Hello all! We are Katie and Kiki, two Resident Pediatricians from the United States, specifically from the University of Virginia. We spent a month in Lusaka, Zambia at Special Hope Network, and now that we have been back in the States, we have had some time to reflect on our time there and wanted to share!

After only a short time in Zambia, we noticed immediately how welcoming and kind the people are. However, something that stood out to us very early on was the degree of contrast between different social classes. Going to one of the local movie theaters at Manda Hill shopping center is so modern and commercial; you almost forget you’re in Africa. Yet, just a few minutes down the road there are compounds where amenities such as running water are the exception and poverty is the norm. Not surprisingly, healthcare is not spared from this dichotomy. There are obvious health inequalities and inequities present throughout the entire country, so much so that the hospitals there are often divided into separate units: “free” and “high cost”.

Image: Interaction Institute for Social Change | Artist: Angus Maguire.” interactioninstitute.org, madewithangus.com

Disability – intellectual, physical, or both- adds an additional layer to these inequities. When we talk about health equity and equality in healthcare ethics, we always come back to the idea of recognizing what challenges the individual faces to achieve good health, and then what needs to be done to help them obtain it. Health equity means everyone getting what they need to have a chance at a healthy and meaningful life. Poverty and limited community resources are challenging enough, but when you add intellectual and physical disability to the story, the struggle is more than many families can bear. Most tragic of all, these are the children who are often neglected and marginalized. As “hidden children” they are not often given the same chance to reach their developmental potential as their peers. As doctors working in the USA, we realized how much medical and social support we take for granted at our own hospital. At UVA Children’s Hospital, we have an entire building dedicated to various Pediatric Subspecialties, and many of the children that frequent the different clinics are not dissimilar to the children we spent time with in Lusaka. In a place where there is so little medical care and education available, we were moved by the efforts Special Hope has taken and is taking to try to help children develop. Special Hope has seen the challenges that these special families and children face and everyday works to make their quality of life better.

The services that Special Hope offers are of course critical to the mission of the organization. It goes without saying that children are gaining skills and milestones by spending time at Special Hope, however, something that is not as obviously portrayed by website pictures is the community that these centers provide for children and families. By visiting the centers, we were able to witness first hand mothers talking to one another about similar experiences and struggles. To us, it seems that the aspects of fellowship and family empowerment are equally as important as the services the children receive. Special Hope has built a haven of acceptance for these children and families, something that Americans probably don’t realize is as unique as it is in Zambia. The mothers truly were excited to come to Special Hope and learn how they can help their children at home. It was humbling to see some of the moms’ dedication to coming to each session.

Between the two of us, we have spent time on global health trips in Guatemala, Honduras, Costa Rica, Haiti, Uganda, India, and the Middle East, but we will always have a special place in our hearts and memories for Zambia. Even weeks after coming back to Virginia, we find ourselves singing some of the songs from the kids at Special Hope in our heads (and sometimes out loud!). The children there are so special and deserve every chance they can get to be able to grow and thrive. As pediatricians interested in working internationally and building sustainable interventions, we hope that the work we did to improve the Health Monitoring Program will help to track growth statistics in the best way possible. It’s always hard to spend only one month somewhere, both trying to learn as much as possible and offer something to leave behind. We hope that one day we can return to Zambia, as we know that Special Hope Network will still be doing their good and important work.

  • Katie and Kiki

After completing residency, Katie will be doing fellowship in Developmental Pediatrics, and Kiki will be doing fellowship in Pediatric Emergency Medicine.