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As was the case in 2020, the COVID-19 pandemic prevented our external examiner from traveling to Cameroon for the purpose of conducting these end-of-year exams. Once again, responsibility for the exams devolved upon faculty.
From the inception of the Internal Medicine residency, we have benefitted from the help of a Canadian Internist. Up until 2019, Dr. Brian Wirzba, clinical professor at the University of Alberta, gave of his time each year to travel to Cameroon for the purpose of conducting end-of-year resident examinations on site. In the span of two weeks, Dr. Wirzba offered a written exam for the entire group, a bedside physical exam for each resident, and an oral exam whereby each resident was expected to offer a systematic approach to a hypothetical clinical problem. In August, about a week before I departed the US to return to Cameroon, Dr. Wirzba sent word that he would not be able to travel to Cameroon in October. A fourth wave of SARS CoV-2, anticipated to peak in his locale during the September/October timeframe, compelled his remaining in Edmonton. He did, however, offer to conduct oral exams remotely for individual residents. The eight-hour time difference between Cameroon and Alberta meant some very early mornings for him. A major advantage this year was the presence of reliable power, owing to completion of the hydroelectric project at the end of September. We do continue to struggle substantially with reliable internet access. Because our bandwidth was not strong enough to support a video link, all images (e.g., ECG, X‑rays) were sent beforehand to be shown locally during the exam.
Observed physical exams were conducted by faculty. The examination process for our 18 residents concluded at the end of October.
The months of August and September were equally challenging for the hospital as a series of lockdowns imposed by separatists had significantly limited patient access to clinical services. Fortunately, our patient census started picking up again in mid-October. So we have been navigating exams amidst increasing patient care responsibilities.
One especially happy note came in late October when we had scheduled a Zoom consultation with a US-based rheumatologist to seek help for an inpatient with rheumatologic disease. On the day of the scheduled meeting, one of our senior residents, Dr. Lubeka, brought another rheumatology patient to my attention. Stella had returned late for her scheduled rendezvous following a longer than expected absence. She had been unable to reach Mbingo on account of road closures and lockdowns. This young woman had been followed for over a year with a Mixed Connective Tissue Disease, which affects the skin and internal organs. While her skin disease had responded to therapy, her persistent pulmonary symptoms were very concerning. In God’s providence, it was possible to include Stella in the same consultation session scheduled for our in-patient.
The rheumatologist recommended changing Stella’s treatment to an alternative monthly chemotherapy that it was possible for us to commence that same day. While Stella awaited treatment, Dr. Lubeka and I spent some time with her asking questions pertaining to her personal life, as well as her relationship with The Lord. Disillusioned by illness, as well as by difficulties accessing the hospital for follow-up, Stella was encouraged to “cast her cares upon The Lord” as Scripture enjoins us to do. We also reminded her of The Lord’s remarkable promise in Romans 8:28. Dr. Lubeka plans to contact Stella by phone to follow up on our conversation that day. Stella also gave us permission to share this request to pray for her.
Mbingo Baptist Hospital, PMB 42, Bamenda, Cameroon