Dear Friends and Family:
Greetings from Mbingo Baptist Hospital in Cameroon. We are in the Northwest Province of Cameroon, a portion of the country that was once part of Nigeria. It has been an eventful and tiring week.
Our flight from RDU to Atlanta to Paris to Douala, Cameroon was unremarkable. We landed on time and went into the barely controlled chaos that is the Douala airport. Fortunately, all of our bags arrived (only one ruined), we weren’t bothered by customs and had only the usual hassle with people who wanted big tips for touching our bags. We arrived at the same time as a medical oncologist arrived from Wisconsin, Dr. Joel Lundgren and his teen-aged son. We were all tired but went out to eat before going to the European Rest House for the night. The following morning, we drove the six and a half hours to Mbingo. Traffic going out of Douala was stop and go and sometimes it was worse and became stop and stop.
We were glad to be shown our apartment and have a few hours to adjust before going to the Sparks for dinner with their family, joined by the Browns (Jim and Carolyn) and Dr. Wayne Koch (an ENT surgeon from Johns Hopkins who is on the PAACS Commission and also at Mbingo right now).
Adjustment to a new place is always tough. The surgical service here is very busy and their patients are very sick. On Tuesday morning, we were introduced during the early morning chapel service and then we hit the ground running. In the OR, the surgeons did 17 general surgery cases Tuesday and at least a dozen the next day. Tuesday night, Bruce gave mock orals to the three graduating residents from Mbingo as the junior residents looked on and thanked God it was not them on the hot seat. Wednesday was a full day with the highlight of fresh donuts at the Sparks’ home in the evening
On Thursday, Bruce left well before the crack of dawn to drive with Steve Sparks down to the small town of Mutengene in the Southwest Province. It was a five and a half hour drive in a driving rain and Bruce was so glad that Steve was driving and not him.
That afternoon, the two professors who were helping with the oral exam flew in from Nigeria. One is Professor O.O. Mbonu with whom Bruce had visited all the then-existent PAACS sites in 2007. The second was Professor King David Terna Yawe who Bruce met in Liberia a few years ago. Both are brothers in the Lord and highly placed within the West African College of Surgery. Professor Yawe lives in the northeast part of Nigeria that is under a state of high alert because of the conflicts caused by the radical Islamists. He was not entirely sure that he would be able to come, but fortunately, he was able to make it.
That evening, Bruce and Steve went with Dr. Henry Ndasi to his new Mutengene Hospital which is still under construction on the upper floors. Henry is a graduate of the PAACS program at Banso Hospital (before it closed) and he then studied orthopedics in the CURE program at Kijabe Hospital in Kenya before returning to his home country. They went over his list of possible patients and also figured out how they would make the exam process flow. Bruce really appreciated everything Henry and his wife did to facilitate the exam process and meals while we were there.
The next day, everyone else who was involved converged on the guesthouse compound that belonged to the Cameroonian Baptist convention. There was also another meeting being held on the grounds of the guesthouse and so things were hopping. Dr. Jim Brown drove down with the three residents; Dr. Wayne Koch drove down with the Cameroonian ENT surgeon, Dr. Acha; and Keir Thelander and his two residents from Bongolo Hospital flew in from Gabon. Due to different reasons, all were delayed and didn’t arrive until early or mid-evening. Two people had been left off the reservation list, so Dr. Acha and the pilot, Rob Peterson, had to scramble for a place to stay. That would turn out to be the only serious glitch in our planning.
It had been a quiet day for the professors and for Bruce while they waited for the others to arrive. He spent the day just catching up on PAACS work and then taking the opportunity to relax a bit and read. Late in the afternoon, he had an impromptu meeting with Professor Pius Tih, the head of the CBC health division. They talked about three important issues and it seemed that God’s hand was in the whole thing.
Early that evening, after everyone had gotten there and had a bite of supper, the team of examining physicians went to the hospital. They examined all the patients that Dr. Ndasi had selected and made the final selection. They also determined the final configuration. Bruce then came back and talked to all the residents, briefing them on what to expect in this new (to them) exam configuration.
Early Saturday morning, Bruce went over to the hospital to help Henry make the final arrangements. After everyone else arrived, they had breakfast together (the examinees eating separately from the examiners) and went over the instructions to the examiners. At 7:30 AM, the first two students got started. The examiners stayed busy until 1:10 PM with only a single tea break. The exam had four parts. One is a series of patients with easily identified physical findings – they had to get through at least three cases in 20 minutes. The second was a full history and physical of a complex case and then a long discussion of the findings and plan. The last two parts were questions on all of surgery. Each examinee was examined by a total of six examiners during the process. After the examinations were finished, the examiners got together and discussed the trainees that had received marginal marks. Four of the five residents passed the exam and the other failed by the narrowest of margins. Bruce was actually quite pleased with their performance, fearing the worst, but was disappointed for the poor chap who did not pass. He honestly believed that graduate is a competent surgeon but his difficulty with English was his undoing.
The Professors then debriefed them. They had a discussion with them about what it would take to be recognized by the West African College of Surgeons. They want PAACS to look just like WACS but even if PAACS puts the differences in educational philosophies aside, it probably won’t ever happen for a series of reasons (including the cost of their proposals). Still, PAACS will continue to explore alternatives and hope it can someday happen. It is important to at least some of the residents.
Tomorrow, Keir Thelander, the pilot and the two residents will leave for the Douala airport, flying their missionary plane from there down to Bongolo Hospital. The two Nigerian professors plan to leave for the airport at noon. Jim Brown and Bruce will leave for the long trip for Mbingo.
Praise and Prayer:
- Praise God for traveling safety.
- Praise God for those who passed and pray for the one who did not.
- Next weekend is the graduation ceremony for both the surgery and internal medicine programs here. Many officials are coming. This program still needs formal recognition by the government. Pray for God’s hand in the whole thing.
Thankful to be here again in Africa,
Bruce, Micky and Sean