Elizabeth Randon

I’m not entirely sure what made me want to travel overseas for my placement. But when I heard about Work the World I jumped at the chance.

When Zambia came up I knew it would be a great chance to see what things were outside the bubble of the NHS. I wanted to experience healthcare that was completely different to what I was used to.

I’d learned and experienced so much from my third year at uni that I knew how everything worked here in the UK. So I was excited to throw myself into something completely different, challenging myself to see from new perspectives.

I wanted to spend time with patients who had cerebral palsy. The guys at Work the World suggested that Lusaka was a great place to get that kind of experience. I’d always wanted to go to Africa anyway, and there was a group of five of us who decided together that Lusaka was where we wanted to go.

When we got off the plane we were knackered! We saw someone from the Work the World team in the arrivals area of Lusaka airport waiting to meet us. We walked outside and felt the Zambian heat straight away!

The Work the World team took us on a city orientation and we went to the hospital for the first time. This was when it really hit home that we were somewhere very different from what we were used to.

We got into the car to head back to the Work the World house.

We met our housemates when we arrived—Dara, Will... And we stayed in the house that evening. The next day the Work the World team took us on a city orientation and we went to the hospital for the first time. This was when it really hit home that we were somewhere very different from what we were used to.

There was no bedding on the beds and there were no curtains. All the patients were crammed in really close together.

As soon as we walked into the hospital, I realised how different things were going to be. They had so little compared to us.

We were on the orthopaedic ward with spinal injury patients and there was only one wheelchair on the ward. There was no bedding on the beds and there were no curtains. All the patients were crammed in really close together. Spinal injury patients with incontinence didn’t have pads because families had to choose between that or feeding the rest of their family.

We did our first week on orthopedics and spinal injuries, and the second week was ICU. Then we did a week in trauma and burns and then a week in paediatrics.

My favourite was paediatrics, it was amazing. I absolutely loved it.

On the paeds ward, we saw lots of cerebral palsy, and hydrocephalus, which I’d never seen. Actually, lots of children there had hydrocephalus. I guess because they didn’t have the resources to spot it as early as we do in the UK and they didn’t have the resources to do much about it once detected.

When children were brought in they didn’t necessarily have a diagnosis. We were only seeing cases when parents realized their children weren’t hitting development milestones. The children were sometimes as much as a year old by that point.

I also went to a clubfoot clinical and I’d never seen clubfoot before.

We would look at their presentation, investigate the birth history, and from there we problem solved to decide whether it was cerebral palsy, hydrocephalus or something similar.

Management wise, shunts were available to children with hydrocephalus under certain circumstances, so there were actually treatments available. But for the most part we were hands-on with patients. If a child wasn’t able to crawl we would get them to sit and help them into the crawling position. This was so their joints got used to holding them up and so that their muscles could learn the movement patterns. There wasn’t much equipment, just toys to stimulate some play.

I also went to a clubfoot clinical and I’d never seen clubfoot before, so that was amazing.

Were there any particular patients who stuck in your mind?

In trauma, I had a patient with an infected stump. In his notes it said ‘traumatic amputation - HIPPO’. I was on a ward round with the doctors and I turned to the physio and asked her, “What does H.I.P.P.O stand for?”. She turned around, looked at me as though I had three heads and said “...It’s an animal.” It turned out that the patient had an amputation because of a hippo bite. You don’t see that in the UK!

We helped the patient by keeping him moving and teaching him gait patterns while supported by crutches. The hospital didn’t have elbow crutches, they only had the old-fashioned wooden ones that sit under the armpits.

I found it difficult to see patients suffering more than they needed to purely because the hospital didn’t have the resources they needed.

The stump was badly infected, and they had stitched it so that it wasn’t fully closed. They took syringes and put them into the holes between the stitches and squirted hydrogen peroxide in to flush out the infection. According to the local staff, this was the normal response to this kind of infection.

I found it difficult to see patients suffering more than they needed to purely because the hospital didn’t have the resources they needed.

I remember one particular patient who had sepsis. She wasn’t well when I saw her, and badly needed antibiotics, but the hospital pharmacy had run out. The patient ultimately passed away.

Even though we saw things like this all the time, we were absolutely fine and we had a great support network around us.

Travelling with Work the World and living in a shared house with like-minded people really helped because we always felt safe at home. Of course we had to deal with challenges in the hospital, but we could head back to the house after it all.

The Work the World team in the house were always there. They made sure we were okay every single day and if we ever had a problem they’d be there for us. While I was out there I failed an essay, which was a massive deal for me. I was in tears and the team knew exactly what to do to help me when I needed it and knew when I needed to be left alone. It was amazing to have that support.

The team really took the time to get to know us. We would all chat together while the catering team were preparing dinner.

The Work the World house itself was lovely, as was everyone in it. We became family.

It made a big difference that the team were all from the local area. Whenever we wanted to go anywhere, they would advise on how best to go about it.

The Work the World house itself was lovely, as was everyone in it. We became family.

There was a nice outdoor seating area on the upstairs terrace. We used to go up there after dinner with a glass of wine and play cards.

We actually socialised all the time. We had plenty of nights out in Lusaka; we often went out for dinner and for cocktails, and it was quite an experience being out and about with local Zambian people!

We travelled a lot together as a house on weekends. We took a trip to Victoria Falls, which was one of the most amazing things I’ve ever seen. We did a game drive in Livingstone, and a sunset cruise. We saw the falls and went down to the ‘boiling point’ too.

Lilayi Elephant Orphanage was amazing as you’d imagine.

On a night drive we saw a leopard and two brother lions.

We went on safari in Kafue National Park at the end of one week. We were really lucky to see so many beautiful animals. On a night drive we saw a leopard and two brother lions. And during the day we saw loads and loads of elephants, buffalo, hippos, crocodiles, monkeys, baboons, giraffe, zebra, kudu… a bit of everything!

The one thing I’ve said to everyone is that I would absolutely recommend the Work the World experience. It will change you completely. My own outlook has completely changed; I’ve become so much more appreciative of what we have in the UK.

I’ve come to realise that the NHS is magical. It’s the easiest thing in the world to go to A&E and complain that you’ve had to wait five hours, but at least you haven’t had to drive 24 hours across the country just to get there. And when you do get seen you’re going to get the care you need and it’s free. These are luxuries that so many other people around the world don’t have.

I think everyone needs to have their eyes opened. It’s so important to understand different perspectives and ways of life, otherwise you’ll just float along in life in your own little bubble.

I feel more confident in travelling to different countries now. Zambia was the furthest I’d been on my own. Now I feel like I could go absolutely anywhere.

If you’re thinking about going on a placement with Work the World, honestly just do it. Stop thinking about it and get on with it. It’s the best thing you’ll ever do.

Do it and don’t look back.