James D Weisfeld-Adams, MD
Cameroon: December 2009

With the help of a $750 grant from the Benjamin Josephson Fund, I spent four weeks as the supervising pediatrician at Mbingo Baptist Hospital, Cameroon. Mbingo Baptist Hospital is a small (180 bed) community hospital facility in a rural setting in a high altitude English-speaking area of north-west Cameroon. The hospital has 20 dedicated medical pediatric beds and a small number of addition cots for newborns in the adjoined maternity facility.

During my time at Mbingo, I oversaw day-to-day goings on the pediatric service and was able to broaden my experience with a wide range of clinical cases. The majority of the caseload comprised children with dehydration and infectious diseases, including complications from tuberculosis, HIV and AIDS. Among other entities, I also saw patients with rabies infection (something I had never seen before and am unlikely to see again), advanced malignancies (Wilm’s tumor, intracranial tumors, Burkitt’s lymphoma) several patients with typhoid infection, and multiple patients with malaria and its compliations.

Having had some experience in clinical Neurology in adults and children, I also saw a number of patients with neurologic problems both in the in-patient and out-patient settings.

Resources at the hospital were in many respects scarse, with no access to ICU monitoring or invasive ventilatory support, no CT or MRI imaging, no EEG, only one X-ray machine, and one ultrasound/echocardiography machine. There was no histopathology lab at the hospital and microbiological studies were also fraught with difficulty, with no body fluid cultures available. In some respects, this was a very enlightening experience, since we were forced to be much more cognizant of the clinical aspects of the cases in order to reach a diagnosis.

I also put in place the foundations for a research project on mitochondrial toxicity among neonates on AZT, an anti-retroviral drug used to minimize perinatal acquisition of HIV infection.

I would like to express my profound gratitude to the Benjamin Josephson Fund for making this trip (and others like it) possible.

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Overlook Medical Center / Atlantic Health System
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