"What Is Time?"

I have a love/hate relationship with the sense of time in Africa. In one respect, it is difficult to get things done because you are always waiting for the proverbial “something”. On the other hand, nothing is hurried because things are not worried over like they are in the States. Let me give you an example.

Today was Outreach day for the clinic. This means several clinic nurses use Thursdays to go into surrounding villages and weigh babies and give immunizations. This outreach is funded by the government as a health promotion initiative so that even those who are not able to make it out of their villages and into the clinic will still receive “basic” health care.

I will be going with two or three other students on Outreach day each week to supervise shot-giving and such, so yesterday I asked Stella, one of the Zambian nurses who goes, if they would be going today. The answer I got was “I think it will be no problem.”. Thinking one of the other nurses might have the inside scoop, I asked Fortune and received the reply, “No, we do not have the fuel to go.”. This answer (though somewhat dismaying) was unsurprising to me. The Outreach team had not gone the past two weeks because the government health district had failed to provide the fuel allotment for the clinic vehicle to drive out to the villages. So we decided to prepare for the best and go to the clinic after chapel this morning, ready for Outreach.

They had told us that if we went we would leave at 10, and we found out when we got there that the fuel had come in, but before we could leave the car had to be utilized by the clinical officer to change money in town-so we waited. We waited so long in fact, that we eventually went up to the Haven to give penicillin shots to the babies with syphilis exposure and when we returned we waited some more. Finally at 11:45 we loaded up-Nurses Fred, Stella, Banda, myself and the two students. Though we were going to a village that was only three kilometers away, it was 12:30 before we arrived at the health post because we had to go back into town first to pick up the vaccines (which had not been done on the first trip into Kalomo). We worked in a little two room outpost provided by the government. A group of women and children were already there, but the numbers were lower than usual because the past two months the clinic sent their outreach team, they were unable to get the vaccines from the district, so people assumed they would not have them this time either. The nurses were unconcerned, saying word would spread that they’d had vaccines today and next month would bring a larger number of people. I had one of the students help weigh babies (there is a scale suspended on a rope that has a hook attached and we hang a canvas bag with leg holes from the hook which we place the babies into) while I helped the other student give immunizations inside. We gave dpt/hib in one vaccine and an oral polio vaccine. Our setup consisted of a cooler with the vials, syringes and needles, cotton balls, and a paper sharps container where we could dispose of the needles.

Once we finished there, we were offered a sweet thick orange drink and a “scone” which was a small corn muffin. Afterwards we loaded back into the car and-surprise-decided to go to another site since we still had vaccinations left. We drove another few kilometers to another orphanage run by a South African couple and played with the babies in-between weighing and immunizing them. Like what usually happens at the Haven, we left all the little ones crying when we put them down to leave. It took us another hour to get back to the mission because we stopped back in town at the district health office for some unknown reason. TIA-this is Africa.

The rest of the week we have gotten on more of a schedule. I’ve gotten up early for Tonga lessons and the Zambian lectures every morning for an hour and a half before breakfast, and gone to either the clinic or the Haven in the afternoon. I’ve taken two students at a time to round on the babies at the Haven to see who is sick, give medications, teach basic assessment skills, and seek out any kids that might need to be seen at the clinic, etc. It has been challenging but fun as well, and I think the students are getting something out of it too :). I say challenging because if you can find an Auntie who speaks English well enough to ask specific questions about the sick baby in their room (like whether or not he/she has gotten their antibiotic that day), they may or may not know the answer and it is usually not recorded anywhere, so it is anyone’s guess! It is also rewarding though to see a sick baby improve based on treatment we are able to administer. We are also able to catch some things more quickly by rounding up there everyday (like the semi-epidemic of pink eye that started around).

Yesterday when the students and I were checking on the sick kids, Kathy (the missionary who started the Haven) came in and asked us to look at Request, an 8 month old who came in last week after his mom died of a “toothache that went to the head”. I took him to the clinic during my rounds on Monday for an HIV send-out test and an xray to rule-out tuberculosis (and he was still getting over pneumonia we’ve been treating him for), and now he was breaking out in a rash. When I went to look at him, there was a raised rash on his entire body and he was so hot it almost hurt to touch him. I asked if we could give him tylenol, but it was still two hours until he could get it again, so the students with me helped me give a tepid sponge bath to bring the fever down. We decided to move him to another part of the house in case he was contagious, and as I carried him he could not even hold his head up. I called Ba Janice and she came with the car, looked at him, and we headed to the clinic with him. Dr. Black and Ba Janice ruled out measles, and we decided to treat him for his dehydration with an iv drip. The only visible vein was in the scalp, so Ba Janice shaved his head and by that time we were able to give him more tylenol. Today he was looking some better, but not quite out of the woods.

Besides the sick patients at the clinic, sickness has been sweeping though our group here. Luckily it has been a 24 hour bug but I even had to give a shot to one of the PA students earlier in the week because she could not stop throwing up. Hopefully it is fizzling out and the rest of us will escape it!

Not too many plans for the weekend, but I have no doubt something exciting will come our way!