Mariecel Pilapil, MD: Mount Sinai, Internal Medicine-Pediatrics PGY-3
Cameroon: October 2011


The first 5 weeks of my trip were spent at BBH which is located in Kumbo, a small town in the Northwest province of Cameroon. The Children's Ward treats both medical and surgical patients and consists of about 30 beds including a small "Intensive Care Unit" for more acute patients. At BBH, there is no full-time pediatrician so the care of the pediatric patients falls directly on the NP and any General Medicine physicians that are assigned to cover the ward. There is also a small room in the Maternity Ward that houses high-risk newborns, including premature infants or high-risk full-term infants.

The last week of my trip was spent at MBH, which is set up in a similar fashion. In addition to leading work rounds on the pediatric patients, I also spent some time seeing adult and pediatric patients in their outpatient clinic.

During my trip I saw a wide range of pathologies - primarily infectious in etiology - including malaria, severe osteomyelitis, tetanus, tuberculosis, typhoid, and HIV. I learned as best I could about the practice of medicine in Cameroon through my interactions with Cameroonian physicians and health care personnel. I was exposed to some important challenges of medicine including the conflict between limited resources and the desire to care for patients to the best of our abilities. While X-rays and basic ultrasounds were available, the luxury of CT scans and MRIs and a radiologist's expertise were not. Supplemental oxygen and even neonatal CPAP could be set up, but ventilators could not. Even more challenging than the lack of availability of certain diagnostic testing was the limitation of patient finances. Patients often had to be discharged because they could no longer pay their medical bill, which was itemized to include every antibiotic dose or bag of IV fluids administered.

My time in Cameroon - as my first travel to Africa - was invaluable. I appreciate the opportunity to work there even for a short while and I hope to return someday. I also have a deeper appreciation for the work that Cameroonian physicians do and a strong respect for their perseverance in often difficult conditions

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Overlook Medical Center / Atlantic Health System
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