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 :-)

A Trip to Kazembe - Part 2

One place most definitely worth visiting in Luapula is Ntumbachushi waterfall. We spent our day off there and had a wonderful time. It was even better visiting with some of our Zambian team members who had never seen a waterfall before! There are numerous waterfalls there so just as you reach one, you find another. I spent most of the day swimming or climbing up the falls - albeit the smaller ones. I also washed my hair there to avoid another cold shower back at the camp!

During the second half of our trip, we ran a series of meetings for children in the community. We had up to 400 children attend the meetings, which consisted of singing songs, Bible stories, praying together and playing numerous crazy games. It was tiring but great to see the kids learn about Jesus and have a really good time.

One of the pre-school kiddies who fell asleep on me!

Towards the end of the week, we also helped with clothing distribution. The clothes were given to children who attend the school where we were staying, but there were lots of other kids who would also have liked clothes. It was absolutely manic as all the children crowded round waiting for their name to be called.

Joseph and Maggie, the pastor and his wife who hosted our team during the visit, are the vision behind the school. They are an inspirational couple. Both have quite severe physical difficulties and yet they are hardworking and faithful people. They used to travel around the village on a bicycle but didn’t find it easy and would sometimes fall off. One of their children was really sad at seeing this, so worked and saved up for a year so that she could buy them the car that they now drive.

Pastor Joseph and his wife Maggie at their house

'The Good Samaritan Community School' was set up to care for orphans. There is a main school building with some smaller buildings built around it, including one which houses chickens. The other rooms are used for classrooms, although there are no desks or chairs. Displays consist of a few pieces of paper stuck to the wall. Ten teachers teach 400 children, and this is a ratio that is much better than in many government schools.

  

The orphans and vulnerable children that the school caters for are also fed there - porridge on Monday, Tuesday and Thursday, rice on Wednesday and nshima on Fridays. There is clearly not much money in the area but Joseph and Maggie have been quite resourceful. For example, someone in the local area gave them some seeds, which they then gave to local farmers on the condition that they would provide the school with 10% of what was grown.  

The school kitchen

Kazembe is a very different place to Ndola, so the trip certainly opened my eyes to life in a more remote part of the country. On our way back we stopped overnight near Lake Mweru. It is such a huge lake that it looks like the sea because you can’t see the other side. We enjoyed a swim, as well as seeing a beautiful sunrise and sunset.

Unsurprisingly, we decided to travel back a different way through Zambia, avoiding Congo! It was a longer journey but a lot smoother. After the rest of the team were dropped off at various places, I got my first experience of driving a minibus! It was good to arrive back at Kaniki both safely and still healthy.

A Trip to Kazembe – Part 1

Kazembe is in the Luapula district in the North of Zambia. It's a place where much of the witchcraft in Zambia comes from and is ruled by a chief who gets his power from witches. Approximately 20,000 people visit Luapula Valley each year, including the president of Zambia, to see the annual Mutomboko Festival which includes symbolic dances to represent the first chiefs who conquered the valley.

We travelled from Ndola in the Copperbelt to Kazembe in Luapula

Statue in Kazembe marking the ceremony

However, we visited Luapula for a different reason. Our purpose for going was to train children’s workers and pastors in the district in children’s ministry (e.g. Sunday School) and to hold meetings for children. It’s a very rural place, so I don’t expect they have many visitors or tourists outside of the festival.

The Apostolic Church where we led the training

A friend of mine called Malene who leads Kids in Ministry in Zambia, had asked if I would be part of a team she was taking to Kazembe. Two years ago she and her husband led a team there and had a pretty eventful time. They saw some quite amazing miracles take place but also found it tough going, with several team members getting very sick. This time we headed for Luapula with many people praying for us and I also took probiotic tablets to prepare my stomach!

I guess you could call us a mixed bunch - one Brit (me!), one South African, three Danes, four Zambians, and a toddler! Different ages and life experiences but one united team. I was pleasantly surprised at how easily we all got on and how well everyone worked together.

Malene with her son Noa, our youngest team member

New friends - Maureen, Mary, Petronella & Deborah

The journey from Ndola to Luapula took two days, with an overnight stop in Mansa, the capital of the district. Perhaps not surprisingly, we had some hassle at the Congo border. Almost every person working there tried to charge us more than we were supposed to pay – there is clearly a lot of corruption. To cut a long story short, we got the Head of Zambian Immigration involved and eventually got through to the other side.

During our trip we slept in tents in the grounds of a school and there was a guard on the gate to keep us safe. Sleeping in a tent and showering in cold water is not my preferred option, but I did survive! We ate mostly nshima and vegetables, sometimes with rice, fish or chicken. It didn’t all look particularly appetising but it tasted pretty good.

My makeshift shower curtain!

Eating the village chicken for dinner!

Food from the local market

Apart from running the training, we visited people in the villages. Generally people were very welcoming and many asked us to pray for protection, wisdom or a blessing for their family. One day we visited the local clinic and spent some time in the ladies/children's ward. It consisted of several beds and not much else. We led some worship songs (mostly in the Bemba language) which they joined in with, and we then prayed for anyone who wanted us to and encouraged them with verses from the Bible. One lady's headache disappeared immediately – it was difficult to judge other conditions but they seemed very grateful that we were there.

Kazembe village

An unexpected addition to our programme was an invitation to go and visit the village chief. We were instructed on protocol before visiting, having to kneel and clap three times when the chief entered. I was actually a bit disappointed that he wore casual clothes rather than some sort of chief costume! Unfortunately we weren’t allowed to take photographs. However, it was an honour to be able to go and to speak to him, and he also allowed us to pray for him.

Waiting to be invited into the palace grounds to see the Chief

Following our visit to the chief, we enjoyed a much needed day off before running meetings for the children in the community. More on this will follow shortly in Kazembe - Part 2!

Parents’ Evening, Zambian Style

Last week we invited parents and guardians to come into school, to discuss their childrens' progress and see their work. It was both similar and very different to parents’ evenings in the UK. I have run quite a few over the years, but I think I enjoyed these ones the most!

Kapumpe Christian Primary School

Our lovely children

Zambian culture is based largely on respect, so parents and guardians were very respectful to us as teachers. They were polite, interested and listened to what we had to say. Many of them said thank you for the job we are doing - they are very grateful their children are getting an education as not all children here have the means to go to school. Of course, many parents in the UK are just as polite as the Zambians, but not all of them. At home it can seem that some parents can forget teachers are professionals and speak to them in a way which they would not dare speak to their boss or their bank manager!

Every parent or guardian wanted to know how their child behaves in school, as this is very important to them. All the feedback I gave was accepted, and never blamed on staff or other children. Fatima, the Zambian teacher who I am mentoring, ran the meetings with me. It meant that she could translate between English and Bemba for the parents and guardians who needed it. I found that having a translator gives you time to think about what you need to say next, and how you will word it.

Fatima, our Zambian teacher

A real bonus for us as teachers was that our meetings were held during the day rather than the evening. It would be too dark for people to attend later, as it gets dark here at 6pm all year round. Rosie and I planned activities that we could run with both classes for a day each, to cover each other’s class whilst the other met with the parents and guardians. At home, a full day of teaching followed by long evenings of non-stop, intense discussions can be very draining.

There is no need to allocate time slots here because people would just not stick to them, in true African style! We invited parents and guardians to come any time between 8am-12pm and 2pm-4pm, which worked very well. Zambian people don't mind waiting so there was no pressure to talk quickly or rush appointments. This was very helpful for me as I seem to talk a lot!

Home and school links are a strength of the schooling system in the UK. Here, it’s more of a challenge because we don’t see parents and guardians very often. Very few of them collect children from school, and they don’t all have contact phone numbers. There can also be language and cultural barriers which are not always easy to overcome.

Most children walk to school, catch the bus or cram in the van!

I certainly enjoyed the more relaxed feel of the meetings over here. Even Archie (Tim & Gemma’s dog, who Rosie and I have been looking after whilst they are away) came with me in the afternoon! 

Running parents' meetings with Archie the dog