Achain

The Tertiary Sisters of St Francis operate 6 Hospitals in Cameroon.  In addition they have 40 Health Clinics in out lying areas around the hospitals.  These small clinics are staffed 24 hours a day by nurses and have 10-40 inpatient beds.  The nurses do deliveries and provide medical care for large areas where there are no other health care facilities.  Last Friday Terry and I traveled to Achain, the Clinic farthest from our hospital.  The road goes up and over several mountains and at times was no more than a path.  Most of the time the road is like a dry rocky river bed.  The road is impassible during the rainy season, more than 6 months of the year.  Sister was correct in predicting that the truck would need to go in for repairs when we got back.  We lost the exhaust pipe after bottoming out one too many times.

The staff at Achain was friendly and were happy to see us.  I think they were most happy to see the supply of medications and IV’s that we brought with us.  We consulted on a large variety patients.  One lady we saw had a large breast abscess.  We were able to drain here abscess sparing her a difficult trip back to our hospital.  The staff provided a wonderful lunch for us at the conclusion of the clinic.  The rain may prevent us from a return trip to Achain.

RSV Blues

The dry season brings an increase in the number of respiratory infections here.  The Peds Ward has been filled the last 2 months with many young children with Pneumonia and RSV Bronchiolitis.  We have nearly depleted the supply of Albuterol that Dr Ed Malphus brought us 2 years ago.  We use the Albuterol for breathing treatments for the children who are wheezing.  Fortunately most of the children respond well to antibiotics, steroids and breathing treatments.

Today I was able to discharge home 4 children all recovering from their respiratory infections.

Junior doing well

Stella doing well

Food Poisoning

Celestine

Last week we had 5 people arrive at the OPD complaining of vomiting and diarrhea after eating a meal of coco yams.  We later found out that a total of 15 people had eaten the coco yams and all 15 became ill.  2 young boys and 2 elderly women required admission.  3 year old Celestine was the sickest and he had multiple seizures over the next 12 hours.

Dr Eugene visited the Family Compound and was able to secure some of the cooked yams and sent one to the Hospital Laboratory for culture.  Today the Lab reported a heavy growth of E. Coli grew from the yams.  While Dr Eugene was at the Family Compound a neighbor showed up and boldly claimed he was so tough that no yam could make him sick.  Against Eugene’s advice the man snarfed a yam down.  We later heard that about 2 hours later the yam was oozing from both ends of his intestinal tract.

Everyone is doing well now.  We removed Celestine’s IV today and hopefully he will be able to go home tomorrow.

Tracy

2 year old Tracy was brought to the hospital 5 days ago by her parents.  She had been hospitalized 3 days earlier in the Southwest with fever.  Her condition deteriorated with development of profound lethargy, prompting her parents to bring her to us.  Her medical record from the other hospital contained no information about her diagnosis or treatment.  Unfortunately this lack of information from other health care facilities is very common.  Tracy’s father could hardly contain his anger when I explained the lack of information sent from the other hospital.  I was concerned about meningitis so we did a spinal tap immediately which was negative.  Her Malaria test was positive and her Hemoglobin was very low.  She was aggressively treated for Cerebral Malaria and given a blood transfusion.  Her father was extremely excited the next morning telling me the moment her blood transfusion began she started getting better.

Over 48 hours Tracy woke up, initially crying, then looking about the room and then talking and walking.  She was well enough to be discharged today.  Her parents were delighted that Tracy’s recovery from Cerebral Malaria was the fastest that we have seen.

Shortages Again

Last January, February and March we experienced severe shortages of the government supplied HIV medications.  No explanations were ever provided.  Our 1000 patients on HIV medications suffered greatly as they made many trips to the hospital and returned home with no medications or only a few days worth of pills.  We had many patients who stopped returning until they became too sick to stay away.

Unfortunately, January 2013 has seen the same shortage of medications that occurred last year.  We were able to secure a few medications on Saturday and today huge crowds of people waited patiently outside of Project Hope praying that there would be enough medications for each of them.  We are all praying that this shortage will not continue.

Triplets

Terry and I had were able to go to Kribi for a 3 day holiday on the ocean last week.  We got in late Friday and Saturday morning while doing rounds we found one incubator packed with babies.  In our absence a lady walked into the hospital and vaginally delivered triplets.  All four babies weighed 4 pounds and are doing very well at 5 days of age.  Mom is struggling with breast milk production which is understandable.  Terry is anxiously waiting for them to grow enough for a picture of her holding all three babies.

Witch Doctor

Before patients ever see us they frequently have already seen the local Traditional or “Witch Doctor”.  Today 7 year old Ibrahim entered my examine room accompanied by his parents.  Ibrahim’s arm was in a homemade sling.  There was an obvious deformity of the proximal forearm and the skin from his elbow to his hand was scabbed and discolored.  Dad relayed that Ibrahim had fallen 2 weeks ago and they knew the arm was broken by the obvious curvature.  Off to the Witch Doctor they went and the arm was covered with medicine followed by a wrap that Dad said was too tight.  A week later when the wrap was removed the entire forearm was blistered and still crooked.  Additionally Ibrahim could not move any of his fingers.  The local health center was their next stop and antibiotics were appropriately prescribed.  With no return of movement at 2 weeks post injury his parents decided the hospital should be their next stop.

Little Ibrahim sat stoically as I examined him.  The prior blisters were all scabbed today and there was no sign of obvious infection.  There was circulation to his hand as it was warm and capillary filling was present.  Unfortunately there was absolutely no movement below the shoulder, likely the result of a tight wrap the week after injury.  Hopefully the nerves in his forearm will recover in the next few weeks and he will regain some function in his hand.  It is difficult seeing cases like Ibrahim’s that could have had a different outcome had they entered the Health Care System through a different door.