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.

Day 4

Day 4:  Another beautiful morning in Samfya with the lake completely still …. like glass. It’s definitely going to be another very hot day.  We had breakfast on the veranda which was quite pleasant with tea, eggs, bacon, baked beans and toasted buns. Mark and Caitlin worked in the SCCP clinic all morning.  Brian went out with Becky on home visits and did all the medical documentation during the visits.  Holly and I headed over to the hospital with our 7 duffle bags full of OR supplies in tow. We inventoried all the supplies and helped organize them in storage.  Dismas Mwanza is the surgical tech who helped us all day, and was very pleasant to get to know.  He and Violet, the general nurse (no specific OR training) who is assigned to the OR, have been at Samfya District Hospital between 8-10 months and help Dr. Lushiku with cases and are responsible for the instrument packing and sterilization.  That brings me to my first disappointment of the trip and is a correction from yesterdays post.  I guess the autoclave, which is technically operational, has not been actually used to sterilize any instruments yet.  I guess the person who installed it only inserviced 1 person, but that person was transferred soon afterward to Kasava in the north.  Carmen has asked Lushiku on numerous occasions about the autoclave, but I guess has asked the wrong questions regarding it’s usage.  That means that all the instruments that have been used over the past year have been sterilized in those small, crappy Chinese autoclaves.  Violet admitted that most of the packs are wet when they come out and are left out to dry (again, this does not meet most infection control standards…at least in Western society).

Despite this, Holly and I did do a case today…hooray!!!  We had to wait for the final day of last year’s trip to accomplish this.  The patient was a 52 y/o male with an enlarging cystic mass  (2cmx2cm) on the left side of his mandible.  Holly and I excised it under local anesthesia alone and it overall went well.  A couple of reminders that we’re operating in Samfya: 1) the first instrument tray that we opened has rusted instruments (again a sign of wet packs), and 2) the electricity went out halfway through (had my headlight but couldn’t continue using the Bovie.  The patient was so thankful and we prayed with him before he left. 

 

We had lunch at Mark and Carmen’s….was nice to have a trustworthy salad, and then back to the OR to finalize the organization of the supplies and try to take a look at the big autoclave and perhaps find the user manual on the internet.  We didn’t have any luck on getting the actual manual, but did find out that the company that produced it is based in India, so I have a few e-mails out to their tech support team.  This kind of feels like groundhog day, remembering e-mailing the Chinese company last year for the small autoclaves.  On my way home, saw a young boy playing in a puddle near a faucet outside the clinic with her Mom right next to him washing the family’s dishes showing the realities of how most live in Samfya.

 

Dinner at Mark and Carmen’s was fantastic.  They served us Indian food (chicken tiki, homemade Nan bread fired on an open grill, vegetable curry and cucumber salad) and I gave Nala and Lily (their 2 girls) some Rainbow Loom craft kits from Andrew and Katie.  The girls seemed to really enjoy them and spent most of the night figuring out how to do it.  Andrew and Katie made a few instructional videos for some of the designs which I passed onto Carmen for the girls to watch. 

Tomorrow, there is one case scheduled and then we are going to try to get the big autoclave fully, totally, completely operational.  Holly and I are also scheduled to give a mid-wives training for delivery techniques and neonatal resuscitation based on videos that an OB from Willowcreek put together. 

Prayer request: 1) For patience and understanding regarding the autoclave

Day 3 - Welcome Samfya

Day 3:  We had a little excitement after coming back from dinner.  As I closed the door, lo and behold a tarantula was at the bottom of the door pane.  Yes, you read that correctly.  Actually, it’s quite unusual I guess, as Mark and Carmen have never seen one during their entire time in sub-Saharan Africa.  Mark got it into the trashcan somehow and off it went back into the woods.  We did stuff a carpet under the door to prevent a reunion.  Went to bed at 9:30, overall had a restful sleep despite our Halloween friend.  Did wake up at 1:30 and had to deal with Mike’s snoring a little.  I took a half an Ambien and slept til 6:15.  Had French Toast with bacon (the bacon was chopped up and on top of the toast…a little unusual, but actually good). 

 

We spent the next 5 hours driving to Samfya and got in town a little after 1.  It was very hot again…well into the mid-90’s.  Again, the amount of new construction was obvious, with numerous larger brick houses with corregated steel roofs going up.  It was nice to see Lake Bangweulu again.  I felt like a kid on vacation trying to be the first one to see the Ocean on summer vacation.  Everything seemed very familiar/comfortable. 

 

We check into the Kwatcha lodge and Mike and I are actually in the same room.  There have been a few upgrades…more reliable lock on the door, a new dining room/patio, hot water, a fan that doesn’t squeak. We were then off for formal introductions at SCCP and the minister of health and then off to see the hospital and clinic.

I have to say that I’m quite impressed with the continued development that Dr. Lushiku has been overseeing after assuming the position of hospital director.  The large autoclave is operational, the maternity ward expanded, a new men’s ward added, the radiology suite and formal operating room are getting put together. The cost of getting the autoclave finally operational (3-phase electrical connection) was paid for by overbudgeted funds from last year’s trip.  Over the past year, Dr. Lushiku has performed 120 C-sections, 50 hernia repairs, 10 laparotomies, 3 hysterectomies and 50 other minor operations.  I didn’t get a chance to ask about outcomes, as our time was limited. 

I’m really looking forward to coming alongside Lushiku to help Samfya District Hospital take the next step.  There are several operations planned for tomorrow, though he couldn’t remember exactly what is planned.  I guess Holly and I will just dive right in.

Prayer request: 1) For the continued safe expansion of hospital resources, 2) That Holly and I would support their needs and not our own agenda.

Day 2

Slept well last night for 6 hours…did take a half an Ambien just to make sure.  The women had to wake up early though and get to the Ministry for their nurses interview which went well.  We then met up, exchanged dollars for Kwatcha, bought some snacks for the road and an internet data bundle so I can blog and Skype with the family.  The car ride today was hot and dusty.  It was well into the 90’s, with no air and several detours onto dusty side roads for road repairs.  There is construction everywhere, evident of an economy which has increased at 6-7% over the past year or so (booming commodities market for copper).  Passed by the brand new national soccer stadium, but right next to it still saw evidence of the marked economic disparity between the ruling elite and the common Zambian.

Just like last year, we made it to the Fig Tree in for lunch, and then traveled a bit further north to the Forest Inn where we will stay tonight before continuing to Samfya in the morning.   The lastscape is a liitle different as Zambia is now entering the rainy season.  There are several flowering tree species that are quite beautiful.

Prayer request: 1) That the team would continue to bond so that His work can be done.

 

Year 2: Day 1

Zambia year 2

Pre-trip:

I have to say that the buildup for this trip was considerably different from last year.  For one, I am much less anxious, which I’m sure is just that there is not as much of an unknown element.  I think this is particularly true for the surgical aspect of the trip.  It may also stem from the fact that I had more of an agenda last year, feeling that I had to control the situation, likely another way I was trying to overcome my anxiety.  For some reason, I am perfectly at peace this year knowing that it is not up to me to control the outcome of the surgical aspect of this trip.  I know that God is in control and will use our team’s faithfulness and talents to further His Kingdom.  I also realize and feel the tremendous support of family and friends back home, more so this year than last.  Sarah has been an amazing anchor, confidant, and prayer warrior on my behalf.  My love for her continues to grow and I haven’t felt closer to her in a Spiritual way.  I just hope that I can support and love her as much as she deserves.  I also feel much closer to both Andrew and Katie.  They are great kids, with loving and compassionate hearts.  I hope that my trips will introduce in them a curiosity to discover what stepping out in faith and Going when called is all about.  Abanim’s card of support and encouragement last month really meant a lot.  There haven’t been many Bible verses that I’ve memorized, but Romans 12:11 really speaks to me……”Never be lacking in zeal,  keep up your spiritual fervor, serving the lord."

Day 1:  We started the day again this year with Katie’s soccer game.  We weren’t able to go to church, but had a little prayer time before leaving for Naperville.  I think Andrew’s main fear is that something is going to happen to me, but his prayer really conveyed a sense of trust in God’s purpose and protection on this trip.  Andrew has a school project where everyone in his class gets a small stuffed animal dog, named Hot Dog, which is sent out on adventures to friends and family and “report” back to the class in the first person (i.e. a journal, postcard, etc.).  I think his “Hot Dog” will win the prize for farthest traveler.   Katie was very sad.  I’m sure that the 2 weeks will go by very quickly, with Halloween, soccer and then Frank and Vicky’s wedding.  Katie’s team lost 2-0, but she played well.  Yesterday’s 2 goals really were a boost.  After lunch at Chipotle, we were off to the airport, where all but one of the team was already waiting.         

Mike Marschke, an internal medicine trained palliative care physician, is the team leader again.  Holly is back, hoping to see the work in the OR continued and expanded.  Becky is a pediatric nurse practitioner, who has been to Samfya 3 times before.  Caitlin and Brian are the remaining members of the team.  It is their first time and they are very excited and seem appropriately nervous.  Caitlin is a general nurse just a couple years out of training.  She was really affected by the African genocide a decade ago, and has wanted to serve in Africa ever since.  Her husband, Brian, has a finance/marketing background and will be helping Mark with several building projects around Samfya and chipping in at the hospital and clinics as he can.  He may also interface with the microloan program through the Samfya Community Care Providers, SCCP.  Based on the training of some of the hospital personnel I met last year, I’m sure that Brian could be very useful even in the OR.

Our itinerary was similar to last year… a KLM flight with a layover in Amsterdam.  Unfortunately, I couldn’t sleep, despite upgrading to the economy comfort section.  That meant I needed some energy which I found it getting some of those delicious little fried Dutch pancakes with powdered sugar.  Not as good as last year, but I guess that’s how it always is.  Very interesting though…..we recognized 2 workers at the pancake place from last year.  Our next flight is “direct” to Lusaka with a brief stop to let people off at Harare.  We didn’t have to get off, which was nice.  This flight was memorable though in the beginning.  I had a very large African lady next to me (starting to remember the African smells) and then the guy across the aisle took off his shoes and gassed his surrounding travelers with some powerful wet foot odor.  The combination was not good. Luckily the flight wasn’t that full, so right after take-off I was able to move up 16 rows into an entire empty middle section and stretch out stinkfree.  We arrived at Lusaka without any issues, collected all of our luggage and found Mark and Carmen both waiting for us.  It was great to see them again…didn’t seem like it’s been more than a year.  We stayed again at the Flight Mission House right next to the airport for a much needed sleep.

Prayer requests:  1) Restful sleep for the team, 2) To lessen Caitlin and Brian’s anxiety as “newbies” 3) That Holly, Becky and Caitlin’s nurse interviews in Lusaka would go smoothly so we can get on the road to Samfya.