Lessons in Zambia

30 May 2014

There is a culture shock that occurs when one travels from the developed to the developing rule.  Uncomfortable, worried, sad, lonely, isolated, irritated describe many of the feelings I experienced when I first arrived in Zambia two-weeks ago.  It was busy, dirty, and foreign.  I stood out as one of the only white faces in a sea of black.  People stared; there were catcalls.  I felt a million miles away from home; I was a million miles away in every sense imaginable.  As the last two-weeks unfolded, and I traveled around the country, my sentiments gradually changed as I really had time to understand Zambia and Africa in general.

After arriving, we had two-days of rest and recuperation in what is arguable the nicest hotel in Zambia before we were thrust out into the heart of the country.  Our first excursion was to the city of Ndola, in the heart of Zambia, the Copperbelt Region.  Our Zambian colleagues boasted that Ndola was the cleanest city in Zambia as we drove into it.  There was nothing aesthetically appealing about Ndola.  It was an industrial town full of copper and steel mills, dilapidated cinderblock buildings, heavy traffic, roads torn apart with construction, red dusty earth, tractor-trailers overfilled with metalwork supplies.  Numerous billboards lined the streets however  90% of the billboards carried only advertisements for G. Rutherford Outdoor Advertising, the company that owned them and sold advertising space.  G. Rutherford tries to entice you to buy ad space by posting photos of people in cheesy poses with encouraging slogans like, “You are never too small to advertise!” “Your advert will look very good here,” “It’s party time, let’s advertise!”

We arrived at what we thought would be our hotel, only to find out the rooms had been booked for the wrong nights and were full now.  The driving tour of Ndola continued until we found a place called Fatmols Lodge, Conference Center, and Casino across the street from a large sports stadium that looked straight out of the Soviet Era.  The rooms we toured were awkwardly designed, some excessively large with old gaudy pleather furniture sitting in oversized areas.  The TV in the reception was tuned to a telenovelo (Spanish soap opera) dubbed in English; a few people watched the laughable acting in rapture.  I realized the casino was not yet operational when I found three dusty, antique slot machines sitting in a room with old two-by-fours and no electricity.  Dinner was served in a dingy, dim area with a Coca-Cola refrigerator that had a built in alarm that sounded incessantly as I gnawed on an over-cooked pork chop.  The bedside lamps in my rooms had no light bulbs. 

We visited three different clinics in Ndola that were simple but overall well functioning.  All were located in a gated area in the midst of slum accessible only by an unpaved, dirt, pothole-ridden road.  I ate more fast food in the Ndola region over the course of three days that I had in the past three years.  First there was Hungry Lion, also known as Zambian KFC, then there was Nandos Chicken, and finally Debonair’s Pizza, which will go down in history as the world’s worst pizza making even Dominos seem gourmet; I ordered the Hawaiian pizza for irony’s sake.  The meat was mysterious to say the least.  That was Ndola.

The next region we paid a visit to was the Southern Province known for its sugar-cane industry, with the provincial capital of Mazabuku.  The drive to this region was much prettier than the one to Ndola.  We drove through rural scenes containing rolling hills, plateaus, open dry plains, and even a few baobab trees.  We learned some of the common names people had in the Southern Province such as, Progress, Loveness, Weather Expert, Liveness, Patience, Gifty.  We visited a very rural clinic where women had to travel up to 15-km on foot or bicycle to receive care for themselves or their children.  A large group of them formed a line in front of a large tree where a hanging scale was suspended to weigh their children.  They talked about us in their local dialect when we arrived, saying something to the effect of, “Children! Stop crying! The white ladies are here!”  They don’t get a lot of foreign visitors out in these parts.

Our only eastbound journey outside of the capital city was to a region called Refunsa, to visit an extremely rural outreach clinic.  There was no running water and the electricity was out.  One of the patients was wearing Toms shoes; I guess they really do donate them in Africa.  The eastern area seemed even drier and for the first time, I saw the mud huts with thatched roofs that one imagines seeing in Africa. 

We made a few stops during our 3-hour drive.  One was at tsetse fly checkpoint where a man walked around our vehicle with a net, ready to catch any of these nasty flies that carry the always-fatal-if-untreated African Sleeping Sickness.  The other stops were at produce stands.  Inevitably, every time we stopped at one, women with bowls full of various produce swarmed our car.  We tried baobab fruit, which came in a large fuzzy shell and had chalky citrus flavored meat, and also had something like jicama.  Our driver bought bananas and sweet potatoes and commented on the fact that the price for the produce went up as soon as they saw “muzukus” (white people) in the car.  A drunk, mentally ill appearing man threw his upper body on the hood of our car when we didn’t give him money.  His hand looked like it had been run over my something heavy.  Our guides were very excited to stop and show us a hot springs on the way home.  Not far off the main road, we got out to see the hot springs water bubbling out of a short fat metal pipe.  The steam smelled like sulfur.  Cattle roamed around.  Our driver, Chris, told us that people come here to baptize themselves in the water, to attempt to obtain improved fertility.  He said people had tried to channel the water into a pipe, but the pipes continued to break.  Salome bought some rape greens (like kale) from a farm just beyond the springs.

The western province of Zambia would be our final journey.  To get to the provincial capital of Mongu, we had to make a 7-hour car drive; two hours of which were through a large national park/game preserve.  This portion of the drive was beautiful in a desolate way; the park consisted mostly of tall dry grasses, brush, and short trees.  We saw brush fires and even a few animals including impalas, small monkeys, baboons, large waterfowl with organ plumes, and even two hippos in the water.  The western province was extremely primitive.  We saw countless villages on the side of the road that were comprised of small mud huts with roofs thatched with dried river reeds.  These villages were extremely cut-off from all modern amenities and reminiscent of how we humans would have lived thousands of years ago.  Cotton and river reeds seemed to be the only industry in this area.

The town of Mongu was perched just above a large flood plain with views as far as the eye could see.  There was an unfinished bridge to nowhere and a stagnant harbor with small fishing boats.  During the rainy season, many parts of the western province become accessible only by boat.  During these times, there are real concerns for tragedies like crocodile attacks while boating to work.  There wasn’t much water left at this time of year, in fact Mongu was almost desert like and full of sand.  Walking around one of the remote clinics was like trekking down a beach with black sand and no water; four-wheel drive is necessary to navigate the area.  Among the sand and grunge also grew tropical flowering vegetation, like bougainvillea and plumeria.  We ventured into the heart of the slums in Mongu during our clinic visits and even visited a small market place where we observed the community health workers as they did a call and response song with the women about Family Planning.  There was dancing and clapping; it was moving. 

Finally back in Lusaka, which felt like a modern metropolis compared to Mongu, we spent our final days.  For our last clinic day, we ventured into an area called Kanyama, which is one of the most densely populated areas of Lusaka containing at least 160,000 people.  Our driver, Chris, had to navigate through a sea of humanity to get there.  He mentioned he would avoid one short cut due to the fact that “thieves” congregated there and another due to the high volume of drug raids.  The streets were packed with cars and buses that did not appear to following any sort of traffic laws.  Thousands of people walked in and around the traffic.  Women carried heavy loads on their heads and babies on their backs so their hands were free to carry more.  I saw one man who had three cases of Gatorade balanced on his head as he walked through the masses, trying to sell the bottles.  Some men even waded through the traffic, standing between the lanes, holding up a random solitary windbreaker jacket, stuffed animal, or even an Ab-Flex contraption in a box with a blond 80’s aerobic instructor on it. 

Kanyama clinic was an experience in and of itself.  One of the nurse midwives gas a tour of the facilities, which also serve the 160,000 plus people in this poor area. There was the TB treatment area, the HIV testing and antiretroviral dispensing area, the children’s clinic and weighing station, inpatient wards, clinics that performed male circumcision, cervical cancer screening, and family planning, and finally, labor and delivery.   There were long lines out the doors of virtually every clinical area.  At one point, a car pulled up, the door opened, and a stiff elderly woman was dragged out of the back seat and thrown on her granddaughter’s back and carried in piggyback style. 

The labor ward was incredibly busy for a tiny facility.  The delivery area consisted of 6 cots separated by curtains.  Women were naked and screaming as they labored and pushed out their babies.  I saw one young woman deliver her baby on the cold hard floor with nothing but a trash bag under her to contain the amniotic fluid.  Another woman was pushing and grunting.  The nurse stood next to her and smacked her legs, yelling at her to push harder, not even trying to really help guide out the head that already stuck out of her vagina.  Flys landed on her newborn baby as it sat on her abdomen.  Next door to the labor room, was the postnatal recovery area, which also doubled as a laboring space.  It was a fairly small, open room, packed with cots.  There were 3 to 4 women per single cot.  Some were nursing their babies, others were moving around, grimacing with labor pains.  The screams of the laboring women were very audible through the wall.  The whole process seemed terrifying, and to think this is considered a safe birth in Africa.

As I sit in the hotel lobby, waiting for my shuttle to take me to the airport.  I feel sadness at leaving Zambia.  When I first arrived, I yearned for home, for the “western” world.  Now I felt surprised at my melancholy in leaving this place.  I had begun to feel more comfortable here, fascinated by the sights and sounds, charmed by the friendly people.  Life is hard here, but the people make the most of it.  They aren’t tied to social media and the many petty concerns that we have.  They appreciated life, health, family, and their country; the simple but important things.  We could learn a thing or two from Zambia.