Shadreck is my next patient in OPD. He is a well dressed gentleman in khaki trousers and a white shirt accompanied by his wife. I recognise him and remember from the ward, he had been an inpatient a short time ago or so I thought. When I examine his green card however I am surprised to see that Shadreck’s admission had been way back in August. It’s a reminder to me of how quick time goes and that my time remaining here is short now. It also reminds me that even though it seems I am stuck in a time bubble here life is probably moving on at home.
Because I left at the start of the Irish ‘summer’ I sometimes think that it must still be summer at home. I have this idea when I arrive home it will be the start of autumn. Being away from home and experiencing life in a completely different country is great but sometimes you forget about the things you miss out at home especially your family and friends.
Shadreck had been treated for severe cardiac failure and required high doses of diuretics to remove excess fluid from his body. Unfortunately since his discharge he has been chronically under dosed with medications and now needs to be readmitted to get stabilised again. He is in good form nonetheless, we talk about ‘Chipata Motel’ the township where he lives in Chipata.
Despite having been here for some time being used to see patients severely ill, adults wasted away from AIDS, children with malnutrition, witnessing death on a near daily basis I am still often shocked at the dire circumstances a fellow human being can find themselves in. My next patient after Shadreck is Mary. She is 19 years old. The first thing I notice about Mary is the smell of urine. But that is not why she has come to the hospital today.
Mary weighs about 40kg, she looks horribly thin. She tells me her problem is cough shortness of breath and weight loss. Examining her there is almost no air entry in her left lung. Her chest X-ray shows a hydropneumothorax, the space where her lung should be is now filed with air and now some of this space is filled with fluid. She does not know her HIV status but is most likely positive. I admit her to the ward, later when someone tries to drain the fluid from her chest several hundred millilitres of frank pus is removed.
I try to ask Mary about her urinary incontinence. It is likely she has a vesico vaginal fistula following obstructed labour. Through an interpreter I try to delicately ask her about her pregnancies and deliveries, if she has noticed any problems, tell her there is a surgeon visiting in the next few weeks who may be able to help her. She denies any problems. She got married at fifteen and has two children but says the labours were fine and the children delivered at the local health centre. Maybe on the ward she will open up to someone about this. As part of my GP training we have to video some consultations we do with patients (with consent) so our communication skills and how we manage the consultation can be assessed. Here mostly working through an interpreter in a busy and hectic environment I fell most of my consultations would unfortunately fail.
Days and weeks pass by quickly, we have less doctors coming up to Christmas, there is more work to do. Sometimes I feel like I am enjoying it more, find the medicine more interesting, that I have an idea what I am doing now and can really make a difference. Other times I feel tired, start looking forward to finishing up in a few weeks, having a holiday, going home. One afternoon after a frustrating morning ward round Pearson walks into room 15 in OPD. I don’t recognise him at first and then think to myself it can’t be, but it is him.
Pearson had been on the ward three weeks ago with a three month history of a massive tumour on his left forehead, growing outwards, down covering his eye and deep, with an X-ray showing some destruction of his skull. He needed treatment quickly. He had some lymph node involvement in his neck one of which was biopsied and sent to the Netherlands for analysis. We gave him chemotherapy treatment for non Hodgkin’s lymphoma thinking that the most likely diagnosis in a HIV positive patient. We told him to come back in three weeks for his next cycle of chemo, the biopsy result may even be back via email then. We doubted that he would make it back.
Pearson is here now three weeks later, his tumour has shrunk dramatically, he feels well. While his left eye is still closed he can now lift the lid and the eye itself and his vision is fine. His results show he has a Burkitt’s lymphoma, a cancer common among African children and in HIV patients. This type of tumour can invade the central nervous system so this time as well as intravenous chemo I have to give him intrathecal methotrexate. This involves inserting a lumbar puncture needle through his back so it is in the cerebrospinal fluid then injecting the medication slowly through this needle. This way the chemo is in his CSF directly into his central nervous system and can reach the brain. It’s not exactly what I thought I would be doing when I decided to become a GP.
After admitting Pearson for his chemo I am seeing the next patient, a lady in for review of her blood pressure, more familiar territory for me. However in the middle of the consultation an emergency case is brought in. An eight month old child is placed on the examination couch, he is warm but not breathing and does not have a pulse.
As I commence CPR and my colleagues come to help me I learn from his father that he has had a fever since yesterday and had not been feeding well today. We continue CPR, can’t get an IV line so give adrenaline directly into the heart. After fifteen minutes his pupils are fixed and not responsive, he has no cardiac output, he is not breathing, he is dead. Probably one of the one million plus children who die from malaria every year in Africa. After barely a few minutes his father picks up his body and leaves for home. I return to my patient with high blood pressure and remind her of the importance of a low salt diet.
Friday, December 31, 2010
Tuesday, December 28, 2010
Happy Christmas!
Just to say (now that the internet is working again) I hope all those who read this blog had a happy Christmas and good luck for the new year. Thanks again to all those who have contributed to my fundraising efforts for St Francis.
What’s in a name?
Surnames are pretty boring here in Eastern Zambia. Much like most people on Achill Island having either Gallagher or Kilbane as their surname, here well over half of the patients have either Banda (which in English means plain) or Phiri (meaning hill or mountain) for their surname. The remainder comprise a scattering of Zulu’s, Tembo’s, Sakala’s or Mbewe’s. In fact when I see a patient with an unfamiliar surname I usually enquire and find that they are originally from a different part of the country.
Perhaps as a means of making it easier for people to identify themselves and keep numbers of John Banda’s or Mary Phiri’s Limited people here are extremely imaginative when it comes to forenames. Some of these names parents seem to pick in the hope that their children will grow up well, to be Good people, Innocent of any faults, live a Happy life, be Smart and do well in school, to be Humble and Decent.
Some I feel are pretty bad choices. I know being overweight here is a sign of affluence but I struggle to understand how anyone could call their daughter Fatness, or Vast for that matter. I think parents should love all their children just the Same no matter what Size they are. To many parents the arrival of a child is seen as a Gift, a Beauty something Precious. And while it’s good to spread the Love, Lovemore sounds like a chick from a James Bond movie.
Maybe parents pick names in the hope that they are Lucky. Calling your child Fertiliser may lead to a good harvest. Perhaps rather than a child they would have preferred the arrival of a new pair of Shoes or a Table. It’s difficult to put together the Chain of events that leads some choices though such as Tennis or Lightmaka or Butterfly or Dynamo to Note just some.
Sometimes the names bear Witness to the child’s arrival into this world. A boy delivered after a difficult labour is not let forget the fact for the rest of his life and often gets named Mabvuto (trouble). Some mothers are thankful for a Nice and Easy labour though. I hope it is Obvious to the reader that all words in italics are actual names of patients I have come across here working as a Doctor. Goodbye.
Perhaps as a means of making it easier for people to identify themselves and keep numbers of John Banda’s or Mary Phiri’s Limited people here are extremely imaginative when it comes to forenames. Some of these names parents seem to pick in the hope that their children will grow up well, to be Good people, Innocent of any faults, live a Happy life, be Smart and do well in school, to be Humble and Decent.
Some I feel are pretty bad choices. I know being overweight here is a sign of affluence but I struggle to understand how anyone could call their daughter Fatness, or Vast for that matter. I think parents should love all their children just the Same no matter what Size they are. To many parents the arrival of a child is seen as a Gift, a Beauty something Precious. And while it’s good to spread the Love, Lovemore sounds like a chick from a James Bond movie.
Maybe parents pick names in the hope that they are Lucky. Calling your child Fertiliser may lead to a good harvest. Perhaps rather than a child they would have preferred the arrival of a new pair of Shoes or a Table. It’s difficult to put together the Chain of events that leads some choices though such as Tennis or Lightmaka or Butterfly or Dynamo to Note just some.
Sometimes the names bear Witness to the child’s arrival into this world. A boy delivered after a difficult labour is not let forget the fact for the rest of his life and often gets named Mabvuto (trouble). Some mothers are thankful for a Nice and Easy labour though. I hope it is Obvious to the reader that all words in italics are actual names of patients I have come across here working as a Doctor. Goodbye.
Monday, December 13, 2010
Katete Prison Blues
From time to time we have a prisoner from Katete state prison on the ward. They are easy to spot in their flimsy white uniforms of shorts and t-shirt usually with a prison guard by their bed. I have had a couple of issues with the prison staff regarding their care. At one point I discovered one of my patients who was confused handcuffed to the bed. The police officer said he was a suspect for cattle stealing and as they felt he was a flight risk and they were unable to provide a guard to watch him they decided to handcuff him. Understandably I was less than impressed that a patient already confused from sepsis was chained to the bed. This led to a heated dispute with the officer responsible until he rescinded.
Come to think of it my only real disputes since here have been regarding prisoners. Recently we had an inmate from the prison admitted quite unwell suffering from HIV and a TB pleural effusion whereby the space where one of his lungs should be was completely filled with serous fluid. After about a week’s treatment including draining the fluid and giving TB meds he was improving, was less short of breath and able to mobilise about the ward. I felt at this stage he was fit for discharge home.
However I didn’t feel prison was the appropriate place for him right now and it would be best for him to spend a few months recuperating at home with the care of his family before returning to serve the remainder of his sentence. Now bear in mind this man is a taxi driver imprisoned for eight months for non payment of motor related fines and has two months left to serve. Surely my suggestion that the remainder of his sentence be deferred sounds reasonable. I tell the prison guard I will be supplying a medical letter recommending this to the officer in charge and as soon as he Okays it I will discharge Misheck. I think this should be a straight forward procedure, but this is Zambia. Whilst not meaning to be over critical of this country which is populated by amazing friendly people with a vast depth of culture, the bureaucracy here can be infuriating.
The following day the officer in charge arrives saying it is not in his power to defer the sentence that the request must go through ‘channels’, that it would take many months, that only the President himself his excellency could grant such a request and so on. Cue another heated debate eventually leading me to desist from further conversation on the matter as it was futile. So my options now remain to leave the patient on the ward for a number of weeks with a guard 24 hours at the Zambian exchequers expense or discharge him to the prison.
What is a prison in Zambia like? The hospital is fairly basic compared to home so how will a prison compare? I don’t like the look of the food the patients get in hospital but Misheck tells me it’s far better than prison food. The guards inform me they have a sick bay for prisoners who are ill and that they bring patients regularly for review to the clinic or St Francis. I grant they do regularly bring inmates for medical attention but Misheck was really sick when admitted a couple of weeks ago.
I arrange a visit to the prison with Chisala one of the guards for Saturday morning. Some of the medical students come along for the trip. When we arrive I ring Chisala who tells me to knock and go ahead in. We are greeted by another guard Kelvin who recognises one of the students having been admitted to the surgical ward a few weeks back. Here at the outer gate one of the prisoners is working as a tailor mending uniforms. After a couple of minutes Chisala arrives in the gate with two cows trotters, which he proudly boosts will make a good meal. We have to leave our cameras and phones behind before proceeding through the inner gate.
Inside is a barren open space with five or six buildings and a toilet block scattered about. The prisoners are mostly sitting down on the ground, it’s hot this morning and there is little shade here. Kelvin explains that this is a medium security prison housing prisoners with sentence of five years or less. There are currently 152 convicts or people on remand (people awaiting trial) here. Some are currently in the prison farm in Msoro camping and sowing crops.
Our first stop on the tour is the ‘sick bay’. We are shown into a tiny room with no windows about 7*6 foot. There is a single mattress on the floor with a net above. Nobody is in sick bay right now but we are told sometimes there are three or four prisoners here. Must be fairly cramped. I enquire about medical care for people from sick bay and informed that someone form Katete urban health clinic attends weekly. In addition sick patients are allowed daily visitors.
Beside this there is a door behind which is the ‘women’s wing’. We are brought here next. It looks like a scene from a Dickens dramatisation, some kind of back alley that Oliver Twist might run down. There is a building facing the perimeter wall some six feet away. There are three wooden doors on the outside to three separate rooms. There are just three female prisoners right now sharing one of these rooms. I later learn the other rooms are used for solitary confinement.
One of the female prisoners is awaiting trial for murder. I briefly get to talk to her, she doesn’t enjoy the prison and tells me that the death of her friend was an accident. With her in prison is her 17 month old daughter Anna. If convicted Anna’s mother faces a sentence of up to 12 years. The death sentence still exists in Zambian law but for men only. The last execution was in 1997. When I ask what the method was I am told it’s a government secret.
We go back through the wooden door into the main compound, the men are sitting about mostly. One is listening to music on headphones, Chilasa informs me he is one of the captains appointed to oversee the other prisoners. We enter cell one, a building where we are told 25-30 prisoners sleep. However there is only cell one and two which would leave quite a shortfall out of the 127 men here. We are told each prisoner has a mattress. In the corner of the cell behind a screening wall is a single toilet. It’s a proper toilet and clean.
We go next to cell two the same size, except kitted out better. On one wall is a big blackboard being used as a sort of count down calendar. The days of December are being rubbed off as they pass, below this reads ‘coming soon: January’ and then ‘next attraction: February’. Elsewhere on the board is a list of activities including ‘Bible day’, ‘quizz day’, ‘complaint day’ and ‘yoyoyo day’ which I’m told means stories. Hen there is a bible quote from one of Peter’s letters ‘one day freedom’. I ask about the spiritual needs of the prisoners and am told that the various churches do come. ‘The churches they do assist us a lot, they provide soap and other commodities, they are helping a lot’ Kelvin explains.
In another corner of cell two is a small TV belonging to one of the prisoners. It along with the single light bulb in each cell are the only twentieth century items here otherwise the prison could be literally be from the eighteenth or nineteenth centuries.
The kitchen is in another building. There is no electricity, water is carried from a burr hole outside. Behind the building some prisoners are lighting fires under where the pots are inside. There is a bowl of Kapenta (small dried salted fish) outside as well as the trotters resting on a lump of wood, flies swarm all about. Chisala tells me there is just nshima and kapenta to eat right now. Normally there is beans and rice but these are currently out of stock, sounds like the pharmacy report in St Francis. The prison does have some ducks here and goats and these are occasionally on the menu.
At the end of our visit we sign the book back at the gate. I am surprised to see the name of one of the hospital staff in the book and am told he came to bring a few prisoners with a guard to do some work around his house. I am told I can do the same at any time if I wish, my own chain gang. The prison is basic but not as bad as I thought it would be. There is a laid back atmosphere no hint of violence, the prisoners even have their own football team. The accommodation is simple but probably not a whole lot worse than the hospital. How will they feed over 100 on two cows trotters? Am I comfortable to discharge Misheck there or not?
Come to think of it my only real disputes since here have been regarding prisoners. Recently we had an inmate from the prison admitted quite unwell suffering from HIV and a TB pleural effusion whereby the space where one of his lungs should be was completely filled with serous fluid. After about a week’s treatment including draining the fluid and giving TB meds he was improving, was less short of breath and able to mobilise about the ward. I felt at this stage he was fit for discharge home.
However I didn’t feel prison was the appropriate place for him right now and it would be best for him to spend a few months recuperating at home with the care of his family before returning to serve the remainder of his sentence. Now bear in mind this man is a taxi driver imprisoned for eight months for non payment of motor related fines and has two months left to serve. Surely my suggestion that the remainder of his sentence be deferred sounds reasonable. I tell the prison guard I will be supplying a medical letter recommending this to the officer in charge and as soon as he Okays it I will discharge Misheck. I think this should be a straight forward procedure, but this is Zambia. Whilst not meaning to be over critical of this country which is populated by amazing friendly people with a vast depth of culture, the bureaucracy here can be infuriating.
The following day the officer in charge arrives saying it is not in his power to defer the sentence that the request must go through ‘channels’, that it would take many months, that only the President himself his excellency could grant such a request and so on. Cue another heated debate eventually leading me to desist from further conversation on the matter as it was futile. So my options now remain to leave the patient on the ward for a number of weeks with a guard 24 hours at the Zambian exchequers expense or discharge him to the prison.
What is a prison in Zambia like? The hospital is fairly basic compared to home so how will a prison compare? I don’t like the look of the food the patients get in hospital but Misheck tells me it’s far better than prison food. The guards inform me they have a sick bay for prisoners who are ill and that they bring patients regularly for review to the clinic or St Francis. I grant they do regularly bring inmates for medical attention but Misheck was really sick when admitted a couple of weeks ago.
I arrange a visit to the prison with Chisala one of the guards for Saturday morning. Some of the medical students come along for the trip. When we arrive I ring Chisala who tells me to knock and go ahead in. We are greeted by another guard Kelvin who recognises one of the students having been admitted to the surgical ward a few weeks back. Here at the outer gate one of the prisoners is working as a tailor mending uniforms. After a couple of minutes Chisala arrives in the gate with two cows trotters, which he proudly boosts will make a good meal. We have to leave our cameras and phones behind before proceeding through the inner gate.
Inside is a barren open space with five or six buildings and a toilet block scattered about. The prisoners are mostly sitting down on the ground, it’s hot this morning and there is little shade here. Kelvin explains that this is a medium security prison housing prisoners with sentence of five years or less. There are currently 152 convicts or people on remand (people awaiting trial) here. Some are currently in the prison farm in Msoro camping and sowing crops.
Our first stop on the tour is the ‘sick bay’. We are shown into a tiny room with no windows about 7*6 foot. There is a single mattress on the floor with a net above. Nobody is in sick bay right now but we are told sometimes there are three or four prisoners here. Must be fairly cramped. I enquire about medical care for people from sick bay and informed that someone form Katete urban health clinic attends weekly. In addition sick patients are allowed daily visitors.
Beside this there is a door behind which is the ‘women’s wing’. We are brought here next. It looks like a scene from a Dickens dramatisation, some kind of back alley that Oliver Twist might run down. There is a building facing the perimeter wall some six feet away. There are three wooden doors on the outside to three separate rooms. There are just three female prisoners right now sharing one of these rooms. I later learn the other rooms are used for solitary confinement.
One of the female prisoners is awaiting trial for murder. I briefly get to talk to her, she doesn’t enjoy the prison and tells me that the death of her friend was an accident. With her in prison is her 17 month old daughter Anna. If convicted Anna’s mother faces a sentence of up to 12 years. The death sentence still exists in Zambian law but for men only. The last execution was in 1997. When I ask what the method was I am told it’s a government secret.
We go back through the wooden door into the main compound, the men are sitting about mostly. One is listening to music on headphones, Chilasa informs me he is one of the captains appointed to oversee the other prisoners. We enter cell one, a building where we are told 25-30 prisoners sleep. However there is only cell one and two which would leave quite a shortfall out of the 127 men here. We are told each prisoner has a mattress. In the corner of the cell behind a screening wall is a single toilet. It’s a proper toilet and clean.
We go next to cell two the same size, except kitted out better. On one wall is a big blackboard being used as a sort of count down calendar. The days of December are being rubbed off as they pass, below this reads ‘coming soon: January’ and then ‘next attraction: February’. Elsewhere on the board is a list of activities including ‘Bible day’, ‘quizz day’, ‘complaint day’ and ‘yoyoyo day’ which I’m told means stories. Hen there is a bible quote from one of Peter’s letters ‘one day freedom’. I ask about the spiritual needs of the prisoners and am told that the various churches do come. ‘The churches they do assist us a lot, they provide soap and other commodities, they are helping a lot’ Kelvin explains.
In another corner of cell two is a small TV belonging to one of the prisoners. It along with the single light bulb in each cell are the only twentieth century items here otherwise the prison could be literally be from the eighteenth or nineteenth centuries.
The kitchen is in another building. There is no electricity, water is carried from a burr hole outside. Behind the building some prisoners are lighting fires under where the pots are inside. There is a bowl of Kapenta (small dried salted fish) outside as well as the trotters resting on a lump of wood, flies swarm all about. Chisala tells me there is just nshima and kapenta to eat right now. Normally there is beans and rice but these are currently out of stock, sounds like the pharmacy report in St Francis. The prison does have some ducks here and goats and these are occasionally on the menu.
At the end of our visit we sign the book back at the gate. I am surprised to see the name of one of the hospital staff in the book and am told he came to bring a few prisoners with a guard to do some work around his house. I am told I can do the same at any time if I wish, my own chain gang. The prison is basic but not as bad as I thought it would be. There is a laid back atmosphere no hint of violence, the prisoners even have their own football team. The accommodation is simple but probably not a whole lot worse than the hospital. How will they feed over 100 on two cows trotters? Am I comfortable to discharge Misheck there or not?
Saturday, December 4, 2010
Katete Mosque
Some of the medical students had arranged a visit to Katete mosque with Yahyah a member of Katete stores Muslim community. I haven’t met Yahyah before but am told he has a shop at the stores which sells nice chitenges among other things. I have never been in a Mosque before and whilst rural Zambia may be a strange location for my first visit it ties in nicely with my previous visits to Christian services.
Yahyah doesn’t at all look like he belongs in Zambia. Whilst many of the Indian Muslim population to be seen in Katete or Chipata are dressed in traditional dress and have beards Yahyah is clean shaven and sports a Liverpool football shirt, slightly modified with the sponsors logo for Carlsberg lager concealed. When he speaks he betrays a slight hint of a scouse accent. But he does belong here. Brought up in Chipata 90km from here he is a second generation Zambian. After school he spent eight years in Liverpool where he still has family before returning to settle in Katete. As well as his shop he has interests in the transport industry and Liverpool football team having previously been a season ticket holder.
Its wet and soggy on the evening we visit the mosque, the electricity is out and the daylight is fading. The dusty ground has a new soggy feel underfoot thanks to heavy rain, the first real day of the rainy season. The Mosque is dark and quiet but Yahyah’s welcome is warm and enlightening about the importance of Islam to him and his fellow believers here in Katete. We take of our shoes at the entrance and the girls don improvised scarves to cover their heads.
Not having been in a Mosque before I have few reference points to compare Katete Mosque with. Its about the size of a small parish church at home, at the entrance there is a washing area, beyond that a small hallway before the main part of the building. To each side there are separate rooms one of which is for women to worship in. Time seems to be a big deal to the Muslims who practice here at least. At the head of the main chamber there is a big clock as well as a big digital time display.
There also seems to be some sort of digital count down clock next to that, I’m not sure as I don’t get a close look at it. Perhaps the poor light is playing tricks on me or my imagination or my prejudices. I forget to clarify this later with Yahyah. Towards the entrance there are various timetables for the times at which the five times daily prayers should be said varying with the sunrise and sunset for each day of the year. Strict adherence to timetables isn’t a major feature of African life and I wonder how well Zambians manage to keep to this.
Yahyah speaks proudly but not boastfully about his faith and the Mosque. The Mosque was originally built in the 1960’s, pointing North towards Mecca. There remains just eight Indian families in Katete but yet the Mosque is thriving with several smaller satellite Mosques in the surrounding areas. One of these is in a remote village where Yahyah explains many of the village have decided en masse to convert to Islam. People generally say their prayers at home but come to the Mosque on the Muslim holyday Friday (Juma).
On Friday’s they will pray together and the priest will give a sermon. Services are generally in the local language of Nyanja rather than Arabic or Urdu. Yahyah is quick to point out that sermons here are purely on religious issues and that members of the community here have no interest or tolerance in extremist beliefs which he feels are against the teachings of the Koran. I ask Yahyah about the role of Islam in the fight against HIV/AIDS, he acknowledges that infection rates are lower in predominantly Muslim communities largely relate to sexual abstinence before and fidelity in marriage.
Its time for evening prayers and the call to prayer rings out over the loudspeaker. As we walk towards the car Yahyah explains that many of those who call prayers have traditionally been Ethiopian emphasising the importance in Africa’s role in the spread of Islam. We meet some others coming for prayers, an Indian man in traditional dress pauses to greet Yahyah and then shakes hands with the men amongst us before proceeding inside.
The visit is eye-opening, the Mosque is so different but in many ways so similar to Christian places of worship here. I am impressed by Yahyah’s friendly welcoming nature and also the strong emphasis of community among the Muslim population here.
Yahyah doesn’t at all look like he belongs in Zambia. Whilst many of the Indian Muslim population to be seen in Katete or Chipata are dressed in traditional dress and have beards Yahyah is clean shaven and sports a Liverpool football shirt, slightly modified with the sponsors logo for Carlsberg lager concealed. When he speaks he betrays a slight hint of a scouse accent. But he does belong here. Brought up in Chipata 90km from here he is a second generation Zambian. After school he spent eight years in Liverpool where he still has family before returning to settle in Katete. As well as his shop he has interests in the transport industry and Liverpool football team having previously been a season ticket holder.
Its wet and soggy on the evening we visit the mosque, the electricity is out and the daylight is fading. The dusty ground has a new soggy feel underfoot thanks to heavy rain, the first real day of the rainy season. The Mosque is dark and quiet but Yahyah’s welcome is warm and enlightening about the importance of Islam to him and his fellow believers here in Katete. We take of our shoes at the entrance and the girls don improvised scarves to cover their heads.
Not having been in a Mosque before I have few reference points to compare Katete Mosque with. Its about the size of a small parish church at home, at the entrance there is a washing area, beyond that a small hallway before the main part of the building. To each side there are separate rooms one of which is for women to worship in. Time seems to be a big deal to the Muslims who practice here at least. At the head of the main chamber there is a big clock as well as a big digital time display.
There also seems to be some sort of digital count down clock next to that, I’m not sure as I don’t get a close look at it. Perhaps the poor light is playing tricks on me or my imagination or my prejudices. I forget to clarify this later with Yahyah. Towards the entrance there are various timetables for the times at which the five times daily prayers should be said varying with the sunrise and sunset for each day of the year. Strict adherence to timetables isn’t a major feature of African life and I wonder how well Zambians manage to keep to this.
Yahyah speaks proudly but not boastfully about his faith and the Mosque. The Mosque was originally built in the 1960’s, pointing North towards Mecca. There remains just eight Indian families in Katete but yet the Mosque is thriving with several smaller satellite Mosques in the surrounding areas. One of these is in a remote village where Yahyah explains many of the village have decided en masse to convert to Islam. People generally say their prayers at home but come to the Mosque on the Muslim holyday Friday (Juma).
On Friday’s they will pray together and the priest will give a sermon. Services are generally in the local language of Nyanja rather than Arabic or Urdu. Yahyah is quick to point out that sermons here are purely on religious issues and that members of the community here have no interest or tolerance in extremist beliefs which he feels are against the teachings of the Koran. I ask Yahyah about the role of Islam in the fight against HIV/AIDS, he acknowledges that infection rates are lower in predominantly Muslim communities largely relate to sexual abstinence before and fidelity in marriage.
Its time for evening prayers and the call to prayer rings out over the loudspeaker. As we walk towards the car Yahyah explains that many of those who call prayers have traditionally been Ethiopian emphasising the importance in Africa’s role in the spread of Islam. We meet some others coming for prayers, an Indian man in traditional dress pauses to greet Yahyah and then shakes hands with the men amongst us before proceeding inside.
The visit is eye-opening, the Mosque is so different but in many ways so similar to Christian places of worship here. I am impressed by Yahyah’s friendly welcoming nature and also the strong emphasis of community among the Muslim population here.
Wednesday, December 1, 2010
World AIDS Day
World AIDS day is held on the first of December each year and is marked by events around the world. I had never heard of World AIDS day before and didn’t really know what it meant. It seems to me working in St Francs every day is AIDS day as we deal with AIDS and all its related conditions and feebly sympathise with those who have lost loved ones to AIDS.
At the hospital the day is marked by drama, games and an educational briefing on HIV/AIDS at the football pitch. Staff members wear new World AIDS day 2010 t-shirts. To get some idea of what the day means I ask some colleagues and patients what world AIDS day means to them. Whilst most of the staff are enthusiastic about the concept many patients have never heard of World AIDS day.
‘It’s a day when you remember people who suffer from AIDS’
Mwambwa, patient
‘It centres on controlling the pandemic, we get to educate people and campaign for voluntary counselling and testing’
Harrison, student nurse
‘They do candle lighting ceremonies where we remember our friends and relatives who have died from HIV and AIDS’
John, nurse
‘Back home I didn’t know that world AIDS day was the 1st December, it should be a day for people from outside countries with high HIV levels to raise money and awareness’
Guru, medical student
‘I only know it is the day for people living with HIV. To me it is a very bad day because many people are dying’
Abraham, patient
‘It’s a commemoration day where we remember people with HIV and AIDS, not only those but everyone, those who have died, who are suffering and those who are preventing themselves’
Greyson, nurse
‘I hadn’t heard of it’
Postan, patient
‘It reminds us of the events and awareness of HIV, also the world as a whole it, reminds everyone of its dangers and existence’
Amitano, school headmaster
‘We must at least make more effort to find the cure, let those that fund help with more resources and share equally’
Charles, workshop
‘It’s the remembrance of people living with AIDS and those who have died’
Naomi, clinical assistant
‘I remember my relatives who have died of AIDS, if that time the ARVs were there maybe they would be alive now’
Catherine, clinical assistant
‘To me it reminds me of what I have done for our friends with HIV and what I think could be done for them’
Frank, lab technician
‘World AIDS day is a day to commemorate and trying to sensitise (people) to get to know about AIDS , to make everyone feel free and to encourage people to get tested’
Kapembwa, lab technician
‘I think of our staff who have died’
Dr Shelagh Parkinson, hospital director
‘It doesn’t really mean anything, I just observe it as a normal day’
Esnart, patient
‘It’s a day when we remember those people who have died from HIV and AIDS’
Charity, clinical assistant
‘For me concerning the day I can’t say much but since I am involved in the home care programme we meet clients with them their concerns and the problems they are meeting and then celebrate the day together’
Agrassia, nurse
‘The people who are positive and the people who have died, we remember them’
Miriam, clinical assistant
‘It’s a reminder that the problem is still there, to work harder to spread the word so that we can empower the community to encourage prevention’
Harrison, Clinical officer
‘It’s a day that people in the community celebrate the campaign against the illness’
Zingani, cotton plant manager
‘The day given to people to commemorate and remember those who died’
Ackless, patient
‘It’s a sign to say that the world has HIV’
Amed, daughter of patient
‘I know nothing, I am just surprised to see nurses wearing T shirts with World AIDS day’
Lebitina, patient
‘A day where we remember those who died and sensitise the others to say the world is full of HIV so we need to keep on spreading the message, it is not the end, HIV is still being spread we need also to prevent’
Limbikani, clinical assistant
‘Even to remember those who died a long time ago even before the virus was discovered’
Tembo, clinical assistant
‘Asking yourself do I know my status, it is important to know so you can take care of yourself’
Frida, ward attendant
‘Everyday should be world AIDS toady, world TB day, world malnutrition day, world measles day, they all get forgotten about’
Helen, Doctor
At the hospital the day is marked by drama, games and an educational briefing on HIV/AIDS at the football pitch. Staff members wear new World AIDS day 2010 t-shirts. To get some idea of what the day means I ask some colleagues and patients what world AIDS day means to them. Whilst most of the staff are enthusiastic about the concept many patients have never heard of World AIDS day.
‘It’s a day when you remember people who suffer from AIDS’
Mwambwa, patient
‘It centres on controlling the pandemic, we get to educate people and campaign for voluntary counselling and testing’
Harrison, student nurse
‘They do candle lighting ceremonies where we remember our friends and relatives who have died from HIV and AIDS’
John, nurse
‘Back home I didn’t know that world AIDS day was the 1st December, it should be a day for people from outside countries with high HIV levels to raise money and awareness’
Guru, medical student
‘I only know it is the day for people living with HIV. To me it is a very bad day because many people are dying’
Abraham, patient
‘It’s a commemoration day where we remember people with HIV and AIDS, not only those but everyone, those who have died, who are suffering and those who are preventing themselves’
Greyson, nurse
‘I hadn’t heard of it’
Postan, patient
‘It reminds us of the events and awareness of HIV, also the world as a whole it, reminds everyone of its dangers and existence’
Amitano, school headmaster
‘We must at least make more effort to find the cure, let those that fund help with more resources and share equally’
Charles, workshop
‘It’s the remembrance of people living with AIDS and those who have died’
Naomi, clinical assistant
‘I remember my relatives who have died of AIDS, if that time the ARVs were there maybe they would be alive now’
Catherine, clinical assistant
‘To me it reminds me of what I have done for our friends with HIV and what I think could be done for them’
Frank, lab technician
‘World AIDS day is a day to commemorate and trying to sensitise (people) to get to know about AIDS , to make everyone feel free and to encourage people to get tested’
Kapembwa, lab technician
‘I think of our staff who have died’
Dr Shelagh Parkinson, hospital director
‘It doesn’t really mean anything, I just observe it as a normal day’
Esnart, patient
‘It’s a day when we remember those people who have died from HIV and AIDS’
Charity, clinical assistant
‘For me concerning the day I can’t say much but since I am involved in the home care programme we meet clients with them their concerns and the problems they are meeting and then celebrate the day together’
Agrassia, nurse
‘The people who are positive and the people who have died, we remember them’
Miriam, clinical assistant
‘It’s a reminder that the problem is still there, to work harder to spread the word so that we can empower the community to encourage prevention’
Harrison, Clinical officer
‘It’s a day that people in the community celebrate the campaign against the illness’
Zingani, cotton plant manager
‘The day given to people to commemorate and remember those who died’
Ackless, patient
‘It’s a sign to say that the world has HIV’
Amed, daughter of patient
‘I know nothing, I am just surprised to see nurses wearing T shirts with World AIDS day’
Lebitina, patient
‘A day where we remember those who died and sensitise the others to say the world is full of HIV so we need to keep on spreading the message, it is not the end, HIV is still being spread we need also to prevent’
Limbikani, clinical assistant
‘Even to remember those who died a long time ago even before the virus was discovered’
Tembo, clinical assistant
‘Asking yourself do I know my status, it is important to know so you can take care of yourself’
Frida, ward attendant
‘Everyday should be world AIDS toady, world TB day, world malnutrition day, world measles day, they all get forgotten about’
Helen, Doctor
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