Saint Francis' Hospital Katete, Zambia
Saint Francis' HospitalKatete, Zambia

James and Faith Cairns revisit Saint Francis'

September 2013

In early September we visited Katete with our eldest son, Andrew, who was born in 1958 soon after we went to Katete. We spent four days at the hospital, following a week with the rest of our family at Jake & Gillie’s, a house for letting just outside the Luangwa national park. Our second son is a farmer in the Southern Province.

 

It was good to be able to go back to the hospital again, even if it was quite rushed and also rather hot! On arrival one was impressed by the Circle, in front of the hospital, no longer a dried up/trodden area, but with flourishing grass; the paths, criss-crossing the site, flanked by hedges. Most of the trees in the middle of the circle are still there, though one of them was now being used as a bench for the weary. A special shaded seating area has been built on the circle, not far from the west end of the front block, which must be a welcome sight for patients, and others coming from a distance. On the right of the front block is a bicycle and also a car park: very necessary in view of the number of cars on the roads all over Zambia. A law in Japan, that cars on the road may not show more than 50,000 miles on the clock, has led to the floodgates opening and many, many more cars in the country. It was a surprise to us to be greeted by a senior nurse in his car stopping to greet us as he came on duty. Much of the day, Lusaka is grid-locked with traffic and trunk roads are much busier.

 

We appreciated being able to talk with Mathew Mwale, Manager Administration, whose office is just inside the front entrance in a room where James spent many hours seeing Out Patients in the past.

 

We had good talks too with Dr Simon Chisi, Medical Superintendent/Ophthalmologist, much of it about the doctors who would soon be arriving and others who were applying for posts at the hospital. On the last night 40-50 people, many of whom had worked with us, were invited to the Mess for the evening meal. This was a good occasion.

 

Thanks to the generosity of people in the Netherlands a new Children’s Ward with 60 beds was opened by the Minister of Health, Dr Joe Kasonde, in November 2012. This is sited on the east of the hospital, alongside the Maternity Ward. It is a large building divided into low walled bays with six to eight beds, each designated for a particular condition. One bay with glass partitions to the roof is specially warm for the malnourished children. The ward is brightly coloured with animals painted on some of the walls. Very soon a special Isolation area will be added. The ward is still called Mbusa wa Bwino, The Good Shepherd, the name suggested for the previous Children’s ward by the then Chaplain, George Hewitt, a wonderful Englishman, who had spent much of his life in Zambia and was nearing 90 years when in 1981 he decided to return to the United Kingdom.

 

The previous Children’s Ward, beyond and to the east of York, the TB ward, has been changed to become the Out Patients Department. The original building was designed with wards round a large quadrangle with a chitenge (round shaded area with a low wall) in the centre. Entering the building the patients pass through an area where their details are checked: a computer searching their previous records of attendance, going beyond the 1000s of Phiris, or Bandas (both very common surnames). The next point of reference is the village where they were born. The clerks seemed to be proficient in tracing previous attendances where applicable.. On arrival the newly arrived patients go to the chitenge where their blood pressure and vital signs checked after which they are directed to the various queues. The rooms are well marked for their different purposes.

 

York Ward, the Tuberculosis ward now no longer in use for that purpose as the TB patients stay in hospital for much shorter periods, is to be altered to become wards for Gynaecological and Eye patients. So far the roofing has been changed as it was originally of asbestos. One of my earliest memories of the hospital is the visit of Michael Ramsay, then Archbishop of York opening this ward in 1961.

 

St Luke, built as an Isolation ward about 1964, the time of Independence, which also has a small central courtyard, now covered over, is now used for offices for various departments after a period as a rather small Out Patient department.

 

The building of staff houses has continued, of necessity. More recently these have been small houses for two people, each with two bedrooms and small living room, bathroom and WC. A number have been fitted between the houses near the Senior Staff Mess. Another group lie next to the White House, now nearly at the end of its life – our first home –and in front of the ‘Y Phiri’ house – a large house built for a family, but now used for groups of visitors, including students.

 

James and I continue to field applications from doctors based in the UK, Australia, New Zealand, and the Netherlands: at present there are no vacancies up to June 2013. For the last three years trainee General Practitioners in their third year have gone to the hospital from the UK for a year at the hospital. At present three female doctors are there from Scotland and there are plans for them to be replaced with a further group. Since the agreement for co-operation with the Borders Hospital, Melrose, Scotland, a number of young doctors have come from there and more are in the pipeline.

 

The Surgical department has benefitted greatly by the arrival of two senior surgeons, both of whom retired early, Prof. Robert Bleichrodt from Nijmegen in The Netherlands and Paul St John, from Truro in Cornwall. This has meant that the surgical patients numbers have increased greatly. The surgeons are very able supported by experienced Zambian Clinical Officer/Anaesthetists.

 

At St Francis the number of doctors at the hospital has been climbing. In 1996 the year we left when the bed numbers had reached 360, the point at which they remain, we felt very lucky if we had five doctors on the staff. Since then the effects of the HIV/AIDS epidemic has meant that the workload has increased greatly. Now the total numbers of doctors are between 11 and 14, on contracts of various lengths, minimum six months. In early 2012 the government started posting doctors to the hospital and since then there have been two Zambian doctors who have completed two years since qualifying. The Zambian Gynaecologist/Obstetrician, Dr Makukula, has now been at the hospital for 18 years. The hospital also receives Zambian doctors during the third year of their post graduate training for M Med. Surgery or Obstetrics & Gynaecology. They come for a minimum of three months; one or two at a time. Another branch of training is for Licentiate Doctors. These are Clinical Officers, who receive three years training, with the emphasis on treatment, post Grade 12. On a competitive basis, after they have completed several years in post as Clinical Officers, they may enter a further course of two years, to become Licentiate Doctors, with a view to their being in charge of Rural Health Centres. On qualifying they serve as Interns for a year and two are quite often posted to St Francis. From time to time Laboratory Technicians and Pharmacists come post training as interns. Also since 1953 Enrolled Midwives and 1956 Enrolled Nurses have been trained at the hospital. A number of these have gone on to become Registered Nurses which is some cases has been to the benefit of the hospital: others have moved elsewhere.

 

The doctors who volunteer from ‘overseas’ (outwith Zambia) usually receive a stipend starting at £150/month if they offer for 6 months. Longer offers and doctors with more qualifications attract more, £200-£250/month. One or two doctors who have retired feel able to go to the hospital on a self-supporting basis.

 

In The Netherlands since the early 90s there has been a support group which largely raises the funds for capital projects, which have helped the hospital greatly. Unfortunately the running costs for maintenance are seldom included in these donations, so there is a problem with upkeep and funds are urgently required for this purpose. The Zambian government makes monthly grants representing 75% of the running costs, so that funds are also needed for the shortfall. To inhibit the draw to the towns, some of the senior Zambian staff receive a ‘top up’ No expenses are drawn by any persons caring for the funds held in this country. The auditor examining the funds for the charitable trust does this annually without charge. The support of people, regular and intermittent, is of great importance to the hospital land we are very grateful.

Bezoek ook onze Nederlandse zuster-website

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