Contagious

 Smiling Germar with fading measles rash

 I had reported a couple of weeks ago that we had a family in the hospital that had the measles.  We put then in a ward by themselves because measles is highly contagious.  

Last week my nurse Germar became ill.  She initially had fever and headache so Dr Eugene treated her for malaria.  When she then complained of sore throat and cough I added an antibiotic.  She did not improve and her cough worsened so Dr Eugene sent her home for 5 days of rest.  

She came back today looking better but she reported that she broke out with measles shortly after going home on Saturday.  A good example to us all on the contagious nature of this illness.

Crystal

Crystal and Staff praying before starting surgery

Crystal Cunningham arrived in Njinikom Thursday for a 3 month mission.  Crystal recently completed her Surgical Residency in Pennsylvania and took her written Surgery Boards a few days before her departure.  

Despite the usual jet lag Crystal began working the next day.  Saturday I helped her with a difficult case.  We spent 5 hours in the OR with a lady with multiple adhesions and a sigmoid volvulus.  The lady is still very ill but stable.  Keep Josephine in your prayers the next few days.

Baby David

Mom and Baby David

Baby David arrived at the hospital nearly 2 weeks ago at 2 weeks of age.  He weighed 2.2 kg at birth and had not been nursing well for a day.  His weight was 1.8 kg and he was lethargic and dehydrated.  He was given IV antibiotics and fluids along with breast milk by NG tube.  He was not looking very good the first 2 days then gradualy showed signs of improvement.  He is now nursing again and gaining weight.  He will likely be able to go home next week.   The Maternity Staff is all feeling good about Baby David as most of the infants who come in ill have been sick too long for therapy to be effective.

Following Up

Mom, Melanie and Arnold

We have over 1000 patients who are receiving their HIV care at St Martin de Porres Hospital.  I record a social history on their medical book and encourage patients to get their children and spouses checked for HIV if they have not done so.  Unfortunately, I frequently find that the testing is not done.
 
Hilda is a young mother who recently was found to have HIV.  I had given her my usual recommendation to bring her children in for testing.  Hilda arrived today to begin her HIV medication and her her 6 year old twins in tow to be tested.  I shook her hand telling her she was a good mom to bring them in.  Her response was “I can not let my family crumble”.  A universal response that most mothers have.  To everyone’s delight Arnold and Melanie both tested negative.

Sister Renata

Sister Renata and Bishop George

Sr. Renata is a nurse who has worked on the medical wards since I arrived last year.  With her ever present smile and sense of humor Terry and I have grown very fond of her.  I was most fortunate to attend her Profession of Final Vows in the Kumbo Cathedral yesterday.  Over 200 Sisters from all over Cameroon attended, it was a full house.  I was seated with the Choir which put me in a great position to take pictures and also enjoy the wonderful music.  It was a 4.5 hour celebration which flew by.  I was able to meet Bishop George who has been a friend of Mission Doctors and Lay Mission Helpers for many years.

It was wonderful to experience the joy exhibited by all the Sisters as 7 new women joined their ranks.  They have a beautiful sense of community and they made my stay in Kumbo/Shisong memorable.

Sister being welcomed to the Family

Measles

Last week Tim and I were called to see a Mom and daughter who were admitted with measles.  After having seen a variety of rashes called measles the last year, I was skeptical that we were actually headed to see actual measles.  A younger child at home had a rash a few days earlier then Roseline developed fever, cough, runny nose and red eyes followed by a rash.  Mom developed fever 2 days later and both were very sick with high fevers.  The nurse was right, they had the measles, something I had seen at home only one time in my 30 years of practice.  They do vaccinate children here for measles but the percent of children getting vaccinated here is not high.

Roseline ready for home

 Roseline recovered quickly while here mother was finally free of fever today.  A 8 month old sibling also developed a full blown case of measles.  Since he was already sleeping in mom's bed we treated him as an outpatient and he too was much better today.  I would have preferred to keep Evelyn in the hospital one more day but the family opted to go home today.  Dad promised to pick up the workload and let mom rest until she felt better but I suspect she will take up the household tasks immediately.

Blackwater Fever

Ibrahim is a 6 year old boy who presented to the hospital 2 days ago.  He had experienced 3 days of fever, abdominal pain and headache.  He also had not had any urine output the prior 24 hours before admission.  His labs revealed he was extremely anemic and his malaria smear was positive.  A catheter was placed  revealing very dark urine.  This confirmed our suspicion that he has Blackwater fever, an old term to describe a complication of severe malaria.  The severe destruction of red cells in the blood results in the kidneys shutting down.  Yesterday we gave Ibrahim a blood transfusion, IV fluids and a diuretic.
 
As Tim and I walked into the Peds ward this morning Ibrahim’s eyes were wide open to our delight.  As we walked further into the ward we could see that his urine bag was nearly full telling us that his kidneys were working.  We could not help but thanking God for the small miracle that happened overnight.  He suffered a seizure this morning which is not uncommon with Malaria.  Overall he is much better this evening and we are optimistic he will be better tomorrow morning.  

Keep Ibrahim in your prayers.

Relindis

Mom and Relindis

Relindis is a 20 year old university student who was admitted 2 weeks ago.  She had started on HIV medications 6 weeks earlier and developed increasing headache and double vision over the preceding week.  She had increased pressure in her head causing her symptoms.  Her condition may be from her immune system waking up and responding to infection or worse could be from a brain tumor or malignancy.  At home she would have had an immediate head CT or MRI.  Here we were able to treat for possible meningitis and give her steroids for the swelling.
 
Over the 2 weeks Relindis gradually improved.  As her headache cleared and her vision cleared she was able to communicate better.  She is a very delightful and articulate young lady.  Her mother was equally delightful.  It was a joy to see them both smiling as she was discharged today.

Friendly Place

I arrived back here in Njinikom one week ago.  I have recovered from my jet lag quicker than on any previous trip.  The thing that has struck me this week is how friendly people are here.  I have been welcomed back by everyone and they all have asked how my family was and were quite sincere in wanting to know.  

I miss everyone back at home but have a comfortable feeling working and living with the Cameroonian people.  They really seem to value relationships more than material things.  I hope I can become more Cameroonian in the next 2 years.