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International Child Health Section: Articles
Glendale, Zimbabwe, November 1-30, 2007
Submitted by Sarah Gander
It has taken a long time to sit down and think of the words to describe my experience of five weeks in Zimbabwe. It is difficult to express what this experience does for the mind and soul. I am a final year paediatric resident at Queen’s University in Kingston, Ontario. I spent five weeks at Howard Hospital in Zimbabwe, Africa running the 40-bed children’s ward and seeing a steady stream of children in the outpatient clinic. I most commonly saw children with malnutrition, orthopedic trauma, burns, acute and chronic respiratory disease and gastroenteritis. The ward is divided into acute care and a feeding program for children who were failing to thrive.
I could continue with the classic descriptions of a nation devastated by HIV/AIDS and economic disaster but it makes me nauseous to know that I have read these blurbs before and I can’t remember one from the other. So consider this, what if you were born in Glendale, Zimbabwe? Perhaps you are a nurse (average salary 15 USD/month), a physician even (average salary 50 USD/month) or just work for whatever you can get. You aren’t always able to access this money because the bank has run out bank notes as they are all tied up in the black market. It is disappointing since it may be time to pay your child’s annual school fees (40 USD), buy their uniforms (14 USD) or buy some soap (9 USD). This doesn’t leave money for food, so you’re hoping it rains soon and the crops you planted grow, but it hasn’t rained well in over three years. You have started a business on the side, selling oil that you get from the black market. It brings in enough cash to buy some maize and peanut butter to keep you and your children alive. Two of your children have died now, from that “virus that makes them loose weight and get bad infections”. Then remarkably, some visitors have come and they are white. They walk fast and seem to think their way of doing things is always right but it seems very invasive. They give you pens and notebooks and take your picture. Then they leave again, they always do, and Zimbabwe remains the same. It is hard to know if I made a difference in saving a life or teaching the staff new approaches to the age old problems.
What I realized on the other side of the world, funnily enough, is that people are much the same. Teenage girls still think they are fat (yes, you read that correct) and boys still think farts and burps are funny. Mothers want to show off their child’s artwork and wail when they die. Couples love each other deeply and stand by each other until the very end. Parents want to provide their children with a life better than their own and take great pride in success in education, art and sports. In contrast, even though there is a not so quiet desperation in every Zimbabwean’s voice, they continue to pray for a better time. Their faith is rich and they take everyday as a gift. The community is strong and rallies together when one is in need. Perhaps it is us, that could learn a lot from them.
I saw the sickest children of my career and lost 16 in five weeks; everyone would have lived if I saw them in Canada. Sometimes the oxygen would run out, sometimes I wouldn’t have any antibiotics and sometimes I have no idea what happened. How much do you rely on chest X-rays, echos, bloodwork and consults? What would you do first if you got called to see a new onset type 1 diabetic in a coma who, when you got there, had already been given a 20cc/kg bolus of 0.9%NaCl and potassium but no insulin? No bloodwork, no urinanalysis, no home glucose monitoring, no diabetic educator, etc.
My experience enriched my perspective on what is important in life and career. As I sit here on December 23rd, Christmas seems a mile away but I am so blessed to have my family close and healthy. My Royal College exam is in the spring. I am sure they won’t have a question on how to console a wailing mother who has just lost her only child when you don’t speak her native language. I didn’t come across in the books the second line management of 60% surface areas burns if you don’t have an IV or how you tell a mother there is nothing else you can do for her baby who was discharged from an outlying hospital at 1200 grams. I am better at these parts of my job now and I will be forever changed. This is the difference my experience has had on me. My interest in global health has increased immensely and I realize our social responsibility is not one just to be worn as a plastic bracelet or the gift of a goat or a chicken to a community, although every little bit must help. It is one of demanding action and not tolerating a nation that sits by and watches their people starve and die of preventable disease.
Thank you for the support of the Canadian Paediatric Society to allow this experience to happen for me.
Posted: February 2008
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