2020

Medical, Zambia Lusaka

I wanted to experience a healthcare system in a developing country to see for myself first hand what kind of barriers and challenges these countries face. 

I think it is great to go outside of one’s comfort zone and experience health care in a setting completely different from your own country.

Tessa Paulis (PAULIS24061)

I’ve always had a love for Africa. The people, nature, and animals amaze me. My parents have lived in Rwanda for three years now and I take every chance I can to visit them. 

Zambia was one of the African countries I had yet to visit and Victoria Falls in Livingstone was definitely on my bucket list! 

One of the first things I thought while getting a tour of the hospital was, wow this is huge! 

The hospital in Lusaka had many different buildings and departments. I definitely got a little lost during the first few days. 

Tessa Paulis (PAULIS24061)

This was my first time visiting a hospital in a developing country so some things were a little shocking. For example, there were many family members gathered around the hospital buildings outside waiting and sleeping on blankets as there was no space for them inside. 

Going home was not always an option for some families as they had spent days travelling to the hospital.

Despite the fact that the hygiene and organisation of the hospital was sometimes lacking, people were nice and I did not feel uncomfortable at any point. 

I remember one day a little girl came up to me and other Work the World students, asking for a photo with us. She told us she wanted to be a doctor, just like us one day. It was so sweet! 

Tessa Paulis (PAULIS24061)On one of my first days in the labour ward, I walked into delivery and got handed a newborn baby. As I experienced more situations like this, I did become more comfortable on the ward and later helped assist with the birth of two healthy babies. So you can say I have gained a lot of new practical skills.

Furthermore, I was able to practice and perfect my patient contact and examination skills. The language barrier with patients made it challenging, but also more fun! 

My supervisors allowed me to assist with examining the patients and encouraged me to ask questions. I am very grateful for that. I had mostly examined healthy peers in class before, so being able to listen to what an unhealthy heart or lung sounds like was a great way to learn.

There were two main differences I observed during my placement in the hospital in Lusaka. 

One of them was the lack of resources. We were encouraged by the Work the World team to bring our own gloves, masks, and stethoscopes and these were indeed needed. 

Basic supplies were often lacking. I was often handing out gloves and masks to other local students and doctors. I even lent my stethoscope to a doctor once as she did not have one! 

The lack of basic supplies was maybe not always life-threatening, but my friend, who was doing their placement on the paediatrics intensive care unit at the time, told me they had a lack of oxygen at the unit which resulted in a few babies dying. 

Tessa Paulis (PAULIS24061)I can also imagine that they had the same problem with certain medication for patients. This is a problem that developed countries do not face. 

Another difference I observed was the doctor/student-patient interaction. I was placed in a teaching hospital so when doing rounds in the morning there would be about five doctors and and many more students. All in very hot hospital rooms together with up to seven patients. 

The doctors would stand around the bed of a sick and vulnerable patient and talk about the patient in the third person to each other. The doctors always spoke English, but often the patients were from small villages in Zambia and only spoke Nyanja. 

There was very limited privacy for the patient, and their case was discussed out loud for all the other patients in the room to hear too. 

On the labour ward, I witnessed a young girl getting stitched up after delivery. She was in a lot of pain, but instead of the nurse relieving and comforting her she was swatting her hand away. In the Netherlands, the importance of patient communication and shared decision making is stressed, and I found situations like this challenging at times. 

The local staff were welcoming and kind. They were driven to make sure the students were getting the most out of their education. 

Most of the staff I spoke to understood they were working in conditions with limited resources and expressed their frustration, but they always did everything they could for their patients. 

Tessa Paulis (PAULIS24061)

we made sure to explore Lusaka and other parts of Zambia.

After placement and during the weekends, we made sure to explore Lusaka and other parts of Zambia. 

Zambia had a lot to offer, there were so many different national parks to visit for animal watching and of course, I couldn’t miss visiting Victoria Falls! 

One weekend, myself and three other girls took an eight-hour bus trip to Livingstone. We stayed at an amazing hostel and visited the Falls. 

Although we went in November during the dry season, it was still beautiful and also a great time to do the Devil’s Pool! 

Other weekends we spent time with each other at the Work the World house, had little day trips and did some shopping. 

A popular activity after placement was to eat and take a dip in the swimming pool as it got really hot during the day. We also had many games nights, visited markets and went for drinks!  

Tessa Paulis (PAULIS24061)

It was a great time to learn, to face and overcome challenges and to make friends! I am still in contact with some of the people I met while living at the Work the World house in Zambia. 

I had the best time in Lusaka and made some great memories. 

To be able to explore a healthcare setting abroad will allow you to observe and learn about diseases that are very rare at home, it will show you a different healthcare approach and it will broaden your practical skills and theoretical knowledge.

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