Earl and Rosemary in Cameroon

We had 2 overcast days without rain this week and then the rain returned for the weekend.  It rained all yesterday afternoon and all through the night. Unless there is loud thunder it is nice to have the sound of rain on the roof during the night.  The dry season which really starts in November is said to begin like the past week with some dry days and a little rain.  We aren’t there yet.  I did some research and the average monthly rainfall for Njinikom in August and September is 12 inches per month.  October averages 8 inches.  Not too far from here is Mt. Cameroon and the slopes of that mountain are one of the wettest places in the world with an average annual rainfall of nearly 40 feet, not inches.  So we are happy to be here where it averages less than 10 feet annually.

There are 2 growing seasons here and it keeps the farmers busy.  As I mentioned earlier most of our Njinikom patients are farmers.  Peptic ulcer disease is common here in the general population but more so with farmers which is also true in the USA.  If worry aggravates ulcers then farmers have a lot to worry about and much is in the control of the weather which must be accepted for what it is.

We are in our last full week of surgery here and also followup of our operated patients.  Things have generally gone well, especially considering the circumstances and limitations that exist here.  We adapt to these conditions but I am not sure we could live with them on a long term basis. Many of the large amount of supplies we brought are exhausted now and we must use whatever is available and that is often non-existent.  Our staplers ran out 10 days ago and we wish we had brought more.  They save so much operative time when doing skin grafts and we have done so many grafts. Without the staplers we must use individual sutures which are much more time consuming.  We also are nearly out of dressing supplies and the local dressing supplies are minimal.  Elastic bandages which are so useful with many of our surgeries aren’t available here.  Sister Martha in the OR has asked for us to bring them with us next trip.  Having been here now we are compiling a “Must Bring” list for next time.  We hope to be able to obtain donations for much of what is needed as the items are expensive to purchase.

While talking about donations I want to explain the cost structures of all the hospitals we have worked at in Cameroon and most hospitals in the country.  The costs to patients seem extremely cheap by our US standards but in light of the degree of poverty and extremely limited income of most people even these reduced costs are unaffordable.  Therefore many people don’t come for care until the last moment and sometimes nothing can done for them at that point. Registering to be seen for the first time in the Outpatient Clinic is only $2 US and revisits are $1 without the cost of any medications or special treatments.  Hospital bed day rate is $1 and dressing changes done daily are about the same.  However the average length of stay of a patient with a large wound and daily dressings is often several months. Sometimes they leave the hospital because of finances even before their problem is solved.  Skin grafting these large wounds greatly shortens their hospital stay when the graft is successful.  The local success rate with grafting is however low and requires multiple efforts.  I was able to teach some better techniques to the residents at Mbingo and here to the staff and hopefully this will help.  The equipment for grafting is in poor condition and primitive which is part of the problem.  Another big issue for patients is the cost of surgical procedures which are very difficult to afford in spite of the relatively cheap cost.  A major operation here is $100-300 US which would cost $10,000 plus at home in the States.  As visiting surgeon many of our patients can’t afford our services in spite of the fact that my surgery fee is $0.  We have decided to assist the majority of our patients with their bill or they would just have to walk away without having the much needed procedure.  On our next trip here we hope to fund raise in advance so more people can be helped.  Mission Doctors does have a fund to help some of these patients but it is limited by donations.  If you are reading this and so inclined to help then I would encourage you to consider a donation to Mission Doctors.  This is tax deductible. You can be assured your donation is going to help the truly needy.

Well, I will wrap this up and we are headed to the hospital to change some skin graft dressings and make rounds.  Until next time stay well and please pray for us and our patients.