Charlotte Soulsby’s Blog

Bamenda, Barr Fish and Bami

16th August 2008

Again this week has been really varied and busy. Last Saturday was spent in surgery delivering a baby via C-section, then running to a party for HIV orphans. This was slightly unexpected as Bami (the Atlanta-living Nigerian born American) who arrived at the Rest House ‘invited’ Eric, Johanna and I to attend. ‘Invited’ was perhaps not the most appropriate word as she left after an hour to let us run the whole show. So 3 hours later and after several renditions of ‘old macdonald’ and rounds of musical chairs, musical bumps, musical statues etc we were all exhausted and Bami showed up to let the children go home. We were so knackered!

After half an hour of rest we we then out for our first invite to Betty and Laurie (2 nurses from the US/Canada) who fed us up on popcorn and introduced us to the wonders of the game wizzard, I’m sure Eric hasn’t had such an exciting night in a while!

The next day had to get up at 6am so that we could meet Pastor Clement to go to his church at 7am. I cannot wait to get back to the UK and have a lie in until at least 8am (oh and a bacon sandwich) Anyway this church service began at 7.30 and finished around 11.30. Talk about a long service! They even had a cattle auction in the church and marched the animals down the aisle so that the congregation could see the animals at their best before putting in their offers! So after that we headed to Gideon’s (a nursing auxillary in OPD) where he taught us to cook fufu and njama njama from scratch which included sifting the corn and plucking the njama njama weeds.

Johanna and I spent this week together on Women’s Ward which was really interesting as we were able to manage our own patients for a few days. One patient which really should be mentioned was a woman who was admitted with shortness of breath I believe, anyway, after an interesting ECG her potassium was returned and was sky high. We immediately decided to reduce this giving calcium gluconate, insulin and glucose (after checking this with the women’s ward doctor). A few hours later we dropped into the ward to find her very hypoglycaemic, clearly the insulin dose had been too great or the dextrose insufficient. We ordered a dextrose infusion (difficult to find) and found the last bag in the hospital. Anyway, after administering this 5 minutes later she was back to her usual self. Her potassium was returned the next day as normal which was a big relief.

On Tuesday, rachel (the public health student from the US) returned to Banso, which was really good for a few days. On Thursday we then left for Bamenda, Johanna was returning to the UK and Rachel to Bamenda (where she is based). More about Bamenda in the next entry…

Cautery, Colons and CPR

8^th August 2008 

Well, as the title of this blog entry may suggest I have spent this week in surgery, which was quite the experience. Although I enjoyed my time on the paediatrics and TB/HIV wards, surgery has been something else. On my second day this week I was able to close up a patient, which is the first time I’ve been let loose with sutures! (For the more anxious of you out there, she’s doing fine and her wound is healing nicely)

I’ve been able to assist in many of the cases, which is a great experience, apart from that fact that I realised they were recording my name as ‘Shallot’ as I’d laughed when one of the surgeons thought I was named after the onion (I had thought he was joking, but clearly not). There have really been too many cases to mention this week, but definitely the most memorable deserves a mention. This was an elderly gentleman, who was opened up (again) with a suspected perforated duodenal ulcer. We couldn’t find any perforation so decided to put in a jejunostomy (tube into the small intestine to feed him). However, as we were closing the anaesthetic nurse (they don’t have anaesthetists here) announced the patient had stopped breathing and had no pulse. At which point the surgeon lunged for the patient and began to perform CPR. This went on for a few minutes, whereby the rest of us, still scrubbed in looked on in horror. I offered to take over when he looked like he was flagging in order to give him a rest, but there is only so much strength you can muster after holding a retractor all day. Anyway, to end the story, the patient regained a pulse (phew), he was closed up and sent back to the ward. After a sleepless night, I went into the ward at 6.50am to find him talking and to this date he continues to improve, surrounded by his many caregivers (which must number in the twenties). He even managed to ask who I was (and thank me) which was so reassuring as he doesn’t seem to have had any side effects from lack of oxygen to his brain! (ie we must have been very successful at CPR) For those of you in need of CPR in the future, my current tally is 50%, so I may be worth having round if you have an arrest!

So back to other matters, we gained another student this week – Eric, who is a Pre-Med from the
US. He’s been based in surgery this week too, which has been nice (although he has been the brunt of many a joke about americans).

The weather has been pretty bad this week, with almost non-stop rain, which has put us off going out as the roads are so muddy it is difficult to walk on them. Instead we’ve spent quite a lot of time going to the children’s ward in the evenings, giving out lollies. There is also one orphan baby in the maternity ward who Johanna and I visited. Her story is really awful as he was found in an outside toilet (a pit) covered in maggots, just down the road from the hospital by one man who heard her cries. The staff here have named her Hope (although one Dr was more inclined to christen her lou lou…). They are really fortunate at BBH to have a Breast Milk bank for babies such as Hope or others who cannot be fed by their own mothers. Hope is doing really well and is a really healthy baby, who is always smiling. We both really hope that they find her a suitable home.

So without going into so much detail about every surgical case I have seen, which I would love to do so, that’s been pretty much my week. Hopefully we’ll get some nicer weather at the weekend, as we’ve been invited out various places and have some clothes to collect. Gideon, one of the outpatient nursing auxillaries has invited us to his home to make Fufu and Njama Njama, which couldn’t be spelt more incorrectly, but is basically a mushy, smash but not potatoes, like corn but very tasteless and this bitter leaf (njama njama) which is far nicer. The other guy who might be invited is the one who has recently proposed marriage to me…quite seriously. I told him I’d love to but I couldn’t because I live in the
UK. I think he only heard the first part of the sentence, which is worrying. On the up-side, I’m teaching him Geordie, which should compensate for any broken heartedness.

‘‘WONDERFUL!!!!’’

(I’ll explain in the next blog entry)

Hope everyone at home is well and those of you away are enjoying yourselves… so many stories to tell!!

Charlotte (Shallot)

T.I.A (This is Africa) 3/08/08

This is the end of my third week in Kumbo, Cameroon and the first real opportunity I’ve had to sit down and update my blog (and gain access to the website!). So, I’ll try to update you and give a little taster of what I’ve been up to in the past few weeks. I arrived safely (as you would have guessed) to Douala Airport to be met by Victor, the Cameroon Baptist Convention (CBC) driver. After spending the night in the European Baptist Mission in
Douala we set off the next day for Banso, travelling via Bamenda. This journey was really interesting, from the bustle and chaos of the roads in Douala to the quiet mud tracks at we travelled through the NW Province.

The Rest House in which we are staying (I will probably refer to ‘we’ a lot during the blog as there is another UK Medical Student here from KCL, Johanna) is basic but nice. Unfortunately over the past few weeks we had a night of termite infestation, whereby millions of the flying beasts were entering the rest house through any space they could find! The other night we arrived back to find a ‘large’ tarantula (I thought it was huge, but the security man decided it was quite small) on our doorstep. Unfazed, he used a large stick to ‘flick’ the tarantula into the air away from the door, leading to much panic and palpitations that the tarantula (which was now hissing) would end up in my hair! Oh and final rest house story was today on the way out to church I managed to pull the door handle with me as I was leaving. Nevermind, hopefully it will be fixed tomorrow. The food is nice, pretty much consists of egg/bread combination for breakfast and beef plus carbohydrate for dinner. Not the most Cameroonian of foods, but we have asked for traditional stuff as we are both willing to try it!

With regards to the hospital, the staff are all amazing and really friendly. We are both given a lot of opportunities and responsibility, which makes me a little nervous that I’m out of my depth. I spent the first week on paediatrics with Dr Njume, which was really enjoyable. It was good to see how similar medical conditions are dealt with differently from the UK but also to gain exposure to many new conditions and styles of management. In particular it was interesting to be able to see patients managed on the Burkitt’s Lymphoma programme.

This last week has been spent on the TB ward (thank goodness for the BCG and facemasks). Although the ward is not full, management of a handful of patients has been challenging with non-response to medication, unremitting fevers and bizarre chest x-rays. (Certainly no Chest X-ray looked like any of those in my ‘chest x-ray made easy book’, may need to move onto the advanced version when I get home). After TB ward rounds I spent the rest of my time in HIV out-patients. This gave me a good insight into the treatment of this chronic condition. It was really notable that only a handful of patients were taking full ownership of their diagnosis, but I believe this is mostly down to an education/language barrier. Some patients were not even able to give their DOB or rough age. Again, I was given the opportunity to consult and stage new patients, which was a good learning experience, although I don’t know if I was quite prepared for it with my 1 HIV lecture and clinic in Ninewells.  

Any spare time over the last few weeks has been spent in Outpatients, which is an experience in itself. I still haven’t really grasped the fact that patients must pay. Luckily we have the ‘guidance’ of Gideon and Marcel, the auxillaries. Not entirely sure if either of them understands us, but they’re always really friendly, falling over patients to rush and greet us. As a side, Cameroonian men seem to greet with a strange handshake which involves snapping one’s fingers off the other person’s fingers, which Gideon is endeavouring to teach us (unsuccessfully so far!). I should probably also note that most people we have come across do not seem to like smiling for photographs. We are accosted once the camera is out for pictures to be taken, but then the subjects all seem to think that ‘stern’ faces are appropriate. I have started threatening that people in the UK will think everyone in Cameroon is miserable!  

So work pretty fills up my time between 6.30am-4pm, after that we hang about, sometimes risking the rain for trips to the supermarket for chocolate spread, biscuits, bread and Top (a fizzy ‘grapefruit’ drink – which tastes of nothing but beats water), this is all we really eat apart from fresh fruit at the market. Other than that we have been spending our time in the material shops, looking for African prints/waxes (After rigorous study I now know the differences between my African fabrics). Hope to pick up some of our clothes next weekend, which will be a great change from the 2 skirts I brought with me! Other than that nights are quite empty as it gets dark at 7pm. Thankfully, we were lent some dvds from 2 students who were leaving as we arrived, so we have been working our way through those, will probably be able to quote ‘Legally Blonde’ word for word by the time I leave!  

So this week I will hopefully be doing surgery, which I’m really looking forward to. Hope everyone is well at home, apologies again for the lateness in posting up my first
Cameroon blog and promise to update the blog a little sooner next time! 

(Oh and as a side T.I.A ‘This is Africa’ – the title of a blog, was a saying taught to us by an American Public Health student, Rachel, who stayed with us the first week. It’s a saying we use daily for the unexpected, odd or downright unbelievable things which have happened and could only seem to happen in Africa!) 

Love to all 

Charlotte

Getting ready to go

Its finally the day before I leave and, as usual, I have left most things until the last minute .. including checking whether or not I received a plane ticket. So the morning has been spent running around shops buying things like elastoplasts and spending hours on the phone to STA travel, AirFrance, Newcastle Airport etc etc.. (FYI I didn’t receive any ticket, not even an E-ticket, apparently a passport will suffice - I’m yet to be convinced but we’ll see!)

So this time tomorrow I’ll be nearly touching down at Douala Airport, its all very exciting yet slightly daunting. Off to catch up with school friends tonight then to bed for a 4am check in tomorrow!  

Exams finished … now the packing begins

So the time to pack has finally arrived. After months of preparations and a week of exams the reality of spending 2 months in Cameroon has finally hit me. I will be spending 7 1/2 weeks at Banso Baptist Hospital, a 250 bed district hospital in Northwest Cameroon. This will be my first trip to Africa and the first time I have travelled alone so I’m a little nervous but still very excited.

At present, I have just completed my 4th Year studying Medicine at the University of Dundee, a small city on the east coast of Scotland, UK. I’m originally from Newcastle upon Tyne in England so this weekend will be spent travelling back there to see friends and family before I leave.

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