Zimba Mission Hospital

Dear Friends,

Things are progressing in Zimba. I am settled in my home although I still have not received my personal items sent by the container. I am surviving (more than surviving...all my needs are met).I am very content and have made many friends.

There is a team from Christ Church in Memphis coming next Tuesday that I will spend time with and they are delivering a few goodies for me. Christmas in May! I know I will enjoy their company and hearing about what has been happening in Memphis and the United States since I left. Is the war in Iraq still being fought?

The past weeks have been very eventful; baptism service in a pond, exorcism after church, goodbyes to new friends from the USA, termites setting up home in my house, cold weather arriving (even I had to put on a sweater), and a few robberies in the community. No need to worry, evidently this crime spree in Zimba is very rare and everyone is very concerned and taking precautions they normally don't take. I have burgular bars on my windows and door so I don't feel vunerable but I am being wise.

Since I have settled, I have actually been able to minister to others in Zimba and this provides that gratification our human nature so desires. The interesting thing is that I am ministering not only to Zambians but to the teams that have visited the area. In turn, they have ministered to me. I am currently working with the hospital to put together a proposal that will help them meet the needs of a proposed HIV/AIDS clinic.

Having said that, I must share my heart with you now. Reasons why I came to Zambia.

The main reason is that it was God's plan and He has made that very evident.

Second,is the Pilgrim Wesleyan Church which has a vision for reaching all Zambian people with God's Word using a holistic approach; spiritually, physically and mentally. They encourage each village/town to minister among themselves and not to depend on outside help. This is a challenge since 70% of Zambians live in poverty. Minimum wage is 1500 Zambian Kwacha or 39 cents per hour. They also realize their responsibility to the Great Commission which includes the world.

The third reason is that the needs are not always met with the best of intentions; computers are sent without instruction; medical supplies are sent that cannot be used because of lack of equipment, lack of specialized training, etc.; money is sent without clear expectations and everyone is disappointed in the outcome; and projects are unfinished because grants or funding did not provide the necessary funds to complete the project or the money was mismanaged due to lack of experience and/or desperation to provide for their personal needs.

Foruth, God thinks I can help the number three!

Zimba Mission Hospital
Zimba Mission Hospital (ZMH) was established in 1958 by the Pilgrim Holiness Church (later to become Pilgrim Wesleyan Church) and is located along the Livingstone - Lusaka Road (420km from Lusaka and 80km from Livingstone). Livingstone is the tourist capital of Zambia, best known for Victoria Falls and Lusaka is the capital city of Zambia.

ZMH plays a leading role in offering quality health services to Zimba and the Kalomo district. It has the potential to be one of the powerful hospitals in the region.

Healthcare in Zambia is managed according to whether the facility serves a rural or an urban area. Government policy states that rural facilities cannot charge patients for medical services while urban facilities are allowed this privilege. ZMH is a rural facility. The government provides funding to each medical facility based on the Central Statistic Office (CSO) data and this data was last updated in 1999.

The ZMH includes the hospital and Zimba Hospital Affiliated Health Centre (HAHC). According to the CSO data, ZMH serves a population of 14,500 people. CSO data is based on the government census count and does not include villages in the bush. ZMH has performed their own census of the area they serve and estimates the population to be 21,000 persons.

In reality, the hospital has no boundaries for the area it serves because of two reasons. One reason is that ZMH is the first level referral hospital in the Kalomo District of Zambia meaning that services that are not provided by clinics in the district refer patients to ZMH even though these patients may live outside the CSO defined boundaries. The second reason is because patients from Livingstone (an urban area) who are unable to pay or do not want to pay travel to Zimba to receive free care.

On average, ZMH attends to approximately 70 patients per day. The hospital has a total bed capacity of 106 with an average of 50% occupancy per day. HAHC attends to approximately 80 patients per day. Total number of patients served within the ZMH system is 186 patients per day.

PROBLEM #1: There is not enough money to provide for basic services in the hospital because the government funding does not allow for the entire community served.

Zimba Mission Hospital HIV/AIDS Services

ZMH provides an HIV/AIDS clinic which has 1169 registered HIV positive patients. Of these patients one third have been diagnosed with AIDS and are receiving anti-retroviral drugs (ARV). The HIV/AIDS clinic is open Monday - Friday from 0800 - 1700. The clinic is staffed by two Clinical Officers (Physician Assistants), two nurses and one lab technologist who also have responsibility for inpatient care.

One day per week is designated as a review day for HIV/AIDS patients due to staffing restrictions. HIV/AIDS patients who come for treatment on the other days of the week are attended to as staff is available.

Approximately 35% of patients who received the initial doses of ARV do not return due to the side effects of the drugs (usually caused by poor nutrition) and the travel distance from their homes. Some patients are required to spend the night away from home in order to be seen by the clinic and receive their drugs.

PROBLEM #2: Diagnosed AIDS patients are not receiving consistent ARV treatment which can cause the drugs to become less effective.

The ZMH laboratory offers hematocrits and rapid HIV Antibody testing. Testing for routine hematology and chemistry panels and CD4s is referred to the hospital in Livingstone. The ZMH staff laboratory technologist travels to Livingstone to perform the required procedures. Results are available once the laboratory technologist returns to ZMH. The delay in lab results is an inconvenience to patients who have to travel. They either return another day to receive proper dosage of drugs or spend the night until results are available. If funds are not available for the laboratory technologist's transportation and travel costs to Livingstone, testing is not performed. This means drugs are administered according to physical symptoms and past lab results.

PROBLEM #3: Administration of ARV is dependent on lab testing and this service is not always available to the patient.

NEWS UPDATE: The Zambian government has designated ZMH to receive a Hematology instrument to do complete blood counts and CHAZ (Church Health Association of Zambia) has promised a CD4 instrument. There were nine hospitals competing for this equipment and there are only two available, one of which will go to ZMH.

PROBLEM #4: The current laboratory is not large enough to accommodate the instruments scheduled to arrive within the next few month.

Construction began this week to expand the current laboratory. I asked the Clinical Director if there was money for this expansion and his response was, "No". I asked how they planned to complete it and the response was basically "if we build it, money will come." I'd like to think that this is based on their faith that God will provide and that this will not result in another project that starts and is not completed. The need is so great!

PROBLEM #5: There is no money to complete the laboratory construction. They have enough cement to pour the slab. They have bricks to build the outer structure. There is no money for cement to lay the brick, provide the roof, increase the electrical power and add additional water outlets.

PROBLEM #6: If the government or CHAZ delivers the instruments and the room is not acceptable, the equipment will be forwarded to the next medical facility on the list.

The interesting situation here is that it seems like it will take thousands of dollars to finish this construction and it will take months to raise the funds. In the United States the answer to this statement would be yes, maybe years. The money needed to complete this construction is 4,000,000 Zambian Kwacha or $1000.

I urge anyone who may be reading this blog to understand that the needs are great and many in Africa, but that even small amounts of money make a big difference.

Greater than 70% of Zambians live in poverty. Nearly 1 million Zambians are HIV positive or have AIDS. An estimated 100,000 died of the epidemic in 2004. Over a half-million Zambian children have been orphaned due to AIDS.

If ten people donated $100 to this project…the construction could be finished!

If five people donated $100, 5 people donated $50 and 10 people donated $25 to this project…the construction could be finished!

If anyone would like to help complete this project please email me and send your contribution to:

Rebecca Locastro
c/o Christ United Methodist Church
4488 Poplar Avenue
Memphis, TN 38117

Place a note to Rebecca indicating it is for Zimba AIDS Project. A contribution statement will be sent to you at year end for tax purposes.

Thank you for hearing my heart and answering the prayer of the Zambian people.

Janet

"But who am I, and who are my people, that we should be able to give as generously as this? Everything comes from you, and we have given you only what comes from your hand.
1Chronicles 29:14