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Medical mission in Republic of Zambia. Continuation

Zambia is a landlocked country that lies in the Sub-Saharan Africa. Approx. 40% of the country is covered by savannah forests. The economy is based on agriculture, with agricultural land comprising over half of the country's surface.

Zambia's territory is divided into 10 provinces. The population is over 14 million. Out of the 186 countries included in the Human Development Index 2013, Zambia is at 163 place, so it is one of the poorest countries. Also, Zambia is in the group of a low Human Development Index; 2/3 of its population has to survive on less than 2 dollars per day. Average life expectancy is 55 years (global life expectancy – 70, Europe – 76). 19.4% of Zambia's population is illiterate. Mortality in children below 5 is 90/1000 of live births. Zambia belongs to the countries with the highest prevalence of HIV in the world. According to the official data of WHO from 2012, approx. 1.1 million residents is infected, of which 160 thousand are below 15 years of age. In 2012 another 56 thousand contracted the virus, while approx. 30 thousand died due to AIDS.

Along with the HIV epidemics, spreading of numerous infectious diseases, Zambia is in need of reliable medical knowledge. The volunteers will largely conduct out-patient care and home visits (diagnostics, prevention, treating patients, referring to hospital treatment), screening tests and educating the Zambians. The volunteers will work within the area of the Christ the Redeemer Parish in Makeni, they will also try to reach inaccessible places and socially excluded persons with their medical help.

People residing on the outskirts of Lusaka are mainly persons of low socio-economic status who cannot afford paid medical care. Contracting HIV is the dominating problem, which is the most frequent cause of premature deaths. It results in thousands of orphans who live on the streets as they do not have the means to support themselves. They are at risk of becoming dependant on drugs, of hygiene negligence and of contracting infectious diseases. Apart from AIDS, other STDs as well as tuberculosis, malaria and fungi infections are the biggest problem. While the number of new cases of AIDS seem to be dropping systematically, the growing number of incidence of cardio-vascular diseases, pulmonary diseases, cancer and diabetes is worrying. These diseases are even more dangerous if they co-exist with HIV infection. The experiences of the volunteers participating in the Medical Mission project in Zambia in 2013 confirm the data. Hypertension was one of the most frequent diseases of the patients. In the majority of cases, the hypertension was not diagnosed earlier, and if the patients did know about it – the diseases was improperly managed. The situation was similar in the case of other civilization diseases such as diabetes, pulmonary diseases and spine diseases. The volunteers often saw that the detectability of cancers (partially attributed to AIDS) in the early stages of the disease. It is mostly due to the low healthcare awareness of the residents and a difficult access to primary healthcare.

The local healthcare system focuses on treating locally prevalent diseases (AIDS, malaria, tuberculosis), without paying sufficient attention to diagnosing accompanying diseases and complications of infectious diseases. The volunteers – physicians – will be tasked with ensuring primary medical care, educating the patients and HBC activists in health topics.

During the project's implementation in 2013, the assumed results were achieved. The outcome requires continuation and long-term follow-up. Project measures will be addressed to the local community residing in the outskirts of Lusaka and in the neighbouring villages. Healthcare and counselling will be provided to all persons that will report to the physicians during that time (estimated out-patient and home visits will cover 1,500 persons). Their work will focus on persons with sight defects, cardiovascular diseases, infectious diseases and pregnant women. Screening tests for fungi infection, undernourishment and sight defects will be administered in particular to children studying in neighbouring schools (approx. 400 children in total) and children living on the streets, mainly residents of the Salvation Home. In order to improve medical awareness of the local community, the volunteers also plan to organise a series of open lectures on primary medical knowledge (150 persons). Trainings on treatment, prevention and procedure in individual diseases will be addressed to HBC employees and volunteers (20 persons), which will make it possible to increase the number of persons, to whom aid will be extended.

Medical mission in Republic of Zambia. Continuation

The project continues the Medical Mission in Zambia undertaking, implemented within the 2013 Polish Aid Programme. Its objective is to provide medical assistance to the residents of Zambia, whose access to healthcare on everyday basis is restricted.

The main project implementation area will comprise the outskirts of the capital city of the country – Lusaka, located in the province bearing the same name. The city has approx. 1.7 million residents and has very high population density. The volunteers will work in the Makeni district, in the Home Base Care facility at the Christ the Redeemer Parish. There are two schools at the Parish – Community Schools – where education is provided to children from the poorest families. They will be provided with screening tests, trainings in hygiene topics and with primary healthcare, if necessary. The area of the volunteer work also covers the Salvation Home – a home for children living on the streets, who will also be covered by medical care. John Laing Compound, a housing community with several dozen of thousands residents with a very low socio-economic status located on the outskirts of Lusaka will also be covered by the voluntary work. Out-patient points manned by the volunteers will also be established in the neighbouring farming villages: Chilongolo, Spalo Vilage, Mukasa. If time and schedule allows, the volunteers will also try, if necessary, reach other points prepared at the parishes run by Polish missionaries run, in a places that are far away from the capital city, in the bush, where access to primary healthcare is severely restricted.

The major objective of project activities is to improve access to primary healthcare, to improve the awareness of the local community in health topics, to provide immediate medical assistance, thus improving the health, longevity and quality of life of the beneficiaries. The project contributes to the Millennium Development Goals in this area, in particular to the objective of reducing mortality of children and hindering the spread of HIV/AIDS, malaria and other infectious diseases.

The residents of the outskirts of Lusaka are mostly persons of very low socio-economic status, who cannot afford paid healthcare or due to their health condition they cannot travel to see a doctor. Apart from the HIV epidemics, diseases accompanying AIDS and malaria, a huge problem that is neglected by the local healthcare facilities takes the form of the civilization diseases. According to WHO, the risk of dying between 30 and 70 years of age due to cardiovascular diseases, diabetes and pulmonary diseases is 34%, one of the highest risk indicators in the world. Moreover, approx. 40% of the Zambia's population aged 25 or over suffers from hypertension (globally – 27%). A significant problem that lowers the quality of life consists in untreated sight defects and restricted access to opticians due to financial and organisational reasons. Screening tests will be held to detect these problems, and treatment will be introduced, if necessary. Pregnant women will be screened towards pre-eclampsia and gestational diabetes. The disabled patients in need of disease management and rehabilitation will be identified and included in the project activities from among the residents of the subject area. The volunteers will also visit the centres run by Polish missionaries that are distant from the capital city, where they will provide primary healthcare in the pre-prepared locations.

Project activities will also include children attending schools within the Makeni Parish, i.e. children from the poorest families, frequently neglected in terms of hygiene, undernourished, HIV positive. Some of them are raised in foster families who cannot afford proper medical care to children. Skin fungal infections, digestive tract diseases due to improper diet, eyesight diseases are a big problem. The volunteers have already worked with these children during the 2013 project. During this year's project, follow-up measures will be conducted along with assessing the efficiency of the treatment as well as further educational activities. Screening will be administered to children starting their education in schools and pre-schools. The volunteers will also reach street kids – young people who were forced to live on the streets of Lusaka due to their socio-economic situation. They are at particular risk of injuries, burns, they require help in emergencies. The so-called care givers will be provided with training regarding caring for the disabled that require rehabilitation as well as bed sores prevention. Care givers are persons without medical education, who have proven themselves the previous year to the volunteers as persons willing to gain knowledge needed to take care of the sick. Information about the trainings will be provided to them via the person responsible for HBC. The entire local community will be invited to participate in open lectures held by the volunteers on health-related topics.

The hosting organisation has been cooperating with the Medici Homini Project (CM UMK in Bydgoszcz) for four years, which in turns cooperates with the Polish Medical Mission. Volunteers have gone to that region of the world to provide medical aid on the invitation of priests - missionaries three times (most recently within the 2013 Polish Aid Programme). The parties keep in touch, sometimes charity campaigns are organised consisting in collecting products needed in Zambia. The current project is the fourth such undertaking.

Medical mission in Republic of Zambia. Continuation

Within the scope of the project, volunteers carried out examinations, as well as treated and provided medical assistance in urgent situations in Namalundu, Likumba, Chamulimba and the area of Makeni parish in Zambia. Because of them, the quality of patient’s life has improved. In the further perspective it should result in raising the length of life of patients who were treated by the volunteers.

Volunteers worked with a selected group of patients requiring rehabilitation once a week. One week in a month they visited staying in home patients who required home treatment. During 150 visits, volunteers took care of 50 patients, and 15 of them needed frequent rehabilitation. During the implementation of the project, volunteers examined approximately 800 Zambians for the sight defects and for 400 people they recommended glasses correction, and therefore they have decreased number of people with untreated sight defects. Implementing the glasses correction for children, improved their chances for a better education.

Volunteers examined approximately 1 200 patients looking for defects of circulatory system and diabetes, and in cases which required it, they implemented proper treatment. Volunteers directed approximately 1800 patients for ambulatory treatment, whom they have examined physically and diagnostically. Volunteers actions contributed to lowering the number of Zambians with undiagnosed and untreated diseases.

Moreover, volunteers organized trainings for people responsible for basic medical care in all of the places where they carried out the project. Thanks to the trainings, competence and qualifications of people taking care of sick in Zambia, had raised. Volunteers promoted general medical knowledge, knowledge about infections, hygiene, prohealth behaviors, and observed application of the recommendations in practice. During the trainings for Zambian people, volunteers talked about: “AIDS – is it also my problem?”, “Ways of infection, possibilities of treatment, when to go for an examination”, “Malaria – do we really know everything about it?”, “Blood hypertension – where does it come from? Why do we have to treat it? Does only medicine help? Consequences of hypertension – heart attack”, “Child with mycosis – rules of taking care of the hygiene”.

Within the scope of basic care of the sick people, volunteers trained 20 local volunteers, who were recruited from HBC and people accompanying doctors in ambulatory points. Trainings were also involving the families of lying patients within the scope of rehabilitation and taking care of ill person. Trainings purpose was to improve the knowledge and abilities of volunteers about basic treatment and nursing abilities. Volunteers also trained 65 people in general medical knowledge, health, hygiene and prohealth behaviors, as well as ways of spreading infections.