Chemotherapy

We see a lot of cancer here at Mbingo.  God has blessed us with a great team to help treat many of those cancers.  Many of the treatments involve surgery and/or chemotherapy and still others are palliative as they present too late or we don't have the necessary technology or drugs to treat them.  Some of the cancers that we treat are: Burkitt's lymphoma, Wilm's tumor, retinoblastoma, osteosarcoma, Hodgkin's lymphoma, testicular cancer, non-Hodgkin lymphoma, prostate cancer, Kaposi's sarcoma, chronic lymphocytic leukemia, breast cancer, colon/rectal cancer, and choriocarcinoma.  We don't have an oncologist here, so we have all learned a lot about how to treat cancer as we are often the ones to decide on the treatment plan and sign the chemo orders.  We also rely on assistance from consultants in the US and and occasional visiting oncologists to help with protocols or more difficult cases.

 These are our outstanding chemotherapy and palliative care nurses.  Harriet, Frieda, and Judith work hard each day to deliver chemo, discuss treatment plans with patients, help them find funds for the expensive chemo drugs, or just spend time with a patient with a difficult diagnosis.  They see people cured of cancer, battle side effects of drugs, but also sit with them as the realize they have an untreatable cancer.  In fact, they were part of a group that just won an international award for delivering palliative care in the third world.

 Chemotherapy is expensive by Cameroonian standards, but most families are able to work together to pay for the treatment.  For most children's cancers, there is a grant that pays for much of their care, which is a huge benefit to the patients and their families.

 This is Angela doing a bone marrow aspirate on a child in the pediatrics ward with JR assisting.  Bone marrow biopsies are another procedure that none of us did at home, but we do regularly here.

 This is Rick Bardin at his microscope.  He is an internal medicine doctor and pathologist who has been here for 2 years and previously worked at a missions hospital in Nigeria.  He is here with his wife Debbie who is a nurse in the HIV/TB clinic.  Rick is a great doctor and a valuable resource.  Having him here allows us to do fine needle aspirations of almost any mass (often with ultrasound guidance if in the abdomen) as well as have surgical pathology and do bone marrow biopsies and have high quality reports to guide our treatment.  The patients benefit in so many ways from his work.

 This is our current chemotherapy room which we have outgrown.  A new one with 10 beds is about to be finished, but in the meantime, chemo is given in this room with EGDs done beside.  This picture shows Judith (nurse) and Mbanga Evans (resident) giving chemotherapy.  Dr. Mbanga is a 4th year resident currently on his chemotherapy month and sees every patient that receives chemo.  It is busy but a great learning opportunity.

 This was taken on a recent hike into the mountains above our house.  It was cloudy, but the sun broke through just enough to highlight the mountain which we refer to as "Half Dome".  The resemblance to the peak in Yosemite is more striking from the side.

 Some kids walk their dog, but here Isaac is showing how he walks Chocolate, the horse.  Don't worry, Angela was close by supervising this outing.

Isaac continues to make new friends wherever he goes.  We were recently invited to Paul's house to visit and Isaac played with his two kids, Max and Maxilene.  Paul is a driver for the hospital, but has also become a friend as we have gotten to know him and his family.

Thanks for following and sharing our adventures at Mbingo Baptist Hospital with us.

Graduation

It has been a busy two weeks since our last blog post.  We took part in the first graduation of internal medicine residents from Mbingo, we had 3 families head home for a few months, and as always, the patients keep coming.

To give you and idea of some of the pathology we have seen recently, we will tell you what Chuck saw on rounds on the men's ward in just one day this past week:  acute stroke, severe pulmonary hypertension, new HIV with pancolitis, acute kidney injury after malaria with creatinine 12, pathologic rib fracture, nephrotic syndrome with creatinine 17 and thrombocytopenia, hepatocellular carcinoma, lung abscess after TB, glomerulonephritis with thrombocytopenia, CML with WBC 85,000, pulmonary Kaposi's sarcoma with additional lesions on the tongue, CLL with WBC 77,000 and splenic mass and hip fracture, Kaposi's sarcoma on the abdomen and metastatic to lymph nodes with new HIV, mediastinal mass, cryptococcal meningitis with CD4 of 6, anemia due to myelofibrosis, acute kidney injury with K 7.7 from benign porostatic hypertrophy, metastatic prostate cancer, bleeding duodenal ulcer, fever of unknown origin in an HIV patient, cor pulmonale, and acute bloody diarrhea.  Remember, that was just one morning on one ward...

 This is a picture of the front of the chapel that sits near the entrance of the hospital.  The hospital was founded in 1952, but for many years was a hospital for leprosy.  It slowly expanded and in the past 6 years it has grown rapidly with the addition of the surgical and medical teaching programs.

 This is a picture of the entrance to the hospital.  This picture was taken on a Sunday afternoon, because otherwise it would be overrun with people and taxis/buses.

 We took an official picture of all of the teaching faculty, residents, house officers, and nurse practitioner students last week.  We continue to be thankful for the opportunity to teach here at Mbingo and all the help the residents/students provide with so many patients to see.

 This picture was taken during our graduation ceremony, which was held inside the chapel.  We had all of the leaders of the Cameroonian Baptist Convention (the larger organization of which Mbingo Baptist Hospital is a part) there as we celebrated the achievements of the internal medicine and surgical graduating residents.

 It was a packed house with many people lined up at the door to get a view inside.

 We also had to tell Dennis and Nancy Palmer goodbye this week.  They are the cornerstones of the internal medicine and pediatrics department here and Dennis started the CIMS (Christian Internal Medicine Specialization) residency 4 years ago.  They have become great friends and serve as our mentors here at Mbingo.  They will be home for 5 months visiting churches, going to missions conferences, and finding volunteers and supporters for Mbingo in addition to seeing their family and friends.  They will be dearly missed.  During the time Dennis is gone, Chuck has officially been named the Interim Director of the CIMS program...big shoes to fill for sure.

 We also told the Sparks (vascular surgeon and family) and the Streatfeilds (Australian anesthesiologist/general practitioner couple) goodbye for a few months.  We have been having a biweekly praise and worship time at our house and used the time this week to both sing and fellowship with them before leaving.  There was more than enough work with all of them here, but we will be trusting God that those of us here will be able to fill in all the gaps while they are home.

 Isaac continues to grow and prosper here.  He loves being outdoors, playing in his new sandbox, helping take care of the Sparks' dog, Archer, and learning new words.  He is always on the go and can easily wear out two adults in one day.

The sunsets here can be dramatic over the mountains especially after the rains.

Thanks to all of you who support us in so many ways.  Please continue to pray for us, but even more for the patients that we see on a daily basis that push the limits of the care we are able to provide here at Mbingo.