A colourful time

Zambia is famous for Victoria Falls. This falling water from the Zambezi that has travelled through Africa and still has a long way to go to get to the sea but throws up the mist that sparkles so brightly in the sun and glows with the wonderful rainbow colours against the thunder of nature. The harshness of the fall is disguised by the subtleties of such beauty. And living in Zambia is also a mirage of colour often disguising the harshness of life behind the scenes. 

Beautiful Victoria Falls and the rainbows in the mist

But these vibrant reds and greens and yellows and blues are everywhere.  Like the chitengi hanging on the line nestled between the wards and the paediatric theatre at UTH.  This enclave of normality and uplifting colours and patterns hanging from the washing line and sounds of lunchtime worship singing brightens up my day. But these colours are not just hanging on the washing lines but they are worn around the hospital, around Lusaka and around Zambia and consequently for me have become synonomous with being here. 

Chitengi on the line and drying on the grass

Colourful chitengi in everyday wear

 And strangely enough whilst sitting in the classroom yesterday listening to the latest teaching session delivered by my colleague I spied in the bookcase a reincarnation of a rainbow in BNF editions! (a formulary of drugs and ensures correct prescribing dosages). Certainly not a Grisham or a Tolkien but each new edition is a distinctly different colour. All of these had been stacked in there by somebody probably without actually consciously striving to recreate a rainbow of books! So even in the classroom there are splashes of colours around. 

Colourful books on the shelf!

And today whilst I was out and about I saw the beautiful orange flame tree set against the blue, blue sky and felt I needed to take its picture as it felt as if it captured my time here nicely. It was only on closer inspection I noticed that I had also inadvertently captured the Dulux paint sign inviting me to join in a 'Let's Colour' exercise. 

And from then I began to think of the different colours involved in my daily life here and how each of these have left a lasting impression of my time working at UTH. A kind of a rememberance of things through colours.

 Take a rainbow – it is a mixture of red, orange, yellow, green , blue, indigo and violet. There is no black – and there’s been enough mention of black moments during my time here and hence I thought I would add some prettier colours to the story!

RED:

Halothane Vaporiser

As an anaesthetist I cannot talk about the colour red without mentioning Halothane (anaesthetic agent) popping into my head. It is now no longer available in the UK and is replaced by either Isoflurane (purple), Sevoflurane (yellow) or Desflurane (blue). But working in Zambia (and many other low income countries) will always be synonymous with not only red for Halothane but its sweet sickly smell!

"The" red line!

I have also referred on MANY occasions about the 'red line' that borders the 'sterile' theatre area and the 'non-sterile' rest of the hospital... I couldn't not include it under the colour red!

ORANGE:

A Lusaka Minibus with its go faster orange stripe!

And talking of coloured lines - Lusaka is full of orange lines. These lines or banners are painted or taped around all the little minibuses and taxis to donate they are from the Lusaka region. Apparently other provinces have different coloured stripes for identification purposes.... I'm not sure what they're to identify but the orange stripes definitely make these guys stand out here as well as their constant horn beeping! And of course as already mentioned at the minute Lusaka is full of the aptly named vibrant orange coloured Flame trees. These bright oranges adorn many a street and have to figure in my Lusaka experiences Rainbow!                                                                                                                                                                                                            

Flame trees in a side street

One of the main reasons I'm back here in Zambia is to work at UTH. This old orange brick building that contains so many memories: good and bad for me has to figure. It still retains its ability to have a complete hold over me and a need to come back for more! Though there are plenty of times when I have thought that nothing short of blasting the bricks to a fine dust and starting to build the hospital afresh would be the best thing!

UTH main entrance

D-block (Paediatric theatres) orange brickwork and place of many happy memories for me during both my time working in Zambia. Complete with David and my bikes - this is morning as the bikes are pointing in and its light!

YELLOW:

During my two stints in Zambia the colour yellow will forever be associated with Lifebox for me.  Initially it was the godsend of monitoring when there wasn't any. The little yellow box that has saved many a life, not just here but world-wide was something you'd look for before starting any case in the morning. Since then I have taught courses on it to help increase the awareness and knowledge of other anaesthetists on how to use them as well as providing them with their own Lifeboxes to take back to their hospitals throughout Zambia to make surgery safer. And now as a sort of full circle I am travelling around checking on how these yellow Lifeboxes are faring throughout Zambia and how the clinical officers are doing and how much they have retained of this learning. For me yellow = Lifebox!

The one thing I had forgotten about but it came back to me on my recent travels was the famous Harvey Tiles signs! These brightly painted yellow signs can be anywhere - on billboards, on the sides of walls or even painted on to police checkpoints! They always have 'life lessons' as seen below a favourite is "A roof without Harvey Tiles is like a country without Police... there will be lawlessness". On the side of many a rural school I have seen police swapped for Education... there will be illiteracy. And down towards Siavonga (where the huge Kariba damn sits) .... without a Damn... there will be flooding. Priceless!

Harvey Tiles clever advertising campaigns!

And who could possibly leave out Leopards under yellow. Zambia has one of the highest chances of seeing these majestic beasts in their natural habitat - a rare but special treat.

GREEN:

One of the main features that I love about the UTH is its ability to transport me from the ward/theatre/classroom to another part of the hospital via outdoor corridors bordering the beautiful greenery of nature. The trees, shrubs and grass are kept immaculately by gardeners and offer a real oasis of calm amongst the chaos of the rest of the hospital that they border. 

Green grass and trees in the airy quadrangles of the hospital

And speaking of calm and relaxed.... here is the women's changing room communal area. There is no coffee or staff room as such but each changing room (there are 4 in main theatres: senior and junior males and females. I was a little offended to begin with being ushers into senior females... I mean I am not THAT old, but it seems that doctors and the matrons and sisters get changed here away from the general nursing staff!! Oh the hierarchy definitely still exists). Each changing room has a little area to sit in and chat - which is a shame as I suspect having one large (open room) would be better not only to enforce mixing but also so that people don't go AWOL or Bisama (Nyanga for hiding!). When looking for anybody the best place to look is the changing room. Anyway green scrubs and hats are not uncommon (though many wear coloured scrubs they mostly wear green hast). So green does remind me if nothing else of at least one theatre sister!

In charge sister for main theatres... due to be scrubbed for my neurosurgical case....

And keeping with the theme of relaxation - you cannot come to Zambia and work hard all the time. There has to be a time to down tools and enjoy and relax. This has been very well supported by the local beer - Mosi. Which is excellent. However it was a little disturbing this week to discover its usual golden colour had now become green - apparently this is  what happens around St Patricks day! Though dubious of it to begin with you'll be glad to hear it didn't taste any different to usual on the obligatory tasting!

Green Mosi at O'Hagan's!

BLUE:

There cannot be a more fantastic feeling than to get up EVERY morning and look out of the window and see just an endless stretching blue sky. It is like being perennially on your holidays! It allows a lifestyle where much time is spent doing outdoor activities. A real highlight of living in Zambia

Blue sky - enough said!

But in the hospital, for me at least. Blue conjures up the image of the blue waterbutts found in each surgical scrub room. These are huge containers full of water to allow the continuation of surgery in times of water shortages, drought or just no water in the hospital - which occurs quite often. No hosepipe ban stops the machine that is the UTH!

Water butt for droughts! Note the glove tying the tap lest you use too much water and of course the highly hygienic and sterile hand soap to used before an operation [white soap on the metal frame!]

Blue waxbills in Mrs Phiri's garden. These bright blue birds offer brilliant flashes of colour as they zip about the garden looking for food.

INDIGO:

 Now this was a colour I thought I'd struggle with. Indigo. Its a funny colour. To begin with I thought I'd cheat a little as one of my abiding memories of being here previously which was the purple blooms of the Jacuranda trees. Beautiful - but currently not in season.

Jacuranda tree in bloom

Spirit on cotton wool ready to sterilse the
skin before cannulation/spinals!

However whilst walking along the corridor to get to theatre yesterday I not only almost went completely flying but my eyes started to water and my nostrils felt like they were on fire. Had there been any more polishing of the floor I suspect even the Scottish curling team would have complained! Cobra (polish make)! I could see at the far end the cleaner with the buffer rubbing in the remainders of the pungent lilac floor polish in. Due to extreme eye watering and inability to breathe properly for at least 5 minutes I missed my chance to get a picture I'm afraid. I suspect this is how they kill off all the cockroaches and bugs too! Having got myself safely to into theatre I was soon in action and I shaping up to cannulate a guy by putting on a tourniquet and asking for the spirit (skin cleaner). I was handed the container and had to delve in and pick out a piece of cotton wool that had the sickly, sweet smelling (not too unlike Halothane but a bit more hospital cleaning smell evoking) spirit poured over it. And once again it dawned on me - indigo/purple colour. This has certainly been a big part of my time here. Not just the colour and the smell of the spirit but placing iv cannulas (drips) which are quite difficult in this cohort of patients as they are often dehydrated and the technique of getting the vein to stand out with a tourniquet is often not of use here. Here one has to shine a light directly on the hand and instead of looking for a big juicy blue line you're looking for the faintest whiff of a thready dark line. Its been a steep but enjoyable learning curve!

VIOLET:

If Indigo provided a challenge I thought I would really struggle with Violet. However, not at all! Although there seems to be a complete shortage of staff (especially nurses) on all the wards and in theatres there are ALWAYS hordes of students everywhere. Ying and yang! I'm not sure where theya all go when they are qualified. They don't just come in ones and twos but they arrive like a pack of penguins all huddling together, seeking some sort of herd immunity I guess. It is not uncommon to be in the operating room and have almost 10 students staring back not only at you but the patient also. And yet there is an obsession with wearing face masks in theatres to make sure that any droplet of breath doesn't contaminate the wound that seems to overlook the fact that 10 extra mouths (20 extra lungs) amy well be adding to this problem! Anyway I have digressed - they are all clad in their rather luminous pink/violet uniforms. Which of course are all neatly ironed.

Three student nurses helping out in theatre

And yes, ok I have cheated a little with the next picture. A beautiful Lilac-breasted roller which I took last time I was here at South Luangua National Park. But it is one of my favourite pictures and a stunning bird with amazing plumage! Not only the bird display a lilac breast but there is the merging of greens and blues and white's - almost a natural rainbow of its own accord!

And so, my trip through working in Zambia UTH via the medium of rainbow colours has taken me from one end of the colour spectrum to the other, much like the memories and emotions here. And of course at the end of every rainbow is an alleged pot of gold. I've yet to find the actual metal but by working here I have had plenty of golden moments and opportunities and the privilege of working with some amazing people. And for sure one of the most amazing sights of all living and working here (as well as in many other parts of Africa and also elsewhere in the world) is the vastness of space and the chance to observe nature without the population and light pollution which gives rise to the most magical and golden sunsets.