Tuesday, 30 June 2015

Healthcare in Zambia

Since I’ve lived in Zambia, it hasn’t taken me long to realise that the healthcare system is poor, and very limited compared to what we have at home. Although most services are free, they are also hugely under funded and suffer from a shortage of doctors. According to WHO (the World Health Organisation), there were only 650 doctors working in the country between 2000 and 2010. This means one doctor to every 10,000 people! Since moving here I have visited three different clinics - Sikania, Kanini and Mary Begg.

The first clinic I visited, Sikania, is in a village along the Mufilira Road, just a little further out of town than KBUC (Kaniki Bible University College) where we live. The clinic serves a large community, about 10,000 adults and probably nearly as many babies and children. This includes some of the children from our school and many people supported by Arise. Rosie and I have visited Sikania on several occasions, taking sick children from school, to get help for a lady in Arise who is bed-bound, and also on a school trip. The staff at the clinic kindly let us take our Grade 1 and 2 children from Kapumpe there to look around and speak to them, as part of our topic learning about peoples’ jobs.

Grade 2 in the waiting room

One of the treatment rooms

Our tour guide

Nurses running a baby clinic

Whilst the staff at the clinic were very nice, we could see that the facilities are basic. This was particularly evident in the maternity area, as there is no washing machine so all sheets and other bedding have to be washed by hand. Outside there is a small building used as a placenta drop! As well as basic equipment, the general standard of hygiene appears poor. The rooms and floors are very bare, with minimal furniture. Another difference is that there is no appointment system. People turn up when they need to see someone and wait around until it is possible. Interestingly, clinical officers are employed instead of doctors. I have learnt that this is a strategy used in some developing countries to alleviate the shortage of medical doctors. Clinical officers have a separate training programme to doctors but their roles include many similar medical and surgical tasks. Reduced training and employment costs as well as retention helps to keep local healthcare systems running, like at this clinic.

The delivery room

Where new babies are weighed
Maternity ward

The placenta drop!

Kanini Clinic is the second clinic I visited, and serves Kanini Village which is just outside Ndola town. My reason for going there was to have the yellow fever vaccination. I have actually had this vaccination before in the UK, but over ten years ago. Within the last couple of years, the ten year booster has been deemed unnecessary in many first world countries since medical staff have found that the original vaccination actually provides lifelong protective immunity. Africa don’t seem to have caught onto this yet so I recently had to have the booster injection to get a certificate which allowed me to travel through Congo.

There were some similarities with Sikania clinic including basic facilities and minimal equipment. Organisation didn't look like it was a priority, with piles of files and receipts stacked up over desks where I went to pay. Whilst the staff at the clinic were able to administer the vaccine, they didn’t actually have any supplies. So I had to drive to a pharmacy to buy one and then go back and give it to the clinic staff to inject in to me! As I sat down on the chair to have the vaccination, I noticed a file on the table next to me clearly labelled ‘CIRCUMCISION’. I’m not sure that is something that anyone would want to endure in that clinic!

Most recently, I have been something of a regular visitor to a private clinic in town, Mary Begg Community Clinic. I first took a friend there for a check-up after a bout of malaria, and then a couple of weeks ago I spent several afternoons there visiting Rosie, my fellow teacher and housemate. You might have already heard that Rosie suddenly became ill and was admitted with typhoid, ecoli and aboebic dysentery! Not nice at all.

These diseases are all passed through contaminated food or water. Since Rosie and I share all our meals, it's only by the grace of God that I kept well! I am also very grateful for our health insurance that pays for a much better standard of care than is generally available in Zambia. Rosie was well looked after during the week she spent in the clinic and since being discharged, she has thankfully fully recovered.

Rosie did well to keep her sense of humour through the sickness :-)

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