Bike Taxis

How is it that I always seem to get the drunk bicycle taxis?

I sometimes take a bicycle taxi (jinga) home from work if I miss the hospital transport, or if I’m traveling somewhere far enough to dissuade walking but close enough not to need a vehicle. It’s a great way to get around. Usually…

Most of the time, the drivers are not too bad – they work hard for their 50 cents and get you to your destination safely. The interesting bit comes some afternoons, especially on the weekends (Sundays are the worst), when your bicycle guy has had too much Shake-Shake. A usually calm, scenic 2 km bike ride becomes a harrowing near-death experience as you dodge and dive dogs, goats, women carrying water or produce on their heads, other cyclists, and the dreaded passenger buses careering by at 120 km/h. The bicycle that is normally a rickety old contraption is even more shaky as you swerve and hit potholes and bumps, and your stomach is sore at the end of the trip from keeping your balance for the past 30 minutes.

Sometimes, however, the opposite can be true. Instead of an exhilarating trip, your driver can be as slow as the old women carrying their goods to the market. You are being passed by kids, women, men, even oxcarts, and this doesn’t bother your driver in the least. I now take these moments in stride, forget about why I’m in a hurry (usually doesn’t matter anyway), and take a good look at the scenery around me. I see Mphangwe mountain in the distance, the setting sun reflecting bright oranges and pinks and reds off distant rain clouds. Beside me is a heron fishing in a puddle in the middle of a wide open field of tall grass. Six small kids are running at me from a village on the other side of the road, huge smiles on their beautiful faces, shouting “How are you?!” at the top of their lungs. All these things are part of this beautiful country, this beautiful town – and though there is poverty and death and suffering, it is good to be here. Life is simpler in many ways, happiness is easier to find.

Student Reflections

Below is one of the first-year student’s reflections after a particularly tough clinical day. I was impressed with his honesty and would like to share his thoughts with you. Feel free to leave any comments or feedback if you have any thoughts, I can share them with the class.


Nursing, a noble career that demands one’s commitment in enhancing proper way of living of the people. It is paramount to note that Nursing is involved in all aspects of life, thus from birth till death of an individual. Being on the wards has been a great experience despite the challenges faced along the way. This journal however depicts a scenario that I fully participated in trying to save the life of an innocent woman named Yaona.

It was a Friday during the late shift when Yaona was brought to Mukasa gynae ward as a trans-in from St. Monica’s female ward with the history of per vaginal bleeding. This patient was pregnant in her 7th month when she miscarried, she bled for two days and suddenly stopped. History recorded that she later continued bleeding yet the family hesitated to seek medical advice. Yaona was brought to St. Francis Hospital when the condition was actually worsening. Fact still remains that her life was in danger because she lost nearly 1000mLs of blood. I could see her gasping and I said a little prayer to God to have mercy in her. It was unfortunate that the in-charge nurse was out for her tea break.

Bearing in mind that my role was to check her vitals, I quickly checked her blood pressure, temperature, pulse, and respiration, everything was abnormal. I could sense death yet I realized my duty was to save her life. I then decided to take up the roles of my in-charge; I got the Doctor’s orders. The orders were for an oxygen concentrator and withdrawal of blood for cross-match and haemoglobin.

I gathered courage and withdrew blood and rushed to the laboratory. I managed to find the oxygen concentrator and, for the first time, administered oxygen. I could see Yaona slightly relieved though she still seemed dyspnoeic. She spoke in a local language “Nalema ine”, translated as “I am tired”. I felt like I was not doing the right thing yet I was. I could see her dextrose drip finishing. Then I decided to rush back to the laboratory for her blood; it was not ready then, I was helpless, my mouth was numb but my mind told me I could do something.

All what my reasoning could tell me was God was in control and that she will live. May Her Soul Rest in Peace. Yaona died at exactly 9pm, I was broken-hearted and the only thing I could do was to pray for God to welcome her.

I’m listening to a group of eight girls singing and laughing outside. They must be around 8-12 years old, and they even have choreographed steps to the different songs they’re singing. The sun is setting and everything is so peaceful, simple, beautiful.

When you move to a different place, at first it’s all so new, so different, even overwhelming at times. After some time, this foreign place begins to feel like home. You begin to dread all those adjustments you’ll have to make when you move back, and things that used to shock you and amaze you are more normal. You look around at the people beside you and you realize you’ve become part of a community, part of a family, and you love these people. This place and these people have made a bigger difference on you than you could have imagined, and as you think about all these things and look back to where you were even 6 months ago, you realize that you’ve changed. You’re still the same person essentially, but you’ve become shaped by everything around you, and you look at the world in a whole new way. It’s quite the thing.

I walked into the classroom to the group of 50 first year nursing students, notes in one hand, projector and laptop in the other, and readied myself for the exhilarating fluid therapy lecture I was about to give. As I organized myself and my notes, I heard quite a bit of shuffling from behind me. A great way to start, I thought, they’re already distracted. As I turned around to greet them and start the class, I realized that every single one of them was standing, now quiet as I face them. Surprised, I ask why everyone is standing. “To show you respect, madam” came the reply from one of the girls in the front. A bit embarrassed now, trying to hide my blush, I quickly tell them to sit down and we begin the class.

After another class, as I tidy up my demo equipment, a student comes up to me, apologizing for the giggle she let out during the class. She explained herself and that she was rude to do that, it won’t happen again. I’m again surprised, and can’t even remember the event; it certainly was not disruptive by any means. I laugh and tell her it’s not a problem, but thank you. I think about how often I would daydream in class and not pay attention, or doze off during a boring lecture, and I look at the concentration in these faces, pens on paper, busily scribbling down any bit of information I throw at them. Here is a chance to get an education and a proper job to make a proper living, and these students aren’t wasting a single second.

Students are becoming more relaxed around me, taking me up on my offer to come see me if they have questions or just want to talk. One afternoon, I escape to my small lime green office after a particularly difficult morning on the wards. I bury myself in the pile of papers to mark on my desk to busy my mind. A few students are gathered outside, and soon make their way in and sit down to chat with me. I ask one why he decided to go into nursing. I’ve asked this before, and the main response is “to save lives” or because it’s a decent-paying steady job and they can provide for their family. This one was different. He told me that he grew up with his aunt and uncle, who was chronically sick and constantly in and out of hospital. He would do basic care for his uncle – bathing, feeding, even toileting. He described how he could see the difference it made to his uncle, and the relief it provided his aunt. He felt satisfaction and joy in helping out as much as he could, and he started thinking about how he could do this for more people, bring this comfort and relief to more families in their difficult times. He was so sincere as he told me this and, after the morning I had just had, I was fighting to hold back tears. It gave me a burst of hope and renewal to hear such a real, well-thought, from-the-heart answer.

A woman I know was in the female medical ward, looking after her younger sister. She was there all the time – when I left in the late afternoon she was there, and when I arrived early the next morning, she was still there. She looked tired - she had slept there, on the floor, but was up all night with here breathless sister. I commended her on her dedication, told her she was a good sister. She just shook her head and said it’s just what she should do. “I’m the older sister, so if she falls sick, who should care for her? If she can’t walk, who will help her? If she soils the bed, it is me that is embarrassed, not her.”
Often it is easier to just walk by, or throw a rope down, or tell someone else to do it, than to get down in the mud yourself to help someone else up.

Grace

I’ve had many days like this one. I’ve cared for many sick patients, many sick young patients, and seen many of them die. So why was today so different?

Grace was about my age, HIV positive, and was in renal failure. This morning she was very sick. Sicker than yesterday; sicker than ever. There was nothing else we could do, fluids wouldn’t help, and no medication could heal her body. Her mother had been by her side constantly since admission, and diligently and lovingly had cared for this young woman, feeding her, dressing her, doing all the things Grace needed her to do, without a moment of hesitation or objection, and not one utterance of complaint. This morning, we had to tell Grace’s mother that there was nothing more we could do, and that Grace is most likely going to die. I’ve been here before, heard this story many times. What got me was the look on Grace’s mother’s face. I saw the moment of realization that her child was going to die. I felt like I could physically feel her heart breaking, and I felt so much sorrow and helplessness in that moment. She was looking from side to side, like she was looking for someone to help her, someone to tell her this wasn’t real. She clutched her heart, asking how? why? As a few tears rolled down her cheek, she looked pleadingly at us and then back at her daughter. There is nothing I can say in this moment, and I reach for her, touch her arm, and mumble something like “I’m so sorry”. As we move on from her bedside, Grace’s mother begins to cry. She leans near her and starts to pray. Though I don’t understand her prayers, I join her silently from where I am standing, asking for comfort and peace for them, and a bit of strength for myself right now, and I let a tear fall.

Not quite 2 hours later, I am helping to prepare Grace’s body and we walk down the long outdoor corridor to the mortuary, mother and fellow bedsiders following behind, wailing for her loss.

Later that day, I think about what would have happened in Canada. Well, first, Grace would have had more medical support available to her, but aside from that, I think things would have been slightly different. When someone dies in the hospital at home, it is very private. For starters, patients often have their own rooms, not just a mobile cloth screen separating them from the 40 other patients on the ward. Family is present, but not as constantly, not as actively. When the deceased is taken away from the ward, it’s done very discreetly, often waiting for a quiet time when no one is in the halls. Here, we make an announcement for the other bedsiders to join the family as we travel to the mortuary together. These other women have been with Grace’s mother since she arrived, caring for their own relatives, chatting about family, health, and other daily things. There is no judgment, whether someone has HIV or not, whether they are rich or poor, they are all here for the same reason, someone is sick and needs their help. And when someone dies, they don’t turn away, not for a moment.

My chains are gone, I’ve been set free
My God my Saviour has ransomed me
And like a flood, His mercy reigns
Unending love, Amazing Grace