My alarm clock wakes me at 7am and I undergo my daily battle with the mosquito net in order to turn it off. After a quiet time, breakfast, and buying bread and vegetables at my door from local farmers' children, I'm in this 200 bed hospital for 8am. We start ward rounds in our paediatric 'high care' room. There are three beds and two oxygen concentrating machines. Many parents are unwilling for us to put their children in this room, or onto the machines, which they perceive as killing people. So many of the children die from meningitis, malaria, septicaemia and TB. Many of them have underlying malnutrition and/or HIV infection. Attitudes to life and death are very different here, with a large degree of fatalism that I just can't adapt to. We are called too late to a baby that was gasping. We try for half an hour to resuscitate her, but are unsuccessful. As I see the young mothers face, I feel keenly the language barrier. Within two minutes of stopping CPR, there are a number of relatives wailing at the top of their voices. This is thought to propel the dead person's spirit quickly into the next world. We stop rounds at 10am to meet with the two or three other doctors, registered nurses (there are five), and clinical officers (four), for morning prayers and tea. I find this a welcome break, a short space in which to re-focus, to lift things into God's hands. Amongst other things, we pray for SIM's work in other countries, which I find myself able to do with more empathy than before coming out here! It seems like a long, hard morning before I get to go home for lunch. Luckily, I brought my umbrella; it's rainy season and it's like stepping out into a power-shower! I have a preciously peaceful hour for lunch, before being called to theatre to assist with an operation for a ruptured ectopic pregnancy. The free blood in the woman's peritoneum is scooped up, filtered a couple of times through muslin, and then transfused back into the patient. This particular woman goes on to do very well. After theatre, I spend a noisy half an hour on the long-stay paediatric ward, collecting data for my project on diagnosing TB in children. Some of the children cry as soon as they see me coming, as I am a muzungu (white person). It seems the diagnostic scoring system in place may be of use in areas of high HIV prevalence as well as in those with a low prevalence such as Papua New Guinea, where it was developed for use. I enjoy the privilege of teaching some of the nursing students on some of the patients; today's session is about snake bites, and how to recognise features of neurotoxicity. The nursing students are wonderful - full of life, and so ready to welcome the steady stream of western visitors to the hospital with infinite patience and humour. Ashamed, I wonder about what the reverse situation would be like: would they be made to feel as at home as I have been? As I saunter along the path home, watching that I didn't step on any snakes, one of my patients comes over. She had been admitted with pneumonia. She beams at me, shakes my hand warmly, and repeats one of the few local words I understand - thank you - interspersed with many others that I have no clue about. I'm overwhelmed by the soft, laughing eyes, wide smile and graciousness which is such a feature of the Zambians I've met, and go home, thankful for those who aren't inhibited by language and culture differences.