"Two Weeks to Go"

Just a few things to catch up on from the past week and a half. Things have been in a comfortable African routine for the most part since we got back from our northern trip, and the group has been enjoying our last few weeks here and trying to soak up every experience we can. I think I left off right before Jannipher’s wedding...

Jannipher got married the Sunday after we returned from Mumena, in the Kalomo high school building. It is the responsibility of the groom’s family to coordinate and decorate for the wedding. When we arrived in our bus we passed the men at the door who were checking the guest list for peoples’ names. The wooden school benches were pushed to either side of the room, leaving the middle clear. The walls were decorated with balloons and streamers and there was a table in the center where the bride and groom would sit after walking down the aisle. For the 45 minutes or so that we waited for the wedding to start, the older women danced around a man who was beating a drum, in celebration of the day. Once the ceremony started (and we were all thoroughly drenched in sweat) it was a mixture of Zambian and Western traditions. The groom danced his way down the aisle, followed by the flower girls and bridesmaids, and finally Roy walked Jannipher down to the front in her Western gown. Due to the poor acoustics we did not hear much of what went on after that, but 40 minutes later the bride and groom were on their way to a local restaurant for a meal with their families, while the rest of the guests waited for them to return and start the reception. We elected not to stay but it was fun to be there for the ceremony.

The previous two weeks the Thursday immunization village outreach has been cancelled for lack of fuel from the district. Both weeks I waited with students for over three hours while we waited to hear whether or not we would go-frustrating. In place of outreach those weeks I went to Kalomo hospital instead with Ba Rogers to encourage the patients and families. Last week as we were praying with the mothers in the children’s ward, we heard terrible, anguished sounds from the window. Three women fell to their knees on the ground and were throwing dust over their heads wailing and crying. One of the girls asked me what was happening, and I told her someone had probably just died. When we made it around to the men’s ward to pray with them, the body of the man who had died a few minutes before was still there. We went outside and spoke with the family, feeling helpless to say anything comforting. We walked down the road to the mothers’ shelter and spoke and sang with them on mais (corn) sacks they laid on the concrete floor for us to sit on. This Thursday outreach actually happened (!) since the district decided to provide their promised fuel, so I took four students and helped them give injections under the log hut. We passed out stickers afterwards, and pointed out what images we thought the clouds looked like on the way back to the clinic from the back of the truck (as we ducked to avoid being hit in the face by branches intertwined over the dirt road).

Monday to Friday has been filled with our typical class/clinic/Haven schedule the past two weeks. There were a couple of days last week that I did not even sit down at the Haven because of all the sick children I was checking on. I would be examining someone, and a student would come in with another child they felt might have a fever or not be feeling well, so I spent a lot of time writing out prescriptions, chasing down medications from the stock room at Haven 3, explaining to the Aunties what needed to be done for the kids, and tepid sponge bathing several with fevers over 103. I could not have gotten it all done without all the students helping-we’ve gotten to where we know these kids well enough to recognize when they are not acting like themselves. I feel like the Aunties are beginning to trust me more and more, and are coming to me with the sick kids more often than I am having to seek out three or four different people to find out who is sick. That has been a very big step in the last month.

Sunday when I was checking on babies at the Haven, I found Trey sick with constant diarrhea and having lost almost a kilo in three days. I sat and attempted to feed him slowly for almost an hour, but he was breathing so fast each time he tried to eat, that I decided to run (literally-I know the Zambians I passed thought I was crazy) the bush path back to the house and get Ba Janice and Dr. Black to come look at him. We all went back up to the Haven, and ended up putting down another nasogastric tube to feed him through overnight. Monday morning we found him still alert but looking more pale and sickly. With lack of anything else to try or test, we took him to the clinic in the afternoon. The attempts to put an IV in were unsuccessful, and his breathing worsened to little more than a gasp even on the oxygen we found for him. Kathy drove to the house just after dinner to tell us he had died a few minutes before, and she needed a death note written before they could take him to the Kalomo morgue. We drove back to the clinic, along with the boy in our group we had named the baby after. He and I washed Trey’s face and chest and wrapped him up in a blanket. That makes eight who have died since we’ve been here; more in two months than the total number of Haven kids that died the entire year last year. It shows the severe impact of AIDS, lack of resources, and a fatalistic mentality on this culture.

While we were waiting on Dr. Black to finish the note, Fortune (the clinic nurse who also lives at Haven 3) called us over to see about Nathan, a 10 month old from Haven 3 on TB treatment who she had started an IV on. He was tachypnic, tachycardic, had a high fever, diarrhea, vomiting and dehydration. His IV was in a scalp vein, and very susceptible to coming out without someone being constantly at the bedside to watch it. We agreed to take him back to our house for the night, since we knew one night nurse to the rest of the inpatients would not be able to keep a close eye on him. As inconvenient as these things seem to always be, the power went off right as we were gathering up his things to transfer him. Dr. Black held the flashlight, big Trey carried the diaper bag, and I cradled Nathan while Janice held the IV fluid bag as high in the air as possible (the clinic only has one IV pole so we couldn’t take it with us). We got him to the house and put him on the spare bed in my room, surrounded by pillows to keep him from rolling off the bed, and treated him with oral syrup for malaria treatment by lantern light. We rigged up a “pole” with string and tied the IV fluids to the top bunk. I watched the buretrol with paranoia to make sure it was still dripping. When he had finally fallen asleep, I laid down beside him and “slept” that way all night with my arm across his hands as a restraint to keep him from pulling out the IV. When he would wake up I would try to get him to take a bottle, give more tylenol, change his diaper, and keep him still as best I could. Somehow the IV made it through the night, and we took him back to the clinic where one of the Aunties met us to watch him for the day. Fortune took out the IV that afternoon and he went back to the Haven. The next day when I went to check on him, he was laughing, eating, playing, and looked 100% better-those are the results I prefer to see.

There are two new babies at the Haven since last week. Wanda came as a 30 hour old infant who was found still attached to her mother’s cord after birth, though the mother had delivered at home without help and had bled to death before either of them were found. She is the sweetest-smelling baby with the softest skin, and we’re treating her with antibiotics for a cord infection. Though the official test for HIV cannot be done nor treatment started until babies are six weeks old, we did a rapid antibody test to see if Wanda had been exposed to the virus (since we did not get a history on whether or not mom was HIV+) and it tested positive. We are anxious to get her to the six week mark so she can be started on treatment if her send-off test comes back positive. Lincoln, one of the babies I tote around all the time, came back HIV+ from his six week test, and he had to be moved over to the hospice Haven. He was immediately enrolled in the ART program and started on HIV treatment, so we pray that when he is tested again at 18 months he will be negative. The other new baby is a 5 month old named Sunday; a cute cubby-cheeked baby who smiles and drools a lot. He will be tested on Monday.

In these past few weeks we have decided that it is almost impossible to have water, electricity, and internet all at the same time in Zambia. We have had so many problems with each of these things the past month, that anyone hardly reacts to finding out the water tank is empty and there is no running water, or that the internet is down again. Or the worst-that the electricity is off and we will have to try to sleep without a fan. Even a fan stirring the hot air around is better than the still heat that is oppressive even through the night. The Zambians themselves have been saying they don’t remember it ever being this hot for this long, and we figure that means we are founded in our groanings of how exceptionally HOT it is this month! We had our first true rain (monsoon really) Tuesday night, and we all stood on the porch in the total darkness (the power was out at the time) and listened to it pound on the tin roof. They say the flight of the termites will come with the next big rain-thousands and thousands of them fleeing the ground and permeating everything; houses, food, every nook and cranny. And then comes the termite feast...so we are steeling ourselves to partake in that bit of culture, yikes.

Our time here at Namwianga is coming to a close. We are in Africa for another month, but we leave the mission two weeks from today to travel to South Africa, Tanzania, Kenya, and Uganda. Kathy asked me the other day if I was sure I wanted to leave instead of staying at the Haven-I told her not to tempt me! She and another clinic nurse, Elizabeth Hallale, have asked me to do six one-hour teaching sessions to the Aunties at the Haven next Tuesday on different health care aspects. We will see how that goes...One of the students is working with me as a part of his class objectives to develop a form that helps the Aunties keep up with how much formula a baby is taking, etcetera so we hope that will be an asset to the Haven. Thank you all for your continued thoughts and prayers for what we are trying to accomplish, and the work we are leaving behind as we leave soon. Until next week...