‘Experiencing a Culture Shock’

Patrick Courtney

Zambian Immersion Project 2007 Health and Illness – Patrick Courtney

“Zambia is not all about the illness and poverty, there is the noise and the fun here too.” A quote from fr John, the parish priest and general hospital Chaplin who is originally from Rwanda and fled during the time of the genocide. We did experience the noise and the fun by visiting the tourist attractions on the first weekend but we also, without a doubt witnessed the illnesses and the severe poverty.

I will now endeavour to give you some insight on the health care in Zambia. The main health issues are:
1. The transmission and prevention of the HIV virus.
2. The prevention treatment of Malaria.
3. The medical problems arising from malnutrition.
4. The Zambian health service.

The healthcare of any country, particularly the more vulnerable e.g. the young the poor and the elderly, depend greatly on the national health services. There are huge demands on the health service and the continued work and support of the likes of us and other organisations such as Trocraire and the Red Cross. These are essential to maintain a basic health service.

We were very fortunate to work with a team led by a Franciscan nun called Sr Mary Courtney. They have a centre in Livingstone which attends to ten compounds. Every morning at 8.00 a.m., two nurses with boxes of medication leave the centre to proceed with their fortnightly visit to a compound. Patients from all around the compound will gather at a designated house that would serve as a clinic where all of the patients get seen to.

The visit begins with a prayer, drugs and medication are then dispensed to the patients to help them with their pains or illnesses. These drugs may include antibiotics, decongestants and painkillers. The distribution of these drugs are also recorded in a small notebook.

As we assisted the nurses throughout the different compounds, we soon became aware that most people suffer from chronic illnesses such as AIDS, TB, Malaria and malnutrition. Anemia, one of the more common blood disorders, occurs when the level of healthy red blood cells in the body becomes too low. anemia can cause a variety of complications, including fatigue and stress on bodily organs. Ways of checking for this disease are checking for a yellowing of the whites of the eyes, an enlarged spleen, and dark tea-coloured urine, although the nurses mostly used the method of checking the eyes of the patients. I was shocked at how white the capillaries of the eye was so white.

HIV is a serious (often fatal) disease of the immune. The culture of polygamy in Zambia, unfortunately allows for the disease to spread- 40% of the population in Zambia have AIDS and 80% have it in the compounds. The fortnightly visit to each of the compounds also allows for an informative talk led by one of the nurses on topics such as the ways in which the viruses can be transmitted and also the treatments that are presently available for them. Counselling and testing for AIDS is provided daily in the St Francis care centre. Pregnant women are encouraged to get tested for the HIV virus as early intervention in pregnancy can prevent the unborn child being infected with HIV. 80% of the patients in the compounds we visited have AIDS which left them looking very thin with blood shot eyes and with lesions on their bodies.

Peggy, one of the nurses we assisted around the compounds has HIV, but with the use of antirectro viral drugs now available freely to any HIV patients, she is able to work on a short term basis as the disease makes her very tired and weak. The evidence of the destruction by the HIV virus is everywhere to be seen. Thousands of orphans are on the books at the St Francis care centre because the majority of their parents have died due to HIV. Another example where HIV is so destructive is in the St Raphael’s Christian brothers school in Zambia, where the vice principal, head of Maths and the head of Science have all died at the fatal hands of AIDS.

We also visited the grave yard in Livingstone and the first thing that we noticed was the very high numbers of fresh graves where the deceased were all aged between their twenties and their mid thirties, but a time that struck me was when we witnessed the very brief and simple burial of a child. This experience was a harsh reality to take in and a rude awakening for us all. The child was laid to rest by what looked to be a grand mother and two other men, the baby was wrapped in a knitted garment which was then taken away with the grandmother. I couldn’t believe what I saw that day, how they could burry a child so young and not have a burial ceremony or even shed a tear. This was obviously the norm in Zambia as it was reflected in their reactions.

Another big health issue in Zambia is Malaria. This is an infectious disease transmitted by the mosquito which bites the skin and directs its disease into the red blood cells and this in turn leads to the damage of the liver. The prevention of the transmission of the disease is by using nets and screens at night and by using long sleeve tops and long trousers at night. We are still taking tablets for the prevention of Maleria even though we are home.

The third health care issue we observed was the serious malnutrition. Children are extremely undersized for their age, most of the people in the compounds are very thin, this is mostly due to HIV but also malnutrition. Where as our staple diet is potatoes, theirs is one that consists of a high carbohydrate called milli meal (similar to rice).

Their diet is deficient in protein and iron and this then leads to their stunned growth and severe anaemia. The people are as a result extremely tired, and this poor diet exposes the people to illnesses such as osteoporosis, chronic eye infections, chest and ear infections and poor healing of wounds. We were all inspired by the determination and positive outlook of Sr Sheila, an 81 year old nun who is away every morning to her clinic to attend to the sick. She showed us 2 projects where people are trying to improve their diet and income by raising chickens and using land to grow a range of fruit and vegetables.

Fr John took us to the general hospital where there is a policy that the Doctors release the patients as soon as possible with followup care by the clinics in the compounds. This policy is used so as the hospitals don’t fill up with patients. The experience of the hospital surprised me greatly, I had expected it to be a lot worse, but Mark told us that the conditions have greatly improved since his last visit.

2 main out comes have been produced from our visit to Zambia.
• Firstly we will now either go back to Zambia when we have professional qualifications and help in any way we can. Two of the group that went in 2005 are involved in projects in Zambia this summer. This is evidence of the long term impact the immersion project has on anyone who is privelidged to experience it.
• Secondly if we don’t get the opportunity to return to Africa, but we hear on the radio or T.V of an African appeal, we will know it will be genuine and will contribute generously.

Zambia has changed my outlook on life and I now appreciate all the opportunities open to me. We have seen the situation of the health care service in Zambia and with the continued support and help from all those people, I can only say that Zambia is looking up and as the saying goes, things can only get better.

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