We're Home!

By now we are either all home, or are where we will be for most of the rest of the summer (Keane we hope you enjoy more time in Zambia). Our time in Zambia was at the same time long and full, and much too quick. We missed the people we loved, but enjoyed the time spent learning new things and meeting new people. Travel to a far away place can be disorienting when you return. Where we were has been separated from where we are by two days in airports and airplanes with little sleep and weird sun schedules – and now Zambia feels distant - it’s beginning to feel like somewhere we were (not somewhere we are). Now that I’ve been home for 15 hours I could almost convince myself it was a dream – except for the laundry to do, the clothes that all smell like Zambia, a computer full of pictures, and a sense of a change in my perspective on the world.

At the airport in Livingstone, preparing to fly away home. Sarah, Annie, Caleb and Jackie.

 We return to things here that are almost exactly the same as we left them (my cats immediately climbed on my lab when I sat down to write this) but we feel different. It can be hard to keep the sense of excitement and adventure once we have returned safe and sound with the spoils of our travel spilling out of our bags. But we were in Zambia, and we were changed by what we saw there. The challenge in Zambia was to push ourselves outside of our comfort zone to experience new things, and now that we are home the challenge will be to keep ourselves from returning to our comfort zone- to be mindful of what we have, what we say, and what we do. Our world has grown and now includes a little Zambian village, the people (and especially the kids) who live there, and the challenges they face.

Returning to Messiah after the trip. Messiah felt too normal!

 It will be important as we return to talk about our time there, but it may take us a long time to process all that we saw. We will be making connections with what we experience now and what we saw there for years to come and in many different situations. The goal is to be permanently changed by experiencing more of the world.  Our minds and our hearts have grown to hold Macha village during our trip, and we will continue to hold it in our hearts and prayers with hope for the future. 

Our time is Zambia is done, but the things we have learned will remain with us forever.

 

A little over 1/2 way home!

We just got to Heathrow airport in London- and found that when no one else is awake at the terminal- there is free internet :)

All is well on the trip so far, we've only lost a couple bottles of lotion and toothpaste, so it's all good. Most of us slept for the trip over Africa, and the rest watched a new set of movies on the plane. We will all be happy to be done traveling for a while when we get home today- it's going to feel weird- we get on the plane at 10 London time (11 Macha time) and land in DC at ~ 1 pm - after an 7 or 8 hour flight!

We're looking forward to seeing you all soon!

Also- we've had some trouble counting ourselves after Stephne taking a different flight, and Keane and Dr. Thuma staying in Africa - our group isn't the same without them.

Safari, and the last day

Our hearts are full from all of the good, fun, challenging and amazing things we have seen in Zambia. After our two-day overnight safari in Botswana, we are starting today on our journey home (except for Keane and Dr. Thuma who get to stay!).

It was amazing and fun and exciting and fantastic to get the chance to safari in Botswana. Our day started early with a drive to the Zambezi river and the boarder crossing (we have extra stamps in our passports!). Once in Botswana, we started seeing warthogs IN the city before heading to the park. After tea (we’ll miss tea!) we had a boat tour of Chobe National Park from the Zambezi river. Here we saw our first elephants, kudu, water buffalo, monitor lizards and more. The animals are used to the tour boats coming through the park, and know that they are not going to be dangerous, and so they hardly move when we get close to them (birds included!). This made for some close encounters and great pictures.

Crossing the Zambezi river to Botswana!

Customs in Botswana - Dr. Thuma, Stephne, Emily, Evan, Jackie, and Dan.

Amanda walking to our touring boat.

Water Buffalo- the African widow maker!

After lunch we went out in the Jeeps for a driving tour of the park. Here we saw more elephants, warthogs, sable antelope, impala, puku, kudu, giraffes, kori bustard, buffalo, hippos, (and I know I’m missing some). In short- we saw LOTS of animals- up close, and then headed back to camp for dinner. We camped- but it was really posh: A) they had set up all the tents and had our beds made (with really nice beds) before we got there, B) they had chairs set up around an already burning fire, and were already making dinner for us when we got there, C) there were flush toilets! D) we were camping under the African stars, E) there was a lit watering hole where we could watch the animals coming for dinner. It was a fantastic night, and we slept to the sound of animals in the distance: hyenas, elephants, and who knows what else!

Zak is SO happy to see giraffes!

Emily and Stephne with an Elephant!

Our tour guides were not afraid to drive really close to the animals.

The very rare and hard to find Preston/Keane Buffalo

The watering hole, Emily, Stephne, Zak, Preston, Jackie, Caleb and Sarah

Day two we awoke before the sun, having breakfast under the stars (like our dinner) and then we bundled up in blankets (it’s COLD in Africa in the winter!) and drove back to the park to see the animals at the river in the morning. We were told that the cats and dogs especially are active in the morning. It was cool (literally) to see the park in the morning, to see the animals waking up or (for the nocturnal animals) going back to bed (the hippos, it turns out, seem very lazy). We saw lots of cool animals (a jackal) but no cats… after brunch back at the camp we headed out for our last chance drive through the park. We saw hyenas who had been gnawing on an elephant carcass (hyenas are WAY bigger than I had thought), AND LIONS sleeping in the cool afternoon shade. The lions were amazing, and when we drove up they woke up and lifted their heads (yes, there were two, Simba and Nala!). While we were there, elephants started moving up the hill towards the lions and chased the lions away! It was an elephant/cat fight! (ok, so not really a fight, but definitely a chase!). Our guide said that elephants proactively seek out the lions and chase them away to protect their young (the only elephants small enough for the lions to kill). It was amazing! And so ended our safari!

The morning drive was dark and cold - but we didn't complain! Mike, Evan, Zak, Emily, Stephne, and Steve.

Mike and the enormous baobab tree!

The striped Zebra crossing- and Caleb hanging out the window.

An elephant was lion hunting!

The Lioness was HUGE and look at the muscles on her legs!

Then last evening we had our final night all together in Zambia. We talked about what we miss from home, and what we will miss from Zambia. And we talked about how we will see things differently (if you’re from Messiah – how we will see things anew) after this trip. It was really fun to hear what the students have enjoyed the most and missed the most- not surprisingly, for most of the students both were people and relationships: people from home that we miss, and people from here that we enjoyed getting to know. It was also fun to hear how the students view of the world, relationships, health, healthcare, and need have changed during the time here. I am again encouraged that the cross cultural experience is world expanding – you cannot help but see the world in a different light after living in a Zambian village for a weekend, after hearing Dr. Thuma talk about his work here, and after spending so much time with the kids, or each other on the trip. We leave this morning full – of new things, pictures, experiences, stories, and love.

Our Safari Jeep group: me, Mutaa (the guide), Steve, Zak, Sarah, Brandi, Mike, Stephne, Emily, Evan

See you all soon.

SAFARI!!!! (also we're all back alive and well!)

We made it back safe and sound from Safari! I'll update with a real post after I have a minute to do so- just FYI, you WILL be seeing a LOT of photos of animals from Africa! It was so fun, and none of us were eaten!

Victoria Falls!

After a slightly delayed start to our morning (flat tire for the bus before it came to pick us up, so we waited in comfort instead of on the side of the road!), we waved a last goodbye to our friends in Macha, leaving behind much of our clothing, and taking with us a LOT of freshly roasted peanuts. Over the time we spent at Macha I asked the students to choose and share a bible verse that they would plan to think about and try to memorize during our time there. As we were pulling out of Macha, the last few students shared their verses. It has been really fun for me to hear what different students have chosen to focus on. Some of the verses focused on offering a ‘cup of cold water in God’s name,’ the Beatitudes, God’s protection, trying new things, caring for the least of these, loving our neighbors, and being One in Christ. I hope that the students continue to think on these things, and that in the future when they hear their verse they will remember their time here in Zambia.

Dan and Sarah in front of the falls- Dan's clearly excited!

We made it to Livingstone for a late lunch (most of the students found cheese or cheeseburgers and/or fries and ice cream. Then we drove out to Victoria Falls, did you know that Victoria Falls is one of the Seven Wonders of the World? It is! There is something like 1 mile of serious waterfalls pounding down into the basin below. Stunning, AND like the genius that I am, today is the one day I forgot my camera in my other bag! It is also quite wet, as the water crashes against the rocks at the bottom of the gorge, water spray come shooting back up (and then down again) making for a very interesting photo op. I think you might be able to see it better from the air where the water droplets aren’t splashing in your face, but then you can’t hear the crashing of the falls.

The group in front of the falls.

Mitchell in the Boiling Pot

Paula, Randy, Linda (joined the trip on Friday) and I crossing the bridge.

The students enjoyed watching the bungee jumpers off the bridge and face first into the spray- terrifying, and also quite the rush – AND disallowed by Messiah, so parents, don’t worry, you kids are all still alive. After spending a good amount of time at the falls, we walked just a bit upstream to the curio shopping area where people from one of the local villages sell crafts etc. Unlike most of our shopping in Macha, bartering is encouraged at these shops (and is welcomed by the shop keepers – everyone says “here’s my price, but I can give a good discount to you, my dear friend. What do you want to pay for this beautiful, handcrafted (by my grandpa), one of a kind (but you can find 10 like it next door), authentic (this is true), African craft?” (ok, so maybe not EXACTLY those words, but close). As you know bartering is NOT a skill we develop in the US, so the students enjoyed the back and forth of the purchasing process at the market.

Linda (Larry's wife) bartering at the curio market

 We ended the night with Pizza, yes, Pizza with a capital P and CHEESE! (freshly baked in a stone oven – it was REALLY good!). I am sure we will all have crazy dreams tonight since we leave early in the morning for Safari, and just had cheese for the first time in two weeks (well, there was that one day with Mac and Cheese, but other than that…). So- early tomorrow we leave for Safari and don’t return until evening the following day- so don’t expect anything new here then.

The last day in Macha

Today involved a last test (for some the last test of their senior year!), the last time in the hospital, one last trip to the fires with balloons, the last time at the market, a last climb of the water tower, a visit to friends to say good bye, the gift of a chicken (I’m not kidding!), and one last blog post from Macha: the last day in our new home. -And then the packing. I’ve already found friends with emptier suitcases to take ½ of my purchases back for me. Then tomorrow will be full of travel and waterfalls, the next day full of wild animals, and two days later… lots of long hours on the plane…

Larry was gifted with a chicken (live of course) from Gideon... we did not eat her for dinner, she went home with Marjorie.

I said good bye to our host Conceptor, her son Twizzy (pictured here) and her brother Confidence (in the back).

 On the final exam today there was a question about what the students found to be the most impactful from their time here, and how it will affect their lives. For a lot of the students, our privilege in the US, to be educated, to have easy access to health care, to have running water, etc. none of those things are taken for granted here. Students were also impacted by the people they met- children at the hospital, people at the market or homestays. The freely given hospitality of a smile, a chair, a cup of cold water – the Zambian people have impressed us. Many of the students also talked about how they will reconsider the path ahead of them after this trip. They have been motivated not only to have more of an interest in public heath, but also in to serve people with the greatest need. We can’t see now what impact this trip will have on students, but I believe it has planted a seed (or two) in each of them that will bear fruits in many different ways in the years to come.

Emily, Stephne, Sarah, Caitlin, Jess and Mike ready for the exam! (and they all passed!)

Preston, Jackie, Caleb, KK, and Brandi ready to be done with tests for the summer!

Mitch, Annie, Dan and Zak ready for the exam.

Amanda, Andrea, Phil, Steve, Evan and Keane

A note to families waiting for the students to come home about what to expect to hear from us in the next couple of days. Tomorrow (Tuesday) morning we leave Macha early for Livingstone and Victoria Falls. We won’t have any internet access during that time, and will have only limited access on Tuesday night in Livingstone. Wednesday morning VERY early we leave for Safari! (WHOO HOOO!) We will be staying overnight in the park so you won’t hear anything from us until Thursday night (and then again it will be quite limited). Friday morning we fly out of Livingstone for Johannesburg, then Johannesburg to London, then London to Washington Dulles. I don’t think we’ll have any internet during that time. Our plane arrives at Dulles around 1 pm, then we have to go through customs, get luggage, find the bus etc. I don’t expect we’ll be back to Messiah until around 5 pm (or so). So the moral of the story is: we’re on our way home, and during this last week you probably won’t hear much from us.  

The students will miss the kids, they have been SO MUCH FUN! Emily is passing out stickers to the girls.

Jakie was with those passing out balloons- today it's windy so it was mostly chase the balloon and hope you catch it before it pops!

Making Smiles

This week a couple of the students took the long balloons and pumps into the children's ward at the hospital to make some smiles. I thought you would all enjoy the pictures!

Evan made a (puppy?) animal for one of the kids in the ward. The person holding the baby is most likely his mother, not a nurse.

Ballooners Unite Or Balloons to the Rescue! (from the Left: Keane, Evan, Preston, Mike)

Annie also joined the ballooning fun.

From Caleb: the tale of the snake (pun intended)

Guest post tonight from Caleb:

Some of the people at the research institute killed a cobra that was warming itself on a fellow workers doorstep.  The students quickly gathered to inspect the snake; very quickly a general consensus was reached to perform a field dissection.  The students quickly found all of the vital organs and skinned the snake as a very unique souvenir. After the dissection was done Dan and Caleb decided to gut the snake and cook it up for a good cultural experience (although it was latter learned that Zambians don’t really eat snakes).   Once word of the cook out got around to the fellow students everyone wanted to at least try to eat the snake.  After the fact the general consensus was that it tasted like chewy fish and chicken.

Dissecting the cobra... this wouldn't happen on a humanities trip!

Snake Fry! From the description, I don't think it will be anyone's new favorite.

Last Sunday (that means next Sunday we'll be home!)

Today was our last Sunday at Macha BIC church. On our first Sunday at Macha BIC, the students really enjoyed seeing all of the special songs that were sung during the service (there were about 6 or so). They thought it would be fun to add our name to the list of special music, so today they were part of the service, singing:

‘Blessed be your Name, in the land that is plentiful

where your streams of abundance flow, Blessed be your Name.

Blessed be your Name, on the road marked with suffering,

Though there’s pain in the offering, Blessed be your Name.’

We have certainly been blessed during our time here in Macha, and hope that we have also been a blessing to those around us. We have also seen great joy, peace and kindness in the people around us, while knowing that their lives are not easy.

Macha BIC FILLS UP on Sunday- attendance (from the board) for last week was ~750 people!

The group singing- Zak played the ukelele while we sang, Annie led the singing, Preston is the idea man behind the whole thing. 

 Last night during our reflection time we were talking about what we will remember and pray for when we leave Zambia. Jess shared a story about a little boy with cerebral palsy who left the hospital against the advice of the doctors because his mother said they could not stay at the hospital any longer since there were other children at home that needed to be cared for. This little boy is named Immanuel, which means: God with us. We all may wish that difficult situations stopped happening to the people we know and love, but that shouldn’t diminish our hope is the God who is here with us, with you, with the kids at the hospital, with our host families, and who will continue to be with us. 

This little boy isn't Immanuel, but he is cute, and he was sitting across from me at church.

Heath Systems in Zambia

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Yesterday we took a field trip out to a rural health center (RHC) in Kamwanu and rural health post (RHP) in Katumbi. These are the primary contact points for people in rural villages, far away from Macha hospital. The idea is to have a network of health stations with various services that will serve as the ‘rapid response’ health centers. In the US, we just drive to the ER or a rapid response health center anytime of the day or night, and for most it won’t take more than 30 minutes of driving to get medial assistance. Here in Zambia there are very few vehicles, so the vast majority of people walk wherever they go –including getting to the health center, even if that involves bringing someone with a broken leg to the health center, of if there are complications in a birth. Thus if the only health care is at the isolated hospitals, that leaves most of the people many miles from modern medical assistance (there are of course the traditional healers, but for the sake of simplicity I’ll leave them out of this). Even with the rural health centers being closer to where people live, many of the rural health centers are only open certain days of the week.

Rural Zambia is very rural - here is a small homestead. Also, note our shadows - we took a 'local taxi' to the RHC

Kamwanu Rural Health Center (as we were driving away)

These health stations are organized such that several rural health centers (RHC) surround each hospital. A nurse and a community healthcare worker staff the RHC. At the center they give vaccinations, address basic needs, are trained birth assistants, do check ups on kids under 5, and can address physical injuries (to a point). They also have rapid diagnostic tests to screen for malaria, and drugs to treat anyone who is infected with malaria. In addition to administering healthcare, the staff of the RHC are also responsible for health education in the community and cleaning the buildings. A team from the hospital will visit the RHC regularly to bring supplies, and have special health clinics. The day before we visited the group from the hospital had been at the RHC doing circumcisions (see post 5/28/13 for relevance). On the day we visited, the nurse was away at a training session, so the healthcare worker who has served at this outpost for the last 13 years was staffing the RHC alone.

This woman has served this RHC for 13 years, and through it serves ~ 1000 people.

Each health center outpost is itself surrounded by a series of rural health posts (RHP). We visited the Katumbi post that also serves as a VCT (Voluntary Counseling and Therapy) center for HIV testing. Volunteers from the community staff each of the RHPs. As Dr. Thuma has said, volunteerism is a luxury afforded to those who have extra time and money – those luxuries are not common in rural Zambia. The woman who serves at Katumbi RHP said that she was chosen by the health committee from her village 5 years ago, and has served since. The initial idea was that each post worker would volunteer their time to the community, and in exchange they would be repaid ‘in kind’ by help from the community, either help plowing her fields, or with harvest etc. Unfortunately that system hasn’t actually worked in practice, so this woman truly volunteers her time. After she had talked with us, Mike asked why she continues to volunteer if she isn’t being helped by the community for her efforts- and her reply was simply that she had made a commitment to the headman and health committee of her village, and so she was continuing to serve.

Katumbi RHP and VTC, two rooms, and exterior space under the grass roof.

Larry and the RHP volunteer.

Each RHP volunteer attends an initial 6 weeks of training at the hospital, and then may attend other trainings as needed. At the health post she is trained as a traditional birth assistant, she can test people for HIV, and has been trained to test for malaria (although she doesn’t have the test strips or drugs to treat malaria yet). We asked her how many people give birth in the village vs. come to either the RHP, RHC or hospital for delivery. She said everyone goes to one of the health centers (since that’s official policy in Zambia). In fact, in her village, there is a fine for anyone who delivers at home instead of delivering at a health center – 7 kg of corn. The RHP volunteer is also trained to go out into the village and do health education, and to encourage people to be tested for HIV (and remember, this is all on a volunteer basis IN ADDITION TO all of the normal work that a woman does in the home).

The RHP. From the left, Dr. Thuma, Mike, the volunteer, Evan, Phil, Stephne and Emily.

 Each RHC and RHP can contact the central hospital by phone, and if they have a patient who needs to go to the hospital, there is a bus that goes Monday, Tuesday and Friday and can take you there, or you can walk to the hospital. After we had asked her many questions, she asked us a few questions, one of which was ‘do you have rural health posts in your country?’ This question is so interesting to me- and reminds me again of why it is so valuable for students to actually GO and SEE what life is like in other places in the world. It shouldn’t be surprising that a woman who has lived her entire life in the Zambian bush wouldn’t know about ambulances, EMTs, or the ER. It shouldn’t be surprising that she wouldn’t assume that everyone has a car (or two) and can easily drive to a health center (or be lifted by helicopter if they need to get there quickly!). AND, the RHC and RHP system is revolutionary to their health system in Zambia where not too long ago it was the traditional healer, walk miles and miles to the hospital or bust! And it makes sense that she would think it’s a good system for other countries as well (and it is!). What we too often forget is that this volunteer (who works on M, T, R mornings) IS the local ER. We, on the other hand, sometimes complain when we wait 3 hours at the bright shiny ER for a broken leg to be treated. 

 

The students had a LOT of fun riding to and from the RHC. From the left - Caitlin, Caleb, Zak (Caleb and Zak's birthday is today!), Preston, Annie, Evan, Phil, Mike.

Late addition pictures from Caitlin of our 'local taxi' can you figure out what it is?

Can you see the cows in the distance? There are cows EVERYWHERE here! Each night my lullaby is cow bells jingling as the cows walk down the path. 

Most of the homesteads we passed had a bunch of people waving to us, so we waved right back!

Living Positive with HIV

How many of you know someone living with HIV? I can think of no one who I know openly living with HIV (although there may be people I know with the virus who are not open about it). But the prevalence of the disease in the US is about 1 %. In this area of Zambia an estimated 14 % of the population is HIV positive, and that number increases drastically (~ 40 %) in the larger cities like Livingstone. In the US, we have lots of high quality drugs available to treat HIV positive patients, and many people have insurance or are able to afford the drugs. Neither of these is true in this area. And- more than that, although HIV began infecting people in Africa (in the 80s), and the rates are the highest in southern Africa, and although drugs were available in the US in the 90s, no drugs were available at Macha (and in much of the rest of Africa) until 2002/3. Even now the antiretroviral drugs are limited to those approved by the government, may be quite expensive, and have serious side effects.

I haven't actually taken pictures of people at the ART clinic, but Marlys Book volunteers there and shared some pictures with me for the blog.

When the students were on rounds they saw a HIV + child who is 18 months old, but weighs only 2 kg (~ 9 lbs). Dr. Thuma has told us that it can take a year after a child is given anti-retroviral drugs (what they use to keep HIV levels low) before the child will begin to put on weight and start growing again. This is especially difficult to see knowing that this is a key point in brain development (and development of other things) for children, and that early detection could have meant that the child was growing normally instead of severely stunted. Many of the older patients with HIV are in the hospital for problems that are usually quite harmless and our bodies can fight off, yet with the HIV compromised immune system they are not able to respond to the sickness and become severely ill.

A little girl at the ART clinic, photo thanks to Marlys Book

 At Macha Hospital they have an ART clinic (not art as in the things you make that look pretty, but ART as in Anti-Retroviral Therapy – don’t feel bad, I was confused for a while too). This is where people can come and be voluntarily testes for HIV, and counseled before they are tested and after the results are back. Because of the significant, long term, health and social implications of a positive diagnosis, the hospital staff treats each case with great care. They ensure that someone with a positive diagnosis has people around them who will be there to support them and talk with them about treatment options early on.

Counseling is available for everyone who is tested at the ART clinic, and confidentiality is a high priority for the healthcare workers and for the patients. In fact, several of the doctors and nurses at the hospital are HIV positive, and choose to use an alias on their records so that others won't know they are HIV positive.

 One of the women who works in the ART clinic is also living openly with the fact that she is HIV positive. She came to talk with us last night to share her story and to talk about HIV in this area. She has been a nurse since 1980, and was the head nurse at Macha hospital when she became ill and got tested for HIV. She knew she had been exposed to HIV by the time of her husband’s death of AIDS in ’94, but wasn’t tested herself until 2002. This may seem strange, wouldn’t you want to know if you have a disease? But in ’94, although they now knew about HIV/AIDS, testing was not common, and (as I said before) there were NO drugs available to treat patients anyway. So the thought was: Why test? There is nothing to be done about it anyway. Shortly after her diagnosis with HIV, she became severely ill, and was in a coma for 2 weeks, and then in and out of the hospital for a long time before recovering enough to go home. Even now, the form of HIV that she has is resistant to the common drugs used, so she is on a very high dose of powerful drugs that have several bad side affects. Her slogan, that she loves to share is "One day at a time!" She loves to encourage people that they can ‘Live Positive with HIV’, and indeed, with the antiretroviral drugs that are available today, the quality and quantity of life that infected individuals can have is quite good.  

The ART clinic is labeled to House of Hope, and certainly the outcomes possible are much better now than they were a few short years ago.

 I’ll talk again about HIV tomorrow when I tell you about our visit to the rural health centers.