Life and work at SFH

If you’re preparing to live, work or study at Saint Francis’, then this section is for you.

It’s not exhaustive, and only as up to date as the last information we have, but is a good place to start. Planning ahead is important - especially when it comes to paperwork and vaccinations.

Good luck, and enjoy the ride!

Getting there

You can fly into Lusaka (Zambia) or Lilongwe (Malawi). If you are coming as a qualified volunteer the hospital will usually arrange for someone to collect you from the airport. If you are a medical student then you will need to make your own way!

Most visitors fly into Lusaka (Zambia’s capital), and then travel by bus to Katete - a 5 - 7 hour ride along the Great East Road heading towards Chipata and Malawi. It is best to take an early bus, as the roads can be risky after dark when it’s more difficult to see other road users (cars, bikes, cattle). So unless you’re a hardy African traveller, consider spending the night in Lusaka then buying a bus ticket in advance ready for travel the next day. The bus goes past SFH’s main entrance road (about 7km before Katete): the driver should know it, and will stop there if you ask in advance.

Alternatively, if you fly in to Lilongwe (Malawi) then take a bus to Mchinji, a taxi to the border, then another taxi to Chipata and finally a minibus to Katete. It’s a shorter distance, and a more colourful way to travel, but considerably more hassle.

Visas & Permits

Visitors from most countries need a visa to enter Zambia.

The visa situation is a little complicated, and due to the long visa processing times, you may struggle to get an appropriate visa in time. If you application to work or study at SFH is approved by the hospital, start trying to arrange your visa as soon as you can.

If you are staying in Zambia for less than 90 days and will not be employed by the hospital, you can purchase a “tourist” visa at the airport or border crossing. Medical student “electives” are something of a grey area: to study in Zambia requires a pre-arranged visa, but visiting the hospital for a period of informal study (as is the case for most “electives”) a tourist visa will suffice. However, to avoid confusion at the airport or border, it is best to state that you are “visiting” Katete.

The cost of a 90 day tourist visa is around US$ 55 for a single entry (if you plan to travel to Malawi, buy a “multiple entry” visa for around US$ 80).

For longer periods and/or for anybody planning to work at the hospital (including any qualified volunteers) you will need to obtain “work” or “volunteer” visa from the Zambian High Commission or Embassy in your own country. At present you will find that you only get 30 days (even if you are issued for a visa for longer by a High Commission or Embassy your passport will be stamped for 30 days on entry) but this can be renewed at the local immigration office in Katete, at no extra cost, for up to 3 months total stay.

Staying Healthy

There are no mandatory vaccinations but plenty of advisable ones. Get advice from a travel clinic or GP at least 6 weeks before you travel. Zambia and Malawi have been declared Yellow Fever free, so you won’t require a Yellow Fever vaccination certificate to travel between them.

Malaria is very prevalent and you must take precautions against this during your stay. Seek advice about prophylaxis at least a month before you travel. Also be aware of avoiding mosquito bites by using a mosquito net, using insect repellent in the evenings and covering your arms and legs if outdoors at dusk or after dark.

If you will be working with patients or in the laboratory, you must be aware that both HIV and Hepatitis B are very common in Zambia. Therefore it is essential to exercise universal precautions, and to take care with using and disposing of sharps appropriately. The Hospital does have a Post Exposure Prophylaxis policy and can provide counselling and a 4 week course of anti-retrovirals to anyone sustaining a needle-stick injury. Disposable gloves are always available (although extra supplies are always welcome!). You should also ensure that you are properly vaccinated against Hepatitis B.

We suggest consulting the Fit for Travel website, which provides up-to-date information for people travelling from the UK.

Climate

Dry season - March/April – November/December.
Initially temperatures are around 20-25°c and then by June/July the temperature falls and for a few weeks it can be cold (10-15°c) with chilly winds. From July it gradually gets warmer again. Before the rains begin, it gets very hot (30-35°c) and the humidity increases.

Rainy season - November/December – March/April.
Temperatures start at about 30°c and gradually fall as the season progresses to about 20°c. Very heavy rain for short periods alternates with bright sunshine. There are thrilling electrical storms but these often cause power cuts or damage telephone lines.

Language

The local language is ChiNyanja (also called to ChiChewa) - which is spoken through most of Zambia and Malawi. Although English is Zambia’s “official” second language, most patients know only a few words. However, almost all of the hospital’s staff speak excellent English, and in clinics or on the wards they will translate for you. But learning a few words will earn you a lot of respect, and make ward rounds much quicker - especially in Paediatrics, where a few stock phrases get you a long way.

Handy words/phrases are...

  • How are you? - Muli bwanji? (reply: Bwino; [Muli] Bwanji? - I’m fine; how are you?)
  • Thank you - zikomo
  • I’m sorry/sad to hear that - Pepani
  • Hospital - chipatala
  • Doctor - dokotala

Clinical words/phrases...

  • diarrhoea - tulula
  • vomiting - sanza
  • cough - kosamola
  • fever - kupiya
  • eating - kudya
  • drinking - kumwa
  • pain - chiwawa
  • chest - chifuwa
  • fit/seizure -
  • medicine - mankhwala
  • lie down - gonani
  • sit up - okani

Food and drink

The hospital pumps its own water from bore holes, which provide safe clean drinking-water all year round.

Outside of the hospital compound, it is best to be more cautious, but bottled water and soft drinks are easily available at the many shops and stores. Mosi, the national lager is cheap and tasty, although most Zambians (when then can afford it) drink the more cosmopolitan Castle lager from South Africa.

The Doctor’s Mess at SFH proivdes three meals daily to clinical staff and students, and bakes it’s own bread. The food is usually good - but the menu is fairly limited, so that after a week or two you will probably want to occasionally cook for yourself or eat elsewhere.

It is always possible to buy fresh vegetables from the Chada (small shops and market stalls next to the Hospital) and Katete, although the range can get very limited at certain times of year. You can also buy good beef, “Hungarian” sausages and chickens from the Stores, along with various tinned goods. Maize-meal is the staple carbohydrate of Zambia, but potatoes, rice and pasta are all available if you search them out.

There are a few good places to eat around Katete (eg. Tikondane Guest House) serving traditional Zambian fare which consists of nshima (a bland but very filling maize-meal dough) with “relish” made from stewed meat, vegetables or beans.

What to wear

Liz Hosegood (SFH midwifery tutor 2007-2012)

St Francis Hospital is part of the local community, it is not part of the tourist trail and the people who use the services come from the local area, often from very rural villages.

When you are here we want people to have respect for you and what you have to offer – much of this comes from how you present yourself and by showing respect to others and considering their feelings, not only at work but also around the compound and town.

Dressing respectfully is part of this, which applies, I’m afraid, particularly to women. It may seem a little strange or old fashioned to you, but this is part of coming to a different culture and adjusting to different ways.

Women are expected to keep their knees & mid-riff covered so skirts and dresses should be below knee or wear trousers. Tops & T-shirts should generously cover the tops of skirts & trousers. Sleeves can be short or no sleeves, tops should not be too skimpy. Clothing should not be too tight, showing too much of your body shape. Shorts can be worn in your home and private garden, if you have one, but if out and about in shorts it is a good idea to cover up with a chitenge (what all the women wear, you will be considered very Zambian if wearing one).

At work there is a dress code for all clinical staff (men & women). You should dress tidily for work applying to the above guidelines (not a chitenge), men should wear long trousers, not shorts. Some people find scrubs comfortable and not so hot. You need a white coat, with three quarter length or short sleeves. On the wards covered footwear should be worn, hair should be tied back.

If you are uncertain about what to wear, or any other issues, then please ask for advice from the Hospital Administrator or the Medical Superintendant.

When you are visiting tourist attractions then of course you are free to play the tourist – but it is always good to be aware of these issues to avoid putting yourself in a difficult situation.

It is also important to bring some warm things if you are here from May to August as it can get very cold, particularly in the evenings, remember there is no heating. A warm jumper & fleece are very useful.

Clinical guidelines and resources

If you are doctor or medical student coming to SFH, you may want to download, read and store some of these guides before you set off for Zambia.

General resources

SFH guide (4th edition)

an invaluable and comprehensive clinical guide written and updated by doctors at SFH over the past 10 years, covering the diagnosis and treatment of most common conditions seen at the hospital

PDF [880.0 KB]

"Sandie Logie" HIV Clinic guidelines (2010)

a comprehensive guide to diagnosis and treatment of HIV/AIDS at SFH

Microsoft Word document (.doc) [316.0 KB]

SFH Surgery:- Antimicrobial Prophylaxis & Therapy Guidelines (Version 4.0, 2015)

PDF [576.6 KB]

Treatment of burns at SFH

by Nathan Kemalyan MD (Oregon Burns Centre)

SFH Burn Care Primer

Microsoft Word Document (.doc) [81.5 KB]

SFH surgical strategies for burns

Microsoft Word Document (.doc) [68.0 KB]

Burns patient admission form

Microsoft Word Document (.doc) [54.0 KB]

Packing list

Here’s a list of essentials to bring if you’re planning to spend time at the hospital. It’s not intended to be comprehensive, but should guide you in the right direction.

  • June-August – warm layers (gets cold especially at night)
  • December-April – footwear suitable for very wet weather (many of the paths around the hospital turn into streams and lakes during the daily downpours)
  • Torch
  • Mosquito net
  • Sun-block (you can buy it in Chipata, but it’s expensive)
  • a hat
  • sturdy comfortable shoes (you’ll be doing a lot more walking than your used to!)
  • Adaptors for any electrical items (the hospital has UK style 3 pin sockets and the voltage is officially 240V but often fluctuates a lot – power cuts are also common)
  • Any toiletries that you cannot survive without – many items are difficult to get hold of, even in Chipata (women please note that tampons can only be obtained in Chipata or Lusaka and are expensive)
  • Lonely Planet Guide to Zambia or similar guide
  • Insect repellant (also easily obtainable from Chipata)
  • Blu-tac - to make your accommodation more homely, eg by hanging chitenges
  • Entertainment – books, radio (with Short Wave to receive international radio stations including the BBC World Service), MP3 player, frisbee, table tennis bat and balls or a football
  • Laptop computer – if you are coming for a reasonable period of time seriously consider bringing a laptop – we used ours for e-mail, watching DVDs and for lots of hospital work (presentations, audits, guidelines, redesigning forms etc). If you do bring one, also bring a surge protector as Zambian electricity is very variable.
  • If you are a keen cook, a supply of spices and maybe some recipes too.
  • Towels and bed-linen are supplied by the hospital, but tend to be significantly past their best - so consider bringing your own, or buying them en-route in Lusaka.
  • first aid - the hospital can supply most things that you might need, but for trips away consider a kit with rehydration salts (eg “Dioralyte” )and Loperamide for gastroenteritis, plasters/bandages, and maybe a thermometer (whenever you have a fever, it’s Malaria until proven otherwise!), needles and i.v. cannulae (in case you’re unwell on your travels away from SFH)
  • batteries
  • security belt (for carrying valuables in the towns, or when “scrubbed up” in the theatre)
  • padlock (for securing your valuables in your accomodation)
  • water filter drinking bottle, eg. Aquapure “Pure Hydratrion” bottles (recommended by the London School of Tropical Medicine)
  • mobile phone: get yours “unlocked” before you travel - which then enables you to use Zambian telecoms providers; SIM cards are easily purchased at the Chada (the small shops next to SFH). Reception at the SFH is “not great” but works well enough, and much better for communicating with home than relying on the hospital’s landline

Additional extras for clinical staff

  • a white coats – students are expected to wear a clean white coat on the wards and in clinics
  • Smart clothes to wear when working - although ties are not necessary
  • torniquet
  • Stethoscope
  • pen torch
  • tendon hammer
  • alcohol hand gel
  • Ophthalmoscope & otoscope
  • Medical books – Oxford Handbooks (Tropical Medicine/Medicine/Specialities) and British National Formulary (or other prescribing guide) are often indispensable.
  • eye protection (for use in the operating theatres)