hello all- sorry this is basically a one line entry but I'm exhausted. I'll probably write more later this week but in summary Botswana was absolutely incredible. Here are some pics to entertain you until I'm done losing the war against jet lag.
Thursday, April 23, 2009
Thursday, April 9, 2009
A shout out from Sara
I'm officially finished with the hospital and now off to go get eaten by a lion in Botswana. The best news of the week is that my friend Sara Kamins is here with me! So she's guest starring in this blog writing it with me this morning.
We got a taste of a classic African bus experience after I picked her up at the airport. I've taken several 4 hour bus rides since arriving in Zambia but everyone has always advised me to take a specific company called Mazhandu. Until Wednesday I stuck with the advise but that afternoon they told us their last bus for the day had already departed when we got there. Fortunately, wink wink, they had a sister bus company with a bus leaving "in 15 minutes". We should have know an imminent departure was less than likely when we got on the large bus to find only 3 other Americans and about 67 empty seats. Sara's first 4 hours in Zambia were spent being told we were leaving in "15 minutes" while guys from the street boarded and tried to sell us boxer shorts, watches and bananas. We eventually left 4 hours after boarding and got to Choma at about 11 pm. So much for showing her the sunset.
Yesterday I showed her around Choma and said goodbye to everyone I've come to know in the past few months. She saw the hospital (Don't worry Sue it was from a distance), a few schools, the market (including smelly dried fish) and the guesthouse. We enjoyed our morning walking around and then hopped on a much less chaotic bus for livingstone. Last night we stayed at Jolly Boys, the hostel I've been at before and now we're waiting to be picked up for our big Botswana adventure.
No internet for the next 8 days so we'll keep you posted when we're back. Take Care!
Melissa AND Sara
We got a taste of a classic African bus experience after I picked her up at the airport. I've taken several 4 hour bus rides since arriving in Zambia but everyone has always advised me to take a specific company called Mazhandu. Until Wednesday I stuck with the advise but that afternoon they told us their last bus for the day had already departed when we got there. Fortunately, wink wink, they had a sister bus company with a bus leaving "in 15 minutes". We should have know an imminent departure was less than likely when we got on the large bus to find only 3 other Americans and about 67 empty seats. Sara's first 4 hours in Zambia were spent being told we were leaving in "15 minutes" while guys from the street boarded and tried to sell us boxer shorts, watches and bananas. We eventually left 4 hours after boarding and got to Choma at about 11 pm. So much for showing her the sunset.
Yesterday I showed her around Choma and said goodbye to everyone I've come to know in the past few months. She saw the hospital (Don't worry Sue it was from a distance), a few schools, the market (including smelly dried fish) and the guesthouse. We enjoyed our morning walking around and then hopped on a much less chaotic bus for livingstone. Last night we stayed at Jolly Boys, the hostel I've been at before and now we're waiting to be picked up for our big Botswana adventure.
No internet for the next 8 days so we'll keep you posted when we're back. Take Care!
Melissa AND Sara
Friday, April 3, 2009
Last Week
Hola,
As is typically the case at the end of an adventure, I'm not quite ready to leave. This week has been really fun as I've been exploring other parts of the hospital in addition to working with Dr Johnson in the theatre. My favorite part of the week was delivering babies! A late night C-section last week reminded me how great is is watching these tiny little guys pop into the world. Since then I've been hanging out with the midwives during breaks this week and delivered 4 babies so far. Labor and delivery is quite a bit different here than at home as there are no fetal heart monitors and NO PAIN MEDS!!! Watching these ladies made me think us Americans are such wimps, but when I eventually get around to having kids you bet I want that epidural.
What the labor room here did have which most at home don't is a resident cobra. Yes, a cobra as in long scary poisonous snake. Here in Zambia there is a old wives tale that a snake won't come near a pregnant lady. Hmmmm...consider that myth dispelled by a bunch of midwives and pregnant ladies running around the ward yelling "snake!". Fortunately nobody was bitten and the snake was beheaded. We're still waiting to see if he has friends who will be gracing us with their presence.
I also attended a general meeting of all of the hospital staff. It was really interesting to see what issues they found most challenging or concerning. In contrast to my last post, saying people weren't so concerned with other staff members dying, much of the meeting was dedicated to the very subject. Sadly they are faced with so many funerals of community members that they have whole policies and committees determining how funerals are handled. Employers here are much more responsible for providing for employees in all aspects of living. Many people are fed and housed by their employers. To an extent this also includes planning/financing funerals and weddings. There were interesting concerns of funerals for employees at different pay levels getting more priority or people in different jobs having more freedom to attend all of the funerals they would like. This is also compounded by a cultural concern that if you don't attend someone's funeral you will be blamed for their death.
They also discussed extensively plans to fix the broken generator versus the broken minibus. These are issues I can't really imagine making it to the board meeting at a hospital at home but truly matter day to day here.
Not much else is new-just lots of social plans this weekend with people in town who know I'm leaving soon. Last weekend one of the cooks from the guesthouse invited me to her home to meet her family which I just loved. While I was there we were watching TV, as they typically do on a Sunday afternoon. There aren't many channels but what was on was WWF wrestling. WWF is ENORMOUSLY popular here. I can't say I'm proud that's what Zambians think America is like, but for whatever reason they absolutely love it here. Perhaps the funniest moment of my time here was when the 3 year old niece introduced me to her teddy bear and told me it's name was John Cena, after a WWF star. Scary!
That's it for now- have a great week!
As is typically the case at the end of an adventure, I'm not quite ready to leave. This week has been really fun as I've been exploring other parts of the hospital in addition to working with Dr Johnson in the theatre. My favorite part of the week was delivering babies! A late night C-section last week reminded me how great is is watching these tiny little guys pop into the world. Since then I've been hanging out with the midwives during breaks this week and delivered 4 babies so far. Labor and delivery is quite a bit different here than at home as there are no fetal heart monitors and NO PAIN MEDS!!! Watching these ladies made me think us Americans are such wimps, but when I eventually get around to having kids you bet I want that epidural.
What the labor room here did have which most at home don't is a resident cobra. Yes, a cobra as in long scary poisonous snake. Here in Zambia there is a old wives tale that a snake won't come near a pregnant lady. Hmmmm...consider that myth dispelled by a bunch of midwives and pregnant ladies running around the ward yelling "snake!". Fortunately nobody was bitten and the snake was beheaded. We're still waiting to see if he has friends who will be gracing us with their presence.
I also attended a general meeting of all of the hospital staff. It was really interesting to see what issues they found most challenging or concerning. In contrast to my last post, saying people weren't so concerned with other staff members dying, much of the meeting was dedicated to the very subject. Sadly they are faced with so many funerals of community members that they have whole policies and committees determining how funerals are handled. Employers here are much more responsible for providing for employees in all aspects of living. Many people are fed and housed by their employers. To an extent this also includes planning/financing funerals and weddings. There were interesting concerns of funerals for employees at different pay levels getting more priority or people in different jobs having more freedom to attend all of the funerals they would like. This is also compounded by a cultural concern that if you don't attend someone's funeral you will be blamed for their death.
They also discussed extensively plans to fix the broken generator versus the broken minibus. These are issues I can't really imagine making it to the board meeting at a hospital at home but truly matter day to day here.
Not much else is new-just lots of social plans this weekend with people in town who know I'm leaving soon. Last weekend one of the cooks from the guesthouse invited me to her home to meet her family which I just loved. While I was there we were watching TV, as they typically do on a Sunday afternoon. There aren't many channels but what was on was WWF wrestling. WWF is ENORMOUSLY popular here. I can't say I'm proud that's what Zambians think America is like, but for whatever reason they absolutely love it here. Perhaps the funniest moment of my time here was when the 3 year old niece introduced me to her teddy bear and told me it's name was John Cena, after a WWF star. Scary!
That's it for now- have a great week!
Saturday, March 28, 2009
Yes, I do actually work also...
Things here are good. I can't believe I have only about one more week of work! Last weekend I had a nice visit to Lusaka. It was fun to visit with Ben and Jen and I also got to spend two days working at Beit Cure Hospital, a hospital started to treat children with orthopedic and neurosurgical problems. It was a bit astounding how a privately funded hospital could have so many more resources. It was much more like operating at home. We also did some rounds at the University Teaching Hospital which was huge. There were hundreds of patients with seemingly very few physicians and resources. Reportedly many pts get admitted then have to wait several days before seeing a physician. Obviously this is another huge contrast compared with Beit or home. After returning to Choma I went with the District Health Office to rural area to do outreach- primarily prenatal care and vaccinations for kids. I really liked doing that and it was interesting to set up a clinic in the little schoolhouse without electricity.
On a more sobering note, two of the town's nurses died this week and we also did an autopsy on a 6 year old girl who it seems was likely abused (she had a lot of blood in her brain). People here just have so much more death to deal with than we do. Its such a contrast to at home where if someone from the hospital dies it would be a big deal rather than just an ordinary week. Its so different here in that regard Today I opened about 15 emails regarding the death of the Oakland Police, who were treated at Highland and much a part of the Oakland community. Amongst them were people gathering funds for their families, shuttles to the services at the Oakland Coliseum and encouragements for people to get counseling in the aftermath of the traumas. At Choma today a few people said the death of the nurse who died yesterday was a pity and were trying to make arrangements to attend her funeral Monday but nobody was particularly shocked or surprised. She had been in her young thirties, working in the theatre without problems when I arrived and now is dead of unclear causes but it doesn't cause much of a stir. Obviously the cop killings were a very different situation but I guess the timing just made me think even more about the difference. I always find myself wondering in environments with so much death and tragedy if the communities just get numb to it on some level. At every stage of life- from in utero, to childhood, maternal death during childbirth, young adults up to the elderly if they make it that far- there is just so much more death here.
I'm not sure where I'm going with all of this death talk but it just makes me realize that for all of the flaws in the health care system at home, even the poorest in the US have generally more access to care than an average citizen here.
That's it- not many posts left. Hope you all are well!
On a more sobering note, two of the town's nurses died this week and we also did an autopsy on a 6 year old girl who it seems was likely abused (she had a lot of blood in her brain). People here just have so much more death to deal with than we do. Its such a contrast to at home where if someone from the hospital dies it would be a big deal rather than just an ordinary week. Its so different here in that regard Today I opened about 15 emails regarding the death of the Oakland Police, who were treated at Highland and much a part of the Oakland community. Amongst them were people gathering funds for their families, shuttles to the services at the Oakland Coliseum and encouragements for people to get counseling in the aftermath of the traumas. At Choma today a few people said the death of the nurse who died yesterday was a pity and were trying to make arrangements to attend her funeral Monday but nobody was particularly shocked or surprised. She had been in her young thirties, working in the theatre without problems when I arrived and now is dead of unclear causes but it doesn't cause much of a stir. Obviously the cop killings were a very different situation but I guess the timing just made me think even more about the difference. I always find myself wondering in environments with so much death and tragedy if the communities just get numb to it on some level. At every stage of life- from in utero, to childhood, maternal death during childbirth, young adults up to the elderly if they make it that far- there is just so much more death here.
I'm not sure where I'm going with all of this death talk but it just makes me realize that for all of the flaws in the health care system at home, even the poorest in the US have generally more access to care than an average citizen here.
That's it- not many posts left. Hope you all are well!
Sunday, March 15, 2009
I'm legal!...and there definitely was a silver lining
Thank you Zambian Immigration office for one of the best vacations yet. I'm back safely and again working at the hospital, allegedly with the correct visa. In the interim, while banned from the country, I got to have some fun cruising around Namibia with my friend Jen and her husband Ben.
After seeing Victoria Falls and having "Sundowners" at dusk on the Zambezi, my friend Jen, Ben and I set out the next day for Windhoek, Namibia. The 18 hour bus ride there was indeed as long as it sounds (actually ended up being 20 hours because of an overturned fuel truck blocking the road)but the bus was definitely the nicest I've ever been on. It felt more like flying with pit stops every few hours. From the minute we crossed the border it was very apparent that Namibia is a completely different world than Zambia despite sharing a border. The immigration office we had to stop in on the Zambian side was a run down house run in a completely chaotic manner. In contrast, the Namibian office looked brand new, was air conditioned and very orderly. All week the three of us were astounded by how good the infrastructure and development in Namibia was- by any standards, but especially in contrast to Zambia.
We arrived in Windhoek which felt much like a German town in the middle of the Kalahari desert. Much to my delight after a month of Zambian food, we stocked up on groceries at a Whole Foods type store then picked up our rental truck and camping gear. Our 4x4 made us feel like we were cheater camping as the tents unfolded on top of the truck. We then drove about 4 more hours out to Swakopmund where we had a seafood dinner looking out at the Atlantic Ocean. Yes, ocean as in beach- very strange after living smack in the center of Africa. Notable events in Swakopmund were Apple Strudel (phenomenal!), riding ATVs in the sand dunes and sea kayaking with literally thousands of seals playing around us.
After Swakopmund we packed up and headed south to Sesrium, our campground at the base of Soussevlei where the largest sand dunes in the world are. The drive out to Sesrium was incredible because we started at the ocean, drove through the desert followed by mountains which turned into canyons with rivers in them, then green rolling hills, more plains, then eventually desert again. This was made all the better by coming over a mountain pass to see an enormous full moon (which my super novice photographic attempts couldn't quite capture).
At Sesrium we pretty much just relaxed, hiked in the enormous dunes and lamented how fast the week had flown by. The dunes were incredible- as always, way more impressive in person than on film but there are pics below.
On 18 hour bus ride round two I managed to wake up enough to plead my case to the immigration officers and was very relieved when they agreed to not deport me. I did get a 30 second lecture that I could have settled all of this on my initial arrival(an even different way than suggested by the previous two immigration offices) but ultimately they smiled and said "We will work with you and want you to enjoy Zambia". So I now have 30 more days to work and then up to 60 days to be a tourist before leaving. This week I'm doing more surgery and also trying to get more involved in seeing other health projects going on locally- I'm going to visit some rural hospitals with the district health office on Friday then hopefully spending some time at the ER in Lusaka next week.
Thats it- sorry this got longer than planned. Again.
Have a great week!
Melissa
http://picasaweb.google.com/melclark217/Webalbum3?feat=directlink
After seeing Victoria Falls and having "Sundowners" at dusk on the Zambezi, my friend Jen, Ben and I set out the next day for Windhoek, Namibia. The 18 hour bus ride there was indeed as long as it sounds (actually ended up being 20 hours because of an overturned fuel truck blocking the road)but the bus was definitely the nicest I've ever been on. It felt more like flying with pit stops every few hours. From the minute we crossed the border it was very apparent that Namibia is a completely different world than Zambia despite sharing a border. The immigration office we had to stop in on the Zambian side was a run down house run in a completely chaotic manner. In contrast, the Namibian office looked brand new, was air conditioned and very orderly. All week the three of us were astounded by how good the infrastructure and development in Namibia was- by any standards, but especially in contrast to Zambia.
We arrived in Windhoek which felt much like a German town in the middle of the Kalahari desert. Much to my delight after a month of Zambian food, we stocked up on groceries at a Whole Foods type store then picked up our rental truck and camping gear. Our 4x4 made us feel like we were cheater camping as the tents unfolded on top of the truck. We then drove about 4 more hours out to Swakopmund where we had a seafood dinner looking out at the Atlantic Ocean. Yes, ocean as in beach- very strange after living smack in the center of Africa. Notable events in Swakopmund were Apple Strudel (phenomenal!), riding ATVs in the sand dunes and sea kayaking with literally thousands of seals playing around us.
After Swakopmund we packed up and headed south to Sesrium, our campground at the base of Soussevlei where the largest sand dunes in the world are. The drive out to Sesrium was incredible because we started at the ocean, drove through the desert followed by mountains which turned into canyons with rivers in them, then green rolling hills, more plains, then eventually desert again. This was made all the better by coming over a mountain pass to see an enormous full moon (which my super novice photographic attempts couldn't quite capture).
At Sesrium we pretty much just relaxed, hiked in the enormous dunes and lamented how fast the week had flown by. The dunes were incredible- as always, way more impressive in person than on film but there are pics below.
On 18 hour bus ride round two I managed to wake up enough to plead my case to the immigration officers and was very relieved when they agreed to not deport me. I did get a 30 second lecture that I could have settled all of this on my initial arrival(an even different way than suggested by the previous two immigration offices) but ultimately they smiled and said "We will work with you and want you to enjoy Zambia". So I now have 30 more days to work and then up to 60 days to be a tourist before leaving. This week I'm doing more surgery and also trying to get more involved in seeing other health projects going on locally- I'm going to visit some rural hospitals with the district health office on Friday then hopefully spending some time at the ER in Lusaka next week.
Thats it- sorry this got longer than planned. Again.
Have a great week!
Melissa
http://picasaweb.google.com/melclark217/Webalbum3?feat=directlink
Saturday, March 7, 2009
Goodbye Zambia, Hello Namibia
Well the visa fiasco, for the pain its been, turns out to have a silver lining. Dr Johnson did some more research and deciphering of immigration policies. While he did get a few different answers, it seems as though if I leave the country for a few days and return with a letter from the hospital welcoming me I should be able to qualify for the required 30 day business visa. The other step, which Dr Johnson is working on, is getting a letter from the ministry of health agreeing to me being here. When I first heard that I had to leave Zambia I was a little unsure as to what I could economically and safely do on my own for a few days. Still unsure of the complete plan I headed to livingstone, zambia (site of Victoria Falls, right on the Zimbabwe border and close to Botswana). I wasn't dying to go to Zimbabwe given the Cholera situation and potentially unstable political environment so figured I would end up in Botswana.
I arrived in Livingstone last night and checked into a great Hostel called Jolly Boys with a pool, lots of young people and several good areas to relax. I woke this morning only to bump into one of my friends from Portland at breakfast! I had known Jen, a med student I worked with at OHSU, was in Africa somewhere but no further details. It turns out she and her husband are doing medical work in Lusaka for the year. They had planned a weeklong trip leaving tomorrow for the dunes of Namibia and kindly invited me along with them. Today we wnt to go see Victoria Falls which was amazing.
So...next stop Namibia! Keep your fingers crossed that immigration is feeling friendly on my return so I can get the business visa and resume working in Choma. There are 2 national holidays this week so we'll se how muchthe ministry of health gets done. Have a good week
Melissa
I arrived in Livingstone last night and checked into a great Hostel called Jolly Boys with a pool, lots of young people and several good areas to relax. I woke this morning only to bump into one of my friends from Portland at breakfast! I had known Jen, a med student I worked with at OHSU, was in Africa somewhere but no further details. It turns out she and her husband are doing medical work in Lusaka for the year. They had planned a weeklong trip leaving tomorrow for the dunes of Namibia and kindly invited me along with them. Today we wnt to go see Victoria Falls which was amazing.
So...next stop Namibia! Keep your fingers crossed that immigration is feeling friendly on my return so I can get the business visa and resume working in Choma. There are 2 national holidays this week so we'll se how muchthe ministry of health gets done. Have a good week
Melissa
Wednesday, March 4, 2009
On a lighter note...
Here's more pictures- not so different than the first set other than I included a few hospital pics at the end. There are a few pictures from a quick day trip I did to a nearby village called Chikuni (Dr Johnson had to do a house call). The Choma girls in the middle of the set were hilarious- they all had about a million modeling poses they wanted to do. In looking at these pics I realized I cut off probably 95% of people at their foreheads, so perhaps next time you'll see some full faces (if you are in the 2 people who aren't totally bored looking at pictures of the same stuff)
If above slideshow doesn't work use address
http://picasaweb.google.co.uk/melclark217/ZambiaRound2
If above slideshow doesn't work use address
http://picasaweb.google.co.uk/melclark217/ZambiaRound2
Visa Purgatory
I was needing a bit of time off to recover from the medication side effects and in quite the unexpected twist of events I may have much more time off than I hoped for. Before I came here Dr Johnson, who has been in Zambia for 15 years and knows logistics here well, checked with multiple official-type people about me visiting. All parties assured him I only needed a tourist visa. He has had many visiting students and residents in the last few years also on tourist visas without problems. Yesterday we got a message from the organization that coordinated this
trip that the state department had issued a new alert that all volunteers must be on a work visa rather than a tourist visa. Apparently some Americans volunteers have recently faced huge fines or even jail time for having the wrong visa. (It is unknown what exactly their circumstances were, politics here can be complicated and perhaps they were up to something else suspicious too). Dr Johnson thought this seemed strange since tourist visas have always been well accepted. Initially we thought I could probably just get approval since he knows many officials in town or say that I am visiting him rather than an official volunteer but he went to the immigration officials who confirmed I cannot be in the hospital any longer without a work visa. Apparently getting a work visa requires applying from your home country at least 6 weeks before entering the country. Dr Johnson is driving to the capital today to talk to the ministry of health and immigration to see what, if anything, can be done. I'm going to see what happens in Lusaka before panicking or scrambling to find a plan B. So here I am a bit in limbo now as to the plans. Sara, my best friend, is due to come here April 8 so we can go on safari. I'm already getting bored sitting around the lodge while under the weather and definitely do not see staying in Choma not working until April as an option. I've thought about emailing everyone I know to see what else I can figure out work wise but that won't make the
visa issue go away, so other projects in Zambia aren't really an option. If it was just a fine at stake I would maybe play dumb about the issue but I'm not really dying to see the inside of a Zambian
jail.
So we'll see. I'm not sure if its fortunate or unfortunate timing that this is catching me at the phase of the up and down cycle where I'm not loving things so much. I feel sick, hate the food here so am alternating between nauseated and starving. There is a small part of
me that is so ready to hop on the next plane home but the bigger part of me knows
I'll figure out a plan B to stay. I don't want to feel like I wimped out if there is an opportunity to stay. I'll definitely go travel for a bit one way or another but as far as work that will be the bigger
challenge to sort out. I'm just keeping an open mind to all the possibilities. Either I'll stay and make the best of it or perhaps find another great opportunity. And at the end of it all, if it
wasn't meant to be I'll putz around a bit, see some animals and come home having had a bit shorter but great experience.
Stay tuned...
trip that the state department had issued a new alert that all volunteers must be on a work visa rather than a tourist visa. Apparently some Americans volunteers have recently faced huge fines or even jail time for having the wrong visa. (It is unknown what exactly their circumstances were, politics here can be complicated and perhaps they were up to something else suspicious too). Dr Johnson thought this seemed strange since tourist visas have always been well accepted. Initially we thought I could probably just get approval since he knows many officials in town or say that I am visiting him rather than an official volunteer but he went to the immigration officials who confirmed I cannot be in the hospital any longer without a work visa. Apparently getting a work visa requires applying from your home country at least 6 weeks before entering the country. Dr Johnson is driving to the capital today to talk to the ministry of health and immigration to see what, if anything, can be done. I'm going to see what happens in Lusaka before panicking or scrambling to find a plan B. So here I am a bit in limbo now as to the plans. Sara, my best friend, is due to come here April 8 so we can go on safari. I'm already getting bored sitting around the lodge while under the weather and definitely do not see staying in Choma not working until April as an option. I've thought about emailing everyone I know to see what else I can figure out work wise but that won't make the
visa issue go away, so other projects in Zambia aren't really an option. If it was just a fine at stake I would maybe play dumb about the issue but I'm not really dying to see the inside of a Zambian
jail.
So we'll see. I'm not sure if its fortunate or unfortunate timing that this is catching me at the phase of the up and down cycle where I'm not loving things so much. I feel sick, hate the food here so am alternating between nauseated and starving. There is a small part of
me that is so ready to hop on the next plane home but the bigger part of me knows
I'll figure out a plan B to stay. I don't want to feel like I wimped out if there is an opportunity to stay. I'll definitely go travel for a bit one way or another but as far as work that will be the bigger
challenge to sort out. I'm just keeping an open mind to all the possibilities. Either I'll stay and make the best of it or perhaps find another great opportunity. And at the end of it all, if it
wasn't meant to be I'll putz around a bit, see some animals and come home having had a bit shorter but great experience.
Stay tuned...
language barrier, religious adventures and more whining
27 Feb
I feel a bit silly with the smile and nod routine when trying to communicate with my patients so I’m resolving to learn a little Chitonga. English may be the official language of Zambia but the vast, vast majority of people speak primarily their tribal language. There are 72 languages in Zambia. In this region that is called Chitonga or Tonga. The men are much more likely to speak English as they have generally received longer education (girls rarely go beyond 7th grade and even that is not common). The kids love screaming “I am fine”, “hello”, etc but that’s about it. I keep wanting to revert to Spanish when my English is failing miserably, but somehow I don’t think that would help much. So you lucky readers get to learn Chitonga with me. Read below for some very common phrases which should come in handy.
Twalumba- Thank You
Mwabuga buti- Good Morning
Ndili mweembezi mubotu- I am a good herdsmen
Hena basokwe balayoowabasiluwe- Are baboons afraid of leopards?
2 March 2009
Obviously still so glad I’m having this opportunity but am afraid I’m entering the fully anticipated “what the heck am I doing here?” phase of the journey. Hopefully it will just last a couple of days and I’ll be back to rose colored glasses. Kevin, the boyfriend figure, asked me last week what I miss most about home. At the time I just rattled off a few people and otherwise nothing came to mind. Of course since then I’ve come up with quite the comprehensive list, 97% food related, 3% brainless TV. Is it bad I’ve been here only 3 weeks and I’m already fantasizing about what to eat when I get home? Not helping the issue is the fact that, after an HIV exposure in the operating room last week, I decided to bite the bullet and start taking HIV prophylaxis. I work with HIV patients pretty frequently at home without giving it any thought. Here it’s just a bit harder to feel safe given the limited resources for personal protective gear. Gloves are thinner and generally the wrong sizes, surgical gowns aren’t waterproof and aren’t worn for anything except major procedures and faceshields aren’t available in the theatre. Thank goodness I wear glasses at least! For those of you who are non-medical, the good news with an occupational exposure is it is a very small less than 0.03% chance of contracting the virus even without meds (and even lower with taking them). The bad news is that I have to take 9 disgusting pills every day for a month that make me feel totally nauseated. So I’m in a little pickle as I probably will be nauseated for the next month or so and the only available foods I don’t hate here are fried chicken and French fries. Not exactly in the jello, ginger ale, saltine family. I suppose it’s time to learn to love Nshima.
Food and nasty pills aside this is a very nice culture. People in the community here are extremely friendly…and very religious. This combination has lead me to receive about 7 or 8 different church invitations so far. I think inviting someone to church is the Zambian equivalent of “let’s meet for coffee”- a safe, public, socially acceptable invitation. Other than 2 people, who seem to be exceptions, everyone here I’ve met goes to church every Sunday. Without saying too much about what I do or don’t believe, let it be said Sunday mornings at home are generally reserved for listening to KFOG’s acoustic sunrise and searching for the perfect brunch. This weekend I got a double glimpse into the religious subcultures in Choma. Experience #1 was Saturday morning after rounds I went with Dr Johnson to the final vows of a woman becoming a nun. Not being Catholic I wasn’t quite sure what this entailed. I ended up having a great time and got to witness some beautiful Zambian singing and dancing at the ceremony. Afterwards there was a reception at a local school for children with disabilities. At home this would have likely consisted of grabbing cake and saying congrats. In true Zambian fashion (or so I’m told) the reception included a very elaborate program- with an emcee, numerous speeches from various community members, a procession presenting gifts to the new sister, a luncheon, several songs by the school’s phenomenal choir of blind children and a cake cutting ritual of a teenage girl dancing for about 7 minutes with the cake knife.
Religious experience number two of the weekend was going to church on Sunday morning with the people who run the guesthouse I stay at. When they said it was a Pentecostal church I somehow had an idea it was different than anything I’d ever been to in the past but wasn't really sure. When I walked into the church there was a pretty much empty sanctuary with a very small enclosed area. Behind the wall was what sounded like about 20 people screaming wildly and singing. Eventually the room filled up with people attending service. The people behind the wall turned out to be the choir. Things started out pretty standard protestant service (except with great African music and more dancing). Then after a few songs things became a little more free form with people yelling out various songs, prayers or whatever else. Being someone who gets self conscious singing Happy Birthday, I didn't have much to contribute to the mayhem. The sermon was quite heated- lots of hallelujahs, amens, and talking of demons and satan. Subsequently they sang some more songs while about 30% of the people fainted,
appearing to be having seizures or speaking in tongues. Had I been in the hospital lobby I would have probably called a code if I saw people collapsing like this, but I suspected all was well and decided to stay in my seat. Everyone recovered just fine and then wished each other a good week and headed out for tea. I returned to the hospital to round then needed a nap. We'll see what's on tap for next Sunday
Friday, February 27, 2009
At risk of a totally boring post there's not much new to report. My
life here is pretty simple compared to home. My main excitement this week was that yesterday I got my cell phone (yay!). The number is 260955084560 if for some reason you have lots of money to blow calling africa or need to reach me. The locals have all been making fun of me for having no way to communicate when they invite me to do things. As many of you have
inferred from my pictures- my main social life has been hanging out with
kids who speak 10 words of English. (but they are REALLY cute and
photogenic!). Maybe the cell phone will help me make some friends over age 12.
It's actually been nice because a couple of girls in
their 20s from Lusaka and an American guy my age were staying at the
same guest house for a couple weeks while they are working on other
health related projects. We've all started eating dinner together so
it's not just me watching Al Jazeera, which happens to be great news
coverage, by myself. Dr Johnson is also good company which is
fortunate because we spend about 12 hours together each day. He is
very knowledgeable about life in Zambia and other world issues and has
lots of good stories. I've also made friends with a girl in my neighborhood who is a teacher and just moved to choma and one of the guys who works in the operating theatre.
Work continues to be interesting and I'm getting more into my routine. This week hasn't been as busy as the last. Lots of TB and Malaria which I don't see much at home- yesterday I put a chest tube into a woman with a huge TB effusion. A couple of kids died last week so that was sad. One quite
expectedly given how ill he was to start with but the other was a bit
more unexpected. Somehow we've turned from an orthopedics service
last week to a urology service this week.
I guess that's it for now.. more interesting next week I promise!
life here is pretty simple compared to home. My main excitement this week was that yesterday I got my cell phone (yay!). The number is 260955084560 if for some reason you have lots of money to blow calling africa or need to reach me. The locals have all been making fun of me for having no way to communicate when they invite me to do things. As many of you have
inferred from my pictures- my main social life has been hanging out with
kids who speak 10 words of English. (but they are REALLY cute and
photogenic!). Maybe the cell phone will help me make some friends over age 12.
It's actually been nice because a couple of girls in
their 20s from Lusaka and an American guy my age were staying at the
same guest house for a couple weeks while they are working on other
health related projects. We've all started eating dinner together so
it's not just me watching Al Jazeera, which happens to be great news
coverage, by myself. Dr Johnson is also good company which is
fortunate because we spend about 12 hours together each day. He is
very knowledgeable about life in Zambia and other world issues and has
lots of good stories. I've also made friends with a girl in my neighborhood who is a teacher and just moved to choma and one of the guys who works in the operating theatre.
Work continues to be interesting and I'm getting more into my routine. This week hasn't been as busy as the last. Lots of TB and Malaria which I don't see much at home- yesterday I put a chest tube into a woman with a huge TB effusion. A couple of kids died last week so that was sad. One quite
expectedly given how ill he was to start with but the other was a bit
more unexpected. Somehow we've turned from an orthopedics service
last week to a urology service this week.
I guess that's it for now.. more interesting next week I promise!
Saturday, February 21, 2009
attempt to post pics
third times a charm? Ok well it wasn't, but after much struggling... try number 4 I think may allow you to see pics on picasa web. Click on
http://picasaweb.google.co.uk/melclark217/OffToZambia?feat=directlink
http://picasaweb.google.co.uk/melclark217/OffToZambia?feat=directlink
Settling in
Hello again friends and family,
Things here are going great- sorry for the whining about the birthday last time (but thanks for all the subsequent e-mails!). Work continues to be very busy and I’m learning a ton- both about diseases I’ve never seen before and managing with minimal resources. I was feeling a bit like a shadowing med student at first in this new environment but finally am starting to feel at least a little bit functional. Dr Johnson and I have about 40 patients on the wards (10 kids, 5-10 women and about 25 men). A typical day is that I show up and make quick rounds in the male, female and children’s wards, mostly just to check if there are any new crises or new admissions we didn’t hear about at night. Next is the “theatre” (what they call the operating room) where we do a mix of basic stuff from reducing and casting the many kids who fall out of trees and draining abscesses to larger procedures like bowel resections. As a sample, the cases in the last 3 days included a dental extraction and partial mandible resection in a girl with a tumor the size of a grapefruit in her jaw, fixing a little boy’s urethra after it was torn by having a ring stuck on his penis for several days (we couldn’t quite get a straight story on how that happened), draining a leg wound of a girl with TB osteomyelitis, resecting a sigmoid volvulus and numerous adult circumcisions. I tend to prefer the quick cases over the big ones- I guess there is a reason I picked Emergency Medicine.
Theatre is scheduled to go until about noon daily but we have yet to stop before about 13:30. Usually around this time someone will arrive after a 6 hour bus ride from their village in pretty bad shape. Today the sick new one was a 9 year old boy with AIDS, TB, renal failure and a bowel obstruction. He is probably the sickest pt I’ve seen here so far and it is pretty sad seeing a child with end stage AIDS. We saw as many as we could of the 30-50 patients waiting to be seen for clinic (“review” as it is called here if they have been seen before) while the theatre got ready to take the new boy. After the emergency case(s) we see the leftover folks from clinic who have waited around since 8 am and then round on the wards. Needless to say, the amount of documentation is a bit more scant here than at home given the amount of people to be seen (and absence of significant medical-legal paranoia).
Ok, enough work talk- I know all you non-medical people are thoroughly bored and at least my roommate Nora is probably trying not to vomit. What non-medical adventures? I made my first trip into town yesterday. We miraculously finished before it was dark out so I went to go check out the market and town (i.e. three block strip with shops on it). The market was mix of booths with stuff like foot long knives and hair scrunchies, an obvious combination, to tomatoes, grilled maize and enormous piles of my favorite tiny dried fish. It was weird being in a really crowded area after just spending time in the hospital and my quiet residential area. Everyone calls me Madame which I find amusing. I keep finding myself in a bit of a dilemma because I probably know 3 people’s names other than Dr Johnson. a) they get introduced as Mr or Mrs 5 syllable last name I’ve never heard before which I immediately forget and feel increasingly dumb when they repeat it and I still have no idea how to say it b) I met about 75 people my first 2 days when I was a jetlagged zombie and now they remember me but I have no idea who they are c) Zambians are super friendly and may talk to you like they know you even when they don’t. Yesterday on my walk 4 different people who looked vaguely familiar came up to me and said “Hello Dr Clark/Melissa- how are you?”. All of this has left me a little confused and waiting for the inevitable embarrassing moment when it is clear that I have no idea what the names are of the people I talk to 10 times daily.
The neighborhood kids continue to crack me up. When I got home last night from the market there were about 30 of them outside of my lodge. I thought it was a different place than usual for them to play but didn’t think much of it. We did our usual round of “hello”’s and “how are you”’s (that’s the extent of most of their English…my inability to speak Chitonga is a whole other story) and I walked for the door. They didn’t look quite satisfied but we had done the “how are you” refrain about 10 times each and my dinner was waiting inside. Finally as I was just stepping in the gate one of the older boys yelled “Photo!” and they all started squealing. A toddler mosh pit ensued as they all fought to be in front for the next 75 pictures you poor souls have to sit through when I get home.
Adios (perhaps by next time I'll be able to say good bye in chitonga)
Things here are going great- sorry for the whining about the birthday last time (but thanks for all the subsequent e-mails!). Work continues to be very busy and I’m learning a ton- both about diseases I’ve never seen before and managing with minimal resources. I was feeling a bit like a shadowing med student at first in this new environment but finally am starting to feel at least a little bit functional. Dr Johnson and I have about 40 patients on the wards (10 kids, 5-10 women and about 25 men). A typical day is that I show up and make quick rounds in the male, female and children’s wards, mostly just to check if there are any new crises or new admissions we didn’t hear about at night. Next is the “theatre” (what they call the operating room) where we do a mix of basic stuff from reducing and casting the many kids who fall out of trees and draining abscesses to larger procedures like bowel resections. As a sample, the cases in the last 3 days included a dental extraction and partial mandible resection in a girl with a tumor the size of a grapefruit in her jaw, fixing a little boy’s urethra after it was torn by having a ring stuck on his penis for several days (we couldn’t quite get a straight story on how that happened), draining a leg wound of a girl with TB osteomyelitis, resecting a sigmoid volvulus and numerous adult circumcisions. I tend to prefer the quick cases over the big ones- I guess there is a reason I picked Emergency Medicine.
Theatre is scheduled to go until about noon daily but we have yet to stop before about 13:30. Usually around this time someone will arrive after a 6 hour bus ride from their village in pretty bad shape. Today the sick new one was a 9 year old boy with AIDS, TB, renal failure and a bowel obstruction. He is probably the sickest pt I’ve seen here so far and it is pretty sad seeing a child with end stage AIDS. We saw as many as we could of the 30-50 patients waiting to be seen for clinic (“review” as it is called here if they have been seen before) while the theatre got ready to take the new boy. After the emergency case(s) we see the leftover folks from clinic who have waited around since 8 am and then round on the wards. Needless to say, the amount of documentation is a bit more scant here than at home given the amount of people to be seen (and absence of significant medical-legal paranoia).
Ok, enough work talk- I know all you non-medical people are thoroughly bored and at least my roommate Nora is probably trying not to vomit. What non-medical adventures? I made my first trip into town yesterday. We miraculously finished before it was dark out so I went to go check out the market and town (i.e. three block strip with shops on it). The market was mix of booths with stuff like foot long knives and hair scrunchies, an obvious combination, to tomatoes, grilled maize and enormous piles of my favorite tiny dried fish. It was weird being in a really crowded area after just spending time in the hospital and my quiet residential area. Everyone calls me Madame which I find amusing. I keep finding myself in a bit of a dilemma because I probably know 3 people’s names other than Dr Johnson. a) they get introduced as Mr or Mrs 5 syllable last name I’ve never heard before which I immediately forget and feel increasingly dumb when they repeat it and I still have no idea how to say it b) I met about 75 people my first 2 days when I was a jetlagged zombie and now they remember me but I have no idea who they are c) Zambians are super friendly and may talk to you like they know you even when they don’t. Yesterday on my walk 4 different people who looked vaguely familiar came up to me and said “Hello Dr Clark/Melissa- how are you?”. All of this has left me a little confused and waiting for the inevitable embarrassing moment when it is clear that I have no idea what the names are of the people I talk to 10 times daily.
The neighborhood kids continue to crack me up. When I got home last night from the market there were about 30 of them outside of my lodge. I thought it was a different place than usual for them to play but didn’t think much of it. We did our usual round of “hello”’s and “how are you”’s (that’s the extent of most of their English…my inability to speak Chitonga is a whole other story) and I walked for the door. They didn’t look quite satisfied but we had done the “how are you” refrain about 10 times each and my dinner was waiting inside. Finally as I was just stepping in the gate one of the older boys yelled “Photo!” and they all started squealing. A toddler mosh pit ensued as they all fought to be in front for the next 75 pictures you poor souls have to sit through when I get home.
Adios (perhaps by next time I'll be able to say good bye in chitonga)
Wednesday, February 18, 2009
I've arrived
1 week down and because I’ve been so busy and with limited computer/internet access this is the first time I’ve had a chance to write. My apologies- I definitely haven’t moved off and forgotten about you all. In fact today is the first day I am somewhat homesick. I’m sure partly because it’s my birthday and it felt weird not talking to any of my friends or family. I didn’t bother telling people here it was my birthday because I don’t really think they celebrate them given most of my patients don’t even really know what their age is. Mild transient homesickness aside, things here have been great.
So, from the beginning…
Day 1
I made it out of my apartment to get my 4 a.m. cab to the airport in typical Melissa Clark fashion- barely finished packing with a messy room left behind (great aspirations of course to leave it immaculate). Rather uneventful 3 flights to Lusaka, the capital of Zambia. Coincidentally I sat behind a former Highland grad who was on his way to South Africa for safari, but had spent time years earlier doing medical work in Zambia. After about 34 hours of mediocre movies and trying to sleep I, shockingly accompanied by all of my luggage, was greeted at airport by Dr Johnson, the surgeon I am working with in the next 8 weeks. It wasn’t too hard to find each other as we were the only white people at the airport . Dr Johnson is a Jesuit priest so we stayed that night at some sort of beautiful property where young men called noviciates live during their training to become priests.
Day 2
Despite being completely sleep deprived woke up around 4 am. Waited anxiously for the sun to rise to get my first daytime look at Zambia- turns out it looked like a pretty typical backyard anywhere. Fell back asleep sometime around 6:30, woke to African songs and drumming about 15 minutes later. Breakfast (Zambian food experience #1) was good- normal oatmeal, tea, bread with mango jam. Very safe. Notably the boys were all cutting fruits the sizes of small football which I thought were large mangoes or something. As it was, their mangoes are the sizes of kiwis and they were cutting enormous avocados. Ran some errands in Lusaka (mob scene) and had a tour of the University Teaching Hospital in Lusaka, for comparison to what I’d see in Choma. Zambian food experience #2 was a little scarier. All was going well- did ok with my first Nshima- a cormeal based porridge/dough which is the staple of their diet. Nshima is usually served with some sort of “relish” which is usually a bit of meat or vegetables. Today was a fish dish. I thought it was just pieces of fish in a tomato sauce, then I looked closer to see hundreds of small fish eyes and realize these were actually 1 cm long fully intact tiny fish. It didn’t help my appetite when Dr Johnson told me they were not cooked but rather dried for preparation. I managed to finish my plate without gagging- strong work. Then tea with other priests (yes there is a bit of a priest, nun theme here- perhaps I will come back a nun) and headed for Choma. An 83 year old priest, not weighing much more than 83 pounds, made the 4 ½ hour drive with us in the pickup truck. Despite our begging, he insisted on sitting on a pillow in the back, IN THE RAIN, for the whole trip rather than sharing the cab with us. The ride was gorgeous- the parts I could stay awake for anyways. I was less embarrassed about my new onset of narcolepsy after Dr Johnson prefaced the drive with a story about the last student who would ask a question on the drive then invariably be asleep before he was even mid-answer. We drove through several different scenic areas on the ways with small towns about every hours or so. I was repeatedly struck by the fact there were so many people walking along side the roads in the 50 mile stretches between towns…where were they going? Quick dinner at Dr Johnson’s then he took me to the guest house “Racheel’s Lodge” which I will be living for the next two months. I fell asleep within 7 seconds of dropping my bags in my room.
Day 3- Saturday
…and again managed to wake up 5 hours later at 4am. When I had checked in the night prior (exhausted) I wasn’t sure how homey my lodging was going to be as my first impression was neon lights and black leather couches. In the morning (neon exterior lights turned off) I realized the place is adorable with a really cute garden and extremely gracious, friendly staff. I love the neighborhood (uhh, surrounding houses on the same dirt road) and have the most beautiful walk to the hospital each morning. Saturday morning Dr Johnson picked me up to go to the hospital at 8:30. Weekend are our light days when we just round or do small procedures. Dr Johnson basically doesn’t ever take a day off unless he is out of town as he is the only surgeon. Words can’t really describe the hospital- I’ll have to send some pictures (we’ll see how uploading them goes, my internet accessibility here is rather limited). There are three open wards that we work on- male, female and childrens. They are huge open rooms with about 30 beds in each.
day 4-7
Ok, well I only made it through 3 days of typing before running out of time- I'll post more later. The 3 line summary is that I've been working a ton and in my limited free time I've kind of turned into the pied piper in my neighborhood with all these kids yelling hello to me and wanting their pictures taken (if they know what a camera is anyways).
I'll post more as soon as I can- Read or ignore as you please. I'm sure it will probably be more medical in the future as I've been working 10-14 hours each day so far (and abut 4-5 on weekends) so sadly don't have much else of a life at this point. I've already seen some very interesting things in the hospital- definitely different pathology here. I've attempted to attach a few pictures- I have no idea what they are of as this computer just showed me a list of the hundred of so pics I've taken already, listed by number. I haven't deleted the bad ones- so we'll be surpised together by what shows up on the blog.
Miss you all- take care!
Melissa
So, from the beginning…
Day 1
I made it out of my apartment to get my 4 a.m. cab to the airport in typical Melissa Clark fashion- barely finished packing with a messy room left behind (great aspirations of course to leave it immaculate). Rather uneventful 3 flights to Lusaka, the capital of Zambia. Coincidentally I sat behind a former Highland grad who was on his way to South Africa for safari, but had spent time years earlier doing medical work in Zambia. After about 34 hours of mediocre movies and trying to sleep I, shockingly accompanied by all of my luggage, was greeted at airport by Dr Johnson, the surgeon I am working with in the next 8 weeks. It wasn’t too hard to find each other as we were the only white people at the airport . Dr Johnson is a Jesuit priest so we stayed that night at some sort of beautiful property where young men called noviciates live during their training to become priests.
Day 2
Despite being completely sleep deprived woke up around 4 am. Waited anxiously for the sun to rise to get my first daytime look at Zambia- turns out it looked like a pretty typical backyard anywhere. Fell back asleep sometime around 6:30, woke to African songs and drumming about 15 minutes later. Breakfast (Zambian food experience #1) was good- normal oatmeal, tea, bread with mango jam. Very safe. Notably the boys were all cutting fruits the sizes of small football which I thought were large mangoes or something. As it was, their mangoes are the sizes of kiwis and they were cutting enormous avocados. Ran some errands in Lusaka (mob scene) and had a tour of the University Teaching Hospital in Lusaka, for comparison to what I’d see in Choma. Zambian food experience #2 was a little scarier. All was going well- did ok with my first Nshima- a cormeal based porridge/dough which is the staple of their diet. Nshima is usually served with some sort of “relish” which is usually a bit of meat or vegetables. Today was a fish dish. I thought it was just pieces of fish in a tomato sauce, then I looked closer to see hundreds of small fish eyes and realize these were actually 1 cm long fully intact tiny fish. It didn’t help my appetite when Dr Johnson told me they were not cooked but rather dried for preparation. I managed to finish my plate without gagging- strong work. Then tea with other priests (yes there is a bit of a priest, nun theme here- perhaps I will come back a nun) and headed for Choma. An 83 year old priest, not weighing much more than 83 pounds, made the 4 ½ hour drive with us in the pickup truck. Despite our begging, he insisted on sitting on a pillow in the back, IN THE RAIN, for the whole trip rather than sharing the cab with us. The ride was gorgeous- the parts I could stay awake for anyways. I was less embarrassed about my new onset of narcolepsy after Dr Johnson prefaced the drive with a story about the last student who would ask a question on the drive then invariably be asleep before he was even mid-answer. We drove through several different scenic areas on the ways with small towns about every hours or so. I was repeatedly struck by the fact there were so many people walking along side the roads in the 50 mile stretches between towns…where were they going? Quick dinner at Dr Johnson’s then he took me to the guest house “Racheel’s Lodge” which I will be living for the next two months. I fell asleep within 7 seconds of dropping my bags in my room.
Day 3- Saturday
…and again managed to wake up 5 hours later at 4am. When I had checked in the night prior (exhausted) I wasn’t sure how homey my lodging was going to be as my first impression was neon lights and black leather couches. In the morning (neon exterior lights turned off) I realized the place is adorable with a really cute garden and extremely gracious, friendly staff. I love the neighborhood (uhh, surrounding houses on the same dirt road) and have the most beautiful walk to the hospital each morning. Saturday morning Dr Johnson picked me up to go to the hospital at 8:30. Weekend are our light days when we just round or do small procedures. Dr Johnson basically doesn’t ever take a day off unless he is out of town as he is the only surgeon. Words can’t really describe the hospital- I’ll have to send some pictures (we’ll see how uploading them goes, my internet accessibility here is rather limited). There are three open wards that we work on- male, female and childrens. They are huge open rooms with about 30 beds in each.
day 4-7
Ok, well I only made it through 3 days of typing before running out of time- I'll post more later. The 3 line summary is that I've been working a ton and in my limited free time I've kind of turned into the pied piper in my neighborhood with all these kids yelling hello to me and wanting their pictures taken (if they know what a camera is anyways).
I'll post more as soon as I can- Read or ignore as you please. I'm sure it will probably be more medical in the future as I've been working 10-14 hours each day so far (and abut 4-5 on weekends) so sadly don't have much else of a life at this point. I've already seen some very interesting things in the hospital- definitely different pathology here. I've attempted to attach a few pictures- I have no idea what they are of as this computer just showed me a list of the hundred of so pics I've taken already, listed by number. I haven't deleted the bad ones- so we'll be surpised together by what shows up on the blog.
Miss you all- take care!
Melissa
Monday, February 9, 2009
What I know so far...
Much of what will happen in the next 3 months is still a mystery to me, but here's what I do know...
a) destination- Choma, Zambia (the turquoise country near the bottom). I leave at the crack of dawn Wednesday (Pacific time) and will arrive to Lusaka at 9 pm Thursday. I'm meeting Dr Kenneth Johnson (The surgeon I'm working with, who also happens to be a Jesuit priest) at the airport. Well stay at a guest house in Lusaka that night then travel a few hours to Choma the next morning.
according to the website of the organization I'm going with...
"Choma General Hospital is located in the town of Choma, Zambia, in southern Zambia. Choma is populated with about 30,000 people and is found on the main North - South road that runs through Zambia. The rural area contains some commercial farming (tobacco), as well as other types of cash crops, including cotton, maize, and paprika. According to the country's constitution, Zambia is a Christian nation. In reality, about half of the population of Zambia are Christians.
The climate is similar to that experienced in the southern United States with one major exception: the schedule is reversed. June to August is quite cool, October to November can be quite hot, and the rainy season lasts from December to March."
b) The hospital - a 200 bed facility serving the town of 30,000 and surrounding area of 380,000 people. There are 4 full time doctors- Dr Johnson and 3 Zambian national physicians. Additionally there is a Director of Health who has an MPH.
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