After four weeks in Lusaka I started off for Nangoma Mission, 120 km to the west of Lusaka. Within the ten days that I stayed in the mission I assisted Damjana with her work in the hospital, I visited the mission project and had a look at home based care and participated in a so called outreach. Damjana is a young doctor from Slovenia, actually not finished with her studies yet, but had only passed six month of her internship in Slovenia. She had already been to Nangoma as a medical student, and now had come back, for one year. When I came to Nangoma her time there was almost finished. The last six month of her stay she had been the only medical doctor in the hospital, as the other doctor, a refugee from Rwanda, had so many hours of overtime that he took almost six months off! Although there where three clinical officers and a nurse who was a very good midwife to help her, it was useful to have another helping hand. However, at first I didn't feel very helpful but at least I tried. And one day there was no clinical officer at all, as one had an off day the other had to go to Lusaka, and the third had to accompany some nurse students, to present them to the district officials in Mumbwa. 

But the out patient department (OPD) was full of patients waiting to be screened. So Damjana asked me if I could start screening, together with an experienced male nurse, while she was doing her ward rounds in the hospital. I had my doubts if I could do it but I just started and when I didn't know further, I just asked the male nurse or ran over to the wards to ask Damjana. What was really difficult was the communication, as most of the patients or mothers didn't know English. So I had to rely mostly on clinical examination, because history taking was only possible to a certain degree. When Damjana had quickly finished her rounds, we continued examining the patients together. Fortunately this was only one day and the rest of the time there were at least 2 clinical officers.

The hospital has got three wards in two buildings. The male and female ward including labour ward with each 20 beds in one building and the children's' ward with another 20 beds in a different house together with the operation theatre. So the next days I accompanied Damjana on her rounds, and we discussed the cases together. I also assisted with minor operations, like incision and drainage (I&D) or curettages and I put on plaster of Paris on fractured legs. Sometimes it was really hard to take decisions, as both of us were not experienced. There was no possibility to consult somebody, as there was no telephone to call elsewhere than within the Mission. Additionally many laboratory or x-ray examinations could not been done. The x-ray assistant had died just some time ago, and his helper was only able to do certain x-rays (Bones and chest) and in the lab there was often a lack of material and the lab-technician was not very hard working. For example he complained that blood sedimentation had become a routine examination, and why this was necessary.