Falling in love with Zambia
A memorable welcome
When I chose to volunteer with IVO, I thought it would be lovely to go to a remote island off the Australian coast or Cambodia. I ended up in Africa, but the continent soon had me falling in love with it. The love affair continued throughout my 20 months volunteering at a HIV hospice in Lusaka, the capital of Zambia. I was fortunate to have a placement that had everything going for me – the role itself, accommodation, location, co-workers and other volunteers.
The first phase of my stint here was interesting and memorable in more ways than one. I was seen by the Indian community as the ‘young’ (debatable) girl with who has quit a corporate job to come here, leaving a husband behind in India. The hospice staff and locals I met thought I was like the Mittals and Tatas with loads of money to offload at the hospice. Having said that, the Zambians are among the warmest and friendliest people one can find and very accepting of outsiders.
It was fun in the initial months learning to pronounce names like ‘mwale, mbewe’ correctly, trying not to laugh outright when I heard names like Survive, Obvious, Wireless, Reloaded, Suffer and Grief, and more importantly learning the names of all 60+ staff that I had to manage at the hospice!
The learning curve was steep and challenging. I learnt a lot about pain management, cultural needs, HIV and AIDS, and resource allocation in a non-private setting, amongst many other things. And for me to be successful in the professional context of the hospice, it was imperative I understand not just hospice management but also the background of the Catholic community that has helped the hospice become one of the best in Zambia. The nuances of the denominations, sub-groups, the church and the politics of money were big learning and very fascinating.
The hospice was set up by Catholic missionaries 11 years ago to provide palliative care for patients dying of AIDS. My background in healthcare definitely helped prepare me for this experience, but as I found out, hospices (by themselves) and in Africa are very different to the hospitals I had worked in elsewhere. In a country where the life expectancy hovers around 49 years, the incidence of disease and death is very high. It took me a few months to reconcile myself to the fact the most of the dying were in what we would call ‘prime of productive life’ in other parts of the world.
The hospice was in the throes of a severe funding crisis when I arrived, with no great source of income for running costs. It therefore became my responsibility to make some very tough decisions about the future of the hospice, and prioritise resources accordingly. We had to partially close some services at the hospice in the light of the financial circumstances. This obviously resulted in a lot of heartache and tragedy with staff losing jobs and patients having nowhere to go for palliative care. We were the last hospice in Zambia to close, which did not help the public reaction to it and for a while I woke every morning thinking I was going to get lynched that day for the terrible decisions I had made.
Breathing new life
Thankfully I survived that difficult phase to make the hospice a well-supported institution for a set of limited services, while I worked on building a business plan to re-open closed services in a self-sustaining model. We successfully launched some new HIV programmes, including starting a support group for teenagers with HIV and AIDS, and partnering with a theatre group to focus on younger children and their parents and caregivers. We began a few income-generating ventures at the hospice and tasted some success there too. I’m glad to report that the foundation for the new business plan is now in place and I hope that successful implementation by the incoming management will breathe new life into a fantastic organisation.