reflections: Experienc in Mukinge Mission Hospital, Zambia

Sunrise in Mukinge

Hospital Courtyard

Recent Medical Mission trip to Zambia was an experience that will stay in our memory for a very long time.This was the first time taht my wife and I were visiting Zambia. Our previous stay in Tanzania many years ago and the tree short medical mission trips taht we made to Kenya in the past three years had given us an idea about the African continent and the many challenges theyface there especially in the field of medical care.World Medical Mission, the medical wing of Samaritan's Purse was doing all the ground work in sending us to Mukinge . Zambia. Mission Hospital in Mukinge has been in operation for over fifty years. Presently a two hundred bed facility, this hospital is owned by the Evangelical Church of Zambia (EZC) sopported by financial grant from the government of zambia. Mukinge is in the North West region of Zambia in the Kesampe district. This poor region that is away from the more developed regions like Lusaka and the copper belt area depends solely on this hospital for any specialised medical care. Unfortunately this facility too is very limited in resources and man power. Their small medical staff has one surgeon from Newzealand, three general practitioners from the USA, a young Zambian physician, another Zambian LMD and another Zambian Clinical officer. It is amazing to watch these hard working people respond to all sorts of medical and surgical emergencies. A twenty four hour emergency room and a busy labor and delivery department and the neonatal unit are all well managed by these men and women who are self trained in multitasking and wearing more than one hat a time! Dr. David Friend, the surgeon from Newzealand was away on a three month sabbatical o his home country. Apparently this was the first time in his six years stay there that he was taking a break, that too forced on him by the missionary friends ta Mukinge. I was there to cover for Dr . Friend for one month and Leya, my wife accompanied me to work in Pediatrics. We both were blessed by the love, support and hospitality of the missionaries at Mukinge.

Library in the Doctors Lounge nearby the painting "Chief of our medical staff"
(We used both books and the consultant while at Mukinge)

From the very first day at the hospital, we both felt that we were needed there. Though we felt apprehensive at times about the lack of many supportive diagnostic and treatment modalities that we came to think were basic, soon we had to change our thinking. We had to repeatedly tell ourselves that we were in Mukinge and we have to do the best with what we have. Laborotory could do a hgb/hct at any time. They would do a full blood count during day time. Urine dip stick and gram stain as well as malaria smears were done in the lab. they may even do a Total bilirubin and alk phsphatase but no electrolytes or any enzyme assays. Blood bank would draw blood and cross match on demand. There was no pathologist, radiologist or anesthesiologist. Two CRNAs there were able to run the anesthesia department by sharing calls. While outside the theatre one was working as the nursing superintant while the other functioned as the Chief Executive officer.

Dr.Daren and Elise Tompkins

Dr. Stephen and Amy Snell

Even the regular nursing staff in the operating theatre knew how to mutitask. One evening I had a patient with perforative peritonitis who needed emergency laparotomy. When I went to the ward to see the patient, Sister Ruth from the theatre was the nurse in charge of taht ward. She was taking care of all the patients in the male ward. When I went to the theatre, sister Ruth was there in the operating room with the patient. She was the scrubb nurse, circulating nurse as well as the recovery room nurse for that day. She already had borowed somebody from some where to take care of the male ward while she was in surgery! Talk about limited resources and multi tasking. It made me think of the "surgery team " that would come when I would call for an emergency like this in the USA! what a contrast. CRNA managed the anesthesia while multi tasking as the circulating nurse and Sister Ruth assisted me while being the sole scrub nurse. Patient had a perforated duodenal ulcer with lot of spillage in the belley. Thank god, he did well.