Tikar village report embarked on an eight hour journey to the Tikar village in Central Cameroon. The volunteers were comprised of an eclectic group of American and French medical students,

Campaign in Nditam, Tikar June 25‐27 2010

ASSOCIATION DES COMPETENCES POUR UNE VIE MEILLEURE Récépissé de déclaration N°0082/RDA/J06/BAPP Contacts : BP : 30169 Yaoundé XIII Cameroun Mail :[email protected]/[email protected]

Tél : (237) 99 74 94 85 / 76 51 50 84

Web site : www.ascovime.fr OU ascovime US

REPORT OF THE HEALTH CAMPAIGN IN TIKAR COMMUNITY Present by KATIE BELLEISLE, NOELLE GORGIS and BWELLE GEORGES

JUNE 2010


INTRODUCTION

On June 25, 2010 thirty five volunteers, many of them first time visitors to Africa embarked on an eight hour journey to the Tikar village in Central

Cameroon. The volunteers were comprised of an eclectic group of American and French medical students, surgeons, an anthropologist, a sociologist, a

computer engineer, a journalist, and a non‐profit organization specializing in child education. Despite the fact that we all came from varying backgrounds we were united with a common purpose: to provide free medical care to the

Tikar and Pygmee people of central Cameroon. Our trip began with a great deal of uncertainty. As inquisitive medical students

we bombarded Dr. Bwelle with a plethora of questions all which were impossible to answer. We had to learn, as Dr. Bwelle has, to adapt and

manage whatever the Bush presents you with. The unreliable condition of the roads, the changing weather, and the poorly maintained vehicles mean one never knows the travel time to the village. While two vans were fortunate to arrive with few glitches, the first van to leave, five hours prior to the others,

arrived only a mere twenty minutes before us due to a rainstorm. Upon arrival, our van was filled with excitement and anticipation.

ASCOVIME is a non‐profit organisation which provides to poor people of Cameroonian villages free health care and school supplies two week‐ends per month and this time Tikar people in Njitam village was chosen under positive influence of my brother and friend Issa Nyaphaga and Jenny Sonborn who left

Santa fe in US to come with us to apply this program.


PARTICIPANTS:

NonProfit Organization Hope for Tikar ISSA NYAPHAGA CAMEROON/USA

JENNY SOBORN CAMEROON /USA

ANITA WOODLEY CAMEROON/USA

MICHEL PAULI SWIZELAND

NGAUILEU CHANCELINE CAMEROON

OUMAROU CAMEROON

Dr. Georges Bwelle Cameroonian Surgeon Dr. Ekani Boukar Cameroonian, Surgeon

Dr.Bola Antoine Cameroonian ENT Noelle Gorgis American medical student Sean Condon American medical student Paul Sousa American medical student Carine Ange-Tagni Cameroon/American medical student A’sha Brown American medical student Cecilia Sorensen American medical student Katie Belleisle American medical student Teagan American medical student Michael Ursiny American medical student

Njille Paule Cameroon volunteer Zeng Anicet Cameroonian volunteer Djeukam Anselme Cameroonian volunteer Nangfang Mesmin Cameroonian Volunteer Anjana Souza American volunteer


Bam Leila France medical student Essome Nahalie Cameroonian volunteer

Beaucanps Hadrien France medical student

Masson Raphael France medical student

Labbe Romain France medical student

Samuel Anene Nigeria volunteer

Eudaline Hell Cameroonian/USA volunteer

Ngoa Etienne Cameroonian volunteer

Desire Djanga Cameroonian volunteer

Christelle Laure France Etudiante en médecine

Christine Buytaert Belgique volunteer

Primary Medical Services: • Patient Consultation

• Administration of Anti‐Parasitic Drugs

• Pharmacy

• Injections of Analgesics and Anti‐Inflammatory

• Laboratory • Surgical Care


DAY 1:

Depart 12 p.m.


Arrival: 9 p.m. Greeted with a warm welcome by the villagers


Reception and Village Ceremony: 9:30 – 11:30

Tents Pitched Outside of Chief’s House and rest for the night: 11:30 p.m.


DAY 2

Breakfast: 7 a.m.

Assemble Clinic: 8 a.m. Registration, Pharmacy, Injection Area, Consultation and

exam room, Laboratory, Anti‐parasitic medication administration site.

Dr. Bwelle Addresses Village: 9 a.m. In order to ease the villager’s anxiety, Dr. Bwelle explained that our team would service as many patients as possible.


Clinical Services Commence: 9:30 a.m. Registration – hundreds of patients waited for hours to receive care


Pharmacy – The primary drugs prescribed were: analgesics, anti‐malarial,

anti‐bacterial, anti‐parasitics, anti‐inflammatory and drugs against gastric ulcers.


Anti‐Parasitic Administration – All patients on site were given albendazol. Beginning with children under the age of 15, followed by adults.

Clothing Donation

Laboratory – Examination of Stool, Blood, Urine, and vaginal specimens

from patients that required additional testing.


Injection Administration Site – Intramuscular injections of

antiinflammatories and analgesics were given post‐consultation.

Volunteers are not alone during their first medical practices


Consultations – All patients were consulted by one of the 3 physicians on site.

Consultations Finished: 9 p.m. We were forced to turn away few patients who

had been waiting all day, due to time constraints and the need to begin surgeries.

Dinner at the Chief’s House: 9:30 p.m. We were fortunate enough to eat a

wonderful dinner in the company of the chief while watching the World Cup on the only television in the village. Unfortunately (or fortunately......) the US lost

to Ghana.


Operation Room Setup: 11:00 p.m. surgical supplies and equipment

were assembled and organized at the nearby hospital.




Surgery Commense: 12:00 a.m. the local hospital consisted of two buildings. The first, comprised of two rooms, one of which was used for surgery and the other housed the post‐operative rooms. Using a sheet, the operating room was split

into two operating units.

Due to our lack of proper anesthesia, monitoring, and specialists, we could only operate under local anesthesia. This not only restricted the possible types of operations, but also caused the patients pain. This is especially relevant for

hernia repairs because the lidocaine does not penetrate the viscera effectively. This can result in stress during surgery, and a repeat herniation of the bowel. If


the proper equipment and staff were available for ASCOVIME, hernias could be performed more safely, and more surgical procedures could be perfomed.

Surgery is Completed: 9 a.m. After nine hour, two surgeons completed 29

operations: primarily hernias and lipomas. Because of lack of resources, the post‐operative room was limited to a small room in the clinic with only a few

beds. The rest of the patients were forced to lie on the cement floor. Those who could afford a mattress brought one, but the rest just slept on a sheet. Post‐operative instructions were given to community health care workers and patients were instructed to visit a local clinic if major complications arose.


Breakfast and Farewell Ceremony: 10:30 a.m. At the ceremony three members

of our team, including Dr. Bwelle, were inducted into the Tikar tribe. One of the three, Anita, traced her geneology to the Tikar tribe and

participated in a ceremonial dance to celebrate her roots.


Departure: 11:30 a.m. In appreciation of our services, the chief presented a goat and many

bundles of plantains.

DID YOU KNOW?

Many of the patients requiring surgery presented with hernias and lipomas. Hernias result from the strenuous manual labor of the villagers, many of which are farmers. There are many causes of lipomas. In Cameroon, they primarily result from malnutrition.

LIPOMA:

Definition: Benign tumor formed of adipose tissue subcutaneously.

Epidemiology: Occur in 1% of the population, generally in adults from ages 4060. Most common location is trunk, neck, and proximal extremities.

Etiology: Mostly unknown. Some known causes – familial multiple lipomatosis, secondary to trauma: sudden fall or heavy object dropped on an area.

Alcoholism and anesthesia bruce; DL The patient recovering from alcohol or drug addiction May JA


STRENGTHS • Free medical consultation of 459 patients

• 53 examination of stool where we discover 73% intestinal parasites, different bacteria and mycosis. We also check malaria and

microfilariosis in 58 samples of blood. 2 vaginal smears were done and were positive to candidiosis and others germs explaining why pelvic

inflammatory diseases are so common.

• Successful treatment of a large quantity of patients without prior knowledge of the types and number of patients

• Administration of anti‐parasitic medication to 167 children and few adults

• 29 patients were operated free from hernia, lipomas and others cysts.

WEAKNESSES • Administration of anti-parasitic drugs to young infants

was difficult. Due to lack of funds, we could not afford liquid medications. If chewing was difficult for

infants, the tablet was chopped, dissolved in water, and spoon fed. This method was not effective. Infants often spit up the medication and may not have

received the adequate dosage of 250 mg. • Because the layout of the village was unknown prior

to arrival, much time was wasted figuring out how to organize the clinic.

• The pharmacy did not have a list of available pharmaceuticals and related drugs. A list of all the


drugs corresponding to each bag would make finding drugs and packaging prescriptions more efficient. • There was a lack of patient privacy during

consultations. Families were shuttled in as a group, improving efficiency but limiting effective

conversation with the physician.



Thanks for all and see you in October 2010 Special thanks to Pr Labyale his permanent

support

Documents

Tikar village report embarked on an eight hour journey to the Tikar village in Central Cameroon. The volunteers were comprised of an eclectic group of American and French medical students,