Earl and Rosemary in Cameroon

WARNING: this blog contains graphic medical images.

We are now down to the last few work days in Cameroon. This week we have divided our time between our home hospital St. Martin de Porres here in Njinikom and the Mbingo hospital. There is a team of hip surgeons that provide hip replacement surgery that arrive tomorrow evening and they are coming from Italy. The main operating rooms here have been closed for thorough cleaning for at least 3 days to prepare for their first day of surgery on Friday. We operated here today for the final time. We have a full day of surgery on Friday at Mbingo since we can’t work here. We have OPD Clinic here tomorrow and Saturday to followup our cases. Looking at the list of cases we have done here in Cameroon it is quite different from previous missions to other parts of the world. We saw only one patient with cleft lip and palate who was a tiny 1 month old with multiple congenital problems and too small to safely give general anesthesia. He will have to put on some weight and get bigger before surgery is an acceptable risk. Likely that will take several months. On most of our other trips about half of all our cases are cleft lip and palate and other congenital birth defects. There is a cleft surgery team that comes here in the Spring each year from Germany so they will probably be able to operate on this child. We have been busy with coverage of large chronic wounds primarily of the lower extremity but some involving other areas. These require skin grafting and that has been the commonest surgery. We also have operated on many patients with burn scar contractures usually a result of the patient having an epileptic seizure and falling into a cooking fire. This has happened to people of all ages. Most of these patients never had any initial skin grafting so they have incredibly severe contractures. Again these patients require skin grafting to obtain lasting results. The post operative care of skin grafts is much more time consuming and labor intensive to obtain a good percentage “take” of the grafts. I have been teaching grafting techniques to the staff at both hospitals and I am hopeful it will help them to have improved results when they graft these patients in the future. Another category of patients that we have seen often is those patients with keloid scars. Some of these are incredibly large and frequently they are painful and itch all the time. They also can become infected and drain. Some keloids are removable but the majority are not and can only be treated with injection of Kenalog a cortisone type medication. Many respond to a series of these injections but it again is a labor intensive treatment program and there are too few resources for physicians to treat very many of these patients. Healthcare manpower is very limited in Cameroon and many conditions don’t get adequate treatment until they are very advanced.

Well I will end this for now. More to follow as we finish up our work here for this visit.