Controlled Chaos: Surgical Adventures in Chitokoloki Mission Hospital

Controlled Chaos: Surgical Adventures in Chitokoloki Mission Hospital

by David Galloway, Jenni Galloway

Paperback

$13.99
View All Available Formats & Editions
Choose Expedited Shipping at checkout for delivery by Friday, June 25

Overview

Chitokoloki Mission Hospital is a remote but remarkable facility in the North-Western Province of Zambia. This book comes from a compilation of daily reports about life in a remote African mission hospital. It is written from a personal and clinical angle and with a surgical emphasis because that formed the bulk of the activity that has been recorded. The detailed experiences of many patients has been captured and the author conveys the almost unbelievable reality that their experience reflects. Initially the reports formed a flowing clinical news blog and they have been assembled in book form to include the Christian context as well as insights into the reality of daily life in the local villages. Again and again these stories have been the focus of discussion and enquiry and it has been good to share the experiences to the point that others who become aware are ready to pray, support, give and even visit in order to contribute in some way to the work of the mission.

Product Details

ISBN-13: 9781912522880
Publisher: John Ritchie Ltd
Publication date: 06/01/2020
Pages: 224
Product dimensions: 5.87(w) x 8.25(h) x 0.25(d)

About the Author

David Galloway MD DSc FRCS FRCP FACS, was a Consultant Surgeon and Honorary Professor of Surgery in the University of Glasgow. He was trained in the UK and the USA as a general surgeon and surgical oncologist. He was elected in 2015 to serve a three-year term as President of the Royal College of Physicians and Surgeons of Glasgow and was honoured with various degrees and Fellowships of numerous international medical and surgical colleges. He lives with his wife Christine in the West of Scotland and is involved as an active member and elder of an independent evangelical Christian church. He is a lay-preacher and itinerant speaker with a special interest in engaging and defending a Christian worldview and challenging the default naturalism that has gripped the scientific community. They have two daughters, Lynda and Jenni and three lively grandchildren.

Read an Excerpt

This book brings together a real life account of day to day activity in a Mission Hospital in rural Africa. I have had the opportunity to visit Chitokoloki in the North Western Province of Zambia several times over a period of five years, spending a month or two each time. Why? Well, I have always had an interest in medical missions but having spent a career serving as an academic Consultant Surgeon in the NHS I really did wonder whether my skill set and experience would be of any real value in the African bush. Having been aware of Chitokoloki Mission Hospital, I made contact with Dr. David McAdam, a surgical colleague who has been based there for many years. Would my narrow specialist practice and experience of high tech medicine and minimal access (so-called keyhole) surgery be applicable there? What about having to work in a setting with severely limited resources? Would I be able to cope – or contribute? It seemed sensible to speak to David. His clinical experience and expertise is quite unlike any other colleague I have ever encountered. Working single-handedly for most of the time means that he not only has to look after patients with diverse problems that would be distributed to a range of other specialists in the West, he also has to keep up to date, maintain records, bear the burden of teaching, and administration, not to mention being available 24 hours a day 7 days a week! He has prepared well for solitary medical practice in a remote setting by training in surgery and anaesthetics as well as obstetrics. Working alone for many years he has had to be capable of dealing with conditions and clinical challenges that cross specialty boundaries and the result is expertise in an astonishing array of disciplines such as surgery (every branch), obstetrics and gynaecology, ophthalmology, paediatrics, intensive care, anaesthetics – the list goes on. There are other colleagues who help out with complex orthopaedics and plastic surgery on an occasional basis. As well as providing expert, Western style medical care David carries the additional responsibility of sharing his Christian convictions as a medical missionary. In addition to the demanding medical work, he is committed to helping people explore and understand the Bible in order to deepen their personal experience of God. As a result he is regularly called upon to lead bible studies, preach and teach in the local church and in the surrounding communities. ‘Remarkable’ fails to adequately cover it! “David, do you think I could be of any help to you? I know virtually nothing about tropical medicine and, like every other surgeon in the UK, my surgical practice has become progressively narrower over the past twenty years.” For him, it seemed to come down to a fairly simple matter. “If you can operate, we can certainly use you here.” On the strength of that and still plagued by a measure of uncertainty and apprehension, I made arrangements to go to Chitokoloki for two months in the autumn of 2015. Quite unable to persuade my wife that it might be a good idea for her to accompany me; she cited teaching duties at home but in reality I realised that the prospect of having to cope with creepy crawlies and other forms of reptilian life forms clinched and confirmed the decision in her mind. The stories and reflections I share here are a personal selection drawn from notes that I recorded at the end of each day. Most of theshort chapters or sections represent a summary of a single day. The actual dates are not especially important but I have left a few details to anchor the accounts in time in order to provide some context. I wanted to try to capture the detail of these patients and their circumstances and to convey the sometimes almost unbelievable reality that their experience represents. When I started to make these observations they were prepared as a kind of daily news blog for the consumption of my family back in the UK but, as is the nature of digital media these days, they found their way around many friends and even did the rounds amongst members of my local golf club. Again and again, they have been the focus of discussion and enquiry and it has been good to share the experience to the point that others who become aware are ready to pray, support, give and even visit in order to contribute in some way to the work of the mission. I welcome the opportunity to offer this account even although it provides a tiny sample of the experience of those working there full time. It would be wonderful if even some of their many stories could be written down and passed on but I fear that the full time mission staff are just too stretched in dealing with the demanding issues of providing care and support in the hospital, church and around the community that I fear the best of these amazing experiences may never make it into print. This therefore comes from a daily stream of the business of living and working in a remote mission hospital and taken together amounts to a total of around six months experience spread over five visits (2015-2020). My daughter Jenni who is an Emergency Medicine specialist accompanied me on my second trip to Chitokoloki (Chit). She had previously spent two months in Chit as her medical student elective. I have included her account of the visit we shared – for each of us our second experience although the fun part was that we were ableto go together and even work as a team. You can read her personal and amusing review on pages 72-88. My hope is that this book will provide an accurate account of the reality of medical missionary endeavour in the African bush. It’s all here; abject suffering in a resource poor setting, staff from many different countries working alongside dedicated Zambians, stories of individual patients and their many and various problems and a commentary on observed aspects of life for a beautiful and cheerful people who have more than their fair share of difficulties. Sometimes the medical work is frustrating simply because conditions which would be readily treated in the developed world are just not manageable in remote parts of Africa. Indeed, the provision of medical and surgical care on the global scene has become an extremely hot topic and many health care professionals now devote a great deal of energy and ingenuity to try to improve prospects for African patients. Beyond the service provision, a number of global agencies like the World Health Organisation as well as individual medical colleges and universities in the US, the UK and Australasia have become active in addressing the desperate need for medical and surgical support from both a policy and practical point of view. It has been a very significant privilege to participate in some small way to provide assistance and encouragement to friends who work in Chitokoloki year round. What they provide is unstinting care. ‘Above and beyond’ takes on a new meaning.

Table of Contents

Dedication 5

Acknowledgements 6

Endorsements 8

Preface 15

Foreword 19

Africa - for the first time 21

Sparkling waters 21

This is Africa! 25

Instant obstetrics 26

Orientation 30

Disappointment 32

Groinery: A specialty in its own right 34

Lurking danger 36

Mental 37

Koomadiki 40

Lessons learned and mysterious Mary 43

Sans eyes, sans teeth 47

J-R Construction 49

Chavuma 51

Controlled violence 53

Pool volleyball 55

Operating 56

"Throw your bones on the bed" 57

Downtime and Supermoon 60

Dipalata 61

Google it! 63

'Where's Kayumbo?' 65

Surrogacy 66

Sepsis 68

One dry hand 70

What a tip! 71

Frustration 73

Success and profound sadness 74

Chinyingi! 76

Pound of flesh 79

Africa again - 2016 82

Back of beyond 82

Welcome back 85

Medical heresy 87

Wonderdrug 89

Bites 91

Peace 93

Election fever 94

Jenni's birthday 95

Happy birthday to Jack! 97

It would give you the willies 98

On the road - "PATRICK!" 99

Market! 102

Reinforcements arrive! 103

Unscheduled care 104

Defeat from the jaws of victory 106

Poor Jack 109

Clearing the decks 110

No pain relief! 112

Pancake Addendum 113

Jenni's Chit Chat 115

Episode 1 115

Episode 2 122

Sad moments 125

Good moments 127

Episode 3 128

Western concern for global surgery 138

Presidents Blog: Zambia 140

"I am paining doctor!" 140

A chance to cut - is a chance to cure! 142

Axes, bullets, a single kwacha and a croc hunt 143

"What kind witchcraft is this?" 146

"How are you?" "Doc, I am a little bit fine" 148

It's a bugs life 149

Colony death and bush funeral 150

Where is the justice? 152

Shootout! 154

BID - Brought in Dead (nearly!) 156

A day of controlled violence 156

A high speed thrill ride 158

Mufwaha and some late night obstetrics! 160

Flying surgical service 161

The flying patient service 162

Just a bit! 165

An early start 167

It's Owen's birthday - Cake Smash 168

Unable to stay away - 2019 171

Noise 171

"One way to keep the population down" 173

Pathology overload 174

Raising the dead 176

Moses 176

A sad reminder 177

Weird and Wonderful 178

A slow day 180

Ingenuity and bravery required 180

Partial lunar eclipse 182

Double crossed 184

'Chachiwahi' 185

Poverty and misery 186

Peace and quiet 188

Indescribable tragedy 188

Moon talk 190

Get it in the jugular 192

Goran the Serb 193

Question of the day! 194

A fateful decision 195

Bush burial 197

Filling the gap 199

Fright of my life! 200

Inexplicable stupidity 201

Likely lads 202

The baby killers are active 204

Obstetrics in the dark 205

Winker 206

James 207

Goodbye Chitokoioki 209

References 212

Author's Note 214

Preface

This book brings together a real life account of day to day activity in a Mission Hospital in rural Africa. I have had the opportunity to visit Chitokoloki in the North Western Province of Zambia several times over a period of five years, spending a month or two each time. Why? Well, I have always had an interest in medical missions but having spent a career serving as an academic Consultant Surgeon in the NHS I really did wonder whether my skill set and experience would be of any real value in the African bush. Having been aware of Chitokoloki Mission Hospital, I made contact with Dr. David McAdam, a surgical colleague who has been based there for many years. Would my narrow specialist practice and experience of high tech medicine and minimal access (so-called keyhole) surgery be applicable there? What about having to work in a setting with severely limited resources? Would I be able to cope – or contribute? It seemed sensible to speak to David. His clinical experience and expertise is quite unlike any other colleague I have ever encountered. Working single-handedly for most of the time means that he not only has to look after patients with diverse problems that would be distributed to a range of other specialists in the West, he also has to keep up to date, maintain records, bear the burden of teaching, and administration, not to mention being available 24 hours a day 7 days a week! He has prepared well for solitary medical practice in a remote setting by training in surgery and anaesthetics as well as obstetrics. Working alone for many years he has had to be capable of dealing with conditions and clinical challenges that cross specialty boundaries and the result is expertise in an astonishing array of disciplines such as surgery (every branch), obstetrics and gynaecology, ophthalmology, paediatrics, intensive care, anaesthetics – the list goes on. There are other colleagues who help out with complex orthopaedics and plastic surgery on an occasional basis. As well as providing expert, Western style medical care David carries the additional responsibility of sharing his Christian convictions as a medical missionary. In addition to the demanding medical work, he is committed to helping people explore and understand the Bible in order to deepen their personal experience of God. As a result he is regularly called upon to lead bible studies, preach and teach in the local church and in the surrounding communities. ‘Remarkable’ fails to adequately cover it!
“David, do you think I could be of any help to you? I know virtually nothing about tropical medicine and, like every other surgeon in the UK, my surgical practice has become progressively narrower over the past twenty years.” For him, it seemed to come down to a fairly simple matter. “If you can operate, we can certainly use you here.”
On the strength of that and still plagued by a measure of uncertainty and apprehension, I made arrangements to go to Chitokoloki for two months in the autumn of 2015. Quite unable to persuade my wife that it might be a good idea for her to accompany me; she cited teaching duties at home but in reality I realised that the prospect of having to cope with creepy crawlies and other forms of reptilian life forms clinched and confirmed the decision in her mind.
The stories and reflections I share here are a personal selection drawn from notes that I recorded at the end of each day. Most of theshort chapters or sections represent a summary of a single day. The actual dates are not especially important but I have left a few details to anchor the accounts in time in order to provide some context.
I wanted to try to capture the detail of these patients and their circumstances and to convey the sometimes almost unbelievable reality that their experience represents. When I started to make these observations they were prepared as a kind of daily news blog for the consumption of my family back in the UK but, as is the nature of digital media these days, they found their way around many friends and even did the rounds amongst members of my local golf club. Again and again, they have been the focus of discussion and enquiry and it has been good to share the experience to the point that others who become aware are ready to pray, support, give and even visit in order to contribute in some way to the work of the mission. I welcome the opportunity to offer this account even although it provides a tiny sample of the experience of those working there full time. It would be wonderful if even some of their many stories could be written down and passed on but I fear that the full time mission staff are just too stretched in dealing with the demanding issues of providing care and support in the hospital, church and around the community that I fear the best of these amazing experiences may never make it into print. This therefore comes from a daily stream of the business of living and working in a remote mission hospital and taken together amounts to a total of around six months experience spread over five visits (2015-2020).
My daughter Jenni who is an Emergency Medicine specialist accompanied me on my second trip to Chitokoloki (Chit). She had previously spent two months in Chit as her medical student elective. I have included her account of the visit we shared – for each of us our second experience although the fun part was that we were ableto go together and even work as a team. You can read her personal and amusing review on pages 72-88.
My hope is that this book will provide an accurate account of the reality of medical missionary endeavour in the African bush. It’s all here; abject suffering in a resource poor setting, staff from many different countries working alongside dedicated Zambians, stories of individual patients and their many and various problems and a commentary on observed aspects of life for a beautiful and cheerful people who have more than their fair share of difficulties. Sometimes the medical work is frustrating simply because conditions which would be readily treated in the developed world are just not manageable in remote parts of Africa. Indeed, the provision of medical and surgical care on the global scene has become an extremely hot topic and many health care professionals now devote a great deal of energy and ingenuity to try to improve prospects for African patients. Beyond the service provision, a number of global agencies like the World Health Organisation as well as individual medical colleges and universities in the US, the UK and Australasia have become active in addressing the desperate need for medical and surgical support from both a policy and practical point of view.
It has been a very significant privilege to participate in some small way to provide assistance and encouragement to friends who work in Chitokoloki year round. What they provide is unstinting care. ‘Above and beyond’ takes on a new meaning.

Customer Reviews