Kalukembe

I have returned from spending 3 days (Monday to Wednesday) at the Kalukembe Hospital, about 200km (~120 miles) north of Lubango.

The journey there was an adventure in itself. Because of the war, the road has not been maintained for over 20 years, and there is a pothole every 5 meters, plus places where mines had exploded. It took us over 6 hours to make this 200km trip, plus lots of bumps and bruises, even in our Ford F350 with raised suspension. There were constant reminders of the war, as we passed wreckages of military vehicles, and the rare “Beware of Mines” signs. Yet, most of the areas have now been cleared of mines and we passed many fields of crops in what is known as the most arable land in Angola. Along with cattle being herded, we passed many trucks heading north, carrying products from South Africa and Namibia to the capital Luanda.

Kalukembe hospital is a hospital built in the 1940’s by Swedish missionaries, and continued by others. It was the only hospital in the region, was staffed mostly by missionary doctors, and has a long history of training Angolan nurses. Unfortunately, during the war, in the mid-1990’s, it was bombed and then looted, losing much of its medical supplies and equipment, including all the books in the medical library amassed over 50 years. Though much of the staff fled, a remnant remained and used (and re-used) the supplies that were not looted to maintain the operations of the hospital. Even now, there are no doctors on staff, and this 200-bed hospital is run by Angolan nurses, who have been trained to do everything from minor surgeries to C-sections to treatment of tropical infections. They have also maintained the nursing school, now with an enrolment of over 90 students. Dr. Foster and his teams come every 2 months from Lubango to performed surgery on the more complicated elective cases.

I made this trip with Dr. Stephen Foster, his dad Dr. Bob Foster (who had worked at the hospital in the 1970’s), and Bartolomeu, a nurse anesthetist. Upon arrival, we rounded on about 100 of the in-patients (many cases of malaria and TB), and saw about 15 out-patients consults. Dr. Foster used this time to teach the nurses as well. Since the staff did not learn that Dr. Foster was coming until the week prior, most surgical patients were told to come back for the planned visit in February. Therefore, over the next day and a half, we only did 23 surgeries, much less than his usual caseload here, with the most major ones being removal of a humongous abdominal cyst (size 30x15x15 cm), and a lower leg amputation.

Even though I did not know many of the patients personally, glancing at their medical and family histories offered a glimpse into their suffering – most women have lost at least one child to disease (I met a women who had lost 5 of her 6 children, each before their second birthday), adults are crippled by cerebral malaria or polio, grandparents who have lost digits to leprosy, and husbands who have buried their wives after childbirth – and that doesn’t even include all those who lost siblings and parents in the war. And I worry about the zit I got yesterday!