Outreach Health Centers of Zambia

Today I went to an outreach center in Zambia to administer vaccinations and weigh babies as well as give prenatal exams to any pregnant mothers. The day began with a long drive on “back roads” of Zambia aka, lots of bumping around and a bit of Bob Marley in the background. We just kept going and going, passing many villages along the way with its members walking behind us with their numerous children and their “under 5 cards,” (basically childrens’ charts). This sight made me think about patients in America. These women were walking miles and miles in the heat with 2 children on their back and one holding their hand to get to the mobile clinic. They know the day and the time they are supposed to be there and they keep track of their own charts. In America, doctors take the time to call patients to remind them of their appointments; they keep their charts; and they often times have to call patients to remind them to come in to take this test, or pick up that lab result. And you know what happens when the patient does not come in to take that test or get that lab result and they end up sick? Lawsuit. I could not help but admire and respect these peoples’ perseverance and personal responsibility. It’s amazing what happens when one simply does not know any better circumstances and is therefore appreciative of what ever they can obtain. The journeys these women make to get their children taken care of is the perfect example of the opposite of the laziness and forgetfulness often demonstrated my members of our own society and other parts of Zambian society.

In terms of Zambian society, our other team perhaps experienced the best example of cultural frustration on their rural health experience. There was an automobile accident and they were supposed to be the ambulance for the day. Unfortunately, their team simply did not wish to mobilize until after they had eaten their lunch, delivered a few watermelons, and picked up a few chickens. This seemed to be a cultural way of life in that no matter how insistent our team was upon rushing to the scene, mindsets simply could not be changed. So I suppose the reality of the situation is that every culture has areas of laziness that compromise the lives of professions of others. Perhaps the biggest problem is when cultural tradition serves as a barrier to growth as a country.

Now, back to my personal rural health experience…when I arrived at the rural health center, we went to a local home that belonged to a friend of one of the nuns. I learned one thing about myself on this trip that I had not entirely known before. I love the kids. I was never without stickers and colored pencils. So upon arriving at this village I immediately began my sticker distribution process. The adults loved watching this whole little routine and before I knew it a group of children was handing me a live chicken that they had caught at the instruction of their father. Sister Piara explained to me that this was a gift and I must accept. I looked at the malnourished kids who were gifting this bird to me and couldn’t help but feel sick about the fact that they were giving me food that they needed. However, I also understand from a cultural stand point that it is very important to their pride that I accept this gift with gratitude.
So there I was, chicken in hand, walking back to the rural health center. Now that our patients had enough time to walk there, it was time to get down to business. We gave vaccinations and weighed babies in a sack attached to a contraption much resembling a vegetable scale in a grocery store that was being all held together by a bent safety pin. We did prenatal exams on the floor of the local school teacher’s office using the width of our fingers to determine the number of months pregnant. It is amazing to see how resourceful one can be without the supplies we in America have come to rely upon. I personally found it very interesting to watch medicine being practiced in its rudimentary form; to watch doctors use their 5 senses to make a diagnosis; to watch decisions be made without a million tests to back them up. In some ways I can’t help but think that it’s what medicine should try to get back to. In other ways, I know that as a first year medical student I cannot presume to make such statements with the little experience I now have in the medical field of our own country.

After all of the vaccinations, weighing, etc. we went to a local village for lunch. I learned to eat Nashima with my hands correctly. I learned how to create a new pocket in my stomach in an effort to get down all of the food the nuns kept piling on my plate. I also observed the inside of a house of a “wealthy” villager. Our call room at Loyola was larger. There was a cupboard made of cardboard boxes with stuffed animals and plastic plates on display. There was a large watch as a clock. There was a radio for entertainment, two couches, and a table cloth that the owners seemed to be so proud of. One word for all of this: perspective. We all define luxury differently; we all define wealth differently. However, the underlying qualities of generosity and family pride transcend all cultures. I ate every bite of the food placed before me because, as in the case of the chicken (still at my side), I needed to show my true appreciation for the generosity being shown to me.

They say there is no such thing as an altruistic act. Even letting a bee sting you should not count because then the bee dies. I can’t help but think that giving when you have nothing to give falls under that category. In fact, genuine generosity defines altruism in my mind. I came home that night with a new African name: Mrs. Piri (my new Zambian husband Mr. Piri was the distributer of the chicken), a chicken, 12 pumpkins, and a new appreciation for the concept of appreciation and ways in which it can be expressed. It was an invaluable day to me.