Day 13

Today turned out to be a lot of fun! We were told that today we would be traveling back to the village in Kafue from yesterday in order to just pick up some data sheets from the nurse at the health center. Many of the med students didn't show up this morning because they knew we were just going to be traveling 2 hours to pick up a few forms and that's it. However, upon arrival to the health center in the village, the nurse asked us to see a few patients while she gathered the data sheets. I partnered up with one of the med students, Gregory, and we began to see patients in the examination room. Though I couldn't understand any of the language, it was very interesting to watch the entire examination. Throughout the exam, Gregory would stop and explain to me what was going on, what the patient's complaint was, how to diagnose it, what medications to give, side effects, etc. It was sad to see the lack of supplies and medications in the clinic. During one of the exams Gregory told me that he wanted to prescribe this one drug to the patient but the clinic and the surrounding health centers did not carry it, so he would have to give the patient a less effective drug with more side-effects. Latex examining gloves and soap soon ran out as well, but the examinations continued as there were only a few of us and about 40 patients waiting to be seen. The nurse later informed us that the single doctor for the health center didn't show up today and that's why she needed us to examine the patients. It is definitely easy to see the lack in access to healthcare that these people have to deal with everyday.

For this reason it's so difficult for places like this to ever keep doctors around. Many of the medical students have told me that they plan to leave Zambia after they graduate in order to work in the US or Europe so they can make more money and have better access to technology. However, most of the students are on scholarship from the Zambian government, so their deal is that upon graduation they must work 2 years in a rural area clinic/hospital before they are free to do as they wish. This is similar in the US, the US government offers scholarships for medical students if they promise a certain amount of time to working in a poor area upon graduation. Or if you join the military, they will pay entirely for your medical school if you devote at least 4 years to being a military physician upon graduation. I definitely don't think I would ever be someone to join the military...way too much for me to handle.

After seeing some of the patients today, we loaded back onto the bus and went to the Kafue River. Because of how close the villages are to the river, most men of the village are fishermen. At the river, some of the fishermen asked all of us if we'd like a ride on their fishing canoes/boats, we all agreed (though I was pretty hesitant, as the boat didn't look too safe...) and rowed off into the water.

All of us in front of the Kafue River. This picture is seriously amazing because one of the old fisherman photobombed it! (second on the right)

This is Gregory, the student I was partnered with today.

Some of the fish being sold near the river.

Blurry, but Lou Pierre, me and Francisca on the boat.

They were yelling, "Jenn take pictures of us!!"

All of the med students in our group!

This is the best picture I could get of the landscape. Cotton fields and palm trees are seriously the strangest combination...

Tomorrow we have the day off so we will definitely be sleeping in!! (Haven't done that in over a week...we wake up around 7am everyday..) Also, we probably need to go by the grocery store to stock up on food for the weekend.

My dad wanted me to include what the weather is like here, so most days are cool in the morning and night, probably around 40-50 and during the afternoon pretty warm in the 80s. Everything is very dry because it only rains in this part of Africa during the months of December through March.

Until next time,

Jenn

Day 12

After a early morning start today, we headed off on the bus again to the rural villages of Kafue. Upon arrival, we separated into groups of 4 and divided up the village between all of us. Each group needed to complete 10 different household surveys today, these surveys basically consist of information about the head of the household's education, age, children, disease, access to immunizations, etc. This village was very poor. All of the households were mud huts with straw roofs, they had shared latrines and a communal water tap. Few of the children had gotten any immunizations, and many of them had malaria and were malnourished. All of the men of the village were fisherman. One interesting thing I found out from the surveys was that most of the mothers were under the age of 20 (some with 3 kids already) and were married to men in their 50s. I didn't see many men around the village because they were probably out fishing for the day. The women were all carrying babies wrapped to their backs and were washing clothes, fetching water, sweeping, or cooking.

It seemed like having a white person in the village was the main attraction of the day. Everywhere around Zambia people tend to stare pretty blatantly at any white person, some of them call out "Muzungu!" which means foreigner in Nyanja, the local language. At one point today around 20 small kids were following me around, it was really funny! I kept smiling at all of them and then they would giggle. One kid poked me for awhile in the leg, another kid stared over my papers the entire time I was doing the surveys. All of the kids were so cute!

The rest of this week we will be continuing with these household surveys and compiling data from local health centers on prevalence of certain diseases in the area. Thursday we will write our report for the week and Friday we will present to the class.

Something completely random about Zambia, due to the poor quality of most of the roads, there are no speed limits (or none that I have seen). However, to ensure cars don't drive extremely fast, there are speed bumps literally EVERYWHERE! This method definitely makes people slow down but it has gotten pretty annoying...

More pictures!

Here's the group of us in Kafue. The Zambian flag is in the background.

These were the huts in the village where we were conducting the survey today.

The huts were very small and most of the doorways were covered with towels.

Here were some of the kids following me and giggling. I am definitely the odd one out here!

That's all for now!
Jenn

Day 11

So today began our real experience with the medical students. Chris and I walked over to the main campus around 8am this morning and had a meeting with our group (14 med students) and Dr. Baboo, the head of the department of Community Medicine. We finally received a hard copy of our tentative schedule for the rest of the summer. The community medicine rotation is 8 weeks, week 1 was lectures; week 2 (this week) is a rural community health survey in Kafue (about an hour outside of Lusaka); week 3 is an urban health clinic survey in Lusaka; week 4 we will be staying in Livingstone (where Victoria Falls is) for the entire week doing school health surveys around the community; week 5 we will be conducting the lead poisoning survey in Kabwe (the focus of our case study); week 6 is the industrial medicine/occupational health unit where we will be going to local factories and job-sites including Chilanga Cement, the Padmodzi Hotel, Kafue Sugar Estates, and King Quality Meat Products; week 7 is the environmental health unit where we will be conducting surveys on sanitation and refuse disposal in various locations (including a sewage plant...should be interesting..); finally week 8 will be our wrap-up week where we will be writing our case study and presenting it to the students and faculty at the medical school. Sounds like an exciting summer!!

TODAY I GOT MY WHITE COAT FOR THE SUMMER! :) Seriously the white coat just makes everyone who wears it look so much more legit and amazing. I get to wear it pretty much everyday for the rest of the summer and it basically made my day when Chris and I got them today.

So after we received our fabulous white coats, one of the med students, Lou Pierre, we were shown around the med student's dorms, student center, lecture halls, and dining hall area. Then, all 16 of us loaded up on the bus and headed off to Kafue, about an hour outside of Lusaka. When we arrived at the Kafue Health Center, we found out that the head of the health department (who was supposed to come with us to the rural village) was still in a meeting and then needed to get lunch. So, we preceded to sit in the bus in the parking lot of the center for about 2 hours waiting for him...however, this was a great time to finally bond with a lot of the med students. I think I forgot to ever mention this, but EVERYONE speaks English SOOOOO well here!!! All of the lectures were in English and all writing everywhere around Zambia is in English (this might have to do with the fact that the British still claimed Zambia until the 60s...). Anyway, we sat in this parking lot talking and joking around for a few hours. It was a lot of fun and we definitely had some interesting conversations...some about witchcraft (which most people here COMPLETELY believe in!), polygamy (which is totally acceptable in life here...part of the reason why HIV/AIDS has become so predominant in sub-Saharan Africa), I remember some argument about renal failure, a huge discussion about malaria and how awful it is (most people here get it around 3 times a year! And while I am taking preventative medication for this whole trip, most of them have never taken it), and of course we talked about the nightlife. Many of them invited Chris and I to tag along with them any weekend when they hang out at the local clubs/bars, etc.  

After we finally picked up the head of the health department, we drove about 45min across the bumpiest rock/dirt road ever! As we began to drive further and further away from urban civilization, we ran across several straw huts and farms across the landscape. Speaking of the landscape, I really need to get a good picture of it because it is so strange! Basically it was high grasses on each side of the road with palm/coconut trees spread sporadically around and then some of those enormous trees with really fat trunks and really skinny branches..think the Tree of Life from the Animal Kingdom.

When we arrived at the next health center, we picked up another person and then drove off again, heading deeper into the rural fields for another 30min down the bumpy road (if you could even call it that).  Upon arrival to yet another health center, we sat in the bus for another half hour while the head of the health department guy went and talked to someone, and then everyone decided that we were done for the day...even though we hadn't even done one household survey yet and I think we were supposed to do 10 today...whoops haha. I took some pictures of the final health center and the area around it:

The thing in the middle is a water pump (probably one of the only for the whole village), behind it is a home with a straw fence.

This marked the first time I have ever seen a rural, poor community. It was really shocking in a bad way. It was just awful for me to realize what some people live like..in conditions that no human should have to suffer through. While we were in the bus we saw a malnourished, stunted child walk by..and though I have seen pictures of what these children look like, I had never actually seen it before. It was truly a sad sight and the entire drive back to Lusaka, Chris and I had a discussion on what we just saw, how to do something about it, what the government can do, etc. The med students even were saying how these people in the rural communities have nothing, poor access to healthcare and how sad it is. I have noticed that the med students are definitely well-off compared to the average Zambian. They all have Blackberries and touch-screen phones, are very educated, and most of them have said the main reason they want to become doctors is to make a lot of money (and most of them plan on leaving Zambia once they have their degree and go to the US or Europe to make more money and live in better conditions).

Well I should probably go to bed as I have to wake up a 6am tomorrow to meet up with the med students and head all the way back to the rural village we were at today...so goodnight!

Jenn

Day 10

Well, I'm back at our house in Lusaka now...the past 48 hours have been  hectic. On Saturday morning we woke up around 4am to head over to the Lusaka bus station for our 6 hour bus ride to Kitwe in northern Zambia. The bus ride was uneventful until we began to get closer and closer to Ndola, the city where the Zambia vs. Ghana soccer match was being held in their brand new stadium. At first I questioned how Zambia was able to afford to build such an enormous new soccer/track stadium...then Anna let me know that it was actually the Chinese government who donated the money and supplies for the stadium to be built. The Chinese have began to invest in Zambia, specifically in the mining industry. I assume they built the stadium for Zambia to get on the good graces with the citizens and government of Zambia (and what better way than through their hearts...aka soccer). Anyway, as we approached Ndola on our coach bus, we began to see people along the sides of the road and in cars tooting their horns, yelling, cheering, blasting music, blowing on their vuvuzela's (the large plastic horns infamous from the 2010 World Cup as the droning noise in the background of all the matches). People were so spirited for the game!! Everyone we saw was wearing their bright green and orange soccer jerseys or wearing long-almost dress-like Zambian flag outfits in support of the upcoming game. It was really interesting to see how much the country is united for the day to support their national soccer team. I attempted to take a picture of some of the people from the side of the road..but this was the best I could do, as the bus was still moving...

I'm definitely going to bring home a few Zambian soccer jerseys, they look so cool! I love the green and orange combination!! So when we finally did get to Ndola, the crowd was even larger along all the roads with people cheering insanely in preparation. The stadium was right off of the main road so we drove right by it, it is ENORMOUS! Well, the rest of the bus ride to Kitwe was completely uneventful, aside from me seeing the true poor parts of the African continent. It was really sad to see how things are in poverty-stricken areas..when we drove by all the areas all I wanted to do was help out those people in some way..but I honestly don't know how. I'm hoping that my way of helping will be through medicine, and in the future I plan to travel at least once a year for a few weeks to poverty-stricken areas and help out with any healthcare they might need.

Upon arrival to Kitwe, we went straight to our hotel (which was amazing I might add) and took some much-needed naps. We woke up for the game and watched as Zambia played to victory against Ghana!! After the game, Ken, the professor from Copperbelt University, came to our hotel and picked us up (he was actually at the game so we had to wait for him to drive back from Ndola) and we went to Mona Lisa Restaurant, a  nice pizza place right down the street from our hotel. We stayed for a couple of hours talking to Ken about Zambia, medicine, lead poisoning, sanitation, malaria and tons of other stuff...all while eating some amazing pizza and watching the Germany vs. Portugal soccer match (GO DEUTSCHLAND!). When the game ended we headed back to the hotel to catch up on sleep before waking up again at 4am to catch the bus back to Lusaka today.

In other news, I did laundry today! It literally took me 3 hours...I hand-washed all of my clothes as we have no washer or dryer. I really took for granted all the work that a washing machine does, because doing my laundry definitely felt like a workout to me!

Tomorrow, Chris and I will be going to the medical school at 8am for a meeting about what we will be doing the next week..and as of now I have no idea what that will be!

Until next time,
Jenn

Day 8

Hello again!

     I'm heading north for the weekend to the city of Kitwe in the northern part of central Zambia. We are all going to Kitwe in order to meet with Ken, an expert on lead poisoning from Copperbelt University. Chris and I are going to interview him (we just made up a list of like 11 questions of random things) to get more information for the direction we should go with our case study. We all have to wake up at 5am (!!!!!) tomorrow morning to head to the bus station in Lusaka to hop on the 6am bus to Kitwe, a 6hr drive.
     One HUGE thing in most parts of the world (except the USA) is soccer..and it is no different here in Zambia. The Zambian people have so much pride in their soccer team, as this past march they won the Africa Cup...which is a BIG deal here. Last weekend we all watched the match of Zambia vs. Sudan, and unfortunately Sudan took the victory there. All week I've been hearing about everyone's disappointment in the loss and how bad of a sign that was. Well, tomorrow is the match of Zambia vs. Ghana (if you don't remember Ghana was the country that bumped the USA out of contending for the World Cup in 2010) and we all plan to go to some type of sports bar as soon as we get to Kitwe to grab some pizza and watch the game with true Zambians. I know I'm super excited to watch it! I remember how exciting it was to be traveling through Europe during the 2010 World Cup, so I know this will be awesome!
     I finally took some pictures today!!! My mom should really be proud of me :)

This is the lecture hall that I've been at all week with the medical students. All of them wear their white coats everyday to class, definitely makes me jealous!

There are bulletin boards posted throughout the hospital where pretty much all correspondence is posted, I don't think the school uses email very often so they post everything here, including all grades! 

All large buildings and well-off houses are surrounded by huge fences usually with barbed wire or electric fencing at the top. However, I have noticed that some people get creative and cover the tops of their fences with broken glass from bottles!

I tried to get a picture of this woman carrying a basket on her head but I didn't want to be too obvious about it haha. It's so interesting to see how many women just walk around balancing such large items on their heads.

This is the front entrance to the Italian Orthopedic Hospital where we are living for the summer.

This is the main building of the Italian Orthopedic Hospital.

Here's our house!! Look's pretty small but it's actually large from the inside!! I'll get some pictures up later of  what the inside looks like.

Well, that's all I have for now. My next post will be from Kitwe!

Jenn

Day 6

So today I sat in lecture from 8:30am until 5pm...basically it was a LONG day. I was literally falling asleep learning about methods of calculating odds ratios for populations with malaria..haha. Some of the medical students were literally passed out on their notebooks in front of them. The lectures were not the most exciting in the entire world, but they were still quite interesting and important to know and understand for field work. I got to walk around the hospital more today and Chris (my partner from Cornell for the summer) and I ate lunch in the hospital cafeteria. I forgot to bring my camera today but I will have it tomorrow!! And I promise pictures will be up soon!

One really funny thing that keeps happening to me is that EVERYONE asks if I am related to the president!!! Obviously having the last name "Bush" I have gone my whole life being asked that same questions, however EVERYONE asks me here! The first occurrence of this was actually when I was in NY at JFK airport checking my baggage. The woman at the counter asked for my passport and upon looking at it, looked up at me with the most shocked expression ever. She was like, "Are you THE Jennifer Bush?!?!?!?!?!" I wish I had played along with it a little bit, but instead I just laughed and was like nope, sorry. She was VERY VERY disappointed to say the least. Anna (one of the other girls on the trip from Cornell) told me I should have said I was so that she would bump me to first class or something...that would have definitely made my 14 hour flight better!! Anyway, yesterday at the beginning of the lectures I had to introduce myself in front of the class (like 40 people). After this every student that came up to me was like, "WHAT?? YOUR LAST NAME IS BUSH!!! YOU ARE FROM TEXAS?????? YOU MUST BE RELATED TO THE PRESIDENT EVEN IF YOU SAY YOU AREN'T!!!" Today one student (who I forgot his name because African names are VERY hard to pronounce, let alone remember..haha) finally approached me and was like "the whole class has been discussing whether you are related to the old president or not," then he preceded to tell the rest of the students that I wasn't.

We met another student today named Hims (he told us to call him that cause we actually couldn't pronounce his real name). He talked with us for about an hour during break and then walked us through the hospital showing us around. Then later he asked us if we wanted to join him this saturday night to go to a poetry reading that the med students put on every other weekend. I really want to go but we already have plans this weekend..just found out that we are taking a 5 hour bus ride north to Kitwe in order to interview an expert on lead poisoning for our case study. Oh well..Hims told us that we could join him for the next poetry reading in 2 weeks.

So for the past week, we have all been getting around the city by being driven by Sailas, the Italian Orthopedic Hospital's hired driver. It has been really nice to have someone to drive you around wherever and whenever you need to go somewhere because many of the streets around Lusaka are not safe. Chris and I might start walking to the medical center in the mornings to go to lecture as it is really only a 15 minute walk from where we live..but for now Sailas is readily available and he is very friendly! Chris took this picture of me and the car Sailas drives us around in (on the left side of the road I might add..), THE CUTEST CAR EVER!!!

So far everyone I have met in Zambia is SO nice and friendly! I had heard this before I came that this was because Zambia a landlocked country and so in the past they had to be extra friendly to all the countries around them in order to get supplies and such! Well, I can certainly say they are super friendly!

Until next time,
Jenn

Day 5

     It is now Day 5 for me in Zambia, and these past few days have been VERY relaxing compared to my hectic 3 days of traveling last Wednesday-Friday. I had to spend over 23 hours in an airplane over those 3 days, with the rest of the time spent waiting to get on an airplane! To say the least, I didn't sleep at all for over 36 hours after going off of 4 hours of sleep the night before (due to the fact I didn't start packing until the day before I left..whoops!).

    When we finally arrived at the Lusaka airport, we were shuffled off the plane, filed through customs, grabbed our baggage, and met our driver who took us to our new house for the next 8 weeks. 

Our house is a guest house for the Lusaka Italian-Orthopedic Hospital. Also connected to the hospital compound is a house of nuns! It is really interesting to see so many nuns walking around outside all the time with all the patients with broken arms or legs. Sometime during the summer I would like to find some doctors in the hospital who I could shadow for a few hours every few days. 

    For the past few days we have all just been getting acclimated to the area, mainly by sleeping A LOT and eating A LOT :) We have been by the grocery store many times now because it seems like we forget to get something every time we go. The grocery store we have been going to is called SPAR, which I think is based out of South Africa. It is a western-style store with all the foods and things that I could find in any normal grocery store in the US (definitely didn't think I'd be able to find one of those here!). This grocery store is at a large outdoor mall called The Arcades. We have also gone by a large indoor mall called Manda Hill (named after Nelson Mandela). It looks just like any large indoor mall in the US as well! 

    However, aside from these areas, the city looks very poor. You can see that many people are not as well off as the typical American, and many homes are poor. There are many vendors on the side of the road with fresh food and items to sell, and many people walk around on the streets and up to the cars trying to sell their goods. The city has a lot of trash filling the sides of the roads and the air seems very dusty. It is also obvious that there is a security problem in most places because every building is surrounded with large metal fences and gates with spikes and barbed wire lining the top. Thankfully, I feel that our house is about as safe as it could get, I mean we live at a home connected to nuns and a hospital!! Hahaha aside from that fact we also have a large fence surrounding our compound and a gate that is locked every night.

    This is completely random but everyone drives on the left side of the road here!!! It is so difficult to get used to! I keep approaching the right side of the car to sit in the passenger seat and then realize that there is a steering wheel!!

    Anyways, yesterday we met with the Assistant Dean of Community Medicine at the University of Zambia School of Medicine. His name is Dr. Nzala and his cousin is one of the professors at the Cornell Law School (who we all met in April back at Cornell). Dr. Nzala gave us our schedule for the week and told us to be at lectures on community medicine with the 6th year medical students for the rest of this week. So, today we attended our first lecture with the medical students. Today's topic was "Control of Lead Poisoning," which will be our focus for our case-study for the rest of the summer. The lecture and lecture hall  are very similar to the Cornell ones, and I took down at least 4-5 pages of notes for the hour and 15min lecture. Tomorrow's lectures include Case Control Study, Cross Sectional Study, Cohort Studies, Psychiatry, and Measurement of Exposure; these will last from 09:00-17:00 (or 9am-5pm). Once this week finishes, I think we will be traveling next week to Kabwe, which is just north of Lusaka. There we will be studying more about lead poisoning and conducting some primary school surveys.

That is all for now, I hope I can post more often but our internet has not been working for the past several days. Pictures will be up soon!

Jenn