Earl and Rosemary in Cameroon

We have had an eventful week of surgery and Outpaitent Clinic.  Our usual start of each day is to awaken at 5:30-5:45 and begin to get ready.  We make coffee and tea and then have a breakfast of toast and a piece of fruit or sometimes we have scrambled eggs.  We have not seen anything like breakfast cereal or oatmeal. The coffee is grown here in Cameroon and there are 2 varieties of coffee trees.  The Robusta is from the lower elevations and is regarded as the less desirable.  Arabica is grown in the highlands and we are in the highlands so we have the Arabica.  It is very delicious and I like it with my breakfast almost every day.  If it is a surgery day we are in the OR Theater by 7:30 and our first case usually starts by 8 AM.  Prayers are said when the patient arrives in the Reception area for surgery  each AM.  The staff of the hospital usually has prayer service for  themselves and for patients who are ambulatory from 7 AM- 7:20 or so.  If it is not a surgery day for us then we have OPD Clinic that starts about 8:30.  Before that or during the morning we make patient rounds and do dressing changes or wound checks on our patients.  There are at least 5 different wards where our patients are residing.  The entire St. Martin de Porres Hospital here in Njinikom is a series of mostly one story buildings except for the main building that houses OB/Gyn and Pediatrics. quite a few of our patients are of pediatric age but they are staying in the surgical male and female wards with adult patients.  Usually a family member sleeps on the floor beside the patient and is there also to cook the food for the patient as well as do their laundry.

Many of the things we take for granted in US hospitals are either lacking totally or sporadically available.  Sutures and dressing supplies including elastic wraps  are very scarce . We brought 4 large trunks of sutures and dressing supplies, staplers, drains and supplies for anesthesia with us.  If we had not brought them we would not have them.  We also were asked to bring suture for general and orthopedic surgeons to use.  The general anesthesia agent of choice here is Halothane which is also used in many parts of the developing world because it is the least expensive agent available. That agent has not been in common use in the States for 15 or more years.  Our USA hospitals are a dream for the waste disposal people as very little of our supplies are reused.  Here and in other similar countries nothing is thrown away until it doesn’t work anymore. We could learn something from these people about repackaging and reusing items whenever possible.  Most hospitals in developing countries, including here, rely heavily on donations from abroad and from those supplied by volunteers who come to work in the hospital.

Patients here are truly patient and wait for their care often for hours.  There is about one MD for every 50,000 people.  This means auxiliary healthcare personnel are numerous and have more responsibility than in the US.  Often the care a primary care MD would provide is given by a Nurse or medical assistant.  Sadly many well trained MDs including surgeons who are native to Africa seek better conditions and much better salaries working in the Middle East, Europe or the USA.  It takes a really committed physician to stay in their home country or another African nation and work with their people. Most of these individuals who do stay have a very strong religious faith that keeps them committed to their people.

I better sign off now and rest for tomorrow.  Keep us in your prayers.

Man with neck mass excised-1 week post op

Keloid scars from very minor trauma like insect bite or scratch are common
problem