Friday, September 11, 2015

Mbingo 2015 - Part 2

Our time at Mbingo on this trip is quickly coming to an end, but a lot has happened in the past few weeks.

These are the 4 new CIMS (internal medicine residency) residents.  From the left, their names are:  Sih Colette, Kafoe Samuel, Epande Richard, and Sunday David.  Colette, Richard, and David are all Cameroonian and graduated from the new medical school in Buea, Cameroon.  They were pictured in the White Coat Ceremony from the last blog post.  Samuel is from Sierra Leone and just arrived yesterday to Mbingo.  It always takes some time to get the necessary paperwork to travel between African countries, but we are happy he has made it.  He represents a big step for the CIMS program - he is the first resident that we have accepted from outside of Cameroon.  Like the other residents, he will train at Mbingo for 4 years, but at the end, instead of working here in Cameroon, he will return to Sierra Leone to serve the people there.

This is a picture of the new ICU at Mbingo.  It is functional now and Chuck has been rounding with Dr. Albert (3rd year CIMS resident pictured) on the critically ill medical patients.  The ICU allows better nursing oversight and monitoring, improved respiratory support, and dopamine infusions for shock.  In addition, we have treated 3 patients (2 adults and 1 child) with peritoneal dialysis in the past 6 weeks and this care is delivered in the ICU.

One of the benefits of returning to Mbingo regularly is getting to see patients in follow-up.  We wanted to share one miraculous story of healing here.  This is a picture of a little girl who came to Mbingo all the way from Gabon (south of Cameroon) who presented at 4 months of age with a massive vascular tumor of her right shoulder and chest (likely a kaposiform hemangioendothelioma for the medical folks). The tumor was consuming all of the little girl's red blood cells and platelets and causing her to have trouble breathing.  She required several blood transfusions and we ultimately treated her with chemotherapy, steroids, and a year long course of propranolol.  She was critically ill, but survived.

 Angela got to see her again on this trip to Mbingo and this is her now!  She is currently 2 years old, she has had no further tumor complications, and is doing very well.

Chuck has also been rounding in the female ward.  As you can see the beds have been full and even overflowed to the orthopedic ward last week - 30+ patients!  Dr. Ernest (2nd year resident pictured on the right) has done a great job of teaching the first year residents and helping the house officers on daily rounds.

Last weekend we hosted the CIMS residents and spouses to our house for dinner.  It was great to spend time together and enjoy some non-medical conversation.  It is always inspiring to hear where they each came from to get to where they are today.  God has had a hand on each of their lives.  We had the hospital kitchen make jellof rice and chicken for the dinner (local favorites) and Helen baked her famous chocolate chip cookies.

This is Isaac going with Angela to the children's ward to give out some gifts.  He gave bouncy balls, toy cars, and crayons with paper.  He wasn't sure about the ward at first, but then opened up and was excited to go back a few more times.  The kids on the ward are always happy to see him and to get some toys!

 Isaac has also been busy doing some incredible hiking on Saturdays.  Two weeks ago, he hiked to the "Back Waterfall".  It is a 7 mile hike with 1500 feet of climbing that starts at 5000 feet.  Chuck was amazed that he made it there and back and the last 45 minutes was in driving rain.  Last Saturday, Isaac hiked to the top of "Half Dome" (pictured) which is a 6.5 mile hike with 1000 feet of climbing.  All of this and he just turned 5 years old this week!

 Ben has been having a great time here as well.  This shows him after church getting some help from a Cameroonian boy in catching grasshoppers.  The older boys helped him get a good hold on them.  His other favorite activity continues to be digging in the dirt with what he calls his "trouble" (aka "shovel").

We also had a snake at the very edge of our yard.  A man saw it while digging a hole and killed it.  It was not very big, but he thought it was poisonous.  After it was dead, Isaac and Ben got a good look at it. 

Angela's Dad, Mike Kimbrell, has been here with us for the past 3 weeks.  He is an internist and has been rounding on the men's ward each day.  After rounding, he has been helping watch the boys the rest of the day.  Isaac and Ben have loved having Papa here!  He will be traveling back to the US with us as well which will really help on the plane and through the airports.

We are heading back to Charlotte soon so we look forward to seeing our family there, but we will miss our family here at Mbingo.  We are already planning to return to Mbingo in the spring!

Wednesday, August 26, 2015

Mbingo 2015

As many of you know we are back at Mbingo and have been since the beginning of August.  We are able to stay here for 6 weeks on this trip.  We wanted to give you an update on how things are going.

The flight over went really well.  The boys slept and watched some movies and there were no breakdowns.  They adapted to the time change very quickly.  This picture shows Benjamin sleeping in a relaxed pose in his seat.  Thanks for buckling your seatbelt for landing Ben!

The teaching school year starts on August 1st at Mbingo, so Mbingo was welcoming the new residents just as we arrived.  Dennis Palmer is in the US while we are here, so Chuck has been filling in as the CIMS (internal medicine residency) program director.  This involved speaking at the White Coat Ceremony for the new residents just 2 days after arriving.  PAACS (surgery residency) was also involved with the ceremony.  The picture shows Chuck speaking while the other CIMS and PAACS leadership is at the table and the new residents are off to the left.

Chuck was also able to bring two residents from Charlotte with him this time.  Chuck is on faculty at Carolinas Medical Center and has developed an international rotation for the internal medicine residents there.  This was the first trip for them to come with him to Mbingo.  The picture shows Dr. Ruchi Jain rounding on the female ward with the ward team.

Dr. Todd Gandy is the other resident that came and this picture shows him rounding on the men's ward.  He is surrounded by two CIMS residents, a house officer, and a nurse practitioner student.  Todd and Ruchi were able to round on the wards, lead daily teaching conferences, and do many procedures.  They did ultrasound-guided fine needle aspirations, thoracenteses, paracenteses, bone marrow biopsies, and even a few EGDs.  They also enjoyed many hikes into the beautiful mountains here.

This is a picture of the GeneXpert machine.  It is a PCR test for tuberculosis.  It is much more accurate than looking for AFB on smears and we finally have one at Mbingo.  Prior to this we were sending our samples to be run on a machine in Bamenda.  The machine takes about 2 hours to run a sample and can do 4 at a time.  You can see the blue topped specimen container that fits directly into the GeneXpert machine below.  The results are then displayed on the computer to the left.  This machine has made a huge difference in our ability to diagnose TB and therefore properly treat our patients.

Yes, that is a chicken in our house.  We bought a chicken, but we were not able to get it killed that day.  While we were out of the house, he got out of his bag and was wandering around the house.  Chuck tried to guide him back to the mudroom, but the chicken was having none of it.  Finally, we had to trap him, pick him up, and carry him back to a box to keep him in until the morning.  Isaac and Ben thought this whole thing was hilarious.

It has been raining like usual in August at Mbingo.  Everything is nice and green and the boys are enjoying walks, rain or shine.  This is Ben walking around with Angela.  This is one of the rare times he was standing under the umbrella.

This picture shows Isaac and Ben with Nathaniel at the Mbingo II Church.  Nathaniel is the oldest son of Jason and Meridith Axt.  Jason is one of the faculty surgeons here at Mbingo with the PAACS program and a friend from Nashville, TN.  We kept Nathaniel for them for the weekend while they celebrated their anniversary with a weekend trip.  The boys had a lot of fun together.  The Mbingo II Church has been expanding and recently put the walls and roof up on this new building.  It is fully functional now while they continue to raise some money to fill in the walls and finalize the flooring.

Helen has been able to cook for us at our house again this time.  This picture shows her making cookies while the boys watch.  Her banana bread and cookies are hard to beat!  We are thankful for her help.

Mbingo really is a paradise for our little boys.  They drive their toy trucks, dig in the mud, collect bugs, swing sticks, and get as dirty as possible.  This picture shows Isaac with his bug collecting box. He is showing some new colorful bugs to Ben who is pushing his toy truck around.

Did we mention mud, rain, shovels, and getting dirty.  Here are the boys digging in a puddle behind our house after a heavy rainstorm.  They are usually so dirty by the end of the day that they have to have baths/showers before coming inside for dinner.

Thanks to all of you for following along on this trip.  We appreciate all of your prayers and support.  It has been great to reconnect with our Cameroonian friends here and jump right back in to work at the hospital.  Thankfully, we still have another 2.5 weeks here before heading back to Charlotte.