Inuvik, NWT. The one gym in town was open 24 hours a day, 7 days a week. After a shift I would head to the gym and ride for 1-3 hours. I would sit there and watch the gym community at large “climbing Kilimanjaro” on my bike. A month ago I arrived in Mongu, Zambia. Awaiting me was 9 Canadian nursing students, two instructors, and 13 yellow Zambikes. I must admit in the first few weeks the bikese didn’t see much of me. However in the last 3 weeks I have been biking almost daily and remember the pure joy of biking. It has also reminded me how HOT it is in Africa! Nonetheless, I am ecstatic to embark on this journey with my good friends Jessica and Bill. It won’t be easy, but we will do our best to have as much fun and as many adventures as possible!

The Story So Far:

I was picked up from the airport by one of our good friends at Zambikes. As we were driving to their farm house we are passing many people on the road with bikes with loads of charcoal, chickens and dogs racing into the streets, and the craziest traffic. The entire time I was chatting away catching up and it dawned on me that this all seemed perfectly normal and not surreal at all. I knew I was home.

At the Zambike farm I had a chance to try welding. It has been something I have wanted to try for awhile, but Zesco that pesky power company has prevented me from carrying out this bucket list activity. However, this time I was fortunate enough to stick weld and make a zambike….Ok, you caught me, I welded two pieces of metal together and then sanded them which is not quite a bike. I did get a chance to see my bamboo frame and instantly fell in love!

The next day I loaded into a bus and set off for Mongu. It was so good to see Jessica, Fay, and my home! I can not believe it has only been 2 and a bit months since I was here last. To be completely honest I was a little nervous to meet all the students as I didn’t really know them and was coming into the program half way through. I was not surprised to learn that all the ladies are amazing nurses!

My first week started off getting to know everyone and the routines. It was great to see how well everything ran. I feel like I live in a commune with 11 other wives who all cook and clean! It was great to be back at the hospital and work with the midwives. I have to tell you one of my proudest moments in my life. I’ve delivered babies here in Zambia before, but this trip was focused on teaching the students. We would discuss how to deliver a baby, possible complications, and cultural sensitivity in nursing practices. It was the most rewarding moment when one of my students delivered her first baby. I remember how it felt for me, and to see the joy on her face made my heart melt. Teaching truly is one of the most exciting things I’ve done in my career!

In saying that….maternity has not been a happy place the entire time. There have been many deaths, complications, and difficult times for the students and myself. We have had many debriefing moments where we have to end the day with a fanta or mosi (soft drink or beer). Overall, the students have been extraordinarily resilient and try to take each moment as a teaching opportunity.

The third trip to Zambia....

Most of our followers are aware that Jess and I are on our way to Zambia again...As usual it has been hectic getting everything together before anothe busy trip. I am writing from London, Heathrow Airport on route to Zambia as we speak!

Jessica has been in Zambia since the end of January. She is accompanied by 9 UBCO nursing students and Fay Karp a proffessor at UBCO. The girls are completing their 4th year practicum and have classmates who are in Ghana completing theirs. We are extremely excited to see the students in Zambia as it was something Jess and I envisioned from the beggining. Naturally it would make sense we would be there to see them on the ground. For the next 6 weeks we will be working alongside Fay and guiding the girls through their practicum. I am arriving a little late, but in time to help out with Obstetrics and maternity while Jess will focus on HIV/AIDS clinic and med/surg.

After our 6 weeks we plan to develop a Post opeative nursing manual for one of our future trips. The manual will be developed with the guidance and support of our Zambian nuse colleagues.

And to finish the 3 month trip off, why not a charity bike ride? Jess, myself, and Bill will be riding our bamboo bikes as part of tour d'afrique. Bill will ride 4500km from Lilongwe to Cape Town. Jess and I, being younger and smarter, will ride 1100 km from Lilongwe to Victoria Falls.

This is just a brief synopsis of our future plans....stay tuned. Check out the new links to OKAZHI, Tour d'afrique, and the UBCO nursing students blog!!

Lianne

Essential Surgical Skills

One of the main objectives of our trip was to help facilitate a week long Essential Surgical Skills (ESS) course. This course focused on essential surgical skills such as knot-tying and suturing, chest tube insertion, colostomies, obstetric emergencies, cast application, and many other surgical procedures. These skills are basic, but given the right application of all these skills...they are LIFE-SAVING! The course was developed by Canadian Network for International Surgery (CNIS) and have been delivered in 7 African countries; Zambia now the eighth country on this list. (http://www.cnis.ca/). We are the first team to bring this course to Zambia, which was very exciting. But this is also the first time CNIS has brought the ESS course to a rural facility, which is our very own Lewanika General Hospital!


Bob and Bill pointing out Zambia on a CNIS poster

Two of our surgeons, Dr. Bill Nelems and Dr. Gary O’Connor, spent a week in Calgary last year taking the training that was required to teach the ESS course. They were joined by Dr. Bob Taylor from CNIS and Dr. Glynn Jones who is an general practicioner, with a speciality in anesthesia.

We had a total of 23 doctors, clinical officers, physician liciensciates, and a registered nurse complete the training. There were 10 doctors from Mongu (all the doctors who work at the hospital) and 13 others from surrounding rural towns in Western Province. The group gathered everyday around 9 o’clock (think 'African time')and finished the day around 5 pm. The group completed hands on teaching done in 4 stations each day.The strongest piece to the ESS course was how it required the students to learn by doing hands on practical skills. This is a concept that is very different to the traditional lecture-stlye teaching that most Zambians are used to, but very well received by all of our participants. There was a break for coffee and a catered lunch by the best caterer in Mongu, Rueben.

Bob teaching the art of 'knot-tying'


Gary teaching venous cut-downs

By the end of the week the health professionals were laughing and enjoying themselves while basking in a wealth of knowledge. Bill’s blog describes the recipients reactions beautifully.

What was our roll in all of this? Jessica and I helped facilitate the course. What does this mean…we really didn’t know what to expect at first. We knew we had a pretty good idea of where most things could be found in town and if we were unsure we knew who to ask. This skill was very useful. Part of our duties as facilitators included:

-getting pig legs, pig chest walls, intestines, and beef hearts from the local butcher (to use as teaching tools for the course)

-ensuring the caterer had all the food he needed for the next day (usually a trip to the market, harbour, and daily Shoprite runs)
- making budgets
- attending dance lessons from our nursing students

- to get 80+ liters of fuel in the 4 hour petrol line-up...when they are only handing out 10 Liters at a time
- ordering a tire from Lusaka for the vehicle
- making sure each team member had an I Heart Zambia Shirt

- serving lunch
- making sure all of the men ate (that even meant buying groceries for our doctor’s for dinner)
- looking after extra-curricular activities such as road trips to Senanga, and play dates with the children at the orphanage
- planning a thank-you dinner for 200 people
- reconnecting with all of our old friends and colleagues in Mongu, and making new friends

These and many more activities were part of the role as facilitator. We also joined in every morning and took part in the learning and teaching. In the afternoons we ran a 2 hour in-service for the matrons/sisters in charge of the wards at Lewanika Hospital. We discussed topics such as chest tubes (thank goodness for the fish spear accident), catheter care, NG tubes, post operative care, peri-operative care, cast care, and surgical wound management. After the discussion we brought the nurses to the ward where we would do a “case study” with one of the patient’s and discuss the appropriate nursing care for that patient. In total 10 nurses were educated with the hopes that the information would be disseminated to the rest of the ward nurses. We distributed handouts and posters to all the wards and included nursing students in our ward discussions.

The 'Fish Spear' patient allowed for great teaching on the ward


Jess and Lianne with all the charge nurses who attended our in-services

Overall, both the nursing and medical components were extremely effective. It was very rewarding to see the changes that had occurred in such a short timeframe. There was widespread acceptance of knowledge and practice. The course was very rewarding as we saw professional growth as well as intersectoral collaboration. One day we even brought the our nurses to the CNIS course, and had them observe a chest tube insertion. It was fantastic to see the nurses and doctors alongside each other, and also promoting OkaZHI's philosophy of intersectoral collaboration. This was the first time a CNIS course has ever had a nursing component complement its content. The general consensus was how very important it was to have nursing education delivered, that would compliment the surgical skills the doctors learned.

Good work team!

Something old and something new.....

Our time back in Mongu has confirmed a few things for us. Some things are new, but other things always just stay the same….and we are very thankful for that!

Things that have not changed:
•The children yelling “Makuwa” as we pass by
•People asking Jessica if her hair is real
•People asking Lianne if she is the older sister because she is taller
•The village children waiting by the gate every morning for us….and are still there when we get back!
Oasis, the only restaurant/club/meeting spot for all expats
•Lewanika School of Nursing continues to have no internet (who keeps forgetting to pay those bills!)
•Sister Christina still taking charge at the convent
•We get the royal treatment while staying at the convent…fresh fruit, home made jam, fresh bread etc.
•Falling asleep at night to the familiar sound of barking dogs, cats in heat, African drumming, and the occasional Shoprite alarm
•Glorious sunsets over the Zambezi floodplains at Lyambai Hotel



•Our students can still shake those African hips
•A minibus to Shoprite is still two-five
•Power outages….Zesco!!! Need we say more?
•Mosi is still very refreshing….and truly Zambian
•We are still so comfortable driving on the left side of the road, we not afraid to use our hazards, and say a friendly hello when we honk our horn!

Things that are new:

The Mongu Shopping Center has a couple of new additions!! Barbershop...AND Bar!

•I-spot Internet Café….fast and only 9 000K per hour!!
•Road to Senanga…..used to take 3 hours with many potholes and now only 1 hour of smooth sailing
•A presence of police in and around Mongu…including photo radar and ticketing for talking on cell phones….What?!!? I thought this was Africa?
•Shoprite having vegetarian ground round, wieners, sausages, and burgers!
•Jessica and Lianne now best friends with the Shoprite Assistant Manager (he even asked us to deliver his baby) and are now masters of the fruit and veggie scale
•Lianne and Jessica’s “muscle memory” and ability to shake their hips (our students even said we were better than some of the 1st years!!)
•We have discovered a different Zambian beer…Eagle (it is made of Sorgum and gluten free – shout outs to Ma Barker)
•New additions to certain shops around town (including a Humble Sheep 2 Barber Shop)

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