These are the words my Zambian co-workers use when they pass through a room with me pouring over registers and trying to get PMTCT documentation up to date. I'm not sure if it is their way of affirming my work or their way of telling me to lighten up a bit. Either way, I hear it a lot these days.
The last few weeks have been busy. There was the National Measles Campaign which I was not directly involved in, but which consumed the Maternal Child Health department where I do most of my work. All week long the nurses would gather there and prepare their supplies for the day before heading out to rural communities and vaccinating everyone between the ages of 6 months and 15 years. They were also tacking on Vitamin A (to prevent blindness) Mebendazole (for deworming) and polio vaccine (though I think we ran short of that). There were some communities they had to return to the next day because the response was overwhelming. They ended up extending the campaign into the first part of the next week. Besides the mobile clinics, hundreds were vaccinated right in our clinic. We had lots of crying babies and kids all week.
The following week, there was a Trachoma campaign. Trachoma is an eye infection which can cause blindness with repeated infections over one's lifetime. Apparently the health district we are a part of has a high incidence, though I've heard the hospital sees so few cases they have a hard time teaching the interns what it looks like. Regardless, we were part of a pilot project which is trying to eradicate the disease by treating everyone with a one time dose of zithromycin. They had tall handmade wooden sticks which were colored coded to tell by a child's height how much medicine they should get. The adults all got 1gm. I heard that some who took it on an empty stomach suffered from vomiting or diarrhea.
We had a couple dozen nursing students here for three weeks from Livingstone. Their time at Macha was their "rural experience". There was usually 4 or 5 of them in MCH on any given day. There was also a group of Dutch medical students around the hospital, though I haven't seen them much. This past week a group of nursing students from Indiana Wesleyan have arrived for three weeks. It really is amazing how the hospital absorbs all these students for learning experiences when we already have our own nursing school and students.
We've had lots of "visitors". Visitors is the term Zambians use for high officials of the Ministry of Health or NGOs who come to check up on our work. You can always tell when they are coming because instead of the calm slow pace of the start of an ordinary work day, you come in to find almost everyone there on time and everyone running around straightening things up etc. Similar to work places in the US when JAAHCO, OSHA or the Health Department are expected.
The entire hospital had a performance review by the Ministry of Health this past week. The same day they arrived, the Aids Relief people came to check in on our PMTCT work. I was unaware they were coming, but was grateful for their visit as I was able to learn things and get answers to some questions. I was also able to participate in a meeting they had with the Community Health Workers. These are the volunteers at the village health posts associated with our MCH department. I had been wanting to meet face to face with these workers and start to understand the realities of their work and see how we could work hand in hand. These workers have been trained in PMTCT, and besides counseling and educating people in the community, they also help track and notify hiv+ moms and exposed babies who have defaulted in their care. I was able to get their phone numbers and hand them a list of the moms and babes from each of their regions who needed to be contacted to come in for care. Hopefully, I then can get feedback from them to fill in some of the gaps in information I have. They usually know these women by face and name and where they live. They often know details of their personal circumstances which can help us provide better care. They are a crucial link in the PMTCT program.
Tomorrow I leave for a one week training in PMTCT. It will be my first formal training and I am looking forward to it. Betty and Grace, the two women who were here this past week with Aids Relief will be teaching the class to health care providers. It is being held at a hotel in a town a few hours from here. I hope it goes well.
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