Bike Ride to Bulebo

I was so excited to return to Macha and be here a whole month before having to leave again. My week, though, had some frustrations, mostly around work, so I have been working on self-care and staying focussed.

My position is a new position, and we are all trying to figure it out. No one is really my direct supervisor, and figuring out what my job will concretely be is largely up to me. There is a general goal, but how I go about that is not clear. I am creating my own way. I have of course been in and out as has the nursing officer and now another key person who I have been trying to sit down and meet with is out all this month. I would like to spend more time in the ART clinic and the nurse in charge of ART agrees with this, but he will be out all next week and it needs to go through the nursing officer first. This week the acting nursing officer was dealing with alot, including the senior nursing students doing their final clincal exams. So I will try and find a time this week to meet with him.

In the meantime, I have been sitting in front of my computer a lot, dealing with data. I also have been trying to pin down a time for a Tonga lesson without success. Thus the need for self-care.

I borrowed a bike for a ride one evening, went for a walk with a friend to the dam another evening. I have been trying to visit people. I harvested my lemon tree Saturday morning (with a few scars to prove it) when the power was out and took bags around to various people. A few of us got together to play a game the other night and some friends had me over for dinner last night. Community is always important. This is the first time I have lived alone in many years, and though I enjoy it in many ways, I have to be more proactive in socializing than when living with others.

Yesterday afternoon Fiona, a Scottish doctor here for three months, and I took a three hour long bike ride out into the bush. It was a great afternoon. With minimal Tonga, no road signs or maps, but a great sense of adventure,  some food, water and sunblock,we headed out. We were really hoping to make a loop. It was quite funny because after riding through the tall grass and past several villages we had very different opinions of where we were in relation to Macha hospital, but we just laughed and kept going. The people we met, who spoke little more English than we spoke Tonga kept telling us we had to go back the way we came to return to the hospital but we kept continuing on, thinking there must be a way to loop back on one of the many village paths. 

We ran into an older gentleman who asked if we were headed to the big bridge. That was exciting for us, because we had wanted to get to a river. So we headed that way, and soon found the bridge and a nearby bar with people hollering at us to join them. We smiled and kept biking. The river was not very inviting with it being the dry season and all. We got the name of the river and the bridge from people on the other side. On we went to a junction in the road with a sign for a school. We wanted to turn back by 4 in case we got lost. It was 3:30 and we decided to keep looking for a loop. Eventually we got to a village on top of a hill where people pointed forwards instead of back when we asked the way to Macha hospital. We did have to cross the same river, without a bridge this time, but it was way dryer in this spot with big sand bars and small streams of water we could step across and push our bikes through. We are guessing people were telling us to return the other way not knowing the height of the river at that crossing. Anyrate, we were quite pleased with ourselves for having found a loop.

Now that we were on the path home, we decided we would be up for stopping and visiting at a house if the chance presented itself. It soon did. We were biking past a house near the football (soccer) field in Bulebo when the women greated us and clapped their hands and said "come". So we went to sit with Grandma Mwaanga, her grandaughter and great-grandchildren and another woman and her child whose connection to the others we didn't quite figure out. The two older women were degraining maize and the younger woman was milling ground nuts in the traditional wooden mortar and pestle. Tonga stools were brought out for us, the bottom of Fiona's was a bit rotten and she immediately fell over which provided for lots of laughter. Grandma Mwaanga's granddaughter did most of the communicating with us. She has 6 children, 5 girls and one boy including two sets of twins. Six month old Choolwe (a common name in Tonga which means luck) and 3 1/2 year old Progress were at mom's side when we arrived. When we sat down, we were a bit too close for Progress's comfort and though she shook Fiona's hand and we tried to sit a distance from her, she still got up and walked away. Later in the visit she was back hovering close by, and even said something directly to me at one point, but I couldn't understand her. Then when her two older sisters Mavis and Natasha arrived carrying water, she was even more engaging. We never did meet Progress' twin Precious. We sat and helped the women finish with the maize. Took a few pictures and headed on our way. I was a bit frustrated not being able to ask simple things in Tonga. I hope to remember where the house is and go back for another visit when my Tonga is better.

Today I have stayed near home. Went to the big BIC church here in Macha. There is a trio that sings every Sunday who are just wonderful. The bigger choirs are wonderful also, but those three are something special. One day I will meet them and thank them for their powerful singing. I am blogging and journaling and still have some lemons to deliver. I also want to go visit the principal of the nursing school who helped me prepare for the exam to say thanks. Then I want to visit my Tonga teacher and try to arrange a new tutoring schedule. Tomorrow is Monday, and the beginning of a new work week. I hope it will be a bit less frustrating than the last. There is much to be grateful for.

My First Game Park

As I write this post in Macha, the young children are noisily gathering for the Bible school session on my back porch/yard. It is hard not to go out and say hi, but the electricity and therefore internet connection has been down most of this weekend, so I feel I need to take advantage. Their teacher (a local youth) has just arrived and order has been restored. A little scolding, a prayer and now a song. I will write with their joyful noises as my background music.

After my nurse's exam on a Thursday, I had to stick around Lusaka to go to immigration on the following Monday. This was the perfect opportunity to e-mail my friend Linda who I met on the plane and see if I could come for a visit. Luckily, it was good timing for Linda, so I had a wonderful day, including an overnight with her and her family just outside Lusaka. I got to see my first game park, and get a window into a different part of Zambia, the white culture.

Linda's husband Ian is a third generation Zambian. His grandfather came here in 1902 from Scotland to work as a railroad man. He bought a piece of land along the railroad in what was then a rural area and now is just on the edge of Lusaka. The Lilayi farm is a big agricultural operation with four generations of the Miller family currently living there. There is also a worker community there of about 30-40 families. The two big crops I learned of were cabbage and seed maize. If I remember right, about 30 years ago they bought the neighboring farm and converted it into a lodge and game park. When they did this, they were one of the first, but now there is quite a bit of competition.

When I first arrived, there was a polo match going on. There are apparently 4 polo clubs in the country and they have one of the nicest fields there on their farm. Linda pointed out and/or introduced me to a few of her family members and then we took off in an old open jeep land cruiser for my own private game ride. I saw zebra which was probably the most fascinating for me. There was one who was quite compliant in posing for a picture. I also saw hartebeest, puku, bushbuck, waterbuck and duiker. All of these, I believe, are from the antelope family, but are of different sizes, coats and horn designs. I also saw a couple warthogs. The grass was still tall, so Linda says we probably missed a lot. My only disappointment was we never saw the giraffes, not hard to miss, and apparently not shy, but we did not see them on our ride. At the end we went to some stables and saw some orphan elephants who were very cute. We weren't supposed to touch them, but they tried their best to make us break the rules,  reaching out and flirting with their trunks. Did you know elephants have pregnancy gestation of 22 months?!?!? The babies are usually 200 pounds at birth.

We made it back by dusk and joined the polo players in the club after their match. We had a home cooked meal there provided by one of the player's and his wife.  Then Linda and I headed home for tea and pastries which I had brought along. Ian joined us later and we talked politics of all things. He had had a few drinks with his team mates, so I think social etiquette was pushed to the side. He seems like a compassionate man and told me his perspective of some of Zambia's recent history.

In the morning I took a walk about a bit of the farm. I talked to one of the workers who was in charge of the cabbage seedlings. He said each week they plant 280 trays of cabbages with 200 starts each. This is all year round! They are six weeks when planted in the field.

After the walk I got to meet one of Linda's sisters-in-law who is an anthropologist and works in hiv/tb research. Most of her colleagues are medical people and she has been to Macha before. Linda and her family are very gracious folks. They treated me like one of the family. Perhaps we will see each other again.

The Big Exam

Well, guess I better write a bit about my foreign trained nurses exam. It was quite a cultural experience. The exam was held at the University Teaching Hospital's Nursing School where I had studied a few weeks before. It was to start at 9am, but we were to be there at 8am to handle formalities. I car pooled with my friend Rachael. We arrived at 7:15. I did not want to worry about getting stuck in traffic! We didn't even move from the waiting area to the room where the test was held till 9am. While we were waiting, I spoke with several of the other nurses gathering for the exam. I had met two of them the day before when we had to go to the General Nursing Council office to pick up our letters of invitation. One, who was from the UK, was sitting the exam for the third time. The other one was of Indian ethnicity, but I'm not sure where she was from. The morning of the exam I met two women from South Africa, one from Nigeria, one from Northern Ireland and one from Zambia (who must have trained outside the country). I also got to reunite with Esther and Solange, both from the Congo, who were part of our study group a few weeks earlier.  There were a few others who I did not meet personally. We were 13 in all, 12 women and one man. I didn't meet anyone working in Lusaka, we all seemed to come from rural provinces, many working at mission hospitals.

They had assigned us seats in the big lecture hall. When we went into the room, we had to leave our books/bags down front and take only our pens/pencil/ruler and eraser to our seats along with our letter of invitation and the receipt we had paid to take the exam. Once we found our seats, they came around and checked our papers. We were assigned a number and that number was to be placed on each page of the exam booklet and on the front. Our names were not to be visible to the people marking the exams. There was then the official opening of the sealed packet, the handing out of the booklets with the test questions and the paper for writing the essays and a reading of the entire exam before we started at 9:50. I actually appreciated the reading of the exam before our time started, because it took away the anxiety of not knowing what would be on the next page. Also,with the multiple choice questions, it gave you a first read through that didn't count as part of your time, so it was quicker when actually answering the questions.

We had three hours.  The multiple choice, matching and fill in the blanks part was 100 questions worth 25% of our score. Then the other 75% was based on three essay questions. The pediatric question was compulsory and was on lobar pneumonia.  The medicine question was hepatitis A, the surgery question dealt with burns and the tropical medicine one was ascarius (roundworm).  I chose the first three mainly because I didn't want to have to draw a diagram of the life cycle of the roundworm (though I know it, I'm not much of an artist and I'm not neat, both of which are important) and it asked for three medicines you could use to treat it, their dosages and side effects. I only knew one for sure, and was not aware of it's side effects, if any. So the only drawing I had to do was of the lower respiratory tract........pretty basic, but it looked like a 5th grader had done it. The questions involved definitions, signs and symptoms, medical management, nursing management, possible complications, prevention and patient education. They broke down how the questions would be scored for you, so you knew where to place your focus. Nursing management was 50%. Two of my questions I had to come up with a nursing care plan with five nursing diagnoses. The third one I used the traditional Zambian format of describing all the elements of nursing care. The study class a few of us took part in prepared us for this. Most of the nurses taking the exam had not heard of the class and we were giving them a crash course before the exam started. I focussed hard on not using abbreviations and giving a rationale for every intervention.  These were also points they had told us in the class we took. I wrote and wrote until my hand was cramped and there were only two minutes left to go. My writing was pretty messy by the end (never a strong point of mine) but I hope I did okay. The results will probably come out when I am back in the US. They post it on a bulletin board for all to see at the General Nursing Council.

On the way home, I had to stop at the MCC office. Eric very graciously offered to take me to lunch and for ice cream as a form of celebration. Half way through lunch I came down off my adrenalin rush and was ready to go home for a rest!

After 25 years of no formal schooling or exams, this was a bit stressful for me. I have always in the past been a good exam taker, especially with multiple choice questions. This exam, however, was very different and something about knowing 50% fail the first time made it all the more intense. I feel I did my best, and we will just have to wait and see. I'm glad it is over and can focus now more on work, language study and settling in to Macha.

Visits to the Village

Hi folks. So sorry it has been almost two weeks since I have posted. The past few days I was been preparing for and sitting the foreign trained nurses exam. The exam was yesterday and it is a relief to have it over, but more about that in my next post. Today I want to talk about my visits this past weekend to "the village".

Going to "the village" means leaving the hospital campus and heading out to the more rural areas where people live more traditionally. On Saturday I went with several other people including my Tonga teacher Bina Tiza and her son (Tiza) to visit Bina Tiza's mother who is in her 80s. In Zambian culture, any family member who has a job with a salary is responsible for taking care of others in their family with economic needs.  Bina Tiza is the only remaining child of her mother, her three brothers have all died. Bina Tiza herself is widowed and was severely ill for a few years. She is also still raising her two children.  Her daughter Taonga is in 11th grade. Her son, Tiza is 21. Though he has tested well and is very motivated to attend university, economically it has not been possible. Usually Bina Tiza sends Tiza out with food and such for her mother because she is unable to walk the 3 miles or so to get there. Today we got a ride, so Bina Tiza could go along.

As we arrived at her home, Bina Tiza's mother who is thin, stooped and wears thick glasses started singing in Tonga that her guests had arrived. She was dancing and clapping, it was quite a welcome. We all shook hands with her and were introduced, she is quite blind, so it was hard for her to really see us.  She has a wife of one of her sons living with her to help her cook and keep the house clean. She also greeted us. We went in to the small central room of the house and sat on the very worn out furniture. We talked for a bit, then presented the gifts we had brought. I brought some lemons from my tree, someone else had brought bananas and oranges. Bina Tiza had brought heart medicine, candles and matches, a bar of soap, a bag of charcoal (which her mother was glad about because she has been cold in the mornings and will now be able to warm herself), a papaya and some beans.  We were served bwate, which is a fermented corn drink. The conversation was mostly in Tonga. Some was translated, though, and I became aware of how sharp Dinah's mind is and what a sense of humor she has. Bina Tiza is much like her mother.  After awhile, Tiza took a few of us outside to show us around.

Villages are traditionally family members all living near each other. This village Maliko was named for Bina Tiza's great uncle, the oldest brother of her grandfather. So the people in the nearby houses are all cousins and such. After a bit of time, some of these family members came to the house and joined our conversation. There was the main house, another shed, a cooking hut (with the traditional grass roof) an elevated food storage bin and a letrine. Outside the shed there was also a fire ring and some food drying racks.  The yard was very well swept, a common thing here in Zambia. People keep their yards tidy.

After posing for pictures, we set off for Macha. On the way home in the back of the pick-up truck (covered by a camper shell) Tiza and I had an interesting conversation as we bounced down the bumpy track. We talked about the cost of university here (2-4 thousand USD/year). He would like to study engineering or business or environmental science. He knows quite a bit of history and is very committed to helping his community and country. He was quite the teacher/tour guide for the young college students with us. He told me more of his mother's story, and how his parent's met. His father is actually from Malawi, though the tribe he is from is both in Malawi and Zambia. As Tiza pointed out, the borders are kind of arbitrary. In his father's tribe, the lineage is passed through the father, in his mother's tribe (Tonga) lineage is passed through the mother. So, for example, when the current Chief Macha dies, his successor will most likely be one of his sister's sons, not one of his. I teased Tiza that whereas he now belongs to two tribes, if it was the other way around and his father had been Tonga then he would be tribeless. It doesn't really work that way though. We spoke of imperialism and foreign aid and how history books are written. I told him about some books I thought he might be interested in. His interest is peaked so I am bringing him some books from the MCC library to read and may look for some used books in the US to bring back.

On Sunday I went to Lupata with Esther and John Spurrier for church. I would say it is probably 1 1/2 miles away in the opposite direction of Maliko. It was a nice walk, through the fires and the market up onto a plateau where you could look around and try and figure out which builidings or water tanks or banana groves you could see in the distance. We saw a lot of birds, I wished I'd brought my binoculars. We crossed the Macha river (now completely dry, though women were digging down into the sand to get to clean water). We wandered a bit and got a bit lost, but made it to church at the end of Sunday school.

Apparently Lupata is where a lot of the support staff for the hospital live. The small BIC church has only been independent for about three years. The lay pastor, who is also the head administrator at the hospital, was away this Sunday, but I was impressed with how well the service went. The youth led it, with one presiding, one translating (into English for the few of us who don't speak Tonga) and one who preached. The ushers made sure things ran smoothly, the chairman made all the official announcements and welcomed us guests. The music was fantastic and both the youth and the women's choirs were decked out in matching outfits. The youth in black trousers/skirts and pink shirts, the women in royal blue chitenge suits with red and yellow circles. I wished I had brought my camera. Apparently it was the third attempt at a church plant in this village, but I would say it was done right this time. You could feel the sense of ownership. Esther had not been there in 1 1/2 years and the letrines and kitchen were new structures on the ground that hadn't been there when she last visited.

They had been advised we were coming, so after the service we were told to hang around a bit. They had made us lunch, but since the sermon had been shorter than normal, it wasn't quite ready. The youth had a meeting in the meantime, but when our meal was ready, they went outside to practice. The three of us ate with the chairman, and what a feast it was. We had nshima with village chicken in a wonderful sauce and "vegetables" (what we would call greens in the states). More bwate was served as a drink. Before we ate, one of the women came around to us one by one with a pitcher of water and a basin for us to wash our hands.

After lunch we were told to wait "ashonto" (a little bit). As we waited, our cooks, most in there royal blue choir outfits came and sat on the bench along the wall to talk with us. They had carefully waited outside till we were done eating. This was when I really wanted my camera. They were all there, laughing and smiling and joking with us with their beautiful dresses and headscarves. Eventually a woman showed up with three rugs that they make together once a week (kind of like quilting circles) out of old feed bags that they hook colorful scraps of material through. They picked the best two, made a few snips here and there and then presented one to both Esther and I.  These rugs are great for getting the red Macha dust off your shoes/feet before entering your house. I will keep it new till I get my permanent house. It felt like an early house warming gift.

I really was touched by the genuine warmth and generosity of the people at this small church. I think I will try and make it there at least once a month.