Cameroonian Pharmacy

Recently I had the opportunity to visit a Cameroonian pharmacy while downtown, to purchase some medication. I knew exactly what I needed, the only problem was I didn't know if the medication was available here (or only in the USA). I entered the pharmacy and it was a very well-kept shop. Very neat, organized, clean, and full of everything. Mostly what I saw were medications lining the walls and further back in the back of the store. One section of the store was dedicated to beauty products.
That was it. No toilet paper, no chewing gum, no office supplies. This pharmacy had a small beauty section and the rest of the store dedicated to medications. I went up to the staff and unfortunately nobody spoke English. Between Lexicomp, some hand motions, and a few broken French words I was able to communicate what I needed. The pharmacist brought me a few medications that might help. I recognized the classes of the medication, but they were definitely ones I had not heard of. Luckily one medicine of the pile was pretty much what I was looking for and it worked. The pharmacist showed me the directions on the box and started counseling me on how to use it, I was glad to see that.
All-in-all a good experience. I'm glad I found what I needed. I'm also glad I was able to see what a Cameroonian pharmacy was like, to compare it to the States.

Vaccination Program

This morning we spent a few hours in the immunization clinic. The clinic runs on Wednesdays and Fridays, from 7:30AM - 11:00AM. Vaccines are an important service offered by the hospital, with 95% of the immunizations for babies/children. The government has programs set up to provide certain free immunizations for babies/children.
At 9:00AM Mr. Adolphe (pictured) gave a short lesson in the importance of Vitamin-A vaccinations for babies, and asked questions of the mothers. Education is something we are pushing here at these immunization clinics. There was a full crowd today and only one nurse, so volunteer Kelly Fromuth was called into action. I was there simply to shoot pictures/video. I did end up trying to draw up some syringes to facilitate the process. It was very hectic watching them give immunizations. There were many crying babies. It was a whirlwind of activity for about 2 hours until all vaccinations were complete.
The babies are weighed and vaccinated at these check-ups, and the information is recorded on their vaccination card.
Its a very good service offered by the hospital, funded by the government, and hopefully after some analysis we may give some pointers to smooth out the process.

A day at the beach; Kribi

The weekend of Nov 22-23, the Project HOPE team traveled to the beach town of Kribi. The drive is four hours long and included passing through many towns, rest stops, and lots of jungle. I am continually amazed at how lush & green this country is. Thankfully the road to Kribi is well built (by the Germans I believe, from many decades ago). Rules of the road still applied; meaning no rules. It is extremely dangerous, in my opinion, to drive in Cameroon.
We passed a 10km stretch of "Palm Tree plantations", where they grow palm trees to harvest the oil. It went on forever, it was great. Every town we stopped at, our car was swarmed by people trying to sell us their wares. We finally arrived to Kribi and the driver (Bala) and our guard (Yves) immediately bought dried fish. The fish from Kribi is the best, freshest in the country. We checked into the hotel, Hotel du Phare (best in the area) and went straight for the beach.
The beach was very nice, brown sand but not full of seashells/rocks/stuff. We are told the sand at Limbe (other beach resort) is black due to oil pollution and volcanic ash. The water was actually warm, way better than I expected. We hung out at the beach until it was time for dinner. We were invited to go to a family friends' house for a late lunch, then a restaurant in-town for dinner. The town of Kribi is very similar to Yaounde in some aspects. Kribi really starts to set itself apart once you get to the beach.
Dinner was delicious, Sole fish prepared with vegetables, plantains, and fries. I tried the head of the fish for the first time in my life. Its a common thing to eat in Cameroon, and some people prefer the head to the rest of the body. Lets just say, it was my "Andrew Zimmern" moment. I couldn't handle it. The night was spent on the beach with a good book.
The next day we had a wonderful "French" breakfast at the hotel, I had fresh coconut from a local vendor, and we spent the rest of the morning on the beach and purchasing goods. Being a tourist destination, many local vendors bring their items to sell right up to the hotel restaurant. I went for a walk on the beach and jumped in the Atlantic Ocean for a last time.
We left the hotel, which was very nice, and had a late lunch again at the family friends' house. It was delicious fish.
After lunch we went to a famous tourist destination, the Chutes del la Lobe. We took a canoe ride around the bay, saw the nearby fishing village, and went right up to the waterfalls. This is the only waterfall in the world that falls into the Ocean.

Unfortunately we had to leave Kribi after being there only one day. It was definitely a needed respite from continuous work at the hospital, and very nice of the Blaz family to set it up for us. We traveled another four hours back to Yaounde, arriving well after dark.

I want to give another shout-out to Jellybean. Megan sends a shout-out for JC & KMo. Kelly sends a shout-out to no one in particular.

Video series: Training videos

I was sent here to Cameroon with an armament of electronics, all in the effort to assist me with capturing my time here with Project HOPE. Use of the video camera has been slow until now; I didn't really know what I should be recording with it. After seeing the YouTube videos created by Alisa/Emily during their Project HOPE rotation, I am inspired. I thought up an idea of recording educational videos for the staff here at MRN hospital. I have been working with Project HOPE volunteer [Kelly Fromuth] to come up with ideas/implementation for these videos.

We just finished shooting our first training video: How To Do An EKG. Although it was a bit rough around the edges, I would call it a success. We plan on analyzing the video and shooting a second one (hopefully more polished) to be used by the staff here. Other ideas include: hand sanitation, aseptic technique(s), vital signs, and more.

Stay tuned for updates on our Video Series.

Motorcycle taxis: will I risk it?

Ever since coming to Yaounde and seeing the prevalence of motorcycle taxis I have wanted to ride one. They are a cheap mode of transportation here and everyone uses them. Apparently they only travel short distances (this was told to me by a taxi driver) so they can have quick turnaround of customers. I've seen all sorts of people on motorcycle taxis. From toddlers going to school, businessmen in suits going to work, and entire families (most I've seen is 5 people on one motorcycle).
I'm told it is a very dangerous method of transportation and there are many motorcycle accidents on a daily basis. I have seen some of the aftermath of motorcycle accidents (nothing too serious) at the Yaounde Central Hospital.
One of the main problems with the motorcycle taxi system is that anyone can purchase a motorcycle and start riding. There is no "Class M license" like in the States. There are no driving schools for motorcycles. No requirements. All you need is your identification card and enough money to purchase one.
True survival of the fittest.
I bring this up today because during our morning run (Yves, Haris, myself) we were constantly honked at by motorcycles. They dodge and weave to beat traffic. We were running at 6:30AM so luckily not as much traffic.
I think I have gotten over the desire to ride a motor cycle taxi. At first I thought it would be a fun roller coaster ride...now I think I might just get hurt. Who knows, maybe I'll do a short run.

We NEARLY ran out of food!

Last Thursday we Nearly ran out of food at HOPE House. We had been warned by previous volunteers to keep on top of the food situation but its been pretty darn good so far. The tipping point was when we ran out of peanut butter (an important protein source for one of the volunteers here). The backstory: due to the previous Sunday being an election day (all stores closed) we weren't able to go to the supermarket to replenish. Thursday night we had cous-cous 'potatoes', at least they were shaped like potatoes. We didn't even know they were couscous. The next 2 days we scraped by on the bare minimum. Saturday morning we literally had nothing in the fridge so we ventured out to forage. We came across a roadside stand directly across from the hospital that sold 'beignetes' (basically donut holes). We were salivating. They are so good.
Breakfast on Saturday turned out to be very unhealthy and delicious, followed by a late large lunch. Needless to say, at the supermarket yesterday we STOCKED up on food.
One thing I learned...people can become a little more irritated if food runs out. So always keep the fridge stocked.

Cabaret with a surprise concert

This event happened quite a while ago it seems. Saturday night, October 8, 2011. For the evening we decided to go to a cabaret to listen to Live Cameroonian music. After much trouble getting a ride, we crammed EIGHT people into a small station wagon and headed downtown. The cabaret was called 'Carousel' and when we arrived, we realized there was a concert that night. The famous Cameroonian pop star 'Lady Ponce' was headlining after a few local bands. We arrived about 10PM and ended up staying until 4:30AM. Did I mention Lady Ponce didn't arrive until 4:00AM? We were absolutely exhausted and by the end of the night (early morning, really) I was absolutely ready to crash. The bands we listened to were pretty good. It was a good experience over all. I'm glad we stayed for Lady Ponce to see who this star is, but I wish she had started a little earlier. Everyone was going crazy for her. People would go up on stage and rub money all over her forehead and give it to her. It was quite an interesting event to watch. I ordered chicken + fried plantains, in addition to eating some mystery roadside meat (chicken on a stick?).
I think I would prefer my cabarets to be a little more low-key. I learned a few Cameroonian dance moves thanks to our musically gifted friend Albert. Hopefully we can go to a cabaret again, I would love to listen to Jazz or French music. Cameroonian music is good too. But definitely don't want to be there that late.
On the way home we had car troubles. One of the cars blew a tire so we had to pack into one car. 7 people in a Mercedes this time, a little more breathing room. Since it was the day of the election, and all shops would be closed, we stopped at a bakery @ 5:00AM. We stocked up on bread and munched on donuts while we waited.

Hospital tours put things in perspective

I haven't updated the blog in a while, and this will be a relatively long blog; I apologize in advance!

Every morning I come to Maria Rosa Nsisim hospital and I round with the medical doctor (and nurses). I take notes and notice differences between care provided here, and what I expect to see in a U.S. hospital. When I round, I keep in mind the resource limitations here at the hospital. The medical staff here are doing an excellent job providing care to their patients given the conditions. To put this [private] hospital into perspective and to learn more about hospitals in Cameroon, it had been suggested we visit [public] hospitals to draw differences.
On Wednesday we had that opportunity to visit both a (General) hospital and (District) hospital, both public. Just the ride to these hospitals was quite an adventure, and almost made me nauseous. I couldn't imagine a sick patient having to endure a ride to the hospital like that.
First we visited Yaounde General Hospital, which is the largest hospital in all of this area. Its patient base includes the surrounding areas outside of Yaounde as well. It is a teaching hospital with medical students and nursing students training, although we didn't get to tour any school campus there. It was a very large compound, it has been around for over 50 years (buildings are very old and showing their wear) although ongoing renovations for the past decade, and it was spread out with each department having its own building. We had a very nice nurse, Jacky, show us around to each department.
What I saw there put Maria Rosa Nsisim (MRN) into perspective. The General Hospital had a huge patient load (and large capacity), although it seemed people were waiting everywhere. The buildings as mentioned are very old. The equipment was very limited and many patient beds were in each room (standing screen dividers for privacy). The hospital is capable of treating many types of ailments and seems very well staffed. I spoke to a ER nurse as he was working on a motorcycle accident patient who had a bone sticking out of his leg; the nurse was prepping the leg for surgery. It was quite intense. It was also comforting to see mosquito nets in the maternity ward, to help prevent malaria. I was impressed by the scope of practice at the hospital but not happy with the cleanliness, apparent lack of infection control, and the sheer number of people at the hospital.
The District Hospital was a further drive away and the first building we walked into seemed very well maintained, clean, and newer. There were many people waiting on benches but none in apparent distress. After we toured that building and went across the street to the next building, I realized the first building was their "administrative" building with a few VIP patient suites. It was mostly administrative staff, MD offices, and various other rooms where patients would meet to resolve issues. The second building across the street was the actual hospital. It was in worse shape than the General Hospital. Similar issues were present for this hospital but it seemed even less resources were available. It was much smaller than the General Hospital and had a smaller patient load. Some beds being used did not have mattresses and were only the metal frames. All in all, I realized that MRN is off to a good start and I hope my work out here is beneficial to the people most in need.
There is definite need in this country for improved healthcare. They need to raise the quality of care here. I commend them for their efforts given the limited resources and conditions. All accounts given of the hospitals were based on brief tours (take everything with a grain of salt), and of course these are my personal opinions.

when in Rome, do as the Romans do.

Had a chance for another cultural experience this morning! I was invited to play soccer with the local team at a nearby soccer field this morning. Due to rain, our scrimmage was delayed; we still played in mud. Soccer is very popular in Cameroon, and everywhere I look I see people wearing team jerseys. Last night Yves took us to the city center to purchase authentic Cameroon soccer jerseys, which I sported at the scrimmage today.
There were about 20-25 players split up. Everyone had jerseys/pennys and cleats. I was lacking the cleats so the entire match was a big mud slip 'n slide for me. My trail-running shoes were not cutting it on the field, but luckily I didn't take a dive for a mud bath. Being the rainy season, I assume every weekend that I play will be rainy & muddy.
These guys were very serious about their soccer. It was very clean (referee), no drama that I usually see from soccer players, minor pushing/shoving to get the ball, and many quick arguments after any penalties were called. They embraced me into their game but I think I will have to earn their respect. Its been 10 years since I've played soccer so to say I'm not up-to-par is an understatement.
They did offer me to kick one of the penalty kicks, which I made to bring us to 7-3. We still lost. Fun match nonetheless. Saturdays are practice scrimmage and Sundays are matches with other towns.

Management 101

Another quick post for the followers. I wanted to update everyone on the work we are doing here at the hospital. This whole week we have rolled out our 'new manager training' program for the future hospital administrative staff. Every day we have been holding meetings based on our training program, which we hope to conclude by the end of my 8 weeks here. The meetings have been going very well and we are making great progress!
The management training is right up Tim Clark's alley, with his experience in the Pharmaceutical industry. This training is also putting my MBA to good use, a degree I have received questions about since I signed up for it.
Many meetings have been held during a time without any electricity/power, so it has been darker and hotter than we would want (and remember, this is the nicest building in this entire area). This is how it has been since we have gotten here. Internet cuts out and power cuts out frequently, but as Dr. Mukalay said to us yesterday: "Welcome to Africa". Makes you appreciate what you have in the States even more.
We have our task from Project HOPE, and we have our task from the Hospital CEO. Starting with this week and for the next 6 weeks we will make as much progress as we can, finish our assignments, and see Cameroon culture!

10 million viewers and counting!

Bonjour!
Yesterday we were surprised to have a TV journalist come to Maria Rosa Nsisim for a promotional video/news clip about the hospital. Their aim was to increase awareness in the community about the hospital and also let viewers know what services are offered. Being the coveted HOPE volunteers that we are, Tim/Megan/Myself were asked to lead the explanations of each department. I personally covered the OR and Pharmacy. No make-up, prep, or lighting done; the video is el-naturale! Apparently it was showed last night on [Canal 2 International], one of Cameroon's most popular TV channels. We were told upwards of 10M viewers would see the 1min summary clip!
It was a nice little surprise to be asked to be on TV; since we get a copy of the entire video I might send it directly to Hollywood. Actor/Pharmacist possibly? I hope that more promotional videos and such are created within the coming months to put MRN Hospital on the map; this place is a boon in the area and with the work Project HOPE is doing (with the help of volunteers such as ourselves) the aim is for the hospital to be a center of excellence serving all types of people(s).

Au revoir!

P.S.
Megan wants to give a shout-out to K Mo and JC. I want to give a personal shout-out to the most important person on the other side of the Atlantic...Jellybean!!

Need to update while I still have internet

Bonjour!
Just another work update from Cameroon. This is Day 7 of 52 for me out here in Cameroon. So far we have been adjusting to the time, temperatures, and lifestyle here in the town of Ahala (section of town where the hospital is located). We have been getting a sense of how the hospital works by observing the different services offered here. There has been a lot of meet & greet, and remembering (and/or pronouncing) everyone’s name is a challenge for me. I have met all of the key hospital staff so far, we have toured most of the areas, and now we are settling in for our first week of heavy-duty work. We have taken a teaching/consulting role here at the hospital for the time being; our task is to train their new hospital administrative staff. Time to put that MBA to good use! We will be rounding with the new CMO every morning and have regular meetings with the administrative staff. It’s all very exciting, as we are charged with building the hospital from the ground up (figuratively).

Au revoir.

Going out of town, literally.

Our first weekend here in Cameroon was a success! We went out both days; spending Saturday touring the countryside with Eve and spending Sunday grocery shopping and dinner with the Blaz family. Saturday included visiting the town of Mr. & Mrs. Blaz and spending time at a family plantation. There we saw papaya trees, plantain trees, cassava (Cameroon potato), a cute goat missing its hind hoofs, a bat-pig, sugarcane, and various chickens/roosters. It was like visiting a farm with a litte more freedom for the animals. I tasted cassava, sugarcane, and Cameroon peanut butter for the first time. The family was very hospitable. Children were playing futbol in the mud. It was a good way to experience the rural areas. We came back to Ahala and hung out at a local bar, which happened to be family owned.
Sunday we went to [catholic] Church with the Blaz family, Cameroonian style. The choir was very lively, with each sermon being followed with song & dance. Church was followed by grocery shopping at an upscale supermarket (very, very expensive!) (but good to have the house stocked up), and a trip to Akono with Mr. Blaz to attend a campaign rally for President Biya. Many top Yaounde businessmen were in attendance; it was quite the event. There we also saw the very first Church built in Cameroon. We finished the evening with dinner at the Blaz compound, which happens to be situated next to Yaounde’s only golf course.
Next weekend we hope to visit a local wildlife preserve and go swimming!

arrived and hit the ground running

Hello readers!
The Project HOPE team (Kamran, Tim, Megan) has safely arrived in Yaounde, Cameroon. I had quite some experiences in the travels; the layover in Paris + Casablanca were uneventful and slightly cumbersome. Finally made it to Yaounde at 3:10AM this morning and on little sleep.
The updates will be frequent and short. Today being the first day, I don't have much to tell about. We took a grand tour of the hospital today, the Maria Rosa Nsisim Hospital and met with the Blaz Family (founders/CEO/board director).
Yaounde is an interesting place, definitely culture shock for me. We don't have running water but we have a 32" plasma! (they are working quickly on the running water issue).
The highlight of the day was meeting with the Blaz family and hearing their vision. The hightlight of the tour was to see the NICU, I saw a 4 babies there and one of them only weight 750gm!! They are so tiny and cute. I hope they make it; unfortunately the infant mortality rate here is very high.
I don't know if I can load pictures but I will try to keep them coming. For now, enjoy the first sight you see at the International Airport in Yaounde`.

Setting off for Yaounde, Cameroon

The time has come for the final Project HOPE rotation to begin! The trip has started with some flight difficulties; flight delays and extra layovers.
I hope to update the blog from Paris, France during my layover, and from Casablanca, Morocco. Finally I land in Yaounde, Cameroon @ Tuesday morning.
I hope my 8-week adventure is as good as the previous ones, and I hope to update this blog as frequently as I can with great photos & stories.
Stay tuned!

Getting closer to 'shipping' out!

It's been a while since I've posted, due to having few updates.
I'm glad to see my classmates, Andy & Andrea, who shipped out to Southeast Asia have returned safely and have great blogs about their trips!
So far in Cameroon things are going good. Project HOPE has gotten volunteers on the ground and working in the hospital. There are always logistical issues with missions such as this, but things are progressing positively. I'm very excited to arrive and 'get my hands dirty'. It looks like I'm a few immunizations short of my early September trip.

Next update will be closer to fly date.

*Make sure to follow our group, Alisa & Emily, who have recently gone to Latin America!

Project HOPE in Cameroon, Africa!

Hello! Welcome to my section of the Project HOPE blog. I will be traveling later than the other Project HOPE students, but I am already very excited! I am so grateful for the opportunity to be the first Pharm-D/MBA student to do a rotation with Project HOPE!

Last week I had the opportunity to attend the 6th Annual Investment Forum (Strengthening Cameroon's Economic Growth Agenda) in Bethesda, MD. Matt Peterson was due to present the Project HOPE initiative as part of the panel discussion. He did a wonderful job giving a summary of what Project HOPE expects to accomplish in conjunction with Maria Rosa Nsisim Medical and Surgical Foundation (MRNMSF). The forum was a 3 day event, with our presentation on the 2nd day. There were about 15 business professionals and representatives attending the forum, and Mr. Peterson's presentation sparked a lively discussion.

This week I have met with individuals to get a low-down of what to expect in Cameroon and I received my iPad. There is still a lot to do before the trip.

Stay tuned for future blog posts!