Our second trip through Harare International airport went much smoother than the first. I (Lori) have just funded another gold-plated toilet for some government official as it was the fourth $75.00 visa I had to purchase for entry into Zimbabwe (because of the way the safari was organized, we re-entered Zimbabwe twice). The kids and Paul are travelling on their Australian passports and are able to get dual entry visas. The jacaranda trees that were just starting to show off the first time we landed were already losing their purple blossoms, covering the ground in a psychedelic carpet. Now there just needs to be some real rain as all the dams and lakes are very low. In Harare, we were frustrated in our attempts to take money out of an ATM and use our Visa card (sorry Ted Sloan no soccer shirt for you), except thankfully for our major grocery shop prior to going to Karanda. It was a challenge trying to gauge how much to buy of everything. We are able to get bread locally and some fruit.

It has been interesting getting into the rhythm of life here. There is singing and devotions each morning at 7. We don’t know what the Evangelicals make of a Catholic family showing up but they are very welcoming even if we don’t offer testimonies. The nursing students’ singing is achingly beautiful. https://www.facebook.com/paulori/posts/10154461412750977 

Dr Thistle (from Ontario) and his wife who is Zimbabwean have three boys and the older two were home from Harare on school break the first week so it was nice to have some kids close in age to the girls for board games and soccer. Exercise is a challenge as it really is only feasible prior to 6:30 am before it gets hot or around 5:30 pm before it gets dark. This morning Paul and I got up at 5 to join Dr. Stephens for a hike up Baboon Mountain.  It was already 27 degrees on its way to 37 by the time we got back at 7 am. We all find we have to stand up slowly or we get light-headed because we are so vasodilated.

In retrospect it was very helpful for me to have gone to Nyanga District Hospital first as because it was so quiet there, I could ask the pharmacist lots of questions and understand the processes and the different medications. In contrast, Karanda Mission Hospital is way busier, including the pharmacy. Interestingly, the staffing levels in pharmacy are about the same except that there is no pharmacist at Karanda, rather a pharmacy technician, Memory, and two nurses, Nyasha and Mugute. Similar to Nyganga, the staff are well trained and very smart. The drug inventory is much better at Karanda (although I wouldn’t have thought so if I hadn’t seen the situation at Nyanga first); I never thought seeing a Novo-cephalexin 500 mg stock bottle would make me feel homesick but it was reassuring to actually recognize a product. I wish at times I could pull out my university notes as there are some drugs I have not encountered since then (can you spell suprilide? Chloramphenicol oral is still available?). I’m now resigned to the mini-plastic bags for dispensing medication with sparse information on them and the poor quality of some of the tablets. Even the product info inserts are cheap-looking. My first job was entering all the drugs into MOIS (the computer system Paul expanded when he was here a year ago) so that the staff can enter patient meds into the system and stop recording everything manually in a ledger book. The staff are quick learners. I also have worked on updating the inventory list Paul established last year that has been very helpful for hospital staff to know what drugs are currently available. While I may have evaded inventory at the FSJ Pharmacy this September, I have done lots and lots of pill counting because they pre-pack many medications and I want to free up the staff members’ time to practice on the computer. I never thought I would be dripping with sweat merely counting tablets but the pharmacy is not much cooler than outdoors. Paul is a little more comfortable in the computer room as that has to be air conditioned to keep the computers cool. Very little chance of ‘store medication below 25 degrees’ here.  I also made simple syrup from scratch so we could make nevirapine suspension because the pharmacy is awaiting a delivery of nevirapine pediatric suspension (given for 6 weeks to babies born to HIV-positive mothers). The pharmacy’s pestle is broken but still functional and there was no glycerin to wet the tablets or preservative; however, it will at least bridge the baby until the family can get to the local clinic, which we hope have stock.

Paul has been doing similar work to when he was here last time – expanding and fine-tuning the use of MOIS (Medical Office Information System). The girls have been helping do some data entry and pill counting and have also visited the school for the staff members’ children.

I read a very interesting book at our lodgings “When Helping Hurts – How to alleviate poverty without hurting the poor and yourself”. It made me think about a lot of issues, especially wrt short-term volunteer stints and also how to approach helping within our own community. We are humbled by the example of the people who work here full-time – it is exhausting. I find I am changing emotional gears often, getting laughs from patients when I attempt to speak Shona but then being overwhelmed by meeting so many patients who are HIV positive. I was enjoying a casual chat with an acquaintance but then we met her cousin, whose 5-year-old died from malaria 2 weeks ago. It places the fragility of life and the blessings we have in a whole new perspective.