Wednesday, May 29, 2013

Peritoneal Dialysis

We are always trying to improve the level of care here at Mbingo for our patients.  Recently, we were able to start a peritoneal dialysis program for acute renal failure.  This was made possible by 2 years worth of donated supplies from the Renal Research Institute in New York.  We hope this will save the lives of some of the patients that have acute kidney injuries by giving them enough time to recover their renal function - usually days to weeks.

We will be teaching this skill to our CIMS residents.  This was a group photo of the residents that we took last week.  We convinced them all to smile...even though most Cameroonians like to be very serious in photos.  The most difficult part of peritoneal dialysis in our setting is actually choosing the right patients that need peritoneal dialysis and are likely to benefit from it.  We hope to find a way to make the program sustainable here at Mbingo after the 2 years of donated supplies are used. We also hope the residents will be able to offer peritoneal dialysis at the hospitals they end up at after their training is finished.

 This is our first patient receiving peritoneal dialysis.  The sterile fluid goes into the abdomen and "toxins" in the body collect in the fluid.  The fluid is then drained out after 4 hours and the process is repeated.  The "toxins" include electrolytes, acid, and other waste products that our kidneys normally excrete.  This 5 year old girl developed acute tubular necrosis (ATN) after malaria and was making almost no urine and was confused from uremia.  Now she is alert and awake and tolerating dialysis well, but we are still waiting on her urine to increase and kidney recovery.  The nurses, Ivor and Gene, have practiced long and hard to be ready to care for these patients and they are doing a great job.

This is Nancy and Dennis Palmer and Patsy and Bill Lawton.  The Palmers have been here for years and Dennis Palmer is the Director of the CIMS Program.  Bill and Patsy Lawton recently came to volunteer at Mbingo for 2 weeks.  Bill is a nephrologist and helped us get our peritoneal dialysis program ready.  Unfortunately, he went home just before we received our first patient, but he had us all well trained.  Patsy is a physical therapist and helped in our PT department.

This is JR and Angela with Tina Slusher.  Tina is a pediatrician from Minnesota with an incredible amount of global health experience.  One of the things that she identified that needed help here at Mbingo were the bili lights (phototherapy units).  Newborn jaundice is a common problem with potentially serious outcomes.  By using a bili light like JR is holding, the high levels of bilirubin in the newborn's blood can be brought down to safe levels.  We already had bili lights like this one before Tina Slusher came, but we learned how to make it more effective.  In fact, she helped us increase the quality of the bili light to five times stronger than it was before.

Technology has changed the way that medicine is practiced around the world and Mbingo is no different.  Well...a little different.  Instead of computers, smartphones, and iPads at the bedside, we use the older Palm PDAs to look up information on medical diagnoses, treatments, and drug dosing.  Each trainee at Mbingo is giving a Palm PDA and it is loaded with useful medical resources.  This is all possible because we are able to get the older Palm PDAs for such a good price.  As you can see in this picture, a house officer and Dennis Palmer are both looking up drug dosing for this patient at the same time.  This greatly improves our ability to quickly deliver higher quality medical care to our patients.

We are excited to show the new roof being added to the outpatient clinic building.  This has been a long time coming and we are still waiting to complete the other half, but we hope we will have the money to do that soon.  Other than it being a generally good idea to have roofs on buildings, it keeps the heavy amount of rain from causing damage to our walls and ceilings...and it looks a lot better.

JR and Chuck recently did a guys hike to the top of this peak in the picture.  It was quite a difficult climb up with plenty of bushwhacking to make a trail, but the view of all the surrounding valleys was worth it.

A couple weeks ago, the other missionaries at the hospital surprised us with a baby shower.  We had great food, some thoughtful presents, and it was a good excuse to get all of us together on a Saturday afternoon.  Angela is now almost 35 weeks pregnant and we will be heading back to the US this week to have the baby there.  We are then planning on returning when the baby is 6 weeks old.

Isaac will be sad to leave his friends here at Mbingo, but is excited about taking the truck, plane, and car rides home to see his grandparents and then meet his baby brother.  Thanks for your prayers for our work here and now as we travel home and for a safe delivery of a healthy baby.

Wednesday, May 15, 2013

Hospital Departments

Mbingo Baptist Hospital has many departments other than the obvious medical and surgical ones.  Each is staffed by Cameroonians, many of whom received much of their training here at Mbingo.  We wanted to introduce you to some of these departments.

Pharmacy.  Manasius, head of pharmacy, is pictured here.  He is involved with dispensing medications, keeping drugs in stock (big job here), mixing compounds, and he often rounds on the wards with the medical teams.  He and the rest of the pharmacy team are a huge asset to the hospital.

Radiology.  This group is focused on xray and ultrasound/echocardiogram.  The ultrasound techs have been trained to read the ultrasounds as well.  We do not have a radiologist and this team is able to provide us with good imaging information despite lack of a CT scanner.  We are currently in the process of upgrading to digital xray, which will be a big improvement over the current film model.

 Dental.  They specialize in extractions, fillings, root canals, and other general dental care.  They have patients come from long distances to receive their high-quality services.

 Physical Therapy.  This is part of the PT team showing how to use some of their equipment.  They provide both inpatient and outpatient service for a range of patients.  They will go from working with a stroke patient, to showing exercises for chronic back pain, to helping an amputee learn to use their new prosthesis.

 Prosthesis Shop.  The prostheses that are used at Mbingo are made on site.  It is easy to tell when one is being made because we can hear the loud sound of drills and sanders being used as we walk past the shop each day on our way in to work.  This picture shows a recently made hip/leg prosthesis...a difficult one to make for sure.

 Shoe Shop.  There is no mall or shoe store around Mbingo, so when shoes start to fall apart, you just bring them to the shoe shop for repair.  Shoes take a beating here, but despite this, almost any shoe can be repaired quickly and be put back to work.  They also make special shoes for former leprosy patients.

 Carpentry.  The quality of the furniture here is top-notch.  The wood planks are made from trees in the area and then brought down to the carpentry department.  The planks are then cut to the correct size before the more intricate work begins.

 This board is being sanded by hand prior to adding it to a new desk, exam table, couch, dining table, bookshelf, chair, or any number of other things that are made here at Mbingo.  In fact, all of the furniture in the houses and any wooden furniture in the hospital is made by the carpentry department.  They even made a toddler bed for Isaac from a picture off the internet.

 Metalworks.  This department accounts for most of the other furniture items in the hospital.  This picture shows welding being done to a medical table to be used in the operating room.  We recently had them make two specialized IV poles for the new IV pumps for the NICU.

 The pregnancy continues to progress without any complications and Angela is feeling well.  Isaac continues to be excited about being a big brother...just look at that smile on his face.

BIG NEWS...Mbingo now has an official website and a new and improved Facebook page.   We have put a lot of work into improving Mbingo's web presence and want it to be easier for people in the US to find out what is happening here.  Please check out the website at and the Facebook page at - and don't forget to "like" the Facebook page so you can see any new updates or pictures.