Written by Caroline Sawyer
So what was life and nursing like at St. Francis Hospital?
St. Francis hospital is located in the district of Katete in Zambia’s Eastern Province. It is about 500 km from the capital of Lusaka - This is a five or six hour journey on the “luxury” coaches. St. Francis Hospital is the largest mission hospital in Zambia, and is jointly run by the Anglican Church in Zambia, and the Catholic Diocese of Chipata (the nearest town). The hospital also receives funding from the Zambian government and various overseas organizations. The hospital contains about 360 beds and cots. However this total is never a limit to the number of in-patients in the hospital, as space on the floor can always be found and it is a common occurrence for patients to be found sleeping on the floors of the hospital wards.
During my time at St. Francis I spent some time on both the medical and surgical wards at the hospital and even went into theatre on a few occasions, and also the labour and maternity wards. On the medical wards, the main diseases I saw being treated were Tuberculosis, Malaria, Meningitis and HIV & AIDS. To be treated, patients must first purchase an OPD (out-patients department) card costing a little more than 50p. However, the treatment received by patients is largely free of charge, and because of this people travel for miles to receive medical treatment at St. Francis (some even travel from the capital city).
Before my time in Zambia, I knew that HIV & AIDS was a serious problem within African countries, however, until my arrival at St. Francis Hospital I never fully realized what this meant. In Zambia 1 in 5 adults are HIV positive and the life expectancy of a baby born in Zambia today is now thought to average as low as 33years . Having seen and experienced the affects of the HIV & AIDS viruses on people, these statistics become more than numbers on a page; they become real, and defy expression. Nursing these people was a humbling experience, and one that I will remember for the rest of my life.
The nursing care that I was involved in giving, such as dressing wounds, was very basic (a gauze swab and strapping), due to the simple supplies and equipment that the hospital had, though it did the job it needed to do. The basic supplies the hospital had rarely seemed a barrier to treating people. I remember one day while I was working on the male medical ward (St. Augustine) an elderly patient was admitted to the hospital for treatment of a painful right knee and bad back that he had been suffering from for 3 years. He was sent to the physiotherapy department and on returning he was shouting at the top of his voice (in Chewa – the local language), and waving his newly acquired walking stick in the air, in what I perceived as a threatening manner. On asking one of the patients (who spoke both Chewa and English) what his man was shouting about, he said that the man was expressing his thanks to the doctors and nursing staff for his new walking stick, which was now the right height for him, relieving him of his aching back and helping him to walk properly.
What I learnt from his encounter was that it is not always necessary to have the ‘high tech’ solutions to meet real needs. Yes, there were times when situations at the hospital were frustrating, such as running out of vital medicines which patients needed to survive, but when these moments arose I had to remind myself of what Dr Shelagh Parkinson, Executive Director of St. Francis Hospital wrote to me prior to my arrival at St. Francis Hospital, “When situations seem frustrating they should be compared with the absence of any healthcare as opposed to the system in richer countries”.
One major difference between nursing care in Zambia and the UK was that family members and not the nursing staff met the hygiene needs of the patients. Each patient had what was called ‘a bedsider’, a family member who remained with the patient throughout their stay at the hospital, attending to all their personal needs – eating, drinking, washing etc. Nursing ‘tasks’ were quite medically orientated due to the few doctors at the hospital, and so the nursing staff were involved in what we in Britain would term ‘extended’ nursing roles, such as taking bloods from patients and cannulation, which I too was taught how to do. This was all very new to me, but the Zambian nurses were very willing and helpful in teaching me how to do procedures that I would not have had the opportunity of being taught in the UK.
My time in Zambia has increased my confidence as an individual and also in my professional life, as I begin my first job as a newly qualified nurse. It has also broadened my understanding of what ‘nursing’ is, and the diseases and social problems that affect individuals in developing countries. Having been to Zambia twice before my elective, and experiencing the Zambian culture, the strong hold the memories have on my life are ones I will never forget. I would one day like to return to Zambia (together with my husband) to thank the people of this country, who have influenced our lives unknowingly, by returning to be of use to them. This placement has already enabled me, to some degree, to give back to a country, which is close to my heart, as well as enabling me to learn about nursing and healthcare within a developing country.
I would like to thank Dr. & Mr. Parkinson (Executive Director and Administrator) from St. Francis hospital for allowing me the privilege to spend time at the hospital and for making me feel at home.
For more inforation on taking elective placements overseas, contact HealthServe on 020 7928 4694
email: healthserve@cmf.org.uk web: www.healthserve.org/electives
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