Back at Mbingo

As many of you know, we are currently back at Mbingo.  We have been here for 3 weeks and we head back home to Charlotte in a week.  It has been a busy few weeks and a lot is going on at Mbingo.

This is the family in our African outfits that the residency program gave us when we left in May.  We put them on to go to church.  Needless to say, the Cameroonians liked it.

Since we left, part of the road between Douala (where the airport is) and Mbingo has significantly worsened.  The government has been repaving part of it, but had to stop due to the rains.  Now there is about an hour and a half stretch that is full of deep potholes.  This picture is out of the front window showing the potholes and traffic on one of the main roads in Bamenda (the large city 45 minutes from Mbingo).  This should hopefully get repaved when dry season comes.

Before we left last year, we raised some money with the Youngs to help the hospital build a new house for volunteers.  This was a big need as we often had to tell volunteers that they could not come due to lack of housing.  There was also not a good option for a place to stay for families with kids before.  This house will help fill those needs.  It was just finished before we arrived and we have been staying here and setting it up with some of the items that we had from being here for 2 years.  The views are great too!

It is a Cameroonian tradition to have people over to eat when there is a new house.  So, we first invited all 40 of the hospital workers that were involved with the house to come to the house to eat fufu and njama-njama and fish (Cameroonian favorites).  This is the crowd enjoying the meal.  They really did a great job with the house.

We also had the chance to host the CIMS residents, the house officers (medical interns), and the nurse practitioners that we work with to a meal.  This shows most of the crowd enjoying the jellof rice, chicken, and homemade chocolate chip cookies.  The best part of this evening was that the doctors were able to relax and spend time together outside the hospital.  They talked the next week about how much fun they had.

This is Norah Njini, one of the 3rd year CIMS residents.  She has an amazing story that we wanted to share.  Norah was certainly qualified, but unable to get into the one medical school in Cameroon years ago when she applied.  Because of this she had to search elsewhere which included China.  Going to medical school in different countries in Africa is common, but China is not - mostly because of the language barrier.  Norah was able to go to China a year early and learn Mandarin Chinese and then do all of her medical training in Chinese.  She then returned to Cameroon and started working for the Cameroon Baptist Convention and later joined the CIMS residency at Mbingo.  She is a great resident doctor and we are amazed at her ability to learn medicine in Chinese and now practice medicine in English and never miss a beat.  (She speaks French and Pidgin English too!)

Before we left to come to Mbingo, people asked us a lot of questions about Ebola.  The effect that Ebola is having on Sierra Leone, Liberia, and Guinea is a tragedy on the largest scale.  Fortunately, Nigeria was able to control the outbreak in its country and now has no cases of Ebola.  Cameroon borders Nigeria, but is almost 2000 miles from Liberia (the closest current case).  When Ebola was in Nigeria, Mbingo requested and received PPE (personal protective equipment) from Samaritan's Purse to be ready in case Ebola did come to Mbingo.  This threat is low now, but as we know things can change.  The PPE has many parts to get on and is quite difficult to take off correctly.  This picture shows Chuck with all the gear on during a practice session.  If PPE has to be used, there even needs to be a person in full gear that is responsible for helping others get their gear off.  Let's all pray that Mbingo and Cameroon never see the virus and that the current outbreak will be controlled in those countries that have been hit the hardest.

In addition to having the PPE on hand and making plans for how to deal with isolating patients, we have also instituted some screening.  Chuck worked with Comfort (the head nurse for the outpatient department who is pictured) to have a basic question for all patients as soon as they arrive to Mbingo.  When they first get registered, they are asked, "Have you traveled outside of Cameroon in the last month?".  If the answer is "Yes", which is rare, then we ask which country.  If they were to answer any of the countries currently involved in the Ebola outbreak, the patient would immediately be dealt with differently in an isolated setting.  Because those countries are so far away and travel is so difficult, it is highly unlikely that we will get a patient from there, but we felt this basic screening was important.

As always we continue to see interesting medical cases daily.  This X-ray was from the men's ward where Chuck has been rounding.  It shows the globular shape of a pericardial effusion.  This patient has advanced HIV and his echo showed a thickened pericardium as well as an effusion.  This was due to TB and represented constrictive-effusive TB pericarditis which is an uncommon, but well-documented, overlapping of different stages of typical TB pericarditis.  TB drugs and steroids were started, but there is still a high risk of the constrictive pericarditis worsening to the point of needing surgical pericardiectomy in these patients. 

Denis Nkenji came to see Angela in clinic the first week we were here.  He is the boy that we were able to help with the cost of his heart surgery (see previous blog posts).  The surgery went well and he has now recovered and is feeling better than he has ever felt.  The VSD was closed and the aortic regurgitation has improved.  He will need to continue to be followed, but he now has a chance at a normal life.  We were so happy to be able to see him again and see how well he was doing.  His mom even brought us bananas and beans as a gift.

Ben is enjoying rainy season here at Mbingo.  As any boy loves to do, he wants to play in the mud and the puddles.  This was one of the days that we just let him loose.

Isaac likes to walk Mom and Dad part of the way to the hospital in the mornings.  This shows Angela and Isaac passing the house that is being renovated to be a daycare.  He always gives us a big hug and kiss before running back to the house.

You can't come to Mbingo without hiking.  It's just too beautiful.  This is the family during a hike to "The Knob", a little elevated area along a ridge at Mbingo.  It was a 3 mile hike and Isaac walked the whole way!  Chuck is enjoying carrying Ben, especially since he weighs a few less pounds than Isaac.

Betty, Angela's mom, came with us for the month.  She has been an incredible help and the boys are loving spending the days with Nana.  Having her here has allowed us to get much more done at the hospital and know that the boys are in good hands.  We are very thankful Betty.

This is our last week here, but it will be busy.  Chuck is traveling with Dennis Palmer to Yaounde (capital of Cameroon) on Tuesday and Wednesday to meet with the US Ambassador and some members of the Prime Minister of Cameroon's staff as well as visit the teaching hospital in Yaounde.  The reason for the trip is to continue to pursue full recognition by the government of the CIMS residency program at Mbingo.  These things move slowly in Africa, but meetings like this help.  Chuck is also currently serving as the Chair of the Advisory Board for CIMS, so he will speak on behalf of that board during the meetings.

It has been good to be back at Mbingo and it is hard to believe a month has almost already passed.  We look forward to getting back to Charlotte, but we will miss our friends and Cameroonian family here.  Please continue to pray for the hospital, the staff, and the missionaries here at Mbingo.