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.

Julianna Abeh is a 94 year old lady.  She comes to the hospital, every few months for her high blood pressure.

This photo she is accompanied by her granddaughter.  It is always a joy to see her smiling face.

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.

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!

Father's Day

Reflecting on Father’s day invariably brings memories of my own father.

He is always there to be a support when needed, provide advice when asked and lives each day as a model of a man I am striving to be.

In our house when I was growing up, I remember a small plaque, hung on wall, not in a very prominent place but a very prominent place in my mind’s eye with the saying:

                        “The best thing a father can do for his children is to love their mother.”

As a physician, may times I am able to see a family at the worst and best of times, seeing the strength of a father in the passing of a loved one and his joy in the birth of a child.  I have truly been blessed to be a witness to these events.

I have stumbled many times in trying to become the father to my children that my father has been to me, but another saying which rings so true for me is…. “It is not the number of times that I fall but the number of times I get up.” With each fall, I feel the helping hand of my father and those that came before me helping me to get up to strive to be the father I hope to be.

Thank you Dad and thanks to all the fathers who have shown me the love of our Heavenly Father touch their families in so many profound ways.

Sister Hilda

Sister Hilda came to Njinikom, from Italy, in 1957 at the age of 27 years old.

She cares for the 65 plus cattle that provide milk for the orphanage and meat to sell to help support the sisters.

A few weeks ago Sister took us to a cave, the hike was challenging enough for the kids and daddy but Sister Hilda, at 84 years old, did not seem to have a problem.

She told us many stories from the past. One of her stories was how she would go up and down the mountain, to the other side of the river, 5 times in a day to retrieve “Elephant Grass” which is/was used to provide the roofs to the buildings. On her return trips, up the mountain, she would rest in the cave as it was much cooler and provided a nice rest before continuing up the mountain to Njinikom.

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.

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!

Collaboration with Mbingo Baptist Hospital

Drs. Chuck and Angela, from Mbingo Baptist Hospital which is about 30 minutes down the road from Njinikom, recently visited St. Martin de Porres and provided an excellent Saturday continuing medical education talk.

Dr. Chuck is an internal medicine doctor and his wife, Angela, is a pediatrician. They have been in Mbingo for the past two and half years.  Their on the ground experience has been invaluable to us and they have shared many medical pearls. They know first hand the challenges of working in a resource limited area.

We have been fortunate to get to know them and have been very fortunate to have had their expertise for some tough cases.

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.

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.

 

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.”