In to the villages

Jun.17th

I went to a local school today with the Zambian data collectors to assess children. The school we went is a Basic school, which is from grade 1 to grade 9. I noticed that not all students go to school for the entire day. At least from what I learned, for the lower grade, only half of the kids go to school in the morning and the rest go in the afternoon. The classes are divided by girls and boys, so all girls are in one class and all boys are in another.

In the afternoon, we went to the villages to visit some families and collect additional consent forms. It was a bit shocking to see how people co-habit with animals so closely. Chickens, pigs, goats, dogs, and guinea fowls everywhere. The dogs were sleeping most of the time, chickens tracing one another, and pigs all do nothing but sniffing on the ground. If there is one thing I have coped with well so far, it is with the animals. Usually they mind their own business and would not bother you.

There is one incidence though that made me concerned about the animals being so close. When we were in a family talking to a mom, she and her little kid (looks like about 2 years old) were sitting on the ground. The kid was eating some nshima (a type of staple food made of maize) from a bowl. I noticed that the chickens constantly sneak stole food from the bowl. The poor child was making fists angrily but he was too small to stop the chickens from coming. Her mom was talking to us and didn’t pay much attention to the kid.Then all of a sudden, a really bold pig almost ran over that kid to get the food. The mom finally realized it and drove the animals away.

The families we visited live in typical rural households. A typical family has multiple small houses. They cook in open huts, sleep in the house made of brick with a grass or tin roof, and they keep their animals outside with dogs to safeguard their home. The typical daily food they prepare is vegetables with nshima. Only in special occasions will they eat meat and poultry. When we arrived, they offered us stools made of tree trunks. One family offered boiled pumpkins and it was probably the best food they had.

Restaurant treat

Jun.16th

I went to a restaurant for the first time tonight (yay there is a restaurant!). The restaurant was about 20 min walk from the campus, and was literally in the middle of the villages. A group of us medical students and researchers went together. After walking in pitch dark with a bunch of flashlights, we saw a house with bright light in the field, and so it is the restaurant!

Prior to going, we all ordered by text messaging to the owner of the restaurant. You have to order in advance because they don’t always have what you want. And if you order when you go there, you’ll have to wait for 2-3 hours before getting your food. The options are very limited so you just order from the few things they have. Nshima is a type of famous staple food here. It is made of maize. The flavor is kind of a blend taste similar to rice. You are supposed to eat by using your hands and mix with sources. I had Nshima and Tonga chicken with some greens (The type of green vegetable that are abundant here is rape).

We had to struggle with some grasshoppers and bees during the dinner, otherwise the restaurant was really fine and I enjoyed my first soft drink since I got here as well. It is fascinating to think how dependent we were on these products in North America. Forget about diet coke, I was happy enough to see glass bottles of Fanta and Spirit.

So we live like a video

Jun.15

It is not news that Sub-Saharan Africa is in an endemic of HIV. However, I am still shocked of how prevalent it is here everyday. When you review medical charts, almost every other one belongs to a HIV positive patient. Luckily, most of them are on ART, and HIV is moving towards like other chronic disease. The stigma has largely diminished. People go to ART clinic regularly to get their treatments. A vigrous big public campaign has been put in place to urge people to test for HIV, called VCT (voluntary consulting and testing). In schools and side of the roads, you’ll see billboards with signs like “Protect you and your family. Get tested for HIV”.

Today I had my very first suturing experience on an HIV positive patient. He was suspected to have kaposi’ sarcoma, an indication of stage IV HIV, and we wanted to biopsy his skin to test if he has it. I wore double glove and sutured the-cutaeously on the skin cut after the biopsy was done. Interestingly, I was so focused on the suture that I totally forgot it was a HIV positive patient.

I saw a live snake today on the path in front of my house! It was light green color, quite big and long. The snake was slithering along the side of the path near the grass edge. At one point, it crossed the path to the other side, and the entire length of the snake is longer than the width of the path. It was pretty fascinating to watch, at a distance of course. I am glad that it is dry season and winter here now, so snake is relatively scarce. I heard that in rainy season like November, there were snakes and rats everywhere. Rats even came into the houses.

Ants have been a major problem though. Whenever I leave a small piece of bread crumb on the counter, within minutes there will be a big ant troop moving. The toaster in the kitchen is their favorite site. I was pretty apprehensive about this at first, but now I have learned to live with them.

This afternoon at the OPD (Out-Patient Department) I was with another Dutch medical student seeing patients. Suddenly we all heard it was getting rowdy outside. We didn’t pay attention at first, but then the noise get louder and louder, so we stepped out to see what happened. I haven’t seen such a gathering for a long time. Men, women, children, women with babies, were all standing around, talking and pointing at something. The center of the attention was a man in red shirt at a distance. He appeared pretty angry and was throwing stones at one of the hospital building window. A bit distance away, an old woman was crying. We were puzzled by what happened. A nurse told us that the man was angry and bit that woman, and now he was throwing stones. A few men went over to catch him, and people said that he would be put into the cellar. The so called cellar is a small room in the Macha police station, which is right in the next to the hospital. It is a little brick house with merely three rooms, the “cell”, the “inquires office”, and “the office in charge”. A few moments later, the entire crowd was running and yelling, without knowing what’s going on, I just saw people laughing and screaming, as if they are all going to the same direction trying to catch that person or that person is approach to this direction and people are running away. It was such a chaos! People seemed to be enjoying this though because they were all out and looked very happy even when they were running and screaming. Eventually we had to lock the office door to not let it interferes with work.

Out in the school

Jun.14

Another interesting day today. I was in the “male ward” following round this morning. They call it male ward for men age 5 and up, so you would see 7, 8 yr olds sitting on the beds playing with their crutches. The ward is divided into surgical and medical sides. On the surgical side, there were many trauma, broken bone, and fracture cases. Many of them were from ox cart accidents. Ox cart is the major form of transportation around the area. On the medical side, there were astonishing amount of HIV/TB infection, almost every other beds was such a case with all sorts of complications. I saw a patient with Steven-Johnson’s syndrome and another with Kaposi’ sarcoma.

In the afternoon, I went with two Zambian research team members to a local school for the parent meeting. The purpose of the meeting was to explain to them the project and ask them to sign the consent form. The parents were very enthusiastic and asked tons of questions. Their biggest concern was collecting saliva sample. They believed that there was something suspicious about taking saliva. Eventually we were able to explain to them. Some of them could not write, so they used ink fingerprint as a signature. The school we went was a basic school, which include grade 1 to grade 9. The kids were really curious when they saw us. Many of them came up and stared at me, LOL I guess they have never seen an Asian face before.


Oh and a really funny story today. I am usually a bit apprehensive about taking adult pictures because I am sure if they liked to be photoed. But today at the market when I was taking surrounding pictures,a woman came up to me and said “can you copy me”? So I “copied” her on the camera and she was very happy to see herself in the camera.

Football rules

Jun.13
Football (not the American kind) is a huge thing here. Especially now since the world cup is playing on African continent. Everyone is talking about it. People take tremendous pride of their African teams. Among them, Ghana is many people’s favorite.

Although not a football fan myself, that Sunday afternoon I was talked into watching a football game between Macha Sparrows (the team represents macha) and a team from another area. The football game was played on an open space of sand ground near the town market. The teams are supposedly professional leagues in Zambia, so they have their uniforms. The players all had pretty amazing skills and they played furiously. I soon found out that some players were actually playing with bare feet, but that didn’t affect the intensity of the game at all.

On my way back some, I saw some beautiful sunset lighting up the clouds, and juxtaposed among the trees. So I thought, what a world.

Sunday at the church

Jun.13

This morning I went to the local Christ church. Most people here are raised Christian, and going to church on Sundays is their routine. I went to the Brethren in Chris (BIC) church, the largest around this area. The church is located in a well-constructed brick building similar to the houses on campus. The interior was a T-shaped room with long benches on three directions of the “T” and a podium in the center. When we got there, the room was already packed. There was a lady at the door to escort us to our seats. Women and men were seated at two opposite sides. Children were sitting on the ground in the front just under the podium, and students were in their uniforms sitting towards the front as well. Old women were dressed in pure white and wear a white head cover.

The service started by a group of women, all addressed in beautiful African gowns made of Chitenge patterns, singing cheerful African songs in front of the podium. The lyrics were in Tonga mixed with English. The song sounds like a medly and towards the end of each segment, the audience would sing along with it. Everyone was smiling and moving with the rhythm and the echoing made up powerful sounds in the church. There were some men sitting on the podium. I guess they must be the priests and important figures of the neighborhood(such as a chief or headman). After the singing was over, two priests came up to the front of the podium and made some announcement. One of them would make the announcement in Tonga, and the other would translate it into English. One announcement I remembered was that there were some sort of Women’s conference at the church next week.

I was reminded in advance that as a tradition they ask new comers to go up to the front and introduce themselves to the entire church. So not surprisingly, the priests invited “the visitors to identify themselves and come to the front”. So I went up along with a few others. After I introduced myself in English, the translator said something in Tonga, and people laughed. I was very confused, later they told me that the priest didn’t get my name so he translated “her name is her name”. It’s funny cuz people frequently pronounce my name as Ping (my favorite is that one of the doctors in the hosptial called me “Pink”…) Among other visitors, there are a group of people from South Africa selling Bibles, and there was a guy from Kenya.

The rest part of the service include a speech by Dr. T, who is a pediatrician from the U.S and has been working in the hospital here since the 70s, he is also the director of the research institute and helped made my trip possible. He gave a moving speech about patience, service, and gratefulness. Although I am not religious, the main points he delivered is true to life in general.

After the speech, there are more singing by different groups. There was the Macha male voice (I heard that they released a CD recently), the equivalent “macha female voice”, a group of old ladies and a group of students singing. There was even a man singing and playing on the keyboard. The audience also sang along with some of the songs in Tonga. It was quite amazing.

at the end of the service, the children left first because they had Sunday schools to attend right after, then the sequence is students, old people, and men and women. The entire service lasted more than 2 hours so I was super hungry when it was over:)

Rachitic rosary

Life here is very simple. I’ve been getting up before 7am everyday and go to bed earlier as well. The roads are unpaved, and when you are driving, you have to slow down from time to time to let donkeys, dogs, roosters, cows, pigs…you name it, to cross. Interestingly they recently put on some speed-bumps on the road (see picture), but as a matter of fact, with sand road like this you really cannot drive too fast. People I have met so far are all very nice. I still could not recognize local people very well, partially because I have met so many people these days. I remember the first day I had an awkward encounter of forgetting a colleague I just met about 20minutes before. Food is the only thing I have not got used to yet. There’s no meat in the little market here. Although I have heard that they have live chicken, I don’t know how to handle it anyway. So I have been practically a vegetarian since I got here.

I spent my Saturday morning in the hospital again following rounds at the pediatrics wards. I feel like I’m learning so much everyday just by seeing all these cases. Today I saw a malnutrition baby with rachitic rosary, which means bead-like bumps present at the junction of ribs and cartilages. It is often seen in children with rickets (Vitamin D deficiency).

Tonight we had some friends over and cooked dinner at my house “Cheetah est”. Among them, there was an girl who has been volunteering here for two years teaching at a local high school, and a nurse who was here working at the hospital for about an year, a couple medical students and a Zambian researcher in the lab. After dinner, we all watched the US versus England football game.It was a relaxing day overall.

I could not upload pictures due to the slow internet. will upload later!