Therapeutic Committee Review

Each week we review all new HIV patients who qualify for HIV medications.  Patients qualify for HIV medications based mainly on two factors: clinical stage and CD4 level.   We also review those patients who are failing treatment.

The meeting is a time when counselors, nurses and physicians come together. Each person
plays an important role in deciding the  treatment regimen and identifying barriers to treatment adherence.

Though it can be difficult hearing the various patient stories, it is also a testament to the love and care the staff have for the people we serve.  We are blessed to be a part of this committee each week.

There has not been a case of Ebola in Cameroon.

We are becoming concerned though, as the outbreak in West Africa has come to Nigeria and a separate outbreak is occurring in the Congo.

St. Martin De Porres Hospital has patients daily from Nigeria and our "Big" cities Yaounde and Douala.

We have have been preparing for the possibility of Ebola with talks and protocols but praying that it doesn't arrive and for those being affected.

We are at the high point of the rainy season. 
The roads have gotten so bad that we are unable to go to our outreach clinics in our trucks.

We are now sending a nurse, by motorcycle, to see patients.

This is a video of one of our outreach trips.

Sonshine Christian Academy

We are participating in a home school program developed by the Cameroon Baptist Convention.

The program, Sonshine Christian Academy, caters to missionary families from many parts of Cameroon. The program consists of home schooling materials, a two week group session in Bamenda in August and again in February, and a two week home visit. The home visit is by the director of the program who helps with assessment and teaching.

We are now in Bamenda for the first two weeks.  Jennifer was here for the first week and I am here now for the second week.  Teaching is done by the parents and it has been really fun getting to know the other parents.

Two other families from Lay Mission Helpers (our sister organization) are also participating and are graciously letting us stay with them in Bamenda:)

The kids are having a blast!

Dublaise

Dublaise, an 8 year old boy, has been coming to the hospital frequently since our arrival. His mother is also HIV positive and his father has died.

He is on ARV’s but almost every month he comes in with worsening whole body swelling, fluid in his abdomen, and difficulty breathing.

The amount of suffering that the child and mother experience is almost unbearable to watch.

However, with medication and prayers, he improves and goes back home… a small miracle in spite of tremendous suffering.

We always know he is better when his insatiable appetite returns

Thank you Dr. Garlitos

Dr. Garlitos, is an internal medicine doctor from Southern California.  He has come to Njinikom through Mission Doctors Association.

He has been with us for the last month and has been working on the Male and Tuberculous wards.

He has also helped in the out patient department and with our therapeutic committee which overseas our HIV patient population.

We have really appreciated all of his help and look forward to his next visit!

Last night delivery

Sisters Hilda and Sister Cornelia called us last night to see one of the cows ("Advent")  deliver.

So at midnight we (Jen, Brent and kids) saw the delivery of "Daisy"..... so named by Julianne.

 

 

Our outreach at St. Martin De Porres includes 6 different clinics.

The clinics are 30 minutes to 3 hours traveling time from Njinikom.

One of the most challenging aspects, for these clinics, is their isolation and lack of transport.  This is especially true in the raining season when only motorcycles can get through.

All of these clinics deliver babies but cannot do a cesarean or transfuse blood.  You can imagine how challenging this would be for a patient with obstructed labor or postpartum hemorrhage at 2:00 AM on the back of a motorcycle!

We have been able to take our portable US to these clinics. Some of these clinics have no electricity which makes having the portable US with batteries especially nice.

We have identified a number of high risk pregnancies and these patients will deliver at St. Martin De Porres. Hopefully our out reach visits will decrease the number of transfers at 2:00 AM!

Jen and I are spending one morning a week in Nicholas's class, helping the teacher. 

There are only 82 kids!

Today, I helped test the kids on religion. This is a child who is reciting a few of the 10 commandments.

Had a long Obstetrical call a while back

4 Cesareans done that day and a referral from another hospital arrived in the early evening with a mother who had been in labor for a couple of days. When she arrived the baby had died and she had obstructed labor (baby too big to come out from below).

I knew it would be a difficult cesarean and asked Dr. Dabo to help.  He graciously came in to help.  When we opened her abdomen we found baseball size clots of blood in her abdomen.  We were sure she had ruptured her uterus but could find no rupture. After delivering her baby we found she had ruptured her spleen.

Neither Dr. Dabo or I had done a splenectomy recently (never) so we called in our orthopedic surgeon, Dr. Lazare who, just happens to be our general surgeon too….. Dr. Lazare came in and performed the Splenectomy.  Mother did well post operatively and went home a week later. 

Needless to say my esteem for Dr. Dabo and Dr. Lazare went up a few notches that night J

Mother’s Day Thoughts

One of my favorite things about Cameroon is the many names I have here. I am Madame, Sister, Doctor, Mom, Mami, Mama. I am also called “Mom of …”(insert any one of my children’s names). Almost no one calls me by my first name. Any person who has a child can be called Mami (pronounced mah-mi) and I use this frequently when I talk with patients. I think it gives a sense of familiarity, especially when I can’t remember the patient’s name.

There are a few staff at the hospital who always call me Mom. This is my favorite title. It is rather endearing and makes me feel needed and wanted. However, with that title comes responsibility. I then need to be a model of kindness, respect, and compassion, taking the time to listen to the patient and do whatever I am called to do with a positive attitude and a grateful heart.

A favorite song at Mass here is “Mama Maria, mama, eh mama…” Mary is called Maria in Pidgin English. When we think about the formal titles we have for Mary like the Virgin Mary and Mother of God, she may not seem as accessible as when she is called Mama. As Mama, she becomes one of us. We need her and want her to intercess for us.

I also see Mary in the many mothers we see here with sick and suffering children of all ages. Mary’s heart broke when she saw her Son suffer and die. I think of the countless mothers here who have lost a child or children and endure that seemingly unbearable pain. Mary, then, becomes a source of comfort.

As I struggle daily with the mother that I want to be, let me look to Mary as my inspiration.

Sister Xaveria

Sister Xaveria recently left her position as Matron at St. Martin De Porres Catholic Hospital and will now be overseeing the Tertiary Sisters of St. Francis’ hospitals and health centers in Cameroon.

She spent 14 years as the Matron at St. Martin De Porres. During this time there was considerable growth including new surgical and obstetric wards, new theatre, chapel, and many other structures that have become part of the hospital.

She also created a place of caring and love, not only among the workers, but especially for the patients who come here.

We have been honored and blessed to know Sr. Xaveria and we know that her new position will bless many more.

Thank You Sister Xaveria!

Junior

Junior arrived from a referring hospital with his grandmother. He had been ill for 6 days and presented unconscious, seizing and febrile. His labs showed malaria, a low hemoglobin of 3 (normal 12 and above), low calcium of 1 (normal 8 – 10) and an elevated white blood count.  Treatment was started.

With a lot of praying and help from our growing expat consulting service (thank you Dr. Angela!), Junior improved over the next few days and was discharged much better than he arrived!

A happy follow up the other day…….

Adamou is a 9 year old boy who came to the hospital for the first time in January.  We were asked to see him urgently.  I was told he was referred from a clinic with the history of an undescended testicle. Upon arriving to see him, he was unconscious with rapid respirations.  He was subsequently found to be in diabetic ketoacidosis and had a fractured femur!

The history was that two weeks prior to his arrival to St. Martin De Porres he had been kicked by a cow and the family had tried various “traditional” treatments at home. He had not been able to walk since that time and the last few days before coming to the hospital he had become less responsive.
He was started on insulin and IV fluids and the orthopedic surgeon was consulted. He improved over the next week and was discharged. On follow up he was doing much better and the family was doing well providing insulin at home.

Youth Day

Cameroon celebrated Youth Day on February 11th.

For the past month, the children practiced and then competed among the schools in our area to see which schools would dance and sing for the Youth Day celebration. Our children’s school, St. Anthony, won first place in the traditional dance and the special youth day song and dance.  St. Anthony’s has been very inclusive, asking Christopher, Elizabeth, and Julianne to participate in everything. Despite their lack of natural rhythm, the kids learned the songs and dances well and really enjoyed themselves. If you look closely at the video, you may be able to spot them.  Surprisingly, it was the best 8 hours we’ve spent in the hot sun in a long time!

(Click on the video to view some of the performance)

Ash Wednesday

Ash Wednesday is always a somber and yet reassuring time for me.  At one level it is a reminder of where I (Brent) came from and where I will go in this world (ashes to ashes) and at another level from God and to God I will go.

It helps to remember the latter especially when it seems that a patient is taken too early from this world……

Welcome Mike and Reneal!

Mike will be working with us on medical ward and in the clinic as well as using his Deacon skills to help our Priest, Father Cletus.  Reneal, a nurse,  will be helping out on the wards and with various projects.

New Ultrasound

We recently received a new ultrasound machine.  This was obtained by a donation from Mission Doctors Association.

It is a portable US so it allows us to take it to the wards, outpatient, maternity and recently to one of our outreach clinics.

It really helps to direct our care of patients!

The photo is of Dr. Dabo our Obstetrician/Gynecologist with the new portable US.

 

Christmas

We asked the children to write "something" about Christmas this year, here is what they wrote.

Nicholas had a bit of prompting.

Christopher:

This year we had Christmas in Cameroon. It was fun, but I still missed my family. I got many Christmas presents like Legos, candy, gloves, a video game, and a magic set. But my favorite gift was Jesus coming to the world. This gift was from God.    

Elizabeth:

This Christmas was special because it was in Cameroon. There was no snow, but it was still fun. We did Advent calendars, hung stockings, decorated our tiny Christmas Tree In-A-Box and watched Christmas movies. The most exciting part was Christmas morning and seeing the presents left under the tree, and the milk, cookies and carrots gone. Christmas is my favorite time of the year, even in Cameroon.

Julianne:

Christmas was really fun. I got candy, a little stuffed bunny that I named Carrots or Fluffy. I also got little glass animals from Santa. I got a Polly Pocket girl with some clothes. I also got princess slippers and a lot of other stuff. We made some ornaments for the Christmas tree. We opened our advent calendars every day. We also went to a play about Mary and Joseph. When we woke up the carrots, cookies, and milk were gone.

Nicholas:

What is special about Christmas?  Receiving presents, time with family, the birth of Jesus.

What did you do?  Put decorations up on the windows and a little Christmas tree including a star on top.

We went to celebrations including mom and dad’s anniversary that the Sisters had for them, Christmas Mass and a Christmas play at the hospital. 

We treat, God heals.

We admitted 2 babies on consecutive days with respiratory distress caused by a lung 
infection. When I saw the first one and the baby was breathing 100 times a minute (normal is less than 60) and had an oxygen saturation of 60 percent (normal above 92 percent), I told the mother that the child was very sick, but that we would try. We started antibiotics and IV fluids. The next day, another infant was admitted in an even worse condition breathing 120 times a minute and with a saturation of 50 percent and again I told the mother that we would try. We transferred the only oxygen we had from the first baby, who was slightly better, but still in need of oxygen, to the second baby. Then, there was no electricity overnight to run the oxygen concentrator, so I was surprised to see that the second infant was still alive the next day. 

Miraculously, both babies survived. “We treat, God heals.”