I will be going to Zambia for two weeks as one of two gynecologists on a surgical team that includes, general, head and neck and plastic surgeons and anesthesiologists to provide surgical care for members of the community of Mwandi.
The Mwandi community of the Western Province Zambia live in a remote area. the Mwandi Mission hospital is currently a level 1, 82 bed referral hospital. They will benefit from surgical expertise. A surgical team comes twice a year with a general surgeon leader, Dr. Margaret Schreiber, performing complicated hysterectomies, thyroidectomies, burn contractures, among other procedures. Many patients are seen in clinic by one team and await surgery until the next team arrives some six months later.
I have been asked to join this team that is well established, and it is my honor to have been invited. Even by vehicle it can take 4-5 hours over bumpy roads to reach a Rural Health Center, so the demand in the area is great and the supply sparse.
While in Mwandi we will be paired with local healthcare providers to teach and learn from one another. I will also work in a clinic providing outpatient care and preoperative evaluations.
My surgical skills for difficult, open hysterectomies especially, will improve as will my understanding of other specialities as will be called to assist when not operating myself. My global health awareness will improve as well.
There is so much need in Mwandi and surrounding area, more than we could ever meet in a single trip. Hernias, goiters, fibroids, pelvic masses, burns, cancers. Dr. Schrieber has been coming to Mwandi Mission Hospital twice a year for a quarter century, bringing committed teams of general, gynecologic, head and neck and plastic surgeons and anesthesiologists to inch the hospital toward level two status. Training local physicians and anesthetists has been essential in making this self-sustaining. Word gets ‘round that her team is arriving and people come, riding multiple busses for many hours, to be seen on triage day. I was most struck by the people’s trust and patience. Their trust in a group of foreign physicians who seemingly appear out of nowhere and disappear nearly as quickly. Their trust that we can do what their local doctor can’t or won’t or won’t because they can’t, for whatever reason-resources, time, skill, training. Trust that we will, despite language and culture barriers, take the best care of them in their most vulnerable time. The operations are often challenging, sometimes because of the anatomy and sometimes because of the available equipment. One OR has no OR lights so we wear headlamps. Some OR sets don’t contain instruments we expect at home. It tests your patience skill and ingenuity. I have thanked every scrub tech I could since my return.
Their patience is remarkable. A half a dozen patients, some days more, line up on a bench in a dark hallway on their surgery day (see photo). They sit silently for hours, never complaining, waiting their turn. I am humbled. And I am reminded that most worthwhile things and experiences require effort and discomfort and inconvenience, otherwise life is a nonstop flight to an all-inclusive resort surrounded by the same people you see every day at work, school, Trader Joe’s and Core Power. There is nothing wrong with any of these things, rather pushing outside your comfort zone nurtures growth.
