Many of our Virtual Doctors volunteer for us because our service gives them the possibility to help on a regular basis, not just on a year abroad – armchair volunteering if you like! The internet has truly expanded our world. Though it is true that the contact is very indirect. And yet, one patient case at a time, relationships build between our doctors and our Clinical Officers. So what happens when a Volunteer Doctor has the opportunity to travel to Zambia and meet the local team and our beneficiaries? A fascinating testimonial and some wonderful photos of recently set up VDrs site the Zambian Helpers Society Hospital. Read on!

I am an Edinburgh-based ophthalmology registrar who volunteers for Virtual Doctors. By coincidence, I ended up moving to Lusaka for 3 months whilst on maternity leave, for my husband’s anaesthetics fellowship. Whilst I was there I visited the Virtual Doctors admin office in Lusaka, and went on a little semi-rural site visit south of Lusaka. Here are some photos from my VDrs encounters. 

Left to right: Stellah Chilembo (VDrs Field Assistant), Nikki Hall (VDrs volunteer Ophthalmologist) and Shakerrie Allmond (Director of VDrs Zambia) outside the VDrs office in Kalundu

First of all, I visited Shakerrie and Stellah in their new Lusaka office in Kalundu. I saw Stellah at work liaising with Clinical Officers and heard about Shakerrie‘s current meetings and plans for VD Zambia. We discussed ways of improving the information to volunteer doctors. One of the things I feel as a volunteer is that it’s often difficult to know what sort of a referral centre you are dealing with and how willing/able they are to refer complex cases. So, in an effort to better describe what the health posts are like to the doctors back home, I decided to visit one. 

Stellah kindly arranged this and accompanied me. 

So, the following week we visited Zambia Helpers Society Hospital in Chilanga. This is about 45 min south of Lusaka and is a small public health centre. It was previously a mission hospital (now government run) and perhaps in part due to this, they have some beautiful gardens and plenty of space, as you can see in the photos below. Sister was keen to point out that the gardens are more beautiful when the rains start – this was last month and still very hot and dry!

My impression was that it fills the role of a GP surgery in the UK. They cover a rural area with the furthest patients coming from 30km away (often on foot). In addition to the clinical officer (who see 100 or so patients a week there in a daily clinic), there is a nursing team and various other community health services on offer (baby weighing, antenatal, HIV, circumcision) and a tiny lab (which if I remember correctly can test for malaria and HIV, not much else). There is also an observation ward, though there were no inpatients when I visited.

Zambia Helpers Society Hospital: view of the main clinic building

Zambia Helpers Society Hospital: reception area with a VDrs poster

Zambia Helpers Society Hospital: the lab

Victor Mulenga, the Clinical Officer, kindly showed us round and introduced me to his colleagues. We worked out we had discussed two cases remotely on VD back in May this year. We chatted about patient care in this clinic. One thing that surprised me was how little they refer patients up to hospital. With the transport and hospital costs involved it is often not something patients and families are keen on either. Victor estimates they refer about 1 per month to hospital (out of 400-500 patients seen). Given how often I have been recommending referral to up for further investigation or to see an ophthalmologist/eye clinic, this was useful to me; I think I will try harder to give advice for managing cases locally. The other thing is that a rapid briefer response is usually more useful than a delayed but more considered one, as Victor told me patients will often wait an hour or so max before trekking off home (though of course sometimes they will be contactable by phone after this). He often asks them to wait on the off chance that a quick reply from VD with diagnosis/management will be forthcoming. As someone who often spends a bit of time on cases if I can (for my own benefit too), I may try a two pronged approach of a quick reply when possible backed up by any educational bits later.

I hope this gives some of the other virtual doctors back in the UK a flavour of Zambia. It is a beautiful and welcoming country, and I highly recommend a visit.

Zambia Helpers Society Hospital: Victor Mulenga (CO) in his consulting room

Victor (CO) and Stellah (VDrs admin) in the reception area of Zambia Helpers Society Hospital

Right to left: Nikki with Fergus (8 months), Victor (CO), Sister and one their nursing colleagues

A Virtual Doctor in Zambia

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