In our first few weeks here, this has been a common introductory question. I’ve enjoyed hearing the variety of answers across our class. Everyone’s journey is unique even within our shared interest for tropical medicine. My answer to the question is better posed as, “Who brought you here?”
These beautiful girls (in the photo to the left) dancing and laughing as a mama leads them in a song…
This is in Eastern Province, Zambia, where we set up our mobile medical clinic and did cervical cancer screening and early treatment for the women. Since my colleague Christine and I started in 2016, we’ve seen over 1,500 women. About 10% need treatment or referral. The screening is so simple: vinegar on a cotton ball and a photograph with a zoom lens to detect precancer lesions. We can treat early lesions with a cold coagulator right there and then, with follow up in one year. Cervical cancer is the biggest cancer killer of women in Zambia so it is gratifying to know that each woman treated is another mother still alive to raise her family. Every woman we see has a story. One afternoon an elderly lady came to be screened. Technically she was outside the age of screening but she persisted. We had a schedule full already but told her to come back the next morning. As we headed home that night, one of our team members showed us the mountain she lives beyond. She walked upwards of 10km to reach us!
The next morning, she was there. Thankfully she was free of any cervical problems. That night as we unloaded, we asked where all the bags of peanuts came from. This 80-some year old woman had carried them on her back all that way for us!
Who else brought me here?
My patients at the faith-based HIV clinic, Circle of Hope, and all the dedicated staff that work tirelessly with me to provide ARVs, TB treatment, antenatal and under-fives care for each of them.
James was in his mid-twenties but looked at least 40 and had to be helped into the room by a friend, he was so weak. I started him on treatment for TB and a few weeks later HIV. Several months later, I saw him again but didn’t realize it was him until I saw my handwriting in the chart. He was back working and looked like a completely different person, gaining at least 15 pounds and smiling ear to ear. He and so many others brought me here.
Then there are the kiddos that warm my pediatric heart. This is Hope. She was born at 31 weeks and is now 9 months old. I get to monitor her at a small, private rural clinic outside Lusaka. She is almost 50% on the normal growth chart, hitting all her developmental milestones and has never been sick. Another day I saw a teenage girl who kept falling asleep in class and her grades were suffering because of her fatigue. A few questions later and one look in her mouth got her a referral for a tonsillectomy. Several weeks later she returned with her dad to thank me (along with her siblings that slept in the same room with her).
Last, but not least is our diligent community health evangelism trainers and workers. They go weekly into their communities teaching their neighbors about a myriad of health topics. They look at resources and problems and come up with solutions. We get to come alongside and help with VIP latrines, rocket stoves (less smoke and wood used), tippy taps (free flowing handwashing), solar cooking and so much more. If you have an hour to spare, just mention Moringa trees near me and I’ll share more than you ever wanted to know.
That is what and who brought me here so I can go back better equipped to help. So if you haven’t been, this is your encouragement to go. It will likely be one of the hardest things you’ve ever done but also the most rewarding (and the views are pretty amazing too)