Day 4

The new operating theater building is connected to the old operating room building but they are separated by a brick and concrete wall (what was the outside wall of the old operating room building). The construction team has been trying to find a good time to take down that wall so that it opens up a hallway between the two buildings. The trick has been trying to do the demolition without disturbing surgeries going on in the old operating room or creating a dust cloud that would contaminate the surgical areas.

Today was the day we had picked for this job. Dr. Kari had multiple surgeries scheduled throughout each of the previous days so we didn’t want to do the job then. But, today she had four procedures schedule for the morning, hoping to be finished by 2 pm because today was the day the hospital had schedule their semi-annual meeting to discuss issues and plan for the future. That meeting was to begin at 2 pm and all of the hospital staff was supposed to attend. We expected that we would be able to start when the last surgery ended and work on into the evening until it was done so we wouldn’t have to continue working on it tomorrow and disrupt the tomorrow’s surgeries. That didn’t work out.

Anesthetist Barb encountered a couple more mechanical challenges with some of the anesthesia equipment which Bud was help to help work around – but lengthened one of the surgeries. Then one of the other surgeries started by the local staff ran into an unexpected problem which took a while to figure out. Since the patient was a male, Dr. Kari (an OB-Gyn) was challenged to figure out how best to solve the problem. (Last evening she was able to use SKYPE to call an urologist colleague in Battle Creek who assured her that she had done exactly the right thing – having colleagues willing to consult and the technology to reach them is a real blessing). Nevertheless, addressing these took extra time. The surgical team finished the planned surgeries by about 3:30. As we began preparations to start the demolition, Dr. Kari found out there were two more emergency surgeries to do.

The surgical team didn’t finish until about 6 or 6:30. By this time, the construction team had decided to wait and start the demolition first thing in the morning.

Nurse Ann had worked with local nurses again and had an opportunity, now that she had built rapport with several of the nurses, to ask questions about why they do things certain ways or don’t do other things. Both what she has been told and what she has observed have been very helpful in understanding the nursing staff better and appreciating the skill level and training. The cultural differences are considerable.

Diane also continued to help around the hospital during the morning. In the afternoon, she accompanied Missionary Joan to Kaloma, a bigger town about 30 miles north of Zimba. They had errands to run. Since Zimba is very small, rural and remote, almost every need generates the a road trip somewhere. It takes considerable effort, time, and resources to sustain normal life let alone the special needs of breakdowns or construction.

Our days have a certain rhythm to them. Most of us begin rising around 6 or 6:30, brace ourselves with coffee and personal Bible study, then gather for breakfast at 7 or 7:10. We leave for the hospital by about 7:50 to attend the morning chapel services at 8 am which attended by perhaps half the hospital staff who will be working that day. The morning service starts with one or two songs familiar to us but in the Tonga language. When a hymnal is available, we can sing along, otherwise we can hum. One of the hospital staff has been asked to prepare the morning’s message and they have almost always been quite good. After the message, the head nurse reports on the census of patients in the hospital for the day. Following this, the hospital administrator makes comments or announcements. Then everyone is dismissed to do their work. We make our way to the construction projects or the patients to be seen.

We try to break for lunch at noon, although the medical team rarely gets back to the mission house for lunch until later, and then return to projects around 1. The mid-day break for locals typically lasts until at least 2 so we sometimes have difficulty getting things going after lunch because the person we need to get assistance from isn’t yet available. We usually wrap up work by 5, although the medical team may keep seeing patients or wrapping up surgeries later than that (occasionally 6 or 7).

We nearly always eat dinner together as a team. Our meals are prepared for us by Missionary Joan and Edy, the Zambian woman who works at the mission as the cook and housekeeper. The menu is filled with common American dishes, albeit with a North Carolina twist, reflecting Joan’s background. Typically, one dinner meal during our visits is a Zambian meal, a pasty grits-like dumpling (Ensema), cooked cabagge, and a stewed chicken eaten together with your right hand. That was our meal this evening. When the Drs. Jones are here, they usually eat with us along with Joan.

After cleaning up after the meal and doing the dishes (we take turns), we gather for an evening devotional. We take turns being responsible for the evening’s devotional. Ann led the devotional Monday, Barb on Tuesday, Larry on Wednesday, Mark today. It’s a minor miracle negotiating shower time among the eight of us in the one shower, but we’re a pretty agreeable, accommodating group of people. Some of us didn’t know each other very well before we came. Getting to know each other better is one of the fruits of the mission trip.