The lights turned completely off in the small hospital in Mwandi, Zambia, yet the Zambian nurses, dressed in their white nursing uniforms, seemed unfazed by the sudden darkness and relied on the natural light coming through the windows. Due to a drier-than-usual season, the hydro-electric dam that powers the country generates less power, so everyone, including hospitals, is forced to endure daily power outages. The BYU nursing students in these hospitals were impressed at how quickly the nurses adapted, exposing them to the realities of global health disparities and the ingenuity required to overcome them.
Leveraging in-country connections to start the Zambian practicum, Professor Cheryl Corbett found an opportunity to partner with the Mwandi Mission Hospital in rural Zambia near Livingstone, a city at the edge of Victoria Falls. The senior chief of the region requested BYU nurses to focus their efforts on menstrual health and injury care. Professor Kristen Erekson accompanied Professor Corbett on the inaugural practicum in the country.
In Mwandi, BYU students worked in conjunction with the hospital to care for pregnant women and other patients. Women nearing the end of their pregnancies often travelled from local villages by oxcart or even walk for miles to receive care from a hospital midwife or doctor. These women find a place on campus to rest before giving birth. Recognizing a great teaching opportunity, the students and faculty used manikins to demonstrate the anatomy of the birthing process and umbilical cord care.
The Zambian women were grateful for these lessons as childbirth is not taught as frequently with visual aids. Few had ever seen physical models of pregnancy and birth and were enthralled by the demonstration, eager to learn. “I felt there was a connection and a bond you can't describe,” said Professor Corbett. Students were also amazed at the strength of the Zambian women, particularly when the women challenged them to dodgeball, and the students lost to the expectant mothers.
When the women finally gave birth, the students were often present. One student, Nautica Spilker, was in the maternity ward as a woman gave birth to her first child without pain medication. The nurse was guiding her through labor. Nautica was tasked with keeping track of the fetal heart rate. Noticing a drop, Nautica alerted the doctor who successfully delivered the baby. Utilizing her nursing skills made Nautica incredibly grateful she was there at that moment.
After witnessing births, students also had some time to visit where the mothers were resting after birth. “They looked exhausted, and I decided to go and visit each woman in the room and learn about them and their baby,” said Nautica. “I offered them drinks and back massages. That experience really helped me to incorporate the Healer’s Art because I was trying to do what Christ would by ministering to each patient.”
Brontë Preece, another student, witnessed four births while serving in labor and delivery. “To watch a new life come into the world is a big testament of our Heavenly Father’s love,” said Brontë. Brontë had respect for these women who were often told to be quieter during contractions, and also witnessed a C-section birth of twins.
Mwandi Beyond Labor and Delivery
There were many differences between the rural Zambian hospital and the US units where the students are accustomed to working. In Livingstone, the nurse was doing sutures for a child with a laceration because there was no doctor in the town. The students were impressed at the dedication and competence of their Zambian counterparts in caring for their patients.
The students also taught about menstrual health and distributed reusable menstrual hygiene kits. Many young girls in Zambia lack access to products and miss days of school because of menstrual hygiene and social embarrassment. These reusable kits would help the girls long-term, and many were ecstatic to have their own menstrual products.
On a community outreach day at an antiretroviral clinic, students conducted measurements, screened for cervical cancer, and educated villagers about how an anti-HIV drug can slow the development of AIDS, as Zambia has a high occurrence of the illness. They drove an hour each way to a tiny village with one building reserved for HIV education. They were impressed at how effective the Zambian nurses are in teaching about HIV awareness.
Livingstone: Home Visits and Community Outreach
In Livingstone, the practicum participants accompanied caregivers on community visits. On one home visit, they saw a nine-year-old boy who broke his femur when he was six. The nurses cleaned an abscess in the area where the fracture wasn’t healing because the boy was unable to keep it clean in the dusty environment. They also visited patients who had injuries uncommon in the US, such as third degree burns from open fires and crocodile bites. The students also conducted blood pressure and diabetes checks at schools in the city.
Brontë enjoyed teaching about infection care during these visits. Even with a lack of resources, they could teach simple things like cleaning a wound daily and boiling water to decrease infection. “I want my future patients to feel as empowered to take care of themselves long-term,” said Brontë.
Cultural Experiences
Outside of clinical work, the BYU nursing group had many opportunities to interact with the local culture. They participated in safaris, camped under the stars, and visited Victoria Falls, one of the largest waterfalls in the world. They also learned about Chitenge fabric, a colorful material worn by women across the country.
On a bike ride to the outer streets of Livingstone, their tour guide walked them up to an older woman in her early 80’s who was pounding rocks into gravel. This woman would walk miles to a cliffside where she would break off rocks with a hammer and would sell the finished gravel at markets. Selling the gravel only makes her 10 kwacha a week, the equivalent of 39 US cents. “That was the most humbling and reverent moment I’ve had in my entire life,” said Bronte.
Kelsey Parker was equally touched by the strength of everyday people in Zambia. “I wasn’t shocked because the Zambians were missing out on the things that we value in the United States,” said Kelsey. “I was shocked that WE were missing out on the values Zambians intentionally incorporate into their everyday lives. What Zambians lack in concrete they make up for in carefully swept dirt courtyards for their families and friends to gather in.”
Students and faculty were also amazed at the linguistic variety in the country and the nurses’ ability to communicate, even if the nurse was not fluent in their patient’s language. While the official language is English, many tribes have their own dialects. The BYU students attempted to learn some Lozi, the language of the women in Mwandi. “It was very sweet because when we spoke the few phrases we learned, they would light up,” said Professor Erekson.
Though far from the Zambian branches of The Church of Jesus Christ of Latter-day Saints, the students attended one week in Botswana. The branch president shared a thought about missionary efforts in the country by explaining how a large fire can often start from a small spark. While the BYU nursing students were not doing missionary work, they connected with this message as their small efforts helped their patients and molded their own view of nursing for their whole lives.