Rural placement in the 'west'

Yes the 'west' has rural areas.
Giant rural areas, filled with poor people who cannot access healthcare or education.
Yeah it exists.
While I am in this country I plan to spend a lot of time studying and working in rural areas because I understand that any area has problems that they seek to find solutions to. And my goal is to learn some of their solutions from being just so physically distanced from the 'west' from the resources and healthcare in their cities.

Anyway, interesting thing about where I went, they don't want me to talking about it, they feel there is the potential that I will insult them online, so they have rules about what I can say online.
This is the first thing I learned from them. I really liked that they control the information out there about them. I wish we did that.
Something I plan to invest in in the future, is taking country of our image online, being the ones who fill in the Wikipedia pages about us (for instance).

In respect of there requests I will only list extremely general lessons I learn, I don't wish to make enemies with people I respect so highly.
Suffice it to say, I am in a 'developed' country with a life expectancy of over 70, and every one has lots of money and in class they tell us about diseases that are never seen in this country anymore except in 'third world' countries, but..
-Here you will find 'third world' conditions, and mentality, the idea that there is little hope and little to expect from the future.
- Annoying you also hear a conversation that goes, 'In a country like this one, it is embarrassing to find third world conditions'
Which basically suggest we should be ashamed of our diseases, generally the idea of 'third world conditions' is directly linked to things associated either with fecal-oral transfer, or dirty water, parasites, there is this association with dirt (sorry side tracked, but seriously there is this idea that we are dirty, so we get dirty diseases!! UGHHH, has anyone noticed this, it can't just be me)
These are not 'third world conditions' we didn't bring them here, they were here of their own accord, and therefore these are first world disease aren't they?!?
It's really interesting to hear the dialogue in this country that defines itself in a particular way and then adds on this little appendix.
'We are first world, except for that corner of there"
We have no TB, AIDS, or -insert 'third world disease here- except in refugees and that corner over there'

This is frustrating. But being frustrated and insulted doesn't mean I am not paying attention and seeking to learn. I am learning very interesting things about point of care testing, about getting specialist care access to people far away from specialists but in areas that are sparsely populated so that you can't pay a specialist full time to be there.
Emergency care is also something that's very complicated when you are located far away from a tertiary care centre.
It's all extremely interesting and I am taking notes, taking pictures and taking brochures for when I will work to implement similar (but obviously different) practices in rural Zambia.

Why Zambia is Amazing

This will not be about tourism or investment or volunteering in Zambia so if that's what you are looking for..look elsewhere.
I did a quick search to see if anyone else agreed with me and all I found was why you should visit Zambia, why you should go help us and how much fun other people had when visiting/helping us.
This is about the fact that after I have travelled I have discovered so many amazing benefits to being Zambian that I never fathomed while actually in Zambia.

1. Weather
1.  No hurricanes
2. no bushfires
3. no tornadoes
4. No El ninos, or la ninas
5.  No snow storms that mean we close the nation down and wait for the snow to melt
1. The weather is AMAZING, they are two seasons, you know they are coming, and they are predictable (okay fine they might be variations some people claim hot and dry, hot and wet and cold and wet or some other variations). But it's predictable, you know what's coming. The only reason we have issues with it is because we don't prepare adequately enough. The fact that in dry season we have no water and in the wet season we are flooded is a testament to our lack of forward planning. This is easily fixed. You cannot forward plan for certain weather dramas.
2. Tribalism
1. It could be worse, I am currently not proud of hearing people discussing politics in light of someones tribe but we are close to many countries where the tribalism has destroyed them. 
3. Things we deal with from our past
1. No giant nuclear explosions
2. No major civil wars that ripped the nation apart
3.  No genocidal history
4. There is nothing preventing us from holding our heads high when we face people from other nations, there is nothing (major) to be ashamed of in our past.

There are many more reasons but the reason I brought it up is because I learned some new things yesterday.
Things about Cambodia I never knew. Honestly, I wasn't even entirely sure where Cambodia was, I now know.
Basically in a quick sentence I learned that Cambodia had a history of colonialism, got independence from France slightly after Zambia, and then they were occupied by Vietnam, and then there was WAR.
LOTS and LOTS of war, things were destroyed, people were killed.
But you're thinking, yeah, everyone had war in the olden days.
BUT NO, Cambodia had war in MY LIFETIME.
Less than 20 years ago there was war ripping Cambodia apart.

I had the opportunity to hear Cambodian Doctors talking about working and living there and it was amazing.
Issues they overcame:

1. After the war the were FORTY doctors in all of Cambodia (14+ million people)
2. After the war, they was a spirit of unease, people didn't know when the next war would come and therefore everyone appears to hoard their money, out of uncertainty. So it is very difficult to get help and funding from the Cambodian poeple
3. Lack of specialists to train new specialists
4. Lack of infrastructures (there was a freakin war!)
1. America was trying to fight Vietnam so they bombed Cambodia over 100,000 times

BUT
- These doctors were passionate, they came to this country to get some new ideas on training new doctors in Cambodia. They were patriotic and they were skilled.
Even had a pediatric cardiac surgeon!
Against such amazing odds they are doing amazing work.
Looking at the stats in Cambodia since even early 2000, comparing things like infant mortality and life expectancy, and poverty, you will see major changes.
And this forces me to ask sometimes...what's our excuse?

3am

Sleep comes in cycles

Something kind of like this, which means at anytime during the night you are more or less likely to awaken.
Generally in my light sleep phases I can wake up check the time and go back to bed.
But every once in a while during these moments of light sleep my brain is sooo excited about an idea that I just can't go back to sleep.



Last night I was in light sleep around 3am, and my brain was just shooting forward about going to Zambia and building a hospital (this will probably be a reality in my 40s!), about being able to visit for the first time in 5 years next year!
My mind is soo excited and it is so hard to have to tell myself to cool it because I have to successfully make it through today, this week, this year, etc. I told my brain to chill, it didn't work...

So I managed to stay in bed for a few more hours, not really sleeping...
But I thought I would share what was keeping awake tonight, because if you get excited about it maybe you can start and I can come and meet you half way in a few years.

Let me start by discussing some of my motivations.
1. specialist care is hard to come by in Africa especially in rural areas
2. Machines and tests and all other shiny equipment needed for new millennium medicine are expensive and also hard to come back
3. I believe the current borders in Africa are not of our own making and I would like to blur those borders.
4. There are a lot of skilled Africans not working in Africa

So I was thinking
1. Building a hospital at a border and in Zambia we have a few pretty epic borders either the Tanzania/Malawi border, or Malawi/Zimbabwe, or the Botswana/Namibia/Angola area (although I have never been there and google says it's very filled with national parks).
Anyway, by building at a border we can pull resources and build a tertiary hospital that all surrounding countries can refer to. But we can all claim it as our own, it can be staffed and resourced by the best that all surrounded countries have to offer.
2. Zambia is currently discussing dual citizenship and if they are smart and let it pass through the new constitution it will mean that more Zambians will be coming back even if it's just to visit. I truly believe there are enough foreign trained or foreign working Zambian doctors that can come and work for a month or a week and volunteer or even be paid (too far ahead to know) for their specialist skills. I don't know the dual citizenship rules of the other countries (and the wee hours of the morning are for dreaming big, not researching). But I KNOW there are enough people in all those countries to build, equip, and staff a giant tertiary hospital.
I laid awake seeing visions of helicopters bringing patients, of specialist care centres, of patient and family residences.
3. I like the idea of building in a non-city. Cities, are already built up with rules of transport and roads and overcrowding, but to build a new city. To start from scratch incorporating all we now know, that is amazing. To start with roads wide enough, to lay a foundation for an effective public transport system, to plan ahea for open areas, for residential areas...
4. Additionally, I had visions of setting up a program to encourage African students studying elsewhere to come and do a placement for a few weeks and show them how exciting medicine can be in Africa, that we can have amazing equipment and they can live comfortable lives.
It can be the beginning of reversing the brain drain, giving them a reason to come home.

I kept seeing this building in my head, kept seeing parts added to it, initially just a clinic, then an emergency department and then a surgery department, then infectious disease, cardiovascular disease wards...obstetrics (that should probably come earlier).
Allowing students from the neighbouring countries to get excited about medicine, facilitating research, answering locally relevant questions.
PLUS tons of OTHER people come to Africa to research on us and then answer questions that matter to them and go back and make their healthcare better, imagine if we were testing new medications, new ideas, new equipment in order to better our own health.
I have images of preventative care, of sexual health clinics, vaccination, exercise and diet information sessions,

Then I thought about a name, I thought Border Hospital but that's already taken.
And then I thought it should be a unifying name something that incorporates either the languages of the relevant countries or their values in some way
Or even something like ZBNA (just the countries letters), but that's not very creative and I think they might be issues with letter order. So just something cool and unifying....I still haven't though of anything...but then it was time to actually get out of bed, and I only got 5 hours of sleep and I have about 7 hours of lectures today...hopefully I can be awake for it all.

*sigh* These are the visions that keep me up at night...