Father's Day

Marcia is the daughter of Jim and Rose Unger who will be starting her third year of medical school in the fall.  

It’s been a wonderful Father’s Day here in Njinikom. Marcia arrived last Monday and it has been great having her here. She had a great 1st week and has gotten to see and do a lot of things. The first day she was here she participated in two deliveries. Later in the week she got to scrub in on a hysterectomy. In the meantime she has gotten to see lots of interesting patients both on the wards and in the outpatient clinic. Dr. Hake has been very generous with his time in letting Marcia see his interesting patients as well as making rounds with him.

Today, Rose and I traveled to Bambui to visit the Dominican Sisters there at their monastery. I had the pleasure of taking care of one of the sisters from there at the hospital here in Njinikom a couple of weeks ago. She is doing very well and well on her way to recovery.  There are twenty sisters there and all are Cameroonian except for one. She is one of the founders of the monastery from Holland.  The sisters are contemplative sisters and their lives are devoted to prayer, manual labor, study, and works of penance in an atmosphere of silence and solitude. We were treated to a wonderful tour of the monastery and a great lunch. We also got to participate and witness their midday singing of the Divine Office in their chapel. It was quite a wonderful experience all the way around. Best of all, they have promised to pray for us and for our family.

Our days here are quickly winding down. Only two weeks left. This has been a great experience for us and we are very grateful that we could come here. We are also very grateful for all the support of all our friends and especially all the generous donations we received from St. Joseph’s parishioners. We can tell you the money has been put to great use both here and in Douala. The money has been used to purchase badly needed medicines, help pay patient’s bills so they could return to their families, and contribute to the building of a desperately needed TB ward here in Njinikom.

I am sure the next two weeks will go by fast. We continue to look forward to the work and play (like with the kids at the orphanage) here everyday. What more could you ask for?

Return to Douala

We traveled back to Douala this past weekend in order to assist the regular OB/GYN there, Dr. Jean Paul to get started with introducing laparoscopic surgery at Padre Pio. He has had some training in Belgium in laparoscopic surgery but has not had much hands-on experience. The hospital there had recently purchased some laparoscopic equipment that arrived last month while I was there. I had been hoping to do a few cases while I was there in April, but it took some time to get everything organized and arranged. So yesterday, Dr. Jean Paul and I did 2 cases of diagnostic laparoscopy and adhesiolysis. The equipment is quite functional and it is all non-disposable like we used to have in the U.S. years ago. Obviously, using disposable equipment here is completely out of the question. Both cases went well and so I think Dr. Jean Paul’s program is off to a good start. He is a very good surgeon and will be feeling comfortable with the procedure in no time.

We left Douala at 5 am this morning in order to avoid our travel being obstructed by the marches and parades taking place in most of the villages and towns we must pass through during our return drive. Today is “Reunification Day” celebrating the unification of Cameroon into a single country. We saw lots of people especially school children in their uniforms preparing to march. However, we had no significant delays and go back to Njinikom before 1 pm. Traveling back with us is Dr. Nestor who is a young Cameroonian G.P. who we met when we were in Douala in April. He is stationed at a “health center” in Edea which is also run by the Tertiary Sisters of St. Francis. He came over to Padre Pio a couple of time while we were there in get started in the basics of doing cesarean sections and is going to continue his training here. He is a very bright young man, but unfortunately has no surgical experience at all. However, he may be called upon to do a c/s in an emergency and so I hope to give him a “crash course” in the basics that he can build upon as time goes by. I hope at least to teach him enough to stay out of trouble in an emergency.

Speaking of emergencies, I operated on a placenta accreta  a week or 

so ago and mother and baby have done well and are going home. Juliette had had 3 prior c/s and had a complete previa. I put her in the hospital after her last bleeding episode at 34 weeks for about a week. She got her family to donate 4 pints of whole blood that we kept in reserve here for her. A week ago Friday she cut loose again and we did a c/s hysterectomy on her as we had planned. Things went very well due to some great help from our expert surgical scrub tech, Conetius and Dr. Hake who was kind enough to assist. I am very grateful that things went so well. I am also very grateful and thrilled that Juliette has decided to name her baby “Jim”. I don’t think that will be his official Cameroonian name, but more of a nickname. Just the same I am very happy.

Anyway, we are back in Njinikom and glad to be here despite that there is no water and no power this afternoon. I’m sure it will get turned back on later tonite. We hope.

The Man in the Avocado Tree

It is great to be back in Njinikom. We arrived last Saturday from Douala and have had a great first week here. There are many familiar faces as well as a few new ones. We are staying with Jim and Terry Hake again and they are both wonderful people. We feel just like at home here and they are a great reason why. Terry will be leaving at the end of May to go home and then Jim leaves about the same time as we do at the end of June.

Sister Xaveria, the hospital matron and Sister Relindis the mother superior are still here as well. They have not changed a bit and like last year are doing everything possible to make us feel at home.

Dr. Dabo, the OB/GYN I am covering for here while he is on leave, does not leave until Monday and so it has been great seeing him and his family again. It has been an unexpected treat having him here this first week and getting me back into the swing of things here. He is a very nice young man and a good doctor. His wife and children are great. Madam Dabo has prepared dinner for us twice already in the week we have been here!

Several of the children that were at the orphanage last year are now gone. There are a few new ones along with their guardians also. Some of the babies from last year are still here and have grown into little toddlers already. They all seem very happy. Also, the Dutch orthopedic surgeons were here in March doing their “crooked leg” surgery and so there are many, many children here with their casts still on. We visited 3 wards today filled with them, there must be close to 30 kids. They will be here for another 10 – 12 weeks before they go to Bafot for rehab. It is an incredible program that happens here twice a year.

As expected the weather has been quite different than Douala. It is cool enough that we wear jackets when we go to mass in the mornings. The rainy season is here and so it rains nearly everyday, at times quite heavy. Despite this there has been at bit of a water shortage because there was an extended dry season this year. At times, for example when the OR is running, water is turned off to the rest of the compound. It was off for several extended periods this past week. Rose, Terry, Jim, and I all agreed that we would rather be without electricity than water.

There is a large avocado tree right in front of our living quarters. Avocados are called pears here. One man was apparently given the assignment to climb the tree and pick them yesterday by one of the sisters. Quite a crowd gathered to watch him as he ascended higher and higher. He got quite far off on some branches and explained to us that you must pick them, you just can’t shake them off the limb. He was very successful and left with a basketful - both he and them completely intact.

Leaving Douala

Consulting in the clinic, Gladys, our interpreter and a patient

It is hard to believe but our time here in Douala is almost up. Sister told us yesterday that we will be leaving on Saturday to head up to Njinikom.  The time has passed very quickly here and we are both very grateful for the opportunity to have served here. The hospital here provides a service for the people of Douala that cannot be measured. The sisters provide quality, low cost care to all in a spirit of charity and compassion. They labor under very difficult and at times trying conditions. We have even seen them donate blood for a hemorrhaging cesarean section patient when no other blood was available. The patients, with very rare understandable exceptions, are very patient and grateful as they wait sometimes for hours in the heat and humidity to be seen. For example, on Tuesday, the entire hospital courtyard was full of pregnant women waiting well into the afternoon to be seen in the prenatal clinic. It must have easily been 200 to 300. They usually begin lining up as early as 7:00am.  The labor room consists of a single small room with 2 beds and chairs along a very narrow hallway. This for 10 deliveries a day. We have seen as many as 30 people (laboring patients and “guardians” crowded into this small space at one time.

The sisters and the cardiologist from Shisong are here to conduct a cardiac screening clinic yesterday and today. There is a very sophisticated cardiac center in Shisong which provides state of the art care. There is currently a US cardiologist there Steve Peck, who we met when he arrived here in Douala on his way there. He is also a Mission Doctors Association doctor and is going to be there for 4 weeks.

The good news is that the eclamptic patient from the other day seems to be recovering very nicely. She seems to be ok and will be going home soon along with her baby.

As of today, we have seen over 400 patients in the clinic and performed 30 cesarean sections as well as 5 ectopic surgeries. Our next blog will most likely be from Njinikom next week.

Morning rounds with Sister Christa and Gladys

Eclamptic patient (in red), her baby and mother

Busy

It has been a very interesting and educational last couple of weeks here in Douala. We continue to average 10 deliveries a day. As expected the C/S rate is very low, although I have done as many as 8 C/S in a single 24-hour period. Most however, were scheduled repeats. The sisters do everything possible to get patients as close to term as absolutely possible because of the high infant mortality if even a bit preterm.  Preeclampsia and eclampsia seem fairly common. Unfortunately there is no Magnesium sulfate available and very little in terms of acute antihypertensives. The only drug for seizures is valium. 

Again, I can’t tell how hard the sisters and staff work here. The work is never ending for the sisters since they live here and they never get away from it.  Even when they are not on duty they are always aware of what is going on. The convent is right above the maternity unit and so they hear things all night long (as do we sometimes).

That being said we had an exceptionally nice weekend this past weekend. First, we attended the wedding of one of the surgical techs, Julius here that we work with. We attended their wedding mass on Saturday morning and then went to their reception on Saturday night. We got another lesson in “Africa time” just in case we had forgotten from last year. The mass was scheduled to start at 10:00 am and actually started at 11:40 am. It was very nice and a mixture of African as well as some traditional Latin mass (e.g., Agnes Dei was beautifully sung).

Sr Christa and Sr Lidwina with the happy couple

The reception Saturday night was held at a very nice venue and very well attended. It was scheduled to start at 8:00 pm and actually started at 11:20 pm. It was very much like an American reception, at least as much of it that we were able to stay for. Unfortunately, we had to leave early around 12:40 am at which time it had hardly started. Apparently it is not uncommon for these things to literally go on all night and finish about 6:00 am. We will find out today what time it actually was done.

Sr Odelia at Kribe Beach

We had to leave early because the sisters treated us to a day at the beach on Sunday.  We left around 7:30 am and drove to Kribe which is about 2 hours south of Douala right on the Atlantic ocean. It is a very beautiful area known for its beaches and hotels. It is usually very busy on the weekends with people getting away from Douala. CY, our driver and Sister Odelia, the Mother Superior went us and we all had a great time including a great lunch of grilled fish at a hotel restaurant right off the beach. It was the first time there for Sister Odelia and she loved it. On the way back we stopped at the hospital and convent in Edea where the sisters provided us with another meal, especially fufu. Sister Odelia was having such a good time we also had to stop along the roadside and pick up some freshly killed and prepared “bush meat”. Sister loved it and ate it in the car on the way home. 

Today, Monday , we are paying of course for our day off. The clinic was very busy, one C/S so far, and a eclamptic who has seized twice so far today. We hope she will recover.

We arrived

We arrived safely in Douala the evening before Palm Sunday and everything is going well except for the internet here at St. Padre Pio hospital which is very hit or miss. That is why we have not “blogged” until now.

Last week was Holy Week and so we were able to go to Holy Thursday, Good Friday, the Saturday night Easter Vigil and Easter Mass . The services were each in their own way very beautiful and for us very unique. At each of them, except the Easter Mass, there was a strong African element. It was very beautiful, although most of the services were quite long – 4 – 5 hours. We both enjoyed the Easter Mass at the Cathedral here the most. The Celebrant was the Cardinal here in Douala and he presented a very meaningful homily on Faith.  

The work here is really as expected. Everyday is very busy with lots of patients. Much of it is routine, with some unique and sometimes intense emergencies like cesarean sections, difficult deliveries, and surgeries for tubal ectopic pregnancies. There is no blood immediately available for transfusion which certainly adds an element of excitement.

The sisters here treat us very well. They have put Rose to good use in the operating room and she is really enjoying that again. She also has a very compassionate touch with the patients and is wonderful at comforting them. The sisters love her.

The Sisters and staff here work very, very hard.  Many patients come here not only because of the quality of the medical care, but also because they will be treated with kindness and dignity by everyone.

Please continue to pray for us and our mission here. 

Preparing

The last few weeks getting prepared for our return to Cameroon have been very busy. Besides the usual packing and making sure we have all the right things, we have had two very special weekends. First, we were fortunate enough to have a very special fundraising event at our parish, St Joseph’s in Shreveport, LA the Sunday before the start of Lent. Rose and I spoke to around 30 people, about our trip last year and our upcoming 3 months to Cameroon that will start at the beginning of April. This was all arranged by our great friend and fellow Vincentian Shy Gardner. Our St. Joseph’s Conference of St. Vincent de Paul sponsored our presentation and provided home-made desserts for all attendees. Our presentation was a success both in terms of creating awareness of the needs of the hospitals in Njinikom and Douala, but also the great work Mission Doctors Association is involved in generally. We were overwhelmed by both the interest and concern expressed by those in the audience about this work and by their generous financial contributions. We plan to use the money raised to help the Sisters in Douala and Njinikom with their most urgent needs of medicine and equipment.

This past weekend our daughters Laura and Julia traveled from San Francisco to Shreveport to attend the White Coat ceremony for our youngest daughter Marcia who attends medical school in Shreveport. They also held a surprise early Mother’s Day and Father’s Day celebration for us. It was great for us all to be together before we head off to Cameroon.