Yet ANOTHER Week in the Life
Every three months or so, I like to journal what I do every
day for about a week so folks can get a glimpse of rural life in Zambia. There is not really a typical “day” as
each day presents its’ own rewards and challenges. The last time I intensively wrote in my journal was from the
last week in June to the first week in July. Enjoy!
Thursday June 28th: Cooking Day
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I woke naturally with the sun and chickens
around 6:30 am. It’s been nice to
not have to use an alarm clock since being posted at our site. Did the morning chores including
watering the garden with our wastewater and fed the chickens. I drank some green tea from a thermos,
which was still warm from last night, and prepared for a big cooking demonstration
day at the clinic.
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Another volunteer Kelly stayed the night to help
with a refresher course I’ve been putting on all week for 6 community health
workers and 11 members of the Safe Motherhood Activities (SMAG) group. Topics covered so far have been:
reasons pregnant women should have a clinic delivery, why fathers should
accompany their pregnant partners to the clinic, HIV transmission, family
planning, and malaria prevention
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Scott helped her fix her flat bike tire in
preparation for the 2+ hour bike ride back to her village later this afternoon.
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Scott went to a mud brick church down the road
to finish teaching a 2-day workshop for fish farmers sponsored by a local
NGO. He had spent all last evening
cutting out paper fish used for an educational hands-on activity as most of the
villagers he taught read and write very little.
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I
arrived at the clinic around 8:30 and Kelly arrived shortly after with her
newly-fixed bike. Since all the
SMAG’s and CHW’s were actually sleeping on foam mattresses in the clinic for
the week (some came walking from faraway villages), breakfast was served. It came a little late but was tasty:
tea with creamer and sugar, boiled sweet potatoes, and roasted peanuts.
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The workshop started at 9:30 (only half an hour
late), and the participants gave a very good re-cap in Lunda of yesterday’s
session. They divided themselves
into 3 groups to practice teaching expectant mom’s coming to today’s antenatal
sessions about HIV, malaria prevention, and family planning techniques.
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During this groupwork, one of the course
participants who had a stomachache was lying on a reed mat on some grass
outside the clinic porch (Lundas like lying in the sun if they feel sick). She was not bothering anyone, but I
went to go get the clinic worker in the next building over to see if she could
get some pain killers and oral rehydration solution.
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Upon coming back, I saw almost the entire group
of 16 participants surrounding the sick one and saying that she was
possessed. Upon seeing that she
had an audience, the woman started convulsing and speaking in tongues. Many started praying and saying that
they needed to carry her to the church to get rid of her evil spirits (granted
we WERE in a clinic). Even the
in-charge agreed that there was nothing he could do and maybe it would be
better for her to go to the church.
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Kelly and I patiently waited in the makeshift
hospital-room-turned-clinic since almost all the class participants were
outside trying to calm the poor woman of her nervous fit. Finally the in-charge (not a nurse mind
you) gave her a shot of some type of tranquilizer and the woman drifted into a
deep sleep.
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It was like herding goats to get all the CHW’s
and SMAG group back into the classroom to talk about this afternoon’s child
nutrition session and cooking demos.
We started with drawing pictures of the difference between extremely
malnourished and stunted children.
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Lunch for everyone consisted of nshima, soya
pieces, and boiled beef leftover from last night. During lunch, I received a message on my phone that the
guest speaker who was supposed to come from Mwinilunga tomorrow to teach about
water and sanitation was not going to make it. This is definitely not the first time that BOMA officials
have cancelled on me! I guess I’ll
just teach all of the content.
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We had one more short classroom session after
the men came back from bathing in the river, and we reviewed ways to enhance
children’s porridges to give them more nutrition. The health workers sorted food into three different baskets:
“go, grow, and glow” for carbs, proteins, and fruits/vegetables and talked
about foods that make you do each of the above.
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Then for the fun part! The groups divided up into 5 co-ed groups, which was fun to
see since traditionally Zambian men don’t cook. They each made a different children’s food: pumpkin
porridge, sweet potato porridge, eggs with veggies, soya patties, and pounded
peanut and dried fish porridge.
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Each group was very proud of what they made and
village toddlers (many of whom were malnourished) came from across the road to
test. They liked them very
much! The health workers were
encouraged to give them small amounts and to eat slowly. Even the older kids wanted to eat some,
but unfortunately we didn’t have enough and we had to re-enforce that the
younger children had priority with the food, which was good role-modeling for
the mothers of the malnourished toddlers.
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As the sun went down, the adults finally got to
try their own creations for dinner, and there were mixed reviews, but most of
them liked the dishes.
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I rode my bike 4k home under the half moon,
which was bright enough to light up the road as I saw warming fires from the
various family compounds.
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I got home, took a quick foot bath, re-capped
with Scott on his day’s events at the fish farming training, and tried checking
my phone messages only to hear that the network was well. Oh well . . . more time for sleep!
Friday June 29th: Toilet Inspections
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This was day 5 of a 6-day course, so there was
no time to do many morning chores except wash my sandals, which really needed
it! I did have the lovely
experience to waking up to a dead bird and big pile of feathers under the bed
that the cat brought in, but no time to even clean it. I threw the bird outside but to no
avail as the cat brought it right back in as a play toy. Sigh!
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Scott spent the day getting wall lime from a
Peace Corps neighbor’s house, visiting me at the clinic, gardening, and making
yummy pumpkin curry.
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I biked to the clinic with full-fingered gloves
and a coat in the early morning chill and brought baking soda and a spatula to
make pancakes for the health workers camping at the clinic for their
training. One of my male
counterparts enjoyed flipping the pancakes, which was fun to see, and everyone
enjoyed eating them. Anything
containing flour and oil in the bush is a true treat.
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The workshop actually started close to time
(9:00) and I had each cooking group re-cap what they made and if it had all 3
food groups. They said that all
the recipes could be used with small children, except for the eggs, since eggs
are too expensive and traditionally eaten by adult men only.
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The Safe Motherhood group finished up their four
days, and they each got mosquito nets and the names of 2-5 pregnant women in
their area to distribute directly to the houses of these women while providing
health education on malaria prevention.
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We were left with the six community health
workers, who were able to practice giving a health talk at the clinic where
over 100 children under 5 years came to get weighed. Even though all day’s session was supposed to be about water
and sanitation, I couldn’t pass up the practical learning experience. Everyone helped with both the weighing
and tallying of kiddos at two different weighing stations.
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Unlike a typical scale day where they just weigh
the kids like produce and then just send them home without telling the parents
if they are underweight, we practiced assessing the growth charts do determine
which children actually needed special assistance and helped the health workers
formulate how to explain better nutritional practices to the parents.
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Scott biked to the clinic to join the group for
lunch, which consisted of nshima, dried fish, and a tomato-onion sauce.
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In the afternoon, we went over a list of
expectations for all of the health workers to receive a refresher course
certificate. They will have to do
different types of health promotion tasks in their villages, and we will have a
follow-up course and give out the certificates in November if they have
completed the tasks.
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We then took a little field trip to some
different compounds surrounding the clinic to assess various pit latrines. The first place we stopped was a nearby
family whose latrine was completely full (and uncovered at that), so everyone
was using the bush, which was dangerously close to the nearby river. We assessed what would be a good spot
to build a new toilet and educated the family on the importance of disease
prevention for the entire community.
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The second compound was strikingly different and
a model for sanitation; both male and female chimbushis, both made out of
strong bricks and covered with good roofs to prevent erosion in the rainy
season. The toilet holes had
covers and were swept daily with ashes to disinfect. This gave the health workers a good comparison so they could
come back to the classroom activity of writing up a checklist of things to look
for in a village toilet.
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For dinner the group had nshima and chicken,
which we had just seen squawking moments earlier. I bypassed this
dinner to come home to Scott’s cooking of pumpkin curry just before dark. As I was arriving our house, there was
also a visitor I had never met asking for money for his HIV group. Most of the villagers know by now that
we just don’t hand out money . . . but there are those occasional few!
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Although I should have been planning for
tomorrow’s lesson at the clinic, I was tired and read a few chapters of my book
before retiring straight to bed.
Saturday June 30th: First Do No Harm
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Today is the last day of the refresher course!
Although I enjoy teaching at the clinic a lot, I’m ready to be done with 10+
hour days at the clinic that include teaching as well as managing meals and
logistics for health workers from remote villages camping out at the clinic.
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Yesterday the health workers prioritized that
they wanted a refresher on basic diseases, so I woke up with the roosters (no
alarm clock these days) to look up infectious diseases and make a little
matching game.
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I was a little jealous because Scott went to the
agricultural show in the BOMA that was happening Friday and Saturday only. I wanted to see it to compare it to the
Yakima fair, but alas, it will have to be next year.
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I again cycled to the clinic in the morning
chill and found that breakfast of sweet potatoes and roasted peanuts were still
cooking over the fire. I prepped
for the last day only to find that the markers we use to write on butcher paper
on the wall were all finished, so I went back home to get more markers knowing
the course would definitely start later than 9am today . . . and so it goes in
Africa!
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I came back and breakfast was ready. We prayed, ate, and prayed again before
the course began. We re-capped the
toilet session and problem-solved how the health workers could address issues
of full toilets/no toilets on family compounds in their communities and ended
the discussion with six toilet experts!
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The next topic was weighing children, since many
of the health workers are very good at the actual weighing, but many have a
hard time looking at the charts to determine if a child is actually underweight
or not. We practiced plotting
lines on growth charts and assessing the curve to see if it was going up or
down. It was fun to finally see
them “get it” to see if a child is actually underweight for his/her age or
not.
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Lunch consisted of soya pieces and of course
nshima. Mmmm . .
. not that I don’t like nshima, but it’ll be nice to have a break when
the course is over.
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The last lesson was called “first do no harm” as
these community health volunteers have pain killers, malaria medications, cough
syrup, antibiotics and a myriad of other drugs (thanks to generous foreign aid
donations) at their disposal.
Unfortunately, their 6-week training six years ago was hardly a substitute
for a solid pharmacology background.
Most of these health workers end up working in the clinic quite often
since we have had no nurse much less doctor there for over a year. They often pass out medications at
patient’s request, thinking they are doing a good thing by making the patients
feel better.
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This session re-iterated that health workers’
main job was disease prevention, and then went over the side effects of each of
the above classes of drugs mentioned above. We also discussed the concept of drug resistance, which they
had never been taught about, and the importance of having a patient finish an
entire course of antiobiotics or malaria medications.
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Many of the health workers had an “ah-ha”
moment, realizing for the first time the dangers of side effects of some of
these drugs they had been passing out like candy. Some even admitted, “we’ve been giving too many
medications.” Even though it was
only a short session, it piqued their interest enough that they want to learn
more about medications from a trained nurse when we re-unite in November.
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The very last activity was the disease matching
game and let me tell you I was surprised by these health workers knowledge of
diseases such as measles, lice, and syphilis. They knew more than I thought!
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The health workers helped clean up after the
week-long course, which involved carrying by hand the church pews we borrowed
from the Catholic Church ½ a kilometer up the road. They got their mosquito nets for distribution, and we ate a
last meal of nshima and kapenta (dried sardines) together.
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I rode home exhausted as the sun was going down
and the full moon was coming up.
It was slow-going since I had a small leak in my front tire and brakes
rubbing in the back which I hadn’t had time to maintain all week. But I did have a good sense of
accomplishment for a week completed.
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I came home to find Scott roasting big marinated
hunks of fresh pork over the brazier, which he had bought at the agricultural
show. He liked the show, but said
that most of the fresh produce was for display only and not to buy.
Sunday July 1st: Water Day
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I slept in until 7am, which is a near record for
the village considering the sound of roosters and people working that usually
wakes me up.
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I helped Scott fill our large drum of water with
our neighbors, which is a 3-4 person affair involving 1-2 people at the well
raising buckets of water on a rope and 1-2 people biking and dumping the
buckets into our drum. I took
advantage of the bounty of water to soak the garden.
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I had every intention of going to church, but
because there was so much to do after being gone for 6 days, I decided to stay
home for some laundry and cleaning.
We ate a simple breakfast of sorghum porridge and canned guavas, and I
started scrubbing away at our clothes by hand as a local high school student
put dried grass on an extension of our outdoor kitchen right above me. We blasted music on our mini AAA
battery speaker and the Zambians loved it. A few neighbors came over just to hear the music.
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Crispin helped Scott dig a foundation for our
new bathouse/bikehouse. Although
the villagers make these mud structures all the time, they got a kick out of a
chindelli (white person) doing it.
They especially liked seeing him use the level.
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I did some gardening/weed pulling and picked
some tomatoes, basil, and lettuce from our yard. This was my first fresh salad from our garden in about two
weeks. Also some bike maintenance
including jerryrigging the back brake until I have time to replace it.
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I rushed to the clinic, thinking I was late with
a follow-up meeting with the clinic in-charge and two of the course
participants. The in-charge said
he didn’t want to meet because he was tired and only one of the participants. Had I known, I would have finished
fixing my brakes. So is life.
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I got home to make dinner of boiled sweet
potatoes, some the size of a small football (took an hour to cook), and granola
with fresh local honey.
Scott made collard greens and cooked up the pork he had been marinating
all day VERY throuroughly as there’s no fridge around here.
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Evening consisted of tea, journal, and bed by 8!
Monday July 2nd: A Baby Named Scott
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Today is some Zambian national holiday that I
don’t remember the name of because these holidays really mean nothing to the
village workers. They still go to
their fields, pound cassava and build bricks like they would any other day.
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I went to get drinking water at a spring about 1
kilometer away. Usually there are kids or women around, but this time I got to
enjoy the tranquility of the hills and trees by myself before lugging 10 and
20L jugs back up a hill to my biked parked at the top.
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Chores today included a deep clean of the
bedroom floor, including removing termite trails, the beginnings of ant hills
and the remnants of Hop’s scuttle with the bird a few days back as well as
starting sweet potato bread.
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I went to the clinic to make the re-scheduled
clinic and the in-charge said he was going home for lunch and gave me the keys
to the clinic. I started counting
money leftover from the refresher course (originally provided by the district
health office) because we had to account for every single kwacha spent and
writing a repot for the district.
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We did have some leftover money, and when the
in-charge and a course participant finally returned, I asked what they thought
we should do with it and they automatically said “bicycles for the clinic
volunteers.” We debated this as
the clinic had two bicycles for this very purpose just a year ago, and they
mysteriously disappeared. Better
to get something more practical like benches and shelves so patient charts
didn’t have to sit on stacks on the floor.
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We moved all the mosquito nets to the locked
pharmacy room to make sure that only community health volunteers had access to
them to distribute to pregnant women.
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I went to the labor room building, and saw the
latest delivery—a male. I asked
what his name was and the mother said that I should name him (this has happened
on at least 3 other ideas, so if anyone has any name suggestions . . . ). Before I could even open my mouth, the
traditional birth attendant piped in, “Scott.” The mother and father both approved, so the name stuck.
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I rode back home and worked on the bread, which
turned out more like flatbread.
Scott cooked up some leafy green veggies and we had some pitas. The full moon rose and the night was
eerily quiet for a full moon . . . no sounds of children playing and no
neighbors huddled around their warming fires.
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Scott started burning our trash, and by 8pm we
heard what sounded like a procession of people singing and then yelling. We didn’t know what it was but thought
it might either be a funeral procession, a witchcraft trial, or some type of
church event. We had a treat of
dark chocolate and dried cherries sent from the States . . . yum!
Another Week in the Life!
