Wednesday, February 17, 2010

Pink eye for a pink day!

Hey all! Happy late Valentine's Day to everyone. I hope that you all felt very loved where ever you were. I can tell that the Zambian's definitely felt the love too. I was surprised to see how big the holiday was in Zambia. I went to Arcades Shopping Center, one of two outdoor shopping malls in Zambia (the shopping malls are primarily targeted for Westerners/Foreigners and well off Zambians) and it was packed. There was like a mini carnival happening there where kids could play on a bouncy house thing, zoom around in kid sized cars, they had some people juggling and doing trip with fire and balancing things, as well as a couple of food carts. This was in addition to the weekly Sunday craft market where most of the westerners buy their souvenirs. The highlight of the day was the wicker love seat they had parked outside of the supermarket with a massive display of heart shaped balloons behind it where people could take Valentine's pictures. I celebrated the day in much less style by developing an eye infection that turned my left eye pink. Thankfully, I happened to be going over to Dr. Tim's house that night for dinner and he was able to evaluate my eye to make sure it wasn't anything serious. We had a good dinner that night-He made turkey, potatoes, green beans, sweet potato pie, and much more. It was delicious! Before I go further, let me go back to where I left off last time I wrote.

Last Wednesday I spent the day working on the new record keeping system for the House of Moses and then walked over to the bible study that I have been attending. It would a good discussion on the necessity for Christianity to be rooted in the resurrection of Christ-and how without the resurrection Jesus and his death means nothing for us. Important stuff!

Last Thursday I was at the clinic and we had a busy day from the time I got there at 9:30, until we left around 5:30. With the exception of our lunch from 12:30-2:00, we were seeing patients whole time. To put this in perspective, let me tell you the following things:
1. The clinic hours are actually only from 2-4 pm and only 10 patients are scheduled to be there on any given clinic day.
2. By the end of the day we had seen between 20-25 patients.
3. The clinic is housed in a room that is approximately 12 feet by 15 feet. In this room there are two computer desks, a patient bed, 6 chairs, two filing cabinets, a step stool, mini fridge, and medication cabinet. Not to mention the clinical officer (like a physician's assistant), program manager, 1-2 social workers, 3 volunteers, a pharmacist, a receptionist of sorts, and 1-5 patients. There also 2 doors to the room. What about privacy and confidentiality? Pshaw! Impossible!
4. I am also working closely with the clinical officer-I start the patients by examining them, doing an initial history or some blood testing, appointment making etc. I can start patients but can't finish them and we usually can't communicate very well. The problem with this situation is that the clinical officer kept disappearing when there were patients to be seen, or if he was around, I couldn't keep his attention long enough to ask a question AND get an answer. It was frustrating! So the patients ended up sitting around, for much longer than they had to, which just added to the chaos!
5. The patient files are always difficult to locate-the office assistant doesn't do her job well and they end up piled in the most random locations, and never where they should be. This usually leads to a 5-10 minute search by multiple people, which eats up a lot of time that could be spent on better things.

So for all the griping I just did, it wasn't that bad-just so that you all know some of the things that I am experiencing here! I am pretty easy going on most things, so that helps, but sometimes....

Friday I was at the House of Moses and was able to make some revisions to the records that I created after discussion with Irene. Then in the late afternoon, one of the employees here dropped me off at Arcades where I was going to meet Ntula (the clinical officer from the clinic) and the other American volunteers before going out for the night. It was an interesting night of some African clubbing (must better than American clubs, I have to say!) before the other volunteers and I crashed at midnight. We have been going to bed around 9 or 9:30 so midnight was pretty late for us. I stayed at their place and the next morning went back to the House of Moses on the bus. This was quite the ordeal because I got lost on the way to the bus station (it was supposed to be really easy to get there, but I messed it up). It should have only taken maybe 10 minutes to get there and I some how bypassed it altogether and ended up in an uncomfortable part of town before finally making it to the station 45 minutes later! It was stressful because I was harassed a lot (a female Westerner by herself is just asking for it!). The once I got on the bus and it started to move, it got pulled over by the police because it was overloaded and we all had to get off! Thankfully a gentleman was kind enough to explain what was going on and helped me get on a new bus. All in all, it took me more than 2 hours to get back when it should been less than an hour.

Later that afternoon I went over to Ruth's house to meet her family. Ruth is one of the staff at the House of Moses and does the laundry, cooking, cleaning, etc. She has been here for a long time and is always a welcome sight when I visit. She is a woman of strong faith and is the sweetest person ever. Her family lives just behind where I have been going to church in a small house. It was nice to meet her family, but I was so tired after the events of the morning that I didn't stay long. I have never been very good at figuring out social expectations in a setting like this one-especially because it's a different culture. I hope they weren't expecting me to stay for a long time! It was also a really hot and sticky day (the hottest one so far-maybe 85-90 degrees with alot of humidity. The rest of the day was spent veg-ing out and resting.

Sunday morning I woke up with pink so stayed home from church and instead got a lesson on how to hand wash laundry. Let me just say that I suck! Janet was helping me and it was so embarrassing because I would wash something and then she would rewash it for me. There were a couple of things that she didn't rewash and there was a big difference afterwards when my laundry came off of the line. After that was my trip to Arcades and so on...

Monday was an outreach day for the clinic. After initially starting off in two small cars, we ended up switching to a bigger one and all cramming into it. We got lost all along the way, and there was definitely no way that we would have made it through those huge mud puddles if we had stayed in the smaller cars. Upon arrival to the clinic where we were going to test, we discovered that we had left the testing kits back at the office! So Ntula and one of the other American volunteers, Brook (he's a guy, fyi!), went back to get it while Anna and Sabrina (the other American volunteers), Justin and Fernando (the social workers), and I waited in the clinic. This waiting period led to hilarious discussions on the proper social protocols for dating couples in Zambia: most people (including the parents) won't even know they are dating until they get engaged, it's acceptable for guys to hold hands in Zambia, and a guy will be affectionate with you until he likes you and then he backs off-that's how you know he likes you. At this point Fernando asks Anna if she has a boyfriend which was quite hilarious because Brook is her boyfriend and they are definitely affectionate in a way that wouldn't be if you were only friends. I know this was one of those moments that you had to be there for, but it just goes to show that lines between friends and more than friends are difficult to determine in a cross cultural situation. Then it also came that Fernando still doesn't know the names of the volunteers-even though we have all been here for almost 3 weeks! Funny stuff! Anyways, eventually Brook and Ntula returned and we tested about 50 people with several positive results discovered.

Tuesday was a better day at the clinic, just as busy as last Thursday, but we had a better rhythm this weeks so it wasn't so frustrating.

And now, here we are at today! I had a meeting with Irene, the head nurse, today and discovered that I am not supposed to be posting pictures of the kiddos here on the internet, so I am sorry to say that you won't get to see lots of photos anymore. I will still be able to post photos from the clinic though, so you can look forward to that!

On one last note, thank you to everyone who has posted a comment on my blog. I don't know how to respond to them individually but I have read them and appreciate it! Thank you!

Until next time!


Thursday, February 11, 2010

Pictures for my last blog

The first picture is of a boy at the Farm

The second picture is of the Lusaka City Market, the 3rd picture is of John Lenge compound where we did the outreach last week, the fourth picture is of Chilala who is wearing Alicia's glasses (and was so excited about them),  and the last picture is of a very excited girl from the outreach.
February 10, 2010

It’s Wednesday and I am at the House of Moses today. When I woke up this morning it looked like it was going to be another sunny, beautiful day but as the morning progresses it’s getting windier and cloudier. Yesterday was gorgeous-hot, bright blue skies, a nice breeze. It hasn’t rained since Friday or Saturday of last week which is good for the poorer neighborhoods in Lusaka that were starting to flood after all of the rain last week. The House of Moses is buzzing with activity. Rumor has it that some Minister (maybe the Minister of Community Planning, whatever that is) is coming to visit today and may give the organization a huge donation. All of the staff are working hard to clean the house and the yard as well as dressing the kids in matching outfits and doing their hair. I was hoping to do some research on the internet today but it seems that every time I carve time out to do it, the internet has problems. So instead I am going to be creating new record keeping documents for the kids here. The current system involves different bits of information in a million different places, nothing really comprehensive. But before I get going with that, I thought that I would take the time to talk about the week so far. Last Sunday I didn’t do much- just read a lot and played with the kids in the downstairs nursery. I also finished my laundry and cleaned my room. It was a very relaxing day. Sunday I went to church with the Murray’s (the missionary family who live nearby) and then went to their house for lunch afterwards. It was delicious and I got to try some fritters for the first time. Fritters are deep fried balls of dough (like a doughnut) and they were delicious! The rest of Sunday was spent doing a little research on the internet. When I arrived in Zambia, I was given the challenge of helping to figure out how the House of Moses can become a model orphanage for all of Africa. For the two weeks that I have been here, I have been constantly pondering what that means, what it would like, and how we could do that here. I have been searching the internet for a definition of what that would mean-certain standards, models of care, definitions, etc. but so far haven’t really come up with a good idea of what it would mean to be a model orphanage. Either no one has done the research to determine what standard orphanages should try to follow, or the research is inaccessible because there isn’t one definitive study that answers the question. While I think that the House of Moses does a fairly good job as an “orphanage” it is not perfect and could make some improvements. The kids still spend too much time in their cribs, and like any orphanage, individual attention is pretty nonexistent. Every day that I am here and walk into the nurseries, I am encouraged to keep up the search because these kids need it. And they deserve it.
On Monday, I went with the Murray’s to another missionary’s house to watch the Superbowl. I normally don’t care about watching any sport, especially football, but the Superbowl is different-it’s more about eating junk food and hanging out with people than about the actual game (oh, and I really like to watch the Superbowl ads). In the afternoon I returned to the House of Moses and continued to work in the afternoon.
Tuesday I went to the clinic for a Tiny Tim and Friend’s meeting in the morning. I got there using the bus (by myself!) for the first time and got to sit next a very friendly lady who was reading the book, The Alchemist, by Paul Coelho. It took me about 1 ½ hours to get to the clinic. The rest of Tuesday was spent seeing patients (I think that I am getting the hang of the assessments, charting, and plan now) with Ntula and meeting a new potential volunteer named Sabrina. She is a nurse from Michigan so we got chat a little bit during the lunch break. After clinic was over for the day (or should I confess, I skipped out on the last 45 minutes), I went with two other volunteers, Brook and Anna, to the Lusaka City Market and Soweto Market to get some supplies and groceries. On my previous trips to Lusaka we had essentially been strongly discouraged from going to either market due to safety concerns, so I was excited to see what the infamous markets were like. They weren’t anything different than the markets in the rest of the world-people see the color of your skin and want you to buy a lot of stuff from them and sometimes will harass you a bit. I didn’t really feel concerned for my safety, but I don’t think that I would go there alone. It was just a little intimidating. I would have taken pictures but that would have just been asking for me someone to try and steal it!
And now, here we are at Wednesday! I am still healthy, enjoying eating n’shema once or twice a day, and just feel really blessed to be here. Oh, and I also got a little bit of smile out of my boy, Matthew, today! Praise God! I am still trying to keep my eyes and ears open for the things God wants me to see, and the ways that He wants me to be involved here in Lusaka. I hope and pray that the rest of you are doing well! Until next time and in God’s great service…


Saturday, February 6, 2010

One week down!

UPDATE: My internet connection is having problems posting pictures to this blog so look for them on Facebook if we are friends. I will try to post pictures on here as soon as it lets me!

February 5, 2010

I can’t believe that I have been in Zambia 8 days already and gone for 10 days total. The time has flown by this past week and I have managed to keep busy. I last wrote the day I arrived so I will fill in the rest of the details from there. I do apologize because this is likely going to be a lengthy post. You have been warned!

So to start where I left off. Shortly after finishing my last blog, I ended up falling up asleep for the next four hours and waking up just in time for dinner. Thankfully, I still managed to sleep all night long and woke up around 5:30 or 6:00, when the house really starts to come alive. That morning (Friday), Dr. Tim sent his driver to pick me up and take me to the Tiny Tim and Friends clinic downtown. Dr. Tim was seeing clients that morning so he left it up the guys who typically run the clinic to show me around. Justin and Fernando are the social workers, Ntula is the clinical officer (physician’s assistant), and Phridae (pronounced Friday) is the program manager. I don’t think they knew I was coming or what to do with me so after sitting for a couple of hours while they worked, I ended up leaving and catching a taxi back to the House of Moses. The morning was fairly difficult because I am not used to sitting around doing nothing, sort of ignored, while other people work around me. The guys were nice enough, but it didn’t leave the greatest impression on me, and I was kinda worried about what the experience was going to be like. After returning to the House of Moses (HOM), I had a yummy lunch of nshima, and then took another nap and then just read the rest of the day.

Saturday morning, Dr. Tim sent his driver to pick me up and take me to the Farm for an HIV outreach. The Farm is not only the home to Dr. Tim and his adopted son, “Tim”, but also home to 8 or 9 orphaned teenage boys with HIV, and an actual farm that will be used to help supply income to the clinic. The outreach was designed to help bring the kids from the HIV clinic to a place where they could have fun for the day, watching skits and dancing, eating good food, and hanging out with other kids like them. It was also a day where the clinic could reinforce consistent medication administration, talk about psychosocial issues and do some risk reduction education. It was a long and busy day but it was also nice to get out and see another side of the organization. It was also a good day because I had the chance to talk to Justin and Fernando and get to know them a little more. Here are some pictures from the outreach of the skits and dancing. 

Upon returning the HOM I was able to connect with some missionaries who live nearby and received an invitation to church from them. So the next morning I was picked up by Tracy Murray and 3 of her children and we drove the short distance to the Baptist church. I went to a bible study before the service and had a good discussion about fasting. The church service was great also and afterwards I walked home getting lost along the way. The rest of the afternoon was spent reading and relaxing.

Monday morning I met with Irene, the head nurse from the HOM and we had a good, long discussion about the work that I am going to be doing here. I also had the chance to ask lots of questions about how things are done and to look at the records they keep of the children. I tried to learn as much as I could about the organization so that I could then figure out where their needs were and how I could have an impact on them. I spent the rest of the day talking off and on with Irene, hanging out in the nurseries, and researching child development etc. Most of the day was rainy and gray, just like Seattle, so I wasn’t feeling homesick at all!

On Tuesday morning one of the teenagers from the Farm had offered to meet me at the HOM to show me how to use the bus system but it was pouring rain that morning, so Dr. Tim sent his driver to pick me up and after making a few stops we made our way to clinic. The drive in to town was good because I was given the opportunity to ask Dr. Tim lost of questions about how he got to Zambia and get a better idea of what his organization does. We also picked up two of the other new volunteers, Anna and Brook. After arriving at the clinic, we had a meeting with all of the staff and the volunteers about the clinic and then had the chance to relax in the office, learning about their charting and filing system (which is quite the disaster!), and then in the afternoon I worked with Ntula seeing patients.

The next day, I was picked up by Dr. Tim’s driver again and driven to the clinic where the staff of TT&F was preparing to go out on an outreach. This outreach was different than the one on Saturday because it involved the staff and volunteers going out to a predetermined location (school, daycare, orphanage) and testing anyone who signed a consent form for HIV and then doing posttest counseling. These outreaches typically have a 10% HIV positive return and these people are then referred to Tiny Tim and Friends for more conclusive testing. The test kits in the field have a high false positive potential, so another more accurate test is always done at the clinic. Most of the people tested are children. On this particular day we tested 90 people with 8 positive results. The posttest counseling was done by Justin and Fernando who counseled the negative people on risk reduction and prevention strategies and then referred the positive people to clinic. I have included a picture of the compound where we were doing the testing. The rains continued all day Monday, Tuesday, and Wednesday. Felt just like home and there were even some moments when I was a little chilly!

That evening, I walked over to the Murray’s house for a cell meeting (bible study). Afterwards I had the chance to talk with Tracy and her husband, Mike, as well as 5 of their children (they have 8 total, but 3 of them are in the states). They are a fun family and have a huge library of books that I was able to borrow from to supplement my own meager supply.

Thursday was spent at the clinic again and I arrived there earlier than I needed to so that I could read about pediatric HIV treatment. Phridae was quite unhelpful in locating it for me and wouldn’t let me look for it either, so I ended up sitting for a while doing nothing. Very frustrating! After a while I begged him for anything to read and he managed to find something to help me pass the time (and to get me out his hair!). Time passed slowly, but eventually patients started to arrive and I was able to start seeing them. The Zambian system for health care is very interesting because the Tiny Tim and Friends “Clinic” is really one office (in an unrelated medical clinic) about 10 feet by 14 feet where the 4 guys work, plus an office assistant and a pharmacist in addition to any volunteers and patients. It is an extremely crowded space and there is no ability to provide privacy or to move. The organization is just too small to provide care for their patients and afford a bigger space. I hope that in the future they will have this very important need met! With my next blog post I am going to post a photo for you all to see just how crowded things are. After finishing at the clinic Ntula offered to show me how to get back to the HOM using the buses. It was easy, and I probably could have done it by myself but it was definitely nice to have a Zambian show me what to do. We ended up stopping at Arcades (the other shopping mall) to go to the grocery store and then continued on.

Today was the first day this week it hasn’t poured rain all day and I actually got to see some sun and blue sky. It might have been short lived, but it was still there. I spent the day at the House of Moses hoping to continuing working on the presentations they want me to do, but the power was out much of the day and even though it’s back on now, I still can’t manage to get on the internet. Instead I spent much of the day in the nurseries or playing with my friends Matthew and Gabriel. Matthew is my chosen boy this time (although I don’t really feel like I chose him, even from the beginning he would come up to me begging to be held). Gabriel is more than 3 years old, a big kid for the House of Moses, but I don’t think they are going to move any more of the children to the Bill and Betty Bryant Nursery until they open up the new house. So in the meantime, he is the oldest and biggest kid here, although he doesn’t talk. He is good at making some sounds, but developmentally he is probably the equivalent of a 12-16 month old American baby. Here are pictures of Matthew and Gabriel. Both of them look super sad in these pictures but they were actually quite content when the pictures were taken.

I am enjoying everything here so much and am so grateful for the opportunity to come here and see things from a different perspective. I continue to feel confident in God’s call to have me here and am excited for what I will get to learn and do.

Here are some prayer requests for this week:
1)     Continued inspiration and direction as I plan some presentations for the staff at the House of Moses. I have about 4 ½ hours worth of time to fill on stimulation, development, hygiene, health, etc. I particularly need help figuring out how to take this information and somehow have an impact on how the caregiver’s work with the children.
2)    Continued prayers for health and safety. I haven’t been sick yet and or felt like I was in an unsafe situation and I pray that I don’t have to deal with either situation.
3)    Prayers that I will continue to develop and form connections with the people here-including the staff at the HOM, the medical clinic, and beyond including both Zambians and non-Zambians.
Well, that’s the main gist of it for now. For those of you who have continued reading this far, BRAVO! That was a lot to read and I appreciate the time it took you to get here. Here are some of my discoveries for this week:

1)     The police in Zambia actually own a hybrid Honda Civic…wonder how much that cost!
2)    The supermarkets have sanitizing wipes to clean off your shopping cart. Such a Western thing!
3)    Using the bus system in Zambia is easier than I thought, yeah!
4)    I have learned how to say “I want a lot of nshima today” in Nyanja. It goes like this: “Nifuna nsima yambili lelo”
5)    There is a frog living in the bathroom where I shower.
6)    The washers at the HOM do not wash well and the dryers do not dry well. Hmmmm….Maybe I should be hand washing my clothes and hanging them to do dry on the line?

In God’s Great Grace and with prayers to you all for a great week ahead!