Our First Day

So it is currently 18:00 hours and I just woke up after taking a nap. Of course the nap didn’t help me switch over to this time zone, but it felt oh so good.

Today was our first day in the hospital. Since it was Friday, the whole hospital got together and had worship. There was song service, a special music via a choir, prayer, and a sermonette.  During the announcement Dr. Peduche introduced us to the whole hospital staff. After that we were taken on a tour of the hospital. It is actually quite big; there is a Peds ward, an OB ward, a physical therapy room, a counseling room, a pharmacy room, administrative offices, an X-ray room, an OT (operating theater), and both a male and female ward.

Everything was alot nicer than I expected it to be. The hospital was built in 1927 but it has been kept up very well. They even just got a satellite which allows them to get internet! So I checked my e-mail today for the first time in rural Africa. Despite the amenities this hospital is still very much in the bush. After our tour I started organizing all the medical supplies we brought over. Then I went to join my wife and Jessica (the other med student) on the wards. On the way I met Humphrey and Peter who are clinical officer students (they are the equivalent to physician assistant students here in the States). Check out the video:

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On the wards I began to see what life was like as a missionary doc. There were patients with gangrene legs that needed to be amputated; there were patients with benign prostatic hyperplasia (BPH) who couldn’t pass urine and needed TURP. Other patients had huge gallstones that had to be surgically removed. Mwami didn’t have the fancy machines that blasted the gallstones with sound waves (or whatever they use). One patient was trying to fix a grinding mill and got his phalanges (2-5) crushed all the way down to halfway of his metacarpals. Many of the patients required lumbar punctures to confirm whether they had cryptococcal meningitis. This is a type of fungal meningitis often seen in HIV/AIDS patients. They would typically put these patients on fluconazole and amphotercin B; they would also start them on ARVs (anti-retroviral drugs). In terms of the conditions of the hospital it is good, but it could be better. The patients each have a bed but they are pretty close together. There is no such thing as sperators between patients. They also don’t use gloves when touching patients nor do they wash their hands often between examining patients. Many times they take the saline IV setup (with the bag and tubing), and use it as as a foley catheter. Most of the problems that I see are dealing with not having consistent electricity, inconsistent lab availability, no pathologist in all of the eastern part of Zambia (they have to mail specimens to the capitol and they get the results sometimes months later), funding, etc, etc.

I hae truly seen the need for all types of health professionals here. There was a patient today who really needed a GI fellow so that he could be scoped. They need X-ray techs, radiologists, internists, pediatricians, OBGYNs, surgeons (all sub-types), physician assistants, nurses, etc. They also need civil engineers who can pave roads to make Mwami more accessible. Being here has made me want to learn plumbing, carpentry, masonry, etc. As a missionary doc you have to often do what you weren’t trained to do. Dr. Ang (trianed as an anesthesiologist) is themain surgeon here. Dr. Peduche (trained as an OB-GYN) worked as an internist today. At certain points during the day I wondered to myself whether I could actually come out here and do this full time. It is so different from America, but I believe that the Lord can soften my heart and help me to let go of the pleasures that I cherished in the States.

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