Friday, June 29, 2018

Chuck at Mbingo in May 2018

Chuck was at Mbingo in May and here are some updates from his trip.

Guess the diagnosis?...TB is always a good guess.  In this case it is the largest TB pericarditis effusion any of us had ever seen.  He showed up as an outpatient with increased shortness of breath and had early tamponade on his echo.  He had 3L of fluid removed from around his heart by pericardiocentesis that night and a drain was left in.  He had another 1.5L removed the next morning.  He was put on TB drugs and steroids and will be followed and hopefully he will not develop constrictive pericarditis in the future.  We see a lot of this at Mbingo, but this was the most extreme effusion we had ever seen.

As Angela mentioned before when she was there in March, the CT scanner is up and running.  This shows a picture from the control room.  The technicians are doing a great job and we are getting digital images quickly.  The images are then sent over the internet and read by residents and faculty at Rush University usually within 24 hours.  The cost is very fair for our area in Cameroon and really as low as we can make it.  It costs about 50,000 CFA for a non-contrasted scan and a little more with contrast.  That is about 90 US dollars.

This is a CT scan that shows a ring-enhancing lesion from toxoplasmosis.  This is an infection in the brain associated with HIV.  It is treatable with antibiotics, but difficult to diagnosis without a CT scan.   This is one example of how the CT scanner has greatly benefited our patients.

The infrastructure at the hospital continues to improve.  This is the new pathology lab with plenty of space for preparation of slides and specimens.  You can see the new chemistry lab through the back windows as well.  There is finally room for all the staff and pathology techs that are helping Dr. Bardin (missionary pathologist/internist at Mbingo).  This is such a huge improvement over the small dark room that he had been working out of for years.

Chuck had 2 internal medicine residents join him on this trip.  This picture is from the back waterfall hike just after it started raining.  Daniel Herlihy (left) and Anthony Roohollahi (center) had a great time at Mbingo.  They both rounded on the wards and helped with teaching conferences.

This shows Anthony teaching the residents and NP students about the lung exam in our new conference room.  Anthony is doing a pulmonary/critical care fellowship next year and also spent time working in our ICU at Mbingo.

Daniel is doing a GI fellowship starting next year and was able to help with some endoscopy while at Mbingo.  This shows him in our new endoscopy suite with Emmanuel on the left (tech) and Dr. Albert Nyanga behind on the right (Internist and Assistant Program Director of the CIMS residency). Dr. Nyanga and Chuck helped Daniel with endoscopy and he did great job.

This is a picture from the new chapel church service for patients on Sunday mornings.  This service has been going for about a year and it provides a way for patients and families to go to church and worship God without having to walk to one of the local churches.  The chapel is right at the hospital and the service is run by the chaplains.  This is a great ministry and we enjoyed being a part of it. 

This is Dr. Chukwuemeka, his wife, and newborn son, Joshua.  He is a new PAACS resident (surgery) at Mbingo and he is from Nigeria.  When he found out he was coming to Mbingo in Cameroon, he did not know anything about our hospital.  He Googled it and found our blog.  He read the whole thing and felt better about moving his family to a new country for his training.  Chuck told him that he had to be on the blog now!

This tiny little frog was parked just beside the lock to our house.  He was there most of the day just enjoying his little spot.  We see frogs often, but never one this tiny or green.

Chuck had a good trip in May, but the political unrest in the Northwest and Southwest regions of Cameroon has continued to escalate.  Chuck thought he might have to cancel this trip, but was ultimately able to go.  Since he left, the violence has increased further and we are not going to be able to go this summer for our normal longer trip with our family.  At this time, no kids and no non-essential volunteers are able to go to Mbingo.  We are praying that this changes soon and that peace can return to Cameroon.  We are heartbroken about not being able to go, but even more so for our friends and family in Cameroon.  Please pray for them.  We know God continues to have a plan for Mbingo.

Wednesday, April 11, 2018

Angela Flying Solo...with her Dad

 I (Angela) just got back from my first trip to Mbingo without Chuck or the kids. However, I was not alone as I had the benefit of my dad (Mike Kimbrell) being able to travel to Cameroon with me.

My dad has volunteered at Mbingo several times in the past, but it had been awhile since he had the opportunity to visit. It was fun to show him the new buildings, introduce him to the new residents, as well as have him reconnect with people he had met on previous trips. In addition, it was such a blessing just to get to spend so much one on one time with my father. I cannot remember the last time, if ever, we have had that much time to be together. This is us on one of the hikes we did during our trip.

Mbingo continues to grow and provide better and better care to the people of Cameroon. Each visit, I love spending time with and teaching the residents. It is such a joy to see them grow in their knowledge of medicine, grow in their walks with the Lord, and to see them sharing God's love with their patients. The hospital structure is always growing, and with that is the improved ability to provide laboratory testing and imaging. We mentioned in our last blog that the hospital was installing a CT scanner. This was my first visit with the CT scanner functioning. In the US we take for granted that almost every hospital has a CT scanner and we can easily get needed scans for our patients. The CT scanner at Mbingo is one of only a few scanners available in the country. I wanted to share one quick story of how the CT scanner is already changing lives. A little girl came in with a neck mass that had been growing for 2 years and who had started to have respiratory symptoms. It was unclear on exam what was the origin of the mass, what kind of mass it might be, or what would be the best surgical approach. She was able to get a CT scan, which showed the mass coming off of her thymus and invading into her lungs. This allowed the surgeons to coordinate so that the head and neck surgeons and the chest surgeon where both present for her operation and were not surprised in the OR. She did great and went home with a smile on her face. This is a CT scan image for you medical folks out there. 

I also wanted to update you on a child from several years ago. About 5 years ago we raised funds for a heart surgery (VSD closure) for a little boy named Denis, who is the only child of a single mom. He did very well, but we knew he likely would need a second operation. A few weeks ago he underwent his second heart surgery (aortic valve replacement) at Shisong Cardiac Center in Cameroon. We were again able to help his mom raise the money for this surgery. Denis is a tough kid and did great with the surgery. This picture shows him after the surgery with his mom. One of the joys of going back to Mbingo every year is the continuity that we can have with people and projects there.

This picture shows my welcoming party in the Charlotte airport as we got home.  As with all of our trips to Mbingo, I am always filled with conflicting emotions. I love my time there. I love the staff, I love our missionary families, I love the patients and their families, but it is also hard. It is hard to be in a different culture. It is hard to face the poverty and the severity of medical illness. It is hard to leave and it is hard to stay. I often feel that my heart is split between two places, my home at Mbingo and my home in Charlotte. I think that tugging helps to remind me that earth is not our true home. No place should ever feel completely comfortable, because we are living in a broken world. So we continue to pray that God will use us for His glory whether it be in our trips to Mbingo or here in Charlotte. We continue to pray daily that He would make it clear how we can best serve Him. Thanks for reading!