Sunday, May 8, 2016

Mbingo 2016 - Part 2

It is hard to believe that this trip to Mbingo is coming to an end soon.  Here are some updates from the past few weeks.

Operation Christmas Child is a program through Samaritan's Purse that allows people in America to pack shoeboxes full of toys and other gifts for children in other countries.  Many of you have probably packed a shoebox in the past.  Many churches have the boxes and instructions to help you take part in this around the Christmas season.  Those shoeboxes are delivered throughout the year to remote areas of the world to children that have few if any toys.  When the shoeboxes are given out, the children also get to hear the Gospel.  This past week, Operation Christmas Child made a delivery of shoeboxes to the School for the Deaf here at Mbingo.  We got to take part in this and Isaac even got to hand out some shoeboxes.  There was incredible joy on each child's face as they opened the shoebox full of toys and other gifts that was just for them!

In addition to rounding on the wards and leading the teaching curriculum for the CIMS program, Chuck has been involved in improving the care in the new ICU (opened last year).  This picture shows Dr. Nshom Ernest and Dr. Tumi Divine.  Dr. Nshom is a 2nd year resident working in the ICU this month and he has a specific interest in critical care.  Dr. Tumi graduated last year from the CIMS program and spent 3 months at Kijabe Hospital in Kenya learning critical care in their ICU.  He now helps greatly in the day to day management of the ICU patients at Mbingo.  Our ICU is certainly more limited than what you would see in the US, but it is a great step up in our ability to care for the sickest patients here in Cameroon.  Chuck has been teaching on oxygen delivery, BiPAP use, shock, sedation, and ventilator management to the CIMS residents and the ICU nurses.

This picture shows some of the ICU equipment we have been using.  The first item is a BiPAP machine to deliver "ventilator-like" treatment to a patient through a mask without an endotracheal tube (breathing tube).  The second machine is a baby CPAP machine.  This had been donated and had not been used because the staff at Mbingo was not sure how to use it.  Angela figured it out (including calling the support line in the UK) and started using it and teaching others how to use it.  The third item is one of our ventilators.  They are quite basic, but Chuck sorted out the settings and how to best use it here at Mbingo.  It is the minority of patients that would benefit from it here, but it is great to have for those people it can help.  One challenge is that we use 5L oxygen concentrators to deliver oxygen and even though we often put two machines together, this setup is still far less than optimal for intubated patients.  There are other technology limitations in our ICU, but things are changing here fast and we are excited about the future.

Angela has also been teaching a pediatric resuscitation course to all of the children's ward nurses.  She has been doing this before or after rounds and even on a couple evenings to catch the night nurses.  Ethan Helm is the full-time pediatrician here at Mbingo now as part of the Samaritan's Purse Post-Residency Program (the same 2 year program that we did).  Angela has been able to work with him some as well as round on the ward to allow him to work on other projects at Mbingo.

This picture shows Chuck with Dr. Norah (4th year resident) and Tom and Edie Welty.  Drs. Tom and Edie Welty have been involved in healthcare in Cameroon for many years and more recently focused on public and women's health issues.  They have asked Chuck to join the board for CHEF (Cameroon Health and Education Fund).  This is a non-profit organization that helps fund projects in Cameroon including many projects at Mbingo.  Chuck will be the Mbingo representative on the board as well as learn about other projects in Cameroon.  One of the most recent projects involved raising money to help fund Dr. Norah and other residents to do their ICU rotation in Kenya.

SIL (Bible translation ministry) has a helicopter to help them get into remote areas of Cameroon.  They also use it when needed to fly patients to Mbingo that would otherwise not be able to get here.  This picture shows Isaac and Ben with some of the Schmedes kids (ENT missionary surgeon) after a recent helicopter arrival.  Chuck has taken care of a few patients brought by helicopter over the past few weeks.

One of our favorite things to do at Mbingo is to have Isaac and Ben go to the children's ward and hand out gifts about once a week.  This year, they brought cars, coloring books, crayons, and blankets.  This gives the kids on the ward something to do and play with and allows us to show God's love in a tangible way.

This is Ben with Dr. Kamdem - a recent CIMS graduate who has continued to work at Mbingo.  Each year we host a big dinner party at our house for all of the CIMS residents, house officers, and nurse practitioners.  Dr. Kamdem arrived to the house and Ben immediately went to sit beside him.  We enjoy hosting this dinner and it is a great way for all of us to connect outside of the hospital.

This is a mango fly larva (aka tumba fly).  We had heard about these, but never experienced them before this week.  It is similar to the botfly of South America.  The mango fly can lay eggs on wet clothes as they dry on the clothesline.  The larva then gets under your skin when you wear the clothes.  They cause a boil and if not removed, will grow for 3 weeks before dropping out of your skin.  Gross!  Isaac and Ben both developed these boils on their skin this week.  We knew they looked a little funny, but then realized that they were indeed mango fly larvae.  We covered them with vaseline to block their air hole and then pulled them out with a tweezer.  Isaac and Ben each had 2 spots and now are gladly larva free!  This picture is of the last larva we removed.  We are now going to invest in a dryer as this eliminates the opportunity for eggs to get on your clothes.

Isaac continues to do incredible hikes.  This was from the top of the "Three Sisters".  It is a hike that he has been planning since our trip to Mbingo last year.  It is 8 miles and has 2000 feet of climbing with a summit over 6500 feet.  The final ascent involved pushing through a fern field and through some fairly dense vegetation.  You can see the hospital in the distance off of Chuck's right shoulder.  This is essentially the hardest of the usual hikes at Mbingo.

Here is Ben hiding in a grouping of banana trees.  He loves to play outside and is enjoying activities like this that he can only do in Africa.

When we leave we will miss our Mbingo family, but look forward to seeing our family and friends in Charlotte.  Thanks for all of your prayers during our trip.

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