Grant and Johnny in Zambia December 2005 to March 2006

Some thoughts on our first days in Zambia - a kind of diary

        We left Edinburgh at 15.10 on Monday 5 December, flying KLM to Amsterdam.  From there we flew through the night to Nairobi, arriving at 6 in the morning.  Despite not having had much sleep the night before, we didn't get much sleep on the plane either, and arrived pretty flagged out.  Grant had a delicious mango salad in an airport restaurant.  We then had a short hop to Lusaka, the capitol of Zambia, arriving at about 11.00.  It had all gone extremely smoothly with no hitches - except that the immigration didn't have the necessary $4 in change for Grant's entry visa.

        We were met at the airport by Friday, a very efficient, friendly and amicable taxi driver who works for Flatdogs Safaris, helping out with clients and staff.  Johnny had to finalize his medical papers, so the first place we went was to the Zambian Medical Council where Johnny sorted out the necessaries.  While we were there there was a slightly alarming incident involving what seemed to be a prisoner or detainee, several officials and two armed guards with sub-machine guns.

        We then went into central Lusaka, booked into the Lusaka Hotel (a very ordinary, slightly grubby place) and then spent the rest of the day wandering around, shopping and enjoying the sensation of being in Africa.  It had been raining and it was a lovely temperature for wandering about.  Probably somewhere in the mid 20's Centigrade.

Johnny's first impressions - I was pleasantly surprised, and I am still to this date (18 Dec, 10 days after arriving), by the lack of intrusion and aggression from the Zambian folk (who were everywhere!) - all so different from the very nasty vibes that one used to get in Jo'burg and Cape Town and even on occasions in Botswana when I was there so long ago (1972-77) and when apartheid and Rhodesian UDI were still alive and dominant.  Memories of that time keep flooding back and it's good to feel the better atmosphere here now.  I wonder how poisonous that terrible regime was to relationships then and how much is left here now.

        The next day Friday (the next day wasn't Friday it was Wednesday!  But it was the taxi-driver Friday) took us to the airport and we flew to Mfuwe in a little twin-engine plane seating about 20.  Grant had a good view of the Luangwa River as we got near Mfuwe, and recognised where Flatdogs was from having already visited Flatdogs virtually on Google Earth.  Johnny didn't much enjoy the bumpy landing! and we got out of the plane in 36°C heat!

        Dr Diane, who Dr Johnny will replace, met us at the airport.  Off we went into deepest Zambia.  Tarmac road was really very good.  Lots of accacia, bananas, mopane, sausage trees, wild mangos along the road as well as lots of little round houses/huts with conical thatched roofs.  Through a couple of villages with shops and lots of activity and down the track, just before the bridge over the Luangwa River and just before the South Luangwa National Park which starts just on the other side of the river.  Into Flatdogs camp where we will be staying until mid January.  Flatdogs is the English translation of the local word for crocodiles!  Then lots of introductions to lots of new faces at Reception and then down to our cottage - newly thatched, plastered and cleaned up specially for us.

Saturday 11 December 2005.  Today it really rained.  Hard and for several hours.  In the evening we noticed lots more flying insects than usual on the screens around the cottage sitting room attracted by the lights inside.  When we went to eat they were everywhere - again attracted by the lights in the dining area and bar.  They are the flying form of termites - the last stage in the termite life cycle.  Then we noticed that many of them had lost their wings and were having a good time together on the floor - securely attached to one another.  Before we had finished our meal it was all over.  The ground was covered with wings and coupling termites.  The next morning the ground around the cottage was covered with termite wings and that was it - over.  What an amazing thing!!

Friday 16 December 2005.  There seems to be a tradition here at Flatdogs.  Every time there is any excuse whatsoever for a party - someone leaving, someone's birthday, St Patrick's Day, 2 days after the equinox - do you get the idea? - everyone congregates on a Friday evening at what is called a Sundowner.  It starts at 17.30 just before sundown and lasts about an hour.  Nibbles to eat and lots of cold beer, juice, cordial, and lots of chat and gossip.  Everyone comes from the nearby camps to Flatdogs and then a lot of them stop at the restaurant for a meal and more chat and gossip.  The younger ones seem to stay up all night drinking, chatting, and - well I don't know, but I can guess even though we haven't hung around long enough to find out!

Saturday 17 December 2005.  The hottest day since we arrived!  We don't have a thermometer, but it was generally agreed that it was in the low 40's Centigrade.  It was HOT!

Johnny's First Impressions of his clinic in the local village of Kalamani

Johnny 18 Dec 2005 after a week at the clinic on my own without Dr Diane to hold my hand but with a lot of help from the nurses - the first impressions of the clinic have been very muddled - it's a pretty basic affair with three "wards" for observation and lodging of patients should it be too far to home or the efficacy of treatment needs to be assessed in case a different remedy needs to be tried.  It's a bit up against it at present as there is no water because the termites have eaten the wooden supports of the water tank and it has crashed to the ground and smashed.   This means that we have no running water to wash our hands let alone the clinic and it is grubby.  I think this isn't a new phenomenon and the lack of water is not the only cause of the problem - there's a pretty terrible atmosphere amongst the nurses and other staff.  I happened to arrive on time one afternoon and blundered into a staff meeting - my goodness the atmosphere was tense!  We had a difficult harangue from the clinical officer who is in charge of the setup.  She has had three years basic training and attends regular teaching sessions thereafter and is a diagnostician and organiser of treatment rather than a nurse.  Nurses also diagnose and treat according to symptomatic guidelines and do very little other than instruct patients how to treat themselves or their relatives - it would be a mistake to think of them as fetchers and carriers of bedpans and persons who smooth down the sheets or act as handmaidens to the clinical officer or me.  After the harangue we got down to the grumbles - what were the bikes doing in the lab?, why was sterilising being done so badly?, is Paul to be trusted with money?, what does being given responsibility for a task mean?  They are a bit short of procedures and routine and they are suffering.  I tried to put in a positive word for process and we will see how it goes.

        Fortunately the nurses who live in rather grotty premises at the back of the clinic are also getting new houses built for them with the luxury of internal piped water and therefore have a huge vested interest in the swift resolution of the water problem.  The safari company operators have got a tank for them, new supports out of brick will be built and the tank will  be in place soon.  I have used the absence of water as a face-saving feature when discussing what I see to be the state of the clinic in the future - somewhere clean and safe and organised - I have started as I mean to continue - I don't start to see patients till the room I work from is clean and tidy, the light has a bulb in it and the door is able to be locked during private examinations.  Hopefully, I will be able to build on it over the coming months - just wait till the water comes - I will go to work with Brillo pads and a mop that day.  We have a huge excess of good instruments, or rather instruments that were good or could be made good.  Some of them come from kits provided by donation, some are old.  But most are horribly cared-for - they have sat too long in sterilising solution and have corroded or have accretions of deposits.  This makes them unsterilisable and dangerous.  However a lot can be redeeemed - I have sat on the stoep after clinic sessions are over and worked my way through them - cleaning with soap and water, washing and then oiling and I have discovered loads that are good enough.  The nurses are now wrapping bowls in material and putting gauze and cottonwool and instruments in them to dress wounds or stitch up lacerations - and they really have done it!!  I think my job here is to get team-working back here again and basic standards re-established.  Watch this space - will it be possible or will I be defeated? As for the medicine - it's not earth-shatteringly difficult so far and not too depressing - I will write about that when I am more au-fait with it and able to be more accurate.

        Am I enjoying it? - yes, it's a challenge, a different challenge from that which I was anticipating but it should be worthwhile and rewarding as well as fun.  Grant will be photographing the wildlife and making pictures of that available to you to see - it is truly remarkable.

These are for Pat who wanted to see some pictures of the landscape and of the people:

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