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John Heimerl Completes His Elective In Zambia

Wow, I am now down to my last few days in Zambia. It is amazing how fast time goes!

This past weekend the farm hosted a Tiny Tim and Friends social and graduation. Each month, children newly enrolled in the program gather to celebrate those who have been in the group already for six months.

The day is filled with education and activity and culminates with a graduation ceremony.

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Over 80 children attended. I had the opportunity to take some good pictures during the event, and as soon as a camera was noticed I was surrounded by children asking to have their picture taken.

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The farm also started building for the animal enclosures that are being planned for the farm.

This is the future site of the chicken house. The farm also plans to keep goats and ducks in the future.

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Also on Saturday we visited Our Lady's Hospice.

Dr. Tim rounds there each week and sees the more complicated patients they are having difficulties with.

We saw three adult patients. One had suffered an acute intracranial hemorrhage following an eclamptic seizure, another was suffering from dementia, and the last was also suffering the devastating effects of a stroke. There were 28 patients at the hospice.

Our Lady's Hospice will be the site of the first pediatric palliative care center in Zambia.

TTF will start with 4 rooms at the hospice and then expand in time.

The project will allow for proper palliation and access to opioids when needed. Currently, terminally ill children in Zambia are either sent the University Teaching Hospital or are sent home with minimal pain relief.

The new palliative care center will be staffed with a specifically pediatric- trained nurse on site to care for the terminal children.

The training is intense and will take two months in Uganda.

There are big things on the horizon for TTF and the children of Zambia.

I will be traveling back to Minnesota on April 5, so this will conclude my blog updates from Zambia. Thanks to all of you for viewing my photos and posts while I've been here.

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Cheers, John

Updates from Zambia

The below post was authored by John Heimerl, PL2, University of Minnesota Pediatrics Residency.

Greetings again from Zambia.

I succeeded in finding a better way to access the internet. There is an internet cafe a short walk from the TTF clinic and the speed is fast enough to upload pictures and not take all day to do it. This is a good thing, as TTF has been without internet all week.

Earlier this week while Dr. Tim was south at a conference, we had a traditional Zambian meal together at the farm.
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Our meal consisted of nshima, Chinese cabbage stew and sausages

Nshima is the traditional food here, and likely everyone in the country can make it. It is made from ground corn and is the staple of the local diet. Nmisha typically is served with beans or rice, and sometimes fish or chicken is served as a side. I can't say there is much taste to it, but I kind of like it at the same time. I will try to bring some back with me so I can make some for my wife.

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Preparing Nshima and the meal

Clinic has been busy this week. We have seen and enrolled numerous children and adults. One of the children was 13 month old with stage IV HIV, due to severe wasting. He will be starting ARV therapy and has been enrolled in the TTF nutrition program.

One of my roles has been to help make it easier to track progress while children are getting nutrition support.

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This mother and child were both new to the clinic. The boy is 4 years old and, as you can see, has a rather large umbilical hernia.

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While Dr. TIm was away I did some shopping. I was able to find a nice selection of tomatoes just outside of the clinic for a good price

Till next time,

John

John Heimerl's 3rd Week In Zambia

This blog posting was authored by John Heimerl, M.D., 2nd year Pediatrics resident at the University of Minnesota.

We had another busy week at TTF.

Clinic days are full of patients to see. Here are two pictures from clinic.

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Here is the TTF clinical team, along with a patient and his mother in the center.

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Here I am with the pharmacist, Thomas.

I also had the chance to visit the large University Teaching Hospital (UTH), which is the referral center for Zambia.

A nurse named Clements (the only male nurse I saw during my visit) give me a tour, which I limited to three hours. He showed me each section of the pediatric wards.

The pediatric department is spread out over a number of buildings, each housing a different ward.

I saw the emergency ward, then Admitting. From Admitting, patients are sent to one of the five remaining wards--Malnutrition, Heme/Onc, PICU, General Pediatrics (x2) and Endocrine.

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I wasn't able to take any pictures of the inside of the hospital, but here is what the grounds and building look like.

Also last week I was able to do something I failed to do on my last trip to Zambia--I took a bus 400km south to Victoria Falls, which borders Zimbabwe (I hear we made good time; it only took us 6 hours, and I've heard it can take up to 10).

As you can see, the waterfalls were spectacular. In a couple of sections, you are drenched by the spray from the water falling, and it was entertaining to watch visitors get drenched.

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Well, I have to get back to clinic to see the rest of the patients. Hope to send more pictures soon.

Cheers, John