Update

Our time in Cameroon is quickly dwindling. This past weekend we had the chance to climb Mbingo hill, a hill right next to the hospital. I think it should have been called Mount Cameroon. The combination of heat, altitude, and me not being in shape made it a tough climb. It was a nice sight once we arrived at the top, though. We were able to view some of the neighboring towns and the hospital compound. Our guide, a native Cameroonian named Caleb, did a good job of leading us up the hill in a very confident manner. It was only afterward that we learned this was his first time up the hill. J

On Sunday we attended the local Baptist church. Almost all of the attendees are hospital workers, so it was good to see a few familiar faces. The church service was quite long (approximately 1.75 hours), but our home church in Minneapolis runs about the same length, so it wasn’t too big of an adjustment. I enjoyed the music the most. All the songs are sung acapella since they don’t have a piano or organ, and they are able to harmonize and keep a consistent beat throughout the whole song. It was beautiful.

My time at the hospital last week was spent rounding in the men, women, and pediatric wards. This week I wanted to focus more on meeting with individuals from the pharmacy to get a feel for their purchasing, distribution, and inventory control system. I also spent some time preparing lectures to give to pharmacy staff and medical staff. My meeting last week Wednesday with the 3 pharmacy technicians turned out to be great! They grilled me with all sorts of clinical questions that I followed up with this week in presentations.

Some of their questions are as follows: At what point do we taper steroids? What is the max dose of prednisolone? Could you talk about the use of steroids in PCP and meningitis? Are folinic acid and folic acid able to be substituted interchangeably? Could you provide us with chemo protocols for ewing’s sarcoma, oropharyngeal cancer, colorectal cancer, CML, CLL, and multiple myeloma? Could you talk about the management of BPH? We have a problem with inappropriate use of antibiotics (initial selection, duration of therapy, potential resistance) – can you help us with this? Can you give us a talk on VTE/PE prophylaxis and treatment? We need guidance for VTE prophylaxis in our surgical population, can you help us with that? Can you provide us with a “guide to clinical monitoring” in the ward? Guidance for developing a pharmaceutical care plan? These are a few of the questions that the pharmacy staff has asked over the last 1.5 weeks. Whew! I think I will need a few more weeks here.