Training at Kalukembe in 2024

How can the work of the hospital continue to benefit the community for years to come? With few resources (both material and human), here is our focus: sustainable medical education. 

Rural medicine training is critical for Angolan physicians. After 7 years of preparing, we are almost at our one year anniversary: doctors have been arriving since January for 2-week rotations in rural medicine, with emphasis in obstetric and pediatric care. These doctors come from our sister hospital in Lubango, CEML. While rounding in the ICU and other wards, they do bedside ultrasound evaluations and improve their diagnostic skills. Being called to assess an obstetric and pediatric emergencies can be stressful - but it's rewarding to deliver a healthy baby or see a child recover. Even our surgical resident enjoyed her Rural Emergency Medicine work - and we loved having her!

Brining in other partners into this work has been important: Christiana Emergency Medicine residents helped Daniel develop the resuscitation curriculum. We have had a team from the central hospital in the provincial capital come teach a class on sedation and assessment of the critically ill patient. The director of the pediatric residency at the public hospital in Lubango has expressed interest in having residents come through for basic procedures and emergency management. We hope these partnerships can allow even more trainees rotate and learn here at Kalukembe. 

To keep this up we need teachers! Dr. Chance Williams, a family physician from Kansas, spent a month with us - even giving a mini-course on placement of intra-osseous needles. Dr. Mariana Vigiola, a general surgeon, jumped right as a teaching surgeon. Dr. Emmanuel K, 4th year surgical resident from Niger, is coming for a site visit in December. We are discussing with him the possibility of long-term commitment here. Would you consider coming to help teach? We may not be able to provide 1st class beachfront accommodations, but I can promise a cup of fresh-ground Kalukembe coffee!

Dr. Ilda (L) and Dr. Mariana (Rt) operating together on a patient 

Eliel helping Ms. Jasmine making yummy fried rice for dinner. . . note our pets waiting for any mistakes to fall to the floor!

Near the end of September, Pri and I were able to participate in teaching ultrasound at the 1st annual Southern Angolan Medical Congress. Priscila also presented the hospital's research on maternal hepatitis B prevalence. We hope such networking will bring attention to Kalukembe hospital's work in the community!

With Dr. Hermenegildo, at the end of his second rotation at Kalukembe hospital. He'll be starting surgical residency in just a few months!

Dr. Ana seeing children in the pediatric clinic. She's a natural around screaming kids!

Dr. Chance ultrasounding on maternity ward with his translator, Ludmila.

Hope in a House: Casa de Esperanca

Women in Kalukembe are resilent and strong... but often suffer devastating losses, especially in pregnancy. Our hospital is in a rural area and often women have many hours (if not days) before they are able to arrive for an obstetric emergency. Even yesterday afternoon a woman, who had a complicated delivery the night before and hemorrhaged from a cervical laceration, arrived in critical condition and died despite our interventions.

Our Maternal Health initiative has grown as a response to this heavy reality. Knowing that the causes are multi-factorial, but often involve delays because of distance, the Casa de Esperança (a Maternal Waiting Home) was built. It is a place for women who are high risk pregnancies or have already suffered traumatic deliveries and need surgical care, can stay. It needs some more work, but is already open and we have hosted over 20 patients (and many more family members). Because it is still fully booked with fistula patients--who’ve suffered through a traumatic birth and often lost a child--care has included trauma counseling and re-integration skills like sewing, cooking, etc. We have also loved organizing and working with a visiting team of nurses for health talks at local communities affected by maternal death, at health clinics, and  around the hospital and in the patient villa. 

 

 

 Julia, the house administrator, registering a patient.

Patients listening to a lesson on how our bodies and hearts need healing! 

 Family member cooking for a patient in the comunal cooking area.

 

Most recent group of patients and their family members!

Nurses Filipa and Amandio (nurses from our maternity responsible for patient and community health education) give a health class. 

There is always so much singing at the Casa de Esperanca! Here is one quick moment.