Day 13: Homeward bound

It’s hard to believe that it’s the last day.  It has gone by quickly, but I am ready to come home.  We have to take a small hopper flight to Lusaka.  Mark, Caitlin and Brian went with Carmen to Mansa, but I guess the Mansa airport is closed.  No one told the pilot or Lusaka airport since the flight plan originated there   The plane landed on a newly made runway still under construction, but I guess it created quite a ruckus.  They were able to take off without problem.  Becky, Holly and I will have to drive back to Kasanka where there is a small airstrip.  Another chance to see the elephants again. 

Once back in Lusaka, we have several hours to kill since our flight doesn’t take off until midnight or so.  Hopefully, we’ll be able to visit the market we went to last year and do a little shopping.

Thanks again for all you prayers.  See you at home!

Day 12

Our last full day in Samfya was very rewarding.  Mr. Zulu was able to get the autoclave fully operational.  Everyone cheered when the vacuum pump started and the sterilized surgical packs were found to be completely dry.   It ONLY took a year to get done, but that’s Zambia.  Another milestone for the hospital was that the first x-ray was done today as well.  Slowly, but surely, the Samfyan people will be able to get better healthcare.

Holly and I did two more cases: a cyst removal from the left eyebrow and an excision of a left breast mass.  That was the first breast case I’ve done in 10 years.  Brian and Caitlin wanted to come and watch.  It was Brian’s first time being in an operating room.

The group then gathered over at SCCP for a time of thanksgiving for the past 10 days.  We shared in a traditional Zambian meal which was very tasty, and gave thanks to God for his faithfulness in bringing hope to our broken world. 

We then went to Mark and Carmen’s for dessert and to debrief. Everyone thought the time here was very productive and suggestions were made on how to maximize the impact of future medical teams. The next team will probably spend a few days on one of the islands, camping overnight to avoid having to cross the lake several times. 

 Prayer request:  1) That God will continue to work through SCCP, 2) That Mark and Carmen will continue to seeks God’s will for their ministry in Samfya.

Day 11: Sweat

So, there’s partial good news on the autoclave front.  The heating and sterilization modes were working this morning; however, the active vacuum drying cycle was causing an error. Mr. Zulu discovered that an electric breaker was malfunctioning and had to go to Mansa to get a new one. 

We were able to use the packs for cases today and did a large lipoma (benign fatty tumor) resection and an incisional hernia repair.  A third case was cancelled due to a probable sickle cell pain crisis and a hemoglobin of 6 (normal is above 12) so we finished a little early.  The OR was so hot though that it felt like we had operated non-stop for 12 hours.  At the end of each case I was dripping in sweat

Carmen took Holly and me to the local market…an interesting collection of sights, sounds and smells, some good and bad.  Bought a couple of souvenirs and deflected lots of giggles and pointing directed our way.

The rest of the team spent the day at Mbebala Island and worked incredibly hard.  For example, I guess Mike was asked to go see a patient “just up the road”, but ended up having to ride a too small rickety bike over the sandy road what he estimated a few miles.  He looked exhausted.

I can’t believe tomorrow is the last day in Samfya.  It has gone by very quickly, and there is so much more that can be done here, but I feel that we have helped “move the bar” a little higher. 

Day 10: Chishi and Zulu

I first want to thank each of you who have been following along with the blog and praying for our team and His work.  I feel your support on a daily basis, and know that our team’s successes have been directly related to your faith.

Holly and I went with Carmen to Chishi Island accompanied by a Ministry Environmental Agent and 2 borehole (well) diggers to address the lack of clean water on the island, which is an hour boat ride from Samfya across Lake Bangweulu.  There are no wells on the island and only a few springs that are very low and murky.  How easy is it to take for granted the clean water that pours out from our faucets and forget the basic foundation of health that clean water provides.  The end of the dry season and beginning of the rainy season is the worst since the water levels in any wells/springs are at their lowest and the rains can mean overflow of latrines that can lead to contamination. Recently, there was a significant outbreak of diarrhea cases presumed to be typhoid primarily down near a fishing village. 

There was a large village meeting where the Ministry Agent gave a presentation on the causes and transmission of diarrheal illnesses and the importance of clean water to the island leaders and over 100 men, women and children.  Carmen then engaged the community to help develop a clean water plan by bringing boreholes to Chishi.  Carmen is mainly working for WATER4, a non-governmental organization (NGO) that brings clean water solutions to different areas of the developing world.  The plan would be for WATER4 to dig 6 boreholes, provided that the island gathers support, forms a water committee comprised of 50% women, help identify potential well locations to maximize the effectiveness, and commit to pay monthly usage fees to support well maintenance and the ordering of spare parts for when repairs are needed.  The idea is to make the local community engage and take ownership of the wells and the concept of providing clean water to Chishi.  WATER4 will provide all the training and tools to get the community to a sustainable level.  Such models are much more effective the just building the wells without the community involvement.  Carmen said that approximately 50% of the wells that were dug outside of such a program are now non-functional.  In contrast, 17 of 18 wells dug on the nearby Mbebala island under WATER4’s program are operational. 

Afterward, we visited the rural health center that is manned by only 1 nurse for a population of almost 5000.  Talk about being overworked with limited resources!  We audited the health records for cases of diarrhea over the past 2 years, which Carmen will use to help determine effectiveness if the well drilling proceeds.

After the boat ride home, we headed over to the hospital and lo and behold……the autoclave was working and in midcycle!  Thank you, Jesus! Hopefully, all the indicator strips in the packs will turn and the packs will be dry and ready for tomorrow.  We’ve got 2 full days of operating to go.

Prayer request:  That long-term, reliable clean water is brought to Chishi.

Day 9: Rats!

Holly and I spent the morning at the hospital, operated on 4 patients and did wound care on 2 other patients.  Gilbert’s foot looks and feels better, but he still needs to go to Mansa for an x-ray.  I think Gilbert is afraid of me, since everytime I see him I cause him pain. 

Mr. Zulu finally showed up after lunch and tried to demonstrate how to operate the autoclave, but had the same problems we had.  We ended taking the front of the control panel off and much to our surprise found that some rodent (probably a rat) had worked its way up into the panel and chewed 14 wires.  Unbelieveable!!!  Mr. Zulu and I then spliced and soldered all the wires back together, but it still wasn’t working.  The temperature was reading correctly and the fan started, which were good signs that we got something hooked back up.  Then the power went out around 5 when Mark came to pick us up, so there wasn’t anything more to do.

Dinner at Mark and Carmen’s was nice as was our group devotional.  I think I’m going to get away from the autoclave tomorrow and let Zambian’s figure it out.  They’re going to have to be able to do it on their own.  I’m planning on going out across the lake tomorrow with Carmen and Holly to Chishi island.  None of our medical teams, or Carmen, have been before, but they recently have had an outbreak of probably typhoid and an assessment team is going (along with the local minister of health) to evaluate the outbreak, water sources, potential well drilling sites, health clinic capabilities, etc.  Carmen wants us to help her with the health assessment. 

Prayer requests:  1) Mr. Zulu can successfully troubleshoot the autoclave. 2) For safe passage across the lake.

Day 8

The team split up today with Mike and Caitlin going on home based care visits, Brian working with the microloan program and the rest of us at the SCCP clinic.  Saw a poor lady who was bit by a snake 1 year ago and now has partial paralysis of the left arm.  Nothing to do except start some physical therapy and strengthen what function she has.  I made a squeezy ball with gauze stuffed into a latex glove.....it actually worked well.  I then took care of an 11 y/o boy named Gilbert who got his foot caught in the spokes of a bike wheel when he was riding on the back.  He had a nasty wound, couldn't move his foot and probably has an ankle fracture.  I took him to the hospital and debrided the wound under ketamine anesthesia, got him admitted for IV antibiotics.  He'll need an x-ray, but will have to wait until tomorrow to be sent to Mansa since the x-ray equipment isn't functional yet at Samfya hospital.

The good news of the day is that Mr. Zulu from Mansa is arriving tonight and will be around tomorrow to investigate the autoclave and possible get the x-ray equipment working.  I think I might handcuff him to the autoclave until its operational.

Mark and I then drove 50 miles to Kaishe, where Becky had identified a couple of possible surgical candidates last week.  Unfortunately, only one of them showed up to be evaluated and actually didn't need surgery.  The 3 other potential patients got scared I guess of the "mazunga (white man) with the knife".  Oh well, we did manage to buy a bunch of beautiful and tasty bananas on the stalk from a roadside stand. 

We've got cases scheduled for tomorrow, Thursday and Friday so Holly and I are excited.

Prayer request:  That Mr. Zulu would show up and get the autoclave operational.

Day 7: Worship and rest in Samfya

                We attended church at the Samfyan Baptist church which is a participating church of SCCP.  The building was basic brick construction with a tin roof.  The space for the windows and doors were bricked out, but there were no frames, glass or doors and the floor was dirt.  Despite the impoverished outward appearance, we were warmly greeted and felt the love of Christ.  In typical African fashion, we were called up to the front of the church for introductions and to greet and shake hands with every church member.  The service was long, but the music was fantastic and the sermon was relevant. The whole experience re-emphasized for me the universality of the body of Christ.

                We chilled out the rest of the afternoon after eating lunch at Kwatcha and went to Mark and Carmen’s for another delicious dinner.  Their dedication to the people of Samfya despite the hardships and frustrations make me think of Romans 12:11, as they seem “never (to) be lacking in zeal, but keep (their) spiritual fervor, serving the Lord.”

Prayer request:  That the Brubachers would continue to rely upon Christ’s loving grace to serve Him faithfully.

Day 6: Kasanka, elephants and bats

The team with Mark and Carmen’s family left in two cars for Kasanka National Park around 8:30 in the morning and drove 2 hours back toward Lusaka.  After we arrived, we spent a little time in the conservation/visitor’s center and learned about the park.  In the 80’s, the park was largely abandoned and run down.  A former big game hunter turned conservationist established the British based Kasanka Charitable Trust and ever since the park has been on the rise.  It was mainly established to protect the migratory pattern of the African fruit bat, where 6-20 million bats each November and December descend on Kasanka which acts as a staging ground to feed on a local fruit trees.  It is the largest mammal migration on Earth and one of the most unusual since there is no breeding involved.  Kasanka is also one of the few places that the sitatunga, an acquatic antelope, can be seen.
                We then drove to the main lodge building for lunch on a veranda that overlooked a large wetland.  We immediately saw a crocodile, lots of puku (local common antelope) and a few sitatunga.  While we were eating pizza, we heard the hippos and then saw a pod of 10 or so swimming. It was an incredible lunch. Right before we arrived at the lodge, the car I was in started making a very high pitched sound and the news after Mark inspected it was not good.  A tension bearing for the main belt was broken, which meant we couldn’t drive the car (more later).

 

                Only half of us could go on a game viewing trip, and just a few minutes from the lodge at the first open field and swamp, we saw 2 elephants relaxing in the water far across the way.  There were also baboon, puku, stork, and warthog.  After 15 minutes, we drove back to the lodge to let the other half get to see the elephants who watched them until the elephants went into the forest.  We then traded and the first half went back got back in the truck for another excursion.  Right after we left, Caitlin spotted an elephant off to the left in the woods about 75 yards away.  We stopped the car and then heard trees cracking right behind us.  All of a sudden, a huge elephant bull emerged 20 yards behind the truck, looked right at us and crossed the road.  It was awesome! But that was not all that God had in store for us.  We crossed a bridge that went over a small river and unbelievably another elephant was eating just up the river.  Mark was completely amazed that we were getting so lucky and said that we’d seen more elephants this day .

 

 

 

                Back at the lodge, we arranged for transportation from the lodge and Mark, Brian, Caitlin and I drove in the back of an open air safari vehicle.  Pretty cool, and exciting especially when it started to rain (the first rain in Kasanka in months).  We made it to the bat observation area, met up with the other half, ate dinner and climbed the largest “treehouse” (really a blind to observe the bats) in a massive mahogany tree. 

                We went back to the main viewing area and at dusk the bats awoke and started to fly and fill the sky.  Although it’s still early in the season with only 20% of the total number of bats that would eventually arrive, the experience was still very impressive.  But again the elephants stole the show.  A different two passed right by, one even gave a “false charge” which caused many including me to start running a little.   After the bat show driving back to the lodge through the forest, we came across the same pair, again right next to the road….one let out a classic elephant call and the other flared its ears.  It was pretty exhilarating!

 

 

                The broken down truck had to be towed back, but there was no tow truck service anywhere close to us.  That meant Carmen towed the second vehicle via tow ropes the 220+ Km back to Samfya.  This is just another reality of living in Zambia and again brought up my feelings of incredible respect that I have for Mark and Carmen’s resourcefulness.  I have never been in a car that was being towed, which was quite an experience.  Mark steered the towed car and applied the brakes to slow down both trucks when needed.

                Overall, the day was one of the best of my life, and I will cherish it always.  I’m looking forward to the day that I bring Sarah, Andrew and Katie to share in God’s incredible creation in Africa.

Day 5

           It was a little cooler today, particularly in the morning.  After breakfast, Holly and I went back to the OR today and helped with 2 cases...tubal ligations.  They went very well and it was a great feeling to do some bigger cases. 

          I wrestled with the big autoclave again and lost.  Did manage to get the power on, but there's something wrong with the internal thermometer because it was reading 150 degrees Celsius even though it was just turned on and at room temperature.  Oh well.
          The rest of the team went to a remote village 100km from Samfya called Kaishe.  The closest rural health clinic is 15 km away so many of the villagers had never seen a doctor.  Lots of protein malnutrition as they mostly eat a plant starch processed from a plant they grow called Kasava, which also is known for having high quantities of arsenic. The team saw 80+ patients and felt like they made an impact.  With Samfya city continuing to grow, outreach in the future will probably focus on these smaller remote villages using Samfya as a staging point. 
        I know this may sound weird, but I led a nurse midwife training session on difficult delivery scenarios and neonatal resuscitation.  An OB from Willowcreek put together some training videos for another medical team to Guatemala which were well received, and we thought to try them in Samfya.  I really acted as a discussion facilitator and got everyone discussing how they handled certain situations and then used the videos as an opportunity to show a standardized method to address each situation.  Carmen and Holly thought it went well. 

          I am completely adjusted to Zambian time now and am looking forward to some rest this weekend.  The hospital and OR's essentially shut down, so we have a little R&R planned.  Tommorow we will head to Kasanka National Park for the day, home to the largest bat migration in the world (featured in many wildlife documentaries, including the Life series).  We also might get to see other animals like elephant, crocodile and antelope, although that is much more hit or miss. 
         
 Prayer request:  That we will wonder with awe about God's amazing creation.