Englannin kurssi on ohi joten viimeisen blogitekstin kirjoitamme Suomeksi. Tultiin Suomeen jo sunnuntaina, mutta kerromme vielä viimeisistä viikoistamme Sambiassa.

Harjoittelun viimeiset kaksi viikkoa oltiin synnytysosastolla ja pari päivää aliravitsemusyksikössä. Synnärillä oli yli 20 opiskelijaa kolmesta eri koulusta samaan aikaan meidän kanssa joten kunnollista opiskelijaohjausta oli vaikea saada. Kaikki olettivat että me osataan auttaa vauvoja maailmaan vaikka kukaan ei ollut kertonut mitä pitäisi tehdä. Meillä ei ollut myöskään teoriatietoa odottavan äidin ja vauvan hoidosta koska opiskellaan niitä asioita koulussa vasta ensi syksynä. Ensimmäiset synnytyksessä avustamiset tehtiin yhdessä paikallisten opiskelijoiden kanssa jotka auttoivat ja neuvoivat. Oli mukavaa nähdä kun uusia pieniä ihmisiä syntyi maailmaan. Molemmat saivat kätilöidä yhdet lapset maailmaan lähes omatoimisesti. Alkuun vähän jännitti mutta kaikki meni hyvin ja kätilö oli lähellä koko ajan valvomassa tilannetta. Tehtiin synnärillä myös yksi yövuoro jossa päästiin seuraamaan keisarinleikkausta. Se oli hyvä oppimiskokemus koska yövuorossa ei ollut muita opiskelijoita.

Kotona taas!

opiskelijoita. Surullisia hetkiäkin osastolla oli kun joskus vauvoja syntyi kuolleena tai kuoli heti syntymän jälkeen. Kaiken kaikkiaan harjoittelu synnytysosastolla oli mahtava kokemus jollaista ei meillä ole mahdollista Suomessa kokea.

Viimeiset pari päivää kävimme tutustumassa aliravitsemusyksikköön. Suurin osa Sambialaisista elää alle dollarilla päivässä, eli köyhiä perheitä on paljon. Tästä johtuen Sambiassa on paljon lapsia jotka kärsivät aliravitsemuksesta. Perheissä voi olla paljon lapsia jolloin kaikille ei riitä ruokaa ja yleensä nuorimmille lapsille jää vähiten. Aliravitsemuksen syynä voi olla myös liian yksipuolinen ruokavalio. Etenkin maaseudulla suurin osa naisista on kouluttamattomia. He menevät naimisiin ja saavat lapsia jo teini-ikäisenä joten heillä ei ole aina tarvittavaa tietoa kuinka lapsia pitäisi hoitaa. Sambiassa miehen tehtävä on elättää perhe ja jos miehellä ei ole töitä joutuu perhe turvautumaan sukulaisten apuun.

Osastolla lapset saattoivat olla muutamia viikkojakin ja etenivat vaihe vaiheelta 1. solusta, jossa oli kaikki ripulista kärsivät ja akuuteimmassa vaiheessa olevat lapset, viimeiseen 4. soluun, josta pääsivat sitten kotiutumaan. Äidit olivat osastolla koko ajan hoitamassa ja syöttämässä lapsia. Lapsille annettiin ravintoaineita sisältävää vellimäistä ruokaa syötettämällä tai nenämahaletkulla tai annettiin kiinteätä pähkinävalmistettä.

Kolme kuukautta meni loppujen lopuksi aika nopeasti ja kotia tultiin monta kokemusta rikkaampana. Ikävä jää uusia ystäviä, joihin tutustuimme Sambiassa sekä afrikkalaista elämänasennetta. Kiva oli tula Suomeenkin ja tavata kaikki tutut ihmiset. Joku päivä vielä palataan Sambiaan:) Tämä blogin päätämme nyt tähän. Seuraavaa reissua odotellessa. Kiitoksia mielenkiinnostanne!:)

On Mayday we went to Livingstone for a week. We stayed in Falty Towers which is a backpakers-hostel. It was cozy but food there wasn`t very good but was cheap, so it didn`t really bother us and there were lot of nice restaurants just outside.

On Sunday we went to see the Victoria falls world heritage side. The Falls' local name is Mosi-oa-Tunya which means the smoke that thunders and that is what it is like. We walk around the national park and we got totally soaked because it was like beeing in shower. After that we went abseiling which was very nice. Paula also did a gorge swing.

Next day in afternoon we went to sunset ”booze” cruise on river Zambezi. It took 2,5 hours and we could drink as much as we wanted. We also see couple animals :) After that we went to see how is Livingstone nightlife.

Tuesday morning we went quad biking and we had lot of fun! We got very muddy because last night it was raining. After that we went to the bridge to do some extreme activities. First we did a slide over the rapids, then we did 111m bungee jumps from the bridge. It was very scary but felt great, it felt like we got the wings for 30 seconds (or how Pippa says it was like being a human jojo). We think that the only mistake was to do it when we were hangower, because Pippa felt very sick after the jump.

We also went for a helicopter flight over the falls. The falls looked fantastic from helicopter. Last afternoon we also went to walk with lions.

Allover we had great time in Livingstone and it was shame that we had to come back already on thursday. We had some proplems with visas so we had to go the immigration office on Friday. But it's all sorted out now and we dont have worry about anything here anymore.

And aswers to your questions:

The best experiences here have been the trip to Livingstone, quad biking and a bungee jump.

We haven't been anywhere else than Malawi and we are not planning other trips outside the country because we haven't had enough time.

Next two weeks we'll be in labour ward and we'll tell about it next time.

We were two weeks in neonatal intesive care unit (NICU). There was much very small premature babies, smallest ones weihgted only a half kilo. This was the first ward where they use a alcohol rub a lot. They had lot of hospital equipments like incubators, infusion pump and rescution tables but some of thems were broken and they didn`t have spare parts to fix them. They couldn`t also use infusion pumps at all because they didn`t have proper giving sets.

The first morning wasn`t very nice, because one baby stop breathing and nurses tried to save him but he didn`t survive. It was very hard to see a little baby dying and we almost cryed. Overall it was very nice to work with tiny little babies, they were so cute. We would have wanted to take one pocket size baby with us to Finland. :) There were babies whose mother were died and one baby who was dumped and we were like the foster moms to them for two weeks.

The hospital didn`t provide nappies or clothes for the babies. If parents didn`t have money to buy them or the mom wasn`t there to taking care of the baby, babies were just wrabbed in the blanked without clothes and a nappy. Mothers came to the ward every two or three hours to feed and take care of the babies and we took care of the babies whose mothers were sick or died. Fathers weren't allowed to come to the ward. We learnt to cupfeed babies because they don't recommend to use feeding bottles because of the hygienic reasons.

There were lot of hiv-positive babies because hiv-mothers have much bigger change to have prematured babies. Everyday at least one baby died. Most of the babies didn't have good change to survive.

Next we are going to labour ward. We have only two weeks left of our practical placement here and soon we will be coming back home.:)

Two weeks has gone very quigly and haven`t had time to write our blog before. After coming back from Malawi we vent to the cancer diseses hospital. It was very nice to notice that cancer diseases hospital was very modern, clean and the nurses there knew what they were doing. Tutoring there was much better than at UTH. Hospital was built in 2007 and it`s only cancer diseases hospital in Zambia. Before that Zambians had to go to South-Africa or somewhere else to get the radiation. Hospital is only for outpatients and the patients who are referred from other hopitals come to see the doctor who plans the treatment for the cancer and then the patients start to come to the hospital to get the treatment like chemotherapy, brachytherapy and radiation. If we had known that the hospital was so good we would have stayed there longer than week, but we had planned to go to Kafue next week.

We went toKafue, which is village near Lusaka, with group of locan nursings students. Pippa stayed in centre of Kafue with half of the group and she was working at Nangonwe klinic. They vaccinated babies, weight babies and they attented materity training classes and for one day they went to rural area to same things for those who are not able to come to the clinic. Paula went to Shanyaya with rest of the group to work at very small rural clinic. There was only one nurse and midwife working there and no doctors at all. Nurse screened all the patients and prescriped medicen. Most of the patients had malaria or diarrhea. On Friday nurse didn't show up so student were working there own their own.

We were staying with local student so all week we only eat sambian food for example nsima, potato and pumpkin leaves, kapentas which are small dried fishes, catepillars, fried chicken and beef and very salty boiled wegetables. There we a lot of huge cockroaches and lizards. And in the place Paula was staying there weren't running water in the house they had to carry the water from the well.The outdoor toilet was only hole in the ground and the ”shower” was a hay hut. Most the people in that village lived without electricity in the clave huts.

On Saturday Pippa and Anja came to Paula and rest of the croup up from Shanyanya and the children there went crazy when they saw three white girsl. They wanted us to take photos of them and touch our hair and skin. It's not very common to see whites in the very rural area. We think that they were really cute.

Somebody asked about the language proplems. I think that at the beginning we had more language proplems than we have now. The most difficult thing here is to speak professional english. Our medical vocabulary isn't that good but it's getting better and we have learned a lot. On the freetime it's much easier to speak English and also speaking with people who we know well is easier because the accent here is quite strong and sometimes when we meet new people it takes little while to get use to her/his accent.

We miss home but because we have bee very busy here so we have't had time to think home so much. Sometimes hits very bad but luckily we have phones and we go to the internet cafe couple times a week. At the beginning it was worse than it's now. We have already been here 7 weeks and it has gone quickly so know that we will be back home soon anyway.

Now we have finnished our practical placement in long term care. This week we started working at neonatal ICU more about that next week.

6.4.2009

Back home from Malawi now. Third Finnish student Anja (or Anna as we call her here, because her name means poo in Nyanja which is the most spoken tribe language in Lusaka area) from Helsinki came here two week ago and we went Malawi with her. Anna had to do research for her final project but for us it was just holiday!

We went there by bus which was meant to leave at 10 o’clock but finally it left 4 hours late, because busses here won’t leave until they are totally crowded with people and stuff. And that’s how our “lovely” bus trip to Lilongwe started. African music was playing very loud all of the way to Lilongwe and spaces were very tight so it wasn’t really possible to sleep. It took 14 hours to get there and we arrived in Lilongwe bus station at two in the morning. Once we got there we didn’t have any local money and our phones stopped working after crossing the border, but luckily one nice lady borrowed her phone and we could call the lift to student hostel where we were staying.

We stayed in Lilongwe for three nights. On Friday we went to zoo and shopping in town. Saturday morning we left for Lake Malawi. Bus trip took almost twice as long as we expected. Finally we arrived at Kande beach. It was ours paradise! The water was clear blue and place was very beautiful. We hired a pedal boat and a canoe and we went to the island to have an adventure. On Sunday we went horse riding with our new South-African friends and in the evening we got drunk with them. 

Everything comes to and end, so did our trip in Kande beach. On Tuesday afternoon we headed for MzooZooZoo, which is back packers hostel in the town Mzuzu. We stayed there night. Our new South-African friends were there too. We had a fun time and in the morning we had to go back to Lilongwe.

The student hostel where we were staying was quite different and we were staying in the same corridor with the local students. They played music starting at six a.m. in the morning and ending no earlier than at twelve.

Early in the morning on Friday we started our journey back to Lusaka. Surprisingly the bus left only 5 minutes late and we were back to Lusaka quite early in the evening. We had some problems at the border and we had to bribe the passport control officer to let us out of Malawi.

Back to reality. On Monday we started a practice in the cancer disease hospital which we write about more in our next blog.

If you want to read more about zambia, here is link to Anja's blog.

http://anjasmith.wordpress.com

19.3.2009 Thursday

This week we have been in casualty. We have seen lot of people who have been in accidents or patients who are very ill and they have come to casualty with referall from local clinics. For example we have seen lot of fractures, burned babies, different kind of tumours and many other severe cases.

It`s been shocking to see this kind of patients, becouse they are very ill and most of them are suffering from horrible pain. We haven`t seen any painkillers been given to patients. We think that the most hardest thing is to see babies and children suffering.

In the morning there are lots of patients waiting for to see the doctor and more and more patients come during the day. Doctors are very effective and they handle one patient in just few minutes. Nurses do simple stitching and we also had change to try it once. All fractures will be plastered first and if it doesn`t heal properly it might be operated, so they make plenty of casts in the casualty.

Last weekend we went to reptile zoo. It was quite far from centre of Lusaka. We had to take a cab and it took almost an hour to get there, because the road was very narrow and pumpy. In the zoo there were lot of crocodiles, snakes and tortoises. Little crocs were very tiny, only half metre long and the huge one`s were at least four meters long and very fat.

Things that are better here than in Finland: We think that people here enjoy their lives and don`t take stress about little things. Zambians are also very generous, we have been invited for dinner even though many people don`t have lot of money here.

In healtcare the staff have to improvized often, because here they don`t have enough hospital equipments. For example they use every cardboard for writing something on, empty infusion bags are used as urinebags and they also make a sling using piece of infusion bag and bandage. We think it`s ekologic and economic. Recycling and reusing is thing that we could learn to do in Finland too.

Next week we are going to Malawi and when we come back to Lusaka we will tell you more about our trip to Lilongwe!

Thursday 12.3.2009

We have been here now almost for two weeks. The weather has been very warm this week. On Monday we had a day off and we went to the Swedish school with Swedes. There was a nice swimming pool and we spent whole day sunbathing there. Suprisely we also got burnt :)

On Tuesday we started practise in male medical ward. It`s almost same than female medical ward. We do lots of same things like dump dusting, bed making and TPR (temperature, pulse and respiration). We have to do everything by ourselves, because there is no other students at the moment.

If patiens` relatives dont have money to buy diapers or other equipment, they dont get them from the hospital. For example a bed-ridden-patient might be swimming in pee if the relatives don`t wash them. Nurses won`t do any basic nursing.

Medical treatment is here very diffrent than in Finland. There isn`t much drugs, and nurses can`t give any medicine like painkillers when it`s needed. For example yesterday one patient was screaming in pain and we asked if we could give him painkillers, but nurse said that they can`t give any extra painkillers (not even paracetamol) without doctors permission. Sometimes it feels fustrating that we can`t do anything for patients.

Patients are very ill here, and every day somebody dies, some days even a few. In Wednesday morning when we went to the ward there was still a body of the man who died day after in treatment room. Nobody picked the body untill midday. Here the dead bodies will be tied up and wrabbed in the sheets and treating the body is not as respectfull as it is in Finland.

Last weekend we went out with one local girl in the club nearby the hostel. The club is in medical campus and there were lot of local medical students. People there were very nice and they came to talk to us a lot. It was just nice to have a couple of beers and relax. Music was very loud and people were dancing like mad. People here drink a lot unlike we thought that they would just have few drinks and still dance a lot. It's quite funny actually because everyone is always asking whether we drink beer and have tasted the local beers Mosa and Castle yet, even a sister-in-charge in female medical ward asked if we drink beer. One beer in the bar cost about 1€, so it's much cheaper than in Finland and we like it here!:)

Here at the hostel has been lot of water breaks during this week. We don't know why, but it's bit annoying sometimes if you can't have shower or cook when you want to.

Next week we`ll go to casualty and next time we will tell about the week there!

Here we are now!

Wednesday 4.3.2009

We arrived here on Monday. The first time when we really realized that we are in Africa was when we felt the very warm breeze of wind when we stepped out the plane. There was our hostels housekeeper receiving us with the name tags at the airport. It was good to have somebody there because we were quite sure that there wouldn´t be anyone picking us up.

Then we got to the student hostel and it was quite a shock to us to find out that the hostel was in pretty bad shape and we didn’t get own rooms. So we’ll be living next three moths very closely. We are sharing the flat with the other exchange student from Sweden and Canada. Flat is in that kind of shape that we haven’t been used to for example there is no locks in toilet, only cold water is running in the showers, there are big spiders and cockroaches in the kitchen, there are no glasses in the windows in the kitchen and bath room and everything looks like it’s need some fixing. After first day we started to get use to live in the hostel and we thought that it is like living in a summer cottage, we got everything necessary but nothing extra.

On the second day we planned our schedule for practical placements. Local student took us to have a look around the school and hospital. We went through almost all wards in the hospital and it was very different from the Finnish hospitals. Everything looked very old and shappy and the wards smell like pee.

People here have been very warm and welcomed us to Zambia very friendly. Zambians are very easy-going and relax people; way of life here is totally different than Finnish busy lifestyle. Nurses don’t seem to be in hurry at all and also all other workers take their time to do their jobs.

Today we started our practical placement in female medical ward. At the beginning of the day was a morning report aside of the patient’s beds just like doctor’s round then we prayed and started dump dusting and straights sheets. They gave us one pair of gloves and we used them almost all morning. Nurses didn`t do basic nursing. Patients’ relatives help them whit washing etc. 10 to 10.30 we took a tea break. After that was a doctor’s round. Doctors were Germany and Arabian. They were very nice and they told us patients conditions and illnesses. 12.30 to 14.00 we had a lunch break. Rest of the day we measured temperatures, pulse, respiration and blood pressure.

We have tasted different foods here. Shops are quite far, so we bought food in Tuesday-market. Local people eat a lot of nsima, which is porridge type white side dish made of maize. It`s very mild tasting and it should be eating by fingers. Today Paula was eating fried caterpillars and it didn`t taste bad but not good either. Food here is different and mild tasting.

These first days have been interesting and it’s going to take some time to get use to this new culture, but have had great time so far. Next week we tell you more about our adventures in Zambia!