Striving Novice On A Mission, Zambia, Africa 2017: What Am I Doing There?

Hundreds of schoolchildren, many clothed in similar uniforms, some wearing shoes, some barefoot, form lines leading to the large tented area in the center of the school yard. Some waiting more patiently, and others, well, less patiently, for their turn to express all their aches and pains to any of the health clinicians who will listen. The process of this system will entail, baseline health screening for the students, referrals as needed and medication prescriptions and administrations as necessary. But how can we ensure that the prescriptions will be filled, that the meds will be taken as prescribed, that follow ups will be carried through, and that our interventions are helping to heal the symptoms?

To make this scenario more applicable, in a world where a 6 year old child is more literate than his mother or father, where the nearest health clinic, may be miles away but transportation unavailable, and where disease and illness are rampant and deadly; how can this continuity of care be maintained? How can one ensure that the child who came to clinic with an ear infection will actually pick up medications and receive follow up to assess whether the infection has healed? 

Here in Zambia, the focus is on the educational system, the most steady and reliable atmosphere in most villages. We recruit some of the more  literate populations, the teachers and the students mostly, with occasional medial professionals or medical professionals in training to participate in health maintenance programs. Many of the teachers undergo a basic health training session, and serve as the pioneers who maintain the connection between the students/patient,the parents and their healthcare interventions, as well as assessing outcomes of interventions and intervening when necessary. The teachers help the medical staff by gathering the children, collecting basic information and bringing their students to the clinic. The role of the teachers who participate in this program, is to help facilitate some sort of continuity of care, via serving as the string that holds the patient and their healthcare resources together. 

This program produces a multifaceted outcome, since many who participate also acquire health education and knowledge through the process of receiving actual medical care. The teachers learn through their training and interactions. The students learn from their teachers and through the health screening programs. And some parents even learn from their children. Even the foreign nurses, such as myself, who travel across the world to participate in this incredible operation learn so much through working in the screening process or just seeing patients at the local clinic. As a nurse, my assessment skills have sharpened, since I assess so many patients each day. I have heard more heart murmurs than I heard when I worked on a cardiac unit, I often make decisions that are way beyond my scope of practice in the states, and I see cases that I would never see working in a large city hospital. 

Everyday that I wake up in Zambia, Africa, to be a part of this project, is like waking up to a new learning experience, and a new world of medicine to experience and acquire knowledge from. It is like waking up to a new, fabulous, brain stimulating adventure each day. 



Devorah Goldberg RN, BSN

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