Wednesday, September 10, 2014

Reflections

Two months ago I left Cameroon. I was exhausted and could rarely see the good and positive - though I knew it was there.  

Today - here and now - I am on the eve of my flight to return to Cameroon for the last time as a resident.  I am seeing snapshots in my mind - scenes of Cameroon’s lush countryside, of steep and rugged mountains, of sweeping vistas, of the black sand beaches of Limbe and the white sand beaches of Kribi.  I see the winding roads through the jungle.

I smell the scent of the wet jungle, I feel the sand and water between my toes, I hear laughter floating across the breeze.

Memories - times shared - conversations engaged - laughter, insights, dreams, trials, struggles, failures, successes.  Each image a story rich in culture, context, and sub-text.

Life is what happens when you aren't looking - or so they say.  But living and working in Cameroon for nearly five years I have been constantly aware of life in the making - here - and now.

I think of the people with whom we have shared this time: Cameroonians and non-Cameroonians.  People of similar faith and those with very different belief systems.

Images of my favorite places to hangout float through my mind: Arne’s; Capitol Hotel; A1-Complex; Gideon, the Shawarma guy; Bonga Juice; Clerks Quarters; and the Mediterranean.

I see Thanksgivings and Christmases and parties at our home and with friends at theirs.  I see quiet evenings and game nights.  I see failed game nights that turned into beautiful quiet evenings and spontaneous quiet evenings that became game nights.

I see church: fellowship meals, sermons, and energetic discussions.  I see the friends and colleagues who traveled far and near to visit.

I taste the many cooking experiments of our own making and that of our volunteers.  I can taste the oil and pepper in the black beans; the succulent chicken and tomato sauce; 

I remember the very day the first time I smelled the grass, February 14, 2010 after the first rain of the season.  I smell delicious food and the burnt aromas of forgotten popcorn or rice.

I feel the cold dampness of the rains; I feel the warmth of the sun and rejoice in the gentle breeze.  I feel the cool of each evening; 

My thoughts drift to the Health Centre, what was, what it has become, and thinking what it can yet be.  Much of this I am still processing.

Some speak of legacy - this time in Africa.  But it is only a drop in the bucket during a rainstorm in Buea.  The entirety of our life is our legacy: the good, the bad, and the ugly.

Each of us is a gift to humanity - a gift of our talents, our time, and our skills.  We gift our interests and efforts.  Sometimes it is appreciated - sometimes not.  The quality of the reception of our gift need not change the gift.  The quality of the gift of ourself is our choice, not the choice of someone external to ourself.  

Let us encourage one another.  Because there are many days of struggle.  

Be courageous! Love with genuine affection.  Love the lovely and the unlovely.  Bless all with the gift of a life lived in and through Love.  

Tuesday, September 9, 2014

Fit for Skyline Drive

The drive to Yaounde from Buea is about 322 km (200 miles). The fastest I made it was in 4 hours the longest included an overnight in Douala because the traffic really was that bad (coming back from Yaounde).  Normally, without feeling rushed it was between five and six hours.  The thing is a Nissan Terrano is an SUV and it drove like an SUV abused in Africa - with good reason - because it is.

When I picked up the Fit I was trying to think about a fun place to drive for an extended “get to know you” experience. The ONLY place that entered my mind was Skyline Drive in the Shenandoah National Park.  I mapped it out in Google to 207 miles with an estimated drive time of 4 hr and 35 minutes. 

It was a beautiful drive. I opened up the sunroof and put the windows down. I was able to work the car a bit more.  The drive to Front Royal was pretty standard but turning up Skyline Drive I immediately noticed the CVT trying to find the right place to be. What I was driving were some rapid up and down hills on corners. It was trying to anticipate what I might want or need but was not meeting with any success. So, I turned off ECON and put the car in sport mode, requiring me to use the paddle shifters. This turned out much more satisfying (admittedly however I am a manual shift guy and still wanted to shift that way).  In any case the CVT obeyed my command. I found the Fit ready to respond with some engine breaking on the down slopes and entering corners before adding power through the curve and up the hills.  It was quick to shift up or down.

The steering is light and precise, coming off the Terrano I simply wasn’t prepared for its accuracy, but that is one reason for me to do this drive. With the wind in my receding hairline, music emanating from the iPod through the sound system, with a “Fit” and capable car I was getting road therapy - salve for the soul.

It was all real good until I realized I went west on 33 rather than east. Oh well - I wasn’t lost just getting extra miles on the highway.  I went back via I-81 to I-66 an extra 60 miles or so.

My entire drive took me about 6.5 hrs with stops out vistas and animals.  I was reminded just how fun it is to drive a car that is so willing to be driven.  To be fair to the Terrano, the few times I found myself on muddy and challenging roads I was ever so pleased it was what it was!!

Everything has its purpose.  I enjoyed the Terrano and am now enjoy the Fit.  To fully enjoy each I have to remember each has a slightly different purpose.  


Everyone has a purpose. Sometimes it seems that our “things” are easier to see and understand purpose. In people purpose may be more difficult. However I would like to make it easier. I believe it is our purpose to love without condition or requirement.  Everything else we are or have is something else - perhaps gifts from God to be given in the service of love.  You are fit for service because you have a purpose and a very high calling: love others as you love yourself.  May the love of yourself and others grow more each day.

Sunday, September 7, 2014

Let It Rain



“Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you where ever you go.” Joshua 1:9

~O~

Sometimes courage is in short supply.
Sometimes strength is found in weakness.
Sometimes the tears threaten to fall.

The glass facade trembles and nears dissolution into a broken heap of shattered remnants.

There are many things to appreciate about my life in Buea. I am surrounded by blessings in the form of friends, pets, smiles, and inspirational stories every day. I live in a people-oriented culture where people take time for people.

~O~

Sister Comfort dropped by the patient's room looking for a pair of baby's shoes. In spite of her busy schedule, she exchanged pleasantries with the new mother for a quarter of an hour before continuing on with her duties. She forgot the shoes.

~O~

A member in church is recovering from an operation at home. Each day a steady stream of brothers and sisters in Christ, visit her, delivering fruits, drinks, and companionship – distracting her from the pain and cheering her through discussions on the local events in town or reminiscing over enjoyable memories.

~O~

Even online, when I open my in-box, it spills over with messages and encouragement in daily snippet exchanges shorter than a tweet but filled with plenty of love.

Everywhere I look, I am blessed.

~O~

Still, there are the periods of loneliness, tiredness, discouragement – seasons of sadness. Or perhaps not an entire season but rather moments of melancholy? Periods in life that remind me I am human, not immune to the tribulations in life.

Sometimes the showers of blessing are showers of sadness too.

The rain outside my window tonight falls lightly, it drips in a steady flow – slow droplets from the sky sighing in their misty descent. Their melancholic liquid symphonies splashing to their death in a mournful rhythm of drip, drip, drip.

I want to join their chorus. I want to let my own tears blend and mix into the watery cascades, allow the sadness  to float away in the same rivulets as the falling water. The rainy splashes can drown out my sobs. My tears will vanish in the fleeting flowing eddies of swirling water.

I want to let the tears come and wash away  this sorrow.

~O~

Emotions are like the waves of the ocean's tide, ebbing to and fro. Sometimes content and happy. Sometimes disappointed and sad. My patience is in short supply these days. It's a thin line. I easily snap at slight provocations.

A new nurse did not know how to set up the quinine infusion for a small child properly yesterday. He almost caused a serious mishap through his ignorance by failing to ask for help in getting the dosage correct. He could have caused a major problem that might have hurt the child.

“How can you not know how to give quinine for malaria?” My voice was angry as I rebuked him for his mistake. “Haven't you worked as a nurse before in other hospitals? How is that you don't know how to set up the most commonly given infusion for malaria? You told us you could do all things. You told us in your initial interview that you were capable of all the basic duties required of a nurse.... ”

The new nurse maintained his composure. He couldn't understand my hastily spoken complaints but he understood that I was upset.

“I'm sorry, doctor,” was all he could add.

Later, I was reminded. “He's just a baby, doctor. He's new.”

It was true. In spite of his deceptions regarding his initial skills, now was not the time to deliver a lecture on his incompetence but rather move forward. Chiding his lack of abilities would not solve the issue. Berating him over his mistakes was not the solution.

I took him aside. “I am sorry for getting upset at you,” I apologized.

~O~

This morning I argued with the auntie and mother of a young child sick in our hospital. “Please, let her continue her treatment. Let her complete her medicine. She is too ill to go home.”

They were determined to go though. “Doctor, you are not getting us,” the auntie complained.

“I am getting you,” I answered. “I am just not agreeing with you.”

In the end, no matter what I said or offered, they left. Their minds were made up.

~O~

“It was the worm medication that the doctor prescribed. It was too much medicine. My doctor in Yaounde says I should not have taken it all.”

The recently bereaved woman who'd just suffered a miscarriage needed someone to blame. It didn't matter that the worm medication she believed to be the culprit for the miscarriage was part of the standard of care given to all pregnant women. She needed a reason. A reason so that she could avoid a miscarriage in the future.

“She has to blame the medication, doctor,” my astute nurse observed. “She cannot just say it happened like that. I could see that she already had it in her mind that the worm medicine was the problem. She has to tell her husband that so he doesn't blame her.”

She was correct, of course. I have to be brave and professional and accept the accusations. Arguing the scientific facts have not convinced her otherwise. She needs a scape-goat. I am that person today. Even though I know I'm innocent and haven't caused her harm, I am hurt. It is a terrible accusation to be blamed for the loss of one's baby.

I want to cry but now is not appropriate. Tears will not help. I continue on with my day. Even when I don't feel confident and brave, I can at least play the part – maintain my role as medical leader. My nurses need me.

~O~

Tonight, alone, the rain falls softly. The burdens on my heart feel extra heavy. I wish I could join the crying sky. I want to weep for all the pain and suffering I witness in my labors. I want to mourn for the tragedies that enter my sphere of awareness here in Buea.

The tears cannot come though.

Instead I let the sky do the crying for me.
Let it rain.
Let the tears from heaven come.
Cleanse away the sadness and the sorrow; make way for the sunshine tomorrow.

~O~

“My eyes fail, looking for your promise; I say, 'When will you comfort me?'” Psalm 119:82

“But those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.” Isaiah 40:31

“This is my Father's world,
Why should my heart be sad?
The Lord is King;
Let the heavens ring!
God reigns;
Let the earth be glad.”
- This Is My Father's World.  Hymn written by Babcock

Saturday, September 6, 2014

Taxi Church

\


“I'm not sure we're going to make it to the church service after all,” I shrugged helplessly and gave Arnoldo a knowing nod as we surveyed the barely half-full minibus. Standing in the muddy car park on a Sunday morning, the two of us ignored the persistent pleas of the bus driver to climb into his minivan. The van would not leave until the seats were taken, aka. 'the bus don flop'. At the rate it was filling up, this could be a while. We were anxious to make it to Limbe to a Catholic mass by the seaside at one of the oldest missions in Cameroon, Bota Holy Trinity. 

Public transport is not always as speedy as one would hope.

“Douala?” a young man urgently shoved his inquiry toward us, anxious to take on another passenger. He pressed forward and tried to herd us like a pair of sheep toward his empty vehicle. 

“No, Limbe,” I refused his offer and scanned the car park again for any other vehicle that might be headed to the beach town sooner. 

The young scout slipped away, lost in the flesh of other anxious young drivers going to Limbe who'd suddenly heard their prompt. 

“Limbe, Limbe!” the man yelled excitedly. He ushered us toward his waiting 'clando' – a private taxi car that he will fill with four passengers in the back seat and two in the passenger seat up front before departing. These clando taxis can fill faster and are sometimes an expedited means of reaching one's desired destination. 

I looked dubiously at his vehicle. There was one elderly gentleman settled in the front seat. With Arnoldo and I, that would mean three more passengers before he'd go. 

I waited, not yet convinced at the drivers insistence, “We're going now, now, like this!” He was still searching for more customers as he proclaimed his imminent departure, waving his arms dramatically. 'Now' is a relative term.

The minutes ticked by and I looked at my watch. “Well, it might be that we are there just to see the church. The service might be over by the time we make it to Limbe,” I tried to look on the bright side. “It will still be an adventure.”

Suddenly the driver's tone ramped up a notch in urgency.  “Enter, enter,” he almost physically pushed us toward his clando. “See, ee de flop. We de go  now. Enter!”

Out of the periphery of my vision, I noted two well dressed women enter the car. The smaller woman was dressed in an cream-colored suit with matching hat – a very stylish hat trimmed with lace and angled jauntily on her head. It reminded me of photographs of certain  British royalty. The woman situated her purse in her lap and folded her hands over her small Bible. 

The other woman did some fast negotiations with the taxi driver and the elderly gentleman in the front seat. She was a much larger woman, actually. Amply cushioned as some might say. She was dressed in high-fashion too. She had on a tailored dress fashioned to accentuate her curves. The material was of the latest design and high-lighted with shiny gold accents. Her head wrapper added an additional six inches to her height. With the air of a queen, she situated herself unashamedly into the front seat while the small elderly gentleman happily stepped aside and moved himself to the back seat. She had that air of regal confidence. 

Recognizing that the taxi was indeed, now full, I gave a nod of agreement and climbed into the back seat of the car. Four in the back seat. We were cozy and ready for the drive to Limbe at last. As the elderly man squeezed his body and shifted toward the middle a bit more in an attempt to close his door, the elegant woman in front turned round to survey her company behind. 

“Ashia, Pa,” she gave the elderly farmer a gracious smile. 

“Thank you, mom,” he smiled up as he succeeded at least in getting the door to latch.

“I can't fit behind. Now I paid for two seats in front.” She smiled broadly. “I'm very comfortably situated now.”

Knees and elbows jabbing into each other in our cramped quarters in the rear of the car, all four of us nodded in agreement. Yes, she did seem comfortable in her front seat. 

Content that he now had a full vehicle, the driver kept quiet as he concentrated on the road. The incredibly green fields of the Tole tea bushes rushed past our window as he drove. A short quiet ensued as everyone sat ensconced in their own thoughts. Suddenly, the woman in the front seat turned slightly. “Today is Sunday. I want us to pray.”

“Amen,” her friend concurred. The elderly man nodded in agreement as well.

“Turn with me to the book of Numbers in the Holy Bible,” she began.

Of course, none of us could actually get out our Bibles and turn the pages given our incommodious quarters but this did not deter our front-seat preacher. 

 Confidently she dug into her purse and pulled out her small white, leather-bound Bible. She turned the pages and left them open on her lap. As she began to expound upon the story of the rebellious and ungrateful Israelites grumbling about wanting meat to eat, I wondered how she was going to turn this into a prayer.

“Now the people complained about their hardships in the hearing of the Lord,” she proclaimed, “Amen?!”

Her friend next to me murmured an agreeing “Amen.”

“...and when he heard them his anger was aroused...' “Praise the Lord?!” 

“Praise the Lord,” the elderly man reflected back. 

“'...Then fire from the Lord burned among them and consumed some of the outskirts of the camp...'” our taxi preacher was gaining steam, “Amen?!”

“Amen,” several passengers nodded.

Her exhortation continued at this enthusiastic fiery pace with loud exclamations soliciting the captive audience's participation. 

“'....Moses heard the people of every family wailing at the entrance to their tents.'”... Praise the Lord!” 

“Praise His Name,” we echoed.

“'... The Lord became exceedingly angry, and Moses was troubled.” Amen?!” 

“Amen,” even the taxi driver chimed in.

I still wondered where the spiritual lesson was going to be in her semonette. 

She continued on to verse 23 of Numbers chapter eleven, “The Lord answered Moses, “Is the Lord’s arm too short? Now you will see whether or not what I say will come true for you.”

“Amen?!” She breathed dramatically. 

“Amen,” the chorus echoed from her back-seat audience. 

Our eloquent taxi preacher tilted her head toward the driver. He kept his eyes on the road and gave her an affirming grunt of affirmation to continue. 

“Isn't God great?” she shouted in enthusiasm. 

“All the time,” we answered with a murmur of nodding heads.

“God is great. Amen?! From this passage we can see that whatever be the problem, God is able to deliver us. Praise the Lord! Amen! Here we see that God is telling Moses that He is not weak. He is mighty,” and her she paused for emphasis, “God is more than capable of delivering us from any problem that we might have – no matter the problem, whether it be financial problem, whether it be family problem, whether it be health problem, no matter  – whatever problem we might have, God is able to deliver us! Amen?!”

She paused to catch her breath, wiping a few beads of sweat that had formed on her forehead. 

“Amen?” She turned to partially face us seated behind her. “ No matter the problem; God is mighty and able to save us. Amen?”

“Amen,” we sighed in reply to her exuberance. 

“Isn't God good?”

“All the time,” everyone in the car answered.

“Amen,” she leaned back in her front seat and studied the words opened before her in her Bible. “We have nothing to fear. Just like God was able to deliver the Isrealites in the Bible, He is more than able to deliver us from whatever problem that we have.”

She folded her hands, satisfied. The verdant green vegetation of the tea plantation fields gradually transformed into the tumbledown wooden houses and dirt yards indicating that we were nearing Limbe.

“The Word of the Lord has spoken. Praise the Lord.”

“Amen,” we murmured in union. 

“Let us fold our hands and pray to our mighty Father in Heaven who is able to solve all our problems.” She raised her own right hand as she bowed her elegantly wrapped head. 

“Father in Heaven, we pray – we pray for your protection as we go to our various destinations. We pray, Father, we pray, that you watch over the driver and keep us safe as we travel. Keep us under your protection, we pray. We praise you that you remind us in the meditation today that you are our Deliverer. And, no matter the problem, you will deliver us.” 

She paused, head bowed, letting the words of her prayer sink in. “In your mighty Name we pray, Amen.”

“Amen,” the rest of the taxi raised their heads from joining her in prayer.


Arnoldo and I reached Limbe safely. We parted ways with our energetic taxi-pastor and her companion at the drop-off. The Catholic service was just beginning as we entered. I believe the sermon was about the Apostle Peter and the cornerstone of the church. It was a lovely picturesque setting for the church service. The waves rolled gently to and fro along the sandy shores. The salty sea breeze wafted through the rafters of the high vaulted ceiling. The choir's voices sang melodiously 
in the apse of the building. 





Two sermons in one Sunday morning. It was a blessed day.


“The Lord answered Moses, “Is the Lord’s arm too short? Now you will see whether or not what I say will come true for you.”  Numbers 11: 23





Sunday, August 31, 2014

Ebola Virus Disease (EVD)


Author's note: I'm sure there are a lot of blog entries out on the internet about missionary's perceptions and experiences with the Ebola virus. I am not one of those heroes on the front line in an official Ebola-infected danger zone. Instead I am only a bystander to the chaos of this epidemic, albeit, I stand a bit closer than perhaps some others. So, if you're looking for a story with lots of spontaneous bleeding and saved-from-the-brink-of-death experiences, this is not the blog entry for you. 

Disclaimer: The opinions expressed therein are not official in any way, shape, or form. Even the 'facts' that I quote are up for debate as they are mainly obtained through my gleanings on the internet and radio. Although I try to stick to reputable web sites, one must read all such reports with a healthy dose of intelligent skepticism. 

~evd~

One of the more common questions I am asked these days, “Is Ebola in Cameroon?”

Officially, no.

Ebola is a hemorrhagic viral illness that causes the sudden onset of high fevers, severe muscle aches, headaches, vomiting, and eventually unexplained hemorrhaging from bodily orifices where, spontaneous bleeding should NOT occur! Given that experimental treatments, like ZMAPP and vaccines, are still far from curing this disease and that it has a greater than fifty percent death toll,  Ebola Virus Disease (EVD) is not a nice virus. In fact, it's a downright nasty serpentine-shaped infectious agent that is spreading from person to person and wreaking havoc on the economics and psyches of people throughout the world, least of all West Africans. Very bad virus!

The rumors about Ebola abound and spread worse than false reports of pregnancy on April Fool's Day. Some are actually a bit comical. A few popular ones:

'Bathing in salt water will protect you from Ebola'.
'Eating monkey kola nuts (common fruit that is a type of Tamarind) will give you Ebola'.
'Eating bitter kola (common nut) will prevent Ebola'.
'Pigs are bad because they have Ebola'.
'Ebola does not exist; it's a made-up disease by the white man to scare Africans'.

Of course, Ebola didn't really hit the world news until the white man was infected, a certain Samaritan's Purse doctor working in Liberia. Notions surrounding his treatment and the experimental drugs and vaccines for EVD have generated some diverse opinions and notions on a continuum of rationality.  I remember walking into clinic one morning after the news announced that the company Mapp Bio-pharmaceuticals had shipped doses of ZMAPP for use in Liberian doctors infected with Ebola. At that time, doctor Brantly, the missionary doctor in Liberia, had already received this experimental drug and seemed to be showing hints of recovery.

“What's the latest news on Ebola?” I asked my junior doctor who is much more faithful in listening to the local radio station than I am.

“Doc, there's a new drug for Ebola. They are shipping it to Africa. Everything will be all right now.”

That was it. No hesitancy that it was 'experimental'. No disclaimer that the drug had not been proven effective. No doubts about its ability to cure the American doctor who was receiving it. No anxiety over potential as yet unknown debilitating side effects.  The only angst was that why the drug had not been used sooner when the former African specialist had been infected with Ebola and was dying.

My GP did not seem to be concerned that ZMAPP was in its experimental stages. Or that all the potential side effects had not been sufficiently explored. Or that the correct dosing and effectiveness was still unknown. The term 'experimental drug' did not seem to deter his confidence that ZMAPP was the answer to the Ebola epidemic. He was content to accept the good news that a cure for EVD was on its way to Africa.

When Canada announced it would donate some experimental vaccinations to the World Health Organization, again my colleagues were confident. “There's a vaccine for Ebola now, doc.”

Maybe...

On August 8, 2014,  the world health leaders convened and decided to declare Ebola an international public health emergency. Since then the virus has continued to escalate at an alarming magnitude in terms of number of new infections and deaths. Just within the last few days, the WHO has estimated that based on the current trend in increasing numbers, the death toll could reach up to 20,000. Currently it stands around 1550 plus reported fatalities, most of them confined to Guinea, Liberia, and Sierra Leone.

~evd~

When Ebola starting making the world news, people would ask me, “Are you worried about Ebola coming to Cameroon?”

 When Ebola was in Guinea, I wasn't worried. When Ebola was in Sierra Leone, I wasn't worried. When Ebola erupted in Liberia, I didn't worry. When Ebola was reported in Lagos, Nigeria, I worried.

Nigeria and Cameroon share a long and porous border. This week, a member in our church will travel back to school at Babcock University, a Seventh-day Adventist University in Nigeria.

“Don't you know the government has closed its schools?” our accountant jokingly chided the young man.

He laughed. “That's only for the government. Babcock will start classes as usual. No one can close down the University. All the top government official's children go to Babcock.”

I shake my head. “It's not safe. The borders are closed between Nigeria and Cameroon, don't you know.”

Again, the young man smiled. “No, the borders can never close, doctor.”

He headed off to look for money to enroll in this year's courses at the university. I know he's not the only student who will be traveling back to school soon.

I recently read an article written by a journalist student about his experience at one border control point between Nigeria and Cameroon.  (http://globalvoicesonline.org/2014/08/28/ebola-scare-trapped-on-the-cameroonnigeria-border-for-over-40-hours/). The unsanitary conditions and crowded conditions are perfect seeding grounds for spreading viral diseases. One infected person among the group could easily infect the others under such cramped quarters. If one didn't have Ebola before they started across the border, the delays at the border for health screenings might ensure that they are infected.

And  yet, ironically, the legitimate business ships and trucks that travel between Nigeria and Cameroon importing manufactured goods like hair mesh, shoes, cloth, processed foods, and buckets are stymied in their travel and sit idle, unable to import/export. I wonder when women will stop plaiting their hair because the hair mesh becomes too expensive to buy?

I asked my friends who have recently flown out of Cameroon back to Europe or the United States. “Did you meet up with any health inspectors? Did you have anyone screen you for recent illnesses or symptoms of fever?”

So far they continue to answer, “No health screenings were done. Everything was as usual for flying.”

I wonder how long that will last.

~evd~

A few weeks ago I printed off some community case definitions of Ebola and Marburg hemorrhagic fevers and posted them in our hospital and clinic. Rumors and misleading information abound regarding EVD. Better to add some truth to the mix.

“Where did you get your case definition posters?” the district health officers queried as they made their monthly inspection of quality indicators in our health centre.

“From the WHO website,” I answered.

A collective sigh of relief seemed to emanate from the group. “The district has not given any circulation on Ebola,” I reassured them. “These are for my own education and monitoring.”

“Ok, then, that's ok, doc,” they smiled at my over-zealous concern about Ebola. “Ebola is not in Cameroon you know, doc.”

“Yes, of course, but it's still good to be vigilant,” I answered humbly.

“A collective nod of their heads reassured me they'd heard me. Having reassured themselves that I wasn't spreading alarming rumors about Ebola and stirring up panic in the locals, they returned to matters more pressing on their mind. “Doc, why are you not writing, 'maculopapular versus not maculopapular rash' in your register? As soon as you record 'fever and rash' we think of measles. You need to reassure us that it is not a measles' rash. Always differentiate the type of rash.”

“Ok,” I agreed. It was an easily rectifiable point. At the close of our meeting, they did not ask for copies of my WHO suspected case definitions for Ebola. I was not surprised.

~evd~

Whether Ebola comes to Cameroon or not we still feel it's effects.

One volunteer at our health institution changed her airline tickets and flew home early.

I know of teams of foreign doctors and other volunteer organisations that have decided to delay their plans to come serve in Cameroon. No one wants to get stuck in Cameroon if the country finds itself quarantined by the world for Ebola infection.

My sending organization recently emailed me a notice from their travel insurance company that we missionaries are insured by. Apparently, there is no provision for emergency evacuation, treatment, or help whatsoever if the word “ebola” enters the insurance claim. Good to know. I found it amusing that this email came within days of reading about Dr Brantly's medi-vac from Liberia to America.

Resources for the cholera epidemic in the Northern regions of Cameroon are lacking but little assistance is available for now.

If Nigerian borders remain closed much longer, prices of manufactured goods will rise and Cameroonian women might have to resort to styling their natural hair.

Most humanitarian volunteers in Liberia, Guinea, and Sierra Leone have been pulled out of the countries due to lack of potential medical access. Health workers are in short supply in these countries. Everyone is afraid. Malaria that presents with high fevers and body aches is hard to differentiate from the fevers of Ebola. Simple access to health care for basic afflictions like malaria, typhoid, and pneumonia are unavailable. Can anyone calculate the ancillary death toll from lack of health care secondary to Ebola fears?

Yes, Cameroon may not have any reported cases of Ebola but we feel the cold-fingers of its dark clutches clawing at our borders.

~ebv~

I don't have a crystal ball to predict the future. The term, 'under-reported' fails miserably to encompass the challenges of tracking a mobile and fearful population in West Africa.  Will Nigeria be able to contain the virus? It's not hard to imagine similar cases like the nurse in Lagos who had contact with the primary Ebola fatality, Patrick Sawyer, escaping quarantine to run back to family in Enugu. Now many of the secondary contacts with her are under quarantine. Then there are the patients like the victim in Port Harcourt, who rather than seek treatment in Lagos when exposed, instead fled the capitol. Are there others? Have some crossed the border? The largest town in Cameroon near to Port Harcourt, Nigeria, is Buea.

What about the new case of Ebola in Senegal reported on Friday, August 29?  The student who was exposed to EVD and escaped his surveillance team in Guinea, traveling to Dakar where he ended up in a hospital there. For three days he lay in the hospital, quietly spreading his germs to his medical team  and fellow ward mates. It wasn't until health officials from Guinea talked to their Senegalese friends and reported that they were missing a potentially infected case that hospital authorities tested and confirmed the 21 year old boy was infected with EVD. Senegal has become the fifth country now to have Ebola. Who is next? Students are gearing up for the new school year now in Cameroon.

We wait and pray and while waiting, we continue to care for each sick client that enters our gates with love and compassion... gloves and clinical precaution.

Oh... and the posters outlining my WHO Ebola suspected case definitions remain hanging on the walls.

~evd~

When Dr Brantly, the American missionary doctor in Liberia, was reported to have Ebola, people asked me if I was afraid of getting Ebola.

No. I'm not afraid although, I must admit, I will be sorely put out if the disease interferes with my holiday plans. I can “sit on a mountain but not on a tack”!