Dr Sics volunteers for the past three years

What support have you given in some of the rural villages in Zambia?

I delivered regular primary care clinics with the other volunteers in the villages we visited. Also helping with health education amongst the patients waiting for their turn in the clinic, and in nearby schools

Can you tell me about the training of Community Health Workers?

We work closely with the Community Health Workers in training, who act as our translators. During our consultations together. I helped them to understand the illnesses we are treating, and coached them in some of the skills and examination techniques to help them decide on the diagnosis and treatment.

During my last posting in 2019, two other volunteers were still practicing GP trainers and suggested we allow the qualified Community Health Workers to see patients on their own, and then debrief with one of us on their diagnosis and management plan, to improve their confidence in dealing with patient problems when qualified medical staff are not present.

This way of working with Community Health Workers was quite innovative, but similar to the techniques of patient centred learning which we use to teach medics in the UK

Why is training Community Health Workers so important?

Settlement patterns in rural Zambia seem very scattered, with staffed clinics long distances from many of the population, with walking often the only way to get to them.

The trained Community Health Workers act as a point of reference for the locals amongst whom they live. They can give advice on when to seek help for their problems, and in certain illnesses. Can offer testing and further advice on treatment. By working with them we can help them to widen their knowledge and experience of the common local illnesses to help them more effectively advise in their local communities.

They are volunteers, and perform great service in this way to their community. Younger Community Health Workers who have achieved a certain level of state education, can also use their training to make them more attractive to higher education institutions for further clinical training in nursing or midwifery. This progression is quite widespread in African countries which utilise high numbers of locals as health volunteers. I’ve encountered this in all three African countries where I worked.

Every September, for the last 3 years you’ve come as a volunteer Doctor, why?

The clinical work out in the villages is very interesting, both in the clinical range of cases seen, which in many ways is similar to UK primary care, but with many tropical diseases very rarely seen over here.

It’s a satisfying intellectual challenge to use our extensive training in clinical diagnosis and management to see how it can work well in relatively cut off very poor communities with very minimal clinical resources.

The camaraderie amongst the volunteers is also very satisfying to experience. At first being thrown together for several weeks at a time can be quite a daunting thought, but I have really enjoyed the way in which older and younger age groups in our profession can come together sharing their different experiences of medicine and enjoying working on a common project.

I enjoy camping under the stars out in the clinic villages enjoying the continual warmth and brightness of the African countryside.

Livingstone is a very lively place, to enjoy walks in the National Park, and around the markets. The restaurant scene is also very wide ranging and our group of volunteers have enjoyed many dining out experiences all over the town. It is also a very good base to plan safari trips further afield into other parts of Zambia, Zimbabwe and Botswana.

Quite a few reasons to continue coming back to work and play.

Would you recommend other Doctors to volunteer?

Certainly. The experience of working just using your clinical knowledge and experience without the massive infrastructure of  rich country medicine, and meeting many common illnesses no longer seen in the UK, as well as uniquely tropical illnesses, along with the help of a great group of volunteers ready to give their advice in deciding on management of a difficult problem encountered in the clinics are the main medical reasons to volunteer.

Working with, learning from and teaching the community health workers is very satisfying.

Then there is the African experience which is quite a jolt to our comfortable ways. But is very enjoyable when you allow it to be is an experiential reason for volunteering.

Finally, the safari experiences you can easily find are often both thrilling, and adrenalin inducing. Not to be missed.

Why did you decide to go into the medical profession?

 My background is traditional working class and the chance of having a well paid professional life was very appealing at 17. Along with my strong early interest in life sciences drew me to it. A school friend who I’ve recently reestablished connections with asked – Tell me Martin that you became a doctor, you were always bringing your toy stethoscope to play with at infant school. So the desire to work in the medical profession was there at an early age.

What is one of the most surprising things you’ve come across whilst volunteering?

That I could drive the project’s 4×4 for a couple of hours at a go on the way to the clinic location or the week’s camping base, over unmade rutted tracks and through dried up stream beds and enjoy the experience

Zambia is a beautiful country, do you have any recommendations for anyone visiting?

Visit the markets in town for fruit and veg, buy local fabric and get handmade shirts sewn up for next to nothing. Consider buying or even just looking at some of the local crafts and art. Learn how to bargain. Visit as many restaurants in Livingstone as you can afford.

‘GnT’ sundowners every Friday after work at any of the hotels just on the river above the Falls, the Royal Livingstone River Terrace has the best views of the crocs, elephants, hippos and birds just above the smoke that thunders. Go there early to get the best seats.

Go to the Avani hotel by the falls and treat yourself to a Saturday or Sunday buffet breakfast and laze by the pool afterwards whenever you’ve nothing planned for the weekend (surprisingly cheap)

Get on as many safaris as you can afford, there’s a great walking one in the Zambian Falls National Park, where you will encounter a herd of (protected) rhinos at close quarters (30m) on foot – just don’t run away, they can run faster.

Visit the museums in Livingstone – there are one or two.

Visit Victoria Falls in Zimbabwe for the better face on view of the Falls, and take tea in the colonial expat splendour of Victoria Falls Hotel (expensive)

Enjoy!