Stars so big!

Jun.11

The hospital has several wards for inpatients, including the male and female wards, pediatrics, TB wards and maternity wards (with a delivery room called the “labor suite”:). The operating room is called the “operating theater”. It also has several departments including OPD (Out patient department), labs, pharmacy and a chaplain.

Tuesdays and Fridays are the days for surgery. Today Dr. Yomo, an orthopedics surgeon from Lusaka, was here to do some operations. There is no orthopedics surgeon in this hospital, so they accumulate orthopedics cases to wait for him to come do procedures every two or three months. The first case I saw today was a partial hip replacement. The patient’s femur head was fractured so they had to replace a prosthetic femur head into the position. The whole procedure was quite traumatic and there was lots of drilling, cutting and pulling. I was surprised by how different the standard of sterilization is here. Except gloves, all the gowns, caps, clothes, and covers are reusable. The cloth covering the patient had stains on it. The scrub-in protocol is pretty standard however despite the lack of equipments. I asked about the post-surgery infection, and was told that it was not a significantly large amount. These patients are usually on heavy antibiotics post-operation for a long period. The next procedure I saw was plating a broken radius. The patient broke his radius and ulnar bones, however only radius was stabilized with a plate because there was no extra plate available for the ulnar. “Hopefully the ulnar will be straighten and grow back itself”, says Dr. Yomo. Another frequent thing Dr. Yomo said during his surgeries was “normally we would do this and that, but here we don’t have it, so we will do… instead” It was amazing to see some creative ways he used the instruments. When he was taking the fractured femur head out, he used a speculum to stabilize on one side and pop it out. In resource poor setting, you just have to make do from what you have.

I also saw a C-section today. Compared to the one C-section I saw back in the US which took about 2 hours, this one took about 10 min. There are two surgeries room. One is for “major surgery”, which requires full scrub in with surgical gowns and gloves. The other two rooms are for “minor procedures”, and all you do is put on the sterile gloves. This C-section was done in a “minor surgery room”. The patient was a skinny 16 year old, it literally took the surgeon Dr. Moon a minute to cut open the belly and expose the uterus. Another few minutes, he took the babe out. The newborn was delivered post-term and was compressed in the uterus and couldn’t get out for the past two days. There was no warmers or any fancy cleaning equipments we use in the US. The newborn was patted in the back to let it cough out the mucus, and wrapped in a towel. A nurse uses rubber bulb to suck out the mucus in the babe’s throat and nose. When the babe started to cry and get less blue, it was putting to the side of the mother. The entire procedure took 10 minutes. I still couldn’t believe that.

Besides the hospital, a few days in Macha, I have been quickly introduced into the social circle of students and researchers around the campus. There are quite a few medical students and researchers from Holland, as well as a few Americans. Tonight, I went to a Dutch family’s house for a movie night. The husband manages the properties in the institute, and the wife is a doctor at the hospital. They have a 6 year old girl. When we came in, the little girl was playing puzzle with a Zambia girl. They have a projector to play the movie on the wall. It was pretty nice. The movie we watched was called “the cider house rules". It is about this boy growing up in an orphanage in Maine. The doctor in the orphanage wanted to make him his successor and trained him to be a good Ob/gyn doc (the orphanage also does abortion for women). However, the boy didn't want to become a doctor like him, rather, he was eager about the outside world. So he left, and worked in a apple farm, there was a lot of things happened, he fell in love with a beautiful woman whose fiancée was at the WWII and was also his friend (similar to the love twist in “Pearl Harbor”), he had to do an abortion procedure for the girl in the farm who was raped by his father,and many other things, eventually he went back to the orphanage to take place of the doctor, who overdosed himself with alcohol before the boy returned. It was an interesting movie with some mixed message, but it's interesting nonetheless.

When we walked back from the movie night today, it was pitch dark and really serene. Everyone here walks with a flashlight at night. It is so dark in the surroundings that you really can not see anything when there is no light - just too few photons I guess. But the stars are really big and bright. It’s mesmerizing to watch them. They are also sorts of in 3 dimensions, you can tell which star is closer and which farther away. And it’s even more amazing to watch when they are half covered by cloud. It makes you feel that they are really close to you.

TIA

Jun.10th
This Is Africa (TIA) Three days in Africa I still haven’t got over the fact of how wondrous this place is. It is a different world. The house I am staying at the research institute and the hospital campus is quite nice. The place has the rare luxury of hot water and internet. It even has its own generator. Last night the power was out in all other places for couple hours, but in my house we only had a couple minutes of black out. Internet is painfully slow, but I’m getting use to it- compare to the surroundings, I feel quiet spoiled to be honest.

The research institute has its own garden where we can get fresh vegetables and fruits. I went and got some fresh carrots, strawberries, and lettuce. I didn’t experience much jetlag the past few days. It is quite nice also that I have completely quit coffee since I got here. Embrace a different life style!

This morning I rounded the hospital pediatrics wards with Dr. S. The peds wards here only admit children younger than 5 yrs old. Most of them I saw were newborns or infants carried by their moms. The wards have several rooms. Each room has up to 16 beds with tight space and very poor ventilation. There were lots of kids with malnutrition and HIV/TB infections. It was heart wrenching to see these little kids wrapped in layers, weighed less than 2kg, and had no fat around their bodies. Their skin is hypo-pigmented and hair color golden because of protein deficiency. There was one critical room (similar to ICU in the States) where there is AC to monitor the room temperature. The kids there were all quite sick – I saw one with meningitis and another with cerebral palsy and spastic diplegia.

Babies!

It was quite chilly when I got up this morning. The temperature must have been down below 10C (50F). I landed on the coldest month of Zambia which should be a good thing. The bus from Lusaka to Choma is about 4 hours. Choma is a township in southern province of Zambia on route to Macha. I was supposed to get there by noon to meet the driver from the institute to take me to Macha. The bus station is an open hectic place. When the taxi dropped me off, almost immediately a dozen men came up and shout different destinations “choma! livingstone! Blahblahblah…” I was told that the carrier called Mazandu family bus service is the most reliable one, and they can be distinguished by blue color. Not surprisingly, they also have very aggressive strategies to get customers by escorting you as soon as you get off the taxi all the way to their ticket booth. Eventually I hopped on their “blue bus”.

The bus ride to choma is quite interesting. Zambia vehicles have driver seats on the right side and people drive on the left side. The bus is a regular size like greyhound, but it has three seats on the left side and two seats on the right side, so it doesn’t leave much room in between. The bus was really crowded. Every woman on the bus invariantly carry a child on her back, some even has two. I was amazed by how many babies there were on the bus. They are all very cute of course.

When I arrived at Choma at the bus station, again there were more than a dozen people came up to offer you to go to all different destinations. Most of them are not with any taxi/cab companies but have their private cars. When I asked for directions to the place where I was supposed to meet the driver, a man insisted to walk me over there which was only about two minutes away. He was very friendly, but asked me tons of personal questions like “are you married?’ I found it slightly amusing and frustrating at the same time.

People here refer a certain time of the day as hours. So they would say 2:30pm as “fourteen thirty hours”. I was going to meet the driver Stem at 13 hours. Stem comes up to choma once a week to pick up mails and do all kinds of shopping for the institute. He drives a big truck with a mechanics and an accountant. They were nice enough to let me sit in the front of the truck, and the mechanics and other people who hitchhiked back to Macha with the truck had to sit in the open trunk.

The route from Choma to Macha was almost all on unpaved sand road. So whenever there is a car driving by, the sand would be blow all over and block the sight. What’s worse is that it really irritates the throat and the lungs. Luckily we were in the front and could close the window. I feel bad for people in the back of the truck breathing in the sand. The truck broke down in the middle and it took them a while to fix it.

Whenever we stopped at little village centers, we were surrounded people carrying goods to sell. There were woman carrying cabbages, tomatos, bananas, green pepers, all sorts of vegetables, and men tend to have stuff like sunglasses, shoes, or small groceries like mirrors and toothbrush. They were much more, and it was really amazing to see the scene.

Finally, regarding my stolen laptop and electronics below is the reply from a colleague:

“Oh too bad! I should have warned you! Joburg is very famous for these things happening. The best story I’ve heard was that a finnish guy had put new leather shoes to his suitcase, coming from helsinki-joburg-lusaka. When he opened the suitcase in lusaka, his shoes had been replaced by old, outworn smelly sneakers! With smelly socks in them! So its not just technical stuff that they steal, they can steal almost anything…”

Zambian land

Jun.8th, 2010
The flight from Johannesburg to Lusaka was a short one—1.5 hours later, I was in Lusaka, the capital city of Zambia. The land was a mix of green and yellow, a typical scene of African. I picked-up my only check-in suitcase quickly, so I can meet with a colleague and hand her the laptop the lab asked me to bring it to her. I put the laptop in my check-in suitcase because I already had my own laptop in my backpack and couldn’t fit another one without abandon other necessities I need on the road. So I wrapped it in a blanket and locked my suitcase and never gave it a second thought. As soon as I got the suitcase though, it doesn’t feel right. The locks on my suitcase were broken, and all the items in the luggage were clearly shifted and all over the place. With a glimpse of hope, I searched the entire suitcase thoroughly, but could not find the laptop. Bewildered, I could not make sense of what happened. The colleague, however, was not surprised. She told me that the luggage was likely stolen at Johannesburg during transfer. “If they scan inside, then they could see the laptop pretty easily. You should never put electronics in check-in bags. This is Africa.” she said. I was shocked. I would never imagine that international airport could so easily do things like that. I went back in to file a missing item report, the people at the counter all concurred that this is most likely stolen in Johannesburg. “This is Africa!” a man waiting in line behind me said bluntly. He is filing for a missing box. Somewhat frustrated and amused by the notion, I proceeded to leave the luggage area. The person at the exit came up to verify my luggage ticket again, seeing I was the only person there, she murmured something like “drink money”. “Pardon me”? I said, wasn’t sure what she was talking about. “Money to buy drinks”, she said, one of her hands stretched out, and the other on my suitcase. Still confused, I asked if she wants tips. She was clearly irritated at that moment, and said “give me some money to buy drinks!” Still don't know what's going on, I gave her two dollars- I was afraid that she was going to hold my suitcase unless I give her the money! I guess it is somewhat understandable for people who earn a few dollars a day to ask for money like that, but I still couldn’t get over the fact that they stole my laptop with such ease. There is no way to locate where my laptop went; Zambian airport insisted that it could only happen in J-burg. Upon further examination of my suitcase later when I get to my destination Macha, I found out that I also lost my outlet adapter (It is European style outlet here) and the USB transfer cord for my camera. I can’t imagine not uploading any pictures in the next two months!!

Currency exchange is another deep learning curve I have to go through. With 1 USD to 5000 Zambian kwacha, I handled my very first million kwacha transaction today-all in cash! The hostel I stayed overnight in lusaka is called “chachacha backpackers” . The 6 bulk-bed lodge I stayed in looks exactly like Washington’s winter camp in Valley forge national park, except with mosquito nets. The temperature was at around 30C (85F) around noon, and dropped to what feels like 10 C (50F)at night. When I was using the sink, a giant yellow cat jumped on the counter quietly and creped me out. Some other friendly visitors include a lizard on the wall, numerous spider webs, and ant troops. However, none of the big 5 s, not yet.

The capital city Lusaka somehow reminds me of my hometown Ningbo in its early nineties. The poorly-paved road, the dust of yellow sands, the smell of the gasoline, the crowded open market, the aggressive taxi drivers calling out for business, are all somewhat reminiscence of my childhood in Ningbo.

This is Africa!

Jun.7th, 2010
Finally! The last couple days had been really hectic.finishing qualifiers, visiting Montreal, moving into a new apartment, and boom, pack and go! This morning, after 3 hours of power sleep, I woke up at 5am to catch the CT limo
to JFK airport. This is my very first Africa trip and I can feel the adrenaline rash in me just to think about it. Not for long though, I fell asleep very quickly on the limo.

My flight was with South African airways (SAA). If not for what happened afterward (it may not be their fault anyway), I would probably vote SAA the best airline I have flew with so far. SAA has excellent on-board service. They provided comfy blanket, a pillow, a headset, mini toothbrush set, eye-covers, and even a pair of warmers for feet! On the plane were many soccer fans going to South Africa for the World Cup. The majority of them are Mexicans and South Africans. They were friendly teasing each other all along the way. The South Africans were chanting their national soccer team “bafana bafana” (means boys), and the Mexicans proudly claimed that South Africans were going to loss, but “we still love you, we will love you more after you loss”. Upon landing, the SAA crew members even put on soccer uniform with “crew” words printed on it.

Fourteen hours later, with two delicious meals and numerous naps, and the entertainment of Sherlock Holmes, I arrived at my first stop in Africa- Johannesburg, South Africa, feeling excited and fresh.

It was local time Jun.8th at 8:40am when I arrived at Johannesburg international airport. The weather was very comfortable at its low 20C, not too warm or too cold. The sky was clear and peaceful. The airport itself was not that different as any other international airports. It has numerous coffee shops and duty free stores. The names of the stores were of Africa signature, such as “Out of Africa”. From the postcards I bought I learned that the “big 5” of Africa are “lions, leopards, white rhinos, elephants, and buffalos”.