The Needle—Peace Corps Zambia, March 6th, 2023

In the summer of 2022, I boarded a plane with a one-way ticket to Zambia. Since then, I’ve been serving as a Peace Corps health volunteer, living and working in a small village just north of the capital. My clinic is excellent: the staff are professional and well-trained, the patients are treated well, and we even have some diagnostic equipment. But whenever you’re working in a rural-African health setting, you can expect to occasionally see difficult things. I’ve witnessed my fair share of teenagers with HIV, malnourished children, and adults who have collapsed in the dirt from malaria-fatigue. That said, the most dramatic medical emergency I witnessed was not at the clinic, but right outside my doorstep.

It was a typical weeknight. I was cooking with my charcoal brazier when I heard a little boy crying outside my home. This is pretty common—between the newborn, the two year old, and the seven year old, someone is always crying. Normally, I peek my head outside and check that everyone is alright, but I didn’t this time. I was busy and it slipped my mind, I guess. I sat down with my veggie curry and waited for him to stop. He didn’t. He kept screaming—shrieking—for half an hour. Eventually, I put down my dinner bowl and stepped outside to see what was happening. The screams were coming from my neighbors’ house, so I walked towards them.

It was a grisly scene. The family—the father, mother, and most of their children—were huddling around one of the older kids, a 9 year-old boy named Chomba. He was lying on the ground, writhing in pain. Everyone was staring at the mom, who held Chomba’s foot in one hand and, oddly enough, a needle in the other. I got closer and saw that his second biggest toe had been ripped open, through the skin and into the pink muscle. I asked the father what had happened. He told me that Chomba had been playing football barefoot and had gotten a splinter in his toe, so the mom was trying to get it out. The mom was using the needle like a shovel, digging it into Chomba’s toe and scooping upwards. Chomba shrieked but somehow managed to keep his injured foot in one place. Good god. I know they don’t have tweezers, but was this really necessary? I put my arm onto the mom’s arm and asked her to wait for me to get my medical kit.

I came back a minute later and handed the mom some sterile gauze and the thinnest tweezers in my bag. Then, to my horror, she tossed the gauze aside and resumed her shovel strategy, this time with one arm of the tweezers and extra vigor. Chomba started screaming again. I didn’t know how much more of this I could watch, and I thought about taking those tweezers and getting the splinter out myself. But I didn’t. For about 10 seconds, I was watched Chomba sob and scream. Why?

A few reasons. For one, Chomba isn’t my child and I didn’t want to tread over his parents and damage our relationship. For another, I felt guilty about lending my medical supplies in the first place (that’s a big no-no in Peace Corps’ book). But the real reason I hesitated was because helping goes against Peace Corps goals, namely “sustainable change through education.” The idea is that volunteers aren’t supposed to fix problems, we’re supposed to show others how to solve their own problems. We don’t build wells, we teach people how to build them. We don’t treat malaria, we give seminars to medical personnel about the signs and symptoms. That way, we can still have a positive impact even when we’re gone. Taking those tweezers may be the right move, but it’s antithetical to Peace Corps’ doctrine of teaching others to help themselves.

I thought about all of that as I watched Chomba’s screams get worse and worse, his voice growing hoarse from the screaming. Could I really just sit back and watch? Did my professional values trump Chomba’s pain? It took me too long to realize that no, they didn’t. I placed my hand over the mom’s and said, “Stop. Give those to me.” She didn’t look surprised. In fact, none of the family did. They all had this expectant look in their eyes, like they knew this was coming. It humbled me. Well, better make good on it. She handed me the tweezers.

Five minutes of rummaging passed before I found anything. The splinter was deep and I couldn’t see anything in the darkness of twilight. I prodded and poked around with the tweezers as gently as I could until I found something hard. I got a grip on it and pulled. Chomba screamed again, but all that came out was a speck of wood the size of a sand grain – I kept on searching.

Halfway through, I realized how focused I had become. It felt like everything from my hands to my breath was honed in on helping him, like my whole world reduced to a pair of tweezers, a splinter, and a wound the size of a dime. It was exhilarating, but it was also horrible. I felt both this pure, unblinking intensity that drove me to act and help, and a deep, empathetic ache every time I pressed a little too hard or pulled a little too quickly. I imagine it was a sliver of what surgeons feel: power to heal embedded within the power to hurt.

After 10 minutes, I couldn’t find any more of the splinter. I told his parents, and they agreed that we would stop for tonight and go to the clinic tomorrow. I rinsed his wound, put some ointment and a bandaid on him, and then packed up my things. And that was it. I washed my hands, went back to my house, and finished eating.

Looking back, that experience marked the final nail in the coffin of “sustainable change through education.” Don’t get me wrong, education is essential, but it’s not enough by itself. If I had stayed in my hut and let that mom “solve her own problems,” or if I tried to explain how to use tweezers in my terrible local language, who knows how long the needle-shoveling would have lasted. And this isn’t an isolated case. I gave a dozen lectures on malaria to local villagers before I learned that 1) they already knew what I was saying and 2) there weren’t enough anti-malarial drugs anyway. I think that we need a more holistic strategy that integrates education, infrastructure, and resource management if we want to be smart about foreign aid.

After hearing all that screaming, my dinner tasted bland—but it’s always bland so I guess no surprise there. When I finished, I went to my desk and typed out everything that had happened. It felt cathartic to get it all out of me, but even then I knew that I would write about it later.

P.S. Chomba is fine now. He went to the clinic the next day and the staff removed the splinter. He was walking normally a few days later.

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(Colton Lipfert is a Peace Corps volunteer in Zambia. He writes about his thoughts and misadventures in Zambia in his own Substack, Stranger in a Strange Land.)