Mbingo 2023

We were able to make a trip back to Mbingo Baptist Hospital in January of this year. Here are a few updates from our time there.

It was great to be back working alongside those that work and serve at Mbingo year-round. There continues to be challenges from the ongoing conflict in the area, but God is faithful to provide for the hospital. We are thankful that we can be a part of that while we are there and also in many ways throughout the year even when we are in Charlotte.

This is Chuck with Jewel Greywoode on a hike to the back waterfall (in dry season). Jewel is an ENT physician with a focus on facial plastics. He has been part of Samaritan's Purse cleft lip trips in the past and has served in multiple hospitals in Africa. He also goes to our church here in Charlotte. Over the past year, Chuck and Jewel have been talking about him joining us on a trip to Cameroon. Mbingo has a ENT/head and neck fellowship program that includes one year of training after completing a general surgery residency. This is led by Wayne Koch (ENT physician) and has been running successfully for a few years. Jewel has an interest in medical/surgical training at mission hospitals and this seemed like a perfect fit. We chose our dates in January to go and only later found out that Wayne Koch was going to be there at the same time. God clearly provided this timing for Jewel and Wayne to work together and for Jewel to see how the training program is run at Mbingo. Jewel really enjoyed the time at Mbingo working alongside Cameroonian surgeons in training and sharing his knowledge and experience with them.

This is the ABG (arterial blood gas) machine in the ICU at Mbingo. This has been a needed advance for delivery of critical care at the hospital. It is challenging to provide care to intubated patients without an ABG machine, but thankfully those days are behind us. This is another example of the staff at Mbingo overcoming challenges to get the needed equipment to provide the best care they can to the patients.

Mbingo continues to use an electronic medical record (EMR) and it has been successful. It is a hybrid system with the main written notes scanned into the chart, but with labs and imaging added digitally. This is a huge advance over the written and filed cards and books the hospital used in the past. Patients still do have their own personal written books that they carry with them. These patient books include outpatient visit notes and hospital summaries and provides a portable medical record for the patients. The EMR at Mbingo is used mostly for inpatient record tracking, but will continue to expand its uses. This picture shows patient registration on the female ward.

Chuck finally tried some goat meat and onions from a roadside grill on the way to (and from) the hospital on the long drive from Douala. It was great and now will be an expected part of lunch on those long drives.

The trip home from Mbingo to Charlotte was eventful to say the least. We took off from Douala and made the normal landing in Yaounde, Cameroon to pick up and drop off people. However, the plane had a mechanical issue and ultimately the flight was cancelled. The next flight was the following night, so we had a full day in Yaounde. This was after getting to a hotel at 5am after a long list of mishaps. While in Yaounde, we were able to see the Shinars who are friends of ours who live in Cameroon. This is Angela with Lori after she helped us get some lunch and we enjoyed an afternoon catching up. Josh was traveling so we missed him this time, but we did get to see their two daughters and the local school where Lori teaches.

It was another great trip to Mbingo and we are already looking forward to the next time we can be with our Cameroonian friends and family.

 

Mbingo 2022

We (Chuck and Angela) had planned on going to Cameroon in May, but we were not able to travel then due to some road closures around the time of a national holiday. Instead, we were able to work at Chogoria Hospital in Kenya alongside our friends, Will and Mary Bailey Smith. Chuck still wanted to go to Cameroon this year and was able to travel to Mbingo in September and JR Young joined him.

Mbingo Baptist Hospital continues to advance and grow despite ongoing challenges related to the conflict in the region. This makes travel difficult for the patients and for the staff of the hospital. Even still, the quality of care and what is offered at Mbingo continue to improve.

This picture shows Chuck and JR in one of the newer buildings at Mbingo. The sign behind is for the Baptist Institute of Health Sciences. The Institute was created and structured to organize all of the teaching and academic programs at Mbingo. This was important to get appropriate recognition from the Cameroonian government for our graduating residents.

This is a photo of most of the current CIMS (Christian Internal Medicine Residency) residents and some of the faculty (both full-time and visiting faculty). Some of the residents and faculty were traveling while we were at Mbingo this time. It is encouraging to see the growth and development of CIMS over the years including seeing some of the former CIMS residents now holding faculty positions at Mbingo.

This is from a morning report case conference. The case is being presented by one of the interns and the discussion is being guided by the chief resident. Chuck saw this patient with them on the wards. It was a patient with newly diagnosed ulcerative colitis with lower extremity skin manifestations. The residents had a great discussion with many important teaching points brought up.

Chuck and JR hosted the Cameroonian CIMS faculty over for dinner one night. It was great to spend time with them and get a chance to hear their perspective on the history of the CIMS program. Dr. Tumi, Dr. Norah, Dr. Sunday, and Dr. Virginine were all prior CIMS residents and have seen the advances of the program over the years. We also had a chance to discuss some of the ongoing challenges and think of ways to address them in an effort to continue to improve the program.

Ultrasound continues to be an important method of evaluating and treating patients at Mbingo. This has been true for years, but over the past year the CIMS program has obtained multiple portable handheld ultrasound devices (Butterfly) which allows the residents to better use ultrasound at the bedside. This picture shows Dr. Alei and Dr. Gaelle evaluating a patient with ultrasound. Chuck was able to work with the residents and teach on POCUS (point-of-care ultrasound).

Due to the ongoing conflict in the region and the COVID pandemic, there have been less visiting faculty at CIMS over the past few years. This means that the teaching requirements of the CIMS program falls on fewer shoulders. We have been able to support the faculty at Mbingo by uploading some of our lectures from our home institution that they are able to use in their teaching conferences. The COVID pandemic moved many of our conferences in the US to a virtual model and the lectures were saved during that time. This gave us the ability to share these lectures with the Mbingo faculty and residents.

Nothing to see here...just a snail the size of your fist making his way down the path.

It was great to be able to serve in Cameroon alongside our brothers and sisters in Christ at Mbingo. Every trip to Mbingo is different, but every time it feels like we are back at our African home. The greetings on arrival are always warm and the goodbyes when leaving are sad, but that only makes us look forward to the next time we can be at Mbingo.

Mbingo 2021

We just returned from a trip to Mbingo Baptist Hospital after not being able to go for a few years. The kids could not join us this time due to the ongoing conflict in the English-speaking regions of Cameroon. Here are some pictures from the trip and some updates on how things are going at Mbingo.

This is a group picture of most of the CIMS (Christian Internal Medicine Specialization) residents. As we have said before it is a 4 year residency and the hospital is taking 4 residents each year. They have all done medical school (mostly in Cameroon) and will graduate the residency as internal medicine physicians and work in Cameroon. The program is now over 10 years old and the quality of the graduating physicians is outstanding. We are proud of the hard work they have put in and the mature Christian doctors they are becoming.

These pictures show Angela rounding with the residents on a child in the ICU. The residents learn some pediatrics during residency as well since there is unlikely to be a pediatrician at the hospital where they end up working. This child was transferred to Mbingo with seizures due to severe uremia from renal failure. The child was started on peritoneal dialysis and ultimately recovered renal function. The next pictures show Angela teaching in conference and then giving a hands on class on newborn resuscitation. During the time at Mbingo, Angela also finished updating the pediatric and neonatal handbooks that she helped create for the hospitals in Cameroon.

The first picture shows Chuck at the bedside with Dr. Evinda and Dr. Chop, two residents in the CIMS program. Chuck is doing some teaching on point-of-care ultrasound (POCUS). This is a valuable tool anywhere, but even more so in Cameroon where other diagnostic options are more limited. The second picture is Chuck working with Dr. Tumi on an EGD. Dr. Tumi is a CIMS graduate who is now on faculty. Chuck helped train him in endoscopy years ago and now he is in charge of endoscopy and trains the residents. This case was especially difficult with a child who had a caustic ingestion with esophageal damage and stricture. The third picture is Chuck giving a lecture during one of the teaching conferences.

These picture are of the 2 dams that are a part of the hydroelectric project at Mbingo. This is a massive undertaking and is now almost complete. Power has always been a problem at Mbingo, but has only gotten worse. The power supply from the country grid is unreliable. It is off and on frequently and rarely supplies the stable current needed to protect expensive hospital equipment. This requires the hospital to often run a diesel generator that is expensive to operate and can sometimes break. The hydroelectric project will supply power for the hospital in the future and resolve these issues. The first picture shows the pipe leaving the first dam. The second picture shows the back of the front dam with it currently drained. When the gate is closed, all of that area will be underwater. The pipe travels all the way down the mountain (>1000 foot drop) and ultimately turns a turbine that creates power. This dam and pipe would be all that is needed most of the year during the rainy season. However, due to the few months of dry season, the front dam could run too dry, so the third picture shows the back dam that can supply water to the front dam during the dry season. It is amazing that all of this work was done in 14 months and now is almost finished.

We were able to take the CIMS residents and others on a hike to see the front and back dams as well as the back waterfall. It was almost 10 miles and we got caught in some rain on the way home, but that is all part of hiking in Cameroon. The first picture is the group sitting on the front dam. The second picture is some of the muddy hiking it takes to get to the back dam. The third picture is Chuck with the CIMS residents that could join us in front of the back waterfall. This is one of our favorite places to hike to at Mbingo.

It was so great to be back at Mbingo with our Cameroonian family. The work at the hospital to serve those most in need while showing the love of Christ continues at Mbingo. Despite the challenges of the ongoing conflict, power issues, or just limited resources, the CIMS residents and other staff at the hospital continue each day to serve their patients and improve the quality of care at Mbingo. We are thankful to God that He has called us to serve alongside them. Please continue to pray for the hospital and the country of Cameroon.

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.

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!

Mbingo 2017 - August Part 2

This trip to Mbingo is coming to an end, but here are some updates from the past couple weeks.

We welcomed the new class of CIMS residents earlier this month.  From the left, Dr. Tchinda Gerald, Dr. Eyambe Lydia, Dr. Chia Blessing, and Dr. Eke Marie  They are all Cameroonian and just graduated from medical school.  We look forward to continue working with them during their 4 year residency at Mbingo.

Each year we have a White Coat Ceremony to introduce the new residents and to welcome them to the residency program.  As the chair of the CIMS Advisory Board, Chuck took part in the ceremony.  Dr. Dennis Palmer (CIMS Program Director) gave the opening remarks, Chuck led them in repeating the Christian Physician's Oath, and Dr. Rick Bardin (faculty internist/pathologist) gave them their new white coats with the official CIMS patch on the chest.  In the picture, Chuck is giving them their copies of Harrison's Principles of Internal Medicine which they will read all the way through 2 times during residency (with weekly quizzes as well).

This is Dr. Sam Webb, an internal medicine resident from Charlotte that came with Chuck this month.  The picture shows him rounding on the men's ward with Dr. Ntusmi (2nd year CIMS resident).  He is planning on doing a palliative care fellowship in the future and was able to work with our palliative care team here at Mbingo including going out on home visits for 2 separate days.  This allows our palliative care team to see and help palliative patients (mostly cancer) that are not able to get to the hospital for follow up.  The team appreciated having Sam join them and he was able to see how palliative care can function in our setting.  It is incredibly valuable, but still rare in the developing world.

This is Dr. Ryan Humphries who is also an internal medicine resident from Charlotte.  He also came with Chuck to work this month.  The picture shows him rounding with Dr. Kinne, one of our upper level CIMS residents.  He is considering a nephrology fellowship in the future and in addition to rounding on the wards, he has been able to take care of a few patients receiving acute peritoneal dialysis (PD) for acute renal failure.  We have written about this PD program at Mbingo before, but it is very unique to be able to offer this at a hospital like Mbingo.  Chuck has been involved with overseeing Ryan and Sam's work and teaching them alongside the Cameroonian residents.  They have been seeing all sorts of diseases that are unusual in the US - malaria, TB, Kaposi sarcoma, advanced HIV, leptospirosis, schistosomiasis and many other challenging cases that are made more difficult in our resource-limited setting.

 This is Angela with Kennedy.  He is head of the vaccine program at Mbingo and does a great job in making sure the vaccination programs are running smoothly.  Angela has worked over the years to expand vaccinations at Mbingo like giving monovalent hepatitis B vaccine to newborn babies of Hepatitis B positive mothers and recommending needed vaccines to sickle cell patients.  This is in addition to the government expanding availability in Cameroon of what we consider to be normal vaccines for children.  There are many elements to a successful vaccination program like maintaining a cold-chain to keep the vaccines active, maintaining sterile technique, and getting the vaccinations to villages/areas that are difficult to reach.

Mbingo has been hoping to get a CT scanner for some time.  It is very complex to operate a CT scanner in our setting, but many of the hurdles have been overcome.  The CT scanner has been purchased and cleared customs and arrived this week (in 5 huge wooden boxes).  The new outpatient building has been built with a leaded CT scan room in the new radiology area.  In order to get to this point, we had to have the funds to buy the machine, a place to put it, an in-country supplier/contractor that could guarantee service to keep it running, and a way to get the scans read.  All of this has been done.  The final step is power.  The hospital already is running our transformer and generator at over 100% capacity (due to the rapid growth of the hospital) and it would be difficult to add the CT directly onto the electrical system as it consumes a massive amount of electricity.  The hospital is working on a solution, but upgrading electrical systems can be quite expensive.  We are hoping to get this resolved quickly.  Currently, the closest CT scanner is about 8 hours away in Limbe.  Sometimes we are able to send our sick patients (in a taxi with many other people) to get this done, but as you can imagine, many of our patients that need a CT scan are too sick to make this trip.  The CT scanner will allow us to provide better care to our patients and will likely serve many other hospitals/clinics in this region of Cameroon.

This picture is from Mbingo 2 church which is about a 30 min walk from our house.  Part of the service is in the local dialect (Kom) and there is plenty of African music - we love to visit there.  You can play "Where are Angela and Ben?" in the photo.  They are walking/dancing forward in the crowd to give an offering as part of a thanksgiving celebration for  an elderly woman who regained her ability to walk.

 Nora is enjoying the fresh air here at Mbingo.

Ben is really starting to enjoy hiking.  He did his biggest hike yet - the "Front Waterfall" this past weekend.  It is ~4.5 miles and 1000+ feet of climbing.  The waterfall is in the background and the valley extends the other direction.  Somehow we have hiked many times in the rainy season this trip and not gotten wet - a feat that will not be repeated!

This is Chuck and Isaac with Sam and Ryan at the top of a recent hike.  It has been great to have them here with us and let them see how God is using Mbingo to improve the healthcare of Cameroonians.

All dressed up in our African clothes.  We had these from a few years ago before Nora, so we will have to get an outfit for her next time!  We are sad to be leaving our Mbingo family and we are already looking forward to being back again.