In the last three months my role has developed into a range of activities. I now work Cardinal Adam Memorial Hospital (CAMH), the emergency department at the University Teaching Hospital and teach medical students at the national university.
Working at the University Teaching Hospital, I have been confronted by the impact of the HIV/AIDS pandemic. Perhaps 80% of the (predominantly young) adults who present to the medical emergency unit are infected by the virus (which infects 1:7 Zambians). They are usually very unwell and afflicted by a range of opportunistic infections and cancers against which they have little immune defence. The main challenge for me is adjusting to the very limited resources available for treatment and the high death rate. Being there, I have learnt a lot about these unfamiliar diseases through working with the more experienced doctors in the emergency unit. I have been asked to make suggestions to improve the general running of the unit but I may need to work there for some months yet before constructive ideas take shape.
The development of CAMH into a fully functioning hospital remains a slow process. For the present, it functions predominantly as an outpatients department. I will have more of a role when there are wards and a theatre, which is still perhaps six months away. An unexpected development has been the opportunity to speak to groups of Catholic clergy about the threat of an epidemic of diabetes in Zambia, as more people live in cities and adopt a more Western lifestyle. Some commentators predict diabetes in Africa may exceed the ravages of the HIV/AIDS epidemic! There exists an opportunity for education of the public about the risk factors for diabetes and I am hopeful that the Church may play a leadership role in this.
A chance meeting with an American doctor at the University of Zambia has provided me with the opportunity to teach 4th year students on a weekly basis. They have proved enthusiastic pupils and I feel privileged to be able to contribute to their training. This involvement looks set to continue into 2014. I have also been asked by Zambia Episcopal Conference (our host organization) to travel out to a Catholic rural hospital on a regular basis next year to teach at an attached nursing school. So, all up, 2014 promises to be a kaleidoscope of teaching and clinical activities. I am looking forward to it.