Livingstone for follow-up and falls

After conducting four follow-up interviews in Monze we hit the road again and visited both Choma and Maamba (off the beaten track!) before getting in to Livingstone (the first capital of Northen Rhodesia - Zambia until 1935) as the sun was setting. The moon was also in ascendancy at this time and it was at its fullest. This allowed us to go and see the amazing lunar rainbow... more on this in a bit!

Lunar rainbow above the  Eastern cataracts 

The follow-up interviews are a collection of questions and discussions and a skills test with each anaesthetist that came to one of the Lifebox or SAFE Obstetrics courses we ran 6 and 12 months ago. This is so that I can provide a bit of a refresher whilst also seeing how much they remember and also get feedback on what we can do to improve the course. It has also allowed me to see and also to get involved and help with delivering anaesthetics in a rural setting.

Equipment graveyard outside theatre!

 Monze was interesting as it had 2 theatres running concurrently whilst I conducted the interviews. Its a busy place and is building a new theatre block which may account for the heap of mangled equipment outside the building as well as the mainly empty oxygen cylinders! The most interesting thing for me to witness was the boxes of glass bottles and then later them hanging up delivering fluids to patients (usually the fluids are in individual plastic container bags). It seems though that Monze still fill their own fluid bottles. Nuts!

Intravenous fluid ready for use!

Box full of self filled intravenous fluid

En route we pass flat fields full of corn and more corn! I also clapped eyes on quite possibly the rarest sight of all here - a functioning train! It was travelling so slowly I'm pretty certain my walking pace would have outstripped it! This is possibly why at each railway crossing there are tonnes of people either walking or sitting on the tracks - they have plenty of time to move!

Lusaka- Livingstone train

Where better to sit and catch up on all the gossip? 

We get in to Livingstone just before dusk with the full moon rising even in the bluw sky but head straight to the hospital to conduct further interview follow ups. The hospital is the old Colonial hospital and the red brick buildings in the middle of well kept gardens are a certain throw back to a past life. However the hospital inside and out has a lovely feeling and it is immaculately clean. We manage just one interview as the rest are busy so we are free in the evening to have a look around (the now dark) Livingstone. So I elect to head for Victoria Falls or Mosi o a Tunya (the smoke that thunders).

Livingstone district hospital

It is quite possibly one of the world's best known sights and certainly one of the new wonders of the world. It marks the border between Zambia and Zimbabwe by virtue of a 250m water drop! It was made extra famous by Dr David Livingstone's discovery in 1855 especially his quote of being greeted by "scenes so lovely they must have been gazed upon by angels in their flight."

By virtue of getting there at night we would not be so fortunate as to witness the cascades in the light (but I wasn't too dissapointed having witnessed them a few times before!) however we were treated by sheer chance that it was full moon and the light of which afforded us some viewing time. However sight wasn't the only sensation that was stimulated - on getting out of the car near to the falls we could hear the thunderous pouring of the mighty Zambezi water over the lips of the Eastern cataracts. Not only was the full moon shedding enough light to see some of the falls but it produces the amazing phenomenon that is the lunar rainbows. These rainbows are the result of refraction of light through the mist that rises from the waterfall. They are clearly seen in daylight. I believe that Vic Falls is one of the few waterfalls in the world that creates this sight at full moon too. The other interesting phenomenon within the phenomenon is that as the moon rises the rainbow seems to descends down the waterfall.

at the start of the evening

Lunar rainbow progressing downwards with the rising of the moon

What an utter privilege and also the fact that I persuaded both Wisdom and Patrick to come too - this was the first time they'd seen it and they were also amazed and happy to have witnessed such an event. I am also pleased to say that the park also reduces the cost of entry for locals in order to encourage their visiting at the sight too which is good to hear. And what better way to celebrate such a viewing but a bottle of cold Mosi (as named after the falls!)!

A magical evening of lunar rainbow viewing

What other beer will do in Zambia?!

In the morning I conclude the remaining follow ups and we start on the 6 hour drive back to Lusaka. The roads are pretty decent to begin with - tarred and straight ( repaired for the UNWTO back in 2013!). However after an hour or so we are back to the old roads that are strewn with pitholes here and there. These potholes are the scrouge of many a driver especially in the darkness of night. There are no street lamps or cats eyes. There are no warning signs of problems. Cars are in bad conditions - no lights, suspension, poor tyres and drivers are often drunk. There seems to be little attention to rules of the highway with frequent vehicles stationary parked on the roads to avoid! Thankfully we were travellign in the day time so we settled back to a good pace and watched the lush green scenery whizz past the window. However we had to stop soon enough as we encountered a sobering sight. An overturned bus. It seems there had been a tyre blow out secondary to pot holes and possibly bad tyre conditions.This is unfortunately NOT an uncommon occurrence. Road traffic accidents (RTA's) are one of the commonest causes of hospital admissions.This is why Dr Michael Dobson's work setting up and delivering the Primary Trauma Care course world wide has been so fundamentally important  for improving outcomes after accidents. This course is currently being delivered throughout Zambia (I was fortunate enough to be involved with one in 2013 and so know first hand how great the teaching really is by the legendary Dr Dobson) which is fantastic news and I am sure it will prove instrumental in trauma victim treatment in the future. For further information regarding primary trauma care see the following link http://www.primarytraumacare.org 

Anyway here was an overturned bus with its approximate 50 people was owned by Shaloom - one of the two most reputable companies on this route (and indeed the ones I and some friend used the last time I travelled down there). Thankfully we (me and Wisdom) were able to help and of these most were minor injuries - cuts and scrapes and only three serious injuries (limbs and head) and no fatalities. These three were jetted off to Monze in an ambulance and the rest of the passengers were hailing down passing mini buses with all their wares to continue along their way as if nothing had happened. The scene was then frequented by the local farmers and passers by - all inspecting the vehicle but interestingly I didnt see a single policeman the whole time we were there! So much for the 'emergency services!' How fortunate they all were however and it certainly underlined how fortunate I had been whilst travelling by bus out here. Goodness knows what would have happened if it had been at night! 

Bus crash en route back

Smashed up bus

Tyre blow out at the front 

The rest of the trip passed on uneventfully and we got home in the dark (but it was dusk on the outskirts of Lusaka) so not too dangerous. There will be a short turn around at home - off to Eastern province at 5am tomorrow morning!