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.