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!
Friday, February 27, 2009
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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