Tuesday, April 23, 2013

Teaching Hospital

As you all know, a big component of what we do here at Mbingo is teach doctors and nurse practitioners in our training programs.  When we first heard about Mbingo and decided that God was leading us to come here, we did not realize how integral teaching was to the hospital.  It turns out to be one of the more rewarding things about working here.

This picture shows Helmine examining a patient on the men's ward.  Helmine is a recent graduate from a medical school in Nigeria and is doing her house officer year (intern year) with us at Mbingo.  She just joined us a couple months ago and is eager to learn.  The doctors, like Helmine, and nurse practitioner students see all of the patients on the wards in the mornings before rounding with the attendings.  This gives them a chance to evaluate the patients, write their daily notes, and develop a treatment plan for the day.

After the doctors and nurse practitioner students pre-round, we join them on the wards for more formal teaching rounds.  We see each patient as a team with the patient being presented at the bedside.  We then discuss the plan for each patient.  This gives us a chance to immediately evaluate what they know and teach them.  This whole process is very similar to what you would find at an academic hospital in the US.  The main difference is that there are 20-30 patients sharing your "hospital room" with you here at Mbingo.

The official pediatric clinic is now open!  Previously, the peds clinic used a couple of the internal medicine rooms, but now they have their own 4 newly painted rooms with a different check-in area.  This picture shows Angela with Philippa Nana (nurse practitioner) and Doris (peds clinic nurse).  Angela, JR, and Lindsay have been training Philippa to be a pediatric nurse practitioner and she helps them with the newborns in maternity and in the clinic.  She is an example of the success of the teaching programs here at Mbingo.  Doris has been a great addition as well as she is fluent in English, French, Kom (local dialect) and Pidgin English and helps the pediatricians communicate with their patients.

There is also a training program for nurse screeners (a level of training above nurses, but below nurse practitioners) here at Mbingo.  This picture shows Kaye Streatfeild (a doctor who helps with the screener program) teaching Philemon some aspects of the neuro exam before rounds in the morning.

Rick Bardin (missionary pathologist) is currently in the US for his daughter's wedding.  This has forced some of us to learn some basic pathology.  Remedy (pictured) is a pathology technician trained at Mbingo by Rick Bardin.  While he has been gone, Remedy has continued to make pathology slides and either take photos of them to email to Rick or package them to send to a pathologist in the US that is helping us for these few weeks that Rick is gone.

JR has even learned how to diagnose Burkitt's Lymphoma in children.  This is a slide from an FNA done last week.  You can see the atypical lymphocyte in the middle with a large nucleus and scattered vacuoles characteristic of Burkitt's Lymphoma.  It is critical to make this diagnosis quickly as the tumor can grow rapidly and any delay in treatment can worsen a child's chance of cure.

This chest xray is from a young man with newly diagnosed HIV (CD4: 12 cells) and fever.  He also had night sweats, but no cough.  The most notable finding is the mediastinal widening and scattered lung infiltrates.  The ultrasound confirmed large retrosternal lymph nodes.  Initially there was concern for lymphoma, but we did an FNA of the lymph node and made a slide...

that we were able to stain for AFB (acid-fast bacteria = TB).  You can see hundreds of mycobacterium (little red bars) consistent with TB.  We started him on medication and he became afebrile and was feeling better when we discharged him to complete his treatment and start medication for HIV.  We certainly miss Rick Bardin, but we were happy with a few successes in the pathology department in his absence.

This picture shows David Uttley and Gary Martyn.  They both work for Samaritan's Purse and were at Mbingo last week.  David is a photographer and Gary is a writer.  They spent time with all of us taking pictures and getting material to write some stories about what God is doing at Mbingo Baptist Hospital.  We don't know where the stories will end up, but be on the lookout on the Samaritan's Purse and World Medical Mission websites and any newsletters that you may get from them.  We appreciate them making the trip and helping us spread the word about Mbingo.

Isaac is really growing up.  Here he is with one of his favorite truck shirts and his bookbag.  Whenever we go to someone else's house, he brings his bookbag with snacks and books or toys.  It makes him feel like a big boy.

Thanks for following along with us and supporting us through prayer.  We appreciate all of you.

Thursday, April 4, 2013


Easter is quite the celebration here.  We woke up before 5am on Easter morning to the sound of African drumming coming from the church just a couple buildings down from our house.  We then got our clothes on, woke up Isaac, put him in the hiking pack, and joined the expanding group of Cameroonians walking up Mbingo Hill.  The goal is to be up the hill before sunrise, which we easily accomplished. 

This shows the group that did the Easter sunrise service on the hill as we all walked back down toward the church for the official Easter service.  The only downside was the dense fog all morning that actually obscured the sunrise.  However, this did not take away from the celebration of the resurrection of our Savior.  It was a great morning and a memorable Easter.

After the church service, all of the missionaries got together for a potluck brunch.  The food was great and we used the opportunity to take a group photo that includes almost all of the missionaries currently working at Mbingo.  We are truly blessed with a great community of friends here in Cameroon.

After breakfast, Isaac and Cathen joined the other kids for an easter egg hunt.  Someone had a few plastic eggs and then Angela hard-boiled some eggs that were then decorated with stickers.  Isaac collected quite a few and you can see Cathen "eyeing" his basket full of eggs.

In other news, Chuck and JR took part in a teaching course for the nurse screeners that work in the CBC system all over the country a couple weeks ago.  They traveled down to Bamenda and gave lectures and facilitated discussion on pneumonia, asthma, diarrhea, malaria, and sepsis.  Nurse screeners are a step above nurses and function as the frontline in the outpatient clinics that scatter the country.  They hold a lot of responsibility and this course was hopefully a chance for many of them to improve and refine their patient care.

Chuck took this picture from a helicopter over Yaounde (the capital of Cameroon).  He recently helped transport a sick missionary to Yaounde by plane and then got to travel back to Mbingo by helicopter.  It was a unique experience to take a 2 hour flight over the country of Cameroon, starting in the flat big cities and ending in the mountainous NW region where Mbingo sits.  The plane and the helicopter belong to SIL/Wycliffe (Bible translators) and they are mostly used for accessing difficult to reach people groups.

This is Chuck and JR on the top of Mbingo Hill with the hospital in the background.  It is a steep climb, but worth it for the views.

Like this view of the entire valley with the hospital below and the road in and out of town visible.  The mountain ranges here belong in a national park.

This is Angela, Isaac, and Isaac's future sibling posing during a recent maternity shoot we did.  Surprisingly, Isaac did cooperate for a few pictures, but mostly because we bribed him with a cookie.  He does like to talk about how he is going to help with the baby, but we will see if he remains this excited when the baby actually comes!