A week after I returned I'm finally getting a start on this. I'm going to write these posts as if I were blogging ever few days, my intent is both to create a record for myself and to hopefully satisfy the curiosity of some readers that might be wonder what it is like to be at a medical mission.
I arrived in Zambia dead tired, I don't sleep well on planes and have been traveling more than 24 hours. This isn't helped by having flown out on a 3 A.M. flight from Detroit.
Most of my fellow travelers are white, which disappointments me a little even if it doesn't surprise me. Zambia is quite poor, $1,600 per capita according to the CIA World Factbook, so it's probably unlikely many natives would be flying to Johannesburg. We claim to be tourists at the customs station, according to one of the doctors accompanying us this makes it less likely for us to be hassled. We brought a large amount of medical supplies with us, we have two checked bags each most of them maxed out at 50 pounds, and we'd rather not have to wait while they're searched. There are five of us and 10 bags total (plus carry-ons), since the two ladies with us aren't carrying any of it this means the rest of us have a fair amount of hauling to do. Incidentally, hauling this baggage taught me why New York airports are so disliked, we have to transfer airports meaning we get to haul all these bags onto a city bus and walk them over to another bag check in. In Zambia, however, e get in without problems and are picked up by the clinic director.
Livingstone appears fairly modern, if poor. We go to a restaurant and do some shopping since we won't be able to do much of either in Zimba. Shoprite turns out to be a fully modern store and we're able to get some essentials like the local beer, Mosi, and tonic water.
It's about an hour drive to Zimba. I'm informed on the way over that the roads are much better than the last time, apparently political control of the southern province has changed which means that fixing the road has become a priority. It is newly paved, but only two lanes. Passing the large, slow trucks seems a bit dangerous to me, but it appears to be standard practice here.
Zimba itself is marked by some low brick buildings along the road. It looks a bit different from Livingstone, there are a lot more people walking along the roads as well as several brown dogs that seem to be permanent fixtures of the area. There is regular bus service, we see a few bus shelters here and they seem to pick up people fairly regularly. I'm unsure if some of these are local trips or if they are all inter-city.
The first thing we do on arrival is go to the clinic to unload our supplies. We are somewhat shocked to see how many people are waiting for us. The clinic has a front porch that was designed to give people that had to travel far a place to stay. They bring with them food and blankets so that they can stay until they are seen. This makes follow-up potentially difficult, later in the trip we have to give money to a woman who we had to monitor for complications because she ran out of food. We learn some of these patients have come from as far as 1000 km away, which with the limited good roads in Zambia could take a very long time to travel (I never get a good estimate).
This picture is from near the end of our stay when the porch is almost entirely cleared out, it was much more crowded on the first day. Patients cook on small charcoal grills either on the ledge or beside the porch. Some lay out blankets or cardboard to sleep on.
While we hadn't intended to see any patients, we learn that we already have an urgent case. A child had his eye badly injured by a stick (we hear this a lot, while injuries with a stick are common it also seems to be the generic response when someone doesn't really want to tell us what happened). We examine the child and schedule him tentatively for surgery the next day. Unfortunately, an operation on a child generally requires anesthesia and we don't have the capability to administer it ourselves. When we find out the next day that we won't be able to get an anesthesiologist during our stay we are forced to refer them to Lusaka, the nearest place with real ophthalmological facilities.
This why it is so important that International Vision Volunteers is in Zambia. There are very, very few native ophthalmologists in the country. Health care has become much better in Africa over the past 20 or 30 years, however, while they can provide decent primary care they are severely lacking in specialties such as ophthalmology. We see a tragic amount of preventable blindness over the course of the trip. Most of the people we see would have no access to this kind of treatment if it weren't for us, though we do see a few patients that were referred from Lusaka or the handful of ophthalmologists in other parts of the country. Though we also hear that we're cheaper, so some patients come for that reason.
After unpacking everything and seeing this patient we head over to the guest house, which is almost next door. Both the clinic and the guesthouse were built by Americans so we find it very comfortable. A major luxury resulting from this is that we can drink the water, we have well water that is treated well enough that we can drink it. We also have a cook that was trained to cook American cuisine by the couple that had overseen the construction of the house and the clinic, we feel more or less at home, aside from the frequent power outages, lack of internet access, lack of TV, and the large number of insects that find their way into the house (my girlfriend, and I admit myself, are particularly displeased by the 3 inch spiders that we share a room with).