hopital de bongolo

Monday we left Libreville for Mouille by plane. Tim and Meredith took us all to the airport where me, Kristy, Anna, and Heather (the intern) waited around for our flight to Mouille. We boarded a small aircraft, about 30 seats total, and headed over the jungle (and the equator!!!) to Southern Gabon.

In Mouille we met our ride to Bongolo. Surveying the red dust covered Land Rover clued us in that not only would it be a dusty ride, but due to the accumulation of dust on the inside, it would be one without air conditioning. Fortunately, since we have slowly become more accustomed to the hot weather in Libreville, it was slightly cooler in Mouille. Felipe drove us the 2 hours to just outside of Labamba, over the red dusty roads, full of pot holes and washboard rutts. The countryside was more picturesque of Africa....minus the wildlife. Finally we made our way through Labamba and wound our way up a small mountain, past the small waterfall and rapids below it, and up to the mission's guest house.

Unfortunately it was already dark by the time we arrived, so true exploration would have to wait until the morning. Felipe dropped us off at the guest house and it seemed like we had stepped into luxury. Gorgeous architecture with polished woodwork and brick floors, arches in the doorways, a large stone fireplace. The guest house was previously a schoolhouse with all of its openness and charm, but converted to have over 6 bedrooms and 4 bathrooms, with a separate suite, currently occupied by one of the missionary nurses.

We had the pick of any room we wanted, but us girls (Kristy, Anna, and me) were enjoying our slumber party time, so we chose the room with double bunk beds --- surprisingly sporting the Ikea style along with Ikea blankets. Just a little touch of home.

In the morning we made our way down the hill to "the plateau" where the hospital sat. Each ward has its own establishment, with hallways serving as porches allowing more fresh air to ciruclate. The surgical suite consisted of a small post-op and ICU area, and 3 operating rooms. It is amazing how easy it is to find your way around an OR, even in another country. Anna (since she is a Pre-Med student) and I observed a laprascopic cholecystectomy (gall bladder removal) first. Similar to the States, but sandels are allowed in the OR and many instruments we throw out in the US are cleaned and sterilized to be reused. They have little waste here. During my surgical rotation I had always thought there was so much waste - disposable gowns, drapes, instruments. These are all valued more here, so cloth gowns and drapes are used so they can be cleaned, and instruments resharped until the next order can arrive, possibly within 2 months.

I was invited by the head surgical resident to scrub in on the next case, a thyroidectomy to remove a very large goiter from a patient's neck. The patient was prepped and cleaned using Mr. Clean Multi-Surface and then drapped for surgery (crazy, huh?). I've been told betadine scrubs are used for more dirty cases. Scrubbing in was just the same, except we used reusable brushes and conserved as much water as possible. There was no "time out" prior to starting surgery, as is strictly required in the US, but instead the doctors took the opportunity to pray over the patient before starting the procedure.

Dr. Thompson told us goiters are not endemic in Gabon, but due to the lack of iodine in the diet, they are seen occasionally. In first world countries, iodine is fortified in salt to ensure adequate intake, but here iodinized salt can be more expensive, so the value is not seen by the Gabonese.

Today (Tuesday) Anna and I joined Dr. Thompson and the surgical residents on rounds. Dr. Thompson requires the residents to know English and study medicine in English, so this we were finally able to understand! We saw a variety of patients, reminding me again of the similarity to the States, minus the elective surgeries. We saw post-op prostatectomies, hysterectomies, myomectomies, and ulcer debridements among other things. Ectopic pregnancy is another issue here in Gabon, most likely linked to the high rate of STDs.

In the peds unit, we saw a young girl, Grace, who was burned in a gas fire one month ago. Her mother died shortly after the fire, and Grace was brought to Bongolo about a week ago. She has been septic and spiking a fever, with an unknown source that has all of the doctors puzzled. One of the residents led us in prayer for Grace after examining her. Please keep this young girl in your prayers so that God may not only heal her physical wounds but her emotional wounds as well.

Another story that touched our hearts was a women burned after a domestic violence dispute with her husband. She has been here at Bongolo for over 20 days and has already received skin grafts to both thighs and has burn wounds on both arms. She is healing well, but has declined any other skin grafts. May God watch over her as she heals and will soon be discharged from Bongolo. Domestic violence is said to be another issue here in Gabon.

Observing the doctors here in Gabon has taught me a new type of medicine. The American view of treating medicine is to heal patients on our own. Here, with the help of prayer - before surgeries, before rounds, and with particular cases, there is an understanding that we can only do so much. We can only give of ourselves and utilize the knowledge that God has given us.

Kristy has been put to work on any computer related issues here at Bongolo. Her client list seems to be growing the more people we meet! Although many things are technical support issues, she is still a big help to the administrative functions of the hospital.