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.


  1. I round with the docs and love being a part of the learning process! My attending is from Ghana and most of the residents are from different countries in Africa... I can envision your mornings very well! Love you all!

  2. I love reading these amazing stories! Isaac is so stinkin cute too. Looks like he is loving it there!