Have a little Faith.

Makadini mose! I'm here in Hwange where it's hot (but not as hot as home) and all settled in the convent with my new glee team - Sr. Rumi, Sr. Jane, Sr. Anastasia, Sr. Johanna and Sr. Noeline. The Sisters have been the best thing about Hwange so far because they are amazing! One of them is a nurse and 2 are recently retired nurses so am learning loads from them but also they are just funny women! I don't have a photo of them all together yet but here's Sr. Anastasia with the convent's very own Nottingham tea towel (I have been resident drier upper since I got here so it seemed apt)!

Sr. Anastasia delighted with her Nottingham teatowel!

The convent is right beside St. Patrick's Hospital (started as a clinic by an Irish priest in the late nineties, thus the name) so it's been an ideal place to stay.
Needless to say it's been a very religious week what with my visit here being organised by Fr. Trust and staying with the nuns. But I've been discovering how large a part religion actually plays in healthcare in Zimbabwe, well, in Hwange anyways.
So far all of the staff and patients I have met (and this goes for Lusaka also) have been religious. Yes, many of the hospitals are Mission Hospitals but not all of them.

The old travelling clinic at Lukosi Clinic, now they just admit women at 36 weeks if they live too far away.

Late last week I visited Lukosi, a clinic in a more rural part of the District. It is run completely by nurses & midwives, there are no medical staff whatsoever. The clinic mostly looks after pregnant women as it delivers free care, which most of the hospitals don't, and they cannot afford to come into the town to the bigger hospital. The nurses here are well trained and run the clinic well but they are limited equipment wise. For example they cannot do ultrasound scans due to problems with the voltage of the scanner that was donated to them. If a woman is having a complicated pregnancy she is referred into St. Patrick's but this is the tricky bit. Often if people cannot afford to pay they won't go into St. Patrick's and will take their chances, sometimes with dire consequences. When I asked the senior nurse there what happens if there is an emergency when an otherwise healthy woman has complications giving birth his answer was that that is the risk they and their patients take.
It got me thinking that it's no wonder religion plays such a big role in health care here. No matter how short staffed a shift has ever been or how lacking in resources we think we are, at the end of the day all I have to do is pull that little red button (have not seen a single emergency call bell anywhere so far) put the crash call out and within minutes a dozen people are swarming around to save the day. Imagine not having that!??
No emergency bell, no call out, no arrest team, no back up. You're it.
I'd be saying more than a few Hail Mary's if it was me, that's for sure.

I spent today in St. Patrick's on ward round, in clinic and checking out the different departments.
Again, the differences are huge. There are no specialties, just male and female wards (other than maternity of course). There are 2 doctors for the whole hospital and not many more nurses.While on rounds they explained some of the more common problems they see - TB is a huge issue here at the moment and treatment for it is scarce. HIV is also a big problem with the majority of the patients we saw today being HIV+. One patient came in with a stroke potentially caused by a lesion due to his being HIV+, he needed a CT scan to confirm this. He's not getting one because the closest place to get one is in Bulawayo (300 miles away) and costs $500, which the patient pays himself. This patient hadn't a hope in hell of having that kind of money, I don't have that kind of money!! In a lot of situations like this patients end up being treated for their symptoms or what they appear to have as the investigations are just not available here and if they are most people can't afford them.
I've found it incredibly frustrating to see people with problems that I know how to fix - so does every other member of staff here - but the medication or equipment just isn't available and in the rare case that it is the patient will often choose not to have it as they cannot afford it.
On a personal note - most of you know that I have rheumatoid arthritis. Since diagnosis it has been hit hard with strong treatment to get me in remission which has worked a dream, you would never guess to look at me that there's anything wrong. After seeing many patients today come in during acute flare ups and really struggling I asked the doctor I was with about the treatment. It turns out there is none. Symptomatic patients are treated with steroids and pain relief as and when and that's it. The medication I take exists here, it's just far too expensive for anyone to even contemplate stocking it, even in the private hospitals. So if I lived here in Hwange I'd basically be a cripple. I have never taken my treatment for granted and have always been so grateful for how well I've responded to it but seeing patients today with the same condition as me who can barely walk was really hard to swallow. The luck of where you are born is a huge factor that most of us never even think of.

Audrey (left) & Luara (right) 2 nurses I worked with in St. Patrick's

Again, you can see why religion comes into it. People here place so much in the hands of God and probably because they have to. To become ill and potentially die from something that isn't even on our radar in the West (there was a huge cholera outbreak in Lusaka last year, malnutrition is regularly a reason for admission of children in the rural parts of Hwange) you have to have faith in something otherwise you are faced with the stark reality that the reason you are in that position is lack of education, investment and turbulent politics which isn't a pleasant thought. At least if you have faith that it is all part of some greater good it is some comfort, to patients and staff alike.
I think that blogs are meant to be upbeat and fun so I'm not doing very well today! I'm off to Binga with Fr. Trust tomorrow to see a proper rural setting. It's close to Lake Kariba which is the worlds largest man-made lake so I'll make sure to take some photos and include something nice in the next blog! It has been a great week though, the whole surrounding area is a national park so it's beautiful, the Sisters are amazing (I remember being much more afraid of nuns in Ireland. Maybe Irish nuns are scarier? Also, maybe it's because I'm 29 rather than 10!) and I've seen so many new things. Plenty more to see and do in week 3 I'm sure but this week's motto is definitely to count our blessings as we don't know what we have until it's gone.

Slán libh.

Kate