June 7th

Ellen and I managed to walk 20km today; it was a long accidental walk.  I think that we maybe have confused many Zambians on our way. White people walking down the road in the middle of the bush, there must be something wrong with them. I am sure though that it must have been a sight; Ellen and I strolling down the road reading our books. When we finally made it home, we both lacked the energy to cook or to wait the two hours it takes to cook beans, so we had chocolate for dinner! I have yet to master cooking of beans, however I have mastered searching the bean carefully for rocks before soaking them over night. On more than one occasion I have had an unexpected surprise in my beans. Chew carefully or you might lose a tooth. 

June 5th

I went to the under-five clinic today. 68 children showed up! It was amazing. It would have been even more amazing if the ministry has delivered the vaccines that were promises, but the children were still weighed and some were given vitamin a so it was not a total loss.

June 4th

I am afraid that they may not allow me back into American society; I think that I may have become just a little too crazy to be accepted back into American culture. Today I went for a walk with my iPod blaring in my ears. A song, I can’t even remember which one it was now, began to play. The music and the lyrics filled me up so completely that I had to start singing at the top of my lungs. Then I thought to myself since I am already making a fool of myself signing to a song that no one else can hear I might as well go all out and start dancing too. So I was singing and dancing down the middle of the road and I don’t feel bad about it; in fact I felt so free and completely I could have stretched out my arms and took flight. So I feel as though this event will officially classify me as off my rocker. 

June 3rd

This is the part of my blog where I discuss race. So if you are extra sensitive about this subject or are easily offended please skip over this entry. I would like to start by saying that I am not a racist these are just events and things that I have observed while in Zambia.

Growing up in America I was raised and taught that a person’s race and the color of their skin is as no more significant than the color of their eye or their hair. The color of your skin frankly should not matter it is what is inside that counts. I am not saying that that is the way that it works in American society I know that civil rights and racism are still prominent issues, I am simply stating that color should not matter. Then I came to Zambia and that thinking is thrown out the window; not by me but by the Zambians I am living, working, and talking with. Just by being white I am set up on a pedestal. I am automatically considered smarter, richer, prettier, and more important because I am white. At first I found this very unsettling and I tried to fight it; I mean this went against everything that I had been raised to believe. But then someone wise pointed out to me that we cannot control the privileges we get in life. We have no control over the color of our skin, we have no control over the families, cultures, or countries we are born in therefore stop trying to fight it or change it. Instead she pointed out use the privilege that you are giving to create something good; use it to better the world. I know that the color of my skin does not make me better in anyway than anyone else, but it does put me in a position of power not because it is right or by choice, but just because Zambian culture dictates that being white is powerful.  Therefore I have an obligation to use this power to help others and initiate change where change is needed; I am not sure yet how or what I am going to do, but I hope it is good.

That’s it that is the end of the race talk so you can start reading again. I made it back to the village today and again I am overwhelmed with the joy that these children bring me. As my departure from this village nears I feel as though it may be impossible to leave them.  Don’t worry I am coming home I just was not prepared to become so attached so quickly. 

June 2nd

Today I ventured back to the hospital to conduct a videotaped interview with three of the nurses. My plan was to also interview the doctors but my camera died. One of most interesting things that I discovered is that the hospital lacks a gurney. They have no way to transport patients, not that there is much need for transport except to the morgue, but as of right now the wrap their deceased in a sheet and ask family members to carry the body the 200 yards to the mortuary.

Just out curiosity I asked a nurse what she would do if a patient’s heart stopped. She looked at me slightly confused and the stated that she would get the vital signs (blood pressure if they can find a cuff and temperature), then they would push adrenaline and solumedrol if there was IV access, and then she stated that they would do CPR. I asked her to walk me through the steps of CPR. She stated that she pushes on their chest a few times, five times to be exact and that is it. When I asked the doctor how they do CPR he stated that it is 5 compressions per 2 rescue breaths, but he also stated that he is never there for the ‘codes’. I also asked how they would manage a patient that stopped breathing the nurse stated that they would push a steroid through the IV, but they would not do rescue breaths. She actually seemed confused as to what rescue breathing was. When I asked about defibrillating a patient she replied excitedly “oh like what you see in American movies! Have you ever seen one!?” I am not sure what I expected, but it seems that the hospital staff would at least be educated in the excepted method of resuscitation regardless if they lack the means to execute them.

Today I also witnessed a child seizing for twenty minutes; it could have been much longer than that since I just timed it from when I arrived. The child was diagnosed with malaria and had been on medication for 48 hours; the child was afebrile and lab values were stable. The mother informed the doctor that the child had not eaten in 17 hours. The most common side effect of quinine, the medication used to treat malaria, is hypoglycemia, or low blood sugar. It was assumed that the child was experiencing a hypoglycemic seizure as opposed to cerebral malaria. Since there was no IV access the doctor pushed 10mg of Diazepam rectally with no response while the RN tried to gain IV access. When a line was finally established 10mg more of Diazepam was administered along with an amp of D50, which is concentrated sugar water.  When the seizures finally stopped the child remained postictal only withdrawing from pain for an hour until I felt. I sadly do not know the outcome of the patient, but the doctors seemed optimistic that the child would be fine. I am not a pediatric nurse nor do I have much experience with seizures, but from my limited knowledge and experience I was still able to stop about 15 potentially dangerous acts during this whole ordeal.  First and foremost administering 20mg of Diazepam in a 10 minute period on a child weighing only 15kg is very risky; the doctors are lucky that they did not kill the child’s respiratory drive.

I am struggling with intervening and giving advice on issues that I am not positive about, since my advice already lead to the circumcision of one man. Although I did protest the issue I do feel responsible. Without the proper resources I am afraid that by giving advice I may actually cause more harm than good unless it is a subject that I am certain about. For example there was a patient with a rheumatoid arthritis flare-up and they were treating her with Aspirin. Aspirin may reduce her risk of heart disease and reduce some pain but it will do little diminish the inflammation or resolve the flair up. I believe that you should use an anti-inflammatory such as naproxen or acetaminophen and that maybe in certain cases use a steroid if the RA is bad enough; but of these two things I am not entirely certain about and I hesitate sending a patient home on a steroid that will lower their immune system when they are drinking unclean water.  So I am torn between not helping when I know the treatment is inadequate or helping at the risk of giving wrong advice. 

June 1st

I spent my morning back at the hospital today. The doctors were only 30 minutes late today. I decided to do rounds in the male and female ward today. I encountered the same problems as I did during my previous visit. No mosquito nets over the hospital beds, no visible hand washing, not following orders, limited assessments, and treating for malaria without conducting the proper tests. When I broached each issue with each a doctor or a nurse they each came up with a different list of excuses. Malaria nets are not hung because it is unsanitary, or the patients take them, or it is not malaria season. Looking around at the stained and dirty beds and the close proximity of each patient I highly doubt that mosquito nets are the worst of their problems when coming to infection control. There are on average 10 people using the same bathroom; which is cleaned only once a day. There is only one bed pan for the entire hospital. There is one thermometer per ward; the temperatures are axillary but I have yet to witness any form of disinfection between patients. And to top it all off I can count on one hand the amount of times I witnessed a nurse and a doctor washing their hands. As for patients taking the nets this in not really a bad thing. For one the patient will have a mosquito net at home, hopefully reducing the incidence of malaria and secondly it would reduce the risk of infection by putting a clean net on each bed after a patient is discharged.  The last excuse about it not being malaria season I find the most absurd. If it is not malaria season then why is the working diagnosis for over half of the admitted patients malaria? Riddle me that one!

When I broached the issue of hand washing the nurses stated that they do wash their hands. They have a hand washing station located in their office. When I asked how often they wash their hands they laughed and said when they look dirty. As a nurse from America part of me died a little inside. Upon further investigation I discovered that the doctors and nurses did have a supply of alcohol based hand gel at one time, but when the supply ran out it was never restocked.

Addressing the issue of not following orders was a little more difficult and I still feel as though no one was able to give me a reason as to why or where the breakdown in communication was occurring. During rounds the one of the two nurses on duty in the female ward rounded on patients with us. The physician wrote an order to change an antibiotic; the nurse was there and saw the order but never did anything about it. The following day the antibiotic had never been changed. So the nurse knew about the order but never followed through, why? I suppose you could write it off as laziness or lack of reasonability, but that seem like the easy way out.  I am sure that laziness and complacency play a role in orders being missed but I think it also has to do with the lack of follow-up by the doctors, the fact that there is repercussion to not following orders, and there is limited understanding of cause and effect. I have found that across the board culturally Zambians do not understand that their actions can have a direct impact on something or someone else; for every action there is a positive or negative reaction. For example by not giving the patient the proper medication or not drawing the lab sample the health and overall outcome of that patient is compramised. And finally the nurses and doctors are not invested in the patient population. The government mandates that nurses and doctors have to survive two years in a rural clinic, therefore there are stationed on average 300km from their families and are unfamiliar with the culture and people of the region that they are serving.  

The majority of the patients that I rounded on today suffered from perceived malaria, but once again the patients were being treated without a positive confirmation of the disease. The breakdowns in this chain are obvious and numerous. The doctors do not always write the order to test for malaria, despite being federally mandated, the nurses do not always follow the orders, the lab samples do not always make their way to the lab, the lab does not always process the samples, the results do not always get relayed back to the appropriate areas, and the results are at times inaccurate due to lab error, faulty machines, and wrong patient labels. I’m not even sure where to start with that one.

I did spend a short time in the clinic today where a police officer brought a two year old girl suspected of being sexually assaulted by her 14 year old cousin. The physician upon examination determined that there were not obvious signs of sexual assault; there was no bruising or lacerations or signs of trauma, and the lab results for STIs came back negative. I was relieved but I was also curious as to the legal processing regarding sexual assault involving two minors. I discovered that at 14 you are not considered a minor and he would have been tried as an adult. The officer also informed me that the parents can also be considered legally at fault for not monitoring their children more closely. The whole encounter kind of made my skin crawl. I wanted to go home and take a shower, but being in Zambia with no running water nearby let alone a shower I did the next best thing and took a ice cold bucket bath. Woot!

May 30th

Just in case any of you were wondering it is possible to microwave a chocolate cake. That is really all I did today. 

May 29th

So today marked my first solo trip from the capital Lusaka to Solwezi; a total of 600 km. I completed the trip in 6 cars/ trucks in only 7 hours. I figure this was a vast improvement from the 12 hours it took Ellen and I to go the same distance last time. I road in a car with a Chinese man who spoke no English, but seemed to really like fish since he kept stopping on the side the road to buy them from different vendors. I think in the hour I spent with him he bought a total of 12 fish; the freshness of the fish I feel is questionable because there was no water nearby.  I also got a hitch from a South African trucker.  Much to my surprise he was not racist; the first and only South African I have met who did not care either way if a white women was to marry a black man.  On the risk of making a gross stereotype I thought that just about all white South Africans were racist, but happily I was proven wrong. As the gentleman so eloquently put it “there is way to much shit in this world to give a damn about who is marrying who, let’s try solving something that actually matters for a change.”

We are fast approaching burn season in Zambia. This is the ever so fun season where the whole nation is set on fire.  It is tradition to burn all the elephant grass that lines the road ways and fields. There are so many fires that the air becomes heavy with smoke and ash; an asthmatics death trap. Walking down the road with a wall of fire on either side of you can almost send you running to a church to avoid an eternity of fire and brimstone. It can also make you walk a lot faster.  The reasoning behind this fiery inferno is unclear. Some say they burn it to catch the field mice, some say to reduce the amount of snakes, others say they do it because their parents did and they are just too lazy to cut it down.  Ill I know is that they are slowing poisoning the soil; leaching toxins into the ground and making the overall landscape ugly.

May 28th

Failed home remedy number one. Jane and I had the brilliant idea to deep condition our hair from a homemade recipe. A recipe that we made up at home. We bought some bananas off the street, picked some avocados off the ground, and mashed it all up with some oil olive, egg, and sugar. With many fits of laughter we loaded our hair with the sticky, chunky, gooey, slimy concoction. Chunks of avocado and banana kept sliding between our fingers and off of our heads into the freshly cleaned tub with surprisingly loud splatting noises.  Looking in the mirror it appeared as though someone had emptied the contents of their stomach on my head. It may have all work out according to plan if the water in Jane’s apartment hadn’t suddenly stopped working and if it hadn’t stopped working for 5 hours. By the 3^rd hour the smell of warm egg and rotting bananas was being to make me nauseous. By the 4^th hour the mixture had melted and started to run down my neck and face in a greenish oily slime, and the white plastic bag tied around my head trying to keep the “conditioner” off Jane’s apartment had turned a concerning shade of green and had become to radiate an alarming amount of heat. So being resourcefully Zambians we tied scarves around ours heads and set off down the street to the Peace Corps Headquarters. Fifteen minutes later we arrive at the house jumped into the shower only to find that our homemade conditioner did not only fail to condition our hair it had seemed to make our hair even drier and dirtier than when we started. It took three shampoos and two intense combings to get at least the big chunks of banana and avocado out of my hair. Every time I turn my head I get the feeling that I am surrounded by rotting bananas. On the upside I learned that walking down the street with a huge scarf covering your head in Zambia can earn you the title of African Goddess by some of the locals.  

May 27th

Jane and I ventured to the city market and the Sunday market today. The two markets could not have been more different. The Sunday market has mainly artwork such as bowls, masks, painting, jewelry, and wooden carvings. This is where I had my first experience bartering and I wound up buying a painting that I had no intention of buying. I learned my lesson though and I’ll be ready next time! The city market is similar to the market in Solwezi but on steroids. There are rows and rows of venders selling fish; dried fish, fresh fish, old fish, smelly fish. Rows of people selling all kinds of meat and to be honest most of the time I don’t even know what kind of meat it was and I was a little afraid to ask. People selling shoes; a lot of left shoes, I am not so sure what you do if you want a pair of shoes. People selling cosmetics, electronics, vegetables, drinks, animals; you name it chances are you can find it there. I didn’t get conned into buying anything at this market though.

May 26th

Today was a day of firsts; not that that is out of the ordinary in Zambia since everything I am doing is new to me. Today I took my first bus ride in Zambia. On a whim I decided to head down to Lusaka with Jane to get a tour of the capital from a resident. The bus ride was uneventful although I did get charged to pee in the bathroom. I feel as though if I am going to pay to use the bathroom you could at least supply a toilet seat and some toilet paper, but maybe my standards are still too high. 

I also had my first real ice cream in Zambia; it was heavenly. And I had my first exposure to Ethiopian food. Six of us went to this little hole in the wall restaurant; a place that everyone knew of but had no idea where it was. The address online is “on the road going to town, near the Christian music store, but behind the lodge;” just to make sure that I am getting my point across that is the address not directions. We are seated in the restaurant and after informing the waiter that it is our first time here, she pulls the menus from our hands and rushes away to find the owner. She soon returns with this large beautiful Ethiopian woman wearing a floor length leopard print gown/moo moo. She coos at us in broken English then disappears returning an hour later with the largest plate of food that I have ever seen. The enormous platter in lined with bread that more resembles and thin spongy pancake. On top of the pancake sponge are mounds of ten different dishes ranging from beef to chickpeas to curries veggies. Ethiopian food like the Zambian nshema is to be eaten with your hands; the sponge like bread is used as the utensil to scoop up the different dishes. It was not all that sanitary but it was extremely delicious. I did become a little nervous when the owner came back round after she noticed that we had stopped eating. We explained to her that we were full, but she replied “No it is ok, you can keep eating it will all come right out of you anyways! Eat, eat, eat more!” I am happy to report that no such issues have arisen yet. 

May 25th

So today had to be one of the most amazing days of my life. I got to spend the day with our closest relatives, chimpanzees. Little fin fact: Chimpanzees and humans share 98.9% of the same DNA. The chimp walk took place in the morning. The owner/ founder, a little 80 something year old lady walking with a cane, greeted us in the morning with a huge smile and led us to a small room where we put on coveralls, took off all jewelry, clips, and anything shiny, and loaded our pockets with cookies, biscuits, and peanuts. We had to quickly sign our life way stating that if the chimps were to beat us up, pulled our hair, or bit off our fingers we could not sue them. Luckily I still have all my fingers and I am only sporting the normal amount of bruises typical with being a Bendroth.

The chimp walk took about two hours. You are placed in an enclosed area, about 5 acres, with 6 chimps. You can feed them, hug them, play with them, kiss them, and tickle them. The chimps are truly like little humans with bigger mouths and longer arms. They smile, and play, and babysit; they are on birth control, they take the same antibiotics that humans do, they use tools, and they can show emotion. One of the chimps named Cindy, had a thing for ground nuts (peanuts); she would search through your pockets throwing the cookies on the ground to get to the ground nuts. When she found one she would grin and crack it open with her teeth eat the nut and throw away the shell. I discovered that if I held onto the ground nuts I could ask her for a kiss. She would stick out her lips then stick out her hand waiting for her reward. Yes I kissed a chimp ok!

The fact that these chimps are so interactive with humans is somewhat controversial but the revenue generated from the chimp walk helps keep the facility running. The rest of the chimpanzees living in Chimfunshi are considered wild since their only interaction with humans is during feeding. The place is huge! It is home to more the 150 chimpanzees. Over all wicked awesome day!

May 24th

Myself and two other girls caught a ride to the Chimpanzee refuge today (the name I cannot spell and you cannot pronounce so I am not even going to try). It is 17km off of the main road so it was lucky that we were in a Peace Corps cruiser and the driver was easily guilted into driving us the whole way. At first glance the chimp place was not much to look at. It was composed of a circular compound with bunk houses off to each side, there was the mess tent, and showers, but no physical evidence that this was the second largest chimpanzee refuge in the world second to Jane Goodall’s in Tanzania. We arrived too late in the day to do the chimp walk so we will do it first thing in the morning. I plan to spend the evening drinking wine (yes again mom), exploring the compound, and hanging out with my new set of Peace Corps friends. 

May 23rd

I spent today at the Peace Corps house in Solwezi. My plan was to get a ride back to the village with the Peace Corps cruiser, but I received an invitation to go to a chimpanzee refuge tomorrow so I decided to chill. What a tough choice! The Peace Corps house is set up very much like a hostel. There are dorm rooms with bunk beds, there is a bar, a common area, a kitchen, a bathroom, a shower, and a whole bunch for crazy ass people. When I say crazy I do not mean this in a negative way; I mean who am I to be calling the kettle black? I am pretty sure that my sanity has been called into question more than once. Although there is rumor of a volunteer killing and skinning and eating a cat in his village, which may categorize him as off his rocker. But anyways I spent the evening drink wine, eating a large family style dinner, hanging out with some fellow Americans, and inhaling more than my share of second hand smoke. I think that somewhere in the Peace Corps hand book it states that in order to be successful Peace Corps volunteer you have to pick up chain smoking.

I cannot recall if I mentioned this before but the electricity in Solwezi can be somewhat unreliable. It has a tendency to turn off right when you need it the most. For example when you are making dinner and just put something in the oven or when you just get put shampoo in your hair in the shower or when you have just taken a dump; all of these are really inopportune times to have the power fail and therefore the water fail. For all of you who have experienced a blackout and I know 99.9% of you have it is almost like a little MacIver is born in all of us. We fine the most ridiculous/creative ways of dealing with our problems and it almost always involves duct tape. Blackouts (the power kind not the alcohol induced kind) can also add a sense of misery to any evening; with everyone walking around the house with headlamps blaring you never know who you are looking at due the bright beacon of light shining from their forehead which leaves you blinded long after their light is gone. Each person is trying to out blind the other, most of the time by accident; but I have come to the realization that headlamps are not meant for socializing it is more on an independent sport.

May 22nd

So another night spent with my rodent friends. I cannot get over how noisy they are. I question whether they are playing racket ball above my head or not.  I suppose all living creatures need their stress relief and these little brats like to do it at 0300 in the morning right above my head.

The house that I stay in Solwezi although plentiful in the rodent department is somewhat lacking in the kitchen area. For example there is a refrigerator that is almost always empty, there is a microwave, a toaster and a two burner hot plate placed on top of an old cast iron oven.  Also crammed into this 10 by 10 room are a washer and drier. All of these things I do consider to be a luxury compared to the village, but when trying to cook a meal to feed on average five people with three girls in the kitchen and only one electrical outlet things can get a bit cramped. I would like to have a word with the electrician who worked on this house. Putting only one electrical socket in each room especially the kitchen is not the most intuitive thing to do. The light switches for some bedrooms are located in the adjacent bedroom or ten feet down the hall or there no light switch at all and the light stays on until the bulb burns out. Also the fact that the bathtub nozzles electrocute you every time you turn on and off the water furthers my skepticism of the electrician. But to be honest there most likely was never an electrician just somebody with a how to book.

Ellen and I made apple crisp in the microwave. Yes it can be done and it was delicious.  I have taken to making pancakes from scratch; and from scratch I mean I just dump some ingredients in a bowl and pray that it is edible. Today was the third day that I have made the pancakes and so far it has been a success. No one seems to have died from them nor has anyone become gravely ill. I like to mark my success with low standards; good pancakes because no one died.

Zambian Pancakes:

1.5 cup flour

2 T sugar

1T baking powder

1T cinnamon

½ c oil

1 c water (Maybe more or less. Add enough to make it pancake batter consistency)

Pinch of salt

Disclaimer: I have never actually measured anything so in all honesty that could be totally wrong. If anyone is brave enough to try it let me know how it turns out.