Back in Macha

This is my fifth day back in Macha after six weeks of travelling. It sure feels good to be home sleeping in the same bed, no longer living out of a suitcase and with no plans to go anywhere in the near future. My time away was full of many good things but the pace was beginning to wear on me.

I did some informal tallies of the six weeks that I was away from Macha. I was in four different countries (one in transit) and 20 cities/towns (5 in transit) While traveling between these different places, I road 19 times in a personal car, 16 times on a train, 10 times on a bus, 8 times on a plane and 3 times in a taxi. Most of that with luggage. Besides my 11 nights at orientation in Akron, I did not stay more than 3 or 4 nights in one place. Too frequently it was just one night.  As I say, I'm glad to be home.

There was a wedding while I was away, and one funeral that I have heard of. There was a 100% pass rate of the national nurses exam by the students from the Macha Nurses Training School. Apparently I missed the worst of the cold season while I was away. Things are much drier than when I left. The temperatures are very pleasant after 100 degrees plus humidity in the midwest, but the heat is on it's way.

I must tell you that I also passed the foreign trained nurse exam, which is great news! I don't have to repeat it in November. I still had to get a temporary work permit as the certification from the General Nursing Council will not be out till the end of the month. I need that certification to get my permanent work permit. I was only given 7 days upon entering the country this time, but went to immigration the next day and procured the temporary work permit. We were hoping to avoid that additional cost, but it was not to be. At least I am able to be here legally and work.  I need to report to immigration in Choma each month until my permanent work permit comes through. I will just try and time it with shopping trips.

So my first day back at work there were important "visitors". People from the Ministry of Health and Boston University/CDC were checking in on our PMTCT work. Apparently they advised us of their visit just a few days before. We actually did quite well, considering that there was a register that had not been updated in the last six months due to a turnover in staff and most of us not being aware that it existed. I have been given the job of getting it up to date. It was a good visit with myself and Mrs. Mabeta, the new charge nurse of MCH (Maternal Child Health) learning alot.

Here in Zambia, patients tend to carry their patient file with them. Just like in the States parents are given immunization cards for their children, here, pregnant women are given antenatal cards that they bring with them to each visit, children are given "under 5" cards, women receiving family planning are given family planning cards, etc. In the general outpatient department patients just have small notebooks that they buy from the hospital ($2 for adults, $1 for children) where all visits and prescriptions are written. Except for inpatients and ART (hiv) patients, no file is kept on record at the hospital. Instead, we have registers (log books) where this information is kept. My observation is that the cards have the most accurate information, which on one hand is good so that when the patient shows up here or at another clinic, the needed information is at the ready. There is no need to look it up in various registers (under 5, safe motherhood, pmtct, integrated mother/baby, family planning....you get the picture). However, the registers are big, bulky and cumbersome. Often you are seeing both mom and baby and so need to write in two, 3 or 4 registers and all those steps don't often get followed through on due to time constraints or someone else using the register etc. So, when it comes time to do a report or gather statistics, the information is not at hand, because the registers aren't up to date. At this meeting the importance of good documentation was reinforced by the visitors. We can't prove we are doing the work if we don't have the documentation. So, we are going to work on improving that.

I had a good meeting with the nursing officer Miriam after our time with the visitors. We have roughed out a plan of where I will focus my energies for now. I told her I want my work to be useful, sustainable and enjoyable. She also is concerned about the sustainable part, not leaving a hole when I leave. It is good to know we are on the same page there. We have come up with three main areas for me to focus on. Helping MCH with better documentation and follow-up of  hiv+ mothers and their babies. Working with the ART clinic's database of exposed babies. Helping with the monthly and quarterly statistic gathering for PMTCT.  I am still pulling together a schedule, and I hope to include going out into the villages 2-4 times a month with either MCH or ART.

My Time in the States

Well dear followers, I obviously did not get around to posting while in the States. I do apologize. Time was fuller than I expected and I focused my energy on being present to those I was with.

Orientation was a good time to reconnect with a few, meet new friends and make connections with those who will also be in Africa, and put faces to the names of staff in the North American offices. There were 29 of us in orientation from Bolivia, Brazil, Canada, Congo, Egypt, Mexico and the US. We were headed to work in Afghanistan, Bolivia, Burundi, Canada, China, Colombia, Congo, Egypt, Kenya, Myanmar, Nepal, Nicaragua, South Sudan, Uganda, US and Zambia. Hopefully I will get a chance to visit or have visits from some of the folks in Central and East Africa. I have the advantage of living only three hours from Victoria Falls, a common vacation destination on the continent.  

MCC had kindly allowed me to stay in the States for a planned family vacation in the Black Hills in honor of my parents' 50th wedding anniversary. Originally, there was a week between orientation and my family trip. Orientation was shortened, and the airlines bumped my flight to the States ahead by one day, so I was able to squeeze in several visits to dear friends on the East Coast I had not seen in awhile.

The easiest east coast friends to visit were Sue and Kevin, formerly members of Portland Mennonite Church, now living in Akron for the past several years. Sue works for MCC, so I saw her frequently throughout orientation. She was my go to person. It was great to spend time and catch up.  I also went to their house for dinner one night and got to catch up a bit with Kevin.

Before orientation I was able to visit my friend Corbin and family. Corbin and I met through SOAW and helped start the Catholic Worker together in Portland. We hadn't seen each other in about 7 years. We walked about Troy, visited a nearby Peace Pagoda and mostly just hung out, played games and caught up. It was so great to meet 11-month old Riley.

The weekend after orientation I spent at Cape Cod with Cole, a friend from Holden whom I had not seen in a couple years. The weather was so pleasant after the heat and humidity of Akron. We walked on the beach, went to a wetlands, walked about the village of Barnstable where Cole's parents live, and visited Provincetown one evening.

Then it was off to NYC where I was able to see my friend David who is now living in Brooklyn. David and I worked together for MCC Work and Learn Teams after the earthquakes in El Salvador in 2001, and hadn't seen each other since. He was my life saver during that stressful six months. David and his family met me at Penn Station on their way home from church and helped me navigate my way to my Aunt Jan's apartment where I would be staying. We visited over pizza and I played hide and seek with the kids before they headed back home.

The next day I met up with my dear friend Julia at Grand Central Station. Julia is a Maryknoll sister who has served the last 4+ years in East Timor as a high school teacher. We also met through SOAW and had last seen each other in 2007 when Julia had visited the Catholic Worker. Julia was in the States on renewal, and the Maryknoll headquarters are just outside of NYC, so we were blessed to have a few days of catching up. We walked along the High Line (a park created on an old elevated train line), explored Central Park and even took a day out of the city to hike at Bear Mountain State Park. Ran into some Appalachian Trail thru hikers and had fun talking trail with them.

Then it was off to the midwest for time with family. Over the last few months, my Dad has developed bad back pain caused by stenosis of the spine which has become quite debilitating. He must now walk with a cane and any movement causes pain. He has a good attitude, pointing out that he has much to be grateful for, 73 years of life without any pain till now. Surgery is scheduled for Monday August 21, we pray that it will be successful and he can have some relief from the pain and return of mobility.

My dad's health meant the family vacation to the Black Hills was cancelled. Instead we all convened in Kansas City where my parents live and then went down to the Lake of the Ozarks and hung out as a family there for a few days. It was not the trip we'd planned, but we were able to be together as a family. We even tried to take some photos, but my youngest nephew was not in the mood to cooperate.

My niece and oldest nephew will be in college when I return. One nephew will be nearly 13, the other in double digits (ie 10) and the youngest will be in first grade and reading. Three years may not be long in an adult life, but children change so quickly. It was good to have some time with them.

With MCC's consent, I was also able to stop a night in London on my way back to Zambia. No, not to see the Olympics, but to see my friends Kath and Steve who I had worked with in El Salvador back in the early 90's. The last time I had seen Kath and Steve, I held their newborn son David who is now in university. We had stayed in touch over the years mostly through their Christmas letters which I would usually respond to by letter or e-mail. We avoided London and instead hung out around their village of Hassocks. Steve and I walked about the countryside around the South Downs one day and Kath and I went to Brighton and the seashore the next day. The countryside near their home is beautiful, with some lovely old windmills. We had dinner with their daughter Anna and pulled out all their photo albums of El Salvador and reminisced.

I am a person rich in friendships. I am grateful for them all. I thank each of you for the chance to reconnect and for hosting me along the way. May it not be so long this time before we meet again.