Mission: To See and Serve Christ in All by Spending Time to Care

P.O Box 8, Bui Division, North Tel: (237) 242659959, 653807563, 695454509 Website: www. Shisonghospital.org Email: [email protected] Cardiac Centre: (237) 69690 –1264, 69948-8412, 67753-6572

44

Table of Contents

Some abbreviations……………………………………………………………….….3 28. CONCLUSION Word from the Hospital Director…………………………………………………….3 Section One: General presentation This year 2016 was characterised with a lot of activities and achievements Brief History of the hospital…………………………………. ……………………..4 thanks to the great collaboration of our stakeholders. These achievements Staff composition…………………………………………………………………5-6 Doctors and responsibilities & other staff information………………………………7 were however recorded amidst some challenges. It is thanks to the collabora- Celebration of St. Elizabeth of Hungary feast day………………………………….8 tion of the Head of Units of the Hospital and Chief of our satellite Health Some significant events within the year……………………………………………..8 Infrastructural Achievements ……………………………………………………….9 Centres this report has been realized. Gratitude goes to God Almighty for his Staff Retirement Celebration 2016…………………………………………………10 continues protection and care as we travelled far and wide for mission or un-

Section Two: Departmental Reports/Clinical Activities derwent some risk to rescue the patients. We look forward to continue to as OPD and Hospitalizations statistical analysis…………………………………..11-12 Laboratory statistics…………………………………………………………….12-13 per our mission statement ―To see and serve Christ in all by spending time to Blood Bank ………………………………………………………………………..14 care,‖ Ultrasound ………………………………………………………………………...15 X-ray………………………………………………………………………………..16 Dental Clinic………………………………………………………………………..17 CONTACTS Operating Theatre…………………………………………………………………..17 Sr. Kinyuy Mary Aldrine Gynaeco-obstetric…………………………………………………………………..18 St. Elizabeth Catholic General Hospital, Shisong Chaplaincy services………………………………………………………………...20 Eye Clinic…………………………………………………………………………..20 P.O. Box 8, Kumbo Physiotherapy………………………………………………………………………21 North West Region, Cameroon Integrated Day Care Centre……………………………………………………..21-22 Tel: (237) 67855-8543 Tuberculosis Reach Laboratory/ Tuberculosis program………………………..23-25 Email: [email protected] Diabetic program…………………………………………………………………...26 Website: www.shisonghospital.org Performance Based Financing……………………………………………………...27 PHC……………………………………………………………………………..27-29 Natural Family Planning…………………………………………………………..30 Dr. Wandji Kounougo René Nurse superintendent‘s office ………………….………………………………….30 Chief Medical Officer Internships…………………………………………………………………………31 Tel: (237) 69471-8754 Cytopathology Unit……………………………………………………………….32 Cardiac Centre overview report…………………………………………………33-34 Auxiliary services…………………………………………………………………..35 Sr. Jethro Nkenglefac, Health Insurance Schemes……………………………………………………...35-36 Cardiac Center General Manager The 2017 development plan……………………………………………………….37 Tel: 2265-9959 or 69690-1264 Construction projects………………………………………………………………38 Email: [email protected] Some major donors and Collaborators……………………………………………..38 Out-reach clinics………………………………………………………………..39-40 Highlights of 2015 events in pictures……..…………………………………...... 41 Sr. Genévieve Nakoma Conclusion………………………...……………………………………………….43 Human Resource Manager SOME ABBREVIATIONS Tel: (237) 65380-7563

2 43

ATT: Anti-Tetanus Toxoid ANC Antennal Clinic CVA: Celebro Vascular Accident CRT Cardiac Resynchronization Therapy FNA: Fine Needle Aspiration GP: General Practitioner HB: Heamoglobin

Staff during training by ICT Specialist on the new MIS PELICAN Blood Bank members in an elective meeting ICU: Intensive Care Unit IDCC: Integrated Day Care Centre ICD Implantable Cardioverter Defibrillators IWC Infant Welfare Clinic LUMOS: Leuvense Universitaire Medische Ontwikkelingssamenwerking en Solidariteit MCHNAW: Mother-and-Child Nutrition Action Week NIDs: National Immunization Days PCR: Polymerase Chain Reaction PMTCT: Prevention of Mother-to-Child Transmission Training of both old and new security guards Award of Certificate to the newly trained security guards TB: Tuberculosis CHW: Community Health Worker PVBDA: Pelican Voluntary Blood Donor Association PMTCT Prevention from Mother-To-Child Transmission PBF Performance Based Financing

WORD FROM THE NEW HOSPITAL DIRECTOR

Signing of the visitors‘ book by Ministers of MINSANTE/ MINSUP Guided tour of the institution by Ministers of MINSANTE/ MINSUP Activities continued in concordance with the mission statement of the institution ―To see and serve Christ in all by spending time to care‖ . Some of the planned activities in 2016 were realized while some would be revisited in 2017. Unlike other years, 2016 witnessed some challenges which were administratively handled for the common good of the pa- tients and the growth of the institution. This report captures the significant events and reforms in the Shisong Hospital Complex within the year. In all things, we want to render immense gratitude to God for working in us and through us for his greater glory. It is our dream, our wish and our prayers that we may follow in the footsteps of our able predecessors to bring the healing love of God to staff joined SECGH Shisong staff in the St. Elizabeth Feast day Typical Kom Cultural animation by staff of Njinikom Hospital the sick together with the constant support of our collaborators within and without the institution. To God be the glory for the great things He has done and is yet to do for the institution.

Reception of equipment from EGPAF for the implementation of Administration with 8 senior staff members going on retirement in 2016 POCEID project 42 3

SECTION ONE: GENERAL PRESENTATION OF THE HOSPITAL Year

Indicator 2014 2015 2016 BRIEF HISTORY OF THE HOSPITAL 1 Outpatient 498 763 2526

St. Elizabeth Catholic General Hospital was started on the 15th of November 1935 as a 2 Inpatient 58 122 497 small dispensary and maternity by five Tertiary Sisters of St. Francis from Brixen, South 3 Deliveries 45 43 125 Tyrol-Italy, who had arrived in Cameroon on October 12, 1935 and reached Shisong on the 16th October. The maternity and dispensary were a simple sun-dried brick house 4 ANC 129 168 472 roofed with grass and had three rooms; one for the dispensary, one for deliveries and a 5 IWC 517 470 931 larger one with eight beds for the maternity. Sr. Camilla Geier, a midwife was the first Matron. She started with an average of 20 consultations daily. Laboratory investigations were also conducted. 271 were tested With the arrival of the first resident doctor, an Austrian General Practitioner, Dr. Hilde- gard Platzer, the dispensary was recognized as a Hospital by the Government of Came- for HIV and 742 tested for malaria roon on the 13th June 1952 and given the Registration number 224. On the 23rd October 1974 the recognition was reconfirmed with the Reg.no.96/A/MSAP/DSP/SDFS/BESP.

On the 1st February 1954, 12 candidates started an 18-months training course as Grade 2 midwives in what is known today as the Catholic School of Health Sciences, Shisong, now training State Registered Nurses, State Registered Laboratory Technicians, State 27. SOME HIGHLIGHT EVENTS OF 2016 IN PICTURES Registered Midwives and Nurse Assistants.

1961 saw the beginning of a massive expansion Program, made possible by generous financial assistance received from MISEREOR-Germany. It was completed successfully in 1987 with the buildings that presently serve as the maternity and theater blocks.

In 1972 Dr. Leonard Sunjo, was appointed as the first Cameroonian Chief Medical Of- ficer. Since 1983 the Administration of the Hospital has been in the hands of African Tertiary Sisters. Sr. Xaveria Ntenmusi was the first matron. In 2002, a diagnostic cardiology department was created in collaboration with two Ital- ian Associations: Bambini Cardiopatici nel Mondo, Cuore Fratello and the Tertiary Sis- Eucharistic celebration & award of testimonials to newly trained auxiliary staff ters of St. Francis. Dr. Jean Claude Ambassa was the first Cameroonian Cardiologist. In 2009, the full-fledged Cardiac Center was inaugurated by the Minister of Public Health – His Excellency André MAMA FOUDA. Being a significant expansion of the Hospital, the Manager, Sr. Jethro Nkenglefac, and a Supervisory Board were appointed by the Provincial Administration of the Tertiary Sisters of St. Francis.

The storey-building hosting the cytopathology laboratory and the integrated Day Care Center was completed in July 2012 in order to integrate the HIV/AIDS program into the Hospital activity and minimize stigma when clients had to move into the former offices, located in the Nursing School Laboratory building. Moreover, the complete Blood Bank was established in the Cardiac Center basement in 2014, separately from the general laboratory. Hospital Administration with newly trained auxiliary staff Thursday Refresher classes to upgrade nursing standards

4 41

STAFF COMPOSITION Year

Indicator 2016 DEPARTMENT No. 1 Outpatient 374 ADMINISTRATION 16 2 Inpatient 68 Director and Deputy 2

3 Deliveries 52 Manager and Assistant 2

4 ANC 234 Financial Managers 2 5 IWC 417 Cashier 2

Doctors 14

Challenges Nurse Superintendent 4 IDCC Coordinator 1 There is still low usage of the Health Center by the community due to insuffi- cient sensitization despite the efforts made by the health committee to encour- Nursing staff 195 age them. Masters of Science in Nursing (Obstetric) 1

Bachelor of Science in Nursing (BSN) 16 Secondly, the health centre has just 1 person for the Lab, 1 in the pharmacy and 1 for birth assistance making the workload heavy on these few staff. There is Bachelors in Laboratory Technology 7 need for more staff Nurse Anesthetists 3

26.2. KINGOMEN HEALTH CENTER State Registered Nurses 55 State Enrolled Nurses 15 The staff of Kingomen Health Center continued rendering outpatient, inpatient, deliveries, ANC, IWC to the population of this health area in 2016. State Registered Nurse Midwives 4

State Enrolled Nurse Midwives 7 26.3 WVEM HEALTH CENTER Nurse Assistants 56 The staff of Wvem Health Center continued rendering outpatient, inpatient, deliveries, ANC, IWC to the population of this health area in 2016. Ward Maids 9 Physiotherapist 2 26.4. WAINAMAH SACRED HEART HEALTH CENTER Imagery Technicians 4 Nurse in charge: Fola Clarisse Suilareng USS. Assistant 2 Activities continued at the Wainamah Health Center as usual thanks to the additional staff strength that maintained the number of staff at 6 despite the retirement of one nurse. In collaboration with the Health Management Commit- tee various services were rendered to the target population of 6102. The Health Centre participated in all the immunization campaigns in the Health Area, such as polio vaccination, mother-and-child nutritional week, etc. Thanks to assistance from SHUMAS through an elite, the Health Center old building was renovated thereby creating space for some laboratory activities, children‘s ward and pharmacy. Financially the Health Center ended the year with a deficit. Below are some statistics:

40 5

Ultrasound Technician 1  Medicines for Humanity, USA Dental Technician 1  Humanitarian Aid, Germany

Microscopist 1  The Clinton Foundation, USA Nurses and Auxiliaries working in attached 28  CYMA Firm, USA Health Centres  Leuven Catholic Hospital, Belgium Laboratory 22  Care Cameroon Master of Science in Haematology 1  Project Hope Bachelors in Medical Laboratory Science 6 (BMLS)  BIWON-Children‘s Brighter Future Association, Shisong Medical Laboratory Technicians (MLT) 18  Archbishop Paul Verdzekov Heart Foundation, Shisong Cytotechnologist 1  Mutual Health Cooperative Society COMMUNICATION 1  BEPHA Bachelors in Journalism 1  Nascent Solutions (Kumbo) TECHNICAL STAFF 15  Brotherly Heart Association Electrician/Mechanics/Plumber 3  North West Special Fund for Health (NWPSFH)

Carpenters 5  All the Institutions that send their interns to us (listed on page…) Drivers 3  All the TSSF Health Institutions Associate Degree, ICT 2

ICT Assistants 2 DOMESTIC STAFF 55 Canteen 12 Cleaners 19 26. OUT-REACH CLINICS General Labourers 4 Tailors 3 Laundry 4 26.1. SABONGIDA Chief of Center: Yinde Lucas Gobi

Security Guards 13 Farewell Home Attendants 3 The 3 staff members of Sabongida Health Center continued to rendered ser- PASTORAL / SOCIAL WORKERS 27 vices to the population of this locality in collaboration with the Health Manage- Chaplains 3 ment Committee . Activities carried out were consultations, delivery, ANC, Full-Time Counsellors 4 IWC and vaccinations in the outreach. A total number of 340 cases were at- tended to in 2015. In order to build capacities, the staff attended seminars and Part-Time Counsellors including some Nurs- 20 es/Community Relay Agents meetings at the District Hospital in Nkambe and others at Dumbo Health Cen- MEDICAL DOCTORS 8 tre. Monthly regular visits by the PHC team from the Shisong Hospital has Surgeons (2 Gynaecologists/1 Urologist/ 4 always been appreciated by the patients, especially those on ARVs. Some of General Surgeon) the achievements as follows: General Practitioners 4 Paediatrician 1 Statistical Analysis

TOTAL STAFF ENROLMENT 327

6 39

DOCTORS’ RESPONSIBILITIES 23.3 CONSTRUCTION PROJECTS Name Responsibility  Complete the Networking of the Hospital / intelcom CMO, GP, Neonatologist, Dr. in charge of Dr. Wandji Kounougo René  Construction of a bore hole in the Cardiac Center the Integrated Day Care Centre  Renovation of drug store Dr. Njiki Jules Gynaecologist  Renovation of the hospital roofs Dr. Ambassa Jean Claude Clinical Director – Cardiac Centre Dr. Tantchou Tchoumi Jacque Cabral Head of Cardiology 24. COLLABORATION WITH THE Dr. Cisse Demba Urologist CAMEROON GOVERNMENT Dr. Charles Mve Mvondo Head of Cardiac Surgery, Cardiac Surgeon Dr. Daniel Foppa Tiankwa Pharmacist  The Government organized seminars in which our staff participated at Dis- GP, in charge of the Diabetes Program & trict, Regional and National level. The collaboration has been cordial and it Dr. Nchare Chouibou

is hope d that this collaboration will continue to be strengthened. Peadiatric unit  Through the Ministry of Health, that of Finance granted exoneration for the Dr. Bernard Kameni Gynaecologist / Obstetrician importation of medical supplies for the Cardiac Center Dr. Kitio Zogni Gilbert Juvelil GP

Dr. Cedric Jean Joseph Mbassi General Surgeon Advocacy is still imperative for government to increase their assistance espe- cially the sponsorship of the cardiac surgery for the underprivileged patients, Dr. Eugene Yeika GP paving of the 3km road from Kumbo to Shisong. Dr. Joyce Foryoung GP Dr. Siben Litila Ophthalmologist 25. SOME MAJOR DONORS AND COLLABORATORS TURNOVER AND OTHER STAFF INFORMATION

Thanks sincerely to each and every one of our benefactors, donors, volunteers Retirement...... 6 and collaborators who assisted us in our effort to bring wholesome and afforda- Recruitment…………………………………………6 + 2 others ble healthcare to the people of Cameroon, Gabon, Nigeria, Chad, and the Re- Wedding ...... 4 public of Central Africa who come to us: Deliveries……………………………………….…...4 Death ...... 0  General Administration of the Tertiary Sisters of St. Francis, Rome Departures ...... 6

 Provincial Administration of the Tertiary Sisters of St. Francis, Brixen Currently on training 2016/2017 The Bishop of the Diocese of Kumbo  Medical doctor in specialisation ...... 1  Ministry of Public Health, Cameroon State Registered nurses ...... 2  Minister of Finance (granted exoneration from custom duties and taxes) Degree in Nursing ...... 2  Bambini Cardiopatici nel Mondo Association, Milan-Italy Midwifery ...... 0 Communication and Public Relations ...... 1 Cuore Fratello Association (Milan and Cameroon) Counselling ...... 2  Capuchin Province of Lombardy and Custody of Cameroon Completed training in 2016  The District service, Kumbo East Nurse …………….………………………………...5  The Franciscan Common Venture, USA BSc Nurses...... 1  Intercare, UK BMLS………………………………………………..1 38 7

FEAST OF ST. ELIZABETH OF HUNGARY 22.2. ECCLESIASTICAL PROVINCE The feast of our patron, St. Elizabeth of Hungary started with a 9 days Novena of HEALTH ASSISTANCE (BEPHA) (BEPHA Staff )

Masses that began on the 8th of November, and closed with a torch light proces- Since 2010, BEPHA has been in collaboration with the Institution in an effort sion from the Sisters‘ Cemetery to the St. Elizabeth Grotto in the Hospital . Inter- to ensure the provision of effective, cheaper, and quality healthcare to mem- bers. The office continued to sensitize the population regarding their ser- estingly this year in the spirit of St. Elizabeth of Hungary, a visit was effected by vices—subsidizing a certain percentage of members‘ consultations, hospitaliza- some staff members to the School for the Blind in Kumbo to share some food items tion, delivery and surgery bills. Below are some statistics: Service Out Hospitaliza- Delivery Surgery Total and pray with them. Patient tion No. 431 230 36 35 733 The Feast was celebrated this year on the 18th with Holy Mass at 9 am officiated Cost 2.649.239 4.545.797 535.125 2.354.550 10.087.710 by Fr. Tobias Ngah, Fr. Nestor Nyamjo, Fr. Roger and massively attended by the new hospital Administration and staff, Provincial Leadership Team, patients, Challenges: guardians, and CSHS students and staff. The Administration and staff of St. Martin  Most people still do not understand the importance of BEPHA thereby re- sulting in low enrolment. de Porres Hospital Njinikom were also present in this year‘s celebration as they  BEPHA‘s inability to cover certain illnesses, investigations and some treat- thrilled the event with typical Kom animation songs. They also came for return ment even when the patients are needy is still a big challenge. matches in the various sporting disciplines which saw the Shisong hospital emerge 23. THE 2016 DEVELOPMENT PLAN victorious in all the games. The following projects are envisaged for 2017. We would be glad with any Newly trained security guards were awarded their Attestations of completion of donor that comes to our aid. course . The day ended with feasting at the IDCC hall. 23.1 EQUIPMENT  November 2016 – Participation in the Parish harvest thanks giving by the Hospital  Suction machine and monitors for the maternity and theater staff.  Ultrasound in M—and B—Mode capable of scanning the cerebro/vascular  Consecration of Dr. Daniel Foppa into the Secular Franciscan of Immaculate Con- system, abdomen, pelvis, neck, thorax, breast, musculoskeletal system, ception oncology and urology.  CT scanner SOME SIGNIFICANT SOCIAL ACTIVITIES / NEWS/EVENTS OF THE  Machine for cutting glasses YEAR  Digital X-ray machine

Staff Retreat 2016 23.2 PERSONNEL nd rd - Staff annual retreat for 2016 for Group One was from the 2 to the 3 of February, Group Two from the 4th to the 5th February 2016 Anesthesiologist Cardiologist - Inspection and working visit by the Divisional Delegation of Vocational Training Internist Kumbo. Pediatrician

8 37

 Primary and final election of the staff Representative They are the first to welcome the incoming patients especially the emergency  Staff/Director visit St. Martin de Pores Hospital Njinikom cases. To in order to reinforce the workforce, some security guards were trained and recruited.  LUMOS team visited Shisong hospital fro 2 weeks  Visit to the sick by the Francophone community in Kumbo and CWA in March The Farewell Home continued with its services to the public as they pre- pared the mortal bodies for removal by the respective family members. Work  March 8th – Celebration of women‘s day with all the female staff. was carried out by three attendants with no major challenges. A new worker was added to reinforce the workforce to four attendants.  May 1st - labour Day celebration: The Hospital staff marched at Tobin.  4staff members got wedded within the year 22. HEALTH INSURANCE SCHEMES  Regular and extra ordinary General Staff meetings were held The Hospital continued to work in partnership with the two existing health in- surance schemes; Mutual Health Organization and BEPHA in health care fi-  Retirement of 6 staff members from the hospital , 1 from Wainamah, 1 Convent nancing  9 janitors underwent in-service training for one and half month as Auxiliary

22.1. KUMBO MUTUAL HEALTH COOPERATIVE staff. (Shisong Branch office Animator) Kumbo Mutual Health Cooperative society, a community based poverty allevi-  Departure of Dr Faustin O. in August 20116. ation scheme, operating on the principle of solidarity and mutual assistance for  Some staff members completed their courses in the various Higher Learning 11 years of collaboration with Shisong Hospital. The following services were guaranteed to its members who fulfilled the benefit conditions in 2016:- Institutes and resumed duty in the institution within the third and fourth quarter  644 cases benefited 50% coverage for out-patient bills worth 2,674,325F of 2016.  304 cases benefited 75% coverage for hospitalization bills worth 6,558,468F

 65 cases benefited 50% coverage for normal delivery bills worth 939,900F.  31 cases benefited 50% coverage for planned surgery worth 1,889,362F

 2 cases benefited 75% coverage from unplanned surgery worth 240,000F

NB: The above surgery percentages were covered only for members who are three years and above in the scheme. Invoices were prepared and submitted monthly from Shisong Hospital to KMHC and were being paid progressively following the Terms of Reference. A total of 1046 cases benefited from the MHC services amounting to 9,895,055Fcfa.

The net-working of Kumbo, Bamenda, and MHOs continued to enable coverage of members who come to Shisong Hospital and vise versa. 3 cases benefited from the networking service amounting to 58,162Fcfa Challenges faced were the high delinquency rate of members who default after benefiting or renew late in most cases when a group members is already sick. Secondly some beneficiaries complained of the non-coverage of some laborato- ry investigations that are too expensive for them to cover.

36 9

STAFF RETIREMENT CELEBRATION 2016 chase of these medications and equipment from foreign markets.  Accessibility to the Cardiac centre still remains a challenge. The 3km stretch The year 2016 witnessed the retirement of 8 staff members from the institution. Six from Squares Kumbo to Shisong is still a nightmare as the bad state of the road to Shisong still remains a great worry. It is hoped that the Government from the main hospital; Mensiy Fokum Grace (39 years), Nsai Helmina (37 years) of Cameroon would do the pave the road in the near future. Veranso James Kevin (36 years), Tatah Mbilam Cornelius (35 years), Ngah Ndzedzeni  Finding Sponsors for the Underprivileged Cardiac Patients Giving hope to the hopeless is one of the major objectives of the Centre. Henry (15 years), Venban Roland (13 years), joined by Mr. Tata Clement (36 years)  Drop in the Number of Surgical Interventions from the Shisong Convent community and Lanjo Emmanuel Bongajum (15 years) from  Post-Surgical Follow-Up Wainamah Catholic Health Centre.  Recruiting patients particularly adults for a procedure like open-heart surgery still remains a great challenge.  Late arrival in the hospital with advanced stage of disease The event took place on the 30th of December 2016 beginning with a Holy Mass at the

Cardiac Centre OPD Hall. It was massively attended by the entire Hospital community, family members and friends of the retirees. 21. AUXILIARY SERVICES The auxiliary services of the Hospital offer humanitarian services to compli- The staff Delegate on behalf the staff members commended the services and longevity ment the medical care provided. They are as follows: of the senior citizens. The Director, Sr. Kinyuy Mary Aldrine, in her speech appreciat- Carpentry Workshop continued to produce and repair all wood work ed the retirees for their selfless and devoted services in the Lord‘s vine yard for their needed in the Shisong Hospital Complex; such as, production of chairs, tables, respective number of years of service and wished them a nice time of rest. The retirees coffins, cupboards, etc. For excellent products, the department stands in need of a plaining machine. received gifts from the Hospital Administration and from colleagues of their respective units and friends. The day was crowned with feasting at the IDCC Hall Mechanical Workshop: This unit continued to carry out maintenance work on vehicles, equipment and sometimes, assembles the mechanical equip- ment needed in the Hospital. Its personnel is made of car mechanics, plumbers, electricians, etc. One staff left and a new mechanic-driver recruited.

Sewing Unit: The three tailors continued with their routine activities in-

cludes sewing and repairing of patients‘ outfit, bed sheets, theatre robes, etc. The staff of this unit were busy sewing new uniforms for the students of CSHS during the last quarter of the year. Some of the challenges faced by this unit are the lack of facilities such as the provision of a water closet toilet for them.

The Canteen Unit: This Unit continued to offer the catering services to the patients, staff and care givers. Its proximity to the patients and its patient- friendly menus are appreciated. The major challenge has been the limited staff especially those serving customers at the canteen eating room and washing dishes at the same time, thereby causing delays in service.

8 Senior citizens with the Administrators Security Guards: Staff of this Unit continued to ensure that order, safety and security reigned at every entry point and within the Hospital premises. 10 35

SECTION TWO Evolution of some statistical indicators DEPARTMENTAL REPORTS OF CLINICAL ACTIVITIES This section captures briefly the activities of each unit with specific or general statis- Annual Totals tics. Activities 2009/10 2011 2012 2013 2014 2015 2016 OUT PATIENT UNIT Consultation 5.956 5.420 5.268 5.246 5.976 6313 6561 The team of Doctors and Compound Nurses continued with daily consultations 24/7 in this Unit. Echo diagnosis 2.423 2.470 2.357 2.520 2.709 2956 3063 Year 2015 2016

ECG diagnosis 2.464 2.263 2.132 2.307 2.490 2579 2787 New patients 26,462 22,874 Stress Tests 00 15 08 06 04 05 05 Old patients 5,952 6,902

Holter ECG 00 60 62 56 77 70 372 Total consultations 32,414 29,776

In-patients 994 1.183 1.213 1.051 1.180 1156 7876 Ten Commonest Causes of Mortality in 2016 Pacemaker 04 17 17 27 22 37 150 1 HIV / AIDS 41 Implantations 2 Malignancies 23 Catheterizations 58 61 78 55 57 70 441 3 Pneumonia 22 Surgeries 104 103 87 101 60 98 630 4 Sepsis 13 5 Meningitis 13 Mobile Cardiac - 420 892 1,354 3672 3625 3692 Clinics 6 TB 10 7 G.E 7 Statistics 1. Admissions; 1007 patients admitted in the Clinical Ward. 8 Malnutrition 7 2. Disease prevalence; This year, there were four diseases that were most com- 9 Anaemia 7 mon among the 10 Malaria 6 patients: A. Hypertension (HTN) - 307 B. Congestive heart failure (CHF) - 220 Ten Commonest Causes of Morbidity in 2016 C. Cardiamyopathies (CM) - 134 D. Valvulopathies – 105 1 Gastritis / PUD 244

2 Malaria 1924 20.1 CHALLENGES OF THE CARDIAC CENTRE 3 R.T.I 1215  Inability of patients to pay for specialised procedures like Open-heart Sur- 4 Rheumatism 1096 gery, Catheterization and Implantation of Pacemakers, defibrillators and Car- 5 Gastro-Enteritis 1089 diac resynchronization Therapy;  The need for more partners and networks to promote the Cardiac Centre; The 6 Urinary tract infections 696 desire to maintain and improve the quality of our services. 7 Hypertension 546  Financial Sustainability of the Cardiac Centre remained a major preoccupa- tion as the high cost of electricity and the maintenance of the heavy genera- 8 Pneumonia 362 tors are really challenging. The absence of major medications and consuma- 9 BPH 284 bles on the local market obliges the Centre to incur huge costs for the pur- 10 Diabetes 216 34 11

HOSPITALISATIONS (WARDS) 20. CARDIAC CENTER Hospitalized patients in the various units received medical attention General Manager: Sr. Jethro Nkenglefac from the nurses and doctors on daily basis. Below are the statistical analysis of hospitalizations registered in the various departments. 2016 was unique in every sense. Some major activities and ‗expeditions‘ were carried out. The Cardiac Centre in its 7th year of operation organized its first Unit Admission Patient Deaths Discharge ‗Open Door Day‘ in Yaoundé, the Capital of Cameroon. This special day that Days was meant to showcase the Cardiac Centre – facilities, specialties, activities, MMW 1880 10573 78 1798 partners, collaborators and to open up more avenues for collaboration in Came- roon and beyond enabled stakeholders of different ranks to discuss pertinent FMW 1688 9643 71 1616 issues regarding this first cardiosurgical hospital in the Central African Sub Surgical II 150 3515 15 134 Region. With the status of a ‗Public Utility‘ following the Presidential Decree N° 2015/493 of 4th November 2015 the Cardiac Centre decided to extend its Maternity 1308 7038 1 1311 outreach activities to the three Northern in September 2016. The population of the Grand North had the opportunity to consult a Car- General Unit 185 2529 24 164 diologist and screen for cardiovascular diseases as a complete team was dis- Paediatric 935 3867 24 915 patched there to give the population this rare opportunity. In 2016mostplanned activities were realised, some challenges were encountered while some im- Surg. I 961 7817 18 925 promptu or spontaneous activities like the Visit of the Ministers of Higher Edu- cation and Public Health in November enabled the Cardiac Centre to give up- Gynae 692 5764 2 688 dates on how it had fared seven years after the inauguration. The Management Cardiac Center 1171 8451 91 1076 and Staff of the Centre continued to put in their utmost best to ensure that the quality of services rendered in Shisong remain unchallenged. The Resident Total 8970 59,197 324 8627 Team had its hands on deck to ensure that some specialised procedures like Open-Heart Surgery; Diagnostic and Interventional Catheterization and Im- plantation of Pacemakers and Implantable Cardioverter Defibrillators (ICDs) were performed. There were five (05) Paediatric Surgical Missions from Italy and Belgium in January, May and November. Some expatriate Cardiac Anaes- 3. LABORATORY thesiologists from Europe and the USA joined the Resident Team to manage cardiovascular diseases in patients within the Central African Sub Region and The Laboratory Unit continued to carry out the different investigations normally within Nigeria. the year. Mobile Screening The staff members took turns to attend the Thursday classes and went on their annual leave accordingly. Some staff members attended some seminars organized by some Mobile Activities of the Cardiac Centre that took off in 2011 and has evolved collaborators of the institution. Reagent purchase was done quarterly to ensure there from mobile clinics in some partner hospitals to free screening of children in was no stock out of material. Students on internship from the various Higher institutes some primary schools of the Kumbo East Health of learning were received in the department for practical experiences. The main lab District. From 2011 to 2016, thirteen thousand six hundred and fifty five supported the blood bank in providing technicians for each blood collection outreach as 13,655 consultations have been recorded at outreach clinics. The Mobile team need arose. held clinics in different Regions of Cameroon. An Electrolyte Analyzer was placed in the lab by Biopharcam Sarl as their property A maiden Outreach was carried out in the three Northern Regions. 9 of the 10 and for the hospital to buy the reagents for the equipment and use. Regions have been covered – Adamawa, Centre, Far North, Littoral, North, A new autoclave was purchased for the Laboratory. North West, South West, South and West Regions. Hopeful the mobile clinics would be extended to the .

12 33

19. CYTOPATHOLOGY UNIT ( Mr. Godfred Shey Utien) Statistical Analysis ANUAL LABORATORY STATISTICAL ANALYSIS 2016 In addition to the normal activities, outreach, sensitization and ANNUAL TOTAL NO OF PATIENTS 19,252 screening for cervical cancer continued at the unit and in some ANNUAL AVERAGE PATIENTS PER DAY 52.625 localities. More women are gradually getting informed on the im- ANNUAL TOTAL NO OF TESTS 88,469 portance of regular cervical cancer screening as the major way of ANNUAL AVERAGE TESTS PER DAY 242.475 its prevention. The year 2016 witnessed a drop in women turnout from 739 women in 2015 to 434 in 2016 due to inadequate sensiti- zation. Below are statistics of services offered within the year. Comparatively, the annual statistical analysis indicate a mile decrease in the average number of patients per day from 53.1 in 2015 to 52.6 in 2016 though with a minute decrease in the average number of tests done per day from 243.9 Pap smear FNA Fluids in 2015 to 242.5 in 2016. Breast Challenges 684 18 40 We constantly encountered some problems with our spectrophotometers and haematology analyser resulting from the aging out of these equipment. This we applied to the administration to look for a possibility of purchasing for the Lab an automated biochemistry analyser and an up to date haematology analyser. Proposals We encountered a few problems with shortage of some materials at the level of  Formation of a cancer sensitization team to create more awareness, suppliers but thank God it was not so serious to interrupt work. strengthen and improve on outreach activities We also encountered some problems with communication, printing and photo-  Pap test to be implemented as a ROUTINE test for all women consulting copying of working sheets. This was due to the lack of a printer and an internet in the hospital connection in the lab  All consultants / doctors to adequately utilize the science of cytology The way forward  A need for a female gynaecologist  Serious need for a pathologist or upgrade knowledge on histopathology  To ensure the proper functioning and development of the laboratory services as all histotechnological techniques are already in place to begin with in the institution, we believe that the following will have very good inputs: biopsies which is very vital for the patients  Some old equipment in the lab. may be replaced with new and up-to-date  Also proper planning , budgeting and funds put in place to boast the out- equipment for better and very reliable results. reach activities on cervical cancer screening.  To avoid automatic disappointments due to equipment breakdowns, a peri- odic equipment servicing protocol should be drawn for the laboratory depart- ment.  The installation of the database, a printer and internet services should also be installed in the main lab for better information management and facilitate workflow  The issue of staff continues education should be given a positive considera- tion.

Plans for 2017 In collaboration with the hospital administration, the laboratory will strive to: - Improve on the quality of the services they render to the clients. - Try to provide the equipment highlighted in the 2017 budget as investment. 32 13

- With the administration draw up an annual preventive maintenance 18.1 INTERNSHIP/RESEARCH (servicing) schedule for laboratory equipment National students from various Higher institutions of learning continued to make Shisong hospital a fertile ground for gaining experience in different 3.3 Blood Bank Report 2016 (Leikeki Thomas) fields, such as nursing, laboratory, physiotherapy, radiography, pharmacy, den- tistry, medicine and research work. Below are the statistics for 2016, exclud- There are 58 villages in Bui Division for mobile blood collection, for ing students from the Catholic School of Health Sciences, Shisong. fixed blood collection, villages and people of good-will around are always en- In Summary: couraged to donate voluntarily. Many high and professional schools around Bui Division were sensitized about voluntary blood donation, however volun- No. of Specialty Name of School tary blood collection was done at GTTC KUMBO Campus, TTC Tatum and Students Catholic school of Health Sciences Shisong. The numbers of donors screened 3 Lab Catholic University of Central Africa were 1210 and numbers Bled were 1099. The number of voluntary donors was 948 and the number of family/Replacement donors was 262. During the 2016 11 Lab/ University of Bamenda World Blood Donor Day celebration, about 350 to 400 voluntary blood donors Medicine came out to match decorated with mufflers. The Kumbo Council band took the 14 Nursing National Polytechnic Bamenda led the march past; the march past which started from Squares- Kumbo through 9 Nursing Bamenda University of Science and Technology Ntoh -Nso palace, Sacred Heart Parish Church premises to the Hospital. Since the voluntary donation activities are still taking off, it is difficulty 6 Nursing St. Jude Institute of Nursing & Biomedical to evaluate its activities; however there were some improvements as compared 12 Nursing International University – Kumbo campus to 2015. The mobile team plan to go out 26 times but actually went out 21 times; very many donors came out for fixe collection unlike last year. One 27 Nursing,Pharma, St. Louis Higher Institute Bamenda meeting was organised for blood donor coordinators, only 30 participants at- Radio, Lab. etc tended the meeting. The partners to the hospital blood bank are the Cameroon 2 Nursing St. Francis Buea Government, The Pelican Blood Association, branches found in 58 villages and 9 Nursing CATUC, school of health sciences, Kumbo/Bda National Voluntary Blood Donor Organisation. The blood bank receives some 4 Lab. Tech Training School for Assistant Lab. Tec. Bda testing kits for Hiv, HbsAg , HCV and Syphilis, gloves, Biohazard autoclave bags, and some blood bags North West Special Fund. 3 Lab University of Buea Number of outreach in 2016 ------———---21 villages 3 Lab HIBUMS Total number of Donors screened------———--1020 Number of voluntary blood Donors tapped------————--476 4 Lab University of Dschang Number of voluntary blood Donors deferred ------————23 1 Medicine YBU –Turkey Number of family or Replacement or paid donors screened —--—-521 1 Medicine University of Yaounde I Number of family or Replacement or paid Donors tapped ---——-327 18 Nursing, Radiog- IAMS Number of Family or Replacement or paid Donors Deferred--—---194 raphers Total Number of Donors tapped------803 Number of pints of blood Discarded------—-113 Total Number of Donors Deferred------217 Number of transfusion------907 Number of Voluntary blood Donors Tapped------—-----718 Number of Family or Replacement or Paid Donors tapped------—---414 2016 world blood Donor`s Day was celebrated at the level of the Hospital on the 14th June 2016. 7th October 2016 blood Donor Coordinators had a meeting with hospital Administration, after which a new Exco-members were elected to function for

14 31

17. NATURAL FAMILY PLANNING the next three years.

The Natural Family Planning (NFP) office continued to attend to clients who Challenges Faced came for natural family planning education. Spacers who have already been Lack of sensitization materials practicing NFP have been doing so well to respect their rendezvous The Blood Bank Need some basic Equipment. Strengths There is still insufficient Staff.  Most spacers have reported success in practice Insufficient sensitization finances.  The Office charts for follow up and booklets are available  Availability of two trained staff for natural family planning services  Post natal exam for all women at 6 weeks Proposed way forward  Achievers promote the services through sensitization  The need to purchase sensitization materials like T-shirts, mufflers, caps,  Health education has been going on in the PHC on NFP Bangles, pens, chain etc  A workshop has been programmed for the hospital women on NFP in  To own tube strippers March  The need to purchase a biochemistry Machine to support the Haemogas Ma-

Challenges chine in the ICU--―Co bass‖  The need to purchase a separator to separate blood into components so that it  With the transfer of Madam Nsa Eunice to teach at the CSHS– Shisong, can be preserved for longer duration. some clients have been loss to follow-up because of tight work schedules  Sterile connector and tube sealers are seriously needed.  HIV-positive clients despite their status who are in need of a baby  The need to purchase a stand-By Virology Machine in case of Vidas  The unmarried have been requesting the services more than the married Virology Machine breaks down i.e. the Architect.  Some people miss appointments.  Most often men are not ready to accompany their wives to the clinic. 4. ULTRASOUND Activities continued normally in the Unit through the year 2016 with no major 18. NURSE SUPERINTENDENT OFFICE challenges registered. A total of 3375 ultrasound exams were done in 2016 as (Mr. Jonathan F. and Tata Rosemary) against 4649 exams in 2015 indicating a drop in the number of clients received. Internal sanitary control team paid visits to evaluate work carried out. Student This office witnessed a change April 2016 as Mr. Jonathan Fondzenyuy re- intern from various Higher Professional Learning Institutions as well as Third placed Mr. Lontum Martin as new GNS assisted by Ms Tata Rosemary. The year students of the Catholic School of Health Sciences Shisong carried out office continued to ensure that the standard and quality of the nursing care, their training at the Unit at various intervals. supervision and evaluation of nurses and student nurses and general coordina- tion of nursing activities within the hospital milieu were implemented. Some Departmental Needs major activities of this office focused on:  The departments needs an Ultrasound machine with current and required  Priority in nursing care/routine procedures, Patient-centered care performance/installations.  Enforcement of Standards Operating Procedures (SOP)  An additional toilet to the existing one to serve female and male patients  Nursing care plan separately.  Teaching the nurses the importance of documentation in nursing practice  Refresher courses for the staff of the department would help them be updated Writing of shift report  on recent and advanced procedures for examinations.  Weekly Thursday classes on various topics  Staff outlook – dressing  Surveys on nursing issues

Most of the lessons planned for the Thursday classes were covered though staff attendance remained poor as mostly the same persons attended the classes. Ultrasound Statistics 2016

30 15

Skull Spine Chest Pelvis Arm Leg ABD HSG IVP BAS04 Fistu- Hydro- Ure- Month- meal/ lograp tubation throgra ly Total enema hy phy 2016 Statistics of ANC and IWC Jan 12 29 114 13 21 25 1 26 8 - - 2 1 252 Feb 10 26 109 2 16 33 8 20 2 1 - 4 7 238 Vaccine Type Total Mar 6 42 115 22 8 37 7 23 6 1 - 8 6 281 Apr 5 43 83 19 14 28 12 32 - - - 6 4 246 BCG 568

May 11 47 147 11 14 31 12 17 2 1 - 2 1 296 I II III Jun 11 61 123 13 12 19 6 19 5 2 - 5 5 281

Jul 6 73 144 24 7 23 7 25 2 - - 5 5 321 Polio 908 300 303 305 Aug 5 83 215 5 18 38 13 22 2 2 - 8 3 414 Sep 2 85 93 19 14 23 6 12 3 1 1 10 2 271 I II III Oct 8 91 81 29 10 25 5 12 4 1 - 9 7 282 Penta 908 Nov - 96 83 23 11 35 7 9 2 - - 8 5 279 300 303 305 Dec 4 44 82 16 5 23 8 19 3 2 - 4 4 214 I II III Annual Total 3375 Pneumo 908 300 303 305

X-RAY (In-charge: Shey Pius Verla) I II Work continued normally in the department as x-rays were conducted for the ROTA 603 outpatients and inpatients. A total number of 3375 radiological examinations 300 303 were performed as opposed to 3928 in 2015. Within the year, we received third year students on practical experience from the Catholic School of Health Sci- I II III IPT 948 ences Shisong and other Higher institutions of training in Cameroon. 442 303 203 The Internal quality assessment team visited the department and made apprais- als about the activities. Measles 282

One of the unit‘s biggest challenge has been the manageable machine, installed Yellow fever 282 in 1974, and has been declared out-dated by the Quality Control Team from the Ministry of Scientific Research and Innovation in 2014. IPV 305 Our desire is for a new X-ray machine to be purchased to ease work and im- Number tested 488 prove on the quality of images. X-ray discussions between doctors , ward Hepatitis charges and X-ray technicians were held. It is hoped that the Administration Number positive 10 will try to reinforce this discussion classes every Tuesday for the interest of our 6-11 mths 12-59 mths patients and knowledge upgrading. Departmental meetings were regularly con- VIT A 3114 ducted. 529 2585 Abdomen Abdomen- Pelvis Obstetrics Thyroid Testes & Breast Others Monthly pelvic Scrotum Total I, II III, IV, V Jan 13 113 86 69 3 6 - 9 229 Tetanus Toxoid 1093 442, 280 226, 92, 53 Feb 20 139 148 94 2 10 1 5 419 Mar 16 132 78 81 1 7 1 6 322 New 300 Apr 20 155 103 54 3 4 - 10 349 I.W.C 2461 May 18 169 91 73 4 6 2 6 369 Old 2110 Jun 41 98 102 80 - 13 1 6 341 Jul 28 108 127 61 1 14 - 11 350 New 486 ANC 3023 Aug 39 112 178 85 2 4 - 19 439 Old 2537 Sep 27 61 227 78 2 11 2 13 421 Oct 33 110 139 71 3 5 3 7 371

Nov 22 88 108 80 1 2 - 12 313

Dec 19 81 134 71 - 6 1 16 328 Annual Total 4321

16 29

16. PRIMARY HEALTH CARE 6. DENTISTAL CLINIC Incharge: Sr. Mark Verjai Primary health care takes care of women in pregnancy and gestation as well as The Dental Unit continued to render routine dental services to the clients who babies from 0 to 12 months through health education, vaccination for immun- came for outpatient consultation as well as the hospitalized cases. Students on ization, etc within the Hospital and in six Health Centers under our supervision. internship from St. Louis Higher Institute and those from the CSHS were re- The outreach posts are mostly found in the Kumbo East District except for ceived in the unit for more practical experience. The staff strength remained 3 Banten, Kouram and Sabongida. persons who have worked so hard to realize the following statistics. Scope of Shisong Health Area Statistics According to the Ministry of Public Health, Kumbo is divided into two Dis- tricts: Kumbo East and Kumbo West. The total population of Kumbo East Procedure No. Procedure No. stands at 17,648. Kumbo East Health District is made up of 20 health areas. Shisong, which falls under Kumbo East, is divided into seven zones where each Caries 489 Scaling 82 zone designates the date for its PHC activities. Activities carried out within the year were as follows: Filling 264 Partial dentures 119

 IWC for vaccinations and education of mothers every Thursday and Saturday Repaired dentures 22 Traumas 7  ANC booking clinic every Friday  ANC subsequent visit every Monday and Wednesday Complete dentures 3 RCT 18  Training of community workers for all the field programmes Abscesses 122 Periodontitis 26  Outreach visits continued to Sabongida, Wvem, Kingomen, Banten Sensitive teeth 25 Tumors 4 Wainamah and Kouram health centers and other outreach areas for vaccination Antenatal Clinic (ANC) and Infant Welfare Clinic (IWC) Extractions 281 Others 596

Trainings 7. OPERATING THEATRE (Njoaka Cyprian M –HOD) More trainings were organized for community workers, vaccinators and other The Surgical team continued to perform different procedures within the unit in health programs carried out in the field. Community workers were also trained course of the year 2016. The Gynecologist, Urologist was joined by a General in the course of the year on the distribution of mosquito nets Surgeon in June 2016 as they each continued with the operations in their re-  Training of community workers on NIDs of which polio vaccines were ad- spective specialties. Surgeries witnessed an increase in the number of cases ministered to many children aged 0—59 months justified by the recruitment of a General Surgeon. The staffing situation im-  Mother and Child Health Nutrition Action Week (MCHNAW), during which proved from 8 trained staff to 10 while the 3 auxiliary workers were there to Vit A was given to children, Mebendazole to children aged 0—59 months. take care of environmental sanitation. A surgical team (Surg For All ) from The PHC statistics are as follows: Spain together with the surgeons serving in the institution carried out a one week Urologic Mission from 17th to 22nd September 2016 during which the first PMTCT ever endoscopic surgeries were done in the hospital at a subsidized rate. Women counselled = 488 as opposed to 893 in 2015 In the quest to improve on the equipment, the unit received an Anesthetic ma- Women tested = 476 as opposed to 873 in 2015 chine, incubator and some other items donated by Leuven—Belgium in March Women tested HIV + = 3, placed on Treatment as opposed to 24 in 2015 2016 to ease surgery procedures. Some electric irons were also purchased to Refusals = 0 as opposed to 4 in 2015 ease the ironing of linens. The unit continued to receive and train Nursing and medical students from na-

tional and international training grounds throughout the year.

28 17

Statistics of Surgical Operations lack of material. Statistics of clients seen in 2016 OPERATIONS IN 2016 Major Minor Hernia C/S POP Suturing I/D Rubric M F Total

1360 464 135 316 3 100 73 Patients admitted 82 67 149 Outpatients 148 125 273 Challenges Patients seen at Diabetic clinic 83 83 166  Absence of an intensive care unit and staff to monitor patients  Delayed sterilization programs because of very old and poor function- New patients 21 24 45

ing machines Old patients 62 56 118  Intermittent shortage of Anaesthetic drugs and surgical materials Needs Patients with complications 42 124 166  Construction and staffing of an ICU Clients with type I diabetes 17 18 35  Construction of more operation rooms (an in-built system) with pro- vision for different surgical specialties Clients with type II diabetes 66 65 131  Proper renovation of theatre II floors and walls New clients with type I 4

No pregnant diabetic woman seen within the year.

8. GYNAECO-OBSTETRIC Recommendations The Gynaecologist and staff members of this unit continued working relent-  Provide an office for the Diabetes program in the institution to solve the lessly to ensure that clients were given the needed medical attention to old, new problem of meeting patients under the tree or in lawns.  We need more nurse educators to continue the education of diabetes melli- and referral cases. In line with the Thursday classes schedule, staff members tus in the Hospital. continued to upgrade their knowledge and skills by attending these classes  We need an emergency department with resuscitation kits for complicated weekly. Dr. Faustin Onivogui left the unit during the second half of the year cases.  Mobilise for the celebration of World Diabetes Day by providing a kit con- and Dr. Bernard came in for a few weeks, then went back to complete his pro- taining glucometers and strips. gram and resume work fully in 2017.

15. PERFORMANCE-BASED FINANCING (PBF) Challenges  Clients unable to pay their bills especially deliveries through C/Section The Performance Based Financing program in its firth year of collaboration with the Shisong Hospital, continued with routine evaluation visits to make  Despite the improved health care, there are still un-booked cases registered appraisals of the quality of services rendered to the public. For administrative who come at last minute for delivery. reasons, the implementation of the program in the institution was halted by the  Some pregnant women still use of traditional medicines with the belief that hospital Administration in the second half of the year it will ease their labour but rather it poses a great risk during labour  Despite constant health education, women with previous caesarean scar still think they can have normal deliveries and tend to stay home till they are in active labour.

18 27

HIV still remains the leading cause of tuberculosis in TB patients as observed Way Forward that out of the 101 patients diagnosed, 57 of them were HIV positive.  Continuous health education at the Infant Welfare Clinic (IWC)

Treatment Outcome  Increase collaboration and organize seminars with health center staff The success rate of patients diagnosed in 2016 will be measured in 2017 but for  Encourage the health centers to ensure that referrals are done promptly those placed on treatment in 2015, the rate of Smear Positive Pulmonary Tuber- culosis (SPPTB) cases dropped from 81% to 79%. This result is given for Statistical analysis SPPTB because it is the most infectious type. Most diagnosed patients diag- nosed in 2015 completed their treatment. There were some cases that died or defaulted treatment due to late diagnosis, long distances and financial con- PARAMETER Definition Sub Total Sub Total straints. total 2015 total 2016

Challenges encountered 2015 2016 The program encountered so many challenges within the year that could ac- Deliveries Male 662 1214 587 1218 count for the poor performance and mentioned. Some of these problems are:- Female 552 631  Poor follow-up of patients in the hospital and homes  High defaulting and death rates C/section 316 316 316 316  Shortage of diagnostic material Referrals 108 108 93 93  Poor sensitization of staff and community Received  Lack of motivation for the staff Male 29 59 22  Difficulty to track and bring back defaulters Premature 65 Female 30 43 Way Forward Male 51 98 42  Addition of staff in the progam to facilitate work and the use of the bike Twin 88 meant for the program by the additional staff to track defaulters Female 47 46  Motivation of staff of the TB program Male 0 0 1 Triplets 3  Increase sensitization within the hospital on TB prevention Female 0 2 The addition of more nurses and empowering them to care and follow-up TB patients will be an added impetus to enhance the services of the TB Unit Still birth 40 40 31 31 Episiotomy 215 215 206 206 14. DIABETES MELLITUS PROGRAM Mother Mortality 1 1 1 1

By Dr. Nchare Chouibou, MD, Diabetes Program Coordinator and Mr. Tachea Babies Mortality Before 24hrs 6 6 12 12 Roger, Nurse Diabetes Educator After 24 hrs 7 7 9 9

Activities continued to be centred on educative talks on diabetes to all the pa- Malaria Positive 0 0 0 0 tients and their relatives in the various units of the institution. During the en- counters clients were schooled on the meaning of diabetes, types of diabetes, common signs and symptoms, the risk factors, healthy diet, the importance of drugs and insulin and their storage condition and the importance of exercise to a healthy lifestyle. Educative talks were also organized with the local radio stations. The Diabetes World Day, we were not able to conduct screening due to time constraints and

26 19

9. CHAPLAINCY SERVICES ZEIHL XPERT FOLOWUPS Fluid Aspirates By Sr. Mary Charles, Fr. Tobias Ngah and Fr. Nestor Nyamnjo NELSON MTB/RIF Mont No No No No Pos Pos Pos Pos The Chaplaincy continued to promote the mission of the Hospital by catering h done done done done for the spiritual and pastoral needs of the patients, caregivers, and the staff irre- spective of their religion. During the year, much time and energy was devoted Jan 22 1 99 7 10 0 0 0 to the sick during daily rounds in the wards to assist them in their spiritual Feb 48 1 128 15 20 0 1 0 needs. Many patients participated in some of the sacraments according to their needs for spiritual healing. Mar 101 1 90 4 14 1 0 0 The chaplains listened, advised, counseled, taught catechesis, and administered Apr 133 9 101 7 11 4 8 3 the Sacraments (for Catholics). They worked in collaboration with the Coun- seling team and staff members, especially the departmental heads. Gifts col- May 105 10 82 6 11 4 5 2 lected at the end-of-year Masses were given to the poor. Jun 124 11 116 12 12 0 7 1 Drawing inspiration from James 5:13-15, the following Sacraments were ad- ministered this year, anointing of the sick people, Holy Communion, sacra- Jul 44 5 83 10 12 0 15 1 ment of Reconciliation administered to patients, guardians and staff during the Aug 77 3 56 6 23 3 12 2 Lent and Advent season. Sep 99 8 - - 7 1 11 1

Some spiritual activities of 2016 Oct 127 8 - - 10 0 12 4 Holy Mass at 6:30 am……...Wednesday and Friday by Fr. Tobias & Nestor Nov 50 0 71 6 10 1 6 0 Holy Mass at 5:30 am……………...Saturday by the Capuchins Morning Prayers at 6:45 am………..Monday, Tuesday, Thursday, Saturday Dec 38 2 60 3 6 1 4 1 Adoration of the Blessed Sacrament ...... Every First Friday monthly Total 968 59 886 76 146 15 81 15 There exist in the institution the St. Camilla SCC and the St. John Paul II SCC

The celebration of the World Day of the Sick took place on February 10 in 13. 1. TUBERCULOSIS PROGRAM Dr.Wandji Kounougo René, (TB Coordinator assited by Mrs. Mary Electa Lybarfe) which the sacrament of anointing was administered. The Chaplains were ac- tively involved in preparations for the celebration of the Feast of St. Elizabeth The tuberculosis (TB) program continued its activities of diagnosing, treating of Hungary on the 18th November, Recollection and organized Retreats in or- and following up of TB patients hospitalized and those discharged to ensure der to uplift the spiritual life of the staff, administered ashes on Ash Wednes- they complete their treatment. The activities of the TB program were not at its day. The doors of the Chaplaincy remains widely open to receive especially best in 2016 as it did not meet its target despite ever effort put in place. spiritual material and financial support to boost the ministry.

TB Diagnosis (case finding) 10. EYE CLINIC Comparatively, the number of TB patients diagnosed in 2016 witnessed a drop With the permanent recruitment of Dr. Siben Litila as the Ophthalmologist of from those in diagnosed and referred 2015; i.e 101 patients in 2016 as opposed the institution, the Eye Clinic witnessed an increase in the number cases re- to 188 patients in 2015. Below are the statistics for 2016 ceived within the year. Activities were intensified on the field during outreach Smear Positive Pulmonary Tuberculosis (SPPTB) 59 screening and diagnosed cases operated upon in the hospital theatre. Many cli- Smear Negative Pulmonary Tuberculosis (SNPTB) 13 ents in need of ophthalmological problems came for the various services. The following are some statistics of services offered in 2017: Extra Pulmonary Tuberculosis (EPTB) 25

Retreatment cases 4

TOTAL 101 20 25

13. TUBERCULOSIS REACH LABORATORY Description Number (By Wirnkar Sequinta) VERNAL CONJUNCTIVTIS 17

ALLERGIC CONJUNCTIVITIS 37 Tuberculosis Reach Laboratory is one of the newly created laboratories that has BLEPHARITIS 190 been screening people with suspected tuberculosis. The creation of this labora- tory is in line with WHO's initiative to reduce mortality and morbidity due to DACROCYSTITIS 0 tuberculosis among immunosuppressed individuals, children and also exposed CORNEA SCAR 10 individuals by early diagnosis, continues follow up and to ensure proper treat- ment and management. These individuals‘ fall under two groups; HIGH CATARACT 138 RISK, LOW RISK GLAUCOMA 101 High risk individuals fall under the following interventions ; REFRACTIVE ERROR 225  Intervention one : Any HIV patient newly eligible for antiretroviral therapy PRESBYOPIA 88 regardless of symptoms,  Intervention two : Any hospitalized HIV positive patient regardless of symp- RETINAL DETACHMENT 6 toms and any hospitalized patient with TB symptoms regardless of HIV sta- DIABETIC RETINOPATHY 3 tus, OPTICATROPHY 9  Intervention three : Any HIV positive outpatient presenting at a health facili- ty with one or more symptoms, 11. PHYSIOTHERAPY  Intervention four: Other TB suspects usually with unknown HIV status- Person's who are exposed e.g. nurses, carers of SPPTB, family members in the household where someone have been infected, the entire community. Statistics analysis for 2016 These groups of person's benefited from more modern ways of diagnosing TB using the molecular technique ( GeneXpert) Ailment 2016 Low risk individuals benefited from microscopy technique. Back pain, joint pain, shoulder pain, neck pain etc. 330 Follow up was done on the first ,second, third , fourth ,fifth and sixth month control samples and in case negative, the patient were declared treated. For Weakness hemiplegia 24 relapsed, defaulters and Xpert positive patients, their samples were collected Paraplegia 12 before the start of treatment and sent to Bamenda for culture for fear of drug resistance and confirmation. Rifampicin resistance cases were immediately Cerebral palsy 5 referred to Bamenda for proper management with MDR-regimens Bell‘s palsy 4 TOTAL 370 Challenges  Lack of space in the lab leading to congestion  Temperature fluctuations Comparatively, the unit witnessed a drop in the number of clients attended to  No intercom to communicate with the other units of the hospital from 380 to 370. The workforce was reinforced by the LUMOS team for two weeks in the month of March. They also donated some equipment to the unit Sr. Petra Muso left for Bafut while Sr.Victorine Ngaibe joined the unit.  Some challenges experienced within the year were that the unit received so many patients and the space remains too small to attain to the clients.  Some cases were difficult to manage while some cases run or were dis- charged without our knowledge.  Lack of patience on the part of some clients to complete their treatment pro-

24 21

gram. Antenatal Clinic Statistics  Lack of cooperation between the Doctors and Physiotherapist for comple- mentary client management. Total Total Female Male Pre. VDRL HB B/G TPHA M HBV  Inadequate space in the unit to accommodate the increasing number of cli- HIV Pos. P ents amidst other needs. There is an urgent need for enough space to ease Test Neg Pos. Neg Pos. Neg Pos. N P work Total 1036 28 968 24 56 4 2.7 980 20 4032 1008 7 2 44 44

12. INTEGRATED DAY CARE CENTER CD4 Statistics Routine activities continued normally in the Integrated Day Care Center rang- Total Therapeutic Pre-Therapeutic Initiated on ARVs Total Clients on ARVs ing from the management of HIV/AIDS to Primary Prevention, Treatment Care and Support of persons affected by HIV/AIDS.in collaboration with Tested ―BIWON‖Children‘s Brighter Future and Project Hope. Out-reach and educa- 2182 1891 301 301 2345 tional programs targeted traditional healers, youths and adolescents. The Fol- low-up program of Prevention from Mother-To-Child Transmission (PMTCT) continued inline with the regulations from the Ministry of Public Health. Polymerase Chain Reaction (PCR) Statistics Care, support and ARV monthly refill was done as work was done in close col- laboration with the Clinic Pharmacy, Histopathology/Cytopatology and the Total Collected Total Results Total Negative Total Positive Tuberculosis reach Laboratory.

87 87 82 5 Routine Weekly/Monthly Activities were as follows

Talks to the pregnant women at ANC on HIV/AIDS prevention and PMTCT activities. Achievements Every Saturdays therapeutic committee meetings  Many clients on ARVs were properly followed up with TB test thanks to Follow up of defaulters by community rely agents on daily bases. the two units within the IDCC. Health education to clients every day.  The support from the Regional Technical Group (RTG) Bamenda, in form Children‘s consultation and refill of their ARV‘s is done following their age of testing kits, lancets etc have helped in the testing of many people for groups i.e. First Saturday (0 -11years), second Saturday (12 -15years), third HIV. Saturday(13-19 years)  Less children defaulting treatment as an outcome of regular meetings at the Children‘s meetings every three months. child play centre that was created. Departmental meetings were held on the last Saturday of the month. Below are  CD4 collection carried out in various outreach stations with the use of PI- some statistics MA machine improving patients‘ attendance and less defaulters.  Continues visits to secondary school students for free HIV testing in the HIV Statistics and Antenatal Clinic Inclusive for 2016 Kumbo East health district.  Continues testing of women for HIV during cancer screening.

Challenges  No intercom in the department, making communication difficult to other departments. Patient retention still a problem.  Insufficient funds to easy the follow up of defaulters most especially in re- mote areas. Flyover from outpatient department to IDCC.  No Wheel chairs for IDCC  Insufficient workers most especially in the Laboratory.

22 23