Dr. Nat's Journal

I welcomed in 2013 on a sand dune in Namibia. It was my first time to Namibia, and my first New Year on a sand dune. It was also the first time I had spent more than four days away from St Francis Hospital since my arrival in August.

Having left behind the hot and steamy rainy season in Zambia, it was a huge contrast to arrive in the parched Namib Desert. Temperatures soared to over 40 degrees with almost zero humidity and clear blue skies.

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Christmas has always been one of my favourite times of year. I have spent many festive seasons in hot climates as well as cold, and have always managed to get into the Christmas spirit whatever the weather. However, this year, in Zambia, it’s taking a bit more effort than usual to create that Christmas vibe.

The weather does obviously play a part… blue skies and blazing sunshine don’t often feature on Christmas greeting cards. However, I think it’s that Christmas can’t get under your skin here the way it does back home, where the radio blasts out Christmas tunes from October onwards and the department stores open the Christmas section at the end of the summer! Visiting the supermarket to find aisles stacked with mince pies, Christmas puds and mulled wine helps too.

Well, here in Katete, we don’t own a radio, we don’t have any large shops, the supermarket is over one hour away and none of the Katete shops have heard of mince pies!

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I spent my teenage years living in Asia, so mangoes are not something new to me. However, I’ve never had my own mango tree before. Now, with three large mango trees in my garden, I have more mangoes than I know what to do with.

In London, it costs upwards of £1.50 (13,000 ZMK / US$2.50) for a single mango. This would mean that if I wanted to have the same number of mangoes at my disposal in London as I do here, I would need to spend somewhere in the region of £750 – £1000.

Daily, scores of mangoes fall to my garden floor and start to rot. I can’t keep up! My fridge is full of mangoes, my hands have acquired a yellow tinge, and I have a callus from chopping so incessantly.

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I have been working at St Francis Hospital for over three months now.

When I first started here, everything was very different to what I was used to. I would walk through the wards glancing at the three children sharing a hospital bed in Paediatrics, or see the X-rays hanging up to dry on a washing line, and wonder what era I had stepped into. I was regularly shocked by the lack of seemingly essential resources. I could frequently be found asking in a shocked tone of voice “what do you mean we can’t measure sodium or potassium levels here?” or “what do you mean the hospital has run out of IV fluids?”

It is amazing how quickly I have adjusted to my new environment. I recently had my first visitors from home this month and as I took them on a tour of the hospital, I was reminded of what a fascinating place this is.

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Everyday at work, I see patients with stereotypical infectious diseases such as typhoid fever, malaria and tuberculosis. However, practicing medicine in Sub-Saharan Africa today requires more than just managing tropical infections. On a daily basis, I also see many patients with non-communicable diseases such as diabetes, heart failure and high blood pressure.

These chronic diseases are often referred to as ‘diseases of the rich’, but in recent years have become increasingly common and problematic in developing countries.

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The rains came, and oh boy, did they come! The Zambian wet season introduced itself to me by producing 12% of its average rainfall for the season in just one night!

The rains decided to arrive during a weekend away to South Luangwa. The drive there was in blistering sunshine, but on entering the park, we could see an ominous black cloud forming… by the time we arrived at our bush camp deep within the park, we could hear low rumbles of thunder, and the wind had picked up speed.

I was alternating between feeling excited about my first Zambian rainstorm and annoyed at the thought of a wet weekend away. However, Will and all the guides at the camp reassured me that the rains tend to come as short, sharp bursts, with the sun coming out immediately afterwards.

I asked whether the roads and the rivers would become impassable if it did rain. I was told that the ground was so dry that the rain would just soak in, and the rivers would take a long time to rise. Don’t always believe what you are told…

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In London, when I was planning a holiday, my first step would be to peruse guidebooks at my favourite travel bookstore, with a particular focus on the ‘when to go?’ chapters. I always left the bookshop with less money, a heavy bag of books, and either a date in mind for the destination, or a destination in mind for the date.

Having moved to Zambia for a year, I will soon find myself in a country at the exact time of year that I usually try to avoid – wet season!

Yet rather than dread, I am filled with excitement at the thought of the imminent rains.

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In 1847, an Austrian obstetrician (Ignaz Semmelweis) figured out that hand washing in hospitals saves lives. On trying to persuade the medical profession of this fact, he came up against considerable resistance, with public ridicule and dismissal from his post at Vienna General Hospital. Nonetheless, in 1861 he went on to publish ‘The Aetiology, Concept and Prophylaxis of Childbed Fever’, and his legacy lives on today as the pioneer of hand hygiene in clinical practice.

150 years have passed since Semmelweis’ seminal work on hand hygiene, and the world today is much more accepting of his findings. It is widely agreed upon that hand hygiene helps in the prevention and control of communicable disease. Nowadays, all healthcare workers receive training about the importance of infection control measures such as hand washing. However, is it always practiced?

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Back when my parents were at primary school, a large emphasis was placed on the 3 R’s – reading, writing and arithmetic.

In more recent years, a second set of 3 R’s (which all actually start with the letter R this time) has been introduced. Reduce, reuse and recycle is the modern mantra taught to encourage social responsibility through waste management.

The 3 R’s are meant to be a hierarchy, in order of importance. Hence, we should start by reducing what we use, followed by reusing, then recycling.

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After spending a long weekend in South Luangwa, I have now seen where Will spends his time working here in Zambia, and I am quite jealous. Whilst the hospital has its charms, the spectacular natural wilderness that is Will’s workplace is on another level.

Being married to a wildlife photographer means that going on safari is not something new for me. However, this time, as Will drove me through the main gate into the national park in our own vehicle it felt very different and exciting.

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