Friday, November 30, 2012

Ultravivid: a tour of Kalukembe

We just came from a week at Kalukembe and are back at CEML doing consults and operating. Our time at Kalukembe solidified our interest in returning long term (but still plan on going to Zambia in January to look at a few more options). We wanted to give you a little tour, since you'll be here with us (whether physically or spiritually) if we return. With the support you've been sending we were able to purchase a new camera (to replace the stolen one) and since Priscila didn't know how to turn off the "super vivid" setting... that's what you're getting! That is just fine: after the rains everything is intensely sweet and green and the images actually do a little justice to the scenery. Enjoy!


Walking from the living quarters to the hospital through a beautiful path under shady savannah trees. 
The patient family housing, many patients come from great distances, stay for months, and are required to feed themselves, hence a family member needs to come along to care for them. 

The banco de urgencia (emergency room) is a little bit of a joke for Daniel: it is a small room off the side of women's ward with a desk and a bed, really nothing else. On one door the sign actually says "gynecology" ... but Priscila has only ever walked passed it. 

Main hospital entrance/drive: in 1994 the hospital was ransacked by government forces, everything from meds to bedding and curtains were stolen, other things were destroyed. The government, however, has just committed $30million dollars to rehabilitating and expanding this 300+bed hospital, and they are looking for doctors to staff it. 

To your left as you walk towards the hospital: the operating theaters. Notice the defunct solar panels and water tank. The water pump was broken while we were there so the pre-op scrubbing was done with rainwater, murky with local red mud. 

Casting room, with a fresh white coat of paint.

Some of the operating theater staff: center is Paulo, head of the OR: a surgical tech of amazing skill, authority, and patience. When we aren't there is he pretty much it for major surgical interventions and does other minor surgical procedures. He does everything from cesarian hysterectomies to hernia repairs. We enjoy working with him and appreciate his tutelage.


This is a crying shame: can you help with this? This is the surgical library. Please let us know if you have any GOOD surgical books you'd be interested in donating. 

Priscila continuing her vaginal surgery work... here we actually had a lovely anterior/cystocele repair (refreshing to mix and mingle the fistulas and hysterectomies with these types of procedures). Notice the size 8 gloves. We don't have much options for glove sizes, you use whatcha got.  

If you were to exit the operating rooms, directly in front you'd see Maternity or ("L&D" for my obgyn friends). Family members are waiting outside for visiting hours.  

A cute baby wrapped in colorful winter clothing. Beatrice is one of the new senior nurses/midwives who I respect and really enjoy working with. She is competent, diligent and responsible. Awesome. 

Wondering what daniel is doing on maternity? Actually doing a consult on a labor bed - he is a prized consultant and so since the outpatient offices were closed he came up to do his consult and ultrasound on maternity. 

The nursing students at Kalukembe are one of our great joys. Here they are curiously peeking over to a police-reenactment of a stolen baby incident. During our time there the dreadful thing did actually happen: a desperate woman, pretending to be a young girl's relative took her newborn to "change the diaper" and never returned. There was a huge uproar, the culprit (unintelligently lived in the neighborhood) was actually nabbed by police within 24hrs. 

I came around later to maternity and found the young 15 year-old mother (one of our FIVE eclamptic ladies admitted over THREE days) reunited with her daughter but also confronting the thief. The police  had brought a professional photographer with them and forced the woman to reenact step-by-step the kidnapping. Once outside maternity such a huge crowd had gathered we were afraid the woman was going to be lynched. Thankfully she was taken away in a police vehicle.  


Exiting maternity and walking down past men's and women's ward you'll hit the outpatient consult area. Here patients start gathering at 7am and (on days that Dr. Steve Foster or Dr. Annelise Olson are around) will wait until 11pm. It was lunch time so folks were out looking for some nourishment.  

Once you register, pick up your outpatient file, make it through the nursing triage, you wait here for a medical consultation. 

This young lady is actually a friend of mine now: Delfina. Her first and only pregnancy was tragically complicated by a diagnosis of heart failure (EF of 10%), we followed her very carefully and were planning on inducing her at 32-34weeks (she was decompensating) but she disappeared for a few weeks and came back with a dead baby. I was surprised but delighted to find her at Kalukembe (she lives in Lubango). Her sister is that wonderful senior nurse Beatrice (on maternity) and so she was being taken care of by Beatrice's family.  


Between the pediatric ward and the HIV/physical therapy buildings are some more lovely trees and landscaping. I'm dreaming of doing more gardening around maternity. 

A typical afternoon for family members: three generations of ladies there to care for a sick child on the pediatric ward. Typical African dress is very practical: these beautiful skirts double up as a blanket, towel, sheet, cover for the rain, etc. 

Our super-boss and Clinical Director of the Kalukembe District Hospital Sr. Nelson. He is an amazing man: graduate of the nursing school here, works NON-stop doing outpatient consults, inpatient care, administrative work, translation and organizing/scheduling surgeries during our visits, follow up, applying for multi-million dollar grants to rehabilitate the hospital, teaching at the nursing school, AND just started doing his bachelors in psychology! We are all lazy bums next to him. I had to take this picture on the run - he never stops moving. 

Well, returning to to the living quarters, we again enjoy the (seasonally) verdant walkways. 

Here are some of the living quarters for the nursing students, notice the plethora of satellite dishes :) 

This is Zeke after a week in Kalukembe: tired but happy to have spent the days running after dogs, birds, chickens, ants, cicadas, lizards, and being shuttled around on the backs of ladies (including mommy who sometimes has to take him to maternity on her back to do consults and deliveries.... but only once into the operating room for an emergency procedure!).  


2 comments:

Adriana Schalkwijk Ribeiro said...

Saudades!
Wish I could be there!
Hug
To all!
Mom Ribeiro

Teague Meyer said...

You guys are awesome. Thank you for your service to the people of Angola. I look forward to seeing you guys again! We will be in Lubango at the end of January (Robert is teaching a class). Remember you are always welcome in Huambo! We aren't there right now, we are in the USA, but we will be back after Christmas.