Saturday, December 24, 2011

Wellbeing Zambia Style

By Alisha Estabrook

In Lusaka, Zambia

The University Teaching Hospital (UTH) has a mission “to provide affordable quality health care, function as a referral center, train health providers, conduct research to find solutions to existing health problems, and for the development of science.” Located in the capital of Zambia, Lusaka, people travel from all over the country to be treated within its walls. And like the name suggests, it teaches students how to become medical professionals.

UTH is the biggest hospital in Zambia. This blog post cannot possibly encompass everything the hospital does and is focused on my personal experiences and observations within my internship with UTH’s Public Relations Department.


The hospital is huge, and I find it easy to get lost. Luckily, there are signs to point out the way, but usually they do not seem to help me out much. The hospital is more horizontal than vertical. Most of it does not pass the third floor, although a few sections reach four floors.

Parking is limited, and people come to visit travel by bus and taxi. Visiting hours last for one hour in the early morning, and one hour in the early afternoon. Otherwise, the hospital would be even more overcrowded.

Waiting areas are basically non-existent. The waiting area for the maternity wing is outside under some trees. Only the more costly areas of the hospital have waiting areas.

Like many other buildings in Lusaka, every window and door is blocked by bars, leaving an uninviting atmosphere to outsiders. Laundry hangs off balconies to dry in the African air and doors are locked with old fashioned keys. When someone is not in the office, it can be quite difficult to contact them. Personal cellphones are used over office phones that are broken and pushed to the side.

At one point I saw a “wheelchair.” It was a plastic chair, one that people in the U.S. put on their decks for a sunny day, attached to a frame with wheels. (Other wheelchairs were actual wheelchairs, I merely wanted to point out that resources are sometimes scarce.)

The air within the hospital is thick. Doors are left open to the outdoor walkways that connect sections of the hospital. Other parts of the hospital are a parking lot away. Only special areas have air conditioning. Certain parts of the hospital reek to an outsider, but no one can complain, because at least they are not the sick one.

Tucked away in a small corner is a door with a sheet of paper taped to it that says “Customer Relations Officer.” It is located near two elevators, of which only one elevator in the whole complex was working last June. The beige walls are offset by the sea foam green and black checkered tiles. A small desk is the only working space available, and electric cords hang out everywhere from the ceiling (if the electric company came and found she worked in that condition, the hospital would be fined). The only light comes from two small windows near the ceiling. But Natalie makes do with what she has. She is the public relations officer of the obstetrics and gynecology section.


UTH is a referral hospital. Patients need a referral from their local clinic to be treated. Local clinics send people they cannot treat, but easier cases that they can treat cuts down on the already swamped and overcrowded UTH by keeping patients at local clinics.

Patients can come to UTH if they do not have a referral, but then they are charged an extra fee.

When a person first comes to the hospital, they have to pick High Cost or Low Cost. It is up to the patient. Low Cost is free to patients (unless they have to pay the bypass fee). High Cost is for patients that can pay the money. The care is technically the same for both areas, but Low Cost is crowded. Beds are lined up with no privacy from other patients. When bed space runs out, beds are placed on the floor.

Even in the intensive care unit (ICU), Low Cost has beds in an open area with not much privacy (although the area is climate controlled). Beeps from machines echoed one another as multiple could be heard at once. High Cost had their own rooms in ICU, with curtains covering all the windows.

High Cost is not much better. The beds are more spaced out, and there is a bit more privacy. The VIP area is more like the hospitals I have seen in the United States. They are single rooms with TVs, radios, air conditioners, and nice linens on the beds. These special patients get cards, sort of like insurance cards, to show the hospital when they come in.

Men are separated from women. They are on opposite sides of a section or in different wings.

Working on a story for UTH's next magazine

Public Relations

The PR department has a magazine (it could use some work, but it’s a step in the right direction), a website (so I have been told, but cannot find it and someone told me it was outdated), and the department talks to patients and families. They also give tours, which is something I found odd. I even helped give a tour to a Chinese family. While photos of patients are not allowed, the tours walk right through areas filled with patients. This must disrupt the already short-staffed doctors and nurses.

My group of 18 from Ohio University went on such a tour. We saw the overcrowded Low Cost, the only slightly better High Cost and way too many sick people. We were even told to make ourselves at home, but we were all out of place and felt like we were invading people’s privacy.

I was told the biggest complaint the PR department gets is rudeness, ignorance, or attitude. There are not enough employees to attend to everyone in a timely manner. So family and friends complain about the inadequate treatment. In the past, people have attacked nurses for these complaints. There are signs within the hospital that say “Don’t Harass.”

Separate Entities

Near UTH are a few other buildings that are not necessarily part of the hospital, but are entities that are somehow associated with UTH and do good work for people. The Cancer Disease Hospital is on UTH grounds, and treats all kinds of cancers. It has helped people with a variety of treatments.

The Nursing school is just a short distance away from the hospital. It teaches students how to become nurses, and then allows them to practice their skills in UTH.

The laundry center takes care of all the linens UTH uses. When I visited, piles upon piles of laundry needed to be washed and dried. I never thought of how hospitals keep up with such large amounts of laundry.

UTH has a gym attached to the side of the hospital that is open to the public to promote healthy habits.

My favorite building was a workshop just up a hill from the hospital. People, who suffer from polio, work there to make structures and toys out of cardboard and papier-mâché. These items help children with cerebral palsy and structures are fitted to each child specifically to help build muscles.

In the papier-mâché workshop, Natalie is on the far right

Further “Enquiries”

In working with UTH, I have not learned all there is to know about the hospital. Some things have made me curious, and I am curious about a few observations I have made.

First, is how does the hospital deal with the issue of clean water? I have not been able to figure it out. Along with that, what about overall cleanliness of the hospital? Bugs crawled up and down the walls of offices where I was placed, so I can imagine what underlying cleanliness issues is a problem.

Natalie told me that people from all over come to UTH to get the best care (I even saw the VIP card of the son of the first president of Zambia). She told me if people wanted to go somewhere else and had the money to get care, they went to India. That probably should not have surprised me, but I would have guessed somewhere closer. What kinds of problems send people to India?

Abortions are illegal in Zambia, unless the mother’s life is in danger. Zambia is declared a Christian nation, so religion influences people in thoughts. Most people I encountered do not believe abortions should ever take place, but a hospital worker told me that they do happen within the hospital on an underground level.

HIV/AIDS is undoubtedly the number one cause of death, followed by malaria, and then vehicle accidents. One nurse explained that if someone comes into the hospital needing medical attention and has HIV/AIDS, the hospital treats the overlying issue first. Say this person has malaria and HIV/AIDS. The person would be treated for malaria. If he/she did not survive, the death certificate would say “Cause of Death: Malaria” as a way to not make the family or deceased ashamed. This makes me wonder how numbers are affected of how many people have HIV/AIDS and how many people die because of the disease.

Alisha Estabrook is one of 18 students from Ohio University, studying abroad in Zambia over winter intercession, about media, society, and governance, through the Institute for International Journalism

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