Students from CSB and SJU enrolled in an embedded study abroad course called “Global Health Service Learning in Zambia” led by Dr. Ellen Block. They spent two months in class preparing for the trip and 3 weeks in Zambia in spring 2023. Here is one blog post written by student Annika Gothmann while in Zambia. Read more about their experience on the Zambia Course Blog.
Last year, in Medical Anthropology with Ellen, I read a book called Improvising Medicine by Julie Livingston. It’s about a cancer ward in Botswana and how limited resources cause providers and patients to improvise when it comes to care. This idea struck me over and over again while in Zambia, especially while on home-based care.
Each morning before going out on project we grabbed our backpacks that contained all the medical supplies we would have for the day. If we were lucky, we also got a tablet to record notes that had the patients’ history on them. If not, we took notes by hand and entered them into the tablet later. We did our best to keep the bags well stocked, but that wasn’t always possible. We are often out of certain medications and supplies or were extremely limited in what we could bring. Because we were so limited, we often couldn’t give patients as much medication or supplies as we wanted to, because we had to make sure we had at least some for everyone. This was challenging because we know that giving someone four tablets of Paracetamol is not enough and won’t dull the pain until we can visit them again or they can get to a clinic, but there’s nothing we can do. The patients know this too and end up improvising their own care. They’ll try to make medications last as long as possible, even if that means taking them less than they need them.
Many times, our lack of supplies caused us to not be able to provide the care we wanted to. This happened every single time we wanted to test someone’s blood sugar. Either the machine wasn’t working, we didn’t have the right strips (or any at all), or we didn’t have needles. We told these patients we would test them next time or referred them to the clinic to get tested, but I’m not confident that any of that will work either. What seems like a simple thing to test was extremely complicated without the right supplies.
Improvisation of medicine can be seriously dangerous and is worrying me even more now that I’m at home. How many people have undiagnosed diabetes because test machines aren’t working, or strips are expensive and unavailable? How many people have wrongly healed fractures that they keep taking pain medication for, but can’t get a permanent solution because they can’t get to the clinic or it’s too expensive to treat? There are so many factors of care that have to line up for it to be successful, like transportation, income, support at home, access to clean water, access to nutritious food, education, sufficient medical supplies, and more. When one or more of these are improvised, care gets difficult. Most people are doing what they can, but more often than not, some aspect of care is lacking.
Hi! My name is Annika Gothmann and I am from Waconia, MN. I am a junior at Saint Ben’s majoring in Sociology with minors in Global Health and Hispanic Studies. I am super excited to go to Zambia as I love to travel and experience new places! I am most excited to learn about public health initiatives in Zambia and get to talk with members of the community as well as community health workers, educators, and health care providers. I hope to learn a lot and apply what I learn once I get back home!