March 21, 2025 • 4 min read
Students from CSB and SJU enrolled in an embedded study abroad course called “Global Health Service Learning in Zambia” led by Dr. Ellen Block. They spent two months in class preparing for the trip and 3 weeks in Zambia in spring 2023. Here is one blog post written by student Annika Gothmann while in Zambia. Read more about their experience on the Zambia Course Blog.
Last year, in Medical Anthropology with Ellen, I read a book calledImprovising Medicineby Julie Livingston.It’sabout a cancer ward in Botswana and how limited resources cause providers and patients to improvise when it comes to care. This idea struck meover and over againwhile in Zambia, especially while onhome-based care.
Each morning before going out on project we grabbed our backpacks thatcontainedall the medical supplies we would have for the day. If we werelucky,we also got a tablet to record notes that had the patients’history on them. If not,we took notes by hand andenteredthem into the tablet later. We did our best to keep the bags well stocked, but thatwasn’talways possible. We are often out of certain medicationsand supplies or were extremely limited in what we could bring. Because we were so limited, we oftencouldn’tgive patients as much medication or supplies as we wanted to, because we had to make sure wehad at least some for everyone. This was challenging because we know that giving someonefourtablets of Paracetamol is not enoughandwon’tdull the pain until we can visit them again or they can get to a clinic, butthere’snothing we can do.The patients know this too and end up improvising their own care.They’lltry to make medications last as long as possible, even if that means taking them less than they need them.
Many times, our lack of supplies caused us to not be able toprovidethe care we wanted to.This happened every single time we wanted to test someone’s blood sugar.Either the machinewasn’tworking, wedidn’thave the right strips (or any at all), or wedidn’thave needles.We told these patients we would test them next time or referred them to the clinic to get tested, butI’mnot confident that any of that will work either.Whatseemslike a simple thing to test was extremely complicated without the right supplies.
Improvisationof medicinecan be seriously dangerous and is worrying me even more now thatI’mat home.How many people have undiagnosed diabetes becausetest machinesaren’tworking, or strips are expensive andunavailable? How many peoplehave wrongly healed fractures that they keep taking pain medication for, butcan’tget a permanent solution becausetheycan’tget to the clinic orit’stoo expensive to treat?There are so many factors of care that have to line up forit to be successful,like transportation, income, support at home, access to clean water, access to nutritious food, education,sufficient medical supplies, and more.When one or more of theseareimprovised, care gets difficult.Most people are doing what they can,but more often than not, some aspect of care is lacking.
Hi! My name isAnnika Gothmannand I am from Waconia, MN. I am a junior at Saint Ben’s majoring in Sociology with minors in Global Health and Hispanic Studies. I am super excited to go to Zambia as I love to travel and experience new places! I am most excited to learn about public health initiatives in Zambia and get to talk with members of the community as well as community health workers, educators, and health care providers. I hope to learn a lot and apply what I learn once I get back home!
