Goodbye

It is hard to believe that we have been at Mbingo for over 2 years and we are getting ready to move back to the United States.  As we mentioned before, we are moving to Charlotte, NC.  Mbingo has become our home over these 2 years and it will be tough to leave.  However, Cameroonians do know how to do a proper goodbye with multiple parties and multiple outfits.

The hospital gave us these "country clothes" as a way to say thank you for the time we have worked here.  They are traditional outfits for the NW region of Cameroon.  They are quite intricate with hand stitched embroidery and very colorful.  They even made one for Isaac and a small one for Ben!

It seems there is a cloth for every organization here.  This is the official cloth of the Cameroon Baptist Convention Health Board.  It shows a patient being cared for and part of the mission statement of the health board - "Assisting in the provision of health care to all as an expression of Christian love".  This picture was from the tablecloth at one of our going away parties.  We have seen official cloths of churches, regions, women's/men's groups, weddings, and many other events and the men and women usually have an outfit made from the cloth that they wear proudly.

The residency program had their own goodbye party for us as well.  This is a picture of us in the outfits that they gave us along with just some of the people at the party.  We ate well and enjoyed the fellowship, but it would not be a Cameroonian party without speeches.  A few of the residents and faculty each took a minute to say some nice things to us and we were able to thank and encourage each of them during this time of transition.  They really are an incredible group to work with.

Angela also received a Cameroonian outfit from the women's group she attends and another outfit from the maternity ward.  She will have to give a Cameroonian fashion show when we get back to the US.

As we leave, there will be some gaps in internal medicine and pediatrics.  Over the past 2 years, Angela and JR and Lindsay Young have worked hard to produce two protocol books - one for pediatrics and one for neonatal care.  These books were recently finished and printed and we have been handing them out to everyone that cares for children here at Mbingo.  We are now in the midst of distributing copies to all of the hospitals and health clinics run by the CBC throughout Cameroon.  Having these books in the hands of the doctors and nurses will greatly improve the quality of pediatric care in Cameroon.

This is Angela with Zidane.  Angela and JR and Lindsay have been caring for Zidane for the past year.  He was extremely ill from an autoimmune vasculitis and has improved with immunosuppression. He has had many bumps along the way, but always has a great attitude.  He is also one of the more knowledgeable patients about his condition.  Although he is only 14, he usually has to arrange his own ride to get to the hospital (he lives hours away) and keeps track of his own medications.  Angela has been able to work with one of the residents (Stephanie) over the past few months to arrange for her to care for him in our absence.  Stephanie will do a great job with Zidane, but she knows we are all just an email or phone call away whether it be for Zidane or any other patient.

This is Unity (on the right) with her mother and child.  Unity has renal failure, but did not know until she presented in respiratory failure from volume overload after she stopped making urine.  Her child was 5 months old.  We did not think she would make it.  She is only 22 years old.  Chuck started peritoneal dialysis on her to stabilize her while we talked to her about longer term dialysis (hemodialysis).  The government helps provide for hemodialysis in Bamenda, but the cost is still out of reach for almost all of our patients.  Unity did not have the money to start dialysis.  In fact, she could not even pay her bill here at Mbingo.  We used some money that had been donated by many of you to help pay her hospital bill here and get her started with dialysis in Bamenda.  The family said they could afford the ongoing costs of dialysis if they could get her started.  We don't know how long she will be able to afford hemodialysis, but we are thankful that we could help her for now.  She and her mother both wanted their picture taken after her bill was paid.  They were so happy and just clapped out of joy for a few minutes.

We are also happy to tell you that Denis Nkenji is scheduled for his heart surgery on May 12th.  We have told his story over the past few blogs and continue to be thankful for your generous giving to make this possible.  Please keep him and his mother in your prayers especially around the time of the surgery.

Dr. Kamdem will be graduating this year from the CIMS residency program.  He spent time at Tenwek Hospital in Kenya doing an ICU rotation last year and has progressed significantly in endoscopy over the past few months at Mbingo.  Chuck has taught him diagnostic EGD, some therapeutic EGD, and colonoscopy.  After he graduates, he is going to stay at Mbingo for a little while during this time of transition and his skills in endoscopy in addition to internal medicine will be a great asset to the workload at Mbingo and the residency program.  He has even started to teach the residents below him some diagnostic EGD and is doing a great job.  Chuck is proud of what Dr. Kamdem and all of the other residents have accomplished during the past two years.

It is also amazing to see how much Isaac has grown at Mbingo.  He was a toddler when we came out and now he is a little boy.  This picture replicates one of the first photos we took at Mbingo and put on the blog.  Take a look to see how much Isaac has grown over the past two years - Feb 7, 2012 Blog.

Ben is growing too and he is loving the swing in our backyard.  He is getting teeth and smiles all the time and we love him very much.  At the goodbye parties, the Cameroonians like to refer to Ben and Isaac as "Mbingo Boys" since they have spent most of their lives here.

This is a picture of the missionaries and short-term volunteers that celebrated Easter with us at Mbingo. You may notice that Mike and Betty Kimbrell are in the picture too (Angela's parents).  They have been here for a couple weeks and will be traveling back to the United States with us this week.  It has been great to have them here to help as we pack and will be great to have them with us as we try to take a 30 hour trip home with two kiddos!

So, goodbye for now Mbingo.  We will miss you.  Although we are leaving, we know God has great plans for the hospital, the training programs here, the hospital workers, and the patients that come for their care here.  As we have mentioned before, we are going to be able to return 2 months a year to work at Mbingo, so knowing this has made the goodbyes not quite so hard.  Still it is hard to leave our Mbingo family, but we are excited about the next stage in our lives and look forward to being back to Mbingo soon.

Partnerships

We have recently had the chance to work together with people from different hospitals in Cameroon, Kenya, and the USA.  We wanted to share some of those experiences.

This photo shows Angela giving a lecture at the Njinikom Catholic Hospital.  Njinikom is only 40 minutes from Mbingo by car and we recently met some family medicine missionaries that moved there a few months ago.  We have served as consultants to them from meeting in our living room and going over cases to answering phone calls and emails about how we would handle patients.  A few weeks ago, they invited us to give a lecture and tour their hospital.  Angela spoke about 4 pediatric topics where small changes can make a big difference - neonatal jaundice, pediatric malignancies, neonatal hepatits B, and sickle cell anemia.  Chuck spent time answering questions on management of difficult medical cases in a resource-limited setting in Africa.  It is great to be able to partner with the Catholic hospital in Njinikom to try to improve the quality of care for all people in this region.

This photo is from the front of Njinikom Catholic Hospital.  Another catholic hospital in Cameroon is Shisong Cardiac Center.  This is where Denis Nkenji (7 year old boy that we have been raising money to help) will get his heart surgery.  The money for the surgery has now been paid and he is scheduled for this open-heart surgery on May 9th.  Please keep him and the surgeons in your prayers.  Thanks again to each of you who donated money towards this surgery.  What an amazing blessing you have already been to Denis and his mother.

This picture shows John and Lovely Mbah.  We took this picture one evening after we all had dinner together.  John is one of the main nurse anesthetists in the surgery department and Lovely is the charge nurse on the pediatrics ward.  They are two of the best and most dedicated staff at Mbingo.  Their partnership and dedication to the hospital started at a young age - they were both born at Mbingo!  They have sacrificed through the years in giving their time and energy to caring for patients and Mbingo is certainly a better place because of it. 

This past week we were happy to have Brent and Morgan McDonald visit us.  They are great friends from Nashville, TN and work at Vanderbilt.  Morgan is a internal medicine/pediatrics attending and the assistant program director for the med/peds residency program.  She rounded on the pediatrics and medicine wards and helped with many of our teaching conferences.  This picture shows Angela and Morgan just after rounding in the neonatal ICU.

Brent works in hospital administration at Vanderbilt and met with our hospital administrators to see how he could help both now and in the future.  It was great to have them visit us and show them what life is like at Mbingo.  This picture is from a hike that Brent took with Chuck.  While hiking up one of the mountains, a local farmer asked us to stop while he went to get his son. He told us his son (pictured) had never seen a white man before.  Brent offered to shake his hand and the boy slowly made his way to the fence line that keeps the cows out of the man's farm.  They shook hands and the boy just stared at Brent and Chuck for a minute or two.  It is amazing that someone that lives just a few miles from our house has never seen a white man before.

This is our new BiPAP machine.  It was brought to us by a respiratory therapist named Annette who has been working at Tenwek Hospital in Kenya.  She came to work at Mbingo for a few weeks.  While here, she helped Chuck take care of a few young adults in severe respiratory distress.  The BiPAP machine delivers positive pressure with each breath and can function somewhat like a ventilator, but with only a mask instead of a tube in the trachea.  Using this machine, we were able to keep the patients alive and breathing long enough to diurese or dialyze them to improve their respiratory status.  In addition, the machine will be able to help many post-operative patients who are still having trouble breathing after surgery.

We also recently started a partnership with Bamenda Regional Hospital here in Cameroon.  They have a GeneXpert machine that does rapid PCR testing for TB (very sensitive test to find TB in sputum, tissue, or body fluids).  We had a meeting with the doctors who run the machine and worked out a way for Mbingo to be able to use the machine as well.  We now collect samples and send them by courier to the Bamenda Regional Hospital (45 minutes away) each day.  After the test is run, the results are texted from a cell phone in Bamenda to our SMS printer in the lab (only requires cell phones to be working).  We then act on the results, whether positive or negative.  The machine is far superior to looking for AFB (TB) under a microscope and even gives information on drug resistance if the sample is positive (rifampin resistance which is a marker for MDR-TB).  Chuck and Angela created the algorithm pictured above to guide our doctors and other staff at Mbingo on the correct way to manage possible TB patients while utilizing the GeneXpert machine.

This picture shows some of the local kids in their school uniforms on their way home after school.  They all decided to give us a thumbs-up, except the girl in the middle who gave us a pose.

This is Ginger (Chuck's mom) with Ben.  Ginger stayed with us for almost 6 weeks and was a huge help taking care of Isaac and Ben while we both worked.  We already miss her and the boys miss their GiGi.