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  • Haiti: Radiology Improves Hospital CaDatum03.05.2015 12:39

    Volunteers lend expertise

    University Hospital initially built its volunteer network through the efforts of radiologist Dr. Jeffrey Mendel, PIH’s senior health and policy adviser for radiology. About 40 radiologists at sites across the country—including the Mayo Clinic, Massachusetts General Hospital, and the University of California, San Francisco—sign up for two shifts per month.

    PIH/ZL hopes to expand these ranks. Mendel would like to have 100 volunteers on board by the end of 2015. Bowder is part of these recruitment efforts; she asks surgeons and physicians who visit PIH/ZL to see whether their home hospitals’ radiologists want to help.

    PIH/ZL asks volunteers to interpret a minimum of four to six scans per shift, Bowder said. She also asks volunteers to be available to read urgent scans that must be interpreted within a day or two. Timely and accurate reading of scans can be crucial for patients.

    “Rapid turn-around for readings is both important for patients with acute illness … and a challenge for a volunteer network,” Mendel said. “Often I am reading urgent studies late in the evening. However, for many patients with an acute illness or injury, a CT scan may be critical. It allows physicians to make treatment decisions and to assess the extent of injury that may not be apparent on physical examination.”

    This rapid interpretation is particularly important for patients with conditions such as trauma, acute abdominal pain, a change in mental status, or chest pain, Mendel said. A CT scan for a patient who had been having seizures and arrived in a coma in December required urgent reading, for instance.
    Mendel would like to have 100 volunteers on board by the end of 2015.

    A 2013 case provides another vivid example. When 17-year-old Roseline Bernard fell from an avocado tree, X-rays and CT scans helped identify broken bones, internal injuries, and a traumatic brain injury. Without the radiology department, surgery, emergency care, and rehabilitation, Roseline’s diagnosis and treatment would have been far more difficult. Read more about her recovery here.

    In addition to reading scans, volunteer radiologists have shared their expertise with medical residents and other clinicians in Haiti, Bowder said. University Hospital staff members have participated in teleradiology conferences with the volunteers.

    “They’ll pick five scans a month where they weren’t sure how to interpret it or needed more imaging,” she said. “The residents will present it to the radiologist in the States, the radiologist will go over it with them … and they can ask questions and have discussions.”

    The main challenge for the radiology department is a backlog of images. As of late December, 170 non-urgent scans awaited interpretation, Bowder said. She and others are seeking more volunteers to help bring that number down.

    Radiologists or fourth-year radiology residents who want to volunteer can apply here.

  • Haiti: Radiology Improves Hospital CaDatum03.05.2015 12:38
    Thema von carlos im Forum Partners in Health (PIH)

    ieuseul Saint-Ange left his native Haiti in 2006. His destination: the United States. His goal: obtain skills that would help him serve people back home.

    Nearly a decade later, he has been integral to the success of the radiology department at University Hospital in Mirebalais, in Haiti’s Central Plateau. Saint-Ange is the administrator for a computerized picture archiving and communication system—called PACS—that electronically stores medical images such as X-rays, CT scans, and ultrasounds and allows clinicians or radiologists to view them anywhere they have access to a computer. Although this technology is common in U.S. hospitals (as many as 91 percent use it, according to one survey), it is far more difficult to implement in resource-poor settings.

    “[PACS] allows doctors and nurses to view radiology images very quickly wherever they are in the hospital,” Saint-Ange said. “They can make diagnoses based on what they are able to see in the images, and when a case is difficult for them to understand, they can ask for interpretation from a radiologist.”

    University Hospital’s radiology department has been operational since the hospital opened in March 2013. Built by Haiti’s Ministry of Health and Partners In Health’s Haitian sister organization, Zanmi Lasante, the hospital houses the only CT scanner in a public facility in the country. Haitians who need a CT scan would otherwise have to pay about $300 U.S. in a private facility. This is out of reach for most people in Haiti, where the World Bank puts per capita income at about $800 a year.

    The hospital also has X-ray machines, ultrasound machines, and dental X-ray capabilities, among other radiology equipment.

  • Thema von carlos im Forum Partners in Health (PIH)

    Dr. Fabrice Julcéus knew of one family medicine residency in Haiti, and it was in Cap-Haïtien, a northern city far removed from the bustle of Port-au-Prince. So when he heard the announcement on Radio Caribe that a new residency would soon launch in the less remote St. Marc, he jumped at the chance to apply.

    Competition was stiff, but Julcéus earned a spot in the inaugural class alongside five other family medicine residents at Hôpital St. Nicolas, where he cared for patients under the supervision of senior physicians, conducted research, and designed quality improvement projects.

    Family medicine was a natural choice for Julcéus, who liked the fact that “you don’t see only a part of the person, you see the whole person—and not only their body. You’re thinking about the psychological and social problems. I love this approach.”

    When it launched in 2011, the St. Marc family medicine residency was PIH’s first formal training program for medical specialists in Haiti, made possible through a partnership with sister organization Zanmi Lasante, Haiti’s national medical school, and the Ministry of Health. The first six residents, including Julcéus, finished their three-year program in December; and five are now working part- or full-time as attending physicians or mentors for residents within the PIH/ZL network. Another 16 family medicine residents are now training at Hôpital St. Nicolas, which is operated by the Ministry of Health in partnership with PIH/ZL.

    “The vision was really to make a difference in residency training in Haiti” by combining clinical experience with research and quality improvement projects, said Dr. Kerling Israel, whom PIH hired as the first director of the St. Marc family medicine residency program. “My only measure of success is whether I would feel comfortable to go to one of these residents if I am sick. This is the ultimate test.” And she feels she’s well on track to that goal. “I am proud of this first class.”

    Choosing family medicine as the first PIH/ZL residency was a wise choice, considering these physicians are the jacks-of-all-trades of the medical world and could help fill the country’s huge health care gap. There are 25 doctors for every 100,000 people in Haiti, compared to the nearly 300 doctors for every 100,000 people in the U.S., according to the World Health Organization.

    Family doctors are especially needed in the countryside, where a wide array of illnesses and injuries affect generations of families who live far from hospitals. The physicians are trained to provide primary and preventive care to people of all ages, over their entire lifetimes. They deliver babies and perform C-sections. They treat childhood illnesses. They stitch up wounds. They provide family planning counseling and advice on preventing the spread of HIV. They care for people with diabetes and hypertension. And they are first responders in an emergency or following a traumatic accident.

    “We are the frontline doctors,” said Israel, who is now director of medical education across all PIH/ZL facilities—including the six residency programs at University Hospital in Mirebalais. Often family medicine doctors are the only physicians in town. Patients who could benefit from the attention of several specialists rely on them to address all of their ailments. “They can do a lot with less and they can be more efficient.”

    By seeing their patients over a long period of time, family medicine doctors develop trusting relationships that allow them to encourage prevention as they treat disease. They also learn about patients’ social conditions—factors such as unemployment, homelessness, or food insecurity—to help them provide better, more compassionate care.

    As family physicians we have a responsibility to be change agents.

    It’s the type of expertise that’s appreciated in a bustling facility like Hôpital St. Nicolas. On an average day, it’s packed with patients. In a shaded open-air waiting area, women and children sit on rows of benches awaiting family medicine doctors. The labor and delivery staff sees more than 250 deliveries a month—one of the highest among PIH-supported facilities in Haiti. An emergency department can provide beds to 11 patients at once; it used to afford only two.

    The residents provide a lot of care and have increased staffing dramatically at the hospital, from four full-time clinicians to 22. They also attract teachers—senior doctors like Israel and other attending physicians from Haiti and the United States—who bring a depth of experience and an extra set of hands to deal with high patient flow.
    Research for change

    In addition to hands-on clinical experience, residents are required to conduct research and quality improvement projects with the support of supervisors and mentors. In St. Marc, residents have worked on quality-improvement projects such as labeling the wards so that patients can find their way around. They’re also tackling the issue of infant identification. Nurses affix newborns with bracelets that identify them and their mothers, but it doesn’t happen all the time. Residents are investigating the systematic causes of this problem. Are there stock-outs? Is there no clear protocol for placing bracelets? Or is it a lack of training?

    Residents also conducted research on teen pregnancy. With approval from the human research board in Port-au-Prince, they reviewed records of all births, miscarriages, and prenatal visits to see if a disproportionate number of pregnancies occurred during the festive Carnival season in the first months of 2014. Julcéus helped investigate the issue and said his group did not produce findings that were statistically significant. If they had, they would have encouraged community outreach and the distribution of condoms in future years’ celebrations.

    “As family physicians we have a responsibility to be change agents,” Julcéus said, “to see what doesn’t work and how we can improve it.”

    Julcéus will have that opportunity for the foreseeable future: PIH/ZL hired him to work full-time as a research coordinator for the St. Marc and Mirebalais residency programs.

  • stories of healing.Datum03.05.2015 12:23
    Thema von carlos im Forum Partners in Health (PIH)

    And every day, there's reason to celebrate when our patients make a full recovery—whether they've suffered from malnutrition in Haiti or overcome Ebola in Sierra Leone. But the title of caregiver doesn't just apply to clinicians.

    Healing happens in the comfort of a hug, the warmth of a smile, and the time it takes to listen to a story. Now, Tobias, we want to hear your story of healing.

    Tell us how you were healed, or helped someone heal. Every day, we'll choose one story to feature and send the author a t-shirt like Dr. Paul Farmer wears in this graphic:

    Share your story.
    You can submit your #WeHeal contribution on PIH's Tumblr page (even if you're not already a Tumblr user).

    Already, supporters from around the world have submitted their stories through anecdotes, poetry, video, and pictures.

    So be part of a movement. Share your story of healing, or see what it means to others, today.

    With thanks,

    Partners In Health

    P.S. And if you want another chance to win, you can enter to win a Heal t-shirt here:

  • Thema von carlos im Forum Partners in Health (PIH)


    The earthquake of January 12 killed many of
    Haiti’s doctors and nurses and destroyed a
    large part of the country’s medical infrastructure.
    But Zanmi Lasante (ZL), the Haitian branch of

    Partners in Health (PIH), was left
    intact. ZL had been the largest
    health care provider in rural Haiti.
    After the quake, it became (tem
    porarily, at least) the largest and
    one of the most important in the
    entire country.
    PIH was founded in 1987 by
    Dr. Paul Farmer and a small group
    of colleagues. Together, they built
    a clinic in a rural, desperately im
    poverished squatter settlement of
    farmers who had lost their land
    to a hydroelectric dam. PIH now
    works in 12 countries on four con
    tinents, but in many ways Haiti
    remains its heart and soul. ZL has
    become a comprehensive public
    health system supported by inter
    national donors but staffed al
    most entirely by Haitians: about
    4000 people in all, including some
    120 doctors, 600 nurses, and 2000
    trained and salaried community
    health workers. It has brought
    AIDS and tuberculosis under con
    trol in the province called the
    Central Plateau, vaccinated nearly
    everyone in its large catchment
    area, cleaned up water supplies,
    built houses for the poorest pa
    tients, renovated and supported
    schools, and launched programs
    to feed thousands of Haitians
    daily with locally produced food.
    All in all, ZL directly serves 1.2
    million people, at no cost to the
    local population, and has built or
    renovated 12 hospitals and clin
    ics, six with surgical facilities, all
    with well-stocked pharmacies, and
    made the Haitian Ministry of
    Health its partner in their owner
    ship and operation.
    Members of ZL’s staff were
    some of the first health care work
    ers to respond to the disaster.
    Some ZL doctors have homes in
    the capital and happened to be
    there at the time of the quake.
    One of them, Dr. Patrick Almazor,
    set up a clinic in his backyard
    and spent the night caring as he
    best he could for about 50 injured
    people. Dr. Louise Ivers of Har
    vard Medical School was also in
    Port-au-Prince, attending (ironical
    ly enough) a United Nations meet
    ing about emergency prepared
    ness. Once she had escaped from
    the crumbling building where the
    meeting took place, she and a
    number of volunteers set up an
    impromptu clinic in a driveway,
    using license plates for splints.
    The leaders of ZL know their
    way around Haiti, and they aren’t
    obliged to wait for instructions
    from PIH headquarters in Boston.
    As soon as they heard of the
    devastation, several of the senior
    doctors at ZL’s hospitals loaded
    Recovering from Disaster — Partners in Health
    and the Haitian Earthquake
    Tracy Kidder

  • Thema von carlos im Forum Partners in Health (PIH)

    The psychometric properties of The Partners in Health (PIH) Scale: validation of a patient rated chronic conditionself-management measure

    The paper describes a process for testing the construct validity and internal reliability of the Partners in Health (PIH) scale

    John Petkov
    Director of the Applied Statistics Unit
    Centre for Regional Engagement
    University of South Australia.


    Dr Peter Harvey (Corresponding Author )
    BEd, DipT, PhD
    Manager Statewide Gambling Therapy Service
    GPO Box 2100, Adelaide SA 5001
    Telephone: 61
    8 8404 2609
    Fax: 61 8 8404 2101
    Mobile: 0434 185 808
    Prof Malcolm Battersby
    Flinders Human Behaviour and Health Research Unit
    Flinders University

  • Thema von carlos im Forum Nepal

    Noch immer sind die gesamten Ausmaße des schweren Erdbebens in Nepal nicht absehbar. Die Rettungs- und Hilfsaktionen vor Ort kommen nur schleppend voran. Inzwischen sind einige deutsche Teams eingetroffen - darunter auch Ärzte.
    KATHMANDU. Nach dem verheerenden Erdbeben in Nepal kommen die Rettungs- und Hilfsaktionen vor Ort nur schleppend voran.

    International tätige Hilfsorganisationen wie I.S.A.R. Germany und humedica haben unmittelbar nach Bekanntwerden der Katastrophe Einsatzteams mit Spezialtechnik in das Katastrophengebiet entsendet, doch aufgrund des zeitweilig gesperrten Flughafens in Kathmandu und der zerstörten Infrastruktur gelangen nicht alle Helfer an ihre Einsatzorte.

    Nach jüngsten Angaben des Innenministeriums sind bei dem Beben, das mit einer Stärke von 7,8 als das schwerste Erdbeben in Nepal seit 80 Jahren gilt, mehre tausend Menschen gestorben und 8000 verletzt worden. Da viele Regionen schwer zugänglich sind, rechnen die Behörden mit vielen weiteren Toten.
    Große Angst vor Nachbeben

    Die meisten Menschen in Kathmandu harren aus Angst vor weiteren Nachbeben im Freien aus. Fast überall ist der Strom ausgefallen. Vielerorts spitzt sich die Versorgungslage zu, da Nahrung und Trinkwasser knapp werden.

    Auf der Suche nach Wasser und Nahrung haben inzwischen Tausdende Menschen das Kathmandu-Tal verlassen, meldeten die Behörden am Dienstag.

    Als eines der ersten deutschen Rettungsteams waren 52 Helfer der Duisburger Organisation I.S.A.R. Germany von Frankfurt am Main nach Nepal gestartet.

    Die Spezialisten aus neun Bundesländern - darunter drei Ärzte, mehrere Pfleger und Sanitäter sowie Experten zur Ortung Verschütteter, Bergungsspezialisten und Rettungshundeführer - haben acht Tonnen Ausrüstung im Gepäck, unter anderem einen kompletten Behandlungsplatz für die intensivmedizinische Versorgung Schwerstverletzter, sowie sieben Spürhunde.

    Geplant sei zunächst ein Einsatz von zehn bis 12 Tagen, sagte Simon Paker, Pressesprecher der Organisation, zur "Ärzte Zeitung". Das medizinische Team könne auch länger vor Ort bleiben.

    Im Katastrophengebiet werde der Einsatz von Spezialisten der Vereinten Nationen koordiniert, die die Teams in die am stärksten betroffenen Gebiete sendeten. Wo man wann zum Einsatz komme, stehe noch nicht fest.
    Ähnlicher Einsatz wie in Haiti

    Ebenfalls am Sonntag ist ein medizinisches Einsatzteam der Hilfsorganisation humedica aus Kaufbeuren (Bayern) mit mehreren Ärzten, Pflegekräften und Koordinatoren nach Nepal gestartet.

    Nachdem ihre Maschine den Flughafen in Kathmandu zunächst mehrere Male vergeblich angeflogen hatte, konnte sie in der Nacht von Montag auf Dienstag endlich landen, wie humedica am Dienstag mitteilte.

    Inzwischen seien die Helfer im Erdbebengebiet und hätten ihre Hilfsmaßnahmen gestartet. "Wir erwarten einen ähnlichen Einsatz wie 2010 in Haiti", sagte Susanne Merkel, Leiterin des Sachgebiets Internationale Projekte und Programme bei humedica.

    Bei dem schweren Erdbeben vor fünf Jahren waren dort über 300.000 Menschen ums Leben gekommen.

    Am Donnerstag werde von Hamburg voraussichtlich ein zweites Team mit fünf bis sieben Einsatzkräften und zehn Tonnen Hilfsgütern auf den Weg gebracht.

    Das Technische Hilfswerk aus Bonn unterstützt die internationalen Hilfsmaßnahmen mit zwei Trinkwasseraufbereitungsanlagen, Zeltplanen, Decken, Küchensets und Kanistern. Für die dringend benötigten Aufbereitungsanlagen suchte man gestern noch geeignete Standorte.

    Das deutsche Medikamentenhilfswerk Action Medeor aus Tönisvorst bei Krefeld hat Medikamente zur Notfallversorgung nach Nepal geschickt, darunter Antibiotika, Schmerzmittel, Verbandsmaterial und chirurgisches Besteck.
    Deutsche Bergsteiger offenbar wohlauf

    Am Mount Everest sind inzwischen fast alle Bergsteiger ins Tal geflogen worden. Ob deutsche Trekkingurlauber unter den Opfern des Erdbebens sind, ist noch unklar, viele sind jedoch bereits evakuiert worden.

    So hat der Münchener Reiseveranstalter Hauser Exkursionen unmittelbar nach Bekanntwerden des Bebens vier Gruppen mit insgesamt 40 Teilnehmern in Sicherheit bringen lassen.

    "Eine Gruppe ist bereits wieder zurück in Deutschland, eine andere wartet in Kathmandu auf ihren Rückflug, eine dritte Gruppe ist noch in Lukla und die vierte gerade erst evakuiert worden", sagte Kundri Böhmer-Bauer, Pressesprecherin des Unternehmens, im Gespräch mit der "Ärzte Zeitung".

    Berichte darüber, dass Mitglieder der Exkursionen durch das Beben und die nachfolgenden Lawinen verletzt wurden, lägen ihr nicht vor. "Nach unseren derzeitigen Informationen sind alle wohlauf."

    Lesen Sie dazu auch:

  • „Bwana“ ist zurück aus Afrika Datum28.04.2015 21:09
    Foren-Beitrag von carlos im Thema „Bwana“ ist zurück aus Afrika
  • „Bwana“ ist zurück aus Afrika Datum28.04.2015 21:09
    Thema von carlos im Forum Zambia

    Sebastian Heibült war zwei Wochen lang für eine Hilfsorganisation in Sambia unterwegs. Der Wiesmoorer Zahnarzt behandelte in den Dörfern kostenlos die Patienten. Das Material und die Medikamente hatte der 39-Jährige mit Hilfe von Sponsoren aus Deutschland mitgebracht.

    Wiesmoor - Sebastian Heibült hat schon viele Zähne gezogen. Doch 66 an einem Tag sind es bislang bei dem Zahnarzt vom Zahnärztezentrum in Wiesmoor noch nie gewesen. Für die Organisation „Zahnärzte ohne Grenzen“ war der 39-Jährige zwei Wochen lang mit seiner Angestellten Jennifer Berens und einem Freund, dem Leeraner Polizisten Stefan Voogd, in Sambia unterwegs, um den Menschen zu helfen. Jeden Tag hat er in einem anderen Dorf rund um die Stadt Siavonga kostenlos praktiziert. Mehrere Kilometer seien die Afrikaner teilweise gewandert, um sich vom „bwana“ – so nennen die Menschen in Sambia einen weißen Mann – behandeln zu lassen.

    „Die Afrikaner haben dieselben Zahnprobleme wie wir, doch können sich viele einen Besuch beim Zahnarzt nicht leisten“, sagt Heibült. Zwar sind in den städtischen Krankenhäusern zahnärztliche Helfer tätig, doch ist ein Besuch bei ihnen kostenpflichtig. Heibült: „Ich hatte auch nicht immer den Eindruck, dass sie wissen, was sie tun.“ Die medizinische Situation sei vergleichbar mit der in Deutschland vor 80 Jahren.

    Der Aufenthalt in Sambia hat dem Zahnarzt, der in Remels wohnt, manchmal unkonventionelle Lösungen abverlangt. Weil es mit dem Strom nicht überall klappte, schloss er zum Beispiel den mobilen Absauger an die Autobatterie an. Die größte Herausforderung sei aber das Klima gewesen. „Jeden Tag bei mehr als 35 Grad und schwüler Luft in nicht klimatisierten Räumen zu arbeiten, zehrt an den Kräften.“ Auch im Umgang mit den Patienten hat sich Heibült umstellen müssen. Vor allem bei älteren Afrikanern war manchmal Überredungskunst gefragt. „Viele von ihnen glauben an Voodoo. Wenn ich ihnen also einen Zahn ziehe, besitze ich einen Teil von ihnen und habe Macht über sie.“

  • Thema von carlos im Forum Indien

    In zwei Folgen berichtet WELTWEIT-Reporterin Marika Liebsch über eine skurrile, aber auch sehr erkenntnisreiche Reise: Was ihn erwartet, erahnt er nicht einmal. Der deutsche Zahnarzt Hans-Joachim Dubau aus Dortmund reist nach Indien, um dort gemeinsam mit Kollegen zu praktizieren. Nichts ist plötzlich mehr so, wie er es kennt: kein Plan funktioniert, der Lärm ist unfassbar, alle wollen gleichzeitig mit ihm sprechen.

  • Thema von carlos im Forum Zambia

    Mit Altgold-Spenden seiner Berliner Patienten unterstützt der Zahnarzt Thomas Riechert (46) Menschen im afrikanischen Sambia. Zweimal im Jahr behandelt er dort Bedürftige

    Dieser Berliner scheut wirklich keine Mühen! 15 Stunden Reisezeit, fast 7500 Kilometer bis zur guten Tat. Zweimal im Jahr reist Zahnarzt Thomas Riechert (46) nach Sambia, behandelt dort Einheimische, die weder Krankenversicherung noch Geld haben.

    Schnell spricht es sich herum, wenn er dort in die Praxis lädt. Vor dem Behandlungsraum bilden sich lange Schlangen. „Wer hier lebt, sieht selten einen Arzt. Behandlungen finden meist nur in größeren Städten statt“, erzählt der Ehrenamtliche aus Kladow. Regelmäßige Kontrolluntersuchungen gibt es nicht. Erst wenn die Schmerzen unerträglich werden, geht man zum Arzt.“

    Für ihn ist der Trip kein Sommerurlaub, in sengender Hitze steht harte Arbeit auf dem Programm – und die kann gar nicht anstrengend genug sein. Statt im kleinen Dorf-Hospital zu behandeln, fährt er direkt ins Hinterland, in den afrikanischen Busch. Lange vor Sonnenaufgang packt Thomas Riechert dafür Gummihandschuhe, Spiegel und Zange in seinen Rucksack. Drei Stunden Autofahrt durch unwegsames Gelände und holperige Sandstraßen. Dann ist er dort, wo Hilfe dringend gebraucht wird. „Meist erwartet mich nur ein leerer Raum, in dem ich meine mobile Behandlungseinrichtung aufbaue“, sagt Riechert. Auch in einem nahe gelegenen Waisenhaus macht der Mediziner halt, verteilt Zahnbürsten, Zahnpasta und Spielzeug.

    „Mit der Hilfe meiner Berliner Patienten habe ich Spenden gesammelt, um ein Schulgebäude für Kinder zu errichten“, erzählt Riechert, „wer eine neue Füllung bekommen hat, konnte dafür einfach sein Zahngold spenden.“ Das wurde anschließend eingeschmolzen und in Bares umgetauscht.

    Die Stiftung Zahnärzte ohne Grenzen vermittelt freiwillige Arbeitseinsätze rund um den Globus. Kontakt:

  • German docs, reporter die on Bottom Road

    Posted in News on April 23, 2015 by Online Editor

    NANCY SIAME, Lusaka
    TWO German doctors along with their driver and a Muvi television journalist, have died in a road traffic accident after the Toyota Prado they were travelling in collided with a construction vehicle on Bottom Road in Gwembe.
    And two bandits have been shot dead after breaking into a house belonging to Chinese nationals at a mine in Chambishi. Two others sustained gunshot wounds.
    Police spokesperson Charity Chanda said in a statement yesterday that the accident happened on Tuesday around 11:00 hours at Muyumbwe, about 80kms from Siavonga.
    “The accident happened after the driver of the Toyota Prado, registration number ABE 2493, failed to keep to his lane and collided with an unregistered construction vehicle working on the Bottom Road,” Ms Chanda said.
    She said the three Germans died on the spot while the journalist, Priscilla Phakati, died upon arrival at Siavonga District Hospital.
    “The quartet was heading to Chaanga Rural Health Centre where they were scheduled to attend to the local people with dental problems,” Ms Chanda said.
    She said the bodies are in Siavonga District Hospital mortuary.

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