Tuesday, June 19, 2012

Tough Bugs

Photo Compliments of the Talented Photographer Natasha Kanji

Joel and Sarah sat in their parents' laps. Sarah was the petite version of her twin brother. She was dressed in a stylish red, polka-dot dress with a matching hairband. The hairband barely succeeded in keeping her abundant, fluffy African curls in orderly fashion and out of her face. Sarah wiggled around on her mother's lap while her mother sat quietly across from me at my consult table. Quiet and demure, the slender Cameroonian mother in a hybrid of Western style clothes sewn with African cloth, held her 10 month old on her lap and vainly attempted to keep her from grabbing every pen and piece of paper on my table.

On the stool next to his wife, the confident and well-built Cameroonian husband sat with his son. His bright yellow, sporting T-shirt stood out from the rest of the family attire. His little boy sat on his lap in a simple, animal-print shirt and pants outfit.  The husband spoke first. "Good afternoon, doctor".

"Good afternoon to you too", I replied. "How can I help you?"

"Well, my cousin, Cynthia, called you earlier," he began. "Did you get her phone call?"

"Yes, she mentioned you would be coming", I answered.

"We're from Switzerland, doctor. Pretty much since we arrived here, our babies have been sick. About one week now. They have a cough, fevers, and are not sleeping at night. Joel, here, (indicating the tot on his lap), was up all last night. We took them to the hospital in Douala last week. They wanted to admit our girl but we refused.

"What did they want to admit Sarah for?" I queried.

"I don't know, doctor", he said. "I think it was because she had a high fever of 39 degrees Celsius." (For those of you used to Fahrenheit, 39 degrees is equivalent to 102.2 degree Fahrenheit) We've been giving them paracetamol (Tylenol) suppositories but the fever continues. They're still sick and don't seem to be getting any better."  The father relayed the children's illness history with obvious concern in his voice for his kids. During the interview, the little boy sat quietly in daddy's lap. His sister sucked on her pacifier and impatiently struggled to get free of her mother's gentle hold. 

I reviewed the children's previous health records from the hospital in Douala. I looked at the laboratory tests and prescriptions written. I did my physical exams on the youngsters. I asked a few more questions to aid me in figuring out why two babies from Switzerland who recently traveled on a crowed airplane might be having persistent fevers. They had definitely been exposed to lots of cold and flu viruses from multiple people on the plane not to mention visiting with lots of Cameroonian relatives. On top of this, the children were in a new environment with malaria-carrying mosquitos for the first time in their lives. The potential for illness abounded!

After talking things over with the parents, I explained to them that I needed a few laboratory tests. The father was not sure if he wanted to repeat blood tests since they were done just last week. I assured him that things can change in a week and his children were still sick so they were necessary. He agreed. I turned to his wife who had been quiet the entire interview. "Any questions?"

"No", she smiled.

Finally, everything was done. The children went home with their mother so she could get more support from her relatives in looking after two sick and irritable, but active, 10 month twins. Quite the handful!

The father sat again in my office. We looked over the test results. Hiding out in the twins' blood was the cause of the fever -  malaria parasites. Not many but enough to cause high fevers in two little visitors from Switzerland with no previous exposure or immunity to malaria. Poor tykes! They came to Cameroon for the first time and their Christmas present ended up being malaria. Despite the prophylaxis medicine, they both got malaria. The malaria parasites are tough bugs in Buea! The children's respiratory colds from the long plane ride only added to their misery.  As I wrote out medication for them both, I talked more with the father. 

"How long have you been in Switzerland?" I asked.

"Fifteen years", he replied.

"Wow! Any plans to come back to Cameroon?"

"No. We just visit", he smiled. "We plan to travel to Yaounde tomorrow."

"Oh", I said. "I guess you won't be able to follow up with me in a couple days so I can make sure the kids are doing better. Do you have any questions regarding the children's medicine and treatments then?" I asked.

"No. It all seems clear to me", he answered. "Thank you for seeing them. I am glad you were here."

"Before you go", I interjected, "since I won't be able to see your children again, let me write down a few things just in case. I will write in their medical records warning signs to watch for that would require you to seek immediate medical assistance again. Just in case."

"All right. Thanks," the father answered.

The father left with a smile. As he strode out the clinic front doors, he seemed just a bit more relaxed - or relieved. As the grey Peugeot rumbled it's way across the front lawn and out the gates, other family members that had been waiting in the vehicle smiled and waved good-bye to me.

What an interesting day, I mused, as they drove out of sight. Here I am in Cameroon at a church mission hospital. I am just back from the United States where I had my first one-month vacation since being in Cameroon for a year. On my flight back, I ran into a young lady with her son traveling from New York to visit her Cameroonian family. Her name was Cynthia. As part of our introductions, I had given her my business card for Buea 7th day Adventist Health Centre. Now today, her cousin and his family visiting from Switzerland came to consult because of our encounter on that airplane 8 days ago. Where else in the world would I ever see such an international patient population! God leads people here from all over the world. Quite amazing!

"But Jesus said, Let the little ones come to me, and do not keep them away: for of such is the kingdom of heaven." Matthew 19:14

Jesus loves the little children
All the children of the world
Red and yellow
Black and white
They are precious in His sight.
Jesus loves the little children
Of the world.
- C. Herbert Woolston