Christmas Gift

While at the OPD this afternoon, there was a faint knock on the exam room door.  We opened it to find an old familiar face smiling at us.  It was Emmanuella who literally was our first patient when we arrived in 2010.  35 year old Emmanuella was in the hospital with HIV and Tuberculosis.  Her hospital course was complicated first by a blood clot in her leg and then a pulmonary embolus.  She nearly died only to recover and then sustain a worse insult.  She had a terrible stroke leaving her with complete paralysis of the right arm and leg and unable to speak.  Despite all these terrible things Emmanuella never lost her beautiful smile.  2 years ago at Christmas, we able to secure a wheelchair for her and she was able to go home for Christmas.

She eventually recovered enough to walk with the aid of a cane and can speak a few words.

Spending a few minutes with Emmanuella today was a wonderful Christmas gift for us.  Emmanuella’s determination and positive outlook is inspirational!

Merry Christmas!

Gertrude

Earlier this year Sister Xaveria made one of those good hires.  Gertrude joined the Pharmacy Staff after finishing a 3 year Pharmacy Technician course.  She always has a big smile on her face and is always helpful when called on.  The Dispensary is running better now with Gertrude and her assistant Agnes than when there were 3 people staffing it.

Gertrude grew up in Buea, the capital of the South West Province.  After attending Catholic primary and secondary schools she attended University and got her degree in Business Management.    Gertrude used her education and became a successful business woman working for several companies.  She traveled to a number of West African Countries representing the different companies she worked for.  I am sure Gertrude’s people skills enabled her to be a success in a field where not many women have traveled.

Gertrude always had an interest in Health care which prompted her to leave the business world and obtain her Pharmacy Technician Degree.  Njinikom is a much smaller community than she is used to living in but she is enjoying it here.  Gertrude main hobby is reading, particularly spiritual genre.  She is active in the hospital choir.  She is very proud of her 19 year old son who is following his mothers pursuit of education.  He is currently at University in Yaoundé working on his Masters Degree in Food Processing Engineering.

Gertrude will always be one of those valued people in any organization she is in a friend to all.

Bridget

32 year old Bridget arrived at the hospital last week complaining of fever, cough, diarrhea and weight loss.  She was extremely thin and weighed 99 pounds.  It was no surprise to us that her HIV test was positive as Bridget could have been this year’s poster child for Slim’s Disease.  She fortunately is getting better with antibiotics and her initial TB tests were negative.  It continues to amaze Terry and I how people endure their illnesses at home for such a long time before seeking medical care.

Shelma

In September 2011,  3 month old Shelma was admitted to the hospital with fever, cough and failure to thrive.  She was unfortunately diagnosed with HIV.  She showed no improvement despite a couple of antibiotic courses.  Without concrete evidence of Tuberculosis we began treatment for that and HIV.  I saw last saw her last December and while she had had still not gained any weight she no longer had fevers and was socially interactive.  Last week I was summoned to the HIV Treatment Unit.  One of the counselors asked me to look behind the door.  There sat Shelma on her mothers lap playing with her bottle of HIV medication.  She was talking and her mother proudly showed me how she was walking.  Our prayers to St Jude were surely answered in Shelma’s recovery.

Beltha

25 year old Beltha was diagnosed with HIV 2 months ago and was started on HIV medications.  She was doing well until she started developing severe headaches and fever last week.  She was admitted and a spinal tap revealed that she had Cryptococcal Meningitis.  Fortunately when Dr Laura was here last month she gave us nearly 3000 fluconazole tablets for our HIV patients.  This will literally save lives as most of our Crypto patients could not afford the medication once they left the hospital.

2 days later Beltha’s headache was no better and her vision was not clear.  This is caused from the pressure in her head affecting the vision area of the brain.  I did a spinal tap and released nearly 2 ounces of fluid which greatly helped her headache and completely restored her vision to normal.  She was even able to read the screen on her cell phone.  This morning Terry and I could tell her headache was back to full strength.  She tried to minimize it as I am sure she preferred not having another spinal tap.  It took little to convince her that another spinal tap was necessary and we took off another 2 ounces of spinal fluid after rounds.  She was still rather miserable when we finished at the hospital this afternoon but I am sure she will be better by tomorrow morning.

Sylvester

I was called last evening to evaluate a man who had been electrocuted.  39 year old Sylvester was working on a 240 volt electrical line that he thought was inactivated.  He wrapped his hand with a very thin plastic bag to protect himself from the current in case he was wrong about the circuit being live.  Unfortunately the circuit was very alive and the thin plastic did nothing to protect him.  He was thrown into the air and landed face down.  He was further unlucky that the wire remained in his hand and the current continued to travel thru his body until a passerby used a stick to dislodge the wire from his hand.

Sylvester had second and third degree burns the entire length of his right arm and then on his lower legs and feet where the current exited to the ground.  He was quite uncomfortable with his pain but was able to communicate well.  I was extremely concerned about Sylvester’s overnight prognosis.  To my pleasant surprise Sylvester was doing much better than expected today.  He was able to get up to go to the bathroom on his own.  His burns were cleansed and debrided today.  There was no sign of compartment syndrome in his arms or legs and his kidneys were working well.  Sylvester still has a long recovery road ahead of him but he is very lucky just to be on that road today.

Whittier Rerun

Dr. Laura and Germar rounding

Dr. Paula on ward

Last year Dr Laura Dooley from Whittier, California spent a month here in Njinikom.  Laura supervises the Tropical Medicine component of the Family Practice Residency Program at Presbyterian Intercommunity Hospital.  The experience was good for the 2 residents who accompanied her so Dr Laura is back, this time with Dr Paula.  They are managing all the inpatients on the medical wards.  This has freed Terry and I up to spend more time in the OPD.  It is always nice to have American colleague available to discuss the more difficult cases that we manage.

Dr Laura’s husband Mike has been busy helping with the never ending maintenance problems.  I am am especially happy that Mike was able to devise and install a snake guard for the front door of our house.

Lawretta

Last week 5 year old Lawretta was admitted to the hospital with a 3 day history of fever and headache.  She was in a semi-conscious state on admission and could only moan in obvious pain.  She was diagnosed with Cerebral Malaria with severe anemia.  After 2 days of IV malaria treatment and blood transfusions she showed no improvement.  The entire time her Grandmother remained at her side stroking her forehead trying to comfort her.  Cerebral Malaria kills 25% of its victims and those who recover usually are slow to show improvement.  Terry and I were pleased to see Lawretta was resting comfortably Monday morning when we started rounds.  We were further delighted to hear that Lawretta had woken up earlier in the morning and asked for food.  Over the last 3 days Lawretta has made a miraculous recovery.  Her Grandmother was all smiles today as Lawretta was discharged home.

Father O’Brien

Njinikom lies at the base of Mount Boyo.  The next closest parish to St Anthony’s Parish in Njinikom is Funantui, a hours walk away, on the back side of Mount Boyo.   82 year old Father Rory O’Brien is the Pastor at Funantui.  He hails from Tullamore, County Offaly, Ireland.  He was ordained to the Priesthood in 1955 as a member of Saint Patrick’s Missionary Society.  He was immediately sent to Nigeria were he remained until 1988.  He was then transferred to Funantui where he has resided since.
 
Terry and I have had the pleasure of seeing Father O’Brien during our stay here.  His big smile and Irish Brogue brighten those days when our paths cross.  With an associate Pastor, Father O’Brien administers to 15,000 Catholics in the area with 10 out-stations in addition to the main Parish.  He stays very busy visiting the sick in the Parish.  Reading is his main passion when his duties allow him the time.
 
When he first came to Africa in 1955 he was able to get home every 4 years to see his family.  Through the years those visits became closer together until his yearly visits home are now the norm.  He finds his work “encouraging and very fulfilling.”  He said if was not he would have retired back to Ireland many years ago.

Elvis

16 year old Elvis was brought to the hospital 2 weeks ago by his family critically ill.  He developed high fever 3 days earlier and he rapidly deteriorated.  He was taken to a local health clinic when he became disoriented and agitated.  He was treated for Malaria but showed no improvement overnight so his family transferred him to us.  Elvis arrived in an agitated state, crying, grasping his head and writhing in pain with a stiff neck.  A spinal tap confirmed that he had bacterial meningitis.  Antibiotics were started and he required a good deal of medication to keep him sedated.

Each morning Elvis’ mother was at his bedside stating that he was better.  Indeed Elvis showed slow but steady improvement.  He became less restless, then began to talk and finally walk.  After finishing 10 days of IV antibiotics we observed him another 2 days before discharging home to his mother’s care.  The entire medical staff shared in the joy of watching his good recovery and his discharge home.

Msgr. Anthony Brouwers

Monsignor Anthony Brouwers, the Director of the Propagation of the Faith in Los Angeles, visited Africa to attend the Marian Conference in 1954.  Remaining and traveling throughout Africa to meet the priests, sisters and local bishops, Msgr. Brouwers wanted to learn how the people of the Archdiocese of Los Angeles could offer assistance. He expected requests for funds, but he also heard repeatedly “We need help!”.  Bishops asked for faith-filled individuals willing and able to provide training and leadership in schools and hospitals throughout the continent. Responding to this need, Msgr. Brouwers founded Lay Mission-Helpers Association in 1955, and Mission Doctors Association in 1959.


September 5th would have Mgrs. Brouwers 100th Birthday.  Not only was his birthdate celebrated in Los Angeles but also here in Njinikom.  During the last 6  months a new TB/Special Care Unit has been under construction.  The majority of the funding for this badly needed unit has come through donors associated with Mission Doctors.  Mother Antonia has also played a big role and spear headed the effort to have the Unit named after Msgr. Brouwers.  The celebration here on Wednesday served to remember Msgr. Brouwers and also to dedicate and bless the new Special Care Unit.  Mass was concelebrated by 4 Missionary Priests and the entire medical staff was in attendance, even those working the evening and night shifts.  Father Arnold, a Mill Hill Missionary Priest from Holland gave an inspiring homily about the history of the Catholic Missions in Cameroon and tied Mgrs. Brouwers contribution in nicely.  Mass was followed by an individual blessing of every patient in the Hospital and then a blessing of the new structure.  Terry and I were very proud to represent Mission Doctors Association at this very special event.

Yannick

20 year Yannick arrived at the hospital 10 days ago seriously ill.  Over the prior 2 days he had developed high fever and become delirious.  He was taken to a local Health Center and was treated for Malaria and Typhoid.  After showing no improvement overnight he was transferred to our hospital.  Yannick was unable to speak and could not raise up from his bed.  Laboratory studies showed he had Hepatitis B in addition to Cerebral Malaria and Typhoid.  Equally concerning was that his WBC count was 110,000.  We had grave concerns he may have Leukemia. 2 days into his admission his blood pressure dropped with his abdomen becoming rigid, indicating a possible bowel perforation from his Typhoid.  Dr Crystal Cunningham consulted on Yannick but he was too unstable to tolerate surgery.  Yannick’s antibiotics were changed and over the next 2 days his abdominal tenderness resolved.  Through all this Yannick’s mother remained at his bedside with an optimistic outlook.

Yannick’s mental status began to improve and over the next 5 days he rapidly regained much of his mobility and strength.  Yannick’s WBC also gradually dropped to a normal range erasing the concerns about Leukemia.  Today was a wonderful day as his smiling mother was able to take Yannick home.  She will continue to provide the loving care that got Yannick through this serious illness.

Another World

Terry and I have been back in Njinikom for 10 days and are well into our second work week.  It was wonderful to spend time with family and friends while we were home.  

It took very little time seeing patients to remind us of the hardships of poverty and illness that so many people endure here.  The devastation that HIV leaves in its wake is all too evident in the lives of our patients.  Despite this we are enjoying being back among happy and polite people.  We frequently have little to offer some patients yet they are always thankful for our efforts.  

We have also been reminded how difficult it would be here without the financial help of our supporters through Mission Doctors Association.  We have already provided many medical tests, medications and surgical fees for patients that could not afford them and would have gone without.  Thank you!

Holidays

Terry and I are completing our second year in Njinikom.  One of the best things about our experience to date has been our relationship with the Franciscan Sisters.  We truly treasure the sense of community we share with them as we work together trying to meet the needs of the poor and sick.  At the same time it reminds us what we miss the most.  Our family, friends and community at home.  Having internet in our home has allowed us to keep in regular contact with everyone back home.  We often remark how difficult it must have been for the Mission Doctors and their families who have served the prior 50 years before the advent of electronic communication.
 
It is time for Terry and I to recharge our batteries.  We will be home for the month of July on Holiday.  It will be wonderful to meet our new grandson, Andrew, and see the rest of our family.  This will be my last blog posting until late August.  Thank you for following our adventure and the support you have provided us.
 

Theresia

40 year old Theresia from Elemighong did arrive at our hospital last week.  Dr Jim Unger saw her and ultrasound showed multiple fibroids in her extremely enlarged uterus.  Theresia had successful surgery with removal of her bowling ball sized uterus.  Theresia is doing very well and will be able to go home later this week.
 
Theresia’s surgery turned out to be a family affair for the Unger family.  Dr Jim was assisted by his daughter Marcia who recently finished her 2nd year of medical school at LSU.  Rose, Jim’s wife, was the circulating nurse during the operation.
 

Theresia

The Unger Family

Godlove

I saw 40 year old Godlove 2 weeks ago with a marked tremor, flat facies, difficulty rising from a chair and trouble initiating and stopping his gait.  It appeared he had Parkinson’s Disease despite his relative young age.  I started him on Sinnemet and Godlove came back yesterday with a huge smile on his face.  He initially sat down on the chair and immediately bolted to his feet with an even bigger smile.  He started bouncing around the room like a boxer warming up in the ring before a fight.  He was so excited about the improvement he had experienced from the medication he had to demonstrate his improved mobility.  Fortunately, a Pharmacist from Holland had just sent us the Sinnemet.  It was the first time we have had the medication in the 2 years that I have been here.

It was a real joy to share in Godlove’s Miracle. 

Elemighong

The Tertiary Sisters of St Frances operate 6 hospitals in Cameroon and another 30 Health Centers.  The Sisters have decided to provide more support from their Hospitals to nearby Health Centers which are staffed by nurses only.  Today, I traveled to Elemighong Health Center, about 15 miles from Njinikom further up in the mountains.  The clinic is staffed by 2 nurses who provide 24/7 coverage.  They have a 6 bed medical ward and a maternity ward where they average 7 deliveries a month.  The nurses themselves provide a few basic laboratory tests.  They had not had a Doctor visit their clinic in years.  I accompanied Sister Philippe today who conducts regular Prenatal and Vaccination Clinics in Elemighong.

While Sister Philippe saw 16 women in Prenatal Clinic I did medical consultations on a dozen patients.  I saw a 40 year old lady with a bowling ball sized pelvic tumor.  She had consulted 2 years ago about the tumor but had no money for the tests that were ordered so she never followed up.  She agreed to come to the Hospital Monday where Dr Jim Unger will see her and with donor money her needed surgery will be done.  I can not help but think it was Divine Intervention that had me in Elemighong today to arrange for this lady’s care.

Innocence

39 year old Innocence came into the OPD on Monday complaining of abdominal and leg swelling of a month’s duration.  Examination revealed multiple hard nodules throughout his abdomen, enlarged lymph nodes everywhere and extremely swollen legs.  I explained to Innocence that he likely had widespread cancer but biopsy was needed to confirm this.  I referred him to nearby Mbingo Hospital for the biopsy but he was very hesitant to go because of the anticipated cost.  Still with a smile on his face he told me “this will be my HIV.”  Since he had recently had a negative HIV test I asked him what he meant.  He replied “surely this will kill me the same as HIV would”.  Like many of our patients with cancer or cardiac problems, he will likely not go for further care as he financially is unable to afford it.  Accepting that we can not do everything for every patient here can be difficult at times.  I have to trust that God has me here to help where I can with the resources available.

Jim and Rose

Dr Jim Unger and his wife Rose are our first repeat short-term Mission Doctor couple.  Jim is an OB-GYN from Shreveport, Louisiana and he and Rose were here last April.  They made an even bigger commitment this year returning for 3 months.  They spent April at Padre Pio Hospital in Douala covering for the OB-GYN while he took his yearly holiday.  Padre Pio is a very busy hospital serving the people in the poorest area of Douala which is home to 5 million people.  They average 300 deliveries per month at Padre Pio which kept Jim extremely busy.  He did 8 Caesarian sections in a single 24 hour period.

Rose and Jim at work

Jim and Rose were happy to leave a hot and humid Douala in May and return to Njinikon in the mountains of the NW Province.  Their presence has allowed Dr Dabo (OB-GYN) to take his first holiday in 2 years.  Rose is a trained surgical nurse so she has been working as Jim’s Nurse.  She is enjoying her time back in the OR after being away from it for many years, 
 raising their 3 daughters.  Terry and I have enjoyed renewing our friendship with Jim and Rose.  We have had some spirited card games with them many evenings.
 
Terry left for her holiday last weekend.  She was anxious to meet our new grandson Andrew back in Washington state.  I will be joining her in a month’s time and until then Rose will watching over the 2 remaining Dr Jims.  It will be nice to have them here for the up coming month.  Their daughter Marcia is finishing her 2nd year of medical school at LSU and will be here for 2 weeks in mid June.  We are all looking forward to her arrival.

Miracle

Christina is an 84 year old lady who was brought to the hospital last week by her daughter.  She reported that her mother had been falling frequently the prior 10 days.  The evening before admission she collapsed and was not arousable.  Christina had suffered a stroke and had already developed large pressure sores on her buttocks.  Her family was informed that her prognosis was poor but we would provide supportive care.  After 2 days Christina began to wake up but was very confused and weak.  The last 2 days she gradually had less confusion.  This morning I was pleasantly surprised to find Christina sitting in a chair while the nurses were changing her bed linens.  She asked her Granddaughter to greet me for her as she did not speak English.  I am sure many prayers had been offered for Christina’s recovery by her family and friends the last week.  I am humbled to have witnessed her Miraculous recovery.

Petra

 Petra is the Charge(Head) Nurse on the Medical Ward.  If there was Head of Nursing in the Hospital Petra would surely be that person.  She runs a tight ship yet has cultivated a team spirit among the staff.  She is well respected by everyone.
 
Petra was born and raised in Njinikom.  After completing secondary school she went to Bamenda for her Nursing Diploma.  Since 2003 she has been working at St Martin de Porres Hospital.  She married her husband Nestor in 2004.  Nestor also is a nurse at the Hospital.  Since last August Nestor has been enrolled in a 1 year Physician Assistant program at near by Mbingo Hospital.  He completes his studies this summer and then will return to work here.  Petra and Nestor have 4 children.  They are the most well behaved children I have ever seen in Church.  I think Petra runs a tight ship at their home also.
 
Despite all her duties as a Charge Nurse, wife and mother Petra finds time do hairdressing and embroidery.  She also is involved in native dancing at the various hospital and community functions.
 
Petra would like to return to school in the future to pursue certification in Pediatric or Public Health Nursing.  She would utilize those skills here in Njinikom.  Petra will continue to be a model employee at the hospital for many years to come.

Eucharia

Eucharia is a 45 year old lady I have seen on numerous occasions the last year.  She has an engaging smile and a unassuming attitude.  Childhood Rheumatic Fever damaged her heart valves.  As her valves worsened with age, she developed Congestive Heart Failure which caused her to be admitted to the hospital several times the last year.  She was referred to the Cardiac Center in Shisong, one of the few hospitals in Sub-Saharan Africa offering cardiac surgery.  Unfortunately the $7000 price tag for the recommended surgery to repair her heart valves was not feasible for her family.  She was having difficulty paying for her daily medications so she would skip her medications some days trying trying to make them last longer.  This strategy only worsened her condition.  Last month I was able to use Donor money to purchase her medications.  Despite her medications, her heart continued to worsen and she was admitted last week again.  Her weakened heart could not pump her blood well enough and fluid backed up in her lungs, abdomen and legs.  I drained fluid from her chest and abdomen trying to give her lungs more room to expand.  Despite our efforts and her strong will to live, her heart finally gave out yesterday morning.  Keep Eucharia and her family in your prayers this week.

Lucy

22 year old Lucy has been working at the Hospital for 1 year.  She registers patients in the OPD and interprets for me whenever the need arises.  She is one of those truly valuable employees who will do whatever is needed of her and with a smile on her face.  Lucy’s sister works in Maternity and her brother-in-law Emanuel is one of the Hospital drivers.
 
Lucy grew up in Njinikom close to the Hospital compound.  She attended school here and has passed her A(advanced) level which would be equivalent to high school at home.  She plans to resume her studies in the future and complete a 3 year Diploma Nurse course.  She like most Cameroonians has never ventured further than a few hours away from her birthplace.
 
Music and Dance are her main hobbies.  She sings with the Hospital Choir and is involved with a Traditional Dance group.  Where ever there is a group of younger people gathered at the hospital, Lucy will usually be in their midst.

Jones

Jones

Beruda is a local NGO that runs a program to assist orphans in Belo, a community 10 miles away.  Most of the children in the program have lost both parents to HIV.  They live with relatives, most often the grandmother.  The social workers bring them to our clinic for an annual physical and HIV testing.  Yesterday I saw 10 of the Beruda kids, the usual van load.  10 year old Jones stood out from the other children.  He was very polite and was wearing his school uniform.  He told me he was in Form 2 which was the appropriate form for his age which surprised me since his situation could have caused him to be behind in school.  The Social Worker confirmed that he was doing very well in school.  I asked Jones what he wanted to do when he finished school.  Without hesitation he told me “I want to be a Doctor”.  Many obstacles lie between Jones and his dream, may we all keep Jones and his fellow orphans in our prayers.  One hurdle was cleared yesterday, his HIV test was negative!

Celeste

3 weeks ago, 30 year old Celeste was admitted to the hospital with marked confusion.  She was diagnosed with HIV which made us suspicious she had either Cryptococcal Meningitis or Toxoplasmosis causing her confusion.  Her spinal tap and Toxo test were negative so we provided supportive care and she gradually improved.  She returned today for follow-up and was doing reasonably well although she preferred to let her husband talk for her.  She will begin her HIV medication today and we will recheck her in 2 weeks.  Her husband has been very supportive and will make sure that she takes her medication daily.

IRIS

The HIV virus attacks the immune system of it’s host.  The longer the patient has HIV the more difficult it becomes to recognize other infections the patient gets and then successfully eradicate them.  After the patient is started on HIV medications his/her immune system becomes stronger and suddenly realizes there are other infections present and begins to attack them.  Patients may develop fevers, cough, sweats and other symptoms depending on which infections are present and where.  IRIS, Immune Reconstitution Inflammatory Syndrome, is what we call this when the Immune System awakens and responds.  Tuberculosis and Toxoplasmosis are 2 infections that frequently become evident with IRIS.
 
Brunhilda is a 33 year old patient who was started on HIV medications 3 weeks ago.  After 10 days of medication she developed pneumonia with high fever, headache, cough and night sweats.  She has IRIS and is currently being evaluated for Tuberculosis as the cause of her pneumonia.  Despite treatment she continues to experience high fevers further increasing our suspicion of TB.  

Brunhilda’s Fever chart, 37.0 centigrade normal

Levi

12 year old Levi was brought to the hospital Monday by his mother after finding him unresponsive.  He had been fine before going to bed.  We did a spinal tap in OPD as we admitted him.  Tests revealed he had Cerebral Malaria.  Sometimes coma is the initial symptom with Cerebral Malaria.  Even though he showed little improvement and was having seizures after 48 hours of treatment, I was cautiously optimistic since treatment was begun early in his illness.  Over the last 3 days Levi woke up, began eating and was able to walk around the hospital compound yesterday.  Levi’s mother had a huge smile on her face this morning when she was told he could go home to finish his malaria treatment.

Levi on admission

Levi 5 days later

Fellicitas

Last week 34 year old Fellicitas was admitted to the hospital.  She had not been seen since last July but had continued to send a family member monthly to pick up her HIV medications.  It turned out she had gained nearly 100 pounds the last year from fluid retention in her abdomen and legs.  She literally was unable to walk.  Testing revealed she has Cirrhosis of the liver from  Hepatitis B and her HIV medications were ineffective with a low CD4 count.
 
Last week I drained 10 liters of fluid from her abdomen and with diuretics we were able to further reduce her swelling so she is finally able to walk again.  She was able to go home today weighing 53 pounds less than she was 8 days ago.  It was wonderful to see the smile on her face each day as her weight dropped.  With new HIV medications I am cautiously optimistic that Fellicitas will continue to improve and regain a functional life.  Keep her in your prayers.

Dr. Rick

Dr Rick Hourigan is a Family Doctor from Moses Lake, Washington.  Rick and I were partners in the same Family Medicine Clinic and our offices were adjacent to each other for 10 years.  We have enjoyed practicing together.  After our short term mission to Zimbabwe in 2007, Rick suggested I do a long term mission so he would then be able to come and do his own short term mission where he would already know someone.  When Terry and I decided to come to Cameroon long-term, I informed Rick he was now obligated to come and we are again working together, now on the other side of the the world from our old hallway.

Rick planned his trip to be here while Dr Eugene was on Holiday, helping me with the increased work-load.  Timing is everything and it was fortuitous to have Rick here as last week I had my first major illness since being here in Cameroon.  With little preparation from me, Rick was able to step in and do a great job managing the Medical Wards.  The degree of illness of the patients the last 2 weeks has been unusually high allowing Rick to see many things he had never planned on seeing during his medical career.  It has been very enjoyable to have a friend and colleague to work with.  We have 2 more weeks before home beacons Rick.

Twins

Too many years ago in Medical school we learned that (in the pre-fertility treatment years) that twins occurred in one out of 88 births in the USA.  We are still in the pre-fertility treatment era in Cameroon yet based on my personal experience here the twin rate must be one out of 10 deliveries.  It is not unusual to have multiple sets of twins on the maternity ward on any given day.  Today 2 of the 7 children on the PED’S Ward are twins.

It begs the question why and I can only assume that it is genetics at work.  With a high infant and child mortality rate the chance of a single twin surviving has increased the likely hood of more twins in each succeeding generation.  Whatever the reason, it makes for a lot of smiling faces around the hospital.

Terry admiring Twins

Twins, why do you ask?

Anita

Anita is a 10 year old girl who had open heart surgery last June at the Shisong Cardiac Center.  She has been doing very well and had a routine check at Shisong 1 week ago.  Her Cardiologist restarted some medications that she had taken prior to her surgery.  By the next day she was extremely lethargic with some fever.  She was admitted and all her blood tests were normal and the new medications were stopped.  Over the weekend she woke a little bit but was still extremely weak and could not sit or stand.  Her affect was very strange with inappropriate laughing.  Tuesday with her eyes more open I could appreciate that her eyes were not tracking appropriately.  I did a spinal tap which was all normal except some yeast cells were seen on gram stain of the fluid.  I asked for another test and her India Ink smear showed Cryptococcal Meningitis.  This is almost always seen in HIV patients but Anita’s HIV test is negative.  After only 1 day of treatment she was much improved and is able to sit and talk.  We hope she will continue to improvement daily.  Keep her in your prayers.

Gerald

Gerald is a new but smiling face here at St Martin de Porres Hospital.  He grew up in Ashing which is 8 miles from Njinikom.  After Secondary school he spent 3 years in Bamenda obtaining his Nursing Diploma.  He the worked at a small health center for 1 year before spending 1 year in the capital, Yaoundé, finishing his Nursing Degree.
 
He began working in the Surgical Ward last October.  Last month he was promoted to a compound nurse.  The compound nurses fulfill the role of ER physicians here.  They see any patient who arrives at the hospital between 2 PM and 8 AM.  They also see any inpatient having problems.  They then call the on-call physician for any serious problems.  Gerald has exhibited very good skills in the short time he has been a compound nurse.
 
Gerald is 26 years old and is single.  Reading is his hobby and he particularly likes to read Health related books in order to be “current”.  He has never traveled outside of Cameroon.
 
His goal is to be a Surgical Nurse.  He equally enjoys working on the surgical ward or in the theatre.  With his pleasant personality and dedication I have full confidence Gerald will be an excellent Surgical Nurse.

For we are God’s helpers

 At completion of the MDA and LMH Formation Program all participants are presented with a ring with the inscription “for we are God’s helpers”.  Terry and I have been proudly wearing our rings for nearly 2 years now.
 
I previously have written about Julius.  He is 16 years old and has Juvenile Rheumatoid Arthritis.  Julius developed multiple open sores of both legs and spent 3 years at St Martin de Porres Hospital suffering through very painful daily dressing changes.  Over the last year I consulted several Doctors in the USA and was able to diagnose his leg problem as Pyoderma Gangrenosum.  Using donor funds to MDA I was able to get medication from the USA and his leg wounds dramatically improved and he was finally able to be discharged home in November.  At a recent follow up visit I found out that Julius(who is non-mobile from his JRA) spends most of his day sitting on his bed alone while his mother sells vegetables in town.
 
With the help of Carol Clementi(a Mercy Associate who is here this month helping children in the orphanage and hospital) we set out for Bamenda last Saturday in search of a wheelchair for Julius.  Through a variety of circumstances we ended up at a small used tire shop looking for a spare tire for the hospital pickup.  We were left to wait in the truck while our driver and a mechanic went in search of the elusive tire.  Suddenly a wheelchair was rolled out of the tire shop soon followed by a second wheelchair.  Both chairs were in very good condition and we were able to secure both of them for a very decent price again using donor funds.  After cleaning the chairs up and getting a seat cushion made this week today was chosen as the day to deliver the wheelchair.
 
With the help of one the hospital nurses and driver we made our way on a steep and winding dirt path in the hospital 4 wheel drive truck.  The road finally ended at a narrow bridge and we pushed the wheelchair up an even steeper hill for another half mile until reaching the compound were Julius is staying now with his uncle.
 
While doing mission work people say they receive more than they give.  Today was an example of that as we were able to witness the joy Julius exhibited after receiving his wheelchair.  After bringing him outside he was like a little child with a new tricycle wheeling himself back and forth across the packed dirt of the compound area.  He stated that this was the “best day of his life”.  Thank you to all of you that enabled us to be with Julius today.  A small amount of donated money dramatically changed Julius’ life today.

Julius on his bed where he spent most of his day

Julius and Carol in the Sun

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What goes Around, Comes Around

Dr Jim and Suzanne

Recently a young lady named Suzanne approached me as I was walking between Hospital Wards.  She explained that she had delivered 10 days earlier but still owed approximately $40 for her hospital bill.  She asked if I could intercede on her behalf as her mother was gravely ill at home.  She was not requesting that I pay her bill but only that I would plead her case to the Matron so she could go home and return to pay her bill when she had the money.  Using money from our Donors I paid her bill so she could go home to attend her mother.
 
This week Suzanne returned to the Hospital with $40 in hand to settle her bill.  I thanked her for her effort to repay the money but refused to take anything from her.  Instead I asked her to help someone else when they were in need.  I hope that $40 will continue to be passed on for some time.  Thank you Donors for all you allow me to do here.

Lillian

Lillian is one of the people I always enjoy seeing at the hospital because she is always wearing an ear to ear smile.  She worked at Project Hope since 2006 and plays a big role in managing  over 1000 HIV patients.  She is involved in enrolling new HIV patients, counseling HIV patients and their families, administering their medications monthly and monitoring all aspects of their treatment.  She also assists in management of our TB patients.  She enjoys all aspects of her job.
 
Lillian was born and raised in Bamenda where her parents still reside.  She is a member of the Bafut Tribe and has 5 siblings, all boys, making her the princess of her family.  After finishing our equivalency of high school she completed a 2 year Professional Course in Social Work and earned her Diploma.
 
Her Hobbies include watching movies and football, listening to music and reading.  She recently joined the hospital choir and is enjoying the camaraderie with other staff members.  She has never traveled Outside of Cameroon.  Some day she would liken to further her studies in the area of Gender Studies.
 
Lillian was one of three people named “Outstanding Employee of 2011” at the hospital.

Lillian counseling a HIV patient and family 

Emceeing Hospital Feast Day Program

Samuel

I wrote about Samuel in November.  He was admitted then with HIV and Toxoplasmosis Encephalitis.  He was extremely confused at that time and after 1 week of treatment he mentally cleared and we got to know Sam as a delightful man always with a smile on his face.  He was able to go home and complete his 6 weeks of Toxoplasmosis treatment.  I had planned to start him on HIV medications last month but due to the absence of government supplied medications that did not happen.  Samuel was readmitted on Monday confused again, along with fever and cough.  His tests showed that he now has Tuberculosis and Cryptococcal Meningitis.  Samuel obviously has tremendous inner strength as after only 2 days of medication he is doing much better and the smile has returned to his face.  If medications become available he will be started on HIV drugs in 2 weeks.  Pray for Samuel and all the other patients in need of medications that the supply lines will open.

Cousins

Last Friday 2 ladies brought in 1 year old Yvette and 7 year old Kelly Bright.  The girls are cousins, both are being raised by Aunts as both mothers died from HIV.

Kelly Bright is the size of a 3 year old instead of that of a seven year old.  Despite eating well she has not grown much and her hair was typical of children with malnutrition.  Her brother is already on medication for HIV so it was no surprise that she is also HIV positive.  Her CD4 is 699 which is much higher than what I would have expected.  Because of her growth retardation we will begin HIV medications and pray that she will thrive.

Yvette was as malnourished as any child I have seen in the 19 months that I have been in Cameroon.  She was eating very little accounting for her physical appearance.  Surprisingly her HIV test was negative.  I ordered a repeat test for today but unfortunately Yvette passed away during the night.  A few days of tube feedings was not enough to stop her steady decline.

Pray for Yvette and Kelly Bright, their deceased mothers, and their extended family who have been caring for them.

Yvette

Kelly Bright

Traditional Healer

Aloysius

Aloysius came in for a refill of his HIV medication today.  As I obtained his history I discovered he was a Traditional Healer.  He agreed to a personal interview for the blog.  He is 56 years old and has been married 4 times.  One wife died, one left and two remain at home with him.  He admitted neither of his remaining wives has been tested for HIV but he promised to bring them in with him next month.  His father was also a Traditional Healer and Aloysius began on the job training with his father when he was 12 years old.
 
The 2 ailments he sees most often in his patients are “belly bite” and infertility.  He is most interested in patients with “belly bite” or insomnia.  I inquired if many patients come to him for Malaria.  He replied that many came but the malady is not one he likes because it requires “much time to fix”.  He boils a concoction of herbs for his malaria treatment.  His fee for a consultation is one chicken and a ounce of castor oil.
 
Aloysius has not traveled outside of Cameroon and his hobby is working on his farm.  Most farms here are what we would consider large gardens at home.