IHE: Cameroon

Cameroon is located at the "hinge" of central-west Africa. Located from 2 to 12 degrees north of the Equator, the country is approximately the size of California. Climate extremes range from the Congo Basin rainforest to the Sahara desert, from coastal presence to central jungle, and from marsh swamps to the mountainous highlands of the Northwest Province. The Bantu speaking peoples likely came from this region, which currently contains 270 tribes and languages.

When the region was first discovered by the Portuguese in 1472, the Douala estuary was filled with shrimp (Camaroes in Poruguese) from which the country received its name. British and French had a presence in the region until 1883 when "Kamerun" became a German Colony. Following World War I (1916) the country was divided into British and French Protectorates. On October 1, 1961 the Federal Republic of Cameroon was born as the only officially bilingual country of Africa - French and English.

SHISONG General Hospital is located in the Northwest Province, an anglophone zone. The population of Kumbo, the nearest large town, is approximately 100,000. The mountainous location is nearly 1 mile above sea level, permitting improved health and less malaria than proximal lowland areas. Located far inland, the region has had limited colonial influence and retains strength of tradition. The hospital was founded in 1935 by missionaries from SudTyrrol; it has grown to its current size of 350 beds with nearly 100 outpatient visits per day. The staff generally consists of 2 expatriates and 2 indigenous physicians. Considerable clinical activity is carried out by nurses; the Hospital runs a nursing school of approximately 50 students.

To learn more about health issues in Cameroon you may want to review some of these papers.

You can view photos taken at SHISONG General Hospital and the nearby vicinity by clicking here.

Clerkships available

* Medicine
* Surgery
* OBGYN
* Pediatrics

Only one student will be chosen to work in Cameroon during Winter/Spring 2004.

Foreign Language

There is no foreign language requirement for this site. The province is officially English; the lingua franca is West African Pijin, which is not a written language. Regional languages heard daily include: English, Pijin, LamNso (tribal), Fulani, French, and neighboring tribal vernaculars. Most of the educated population speaks several languages. An attendant always stands with the doctor/student and expects to translate. Language preparation would be futile, as neither the tonal qualities nor the idioms would be understood even if the words are clear.

Outreach/investigative opportunities

1. 12 Rural Health Centers (40 beds), each with multiple remote posts are visited by the physician and students at intervals.
2. Primary Health Care education - i.e. AIDS education/counseling, nutrition courses, neonatal immunization clinics take place daily.
3. Filaria eradication program by collaboration with the International Volunteers in Urology
4. Investigative program on traditional healing: "Explanatory Models of Febrile Illness"

Conferences

1. Joint conference with staff and students of neighboring hospital each Wednesday PM - case reviews and academic presentations
2. Monday morning X-ray conference
3. Thursday morning case review/management with senior nurses

Teaching commitments

At most times two medical students from Cameroon University Medical School are rotating at SHISONG. It is common to have 2-3 expatriate students also on rotation. The School of Nursing and Midwifery educates nurses to a level at which they may run a ward or a remote Health Center indendently.

IHE Student Teaching Responsibilities

1. Active participation in all conferences
2. Presentations to the hospital staff at Thursday morning conferences
3. Teaching a course in the School of Nursing (to be confirmed)
4. Note: The hospital has recently installed a "coronary care unit" - special preparation in ACLS, arrhythmias, and cardiac conditions would be a special teaching benefit to the staff.

Other requirements

1. 10 minute presentation for members of the UWSOM administration and Puget Sound Partners for Global Health upon your return to the United States.
2. 5-10 digital photos of yourself with patients and staff on site. Be sure to ask permission from patients and staff before taking any photos.
3. Complete and turn in your activities diary, Evaluation form, receipts and Expense Report form and receipts to Daren Wade, Program Manager, Health Sciences Global Training Resource Center, C-314 Health Sciences Building, Box 356355, University of Washington, Seattle, WA 98195.

Optional

1. You may take call a maximum of 2 nights per week or one week night and a weekend. You will be supervised while on call.

Travel to and within Cameroon

* A visa is required for travel to Cameroon. Multiple-entry visa for stay up to 3 months requires $65.22 (money orders only), application form, passport photos, proof of return/onward transportation, exact dates of travel, copy of recent bank statement, a letter of invitation and statement of trip purpose from SHISONG General Hospital, and self-addressed, stamped envelope. (For more information, see the United States State Department and the Embassy of the Republic of Cameroon, Tel. (202) 265-8790. You may also try the Nader VISA Service, 422 East Indian Spring Drive, Silver Spring, MD 20901, Tel. (301) 608-3511.)
* Fly to Douala, the economic capital of Cameroon (Yaounde is the political capital).
* From Douala overland buses may be used to Bamenda in the Northwest Province. The distance is about 400 km and takes about 6 hours.
* From Bamenda take a bus or taxi to Kumbo, which is about 110km and 3 hours (expect an overload and goats strapped to the roof).
* From Kumbo a taxi to SHISONG is 20 minutes.
* Though it is ideal to be met at the airport with a hospital vehicle, it is not predictably possible.
* Travel of cultural interest within 3 hours of SHISONG to multiple areas by taxi is predictably available.

Housing

Lodged by the hospital administration and comfortable. Basic facilities include bed, mattress, sheets, electricity, chairs, cooking utensils, gas cooker and refrigerator. Utilities include flush toilet and shower with water heater.

Safety

The population has a seropositivity rate for HIV-2 of approximately 5-10%. Transmission rate would be low with proper cautions. You will be expected to have post-exposure prophylaxis with you.

You will not be provided with protective TB masks at the hospital. It is important that you bring your own NIOSH-certified particulate filter respirator. A list of NIOSH-approved N95 disposable particulate respirators (including supplier/manufacturer and contact numbers) may be found here.

Petty theft and bribery are common. Violent crimes are quite rare, except in large cities. Walking to a specific destination after dark is generally safe until around 10:00 PM. The population is protective of expatriates and walking to the hospital at any hour has been safe. SHISONG is a rural location.

Traffic accidents are the major cause of injury or death for students in overseas programs. Read more about how to protect yourself at the Association for Safe International Road Travel (ASIRT) website. The ASIRT has compiled Road Travel Reports for 150+ countries. You can order copies of these reports at no charge. The U. S. State Department also provides safety suggestions. Finally, you may find this recent article in the New York Times helpful.

Budget

You are required to purchase all items outlined in the budget. You must bring with you needlestick prophylaxis and other listed supplies. This is NOT optional.

This budget is approximate. We have done our best to estimate the costs students might incur. If your costs exceed the stipend you are given, these costs will be your responsibility to cover. If you underspend the budget allocated for a particular item, you may apply the excess funds to any other item in the budget except food. The amount allocated for food is not intended to cover all your food expenses.

The Central African Franc is the exchange currency. Approximately CFA500 equals $1. The currency cannot be purchased in advance and is not exchangeable outside the country. Cash is best received by writing a check to the hospital administration in exchange for cash. Banks to do not exist in the region. Credit cards are of no value in the region of destination.

Telephone/Internet

Telephone communication, though available, may be difficult. Computer/e-mail/internet access, is available with some logistical arrangements with varying dependability.

Additional supplies to bring

* Short-wave radio: main contact with the outside world. Expect to leave it there as a gift.
* Camera
* Snap-tip ball-point pens (150 of them as gifts)
* Multiple pictures of your family and home and even poverty in America -- this is very meaningful to them.
* General medical textbooks that may be left.
* Basic medical durable items as blood pressure cuff, stethoscope, otoscope. If you have access to donations of such items, bring as many of these items as you can to leave as a gift.

Collaborative Organizations

Dr. Brannen is in the Department of Urology at the University of Washington. He and his wife have worked at SHISONG General Hospital in Cameroon for many years. In establishing a permanent collaborative relationship between SHISONG General Hospital and the University of Washington, they will be collaborating with a number of other organizations. For more information, download this document by Dr. George Brannen.

Miscellaneous information

* Goheen, M. Men Own the Fields, Women Own the Crops: Gender and Power in the Cameroon Grassfields. 1996.
* Pool, R. Dialogue and the Interpretation of Illness: Conversations in a Cameroon Village. 1994.
* Mbiti, John S. African Religions and Philosophy. 1990.
* Nsamenang, A. Bame. Human Development in Cultural Context: A Third World Perspective. 1992.
* Mbuagbaw TE, Brain R, and Palmer R. A History of the Cameroon. 1987.
* Barley N. The Innocent Antrhopologist. 1986.
* International Volunteers in Urology: Spring 1996 newsletter, Summer 1996 newsletter
* Friends of Cameroon
* Lonely Planet