Success in the Central African Republic

A lot has changed in the last several weeks: The political situation has eased and only occasionally attacks on the transit route from Bangui to Cameroon by the Anti-Balaka occur. The maintenance and expansion of the district-hospital Bossembélé and the two smaller hospitals in Boali and Yaloke, which are close to the transit route, run at full speed. We have about 110 paid employees, from the construction worker to the hospital head, and are probably the largest employer in the area. The government is by no means fully operative and has stopped the payment of salary a year ago.

Just in October we treated 450 stationary and 5,300 ambulant patients with staff, medication, and commodities. The medication is handed out for free, after the government announced free treatment for all, to acquit themselves of this duty. The operating rooms are working at full capacity, to treat the numerous injured people of the partly devastating accidents on the transit route.

However, the majority of the stationary patients are seriously ill malaria children, of which some require blood transfusions.  These patients can normally leave the hospital after five days. A big improvement for the anemic children is the introduction of the hemoglobin measurement through the fingertip. Now, the results are collected uncomplicated and fast. In the hospital, the pediatrics department is permanently manned up to the last bed. In the nursing rooms of the pediatrics department is now as well a small milk kitchen to treat the occasionally malnourished children.

The collaboration with the local employees functions very well. The Cap-Anamur-Team established an outstanding reputation in the area. In the district-hospital, our technicians renovate piece by piece the ramshackled buildings. After the completion of the waiting hall and the outpatient clinic, including an emergency room, the toilettes and showers are currently being completed. Next, the rebuilding of the operation rooms is planned. The team is comprised of one doctor, one nurse, one logistician, and one technician who all strive by all available means, to slowly adjust the standards of the district hospital also to the other hospitals. The success is admittedly taking place in arduous small steps, but everyone involved enjoys the work.

For instance, the physicians were able to reduce at least by a little the prescription of antibiotics, which are often seen as a magic bullet. This was, among others, done by Cap-Anamur physician Dr. Peter Holzer, who held an advanced training certification regarding antibiotic therapy and educated the staff about the development of resistance as well as the correct administration of antibiotics. Since the advanced training, the medication is prescribed with more cautiousness. It is also apparent that the trainings in the field of hygiene by our nurse Sonja Schmidtmeier have also shown improvements.

Oral vaccination is sweet

Our team is also active outside of the hospitals for a healthier population: e.g. with a widespread vaccination program in the whole Bossembélé district. An issue to consider is, what works nowadays in Europe is naturally a challenge on several levels in Central Africa. Due to the civil war and the related collapse of the infrastructure, regular vaccinations did not take place for several months. In addition, several polio infections of children appeared on the border to Cameroon. For that reason, we started at the beginning of October one of the largest vaccination programs of the country: Until the middle of October we vaccinated 18,000 children in total.

Our logisticians Marius Apke and Volker Rath and their team took care of the majority of the logistics, including the necessary distribution cold chain. The biggest challenge is to maintain the cold chain. For that reason, on the technical side, five cars, thirty motorcycles, and countless cooling boxes were used to bring the vaccines to even remote villages. Several hundred local helpers went during weekends, because this is the time families spend the day at home, from door to door to give the children in each case two drops of vaccine to prevent the cruel infantile paralysis. For the vaccination program it is important that beforehand the villages elder are informed and are sensitized about the topic.