Blog 2

Our Programme in Monze 1/11/08

We continue to be very happy and well apart from Judy’s mild cold.

There is never a dull moment with constant new experiences, battling with the heat, keeping on top of the process of purifying our water and keeping the red dust and potential burglars at bay. We haven’t started work yet, partly because of the Independence Day celebrations, our trip to Lusaka to register with the Zambian Medical Council, the Presidential elections and the continuing induction process. We will probably start work the week after next unless there are any riots with the results of the election imminent today. However we both have a good idea of what we would like to be doing. Judy, homecare of HIV/AIDS patients and mothers and children in the community in association with the Buntolo project, more of which will be in later blogs. Mike hopes to be involved in the surgical treatment of sigmoid volvulus (twisted colon) which is said to be common and the vesico-fistula repairs at which Michael Breen

Michael Breen

must be one of the world experts. He does about 150 a year and visits other hospitals to do the same and other gynaecology operations mostly hysterectomies some for cervical cancer. He has been in Monze for over 7 years and before that in Africa for several years including South Africa. His life is committed to his patients and was drawn to work at the Monze Mission Hospital

by its founder Sister Lucy O'Brien an amazing and inspiring nun, doctor and gynaecologist. Michael plays a very active part in the local Monze Catholic community but finds the hospital managers difficult and manages to be effective by being fairly independent.

One of Michael's other interests!

Several of the senior managers running the HIV/AIDS service, including an accountant at the hospital, were arrested for financial irregularities just before we arrived and it is likely that the government will insist on a complete change in the senior managers over the next year or two. The Hospital is owned by the Church with the Bishop at the top of the pyramid, a board of trustees overseeing the running of the hospital by the senior management. However most of the funding seems to come from the government including our wages. We both get 1,850,000 Kwacha per month (how lovely to be multimillionaires!), or £308 (£ 616 for the two of us) per month, which we think will be more than enough until we buy a car probably a 4WD Pajero Mitsubishi or Toyota RAV 4 (we never did and did a lot of walking instead). The problem is that petrol is expensive and distances you need to do to get anywhere long.

So back to the end of the last blog.

PM started as our cleaner and did a good job including stealing a few small items from our pantry. We were advised that we shouldn’t ignore it and Judy advised Mike to phone PM which he did and in a face to face meeting 2 days later she totally denied she took the goods and another item we hadn’t noticed was missing! We asked Father Rogers

Father Rogers and two alter boys on Palm Sunday processing to church.

for advice as he new her family and he has promised to talk to her. We hope we can still employ her, as she is a widow bringing up young three children.

Unfortunately that was never possible but meant that were able to have Bridget who was 21 and still at school repeating years she had missed probably because she having her daughter who often came with her. Bridget was very bright very thorough and reliable and as normal asked for advances, but never extra in her salary, to take exams. She also helped look after her sister's daughter and it was sometimes difficult to work out who was who. We never quite worked what her living arrangements were although she probably lived with her grandma. Neither she nor her sister were married.

I'm not sure which the two girls was Bridget's daughter, probably the one on the left.

Bridget


We will leave the potted histories of many of the lovely and interesting people we have met, to later blogs. Many of them are very disappointed that we are only coming for a year.

So what about two of the major events in the first 2 weeks.


Independence Day Celebrations. 23rd and 24th October in Monze.

The Thursday leading up to Independence Day turned out to be more interesting than we had bargained for. Still reeling from the concentration and intensity of our induction programme – eg half a day looking at various hospital departments then – ooh er – why don’t you take the afternoon off? Who are we to argue in this dust and heat? It was to be an arduous morning with meeting both the Roman Catholic Bishop of Monze and the District Commissioner!

We set off with Mrs Y who obviously loves these social visits.

Mrs Y and her son outside the rondavel she grew up in and she was proud to show us. Her father was the headmaster of the local school which she attended and she eventually spent a year in Cardiff studying hospital management after training as a nurse. Mrs Y was the senior hospital manager of Monze Mission Hospital and was very good to us arranging our introductory programme and generally overseeing our stay. She had 10+ sibs her brothers sleeping in one rondavel and sisters in another. Although she was now a committed Christian in the RC church, clearly her early years were spent in a very simple rural community and she probably grew up with many of the traditional cultural traditions.

Dhun, who is a VSO colleague working at the hospital doing monitoring and evaluation of HIV/AIDS services came with us on these trips. She is uncertain about her role as four of the HIV service and one accountant have been arrested for fraudulent activity. This might add a slight challenge to her job as her potential line manager/partner is in prison.

The Diocese has a wonderful new red brick building just out of town. It is well designed, light and cool. The reception area appeared welcoming and we were warmly greeted and offered drinks and biscuits. We were shown around various offices and then taken to meet the Bishop. He was an elderly Italian with wild white hair, a black polo-type shirt and black trousers. He greeted us very formally and Mrs Y kept calling him My Lord and curtseying. We made typical conversation about why we were there and our impressions so far and it all seemed a bit of a formality. How ever the unsuppressible Michael couldn’t resist asking more personal questions as we made our way out and discovered he is a great football fan and supports Juventus. Michael is now fantasizing about watching matches on Sky with his new best friend the Bishop (this never happened, the bishop was a bit of a recluse).
After that we met the District Commissioner (DC) in her office which is next to the hospital. She is a traditionally built woman who we are sure rules with a rod of iron. All the men are afraid of her! I was unable to see a packet of red bush tea but I am sure that is what she drinks. Her office also has a front room quality to it with red plush chairs and sofa. Again we sat for formal conversation but towards the end were invited to join in the beginning of the Independence celebrations, which would begin at midnight with the raising of the Zambian national flag.

This was to be preceded with song, dance, marching and a speech by the DC. We felt very honoured – but knew it would be quite a challenge as we are becoming used to bed at nine thirty and rising at six thirty.
You may not believe this but in spite of knowing better we were actually on time for the celebrations in the gardens outside the DC’s office. And we sat for over an hour waiting for something to happen! People slowly arrived and a group of young students were dancing to recorded music – probably pop African. Eventually the DC arrived, in gold splendour with blue turban accompanied by some of her staff.

She sat down and our hopes were raised that we would not have too long to wait. We were seated in rows of seats facing each other with a space for performing in the middle. The DC was in front of us on the front row, a table in front of her with a great bowl of artificial flowers on it – removed from her office/parlour - adding a sense of splendour. The M.C. was a very slim glamorous young woman in a close-fitting shiny pink evening dress, a gold shrug and gold high heels. The celebrations were ready to start – or were they?
The young students started with the ubiquitous drumming singing and dancing. The dance is the only one we have seen in this area and consists of the men and women lining up in rows facing each other. A woman then selects a man to dance with and a lot of bottom wiggling and pelvic thrusting occurs with the man standing behind the woman.

Each pair takes it in turn and then the dance is over. The singing and drumming gave real atmosphere under the dark Zambian skies. However all was not to go smoothly. The next group was called on to prepare – no response. Then an adult peer educator group – no response, and finally a group called The Matantala Cultural Club who also failed to appear. The M.C, was becoming more and more irate at these upsets to the programme and finally called on a youth Cadet Force to go through there paces. Again there was no response, and understandably so, as they had shot up the programme order. There was some shuffling around off stage in the dark but our M.C. made a few sarcastic remarks suggesting the cadets were either lost or even asleep. At that the older portly officer in charge of them, rather like Captain Mainwaring, emerged at great speed out of the dark, marched forward, saluted the DC as he passed her and demanded an apology or else from the elegant M.C. She apologised saying “of course everyone knows the army never sleeps” which caused some merriment from the audience and in spite of this the cadets eventually emerged from the dark in their sand coloured uniforms and floppy brimmed hats. They marched with small shuffling steps and lopped sided walk we thought caused by the restricted space in front of the DC. However having seem another group in a much lager arena it turns out

it is just their style. It seems that almost a dance routine has been created from marching manoeuvres such as “ about turn “, “ at ease” and “present arms”. The evening continued with more of the same – literally as half the entertainment had not turned up and the M.C. kept urging those there to perform again. We were served soft drinks and beer and valiantly tried to stay awake. At last it was decided the time had come for the DC to give her speech and for the flag to be raised. It was in fact about ten to twelve but it had been a long evening and no one pointed this out. In our experience so far the only time anything has been early in Zambia. And so to bed.
We were up much later than usual the next day in spite of the parade being scheduled for 7.30am. The sun was hot as we made our way to the Harry Mwanga Nkumbula Stadium. It is about twenty minutes from where we live and is simply a large rough field with a mixture of earth, grass, stones and goal posts. The crowds were gathering in a large circle around the field. The DC was on her red plush sofa under a make shift awning which could shelter about thirty people on chairs. Splendidly dressed again – this time in an embroidered silver fabric and turban.

She made her speech and after she had sat down spotted us, and we were invited to sit in the shade with her.

Judy is to the left of the left hand pole I'm behind the camera!

Most of the local schools performed with dancing ,drama and poetry. Some of this was very powerful with different themes ranging from the brutality of colonialism, (a little uncomfortable) to marriage of girls too young and issues regarding HIV/AIDS. There was an impassioned poem by a young girl who had been orphaned due to AIDS and another by two girls pleading for young folk to be aware of health issues and to take responsibility for this. Towards the end of the morning we were ‘Cordially invited to an African luncheon. Venue – Truckers Restaurant'.

Mike outside "Truckers" on a different occasion. We never had another meal there!

We were transported with the DC to a large partially open room at the back of the Truckers Restaurant. The lunch was food we had not had before – chicken or fish stew. The fish is interesting – dried but when cooked is eaten bones and all! It was the best meal we have had so far, eaten with fingers only and served with nshima (maize or mealy meal with texture of mashed potatoes). The first meal we have had without chips and tomato ketchup -Dawson eat your heart out, bet you can’t wait to visit us!
It was then back to the ‘arena’ for an afternoon of sport – football and netball. Such a challenge on a hard uneven pitch with a very bouncy ball , bare feet and a strong wind. It was entertaining however and the boys’ energy in the heat was quite amazing. Michael is taking his role of Pompey scout in Zambia very seriously, especially as we have been let down so badly by Harry. In fact we were at the GP (Golden Pillow) doing emails when we saw him on the BBC World News. Ironically the clip shown was of him on the bus with Kanu (Nigerian) post F.A. Cup victory. THAT is how important it was in world affairs! An even more cruel blow is that he has gone to Spurs. We think it is just as well that we aren’t sharing a home with Tom at present.
Our day there ended as the DC left with an elderly rich local farmer and businessman Mr Cornhill. He must have a story to tell, as his father was a white Zambian (possibly Scottish) and his mother Zambian. He had several wives( serially), many children and countless grandchildren. He use to own 5,000 cattle now down to 2,000, hard times. The local prisoners arrived to take down the awning and we set off home in the lengthening shadows. The sun sets at six o’clock and it is dark by six forty five with all the stars and the moon out. We arrived home hoping there would be water after a long dusty day and power long enough to cook supper if we timed it right. I think we face a future of romantic candlelit but possibly uncooked suppers.

The trip to Lusaka for our interview and registration with the Zambia Medical Council (ZMC) 27-28/10/08.

We rose from our beds at 6.30am followed by the now usual rituals of tea (Rooibos for Judy, Mike thinks he is getting to like, or Earl Grey) watering the small oasis we call a garden,

if we haven’t the night before and washing ourselves, if we are lucky in warm water followed by breakfast and then before leaving the house checking that all the taps and lights have been turned off (they may have been on when either or both failed), closing all the windows and double locking the front door (mortice and padlock), and finally removing the padlocks on the

The window and front door of our flat with the padlocked corrugated iron gates you can just see 7 yards in front of the window.

9 foot high sliding corrugated iron gates, which open with considerable reluctance and noise probably similar to that heard by the prisoners in Alcatraz! These are set in an equally high, cement covered white concrete walls which surround the compound to include ours and another semi-detached bungalow and a mostly unoccupied smaller residence owned by WWF and lived in by Crispin when he is working in the area,(and occasionally by his wife, 2 children and nanny also) all connected by a small red dusty garden. Our small oasis growing a few hopeful tomatoes, very dry and brown cucumber plants and a few brave emerging seedlings is between our bungalow and the high white wall. We hope our garden will provide greater variety to our diet in the near future. (it was aforlorn hope!)

We expected a lift in the hospital bus to our first meeting with Dr. Mvulla the medical Director (MD) at 0800 hrs. At 8.20 after a failed attempt at phoning Mrs. Yamba the senior hospital administrator to enquire what has happened to the transport we struck out for the hospital, a 20 min dusty walk in the glorious, fortunately only warm sunshine, in our formal gear including tie and shirt both for our meeting with the MD and our interview in Lusaka with the ZMC with our kit and documents in a rather weighty rucksack. We arrive at 0840hrs to discover Mrs. Y and the MD in a meeting, which lasts to 9.00. At 9.30 we are introduced to the MD and have a very nice chat with Dr. Mvulla. He is a Zambian trained Doctor aged about 33yrs. He resigned from medicine 3yrs after qualification did training for the priesthood in South Africa then changed his mind again and returned to medicine and two years ago was selected to run Monze mission hospital. He does not have too much time to do clinical work but does 1 day a week doing outpatients. He seemed fairly vague about definite plans for us and as we are still familiarizing ourselves with the hospital departments it is difficult to be quite sure where we will eventually fit in.
We then had to wait another 30 minutes for hospital transport to the coach station mostly in the rapidly warming sun. The trip to Lusaka is a fairly tedious one; hot, dusty, bumpy and lasting at least three and a half hours. We had to include an overnight stop as the ZMC had given us all an appointment for 0900hrs the following morning.
Life then started to become difficult. We were dropped off at the Golden Pillow (GP), the best

This is not the Hotel itself, which was much less impressive and of which I didn't have a photo!

hotel, restaurant and fastest internet connection in town that also has the coach stop to Lusaka and discovered, as the hospital bus was disappearing, fortunately not completely, that all the clean and comfortable and cool coaches for the journey to Lusaka were fully booked for the rest of the day. Before the hospital bus completely disappeared, the first lucky break of the day, I raced to the road in my formal shirt and tie and long but fortunately light trousers raising only mild perspiration and persuaded the hospital driver to come back and help us try and get round the problem. It turned out that the coaches were unusually busy with folk not only returning from celebrating Independence Day but also travelling to where they were registered ready for the election of a new president.
We also had the faint hope we might get a lift to Lusaka in the not so cool but at least comfortable hospital transport.

We then returned to the hospital to negotiate with Mrs. Y this alternative form of transport. However at her suggestion we returned again to the coach station in the hope that the 13.00hrs coach may have spaces and if not the hospital bus would return and take us to Lusaka. At 13.00 we established there no spaces in that coach or indeed any of the others leaving that day. Mrs. Y then asked whether we would be willing to travel in the smaller less cool and perhaps more crowded but cheaper blue buses used by the poorer folk. In a moment of weakness we agreed

Our bus (above) and a similar one but even less salubrious!

and on our way back to the small blue bus station our second lucky break occurred, as they were able to flag down one such bus just as it was leaving. We were ushered on to this not completely full rather grubby clearly quite well used older type of bus with flapping curtains that had to be restrained to stop them from hitting us repeatedly in the face and were fortunate to find two spare seats right at the back. The drivers assistant suggested we each pay 50,000 Kwacha (about £8) which we knew was excessive and eventually beat him down to 45,0000K which was still excessive but we didn’t have the heart to negotiate a further reduction.

It was now around 15.30 hrs, nine after getting up and all we had achieved was a 45min meeting with the MD but at least we would now make it to Lusaka?

Four hours later after being bumped and bounced along the long very straight, potholed and now hot road with very changeable companions, including young women with much luggage that was skillfully packed into the boot beneath and pushing up through our seats and a sick one- week old baby, we arrived in a very busy and congested bus station in Lusaka. Unfortunately we were still 7 kilometres from the Combroni Convent House where we were staying. However the driver and his mate, after otherwise emptying the bus insisted that he knew where the convent was and insisted in motoring us back out of Lusaka. The journey seemed longer than it should be and I could tell that Judy was getting a little anxious!

However our trust was rewarded and down an unmade road and after overshooting it we eventually found number 9. By the time we returned Sister Conceilia was already outside to conduct us through the 9-foot corrugated iron gates (sounds familiar?) to a lovely quiet clean and very reasonable hostel with a lovely garden where we spent an excellent night and for the first time since coming to Z. slept without a mosquito net. Another VSO Doctor and his wife, Andy and Gaby

Andy and Gabi on the left who unfortunately had to return to England after only 3 months in Zambia.

joined us for dinner in a restaurant within walking distance from the hostel called “Comfort Zone”. As we arrived there was a power cut but undaunted, our simple meal was cooked on gas and we dined by candlelight in a lovely garden by a pool and drank two small bottles of beer each. We had a great chat about our experiences in Zambia so far, its amazing how quickly you build up quite close friendships in these situations and were back in the Hotel and to bed by 10.00 to build our strength up for the battle the next day.

We woke to a dust free world and were able to have a shower – wonderful! We helped ourselves to the breakfast provided and at 7am set off for the VSO offices so that they could get us for our interviews in plenty of time. We have to say here that we now KNOW that there is no doubt where Thompson Time came from. Some of us have retained our African genes more strongly than others and even we are having great difficulty in not being incredibly EARLY for everything. I know some of you may find this difficult to believe and it certainly is a strange experience for us.

It is now 01.00 and I must go to bed with the noise of surprisingly loud croaking frogs and barking dogs. It is now quite cool and I wont have any trouble sleeping.

I didn’t and Judy has now added some paragraphs, can you guess which ones?

The taxi in Lusaka took us through the busy early morning traffic and we arrived at the VSO offices which are in a very large airy six storey building standing in extensive gardens with brilliantly red Flame trees. The building is one of the higher buildings in Lusaka, is close to the main bus station and city centre. We had time to do some emails although the system is incredibly slow compared to home and the Golden Pillow in Monze.

We arrived at the Faculty of Medicine Office which is in the Medical School in the University Teaching Hospital (UTH) in Penn time at 9.00am only to be told that the interviews were in 14hrs which I initially thought meant it would be at 11pm!! Fortunately this is the Zambian way of saying 2pm and we suddenly had only 3hrs of shopping time! This extended to 3hrs+1hr of coffee further shopping and wondering whether we should have lunch. We had a considerable amount of luggage including a brush, iron, ironing board, toaster, electric kettle, hammer, nails and a lot of food. This was because we were expecting the hospital Land Cruiser to pick us up. This eventually arrived too late at 2.00pm (sorry 14hrs) 30 minutes after we had left to get to UTH in a taxi with all our purchasers left packed into the VSO car we had been using to get around.

We arrived at the Faculty Office at 1400hrs, waited until 1500hrs, were all interviewed (Judy, Michael, Andy Moulson, and Hiran de Silva) within 30 minutes by three impressive Zambians including the Dean, Professor Mulla an orthopaedic surgeon, the Professor of Medicine and an obstetrician and gynaecologist. We are now registered on the Zambian GMC to practice in Zambia. Professor Mulla asked Michael to email him his main interests, as they would like him to give a lecture in Lusaka so we can have another enjoyable journey to Lusaka!! (this never happened)

After the interview our hospital transport was still nowhere to be seen all six of us squeezed back into the in the VSO car with all our luggage to drive back to the VSO office with the gear lever indecently close to Michael’s upper right thigh. He did suggest to Eleanor that he would change gear if she wished but she managed with Judy watching, tightly squeezed between Michael and the near side door.
We looked forward to getting our kit and rapidly melting provisions, (leaking fishy water) out of the VSO vehicle and the into the more spacious hospital Land Cruiser. To our surprise this was already half filled by six large Zambians with some of their provisions and kit for the hospital pharmacy and other departments.

The Land Cruiser with Judy and our buys before Mike and the three more Zambians piled in!

They were very apologetic for missing us at the shops, were fortunately friendly and most of the extra passengers worked for the hospital. We had interesting chats with our knees close to theirs facing each other across the back of the Land Cruiser, provisions and household goods amazingly stashed away we hurtled back on the long very straight 2 track main road south with many other vehicles going in both directions. Initially this was in sunshine but we watched the sun rapidly set and most of the journey was in darkness the car intermittently lit from the front and back silhouetting its passengers. Two were drinking whisky diluted by what looked like lemon juice, which we politely refused when it was offered! They were happy and not too the worse for wear. They looked together at something on a cell phone, which highlighted their chins, noses, eyebrows and shaven heads with a bluish glow in the deep black night as we were bounced and bumped back to Monze with just a brief stop at Masabuka. Here there were youths packed into the backs of lorries waving flags for the imminent Presidential elections. The only way to stay cool was to have all the windows open and the air rushed through the Land Cruiser at 60mph tugging at what’s left my hair making my scalp itch but the overall feeling was very relaxing.

On arriving in Monze at 2000hrs all the boys helped us unload, all the provisions survived and are keeping us alive a little longer. We know our chats with the physiotherapist and nurse (the whisky connoisseurs) will have built a few bridges, it was great meeting our VSO colleagues again in Lusaka which we hope to visit in the Eastern province and once again many adventures in what should have been a very straight forward trip to register with the Zambian Medical Council!!!!!

Sorry this is so long, the blogs will get much shorter when most of these things begin to be more mundane??!! ( that never happened!)