Roger and Rita Holland are in Lusaka at the moment. Roger underwent kidney dialysis as soon as he arrived at the hospital in Lusaka and has had several treatments since. Sadly, as of now, his kidneys have still not recovered. They plan to fly back to the USA on Tuesday after a dialysis with the plan being that he goes straight to see nephrologists and have dialysis as soon as he arrives in the USA. Please continue to pray for them and that the flight home would pass without problem.
At Kalene the hospital is functioning with three “stand ins”. Dr Kapaya, the District Medical Officer has thankfully been able to engage in hospital and on-call duties on top of his administrative duties for the District. Also, Dr Allison Henderson (a physician) is still able to be here, though expects to move on to Mwinilunga soon where she had planned to be. And then me, an hard of hearing orthopaedic surgeon who can’t use a stethoscope so listing to chests and hearts and abdomens is a non starter and hasn’t “physicianed” for over 20 years. Please pray for all of us and that some Zambian Doctors would be able to come as we have been led to believe would be coming several times.
The week began with a pleasant surprise in that another doctor, Allison, had arrived at Kalene two days before me and was at Kalene for almost the same time. Her husband was connected to the Rea family and was in Zambia doing research on sustainable animal husbandry. That meant three of us (Roger Holland who was here full time, Allison and myself) to share the on-call duties. However, things went downhill after that. The following day one of the drivers for the Nursing School (who is also one of the most capable interpreters in church) fell ill and had to be medivaced by air to Chitokoloki. Allison was the medical escort. He is now much better.
A day after she returned I was contacted about the mother of a missionary at Loloma who had come out to visit. Two days after arrival the mother fell and fractured her left hip. After some consultation with David McAdam, the general surgeon at Chitokoloki, it was decided that the best plan was to fly me to Lolomo and medivac the patient to Chitokoloki where I performed the first ever hip fracture pinning there. She is now starting to walk and is doing well.
Then on Friday morning first thing I received a phone call from Allison. Roger Holland was not well. To cut a long story short, Roger was in acute renal failure. At Kalene we do not have the facilities to manage this so Allision medivaced Roger, with his wife Rita, to Lusaka where he is currently undergoing kidney dialysis. So far the blood results are looking better but, in Rita’s own words, Roger is not. The hope is to get him well enough to be able to fly back to their native USA. Please pray for Roger and Rita at this very stressful and uncertain time for them and thank the Lord that He provided the right people to help in all these situations at the time of need.
Three months seems a long time, but the time has just flown by! Such a lot has happened. While at home in the UK I was frustrated that I could not do a number of things due to my foot. It is now much improved though it still aches, and if I do too much it lets me know the following day. That said, it is now only 4 months from the injury so it should improve further.
While at home I worked as usual at Sunderland Royal Hospital and as well as all the clinical work, I underwent appraisal and undertook study leave which was at the annual conference of the American Academy of Orthopaedic Surgeons in Chicago. Isla came with me and we spent the first weekend with Joan, our daughter in law’s mum. Then, while I was at the conference Isla had a day with one of our dear American friends, saw the Chicago river dyed green for St Patrick’s Day, went up the Sears/Willis Tower onto the Sky Deck and finished the last week of her Precepts Course.
We then spent a wonderful week with Matthew and Christy at Atlanta. We saw their new house, we met their dogs (2 Dachshunds), their friends, their neighbours and went to their church (Passion City Church) where we heard Louie Giglio speak.
All too soon we had to return to the UK and 4 days later I set off for Zambia. I have now been in Zambia for one week. I had to stay in Lusaka for 2 days after arrival to do the paperwork for my medical registration. I then went to Chengelo School where I took a Taylor Spatial Frame off a girl’s leg whom I have been treating for a severely bent leg. Then it was off to the Copper Belt where I picked up Rob Woodhouse and we travelled together to Nyangombe. I spent 2 nights there and in the day unloaded a forklift from the container that Alex McConachie and I had loaded and sent to Zambia and planned foundation and windows for the house that we are building at Chinyazhi (about half way between Kalene Hospital and Sakeji School).
Now I am settling into the Reed’s house at Kalene but will probably have to fly to Chitokoloki to operate on a lady’s fractured hip.
Time is an amazing healer and our bodies are indeed fearfully and wonderfully made. I am now back in the UK thanks to my good friend Raymond Allen who was out at Kalene when the mishap happened. I could not have driven to Lusaka for the flight home – Raymond had that chore for which I am so grateful. With his help we got through all the check-in procedures for the BA flight to London without too much pain from my foot. We were seated comfortably on board next to each other, thanks to the services of our good friend Raymond Parker and his team at Feherty Travel, ready to go when there was an announcement – there was a problem with a fuel pump! To cut a long story short we had to disembark and were put up in hotels in Lusaka courtesy of BA. The problem was fixed so we were able to depart the next day but only after a delay due to a baggage reconciliation problem. Unfortunately this meant we missed our onward connections – another night courtesy of BA, this time at Heathrow. We eventually got home on the 19th, not the 17th December as planned. Sadly, Isla had to abandon her flight down to Heathrow to meet me on the 17th.
The first task on getting home was to become an out-patient at my hospital. I was supplied with a pin cam walker (a removable Velcro boot). I have prescribed these before for patients but did not fully realise just how good they are – I was able to abandon the walking sticks and rely on the boot alone – fantastic. The pain has gone – I just feel as if I have a great big ball inside my forefoot that gets tighter during the day and at times feels as if it wants to explode. This will no doubt settle in time but, as Isla so often says, I never was much good at patience!
I was out on my BMW motorbike (F650GS – the old single cylinder model) yesterday and on returning to Kalene from Ikelenge (16km away) went to avoid a rocky patch of dirt road so drove along the narrow strip at the very edge where all the bicycles obviously went. After all, a motorbike is a bike. Unfortunately I didn’t see the rock in the grass at the very edge but my right foot found it at about 25mph. Oh, the pain, the pain. I stopped the bike and slid/fell off onto ground lying on my back with my right foot elevated on the saddle. It wasn’t long before a crowd of locals gathered round me and I could hear “Dr Gill” repeatedly in their conversation so they knew who I was. Two vehicles passed and stopped, their occupants asking concernedly if I was OK. I reassured them but, oh, the pain!! Eventually it eased a little, enough for me to get on the bike again and ride back to Kalene – the right foot is for the rear brake on motorcycles, the least important function so I was OK. When I got back to Kalene I lay down on the floor of the living room with my foot on a table. Raymond, who had been out at a container, came back and tells me he stopped outside a he could see my on the floor and I was not moving – he wondered if I was dead -my time has not yet come. When he was reassured I was OK he went and got a cocktail of pain-killers and anti-inflammatories and dosed me – it can be very useful having an anaesthetist as a friend! Later, we went down to the hospital and had a look at my foot with the X-ray image intensifier. I have angulated fractures of the necks of my second, third, fourth and fifth metatarsals as well as the scraping and battering of all my toes and a nice pressure/puncture wound on the inside of my lower shin. This morning my forefoot is swollen like a balloon and the bruising is starting to show signs of appearing. In a few days time it is going to look spectacular. It will be many weeks before I can walk normally again. The bike – not a mark on it, my shoe – the rubber toe cap has been ripped off. I am just so thankful to our Lord that it is not a major injury and that it should heal well without long term problems.
It was a long drive but I was able to accomplish several things. I have a patient who I needed to see at Chengelo School (near Mkushi on the road to the Northern Province) who has a Taylor Spatial Frame on her leg to treat old Blount’s disease. She had a combination deformity of 35 degrees bow legged, 25 degrees in-toeing and 20 degrees flexed knee. The frame had completed the correction of these deformities and was holding the corrected position while the new bone matured. I also needed to go to Macha (near Choma on the way to Livingstone) with Owen Shindanyi to collect a lot of wireless networking equipment and some servers and desktop computers and to bring back Oscar to set-up and align the satellite dish for the Linknet satellite internet container that has been moved from Kalene to Ikelenge. I also needed to collect my long time friend Raymond Allen from Lusaka airport when he arrived on the 28th November. Plus there was a pile of shopping and medical equipment needed to be brought from the Flight House in Lusaka.
So Owen and I set off on Friday 23rd November in the Land Cruiser with an empty trailer. We spent the nights at Garneton, Chengelo School, Lusaka, Macha, Lusaka, Garneton and back to Kalene. When we arrived back we had four people and luggage and stuff between the driver and front seat passenger, the two in the back were separated by a pile of goods, the back of the Land Cruiser was piled to the roof with goods and the trailer was loaded to twice the height of the rim. The trailer has been one of the best things I have out here. It is a military surplus one so is very robust, it is very stable on the road and dirt and has the same wheel base as the Land Cruiser – overall it is fantastic! And so we eventually arrived back at Kalene, tired but safe. We thank the Lord for answered prayer for safe travelling .
My fridge died today! There was a lightning storm this morning and the power went off – not that unusual an occurrence. The power came on after about an hour and all seemed OK. About three hours later I happens to go into the fridge and realised that it had no power, nor had the freezer. I had both plugged into a Sollatek Voltshield to protect them against lightning and under-voltage. This had been zapped. I removed it and plugged fridge and freezer into the sockets of a Furse lightning protection 4 gang. As I did so there was an almighty bang. Help! I then plugged the fridge and freezer into the wall sockets – the freezer worked the fridge did not. I checked the fuse in the fridge plug – it was OK. I then pulled out the fridge and dismantled the cover where the power cable entered. There, across the terminals of one of the components was a dead mouse. I pulled out the cable to start sequential testing to find the problem when I noticed that at one spot the power cable had exploded – the insulation had blown apart and the wires were charred. I cut the cable and put a plug on the drastically shortened cable and nervously plugged it into the wall socket – the fridge now works!! Thank you Lord.
Kalene Nursing School is a great asset to the hospital and the encouragement of young people learning has helped to elevate the overall standard of care in the hospital. As with all learning environments some struggle more than others and all of us will remember the stresses of exam time. The standards are quite high and consequently a reasonable number of students have failed some of their last round of exams. Sadly, one student failed four and was consequently dismissed (failing three or more results in this). This is not the first time this has happened but the young man in question was found dead near Mwinilunga the following day. At his funeral some unfortunate and unpleasant accusations were made about the local Lundas failing and the Bembas from further away passing. I threw a patient out of the hospital for making such sectarian remarks. Some of the nursing school tutors have departed for a time due to concerns for their safety. All of this is distressing for the remaining students and hospital staff. Underlying this incident is a real issue in that the education in the North Western Province is poor – I learned yesterday that the pass rate is the lowest in the country at 50%. This emphasizes the importance of the education facet of the North West Zambia Development Trust‘s work. Please pray that peace and calm and common sense would prevail and that the opportunities this presents for speaking the Gospel and for improving education will be grasped.
Last week started with Sam and Marian Phillips, Alex McConachie and myself visiting Munangala (hydro) Church where Sam had been asked to preach. He was pleased to see the building as his home church had assisted with the bench seating and painting. The next day some of the harsher realities of life hit when I had to amputate some more lower limbs. This time it was both legs from a young man called Edony. He is an epileptic who had a seizure and cooked both of his feet in a fire. They could not be saved.
The wet season has started with the usual spectacular lightning storms. The lightning strikes often cause the shutdown of the hydro but on one day it was a power line pole falling down that was the culprit. The termites are a serious problem (even for ZESCO – Zambia Electricity Supply COmpany) and attack wooden poles, even after being treated with a cocktail of anti-termite chemicals and preservatives. On this occasion it was the wind with the storm that was the final straw for the eaten pole and it fell over, causing a shut-down. The hydro team were on site quickly to effect repairs. I obtained this photograph as I was nearby with Danial Rea on our motorbikes. Riding back to Kalene after taking the photograph we both got soaked and covered with mud due to having to ride through large puddles – well, small lakes really – on the “road”.
On Saturday the Harvesters had a day’s conference and I was the speaker. This was an enjoyable and stimulating time and it was a delight to see so many of them there. I spoke on the significance and difference between making disciples (Matthew 28) and being witnesses (Acts 1). The following day Alex and I attended Sahandu Church where Alex was the speaker. The service was very short for Zambia – just under two hours.
Peter is back at Kalene after 3 months in the UK. The 3 months was very busy with a lot of time spent with Alex McConachie filling a 20ft container with a wide variety of equipment, including an ultrasound scanner, an operating microscope, a theatre table and surgical instruments that had been donated. We also managed to get a forklift into the container.
Settling back in at Kalene has been a surgically distressing time. My first operation was an above knee amputation in a teenage girl from Angola. She had sustained a straightforward mid-shaft tibial fracture with the fibula (the smaller of the two bones) being unbroken. If nothing had been done she would have healed well and had a normal leg. Instead, we were told, a doctor had put a tourniquet round the leg just below the knee. It had remained in place until her parents decided to bring her to Kalene two days later. By the time she arrived the whole leg below the knee was cold, insensate and beginning to break down. Instead of ending up with a normal leg as should have been the case she ended up with an above knee amputation. It would make you weep.
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