Macha Mission Hospital

Mission: Brethren in Christ Church in Zambia

Profile: Macha is a 208-bed hospital with medical and surgical services.

Time Difference: +6 hours Daylight Savings Time (EST), USA; +7 hours Eastern Standard Time, USA

Travel: Volunteers fly by commercial airlines to Livingstone, Zambia and then have a three and a half hour drive to the hospital.

Location: Macha Mission is located in the Southern Province of Zambia. It is just 40 miles due west of Chomas on the Namwala Road in southern Zambia. It is three and a half hours from Victoria Falls and Livingstone.

People: Macha Mission Hospital serves approximately 160,000 Nationals. People of the Tonga-tribe populate the area, living in small homesteads (villages). Maize is the main crop grown and the staple diet supplemented with peanut, sweet potatoes, tomatoes and other leafy green vegetables as a relish. Most farmers in the area own cattle, goats, chickens, and guinea fowl which are sold for cash and provide protein to their diet.

Language: English is the official language and is routinely spoken in the hospital and in business transactions. There are 72 tribal languages in Zambia. Staff can interpret for local persons who may not know English. The local language is Chitonga.

Climate: Zambia has three seasons: cool, hot, and rainy. The cool season is from May to July. It is dry with temperatures from 45° – 74° F. The hot season is from August to October. It is dry with temperatures from 64° – 88° F. The rainy season is from November to April. Temperatures range from 54° – 84° F.

Orientation: You will receive a verbal orientation and hospital tour by Dr. James DeBoe from the US, who is the Hospital Director and Visiting Staff Coordinator.

Medicine: There are 2 adult wards (1 male, 1 female) with a total of 94 beds. There is a separate inpatient TB wards with 24 beds total as well. Many admissions are for HIV related illnesses. Other admissions are for common internal medicine diseases like heart failure, acute carditis, diabetes, stroke, COPD, hepatic failure, acute infections like meningitis, tropical diseases including diarrheas, malaria, echinococcosis, acute and chronic osteomyelitis, “Norwegian” scabies, Viral illnesses, various anemias and hypertension.

The medical staff includes 1 American family practice physician, 1 American Surgeon/General Med, 1 American Pediatrician, 1 Ophthalmologist from the Netherlands, and 5 African Medical Doctors.

Pediatrics: There is 1 pediatrics ward with 60 beds. Most admissions are for malaria, pneumonia, gastroenteritis, malnutrition and chronic infections, Sickle cell disease.

Obstetrics: The OB ward has 4 delivery room suites and a capacity of 30 beds. Zambian midwives conduct all routine deliveries. There is an average of 3000 deliveries per year and a complicated delivery rate that includes approximately 300 C-sections per year.

Surgery: The Theater department with an operating room for major surgeries involving anesthesia and 2 minor surgery rooms for D&C’s, reduction of bone fractures, injuries, trauma and abscesses.

Anesthesia: There is an anesthesia machine available in the theater. Spinal anesthesia and Ketamine are used as a mainstay. Oxygen is provided from large rental cylinders. The doctors on staff handle anesthesia as there are no CRNAs available.

Ophthalmology: Dr. Samuel Verkerk began an eye clinic and surgery for cataracts and glaucoma at Macha in January 2017. Tamara Verkerk, OD, has opened the full optometry clinical practice. There is also a specialty trained ophthalmology RN.

Physical Therapy: There is a trained Physical Therapist who does day hospital rounds.

Dental: Dental Services include a Dental Tech, Tooth extractions, and basic dental care.

Outpatient Clinic: An average of 120 patients are seen in clinic each day. Zambian clinical officers triage most patients and refer to the physician for consultation for more complicated cases.

Emergency Services: There are acute beds in the Medical/Pediatric wards. Patients are initially evaluated in the 24-hour outpatient clinic.

ART Clinic: Antiretroviral medications are prescribed for patients with HIV/AIDS. The client population served is >11,000 open 3 days per week. Medical volunteers are allowed to participate in a limited role due to the complexity of paperwork and expectations from the CDC. Clinic outreach on Fridays may offer an opportunity for medical volunteers to visit the rural health clinics.

Radiology: Macha has excellent radiographers who manage a stationary x-ray machine which is very helpful. There is no radiologist on staff.

Laboratory: Diagnostic testing is available but limited due to high cost of reagents for COBAS analyzer blood sugar, creatinine, AST-ALT, bilirubin; Hematol analyzer cbc, ers, sickle cell prep, bleeding time, Blood Bank type-corss; aerobic cultures urine and pus; routine urinalysis. Microbiology is available as well.

Medical Records: Notes are handwritten in English in the patient files.

Workload Expectations: The work load is moderate to heavy as you choose.

Teaching Opportunities: There is a Nursing School with a 2 year program for Zambia Enrolled Nurses (ZEN) with approximately 150 students. Visiting surgeons and anesthesiologists will be working with the Zambian medical licentiates or doctors at the hospital. There would be the possibility of some individual clinical instruction in the operating room and on the wards.  There would be no specific preparation needed for these interactions with the staff. 

Clinical lectures for the medical staff sometimes take place on Wednesday and Thursday mornings at 0730.  If the volunteer doctor had a specific field of interest, it could arranged for them to give a lecture on that topic to the staff during their visit to Macha Mission Hospital.

Community Health Program: There is a Hospital Department which addresses Community Health related to Immunizations, HIV Testing, Male Circ Program.