Report 1

Reporter: Rebecca Hancock

 Contact at destination: Dr Bray Zoua

 Year of visit: 2010

 Country: Cameroon

 Institution: Hopital de Meskine, Medical Centers of West Africa (MCWA)

 Departments: Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology

 Work / Study undertaken: Reflective report on the use and access of healthcare services in Cameroon, and the effect of culture on health behaviour.

Attended ward round in the morning, which lasted about 1 to 1 ½ hours per ward (we generally only went to 1 or 2 wards each day), then went to the outpatient clinic for the rest of the day, where we sat in on consultations. Also spent a few days in other departments of the hospital to help out and see how things worked.

 Description of the service and department:

The hospital is a mission hospital, founded in 1989 by some missionaries from Louisiana, USA. The hospital has about 100 beds, split into 5 wards – male, female, paediatric, maternity, and isolation. It also has a laboratory, pharmacy, physiotherapy department, prosthetics department, x-ray/ultrasound department, and an outpatient clinic or dispensary, which sees more than 100 patients a day. There is also an operating theatre, which averages about 4 cases a day, but this may be much more. The hospital also provides child vaccination clinics and child health clinics. The hospital is run by Western missionary volunteers with a large staff of African employees. The patients have to pay for all treatment, but it is cheaper than some of the Government-run hospitals, as the hospital is a non-profit organisation.

 Description of the destination:

The hospital is in a very rural location, in a small village called Meskine, of about 10,000 inhabitants. The nearest city is Maroua, about a 15 minute taxi journey away from the hospital. It is in the Far North Province of Cameroon, close to the borders with Nigeria and Chad.

 Were the local people friendly? Did you feel safe and if not why not?

Very friendly. We met some lovely people and were made to feel very welcome. As with many places, we would not have gone out at night by ourselves, but this was just for general safety reasons, rather than because there were any specific dangers in the area.

 What did you do in your spare time? Is there anything that you would particularly recommend others to do?

In the evenings we were often invited to some of the missionaries’ houses on the hospital compound for a meal/film/games. We also had Bible studies and worship/prayer meetings with some of the missionaries in the evenings. The missionaries were amazingly friendly and welcoming and we made some really good friends and felt very at home.

We went into Maroua, where there is an Artisinal/market where you can buy gifts for people, and also have an interesting cultural experience, with everybody trying to sell you things! Maroua also has a couple of nice restaurants where you can go out for a meal.

We went to the market in the village, Meskine, just a 5 minute walk away from the hospital. This was interesting to look around and there are a couple of things to buy.

We visited Waza National Park and went on a 2 day safari. This was really great fun and we got to see lots of animals – giraffes, gazelles, deer, baboons, warthogs, elephants, ostriches, lots of birds.

We visited Rhumsiki, which is a village on the Nigerian border, with really beautiful landscapes and scenery. It is a good place to go if you are into hiking, but it was a bit too hot when we went, so we just went on a couple of gentle walks around the mountains and into the village.

We also took a day trip to a village called Maga where we went on a boat trip on a large lake where you can see hippos.

 What time of the year were you there? What was the climate like?

April and May. This is the hottest time of year, the rainy season starts in June. Daily temperature was generally above 40°C, humidity increased as rainy season got closer.

 What was your accommodation like? Fantastic! It was not like being in Africa at all. We stayed in a small house on the hospital compound, which had electricity and running water. The bedroom also had air conditioning which would have been difficult to cope without because of the intense heat! We had one main meal a day provided for us in the Guest House on the compound and we prepared our other meals. The house was cleaned once a week and we had washing done twice a week.

 Was it provided? Yes

 If not who arranged it?

 How much did it cost? Roughly £300 for everything, apart from the meals we cooked for ourselves, but cost of food was very minimal.

 Did you enjoy your visit? Yes it was absolutely fantastic. I fell in love with Africa and Cameroon especially, and am already really longing to go back.

 Did you find the visit useful medically? – in what way?

Yes, in terms of knowledge of tropical diseases. I was able to see lots of diseases, such as malaria, yellow fever, typhoid fever and TB, which would rarely be seen in this country.

 Has it improved your French? I am more confident in speaking French now, and can understand a lot more. My knowledge of French medical terminology has greatly improved.

 How has it increased your knowledge of French culture? Not really. The cultural group is the Fulani, and is very influenced by Islam, so this was interesting to experience, but not very French.

 If you went back would you do anything differently? Probably not.

 How did you get there? Air France flight from London Heathrow to Paris, then from Paris to N’Djamena, Chad. We were picked up from Chad in a taxi, arranged by the hospital, and driven over the border into Cameroon, which took about 5 hours.There was also the option of flying from Paris to Douala, in the South of Cameroon and then getting an internal flight to Maroua, but these flights are quite unpredictable and unreliable, so on the advice of the missionaries at the hospital, we chose to travel via Chad.

 What was the approximate total cost? £2000

 Is there any other information that you think may be useful? The hospital is a mission hospital, set up by American missionaries, and a group of missionaries live on the hospital compound, where we stayed. We spent a lot of time getting to know the missionaries and there is a big emphasis on meeting together for worship and prayer, which really appealed to us, and played a big part in making our stay so wonderful. However, for this reason, I think this placement is only suitable for Christians. We arranged the elective through the UK-based Christian Organisation, Pioneers, who were really helpful in assisting us with finding flights and insurance etc, but again, there is a big emphasis on Christianity.

Start organising things such as visas quite far in advance as this can be quite complex and time consuming, especially if you travel via Chad.

Be aware that the area is Muslim so you have to dress and behave in a way that is respectful to this – for females, you must cover your head at all times. Your clothing must be very modest – knees and shoulders must be covered at all times, and long skirts should be worn as opposed to trousers.

The hospital’s website has some good information and pictures: