Fall 2016

This trip, I am accompanied by Dr Ronnie Mubang, a PGY4 General Surgery resident, and Mr. Tony XIA, a TUSM 4th year medical student.  Enjoy the posts!

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L to R: Tony Xia (MS4), Richard Sharpe, MD, Ronnie Mubang, MD

 

Sept 2

Some quick captions for the attached photos!

*Here we go Cameroon we come.
*Shout out to Ryan setting out clean water supplies in Liberia. The world needs more of Ryan.
*Why not. Shades all the way lol.
*Transit Brussels. Tired but excited!

Ronnie

Sept 3

(Ditto)

*Thank you sir Brussels for the great movie selection. Everest movie was amazing. Yes Dr Sharpe I said it. Apparently the crew from air Brussels said kingali Rwanda best city to visit y? Because so clean and no plastics banned in the country.
*Respect to other missionaries here in Cameroon. Thank you for setting up the school systems. The world needs you.
*Beinvenue a Douala.
*Feet on soil.

Ronnie

Sept 6

We arrived the evening of 3 September, relaxed a little after dinner, and got a much needed good night’s rest. The next day was Sunday and we spent the day unpacking the four suitcases of supplies we brought with us and putting them into the OR supply room. Most of them were critically needed by the surgery service. I was also able to supply the surgery residents with over 30 pairs of scrubs donated to the SLISS program for this purpose! Tony and Ronnie met many of the residents and they got organized for work the next day. Monday was busy; the residents warmly welcomed us, as usual, and we got right to work operating. It is a pleasure for me to be back here with another team!

Dr. Sharpe

Sept 6

A nice panoramic shot of the grounds from the back balcony of the surgery clinic. The building on the right with the red roof is the chapel. At the daily chapel service, it is a tradition when visitors arrive and depart to introduce ourselves and say our farewells to the entire staff of over 600 people in the hospital. On the left is a view of the mountains of northwest Cameroon where the hospital is nestled.

Tony

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Sept 7

I was happy to find many visiting professionals here this month. Surgeons fellowship trained in ENT, OBGYN, Trauma/SCC and Pediatric Surgery are currently here from prestigious institutions including the Mayo Clinic, Johns Hopkins University and, of course, St. Luke’s. Additionally, MBH has 3 full time general surgeons and 13 General Surgery residents. This may sound like a lot, but there were over 70 surgery patients on the wards to see this morning, approximately 80 will need to be seen in the outpatient clinic and then there are 25 scheduled surgeries to be done not counting the handful of emergency surgeries that seem to be consistently needed every day. It’s quite a busy surgery service! The picture below was from our morning meeting today.

Dr. Sharpe

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Morning Report

Sept 8

Many have asked me about our accommodations while serving at MBH. Since MBH has over 100 visitors per year, they have many places for guests to stay. Single family houses (for groups or families) and two Hostels are able to meet housing needs. For visitors who don’t want the hassle of making their own meals, a small kitchen and dining room provide three meals per day “family style”. I have always found the rooms to be very comfortable and the food excellent. Over the last several trips, I have stopped eating lunch to avoid gaining weight!

Dr. Sharpe

Sept 12

Well, our team just completed our first weekend on call (Friday through Sunday) along with three of the PAACS residents. I’ll let them blog about their impressions, but I was proud of all the work they were able to do and the long hours required. After 72 hrs, Ronnie and Tony are still at it in clinic today and still seem to be enjoying the experience. Here are just a few pics.

Dr. Sharpe

Sept 13

I thought I’d share a success story form yesterday. This 8 yo was suffering from complications of his Tb infection; one complication being restrictive pericarditis. This is a condition where the sac around the heart scars down and literally squeezes the heart so that it cannot function well. The surgery was a removal of the sac around the heart which was done yesterday, but he suffered two cardiac arrests. We were able to get his heart started again and this is a photo after a rough night in the ICU. Big shout out to Cory Bond from Good Shepherd Rehab for the donated vent! Without that the patient would have been “bagged” all night by a family member. After many prayers, the boy was extubated (breathing tube removed) today and is now crying to eat dinner!!

Dr. Sharpe

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Sept 14

The surgeons here in Mbingo take care of patients of all ages with any variety of conditions. This is a 4 month old baby with a patent ductus arteriosus (PDA) causing him respiratory distress. After a technically difficult operation, the team managed to fix his defect and send him safely to the ICU. The first picture shows a red vessel loop around the PDA coming of the child’s aorta, and the second picture shows both sides of the vessel clamped off after it was cut.

Tony

Sept 18

There is no trash pick up here. All trash from the hospital is incinerated. There are two homemade brick incinerators located in a small, separate building. It makes for a fragrant morning, but they work well!

Dr. Sharpe

Sept 19

This is our last week here and, after our first weekend off, we are ready for a busy week. A pleasant surprise happened today. We were told that 18 boxes of supplies shipped from our distribution center sometime last year arrived to the hospital. it was nice to see these much needed items get unpacked and placed onto the OR supply room shelves. Great job St. Luke’s!!

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Sept 21

This is a 67 year old woman who suffered a blunt abdominal trauma and was taken to a
Hospital where she underwent multiple surgeries with severe postoperative complications. She was told there was nothing more they could do and was discharged. She arrived at Mbingo gravely ill aand with little chance of survival. We were able to get her strong enough to undergo yet another surgery and after 2 months of being at the hospital she was ready to go home with no further complications. This was such an emotional trip for her and her family. Thank God for the team at mbingo!

Ronnie

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This is a 60 year old male who had been having symptoms of intermittent nausea and vomiting and unable to eat for for over 4 months. He had been to over 5 hospitals in Cameroon and was told there was no hope for him. Finally, he came to mbingo and was taken to the operating room where we were able to correctly diagnose him and fix the problem. One week later, he was ready to go home and live a normal life! Just another day at mbingo.

Ronnie

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Below is a picture with the nurses from the surgery outpatient clinic. They are absolutely incredible! Each day in clinic we average over 80 patients; speaking many different languages including French, English, “pigeon English” and tribal languages. These nurses translate and keep the entire clinic moving so all can be seen. Thank you so much for all you do!

Ronnie

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22 Sept

Today was our last day here and we had a good day of academic presentations and discussions. We were blessed to have ENT, OBGYN and plastics surgery specialists visiting from such prestigious institutions as Johns Hopkins University and the Mayo Clinic. It was a pleasure to be part of such a talented team this month and I especially thank my friends at Mbingo for their continued warm welcome and making us part of their team.

Dr. Sharpe

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Pictures!

Mbingo Scenery

People

Mbingo Baptist Hospital

 

Bamenda Main Market

MBH OR

MBH Market

PAACS

Getting There!

Agape Foundation

 

Spring 2016

The Kiddos of Cameroon

One of my favorite parts about the trip was meeting all of the children. We performed all of the pediatric surgeries and took care of the children afterwards. There was also a school on the hospital grounds for local children and many children of hospital employees. The energy and spirit of these children was incredible. These are just some of the children I befriended during my time in Mbingo.

The Amazing Residents

The surgery residents at Mbingo Baptist Hospital were hands down the hardest working people I have ever met. Work hour restrictions are non-existent. They are making major clinical decisions and operating independently from very early on in their training. Training to be a surgeon is such a privilege to these residents and they don’t take any learning opportunity for granted. I am forever grateful to my friends and co-residents in Cameroon who helped put things into perspective for me and showed me just how lucky I am to be training at St. Luke’s.

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April 16, 2016

Dr. Mao and I had mixed feelings about this trip before we left. On the one hand, we wanted to come, but on the other hand, we knew two weeks would be too short. We decided to get to work as soon as we arrived at Mbingo and continue to do so until we had to leave. We worked for 12 of the 13 days we were here. Combined, we performed over 60 major surgeries and saw at least 300 clinic patients. Memorable cases were many, but two stuck out in our minds. For Melissa, she will always remember a 3 day old baby born with esophageal atresia. This is a condition where the food pipe is not connected to the stomach. Melissa surgically placed a tube into the baby’s stomach so that she could receive nutrition and get strong enough for a much larger surgery. For me, I will always remember a woman who had suffered for over 10 years with a slowly enlarging tumor in her abdomen. We were able to remove it safely; it weighed over 35 lbs!

Yes, the trip was too short, but we were able to save lives and greatly reduce the suffering of so many in this short time. You can be assured we are glad we came!

Dr. Sharpe

Winter 2016

Blog 1 Feb 2016 pic

Photo (from left to right) Drs Cleve Sides, Shenali Abeysekera, Maggie L in, Richard Sharpe, Gail Burgey, Chineye Nwachuku

February 13, 2016

Our team of six physicians posed for this photo at the Philadelphia International Airport prior to the first of several flights which will land us at the Douala Airport in the evening of 6 Feb. After over 24 hrs of time in the air and sitting at airports, we will be ready for a rest and another day of travel by ground to our final destination, the Mbingo Baptist Hospital (MBH),in Cameroon, Africa. We expect our fatigue from travel will rapidly vanish as we get settled into our areas of specialty and get to know the great people working at MBH and the patients entrusted to our care.

This team includes specialists from orthopedics (Dr.Nwachuku), obstetrics and gynecology (Drs.Burgey, Sides and Abeysekera) and general surgery (Drs. Lin and I).We carry with us many supplies donated by St. Luke’s University Hospital and AmeriCares; these supplies fill some critical needs at MBH.

This page will have numerous blogs from us encompassing all of our specialties and areas of service. We trust you will check back often and thank you for your support!

Dr. Sharpe

February 16, 2016

After a safe 36 hrs of travel, we had dinner at a local restaurant in Douala (photo 1)and spent a restful night at guest quarters arranged for us. The next day,we traveled by van to Bamenda and finally to MBH. The trip was broken up into several stops for fresh fruit, one being ripe pineapple which proved to be quite tasty but a little messy (photo 2). Many photos were taken during the ride as we absorbed a lot of this new and interesting culture. A boy with a pot on his head was selling “bush meat” which,as the name implies, contains any kind of meat killed in the surrounding woods and fields.Not surprisingly, none was adventurous enough to give it a try.The evening was spent at MBH having dinner and getting settled in for a busy week. As expected, we arrived tired but eager to get starting with the staff at MBH.

Dr. Sharpe
Blog 2 Feb 2016 pic3
Blog 2 Feb 2016 pic2

February 16, 2016

The kitchen starts its work early by starting the fires both under the large pots in a shed and in small brick openings that sit under the big cast iron stoves in the general kitchen.  The shed has a place for firewood that is used on all fires and is replenished daily.  Today the kitchen table is covered in freshly harvested carrots, and large bags of beans sit nearby.

Dr. Burgey


February 17, 2016

Gardening here means providing for your family and sales at the market place.  All types of terrain is cleared by hand with raised beds…mountainside, valley, and small gardens near the home.  While the soil appears dusty now, and planting is just starting in the dry season, the depth of the furrows makes for arduous work. The hoes are small shovel blades on a small handle.  As one person digs, the other pulls and clears the brush.  Some small trees are left.  When the planting is done, some tall sticks are placed for the beans to grow up on.

Dr. Burgey


February 18, 2016

Busy week. I am impressed by the type of surgery that this hospital does on a daily basis with the resources it has. I knew it would be a challenge to tackle the cases here, but felt as a gynecologist trained in the times of open procedures I would be up for it. While I feel I have been able to do an okay job, I feel woefully inadequate and admire the cases that they cover as general surgeons everyday. Feeling like the lighting is not good enough, the clamps and instruments are the wrong size and only partially function, the self-retraining retractor doesn’t, and suture type and size is variable. Even a basic case would be challenging. But there seems to be no easy cases. The cases here would be a challenge even in our facility. Being here makes me even more aware how spoiled we are, that we complain about our operating room times…and pout if our favorite piece of equipment isn’t ready. The resources that we have, take for granted, and often waste is a shame is even more apparent to me now.

Dr. Burgey


February 18, 2016

Maternity Ward

The maternity ward is run by midwives with nurses.  There are 7 midwives that all rotate the 3 eight hour shifts.  They handle all the labor patients, deliveries, postpartum and post operative care.  The front room is divided into two sections that look the same, with the nursing station in between.  The left is for the vaginal postpartum patients and the right is for the cesarean postpartum patients.

When a patient is being evaluated in labor, she is taken to a small room with 4 beds in the back.  Her vital signs are checked every 4 hours and fetal heart tones are evaluated every 30 minutes.  The midwives will use cytotec for cervical ripening, and will begin pitocin as needed to augment labor.  There are no pumps so any medicine is given in the drops per minute method.  Everyone must have a caretaker, and that person stays with them throughout their stay.

When the patient is ready to deliver she is taken to the delivery room.  The midwives deliver all the babies, including breech if the patient has had at least  one vaginal delivery before, and twins.  They will repair most lacerations but if it involves any of the rectal sphincter the surgeon will be called and she will go to the operating room for repair.

If a cesarean section is needed, the surgeons are called and the patient taken to the operating room.

Dr. Burgey


February 18, 2016

The busiest week of my life (literally)

Due to a medical conference scheduled a while ago, four of the general surgery residents and both of the general surgeons were gone this week (14 – 20 Feb).  In addition to this, one of the visiting general surgeons could not come leaving me as the only general surgeon here for 7 straight days.  I am 5 days into this experience and can honestly say that I have done more surgeries than in any consecutive 5-days in my professional career.  Add to this the responsibilities of supervising and teaching the 5 residents that remain coupled with over 175 clinic patients in three days and you can imagine that it has been a whirlwind of activity from dawn to dusk (and later).   Many were seriously ill and required ICU level care and attention.  While three of our patients died, many more were saved and countless morbidity averted simply because we could offer surgical care this week.

A significant blessing to me was that our team from St. Luke’s included Dr. Burgey, an OBGYN, and two OBGYN chief residents, Drs Abeysekera and Sides.  Drs Burgey and Abeysekera were able to cover all the c-sections and gyn surgery leaving me free to focus on the general surgery.  Dr. Sides was able to fill a critical need at Banso Hospital, which is about a three-hour drive away, and will be returning to Mbingo today.  He will likely have some great stories to tell tonight at dinner time!

Dr. Nwachuku, the orthopedic surgeon in our group, has literally been operating everyday and has expressed to me his amazement at the type of cases he has managed this week.  Hopefully, we will see some blogs from him soon.  He has some terrific X-rays to share!

Dr. Sharpe


February 19, 2016

Leaving Today

Last day at Mbingo, saying goodbye to one of my roommates, who is usually on the wall, or in the shower stall, until the light goes on, then he leaves…

Having the last cup of early morning coffee from Dr. Sharpe, who kindly made a pot every morning and shared a cup at 0600.  A lifesaver as breakfast wasn’t until 0800.

Not sure what made me want to come, or what I expected to do, or if I expected to find something for myself.  All I know is it was a very humbling experience: to see what people go through here, waiting to get health care that we take for granted, traveling to get healthcare that we have right down the road, the thankfulness for the care they receive and how the physicians and surgeons are able to care for them as well as they do with their limited resources.

I hope I made a small difference, and maybe was able to help some people.  Most importantly I hope I have learned how fortunate I am to have the healthcare and resources available to me, and not take them for granted.  Hoping I will be fortunate enough to come back and do it all again.  Thank you to all who support this project and to my family for supporting me.

Dr. Burgey

 

 

Fall 2015

September 16, 2015

Multi-international Effort

The multi-international effort that has been demonstrated at Mbingo Baptist Hospital in Cameroon has been truly remarkable. The SLISS program at St. Luke’s has been working diligently with the PAACS residents and the general surgery department, but we are by far not the only ones. The surgical presence from Johns Hopkins and Vanderbilt have also been instrumental in the continued success of the efforts here at MBH. Also, volunteer attending physicians from various regions in the United States have assisted greatly. With the help of a pathology resident from Loma Linda, Summer Blount, we have been able to successfully treat diseases by surgical means and offer necessary adjuvant therapy. A recurring volunteer, Courtney Bell, is a speech therapist working with in-patients and the school for the deaf which is on hospital grounds. Visiting pediatricians and internal medicine physicians have been critical in assisting in sustained improvements in the level of care offered. Another critical staffing need is an OB/GYN specialist. Even as I am typing this, our SLISS program is attempting to make this happen in early 2016 with an attending from St. Luke’s and perhaps a resident or two! Stay tuned!

The photos attached are just some of these incredible volunteers.
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Photo 1: Left to right: Courtney Bell (speech therapist), Ike Akusoba (PGY 4 St. Luke’s general surgery resident) and Summer Blount (pathology resident, Loma Linda)
Photo 2
Photo 2:left: Richard P. Sharpe (St. Luke’s general surgeon); right: Greg Schmedes (ENTsurgeon with World Medical Missions)
Photo 3
Photo 3:left: Dan Phillips (GI physician from Oregon); right:
Steve Norton (general surgeon from Washington)

September 19, 2015

A success story!

I would like to illustrate just one way the care here at MBH is improving and broadening. The first photo is from Oct 2014 when Kathryn and I toured the new ICU. It was just beginning to be stocked with equipment and had no ventilators. The video was my report during that trip regarding how important this capability was and how St. Luke’s could help. Good Shepherd Rehab donated two portable ventilators which were hand-carried by Drs. Balinger and Keeney when they visited in April 2015. They instructed the residents and nurses on how to use the ventilators and the last photo was just taken this trip which shows a full ICU caring for both pediatric and adult patients. During the last three weeks, there were four patients who are alive today because of the ventilators alone. The ability to administer pressors and cardiac medications by continuous infusion has saved many more. There was a lot of help over this past year from many individuals volunteering at Mbingo, but it shows how a focused effort in providing assistance in a specific area can really result in sustained improvements in care!

Dr. Sharpe


September 20, 2015

PAACS

The Pan-African Academy of Christian Surgeons is a fantastic organization. They are a “non-denominational, multinational service organization training African physicians to become general surgeons who are willing to remain in Africa to meet that need”. There are currently nine general surgery training programs administered by PAACS producing highly trained and experienced surgeons to serve in some of the most needy areas in Africa. Having a PAACS residency at Mbingo was one of the main reasons why I chose this location as a partner for our SLISS program. The photo shows the current residents as well as the full time general surgery faculty (Center back row from left to right: Jason Axt, Jacque Ehbele and Jim Brown).They welcome us with open arms and make us feel at home and part of the team. There is a lot of work t do by such a small group, but they are tireless in their efforts to assist all who need their care. They are in need of additional general surgeons as well as specialists in OB/GYN, Urology and Neurosurgery. As this facility continues to grow, this will become an even greater need.

Photo 8 PAACS.jpg


October 22, 2015

And in the end we stood, brought together by a common goal, faith and commitment; feeling a sense of accomplishment, but knowing we are in for a long battle to truly provide the best surgical care to those in need.
Ike Akusoba
Photo 9 Last Day

Spring 2015

 

April 3, 2015

cameroon1This is the first entry for our blog about our trip to Mbingo Baptist Hospital in
Cameroon. It’s hard to believe that it’s April 3 and we have yet to reach our destination. The travel, while long, has not been terrible. Even our brief stop in Douala International Airport, which we were warned might be the worst part of our trip, wasn’t terribly bad. Everyone has been incredibly nice and welcoming so far. As I write this, we are staying at a guest house in Douala, waiting to make the final 7 hour drive to Mbingo. We spent last evening with Linda and Bill Martin. Linda is a neurologist from Arizona who spent the last two weeks at Mbingo and is now leaving to spend the next two weeks in Ethiopia to complete her month long mission trip. We had a fantastic dinner in town and spent the night hearing stories about the hospital and the people we are about to meet. The enthusiasm and excitement from Dr. Sharpe, Kathryn, Linda and Bill have led to such anticipation for our arrival. Chris and I are very eager to get to the hospital.

Scott Keeney


April 4, 2015

First impressions

My first day as a surgical resident working along side African surgical residents has come and gone and I feel it is prudent to describe the feelings being in a different world, working alongside culturally different people but with similar objectives.

View of Hospital

Front of Hopsital

Our trip here was not easy but hardly arduous. We flew in a cramped plane for a total of about 14 hours. Then after a 6 hour drive we made it to Mbingo which is an oasis in the Cameroon countryside high up into the mountains. After a two day weekend complete with Easter celebrations our work began. The hospital is a step back in time. People come from all over the country to the hospital sometimes taking 2-3 days to travel and most are too poor to afford any accommodations so they sleep on the grounds of the hospital. A true sense of community is felt on the grounds as the patients are for the most part accompanied by a caregiver. Admittance into the hospital is not permitted without a caregiver as the nursing staff is not capable of taking care of all the patients that visit. Despite the hardships the patients face no one complains.

In the operating room things are different then in the States. You are reminded of that as soon as you walk into the OR. Patients typically receive spinal anesthesia, there is no anesthesiologist and there is no mechanical ventilator so patients are ventilated by hand. Even sutures are precious so they are picked out before our cases and placed as to conserve as much as possible.

Chris Balinger

Sterile Room in OR

Sterile Processing Room

Operating Theatre

Operating Room

Anesthesia Machine in OR

Anesthesia cart in OR

 


April 6, 2015

Today is our first real day of work. The weekend was spent making rounds and getting to know the hospital.   We were also fortunate enough to be invited to attend an Easter ceremony which began at 04:30 in the morning with banging drums, singing, dancing, and hiking a mountain. It was amazing.   Today was busy! Between Chris and I, we did over 10 cases, which ranged from hernias to surgery for advanced peptic ulcer disease, and also included urologic and gynecologic operations. The chief resident took me through my first C-section. I’m quickly realizing that I will learn as much from the African residents as they may learn from me.

Scott Keeney


April 10, 2015

After a Week of Operating

So the first week of being here is in the books and it has been beyond words and what I will write will not justify how incredible this place is. The scenery is spectacular. The people are warm, gentle and appreciative. The pathology is advanced. People often sit and wait when something is not right. Access to health care in Cameroon is limited and typically requires a long journey for most so once a patient presents to our clinic the ailment has obviously been present for much longer than would be typically seen in the States. In one day of clinic I saw four fungating masses all of which were advanced cancers.

One aspect of medicine here that is the most difficult to get used to is the patient selection for life-saving surgery. There are limited critical care resources here so we can perform a life saving operation on a critically sick patient but there is almost no way to keep someone alive after surgery if they can’t wake up from anesthesia, nor is there a mature blood bank from which to resuscitate patient or even medicines used to maintain a patient’s blood pressure when the patient is unable to maintain it them self. We have brought along two ventilators with us which will no doubt save many lives. Next week the staff will be trained on using them to help the people of this area.

Chris Balinger

Mountain on Grounds

Mountain on the Grounds

 

Recovery Room

Recovery Room


 

April 11, 2015

Today is Saturday and Chris and I do not have clinical obligations. We spent the day in Bamenda, which is the nearest urban city. Sharon Davis, who we met in Douala was our tour guide. Sharon spends about 4 months out of every year in Cameroon as a humanitarian. This trip she is hoping to educate the locals about the importance of clean water and she is helping install solar panels in a nearby village as an alternative to kerosene. Kerosene fires are a major cause of morbidity and mortality in the northwest region of Cameroon. We have yet to meet anyone, local or foreign who does not want to improve the quality of life in this country.

Scott Keeney

Friends and Other Physician from Mbingo

Friends and other Physician from Mbingo2

 


April 14, 2015

Today was very exciting. It was the first day our two donated ventilators were introduced to the Intensive Care Unit. Before now, Mbingo Baptist Hospital did not have any mechanical ventilators. If a patient needed to be ventilated for any time besides the perioperative period, family would work in shifts ventilating the patient by hand until they either woke up, or succumbed to their illness. My day was spent in-servicing the nursing staff of the ICU and the surgical residents as to the benefit and function of the ventilators. What struck me was the enthusiasm from nurses to administration… residents to attendings. Everyone wants to be able to care for their patients better. These ventilators will no doubt save lives.

Scott Keeney

Vent Nurse3Vent Nurse4Vent Residents2


 

April 20, 2015

After a whirlwind weekend we placed the first patient in Mbingo Baptist Hospital on a ventilator. I’m sure he will be the first of many to benefit from the two ventilators we brought with us to Cameroon. Given the lack of resources here we also had to figure out a sedation protocol and pretty quickly.

So back to this weekend’s events. At about a 7am just as I appeared on the wards I got a call that there was a sick patient in the outpatient clinic. He was found at the bottom of a palm tree and it took his family about 8 hours to bring him to the hospital. Needless to say he was barely alive. He was hardly breathing and his blood pressure was almost absent. I rushed him to the operating room, placed a chest tube, then we removed his spleen and because he had a head injury drilled a hole in his skull to evacuate blood from his brain. He is currently on a ventilator and alive but prognosis is guarded. Later that day we performed two C-sections and closed another young woman’s abdomen who has been clinging to life in the ICU. Not a bad day’s work.

Chris Balinger

First Vent2

Fall 2014


October 1, 2014

Dr. Kathryn Balinger and I are now at the Philadelphia International airport Awaiting the first of four flights ultimately landing us in CAMEROON, Africa, in about 38 hours. After a night of much needed rest, we then travel by vehicle for 7 hours before arriving at Mbingo Baptist Hospital (MBH) with the nearest large city being Bamenda. Although we are not looking forward to these next two days of travel, we are excited about this first rotation for the newly developed “St. Luke’s International Surgical Studies” (SLISS) and serving a population in great need.

I invite everyone to visit this site as much as possible to view our experience and see what St Luke’s University Hospital is doing through us, and ultimately, you. Since SLISS is funded solely by donations, we rely upon you and your generosity. All funds are used for travel expenses and purchasing supplies; these supplies are carried with us on each trip, as well as sent by international shipping. None of your money will ever be spent on salaries or “administrative overhead”; all travelers are volunteers. My hope is that as more of you support this effort, we will be able to purchase supplies and equipment which will create a sustainable improvement in the level of care offered by MBH. That’s the key for international medical missions: make a change that lasts.

We will attempt to post pics, videos and blog daily. Check back often!

-Dr. Sharpe

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October 6, 2014

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Today was our first real operative experience on this trip… We had a pretty full day in the OR doing everything from hernias to hysterectomies (Dr. Sharpe even performed a transvesical prostatectomy). Before our day began, however, we were able to unload all 3 suitcases full of OR equipment that was generously donated by the folks at St. Lukes. We had brought a wide assortment of gear – lap sponges, bovies, JP’s, staplers, gowns, ET tubes, LMAs, drains.. the list goes on. Everyone was incredibly grateful and our supplies were in demand even for today’s cases. It’s hard not to reflect on how much we have back home and how everything is so readily available to us. Here, they make do with what they have and find a way to make it work…

-Dr. Balinger


October 7, 2014


October 8, 2014

The kitchen at Mbingo Baptist Hospital is like nothing you have ever seen! All food is traditional African meals made in typical African fashion. The open air building, partially obscured by laundry drying, is where all the food is prepared for the patients. A small shed out back is where the cooking takes place. There is no gas or electricity – all food is cooked over wood fires which are lit in holes in the ground! The ladies in the main building were gracious enough to allow me to photograph them preparing the vegetables for today’s lunch. The cooks do a great job and patients are very grateful for the meals provided in this simple kitchen.

This is just one of the many things that strike me about this place: They do so much with so little and are thankful and content. Truly a wonderful place to serve.

-Dr. Sharpe

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October 9, 2014

2014-10-08 11.20.47

I had my first Mbingo clinic experience yesterday and my mind is still reeling…Within an hour, I saw patients with everything but general surgery problems. I took care of several patients with prostate CA, normal pressure hydrocephalus in a 1 month old, trauma patients who were several days out from their initial injury, a 14 year old girl with an imperforate hymen and hematoculpos (I had to google this while seeing her), and even pinworms in a grown man. As the day went on, I began to see more general surgery patients but was amazed by the amount of Ob Gyn, urology, neurosurgery and even ortho that these general surgery residents here take on. To them, that’s just how it is because if they don’t take care of these patients, no one else will…

Initially I was concerned about the language barrier as French is the primary language here in Cameroon. However, the nurses were fantastic translators and were the foundation of the clinic. They did it all- assist in minor procedures (and our definition of minor is slightly different in the states), schedule patients for the OR, kept clinic moving and acted as bouncers for the 100+ patients a day who came to clinic.

The people here are incredibly grateful for any care or help that you give them. They are never demanding and always are very kind and happy- even if they have traveled for several days to see you and have slept outside the clinic door for you to ask them to come back tomorrow after some test results have not come back yet. It blows my mind that these people put so much trust and faith in the health care providers here and never question anything. They are so incredibly patient and trusting. It is an absolute joy and privilege to be able to provide whatever assistance I can here and I feel truly blessed to have this opportunity…

-Dr. Balinger

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October 10, 2014

2014-10-09 10.52.32 editedThe CBC hospital in Mbingo started off many years ago as a Leper’s colony. Gradually over time it became a full fledged tertiary care center taking in patients from all areas of Cameroon. In addition to housing and taking care of patients, there are several places within this hospital that provide items for patients. There’s a place that makes prosthetic limbs, another in which furniture is created, and even a shoe shop.

Dr. Sharpe and I stopped into the shoe shop the other day and were amazed by not only the quantity but also the craftsmanship of shoes that are specifically created for patients in the hospital and school children on campus. Each shoe is created over a period that can take up to three days. A pattern of the patient’s foot is taken and then the sole is created from rubber. Nigerian imported leather is heated and molded and the shoe is lined in assorted materials (basically whatever is available in the hospital). Each shoe is individually designed – the shoe in the photo was designed for a patient who had all of his toes amputated. These shoes cost less than $2 and are free to school children and those patients who can’t afford them. The gentlemen in this photo take an enormous amount of pride in their work and shows in the quality of their product..

-Dr. Balinger

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October 11, 2014

2014-10-06 09.41.31 editedI thought that it was about time to include some photos from the OR and give a quick report on our experience operating thus far. The general surgeon here, Dr. Jim Brown, and his residents welcomed us warmly and we began operating the first day. The number and variety of cases including major procedures done here in this austere setting is truly remarkable. Kathryn and I have performed many procedures typical for the general surgeon such as hernia repairs, gall bladder surgery, breast cancer cases, and surgery for perforated gastric and duodenal ulcers. In addition, we have performed many surgeries outside the normal practice of many general surgeons in the U.S. These include various procedures on the ovaries and uterus, prostate and sarcoma resections, and several different pediatric surgeries. Finally, the residents here are very skilled in assessing and managing these diverse and difficult cases; at times, I learn as much from them as they learn from me!

On another note, MBH has an excellent oncology service and has numerous chemotherapy protocols including several for patients with breast cancer. We have seen patients with locally advanced breast cancer and they can now receive chemotherapy before surgery which is an option in the States and rarely offered at other hospitals in Cameroon. MBH is continually improving the level of care they offer and it is a pleasure to observe and be a part of this transformation.

-Dr. Sharpe

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October 13, 2014

2014-10-06 21.18.02 editedOne thing that struck me about the wards was the amount of friends and family present
for each patient. These caregivers are present 24/7 and are very active participants in the patient’s hospital course. Patients are required to have at least one caregiver present at all times during their hospital stay. As a general rule, if the patient does not have someone available to fill this role, they will not be able to be admitted to the hospital.

Caregivers are responsible for feeding, bathing, and ambulating the patients. During the day, the caregivers are always at the patient’s bedside and at nighttime, you can find them sleeping on cots or blankets in between hospital beds.

-Dr. Balinger



October 15, 2014

It has been a couple of days since our last blog simply because Kathryn and I have been too busy. That is a good thing!

I thought you might like to get an “inside look” at the x-Ray department at MBH. The waiting room has comfortable benches and is very breezy! The red Christmas tree light reveals when An x-ray is being taken. The x-ray machine has been recently replaced and is even digital! They have a full range of studies available; if it can be x-rayed, they can do it! Contrast studies via catheters and drains can also be done, but the physician ordering the test must be present to inject the contrast. The Department also offers ultrasounds via a portable machine which provides nice images.

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There is no radiologist here. X-Rays are read by the ordering physician and the ultrasound technologist writes up a very detailed report which includes images. X-Rays and ultrasounds are relied upon heavy by all departments here.

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The next step is a CT scanner. Even a “one-slice” or “four-slice” scanner (too old for use in the U.S.) would be of tremendous use here. The radiology department will be moving into a new addition currently under construction which has the room for a scanner. Financial capability to purchase one depends upon supporters of the hospital as well as availability of an installer and maintenance of the machine. I was told by one of the physicians here that a “one-slice” would cost around $25,000 and “four-slice” scanner around $50,000. It CAN happen!
-Dr. Sharpe


October 23, 2014

I thought you might like to see the main Medical Staff Conference Room. It serves two basic purposes. The first is a place for the mid-morning “tea” break. From around 9-11 am each morning, coffee, tea and a snack (usually including a fried bread item of some sort) are served here for the physician staff. It is a nice time to talk to other physicians about the day and discuss patient issues. Another function of the room is a location for meetings and lectures. Every Thursday, the General Surgery Department spends 3-4 hours here for their academics. This includes a textbook chapter review and written testing, Morbidity and Mortality review, and Bible study. The photo shows me giving a lecture on the basics of ventilator settings for the general surgery residents. A main function of this international rotation is an active exchange of information where we each learn from our own teaching and experiences. At the end of the day, I think I learn from them just as much as they learn from me!
-Dr. Sharpe

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