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Muchinga province, Zambia
“I have to work, for the people. That’s why I chose this career. I’m proud to work for my Zambian people.”
Nurse Lizzie Banda works as part of a three-person outreach team in the Muchinga province of Zambia. She is one of many MSI Reproductive Choices' team members who travel over extraordinary distances to get contraception to women who would otherwise be unable to access it.
“With MSI, we travel out to typical rural areas. We leave home the whole week, and it’s very tiring. We go early in the morning, we come back late. The roads are bad, especially in the rainy season.”
In Zambia, around 60% of the population lives in rural areas, a large proportion of them many miles from the nearest town. Away from the big cities, the country’s infrastructure is largely under-developed, and Lizzie’s team often has no option but to travel via bumpy dirt roads.
Travel can be slow on the best of days. From November to April, when the rains come, the roads turn to mud and the outreach vehicles can get stuck. “It’s not an easy thing. But because of the nature of the jobs we are doing, we just have to do it despite the challenges we go through.”
Healthcare facilities are few and far between, so Lizzie’s team bring their own, travelling with an inflatable, three-chambered tent that doubles up as a consultation room and medical space where women can be fitted with long-acting contraceptive methods such as the implant or IUD.
For many women living in remote areas, MSI's outreach work is the only way they can access the contraception they need to plan and space their families.
“We might ask a client, have you used any family planning before, and she will say no. Then we ask how many kids she has, and the answer might be 10 or 12. It’s a lot of kids.”
With no electricity in the tent, the team can only carry out procedures in the daylight, and they almost always have a long queue of women waiting for services. On some days, they serve as many as 70 women. Coffee breaks are not an option.
“There are only three of us: the driver, the team leader, and me. It’s just the three of us and a lot of work. So if you see us when we’re working, you will find the driver is also washing the instruments and other things, the team leader is maybe doing the group counselling, I will be inside providing services. We don’t just stick to our job descriptions, the things you have to do according to your title. We work as a team.”
“We’re going deep, deep into rural areas where other people can’t reach. But MSI Zambia is reaching them. We are getting services through to people.”
Lizzie and her team are passionately committed to their mission of getting services through to women in remote areas. “Sometimes you just put yourself in someone’s boots. You just think: ‘What if I were a villager living out in the bush?’
“We’re going deep, deep into rural areas where other people can’t reach. But MSI Zambia is reaching them. We are getting services through to people.”
Because of the distances involved in the outreach, the team is regularly on the road for up to seven days at a time, sleeping in different locations every night.
“We sleep in different places depending on the area where we are. At times we even sleep in the clinic, if we have found no other option. But that doesn’t matter. I have to work, for the people. That’s why I chose this career. And I’m very happy. I’m proud to work for my Zambian people.”
Aside from the physical hardships of life on the road, the biggest challenge for Lizzie is being away from her family, who have stayed in the capital Lusaka. “I miss my family. I’m just by myself in Mpika. My boy is 14 years old, the only child that I have. I really miss my family. But at the same time, I’ve come to enjoy the work that I’m doing here.”
