Reflections from Ndola: A Hospital Staff Wellbeing Project in Zambia

Having worked in healthcare systems back home, I knew that burnout and occupational trauma weren’t confined by borders. Still, I quickly learned that the local context shaped everything—from the resources available to the ways people coped, communicated, and supported one another.

Ndola Teaching Hospital is one of the main referral centres in the region. From the outside, it’s a large, towering block—almost a beacon for the surrounding areas. Inside, it was a cacophony of noise, sights, and smells, with ongoing building and improvement work taking place alongside regular patient care. Under the guidance of Christine Jere (Country Coordinator for KGHP in Zambia), I was expertly oriented in my first few days—learning who’s who, how things are done, and how to navigate the many floors and zones of the hospital. I often joked with Madame Christine that she knew every single person in Ndola. It didn’t take long before I started to recognise names and faces throughout the hospital. I was also introduced to Dr Hope Namoje, a clinical psychologist, often based in the psychiatry department in the hospital grounds—an incredible, strong, and inspirational woman and mother who has been instrumental in shaping the psychiatric care provision in the area.

Healthcare staff wellbeing survey

Our project involved conducting a survey among healthcare staff—nurses, junior doctors, and senior clinicians—exploring levels of depression, burnout, and trauma. The results were sobering, if not entirely surprising. Around 50% of the workforce reported high levels of psychological distress. Many participants described feeling emotionally exhausted, detached from their work, or unable to switch off after their shifts. Several recurring themes emerged from the data: low salaries with limited opportunities for progression, heavy workloads, communication breakdowns within teams, and frequent exposure to death and dying. Rota issues were significant too—staff often had to cover for absent colleagues, work extended hours, and struggle to find time for rest. Perhaps most starkly, many spoke of the daily frustration of working in an under-resourced environment—doctors having to improvise treatments due to lack of equipment, nurses caring for far more patients than safe ratios would ever allow—all against the backdrop of a healthcare system that, despite its cracks, continues to function through sheer will and determination.

We presented the findings to staff and management, along with several recommendations. Chief among them was the creation of on-site psychological support for staff. Crossing the road to the psychiatry department was seen as too stigmatising, so having confidential, in-house access would make support more accessible and acceptable. While this alone won't solve the socio-economic challenges facing the hospital, it's a vital first step toward ensuring staff can access timely mental health care and stay well while working in such demanding conditions.

Next steps for the project

We’ll also be holding meetings with staff to address other challenges raised in the survey, particularly around improving team communication and fostering a culture of social and peer support to counter feelings of isolation and blame. There are still many conversations to have, findings to reflect on, and strategies to co-develop with staff that will continue even after I return to the UK. But I also leave with deep appreciation—for the people I’ve met, the warmth I’ve been shown, and the lessons that only emerge when you step into someone else’s world and open yourself to new ways of being.

One of my most memorable moments came during a meeting with the hospital director to review the results of the project. He has been hugely welcoming and supportive from the outset—an ambitious leader with high expectations for what good care should look like. As the meeting ended and I began packing away my notes, he looked at me and asked, “So—do you know any Zambian words?” For a moment, my mind went blank. I knew I’d been taught a few greetings when I first arrived, but in the heat of the moment, they disappeared. Then suddenly, like a lifeline, one word floated to the surface: Muli shani—hello, or how are you?

I said it with what I hoped was passable pronunciation. He burst into a big smile. It was a light-hearted moment, but one that stuck with me. It reminded me that relationships are often the most important currency when working in new environments.

The Frontline Healthcare Worker Wellbeing project is funded by Global Health Partnerships (formerly THET) through the 'Global Capacity Building Programme Small Grant.'