As well as working with one of our pupils, Lawrence, during her time in Zambia, my sister Rhi used her healthcare skills in many different ways. Here she tells us about some of her experiences...
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Rhi with Lawrence at Kapumpe |
During the
time I spent in Zambia I had the privilege of seeing a number of different
local healthcare facilities. As a healthcare professional (Occupational
Therapist, or OT) from the UK I have been interested to see both the
similarities and differences between healthcare offered in Zambia compared to
what our National Health Service provides back at home. I also had the incredible
opportunity to offer support to a few
adults and children with different health challenges of their own.
One of
the biggest difficulties faced by so many people living in Ndola is the lack of
available health information and education. Coming from a culture with the
opposite problem where patients diagnose themselves (often incorrectly) using
Google, I loved being able to teach a handful of people from the local
community how to look after their own health. In Zambia, many myths are passed
down through generations about different causes and treatments of illnesses
that we would probably find bizarre, so it has been great to spend some time
teaching the physiological explanations and helping the local people understand
things a bit better. I expected some resistance to the information that I was
sharing, but in reality I ended up being really impressed and encouraged by their
enthusiasm to learn.
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A very useful book we were able to buy for the Arise Project |
My main
opportunity for teaching was with the Arise guardians. The guardians have a
weekly meeting of singing, prayer and encouragements from the Bible and during
some of these meetings I was asked to conduct some teaching sessions on managing
common health difficulties. It was a lot of fun teaching the guardians
different exercises they could do to help ease pain and strengthen their
muscles, and also having to put everything into picture format as many of them
are unable to read. I also ran two sessions about food hygiene, looking at what
food is good for us and the healthiest ways to cook. These sessions ended with
the guardians putting what they learned into practice by cooking lunch for us
all to enjoy together (see previous blog post entitled ‘Masterchef – Zambian style’). We subsequently realised how much this knowledge is needed
when I was asked by a local organisation called Beyond Ourselves Zambia (BOZ) to teach the cooks at their four local schools. You can read more on the BOZ blog here.
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Teaching guardians how to look after their knees |
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Running cooking lessons with Beyond Ourselves Zambia school cooks |
In June I
was grateful to be taken on a tour of Ndola Central Hospital, the main hospital
in the city of Ndola. It was interesting to note the differences between this
hospital and the ones I have worked in in the UK, particularly in the equipment
and furniture that is used until it is beyond repair, rather than being
disposed of at the first sign of wear. Perhaps the most reassuring thing was how
familiar everything felt with similar hospital departments and layout.
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Ndola Central Hospital entrance |
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Ndola Central Hospital building |
During my
tour of the hospital I also visited the Physiotherapy department. The
physiotherapists there explained that they did not know of any Occupational
Therapists working in the whole of Zambia and asked if I would come back to see
some patients for them. I returned to visit the department on two further
occasions and met a few of their lovely patients. I visited one of their
patients at his home as he had been in a car accident 12 years earlier and a
spinal injury had left him paralysed from the waist downwards. His biggest wish
was to be able to feed and drink independently so that his family did not have
to be present 24/7. I was faced with the challenge of finding equipment for him
that wasn’t available in Zambia. I tasked the carpentry and maintenance team at
Kaniki Bible College to make me a bed rail, giving them the specifications that
would be used in the UK, and Charles the carpenter did me proud! I was also
able to get hold of a few smaller aids from the UK which enabled the patient to
achieve his dream of feeding and drinking independently. Just the smile on his
face made my whole five month stay in Zambia thoroughly worthwhile.
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Charles and the new bed rail
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The patient now able to drink independently
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Coming
from a culture where you need a DBS (Disclosure and Barring Service) check
before you can work in healthcare, I was surprised how often I was informally
asked to get involved with treating people and providing advice. At a local
school supported by BOZ, there is a lovely girl in Grade 5 who has
had hemiplegia (weakness down her left side) since she suffered a brain injury when
she was a year old. Her mother has struggled to find the right support for her,
especially since her father died who was the breadwinner of the family. I was
able to teach the girl and her mother some exercises to help her muscles, but
it was still frustrating for me to see how much her life and education are
limited by her disability, as if she were in the UK she would have had a much
wider range of support.
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Teaching mother and daughter |
Another
person I loved visiting was a 10 year old boy who lives next door to Kapumpe School. He was born with a spinal condition which has left him with clubbed
feet and no sensation in his feet or legs. The impact of this disability has
meant that instead of being in Grade 4 at the local primary school, he is still
in Grade 1. Because his family cannot afford the aids that he needs, he has had
to miss a lot of school. He is a bright, friendly and determined boy who finds very
inventive ways to manage even though he is unable to walk. Unfortunately he has
developed large sores on his feet, so following the advice of a friend
experienced in healthcare in Zambia, I visited him regularly to provide and
change dressings. As specialist products are not available here, I have
challenged our mechanic (who is also a tailor in his spare time!) to create a
special pair of shoes for this boy who has never had a pair of his own. Visiting
this boy and his family reiterated to me the lack of education given to
patients and their families, as I discovered that nobody had explained to them
that his condition would never improve and that he would face these challenges
for the rest of his life.
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Boy from next door (in wheelchair on right) and his cousins, showing off his wheelchair and hand bike |
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Being taught about wounds and dressings |
During my
time in Zambia I also had the opportunity to visit a rural mission hospital and
our local children’s hospital, as well as being able to talk to local
healthcare staff. I found it interesting to hear about challenges similar to those
faced in the UK, although to a far more extreme degree. Lack of staff,
resources and funding mean that staff in Zambia are expected to lift, move and
treat patients in ways that would be deemed unacceptable back home. The lack of
the litigation and blame culture that we face in the UK means that healthcare
staff in Zambia do not have the same fear of being sued and are not faced with
the same red tape and hoops to jump through that staff working for the NHS so
often are. However, this also seems to result in less responsibility being
taken for decisions and mistakes that are made.
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Mpongwe Mission Hospital |
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Equipment at Arthur Davidson Children's Hospital |
As with
the NHS, healthcare in Zambia is generally free to patients. However, patients
are expected to pay for more specialist or expedited services. There
are so many things we often take for granted as part of the NHS’ healthcare
provision that are very different here. In Zambia there is approximately one
nurse per ward. When patients are admitted to hospital they must have a friend
or family member with them throughout their stay and attend to their hygiene
and care needs. These bedside carers are not given their own beds so must
either sleep in a chair next to their loved one, or share their hospital bed!
As some patients are kept in hospital for many months, this is a big commitment
for their friends and family members, who are also often expected to provide
food for the patient. Things that we would expect to be a part of free
healthcare treatment in the UK, such as anaesthetic for an operation, are sometimes
billed to the patient.
The
healthcare staff I have seen whilst I was in Zambia impressed me with their
ability to do so much with so little. Nonetheless, I also found that the
Zambian culture of not sharing knowledge can also apply to the healthcare
setting, which was frustrating to watch as I believe that teaching self-care
enables people to look after their own health and reduces their reliance on
healthcare services. Perhaps the most important thing I learned from my
experiences of Zambian healthcare is how easy it is to come to a developing
country and think you know so much more than people who live there, but after
spending time with them you realise they have far more to teach you than you
could ever imagine!
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No running water means hospitals have to be inventive! |