Catching Up

Our internet was down for a few days, which allowed for some time to catch up on life. A lot has happened since we last posted, so I will try to give an overview in brief snippets:

Graduation: the culmination of many years of hard work came to fruition for two of our fine residents a couple weeks ago with our first CIMS (Christian Internal Medicine Specialization) graduation. Drs. Divine Jam and Francine Kouya are the first two graduates of the four-year program, and will be serving at Banso Baptist Hospital and continuing training in South Africa in the field of oncology, respectively. The graduation ceremony was well attended by members of the Cameroon Baptist Convention in addition to the expatriate medical missionaries that are training the residents here at Mbingo. It was an honor to be part of the ceremony, but more so to be part of the training that is occurring here at Mbingo Baptist Hospital (MBH). We are excited to continue to work on the pediatrics curriculum (the CIMS program is ~ 15% pediatrics training) and to further the education of the residents.

Dr. Divine Jam & Dr. Francine Kouya with the Attending Physicians
(Chuck Barrier, Rick Bardin, Angela Barrier, Dennis Palmer, Divine Jam, JR Young, Francine Kouya, Kaye Streatfeild, Lindsay Young)

Ward Changes: nursing here at MBH works on an antiquated system where rather than assign nurses to individual patients, each nurse on duty manages a particular skill set for the shift – vitals, oral medications, IV fluids, etc. We have found that with the current system, the comprehensive details surrounding each patient sometimes get lost. As such, we have spoken with the head nurse of the hospital and are hoping to try a pilot of sorts, revamping nursing on the children’s ward to have each nurse care for about 5 individual patients. The hope is that we will be able to have a more complete picture of what is occurring with the patient when both the resident and the nurse have ownership of individual patients. Change is never easy, but we hope and pray that we can really improve patient care by implementing this change on the children’s ward. If all goes well, we will then promote change on the other medical wards as well.

Comings & Goings: many of our friends and colleagues have recently left for furlough. The Palmers (Dennis created the internal medicine program here, and his wife Nancy, is the administrative head of the program and a doctor of psychology) have gone home to the US for 5 months. Keith and Kaye Streatfeild (anesthesiologist and internist, respectively) have returned to Australia for 10 weeks. The Sparks (Steve heads up the PAACS [Pan-African Academy of Christian Surgeons] program at MBH) have returned home to the US for 6 months. The Bardins (Rick is our pathologist and Debbie is a nurse working in the HIV Clinic) are leaving in July to return to Nashville and Colorado for one month. In addition to the faculty that have returned home to raise support and to reunite with family, we have graduated our two senior residents, and two of our house officers (essentially interns) are transferring to other CBC facilities. In their absence, we are all filling in as best as possible and trying to divvy up the workload. Pediatrics (which was created just 5 months ago here at MBH) is now the best staffed of the services with three attendings! We will miss our friends and colleagues, but we are excited that they have the opportunity to return home, to relax with family and friends, and to raise support so as to continue their work here in the coming months.

Fortunately, we are blessed with frequent visiting physicians to help lend a hand on the wards and to teach. We currently have two wonderful couples with us: Robert & Melissa (Neurologist and Pediatric Nurse) and Dorothea & Drew (Psychiatrist and Anesthesiologist). They have been a wonderful addition to the team and have really helped to smooth things out with many of our colleagues out of town.

The crew - up early on Saturday morning before rounds to go hiking

Chickens: our first batch of chickens have grown up, fattened up, and already appeared on our dinner table… chicken pot pie, Banso chicken stir fry, fried chicken, chicken fajitas, etc., etc. The chicken coop was a huge success, thanks to Chuck, and now that the first four chickens have been eaten, we have a new batch of chicks for the kids to enjoy until they too become dinner. Chickens are rather pricey here in Cameroon (not to mention quite chewy), so raising them on our own is cheaper and it provides entertainment for the kids (and the adults when the chickens escape from the coop – one of the ornery chicks got out three times just during a recent evening’s dinner!).

The chicken coop

Hiking: it had been almost three weeks since I'd been out for a good hike, so Chuck and I got up early last Saturday morning before rounds and took a 3.5 hour hike up the mountains on the east side of the hospital. We ascended just under 2000 feet and got an incredible early morning panoramic view of the surrounding countryside. It was phenomenal, and a great reminder of the beauty that surrounds us here.

Looking back at MBH

Panoramic facing southeast

Medicine: In the past week alone we have seen a barrage of pediatrics cases on the wards and in clinic. Some of the more interesting cases included:

-       Suspected congenital adrenal hyperplasia in a 5 week old

-   Disseminated MAC 

-       Pseudomonal infection of crush injury

-       Cerebral malaria x 2

-       Gram-negative meningitis (likely H. flu)

-       Bilateral retinoblastoma, presenting with an exophytic mass (extending ~3 inches from facial plane)

-       Burkitt’s Lymphoma presenting with intraoral mass, sepsis, acute renal failure, and right cranial nerve 3 palsy

-       Hepatic mass with obstructive jaundice and ascites

-       Inflammatory bowel disease

-       Osteomyelitis with sequestrum
-       Suspected adrenoleukodystrophy

We miss you all and cherish your prayers and support. Thanks for following along. Blessings.

Picture Quiz: Does anyone know what this is? This is really random…