Mutozi- volunteering at the hospital

Cris Ballonoff
May 24, 2022
4 min read

5/17/2022

Day #62 3 days of volunteering at Mwandi Hospital - tried to edit out all medical jargon.

Mwandi, Zambia

MUTOZI “good afternoon- Lozi language”

It’s almost 10 pm and kids are asleep at the ultimate comfortable home of Simba House- where we are staying in Mwandi, Zambia for the week. Ari is reading after a busy and productive day as our token travel agent as well as OVC volunteer serving lunch and laughter to the kids, including ours. He somehow managed to secure the last accommodation and car rental reservations for our final destination of sabbatical- FRANCE!!! I was once again the ultimate procrastinator with my planning of the Europe bike trip so he jumped in energetically as my knight in cute shorts, tennis shoes and a Denver sweet cow ice cream t-shirt (who needs shiny metal armor anyway!!!?) . So as of now we have a flight to Paris, 3 nights Airbnb there in Bastille, a car rental leaving Paris for Normandy and another sweet ocean front Airbnb in Normandy (Deauville area) and then a car rental drop off from our starting place (Tours) in the Loire Valley bike trip!!! I’m so excited!!!

Now back to Mwandi- day two volunteering/ observing at Mwandi Medical hospital.

Yesterday was a nice and quick orientation to the hospital grounds by Lawrence, Dr. Fred Mukoka (only doctor!) , Inuto and Gwendoline at the cervical cancer screening area. The hospital was busy that day with a lot of obgyn so Dr. Fred had some work for me! I was able to round on some patients and document some good old SOAP notes in paper! That took me back to my internship era in 2003- the last time paper notes were really a thing at St. Joes. Post operative patients, incomplete miscarriage patients, a possible ectopic patient without blood pregnancy levels at the lab, heavy bleeding, and some high risk pregnancy patients were all rounded on and discussed with the student clinical officers from Lusaka. I really enjoyed working with Ocrin, Joseph and Rachel and we all learned and laughed a lot. I hopefully helped some but due to the major differences in our systems it was a challenge- add a major language barrier let alone scant cultural competency here I was sorta lost. Oh yeah and masks don't help either! Touring the cervical cancer screening area was very interesting as well. Gwendoline reviewed the process here that entails a no microscope colposcopy every 2-3 years depending on HIV status. If the cervix appeared precancerous then scheduled for excision (LEEP) in same area by Dr. Fred with a 6 month follow up. Excision pathology typically takes 4-6 months anyway unless the patient is willing to pay about $30 (Zambian Kwacha 500); which is steep. All patients carry around a small notebook regarding their medical care.

On day #1 I realized around 2:30 pm that I better sneak away for lunch at Simba or "hangry" would be my middle name. I had a quiet, peaceful, and yes prepared meal outside on the patio right on the Zambezi river! Irene and Kelvin really know how to spoil the guests here! I slammed my instant coffee and savored the small slice of homemade chocolate cake with powdered sugar sprinkled on top and headed back to the hospital. More of the above, checked on morning patients as well as tried to figure out the work flow and processes on the maternity ward. At 6:00 pm I realized that I probably should not walk the .5 mile to home in the dark so snuck off again to be greeted by Ari on the walk- again my smiling knight in the cute KUHL shorts, tennis shoes and sweet cow t-shirt.

Day 2 was more of the same with rounding, occasional debriefs with Dr. Fred but mostly working/ trying to figure out the workflows with the clinical officers in training from Lusaka. I spearheaded my goal of understanding the maternity ward once again- but failed. I saw multiple outpatients with and for Dr. Fred. Patients wait for hours on a small bench at the entrance to the dimly lit small hospital (until he has time to address them in the doctor office nearby. His office consists of a table and a small exam table but scant “essentials” like sink, lights, otoscope, etc. The other essential missing were easy access to sinks for hand washing and drying. I brought my own Purell. A small success did include another visit to the maternity ward. In a nutshell, higher risk pregnancy patients come to the hospital from their outside villages about 1 month before their estimated due date and live behind the hospital in a small shelter. Daily they report to the ward for routine vitals- sort of an assembly line of 10 or so getting blood pressure, temperatures and pulse. Then they head to the back room for a student to measure the uterus for growth, position of the head and fetal heart tones with a metal fetoscope.

Oh boy- now it’s past 11 pm and Ari is snoring soundly. I best jump to bed to finish my last day in Mwandi strong- starting with a 6:30 run/walk! Then we are taking the kids to the daily 8 am chapel at the hospital. I’m not sure they have ever been to church? They have never been to my Presbyterian church in Tacoma- strange to think I went SO much as a child and now no one in the family goes. This trip has opened our eyes to so much! We continue to discuss precious questions about everything from religion, biology, compassion, and humanity. As we go we hopefully will pass less judgement and more compassion. Travel makes us grow and become more human for sure. The kids also really want me to serve lunch at the OVC tomorrow and Ari wants to show me the real/ off campus neighborhoods and the true Zambezi (I guess Simba is on a smaller tributary) with a sunset walk/run.