Give and Receive

On Saturday, May 14, our team put on a tea for a group of widows from Chikankata.  In one of the buildings in the seminar centre we welcomed them, washed their hands, and served them all tea and scones.  After getting to know one another a little, through the aid of translators, the group split into two.  Half of the widows stayed in one room with a few of our team members who provided them with teaching on some topics that might apply to them, such as menopause, caregiver role strain, and some common health challenges associated with aging.  (Apparently many of them had never had menopause explained to them, and were quite relieved to hear that there was an explanation for the changes they were experiencing!

Meanwhile, the other half of the group joined the rest of us in another room.  There, we washed and lotioned their feet and painted their fingernails and toenails.  Many of their hands and feet were very tough and dirty - testimonies of the hard labour that many of these women carry out each and every day so that they and their children can survive without the support of a man.  Many of them are quite alone in the world, aside from their group, as not all of them have the support of their late husbands' families.  It was so neat to be able to serve them even in such a small way, and they were so grateful.  We gave them a little of what we had... our time, a few supplies, and small gifts to each of them as they left.  In return, they gave us their stories - a chance to see a little bit of life through their eyes, to see the strength that they show in living every day with the loss of their loved one and in trying to survive in a highly male-dominated culture which places little value on widows.  More, they showed us what it means to be joyful in suffering.  Their lives were wrought with many hardships and heartaches, yet they bore witness to Christ's goodness and sang of his support even as they shared their heartbreak with us.  They left telling us how much it meant to them to have been served by us, but we could not begin to express to them what it meant to us to have been given even that brief interaction with the power of the witness of their lives.

Washing the feet of the women

Each woman got her feet washed, lotioned, and painted, and her fingernails painted. 

Sometimes both at once.

At the end, we gave each woman a little gift bag with a few things to take home: lotions, shampoos, deoderant, and the like. 

Hospital Adventures

Thursday, May 12, was our first day in the hospital!  For the two weeks that we worked at the hospital our schedule went somewhat as follows:

6 am - Emerge from under our mosquito nets to throw on some scrubs, get ready for the day, and head to the kitchen

My bed and trusty mosquito net

6:30 am - Breakfast!  Most of us had brought a little bit of Canada with us to Zambia in the form of a jar of peanut butter, and we learned quickly to bring it with us to breakfast every day to add a bit of flavour and sustenance to the plain white buns that greeted us each morning.  They weren't too bad on the whole, our breakfasts... the buns were often joined by oatmeal, yogurt, and sometimes eggs and/or fruit.

6:50/7:00 am - Walk from the seminar centre to the chapel across from the hospital for morning devotions.  Although they technically began at 7, we soon fell into "African time", arriving anywhere between 7 and 7:15.  These devotions were refreshing starts to our days, consisting of a few songs from the Salvation Army hymnbook, sung in traditional African style and accompanied by a drummer.  The songs were followed by a short message preached by one of the nursing students.  Our very first day the message was from Joshua, and the theme was fitting: "Don't quit on day one".  And so, with that on our minds, we were taken to our assigned ward for the morning.

 The chapel

 The hospital entrance 

7:30 am - In pairs or trios, we were taken to a different ward each day.  As we were not permitted to do any "invasive care", that is, we could not give injections, give any medications, change wound dressings, or do any of the typical nursing actions we would normally be able to do at home.  This was a challenge, not only because it causes the nursing students to believe us incapable of doing anything, but because it forced us to focus on other ways of caring for the patients.  Our time on the wards was spent observing, learning from the nurses and student nurses, talking to the patients, helping with other tasks such as cleaning and bed making, and demonstrating "patient-centred care".  This patient centred care is a concept which is fairly drilled into our skulls at TWU, and yet is hardly to be found at the Chikankata hospital.  Not that they do not care for their patients, but the role of nursing is very different there, and the very structure of the hospital is less conducive to the type of care we are accustomed to offering.  For one thing, workload is not divided up into patients assigned to each nurse, as it is in Canada, but rather by task.  For example, let's say a ward of 20 patients has four nurses.  In Canada, each nurse would be assigned five patients.  In Chikankata, however, one nurse might do all the medications, while another would do all the wound dressings, and another two might follow the doctor on his rounds and then do all that he ordered.  Although there is a head nurse responsible for ensuring that everything gets done, it seems to me that this method is far less holistic, and is more likely to allow things to slip through the cracks.  If there is not one specific nurse responsible for any given patient, how does the team ensure that all his psychosocial and teaching needs are met? 

In addition to this, the hospital is very short staffed, and as a result is virtually run by the students.  While they are very confident and competent, they are only students, and without the mentorship and instruction that we are blessed to receive, they cannot always provide the best possible care.  I saw wound dressings with 'sterile' technique that made me squirm, with little or no pain medication given in advance.  But I am getting ahead of myself.

Scrubbed up and snagging the chance to hold a beautiful baby

10:00 - If we were not too busy, we would walk down to the seminar centre for tea and sometimes a snack, and then back up to the hospital for the remainder of the shift.

12:00 - Lunch time!  The common fare for us often consisted of rice or pasta, chicken, a cooked leaf-type vegetable, and the ever-present white buns.  Or, we might be served sandwiches made of two pieces of white bread with some sort of unidentifiable spread and possibly one slice of tomato or a few shreds of cheese.  After lunch we had a bit of time to nap, relax, or journal, before...

 One of my journalling spots

14:00 - Speaker time.  Most days, we would have two speakers come to the seminar centre, for one hour each.  Theoretically.  In true African style, many went a wee bit overtime, they were that eager to share with us about their topics.  We heard about everything from nursing in Zambia to their home health care system to AIDS and orphans to leprosy.  Many were very interesting topics, however I learned a very interesting thing about myself.  Whether it was the heat, the time change, the time of day, or the room, I know not, but every day like clockwork I would arrive at 14:00 and by 14:20/14:30 I could not for the life of me keep my eyes open and my brain focused on the speaker.  Try as I might I retained virtually nothing of what was said for about 25 minutes, until I would regain some measure of alertness around 14:50.  For the last portion of the first speaker and most of the next, I was attentive as could be.

18:00 - Dinner!  See lunch.

One of the stranger things I ate... 

After dinner we would have devos/debrief, which involved singing, one of our team sharing a brief devotion, and then talking about our days.  This would be followed by some journalling, maybe a shower and a bit of reading time, and then bed.  Given that we were a group of university girls, you might be surprised that without fail, we were ready to hit the sack within a few hours of devos.  Staying up until 22:00 was a late night; we could barely keep our eyes open to journal about the day.  So we tucked ourselves back into our mosquito nets, said our goodnights, and were lost to the world.

A Different Take on Tourism

Of day two of our time in Zambia I've little to write, except that I spent most of the day sick in bed.  After a vicious bout of nausea after seeing the hospital, I was sent back to the compound to have a nap while the rest of my group went on with more orientation.  I was disappointed to miss meeting the chieftainess, going to the market, and most of the welcome BBQ, but I really wanted to make a quick recovery so as to be able to go to Kasiwe the following day.  Kasiwe is an 'eco-tourism' village, meaning that they offer tours of their village to visitors, complete with local food, a hike up the nearby mountain, and experiences of their day to day life, such as pounding maize and carrying water on your head.

The following morning I still had little energy, but was determined to go, hoping my nausea would stay under control during the 45 minute land cruiser ride.  When I say ride, picture your and my version of going for a car ride.  Got it?  Now scrap that picture, and instead imagine something akin to offroading, or the Indiana Jones ride at Disneyland; we were driving along a dirt road full of bumps and ditches, over hills, and eventually left even that road to simply drive through a field, mowing down stalks that reached our windows.  Being sick, I was fortunate enough to sit in the front.  The rest of the group was piled on two benches facing each other in the back, landing on one another each time we hit a bump.  Seatbelts, of course, were nowhere to be found.

Before you believe the ride was miserable, however, let me add this.  Picture, now, rolling along the Zambian countryside with a cruiser full of friends and a local driver.  The sun is shining down on the yellow fields, the hills are beautiful in the distance, and the radio is playing traditional African music.  And I did not feel nauseous once :)

Upon arrival, we were ushered into a mud hut (no joke) where were were served breakfast and introduced to the village.  Then, while the rest of my team went on the hike, my instructor and I got to visit the health clinic - a building in their village at which they are visited once a month by nurses and nursing students from the Chikankata hospital.  After resting for awhile, I went outside to where all the children and mothers were.  Aside from a greeting, I spoke no Tonga, and they spoke no English.  Yet within minutes, I was sitting against the building, surrounded on all sides by children of all ages who were curious about my hair, my skin, my clothes, my bracelet, my glasses, my camera... basically everything about me was different.  It was a bit of an odd feeling, spending that much time with people without being able to talk, yet kind of neat at the same time.

After returning from the hike and eating lunch (chicken, cooked cabbage-like plant, and their traditional nshima, all eaten with our hands, of course), the rest of the day consisted of playing soccer (football) with the kids, carrying water on our heads, pounding maize, touring the village, and learning to dance like Zambians.  Well, at least they tried to teach us...

For the most part, it was a pretty fun day.  We got to learn about their village, their culture, and some of the problems they faced, but overall I found it to be light and enjoyable.  Towards the end of the day, however, one moment stood out as a reality check, and a hint of the great divide between how we live at home and the lives of the nation to which we had come.  When I think of visiting a tourism village, I imagine one of those heritage villages at home, in which a bit is preserved of how people used to live, complete with people acting as though they really lived there.  In many ways, that is what this village felt like... mud huts, pumping and carrying water, pounding maize... showing us what life in Africa was like.  And much of it was similar to what you'd see on the World Vision channel or documentaries on Africa.  At one point, we were taking pictures outside a tiny mud hut and as the door was sagging, leaving an opening into the hut, I asked if I could take a peek inside.  Their response:  well, that's someone's home...

This hut was tiny.  It was a circular mud building, with a grass roof and the door sagging inwards.  Although I had known it before, it was at this point that it really struck me: this is not some documentary of how people used to live, or a glimpse into the past.  These people were sharing with us how they live today, and what they are trying to overcome.  Before going to Africa, I would say that I was fairly aware of how they live, the struggles they face, and all the basics of life that they lack, which we take for granted.  Yet continually throughout the trip, I was hit by how different it is to sit at home knowing these things intellecturally and to actually experience them.

And so it begins....

Hello again!

It's strange to think that I'll be heading home tomorrow... in some ways it feels like just yesterday that we left, but in other ways it feels so long ago.  Because I wasn't able to update while I was in Zambia, I'll start from the beginning and try to post every day or two as if I was there, for those of you who are interested.

So I shall begin from the beginning.
After about three hours of sleep, four hours of driving, three hours at the airport, a three and a half hour flight, a three and a half hour layover, an eight hour flight, a seven hour layover, and a ten hour flight, I was finally in Zambia!  Local time = 6:30 am.  We didn't slow down much that first day, either.  After breakfast and some grocery shopping, we drove the few hours to Chikankata, in a Salvation Army van with holes in the ground and our luggage on the roof.  It was a little strange arriving in Lusaka, the capital city, and going to a very westernized shopping mall, and then seeing the transition from urban to rural.  It was not uncommon to see people walking along the side of the highway, in what was to us the middle of nowhere.  We soon learned that the people of Zambia who cannot afford a car will walk distances that we in North America would never dream of walking, often with baskets on their heads and/or babies on their backs.

Our accommodations at the seminar centre in Chikankata were a little small, but more than comfortable.  Although I was surprised at how awake I was through all my travels and that first day, it was so glorious to lie down in a real bed for a good night's sleep, all tucked into my bed and mosquito net. Being almost winter in Zambia, it got dark around 6:30 pm and light around 6 am.  This, combined with how exhausted we were each day and the fact that breakfast was served at 6:30 almost every day, forced us all to become obligatory earlybirds... our usual routine involved going to bed anytime between 9 and 10 pm and getting up around 6 am.

Worlds Apart

Hello my friends!

I'm so sorry it's taken this long to post... lesson number one from this trip: do not rely on internet access in rural Africa.  It turns out that the internet access we had was at the local high school, involved a minimal fee, and took about half an hour just to check one or two important emails.  Furthermore, blogger was in German and wouldn't let me post.  So I apologise for the lack of contact, and will do my best to post a couple times in the next few days and then again more frequently when I get home.

We flew into London on May 30, and I will be flying out for home on June 5.  I'm loving London, but in many ways it feels about as polar opposite from Zambia as you can get.  Adjusting to a busy, aloof city is difficult after spending two and a half weeks in a laid-back, friendly mission compound, where showing up 15 minutes after the projected starting time is considered early, and not greeting virtually everyone you pass is considered rude.

I only have a few more minutes of internet time remaining, so I'll leave you with that for now, and a plan to update again in a couple days, when I should get more internet time.
Twalumba,
Cayla

A Bit About Zambia

To give you a bit of a taste of where I will be and what I will be doing over the next month, here is a brief introduction to the nation of Zambia and the town in which I will be staying.

The Republic of Zambia is a nation in southern Africa, just above Botswana.  Its official language is English, although a number of other languages are recognized, including Tonga, the predominant language spoken in the area which my team will be visiting.

Zambia became the British colony of Northern Rhodesia towards the end of the 19th century, and gained its independance in 1964.

Zambia is a fairly large country - approximately 4/5 of the size of British Columbia, although its population is almost three times what ours is.  Of these people, almost 70% live below the established poverty line.

The official religion of Zambia is Christianity, but a wide variety of religious traditions exist, including Islam, Judaism, the Baha'i faith, and a number of syncretic churches.

The literacy rate is approximately 80%, however most children drop out of school after year seven, as schooling beyond that is no longer publicly funded.  If children do go on to complete primary and secondary school, pursuing further education is very difficult, as there are a limited number of universities with a very competitive entry system and many cannot pay tuition.  One alternative to university education is to attend a nursing training program at a missionary hospital.  One such hospital is the salvation army hospital in Chikankata, which is where my team and I will be spending the majority of our time in Zambia.

This hospital is well known throughout Zambia as a leader in excellence, and people come from all over to take courses in HIV prevention and management (the prevalence of HIV in Zambia exceeds 10%).  The mission includes a high school, hospital, and nursing school.  We will be working alongside the hospital nurses and student nurses there.