i delivered my first baby!!

Dear Diary,

Yes that is what this blog has turned into for me, a place where I can relay my thoughts and feelings. So back to that emotional roller coaster, these past few days have been all right. The frustration remains, but my outlook has changed.

Yesterday I got a package from my family. WOW! I can not tell you how good a “fruit to go snack” tastes. In saying that we have been eating really well, but home will always be home (and when I return all I will want in Nshima). It took almost 2 months to get the package, but it made my whole week! Thanks mom and dad.

Yesterday was one of my favourite days in Africa. Right up there with my visits to the orphanage. I worked on the labour and delivery ward while Jessica went to the HIV clinic. Right off the bat a women was set up to go to the operating room for a Caesarean Section. She had a previous section for having a big baby that wouldn’t fit through her pelvis (CPD) and was not progressing with this baby, so she was sent to the OR. In the OR, the General Practice doctor scrubbed in (remember they have no surgeons) and the woman was put under general anaesthetics (usually in Canada we would use an epidural as it is less of a risk for the mom and baby). The baby was born pretty blue….so the midwife held the baby up by the feet and started to rub the baby to get it to cry….The methods used to stimulate the baby’s first breath were different than ours (I’ve never seen a baby held upside down from it’s feet!!) but regardless, the baby was fine and we welcomed a baby girl into the world.

As I got back to the ward, there was a first time mom who was starting to push. I popped into the labour room and the midwife says, “do you want to deliver this one” as she was cleaning up after the last delivery (which was right beside this bed only 1 foot away). I thought, well I taught all the students the theory on how to deliver babies, and I’ve seen lots before, and she is only right there. So I did it! I delivered my first baby all on my own. It was so amazing, this mom did really well, and the baby was a little premature (34 weeks) which I was kind of glad because it slipped out of there real nice and was very vigorous too. The midwifes were so supportive all day and it was one of my favourite hospital experiences. Plus, it reminded me of home and how amazing my job is. I am so lucky to be a nurse, I get to teach and be with patients….It is the best of both worlds here.

A few things I need to note so you can get the full experience. Women who have babies here are often quite young and usually have many many children. The first time being pregnant, as we all know, can be a scary experience. In Canada the support of a labouring patient is unreal. There is the husband/boyfriend, the nurses, the doctor/midwife, the extended family, a few friends, maybe a doula….lots of people. Women here are not allowed to have anyone in the room while they deliver except the midwife. Imagine being 16 and having your first child while a stranger is yelling at you to push. I think this is why I felt so humble that I could be part of this experience for this amazingly stoic woman. However, once the baby is delivered, the extended family does EVERYTHING. From watching the IV rate (mainly to see if it stops dripping) to bathing the baby and mother. Things are not better or worse here, they are just different and it is so important to keep this in mind when seeing a new culture in play.

When I called my mom to thank her for the package she made a really good point. “You are making a difference Lianne, you helped bring a new life into the world today.” This is the taken for granted little things that I am able to do everyday to make a difference. I am so grateful that this was pointed out because it makes me realise how much the little things in life do count. It doesn’t matter if you are in Africa, Canada, or China (at the Olympics), one person has the ability to make a difference in someone’s life. Think about it, whether you are working with palliative patients, delivering babies, caring for new families, shaping the young minds of the world, or just being a good friend you are touching the lives around you in some way. I have just listed a few of the roles that come to my mind. You guys reading this blog and sending your words of encouragement, funny stories, or even just stories about what you made for dinner last night really make a difference in my life, and I never ever want you to forget about it.

love Lianne

attention UBCO

• To All of the nursing faculty at UBCO,
  
  First off we need to say how sorry we are. Here are the following reasons why we are sorry:
  
  - That we didn’t pay more attention in class
  - That we complained about the amount of notes
  - That we asked the question ‘what is going to be on the exam??’
  - That we talked in class, passed notes and pretty much acted like children
  - That we complained about having to buy textbooks
  - We may have ‘put our heads down to rest’ a few times in class
  - That we got frustrated when you couldn’t answer our questions
  - That we kept asking you ‘why do we need to know this??’
  - That we laughed when you had ‘technical difficulties’ with your computers
  
  We did not appreciate how much prep work you put into all of your classes, the extra time spent meeting with us after hours, and taking the time to listen to our concerns. Sometimes all we want to do is shake our students and say ‘what more do want from me??’ What we have realized is that as a teacher ALL you want to do is make your students succeed. We get it. We finally get it!
  So what we are trying to say is how truly grateful we are for EVERYTHING you have done to help us to succeed and lead us to this point. You shaped us into the nurses and teachers that we are today.
  
  Love
  Lianne "laughing in class" Jones and
  Jessica "just started studying, the exam is tommorow" Barker

we are in a glass cage of emotionssssssssssssssss

Today is our two month anniversary. Emotions are high. Our only Canadian friend here has left this week..and we are lost. Everyone told us that once you hit the two month mark, the reality of what you are doing sinks in. The reality is: we don’t feel like we are making a difference!!!

Here is what we are feeling:
Sad
Lonely
Wanting to come home to Canada
Worried and scared to come back home
To know what is going on at home
Frustrated
Useless
Lost
Confused
Grateful to have each other so we can talk

Ok I know everyone is starting to get really worried after reading these emotions, but this blog is turning into therapy for us. We do have a few reasons why we have been feeling this way. The first is that we have been working hard to prep our lectures and then to deliver them. It takes a long time to prepare for a lecture. At the beginning of our lectures, the students requested that we elaborate in more detail with our notes because they have no textbooks. Now, the students are feeling overwhelmed by the amount of content in the notes and are unsure of what to study (next week is the final exams). On that note, we don’t really know what they are suppose to study either, as there is no nation-wide specific curriculum and we are lacking guidance from our colleagues!

We are stressed because there is only one more week of lectures left for our 2nd year students. We still have so much content to cover, for various reasons. For the past two weeks none of the lecturers have been here, except for us. One day we walked into our class to find the students all sitting there with no teacher, not one teacher had shown up all day to any of the 3 lectures. When we went away, and assigned topics for substitute teachers, none of the topics were covered. Sometimes the teachers will just leave notes for the students and leave it to them to teach themselves. Since no one has been here, we have not had anyone to give us direction. Often we don’t know if the content we are covering is actually what the students really need to know!

We just found out that the results of last year’s licensing exam (equivalent to our nationwide RN exam)..the failure rate was 50% for Lewanika School of Nursing. How does that even happen? This is why we are feeling so frustrated and useless; we just don’t feel like we have enough time here to make a big impact. The problems are so much bigger than just going in and teaching, we see problems with attitudes, motivation and communication. All of these will take time.

Let’s address why we are feeling sad and lonely. First off we just miss the connection of our friends and family back home. We are going to be sad when people are talking about summer of 2008 (Pemberton Festival, the new music, all the new movies/TV shows that came out) and we are so disconnected from it all. So we feel like outsiders. We are also outsiders here as well, as we haven’t grown up in this culture and are feeling disengaged. Sometimes we wish that we could just be black and fit in so we can avoid being a spectacle all the time. It is not always in a negative sense, but when you walk down the street, you know that you are different from everyone around you. Don’t get us wrong, we have met some amazing people that have gone above and beyond welcoming us here. But we miss being able to relate to good ol’ Canadian sarcasm. So what we are trying to express is.. we know that when we get home we won’t feel like we fit in, and we don’t fit in here either, so if someone could just tell us where we belong we would appreciate it!!!!!

We are truly grateful for this experience, and we know we are being just a little bit irrational but that is how the progression of Expat emotion goes. All I can say is thank god for daily power outages that allow for time of reflection. Also, we would be lost without each other and don’t know how someone could do something like this on their own.

love jessica and lianne

Good Quotes..

"For mine is a generation that circles the globe in search of something we haven't tried before, so never refuse an invitation, never resist the unfamiliar, never fail to be polite, and never outstay your welcome. Just keep your mind open and suck in the experience.... and if it hurts you know what - it's probably worth it."


This is a quote that our friend Joe sent us. He recently returned from a life changing experience in Tanzania, where he spent that last year educating about HIV/AIDS..among many other things! This explains how we all feel...

Jessica

Free The Children

Here is a link to a website about a Canadian run foundation called Free The Children. When you get to this website check out the link that says 'Click here to check out additional videos'. Watch the one on Kenya...and you will understand why we love Africa so much.

http://www.freethechildren.com/aboutus/index.php

Meet Mubanga

Name: Mubanga
Age: 30
Status: Very Single
Occupation: Driver for the Lewanika School of Nursing
Favourite Color: Yellow
Time in Western Province: His whole life
Favourite type of music: Gospel
The only thought running through our heads when he is driving us: We are going to die

Mubanga is our driver at Lewanika School of Nursing. He is responsible for picking up all the staff members in the morning, takes us all home for lunch, and then drives us home from school each day. We live quite far out of town compared to the other staff members, so we very much appreciate what he does for us.

When we first met Mubanga, we were ready to ask for a new driver. Because of his erratic driving, we really did think we might die…or we would hit someone else on the road. At first we didn’t think he really liked us (come on everybody likes us!) because he barely ever said two words to us. But then we realized we had quite the language barrier on our hands..as he answered Yes to every single question we asked.

Our bonding with Mubanga began with our ‘professional development’ trip to Livingstone. He enjoyed the music that we played (we busted out the ITrip), and our dance moves. He was also impressed with the fact that Lianne could drive the Land Cruiser.

Now every morning at 8am he picks us up with a smile on his face. He always says ‘Hello, Hello…and gooooooood morning!’ Every time we see him our little hearts just light up, and he now even talks to us each time we are together. We are still concerned for our lives due to his excessive speeding around town, but at least he cranks the music up loud when we get in the truck.

The Reality of AIDS

Friday was our first day working in the hospital. It was weird to put on our scrubs again, we both feel like we don’t remember how to be nurses. We decided to go to the Female medical/surgical ward to try out our skills. Now normally in Canada the wards are split into medical and surgical each with their own specialties, but here due to lack of funding, staffing etc.. all the patients are on one ward. The ward we were on today had 40 patients…with only two nurses. The patients are so sick, I have no clue how the nurses are even coping. Another thing we noticed was how it is all young people that are dying. Those that are dying are between the ages of 20-40, no wonder the life expectancy of a Zambian is only 38 years.

We came onto the ward and began to shadow the two nurses on for that day. Our first duty was…dusting. Yes our Ghana Sisters, we were dusting again. Only this time people were dying all around us and we just kept spreading that dirt around. We were both at a loss as to what we were supposed to be doing. At home I would have been right at that person’s bedside, calling the doctor, giving medications..doing something! But we had to keep in mind that this was our first day, and we are here to learn from the nurses and support them. Part of the problem for nurses here is that they just don’t have the tools, supplies or resources to nurse their patients.
We attended rounds with the doctors, reviewing each patient. Here’s the shocking truth, 90% of the people are HIV positive. 90%! And they were all admitted due to secondary complications associated with AIDS. AIDS has completely changed the face of health care here. To be a nurse or doctor here in Zambia, you have to become a specialist in dealing with AIDS. Here is a list of conditions we saw today, most of which we have never seen at home:

Kaposi’s Sarcoma (secondary to AIDS)
Congestive Heart Failure (secondary to AIDS)
Cervical Cancer (secondary to AIDS)
Encephalitis (secondary to AIDS)
Herpes Zoster (secondary to AIDS)
Tuberculosis (secondary to AIDS)
Pneumocystis Carinii (secondary to AIDS)
Gastroenteritis (secondary to AIDS)
Snake Bites
2nd and 3rd degree burns

A heartbreaking thing for both of us is when the Zambian nurses ask how we treat our HIV positive patients. It is so hard to say that we barely ever see it in Canada. In our six years of nursing, collectively we have only had 2 patients with HIV. Then they ask us why we don’t have HIV. We don’t even know how to respond.

At home the majority of our patients come to the hospital; they get better and go home. Here people come to the hospital and they die. The whole hospital is basically palliative care, but they don’t even have the means to provide proper palliative care. It is a very disheartening experience for both of us, but it just makes us that much more thankful for what we have at home. Even though this is extremely hard, we know these are invaluable experiences that are shaping us into stronger and more well-rounded individuals.