Its been over a year since I left Zambia after my 3 month placement at Kanyanga Rural Health Post, but in some ways it doesn’t feel as though I ever left! I was lucky enough to be back for a short visit last month, and returning both to Livingstone and to Kanyanga felt like coming home. Over the last year myself and other volunteers have continued to keep in contact and be involved with the organisation: whether its talking to prospective volunteers about our experiences and answering their questions, or presenting the findings from our assessments and project report, we’ve definitely been kept up to date with the ongoing work of OCA, and have even had the chance to have an input into ongoing development of the rural health service package. I was so excited to be able to go back out in person and see first hand the developments happening since we left.
Work on our Antibiotic Stewardship project has continued from the UK, and we are currently finalising a paper hopefully for publication, demonstrating that our quality improvement interventions led to a decrease in inappropriate antibiotic prescribing. We are delighted that the project has been accepted for poster presentation at the 7th Global Symposium on Health Systems Research in Bogota, Colombia later this year – wonderful to get some international recognition for OCA! Back out in Zambia, I was thrilled to catch up with John, a current OCA volunteer, who recently audited the prescribing rates at Kanyanga and found a sustained improvement. He has also been working on further training for staff to hopefully continue this improvement, and has even been able to produce some resources in Tonga for staff and the local community to use. Plans are underway to upscale the teaching to other Rural Health Facilities (and this has already started in Chalimongela): potential collaborations with The Virtual Doctors Charity has the potential to deliver this on an even larger scale! Among his many other projects, John is also working on an improved stock inventory system which should help to reduce stockouts and continue to improve the prescribing rates. I had the chance to catch up with Christon, the Clinical Officer at Kanyanga, who tells me that he can see the improvement in antibiotic usage first hand – its really amazing to be able to see the sustained impact of our relatively simple interventions.
Its a busy time at Kanyanga: the COVID vaccination drive is ongoing, and lots of the staff and CHWs were out in the field administering vaccines to the most rural of their communities. This is a big change from last year, when the first vaccines were only just starting to arrive here.
During our stay in Kanyanga, we had identified the mothers’ shelter as a key priority for improvement of maternal and infant health: this is a structure where pregnant women come to stay towards the end of their pregnancy, sometimes for weeks or months at a time, to ensure that they are at the RHP in order to give birth safely. The current structure is inadequate, with no bed, no water or ablution facilities.
OCA asked Ellie and I to pick a project to raise money for in the Big Give, and we of course chose the construction of a new mothers’ shelter. We were so grateful to everyone who helped us raise the money at our ‘Step to Change’ event at the Royal College of GPs in October, and then again during the Big Give in December – so many of our friends, family, colleagues and previous volunteers were incredibly generous and we successfully raised enough money for a brand new mothers’ shelter, which is planned to have 20 beds, with showers and flushable toilets.
Work had been delayed by issues finding a new water source, and this is clearly a current hot topic – everyone I spoke to in Kanyanga and back at base in Livingstone told me about the recent unsuccessful attempts to drill a new bore hole, and there is palpable hope in the air for the next steps. We were accompanied on our visit to Kanyanga by a team of geophysicists from Canada who are doing a detailed survey, and also looking into alternatives such as rainwater harvesting – at the time of writing a new potential site for a bore hole has been identified, and I (and I think the whole OCA and Kanyanga team) have everything crossed for success. Meanwhile, I was able to see the raw materials for the shelter had been collected by a huge organised and voluntary community effort: it’s inspiring to see how people can pull together to create something to benefit the entire community. Just a few weeks after returning, progress has been rapid and the basic structure is almost ready.
Aside from seeing the progress of our projects, I took some time to catch up with old friends. It was great to see our host family who we lived with last year – Mum – Trevyllyn (Community Health Worker at the RHP) and I was pleased to be able to cheer on Dad – Brian on the local football pitch playing for the Kanyanga Registers (winning 3-0 during my brief visit!). And of course back in Livingstone I was reunited with the OCA team (and its many new members), thankful to be there in time to celebrate Rachel and Emmanuel’s wedding!
Coming back again has allowed me to see the impact of our short time in Kanyanga, and how it fits into the bigger picture of what’s going on at the RHP and in the wider district. Back in the UK, Ben and I carried out a workshop at the WONCA 2022 Pre-Conference where we talked about OCA’s work and gave participants the opportunity to design their own roadmap for an RHC, generating some really interesting discussions with early career European GPs. Even from afar we can continue to help and ensure that everything we do remains sustainable – the recently launched OCA Alumni Network is a great way to feel connected even when you can’t physically be there (although I’m sure it won’t be too long until I’m back again!). If you feel inspired by the work of OCA in Zambia and want to contribute, you can always sponsor our team running the Richmond Half Marathon in September (or feel free to join us!).
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