44

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

P.O Box 8, Kumbo Bui Division, North West Region Cameroon

Tel: (237) 242659959, 653807563, 695454509

Website: www. Shisonghospital.org Email: info@shisonghospital.org

Cardiac Centre: (237) 69690 –1264, 69948-8412, 67753-6572

2

Table of Contents

Some abbreviations……………………………………………………………….….3 Word from the Hospital Director…………………………………………………….3

Section One: General presentation

Brief History of the hospital…………………………………. ……………………..4

Staff composition…………………………………………………………………5-6

Doctors and responsibilities & other staff information………………………………7

Celebration of St. Elizabeth of Hungary feast day………………………………….8

Some significant events within the year……………………………………………..8

Infrastructural Achievements ……………………………………………………….9

Staff Retirement Celebration 2016…………………………………………………10

Section Two: Departmental Reports/Clinical Activities

OPD and Hospitalizations statistical analysis…………………………………..11-12 Laboratory statistics…………………………………………………………….12-13

Blood Bank ………………………………………………………………………..14

Ultrasound ………………………………………………………………………...15

X-ray………………………………………………………………………………..16

Dental Clinic………………………………………………………………………..17

Operating Theatre…………………………………………………………………..17

Gynaeco-obstetric…………………………………………………………………..18

Chaplaincy services………………………………………………………………...20

Eye Clinic…………………………………………………………………………..20

Physiotherapy………………………………………………………………………21

Integrated Day Care Centre……………………………………………………..21-22 Tuberculosis Reach Laboratory/ Tuberculosis program………………………..23-25

Diabetic program…………………………………………………………………...26

Performance Based Financing……………………………………………………...27

PHC……………………………………………………………………………..27-29

Natural Family Planning…………………………………………………………..30

Nurse superintendent‘s office ………………….………………………………….30

Internships…………………………………………………………………………31

Cytopathology Unit……………………………………………………………….32

Cardiac Centre overview report…………………………………………………33-34

Auxiliary services…………………………………………………………………..35

Health Insurance Schemes……………………………………………………...35-36

The 2017 development plan……………………………………………………….37 Construction projects………………………………………………………………38

Some major donors and Collaborators……………………………………………..38

Out-reach clinics………………………………………………………………..39-40

Highlights of 2015 events in pictures……..…………………………………..........41

Conclusion………………………...……………………………………………….43

SOME ABBREVIATIONS

43

28. CONCLUSION This year 2016 was characterised with a lot of activities and achievements

thanks to the great collaboration of our stakeholders. These achievements

were however recorded amidst some challenges. It is thanks to the collabora-

tion of the Head of Units of the Hospital and Chief of our satellite Health

Centres this report has been realized. Gratitude goes to God Almighty for his

continues protection and care as we travelled far and wide for mission or un-

derwent some risk to rescue the patients. We look forward to continue to as

per our mission statement ―To see and serve Christ in all by spending time to

care,‖

CONTACTS Sr. Kinyuy Mary Aldrine St. Elizabeth Catholic General Hospital, Shisong

P.O. Box 8, Kumbo

North West Region, Cameroon

Tel: (237) 67855-8543

Email: info@shisonghospital.org

Website: www.shisonghospital.org

Dr. Wandji Kounougo René

Chief Medical Officer

Tel: (237) 69471-8754

Sr. Jethro Nkenglefac,

Cardiac Center General Manager

Tel: 2265-9959 or 69690-1264

Email: cardiacadm@gmail.com

Sr. Genévieve Nakoma

Human Resource Manager

Tel: (237) 65380-7563

42

Staff during training by ICT Specialist on the new MIS PELICAN Blood Bank members in an elective meeting

Training of both old and new security guards Award of Certificate to the newly trained security guards

Guided tour of the institution by Ministers of MINSANTE/ MINSUP Signing of the visitors‘ book by Ministers of MINSANTE/ MINSUP

Njinikom staff joined SECGH Shisong staff in the St. Elizabeth Feast day Typical Kom Cultural animation by staff of Njinikom Hospital

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

3

ATT: Anti-Tetanus Toxoid

ANC Antennal Clinic

CVA: Celebro Vascular Accident

CRT Cardiac Resynchronization Therapy

FNA: Fine Needle Aspiration

GP: General Practitioner

HB: Heamoglobin

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

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

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

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.

4

SECTION ONE:

GENERAL PRESENTATION OF THE HOSPITAL

BRIEF HISTORY OF THE HOSPITAL

St. Elizabeth Catholic General Hospital was started on the 15th of November 1935 as a

small dispensary and maternity by five Tertiary Sisters of St. Francis from Brixen, South

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

roofed with grass and had three rooms; one for the dispensary, one for deliveries and a

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.

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-

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

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-

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.

41

Year

Indicator 2014 2015 2016

1 Outpatient 498 763 2526

2 Inpatient 58 122 497

3 Deliveries 45 43 125

4 ANC 129 168 472

5 IWC 517 470 931

Laboratory investigations were also conducted. 271 were tested

for HIV and 742 tested for malaria

27. SOME HIGHLIGHT EVENTS OF 2016 IN PICTURES

Eucharistic celebration & award of testimonials to newly trained auxiliary staff

Hospital Administration with newly trained auxiliary staff Thursday Refresher classes to upgrade nursing standards

40

Challenges

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-

age them.

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

need for more staff

26.2. KINGOMEN HEALTH CENTER

The staff of Kingomen Health Center continued rendering outpatient, inpatient,

deliveries, ANC, IWC to the population of this health area in 2016.

26.3 WVEM HEALTH CENTER The staff of Wvem Health Center continued rendering outpatient, inpatient,

deliveries, ANC, IWC to the population of this health area in 2016.

26.4. WAINAMAH SACRED HEART HEALTH CENTER Nurse in charge: Fola Clarisse Suilareng

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:

Year

Indicator 2016

1 Outpatient 374

2 Inpatient 68

3 Deliveries 52

4 ANC 234

5 IWC 417

5

STAFF COMPOSITION

DEPARTMENT No.

ADMINISTRATION 16

Director and Deputy 2

Manager and Assistant 2

Financial Managers 2

Cashier 2

Doctors 14

Nurse Superintendent 4

IDCC Coordinator 1

Nursing staff 195

Masters of Science in Nursing (Obstetric) 1

Bachelor of Science in Nursing (BSN) 16

Bachelors in Laboratory Technology 7

Nurse Anesthetists 3

State Registered Nurses 55

State Enrolled Nurses 15

State Registered Nurse Midwives 4

State Enrolled Nurse Midwives 7

Nurse Assistants 56

Ward Maids 9

Physiotherapist 2

Imagery Technicians 4

USS. Assistant 2

6

Ultrasound Technician 1

Dental Technician 1

Microscopist 1

Nurses and Auxiliaries working in attached Health Centres

28

Laboratory 22

Master of Science in Haematology 1

Bachelors in Medical Laboratory Science (BMLS)

6

Medical Laboratory Technicians (MLT) 18

Cytotechnologist 1

COMMUNICATION 1

Bachelors in Journalism 1

TECHNICAL STAFF 15

Electrician/Mechanics/Plumber 3

Carpenters 5

Drivers 3

Associate Degree, ICT 2

ICT Assistants 2

DOMESTIC STAFF 55

Canteen 12

Cleaners 19

General Labourers 4

Tailors 3

Laundry 4

Security Guards 13

Farewell Home Attendants 3

PASTORAL / SOCIAL WORKERS 27

Chaplains 3

Full-Time Counsellors 4

Part-Time Counsellors including some Nurs-es/Community Relay Agents

20

MEDICAL DOCTORS 8

Surgeons (2 Gynaecologists/1 Urologist/ General Surgeon)

4

General Practitioners 4

Paediatrician 1

TOTAL STAFF ENROLMENT 327

39

Medicines for Humanity, USA

Humanitarian Aid, Germany

The Clinton Foundation, USA

CYMA Firm, USA

Leuven Catholic Hospital, Belgium

Care Cameroon

Project Hope

BIWON-Children‘s Brighter Future Association, Shisong

Archbishop Paul Verdzekov Heart Foundation, Shisong

Mutual Health Cooperative Society

BEPHA

Nascent Solutions (Kumbo)

Brotherly Heart Association

North West Special Fund for Health (NWPSFH)

All the Institutions that send their interns to us (listed on page…)

All the TSSF Health Institutions

26. OUT-REACH CLINICS

26.1. SABONGIDA Chief of Center: Yinde Lucas Gobi

The 3 staff members of Sabongida Health Center continued to rendered ser-

vices to the population of this locality in collaboration with the Health Manage-

ment Committee . Activities carried out were consultations, delivery, ANC,

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

meetings at the District Hospital in Nkambe and others at Dumbo Health Cen-

tre. Monthly regular visits by the PHC team from the Shisong Hospital has

always been appreciated by the patients, especially those on ARVs. Some of

the achievements as follows:

Statistical Analysis

38

23.3 CONSTRUCTION PROJECTS

Complete the Networking of the Hospital / intelcom

Construction of a bore hole in the Cardiac Center

Renovation of drug store

Renovation of the hospital roofs

24. COLLABORATION WITH THE

CAMEROON GOVERNMENT

The Government organized seminars in which our staff participated at Dis-

trict, Regional and National level. The collaboration has been cordial and it

is hope d that this collaboration will continue to be strengthened.

Through the Ministry of Health, that of Finance granted exoneration for the

importation of medical supplies for the Cardiac Center

Advocacy is still imperative for government to increase their assistance espe-

cially the sponsorship of the cardiac surgery for the underprivileged patients,

paving of the 3km road from Kumbo to Shisong.

25. SOME MAJOR DONORS AND

COLLABORATORS

Thanks sincerely to each and every one of our benefactors, donors, volunteers

and collaborators who assisted us in our effort to bring wholesome and afforda-

ble healthcare to the people of Cameroon, Gabon, Nigeria, Chad, and the Re-

public of Central Africa who come to us:

General Administration of the Tertiary Sisters of St. Francis, Rome

Provincial Administration of the Tertiary Sisters of St. Francis, Brixen

The Bishop of the Diocese of Kumbo

Ministry of Public Health, Cameroon

Minister of Finance (granted exoneration from custom duties and taxes)

Bambini Cardiopatici nel Mondo Association, Milan-Italy

Cuore Fratello Association (Milan and Cameroon)

Capuchin Province of Lombardy and Custody of Cameroon

The District service, Kumbo East

The Franciscan Common Venture, USA

Intercare, UK

7

DOCTORS’ RESPONSIBILITIES

TURNOVER AND OTHER STAFF INFORMATION

Retirement............................................................... 6

Recruitment…………………………………………6 + 2 others

Wedding ................................................................. 4

Deliveries……………………………………….…...4

Death ...................................................................... 0

Departures ............................................................... 6

Currently on training 2016/2017 Medical doctor in specialisation ............................... 1

State Registered nurses ............................................ 2

Degree in Nursing ................................................... 2

Midwifery ............................................................... 0 Communication and Public Relations ....................... 1

Counselling ............................................................. 2

Completed training in 2016 Nurse …………….………………………………...5

BSc Nurses.............................................................. 1

BMLS………………………………………………..1

Name Responsibility

Dr. Wandji Kounougo René CMO, GP, Neonatologist, Dr. in charge of the Integrated Day Care Centre

Dr. Njiki Jules Gynaecologist

Dr. Ambassa Jean Claude Clinical Director – Cardiac Centre

Dr. Tantchou Tchoumi Jacque Cabral Head of Cardiology

Dr. Cisse Demba Urologist

Dr. Charles Mve Mvondo Head of Cardiac Surgery, Cardiac Surgeon

Dr. Daniel Foppa Tiankwa Pharmacist

Dr. Nchare Chouibou GP, in charge of the Diabetes Program & Peadiatric unit

Dr. Bernard Kameni Gynaecologist / Obstetrician

Dr. Kitio Zogni Gilbert Juvelil GP

Dr. Cedric Jean Joseph Mbassi General Surgeon

Dr. Eugene Yeika GP

Dr. Joyce Foryoung GP

Dr. Siben Litila Ophthalmologist

8

FEAST OF ST. ELIZABETH OF HUNGARY

The feast of our patron, St. Elizabeth of Hungary started with a 9 days Novena of

Masses that began on the 8th of November, and closed with a torch light proces-

sion from the Sisters‘ Cemetery to the St. Elizabeth Grotto in the Hospital . Inter-

estingly this year in the spirit of St. Elizabeth of Hungary, a visit was effected by

some staff members to the School for the Blind in Kumbo to share some food items

and pray with them.

The Feast was celebrated this year on the 18th with Holy Mass at 9 am officiated

by Fr. Tobias Ngah, Fr. Nestor Nyamjo, Fr. Roger and massively attended by the

new hospital Administration and staff, Provincial Leadership Team, patients,

guardians, and CSHS students and staff. The Administration and staff of St. Martin

de Porres Hospital Njinikom were also present in this year‘s celebration as they

thrilled the event with typical Kom animation songs. They also came for return

matches in the various sporting disciplines which saw the Shisong hospital emerge

victorious in all the games.

Newly trained security guards were awarded their Attestations of completion of

course . The day ended with feasting at the IDCC hall.

November 2016 – Participation in the Parish harvest thanks giving by the Hospital

staff.

Consecration of Dr. Daniel Foppa into the Secular Franciscan of Immaculate Con-

ception

SOME SIGNIFICANT SOCIAL ACTIVITIES / NEWS/EVENTS OF THE

YEAR

Staff Retreat 2016

- Staff annual retreat for 2016 for Group One was from the 2nd to the 3rd of

February, Group Two from the 4th to the 5th February 2016

- Inspection and working visit by the Divisional Delegation of Vocational Training

Kumbo.

37

22.2. BAMENDA ECCLESIASTICAL PROVINCE

HEALTH ASSISTANCE (BEPHA) (BEPHA Staff )

Since 2010, BEPHA has been in collaboration with the Institution in an effort

to ensure the provision of effective, cheaper, and quality healthcare to mem-

bers. The office continued to sensitize the population regarding their ser-

vices—subsidizing a certain percentage of members‘ consultations, hospitaliza-tion, delivery and surgery bills. Below are some statistics:

Challenges:

Most people still do not understand the importance of BEPHA thereby re-

sulting in low enrolment.

BEPHA‘s inability to cover certain illnesses, investigations and some treat-

ment even when the patients are needy is still a big challenge.

23. THE 2016 DEVELOPMENT PLAN The following projects are envisaged for 2017. We would be glad with any donor that comes to our aid.

23.1 EQUIPMENT

Suction machine and monitors for the maternity and theater

Ultrasound in M—and B—Mode capable of scanning the cerebro/vascular

system, abdomen, pelvis, neck, thorax, breast, musculoskeletal system,

oncology and urology.

CT scanner

Machine for cutting glasses

Digital X-ray machine

23.2 PERSONNEL

Anesthesiologist

Cardiologist

Internist

Pediatrician

Service Out

Patient

Hospitaliza-

tion

Delivery Surgery Total

No. 431 230 36 35 733

Cost 2.649.239 4.545.797 535.125 2.354.550 10.087.710

36

They are the first to welcome the incoming patients especially the emergency

cases. To in order to reinforce the workforce, some security guards were trained

and recruited.

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

was carried out by three attendants with no major challenges. A new worker

was added to reinforce the workforce to four attendants.

22. HEALTH INSURANCE SCHEMES

The Hospital continued to work in partnership with the two existing health in-

surance schemes; Mutual Health Organization and BEPHA in health care fi-

nancing

22.1. KUMBO MUTUAL HEALTH COOPERATIVE (Shisong Branch office Animator)

Kumbo Mutual Health Cooperative society, a community based poverty allevi-

ation scheme, operating on the principle of solidarity and mutual assistance for

11 years of collaboration with Shisong Hospital. The following services were

guaranteed to its members who fulfilled the benefit conditions in 2016:-

644 cases benefited 50% coverage for out-patient bills worth 2,674,325F

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 Boyo 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.

9

Primary and final election of the staff Representative

Staff/Director visit St. Martin de Pores Hospital Njinikom

LUMOS team visited Shisong hospital fro 2 weeks

Visit to the sick by the Francophone community in Kumbo and CWA in March

March 8th – Celebration of women‘s day with all the female staff.

May 1st - labour Day celebration: The Hospital staff marched at Tobin.

4staff members got wedded within the year

Regular and extra ordinary General Staff meetings were held

Retirement of 6 staff members from the hospital , 1 from Wainamah, 1 Convent

9 janitors underwent in-service training for one and half month as Auxiliary

staff.

Departure of Dr Faustin O. in August 20116.

Some staff members completed their courses in the various Higher Learning

Institutes and resumed duty in the institution within the third and fourth quarter

of 2016.

10

STAFF RETIREMENT CELEBRATION 2016

The year 2016 witnessed the retirement of 8 staff members from the institution. Six

from the main hospital; Mensiy Fokum Grace (39 years), Nsai Helmina (37 years)

Veranso James Kevin (36 years), Tatah Mbilam Cornelius (35 years), Ngah Ndzedzeni

Henry (15 years), Venban Roland (13 years), joined by Mr. Tata Clement (36 years)

from the Shisong Convent community and Lanjo Emmanuel Bongajum (15 years) from

Wainamah Catholic Health Centre.

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.

The staff Delegate on behalf the staff members commended the services and longevity

of the senior citizens. The Director, Sr. Kinyuy Mary Aldrine, in her speech appreciat-

ed the retirees for their selfless and devoted services in the Lord‘s vine yard for their

respective number of years of service and wished them a nice time of rest. The retirees

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

8 Senior citizens with the Administrators

35

chase of these medications and equipment from foreign markets. Accessibility to the Cardiac centre still remains a challenge. The 3km stretch

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

of Cameroon would do the pave the road in the near future. Finding Sponsors for the Underprivileged Cardiac Patients

Giving hope to the hopeless is one of the major objectives of the Centre. Drop in the Number of Surgical Interventions Post-Surgical Follow-Up 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

21. AUXILIARY SERVICES The auxiliary services of the Hospital offer humanitarian services to compli-

ment the medical care provided. They are as follows:

Carpentry Workshop continued to produce and repair all wood work

needed in the Shisong Hospital Complex; such as, production of chairs, tables,

coffins, cupboards, etc. For excellent products, the department stands in need

of a plaining machine.

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.

Security Guards: Staff of this Unit continued to ensure that order, safety

and security reigned at every entry point and within the Hospital premises.

34

Evolution of some statistical indicators

Statistics

1. Admissions; 1007 patients admitted in the Clinical Ward. 2. Disease prevalence; This year, there were four diseases that were most com-

mon among the

patients:

A. Hypertension (HTN) - 307

B. Congestive heart failure (CHF) - 220

C. Cardiamyopathies (CM) - 134

D. Valvulopathies – 105

20.1 CHALLENGES OF THE CARDIAC CENTRE

Inability of patients to pay for specialised procedures like Open-heart Sur-

gery, Catheterization and Implantation of Pacemakers, defibrillators and Car-

diac resynchronization Therapy; The need for more partners and networks to promote the Cardiac Centre; The

desire to maintain and improve the quality of our services. Financial Sustainability of the Cardiac Centre remained a major preoccupa-

tion as the high cost of electricity and the maintenance of the heavy genera-

tors are really challenging. The absence of major medications and consuma-

bles on the local market obliges the Centre to incur huge costs for the pur-

Activities

Annual Totals

2009/10 2011 2012 2013 2014 2015 2016

Consultation

5.956 5.420 5.268 5.246 5.976 6313 6561

Echo diagnosis

2.423 2.470 2.357 2.520 2.709 2956 3063

ECG diagnosis 2.464 2.263 2.132 2.307 2.490 2579 2787

Stress Tests 00 15 08 06 04 05 05

Holter ECG 00 60 62 56 77 70 372

In-patients 994 1.183 1.213 1.051 1.180 1156 7876

Pacemaker Implantations

04 17 17 27 22 37 150

Catheterizations 58 61 78 55 57 70 441

Surgeries 104 103 87 101 60 98 630

Mobile Cardiac Clinics

- 420 892 1,354 3672 3625 3692

11

SECTION TWO DEPARTMENTAL REPORTS OF CLINICAL ACTIVITIES This section captures briefly the activities of each unit with specific or general statis-

tics.

OUT PATIENT UNIT The team of Doctors and Compound Nurses continued with daily consultations 24/7

in this Unit.

Ten Commonest Causes of Mortality in 2016

Ten Commonest Causes of Morbidity in 2016

Year 2015 2016

New patients 26,462 22,874

Old patients 5,952 6,902

Total consultations 32,414 29,776

Gastritis / PUD 244 1

Malaria 1924 2

R.T.I 1215 3

Rheumatism 1096 4

Gastro-Enteritis 1089 5

Urinary tract infections 696 6

Hypertension 546 7

Pneumonia 362 8

BPH 284 9

Diabetes 216 10

1 HIV / AIDS 41

2 Malignancies 23

3 Pneumonia 22

4 Sepsis 13

5 Meningitis 13

6 TB 10

7 G.E 7

8 Malnutrition 7

9 Anaemia 7

10 Malaria 6

12

HOSPITALISATIONS (WARDS)

Hospitalized patients in the various units received medical attention

from the nurses and doctors on daily basis. Below are the statistical

analysis of hospitalizations registered in the various departments.

3. LABORATORY

The Laboratory Unit continued to carry out the different investigations normally within

the year.

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

collaborators of the institution. Reagent purchase was done quarterly to ensure there

was no stock out of material. Students on internship from the various Higher institutes

of learning were received in the department for practical experiences. The main lab

supported the blood bank in providing technicians for each blood collection outreach as

need arose.

An Electrolyte Analyzer was placed in the lab by Biopharcam Sarl as their property and for the hospital to buy the reagents for the equipment and use.

A new autoclave was purchased for the Laboratory.

Unit Admission Patient

Days Deaths Discharge

MMW 1880 10573 78 1798

FMW 1688 9643 71 1616

Surgical II 150 3515 15 134

Maternity 1308 7038 1 1311

General Unit 185 2529 24 164

Paediatric 935 3867 24 915

Surg. I 961 7817 18 925

Gynae 692 5764 2 688

Cardiac Center 1171 8451 91 1076

Total 8970 59,197 324 8627

33

20. CARDIAC CENTER General Manager: Sr. Jethro Nkenglefac

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

‗Open Door Day‘ in Yaoundé, the Capital of Cameroon. This special day that

was meant to showcase the Cardiac Centre – facilities, specialties, activities, partners, collaborators and to open up more avenues for collaboration in Came-

roon and beyond enabled stakeholders of different ranks to discuss pertinent

issues regarding this first cardiosurgical hospital in the Central African Sub

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

outreach activities to the three Northern Regions of Cameroon in September

2016. The population of the Grand North had the opportunity to consult a Car-

diologist and screen for cardiovascular diseases as a complete team was dis-

patched there to give the population this rare opportunity. In 2016mostplanned

activities were realised, some challenges were encountered while some im-

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-dates on how it had fared seven years after the inauguration. The Management

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

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-

thesiologists from Europe and the USA joined the Resident Team to manage

cardiovascular diseases in patients within the Central African Sub Region and

Nigeria.

Mobile Screening

Mobile Activities of the Cardiac Centre that took off in 2011 and has evolved

from mobile clinics in some partner hospitals to free screening of children in

some primary schools of the Kumbo East Health

District. From 2011 to 2016, thirteen thousand six hundred and fifty five

13,655 consultations have been recorded at outreach clinics. The Mobile team

held clinics in different Regions of Cameroon.

A maiden Outreach was carried out in the three Northern Regions. 9 of the 10

Regions have been covered – Adamawa, Centre, Far North, Littoral, North,

North West, South West, South and West Regions. Hopeful the mobile clinics

would be extended to the East Region.

32

Pap smear FNA Fluids

Breast

684 18 40

19. CYTOPATHOLOGY UNIT ( Mr. Godfred Shey Utien)

In addition to the normal activities, outreach, sensitization and

screening for cervical cancer continued at the unit and in some

localities. More women are gradually getting informed on the im-

portance of regular cervical cancer screening as the major way of

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.

Proposals Formation of a cancer sensitization team to create more awareness,

strengthen and improve on outreach activities

Pap test to be implemented as a ROUTINE test for all women consulting

in the hospital

All consultants / doctors to adequately utilize the science of cytology

A need for a female gynaecologist

Serious need for a pathologist or upgrade knowledge on histopathology

as all histotechnological techniques are already in place to begin with

biopsies which is very vital for the patients

Also proper planning , budgeting and funds put in place to boast the out-

reach activities on cervical cancer screening.

13

Statistical Analysis

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

in 2015 to 242.5 in 2016.

Challenges

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.

We encountered a few problems with shortage of some materials at the level of suppliers but thank God it was not so serious to interrupt work.

We also encountered some problems with communication, printing and photo-

copying of working sheets. This was due to the lack of a printer and an internet

connection in the lab

The way forward

To ensure the proper functioning and development of the laboratory services

in the institution, we believe that the following will have very good inputs:

Some old equipment in the lab. may be replaced with new and up-to-date

equipment for better and very reliable results.

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.

ANUAL LABORATORY STATISTICAL ANALYSIS 2016

ANNUAL TOTAL NO OF PATIENTS 19,252

ANNUAL AVERAGE PATIENTS PER DAY 52.625

ANNUAL TOTAL NO OF TESTS 88,469

ANNUAL AVERAGE TESTS PER DAY 242.475

14

- With the administration draw up an annual preventive maintenance

(servicing) schedule for laboratory equipment

3.3 Blood Bank Report 2016 (Leikeki Thomas)

There are 58 villages in Bui Division for mobile blood collection, for

fixed blood collection, villages and people of good-will around are always en-

couraged to donate voluntarily. Many high and professional schools around

Bui Division were sensitized about voluntary blood donation, however volun-

tary blood collection was done at GTTC KUMBO Campus, TTC Tatum and

Catholic school of Health Sciences Shisong. The numbers of donors screened

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 World Blood Donor Day celebration, about 350 to 400 voluntary blood donors

came out to match decorated with mufflers. The Kumbo Council band took the

led the march past; the march past which started from Squares- Kumbo through

Ntoh -Nso palace, Sacred Heart Parish Church premises to the Hospital.

Since the voluntary donation activities are still taking off, it is difficulty

to evaluate its activities; however there were some improvements as compared

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

meeting was organised for blood donor coordinators, only 30 participants at-

tended the meeting. The partners to the hospital blood bank are the Cameroon

Government, The Pelican Blood Association, branches found in 58 villages and

National Voluntary Blood Donor Organisation. The blood bank receives some testing kits for Hiv, HbsAg , HCV and Syphilis, gloves, Biohazard autoclave

bags, and some blood bags North West Special Fund.

Number of outreach in 2016 --------------------------------———---21 villages

Total number of Donors screened---------------------------———--1020

Number of voluntary blood Donors tapped--------------————--476

Number of voluntary blood Donors deferred -------------————23

Number of family or Replacement or paid donors screened —--—-521

Number of family or Replacement or paid Donors tapped ---——-327

Number of Family or Replacement or paid Donors Deferred--—---194

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

31

18.1 INTERNSHIP/RESEARCH

National students from various Higher institutions of learning continued to

make Shisong hospital a fertile ground for gaining experience in different

fields, such as nursing, laboratory, physiotherapy, radiography, pharmacy, den-

tistry, medicine and research work. Below are the statistics for 2016, exclud-

ing students from the Catholic School of Health Sciences, Shisong.

In Summary:

No. of

Students

Specialty Name of School

3 Lab Catholic University of Central Africa

11 Lab/

Medicine

University of Bamenda

14 Nursing National Polytechnic Bamenda

9 Nursing Bamenda University of Science and Technology

6 Nursing St. Jude Institute of Nursing & Biomedical

12 Nursing International University – Kumbo campus

27 Nursing,Pharma,

Radio, Lab. etc St. Louis Higher Institute Bamenda

2 Nursing St. Francis Buea

9 Nursing CATUC, school of health sciences, Kumbo/Bda

4 Lab. Tech Training School for Assistant Lab. Tec. Bda

3 Lab University of Buea

3 Lab HIBUMS

4 Lab University of Dschang

1 Medicine YBU –Turkey

1 Medicine University of Yaounde I

18 Nursing, Radiog-

raphers IAMS

30

17. NATURAL FAMILY PLANNING

The Natural Family Planning (NFP) office continued to attend to clients who

came for natural family planning education. Spacers who have already been

practicing NFP have been doing so well to respect their rendezvous

Strengths

Most spacers have reported success in practice 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 Achievers promote the services through sensitization Health education has been going on in the PHC on NFP A workshop has been programmed for the hospital women on NFP in

March

Challenges

With the transfer of Madam Nsa Eunice to teach at the CSHS– Shisong,

some clients have been loss to follow-up because of tight work schedules

HIV-positive clients despite their status who are in need of a baby

The unmarried have been requesting the services more than the married

Some people miss appointments.

Most often men are not ready to accompany their wives to the clinic.

18. NURSE SUPERINTENDENT OFFICE

(Mr. Jonathan F. and Tata Rosemary)

This office witnessed a change April 2016 as Mr. Jonathan Fondzenyuy re-

placed Mr. Lontum Martin as new GNS assisted by Ms Tata Rosemary. The

office continued to ensure that the standard and quality of the nursing care,

supervision and evaluation of nurses and student nurses and general coordina-

tion of nursing activities within the hospital milieu were implemented. Some

major activities of this office focused on:

Priority in nursing care/routine procedures, Patient-centered care Enforcement of Standards Operating Procedures (SOP) Nursing care plan Teaching the nurses the importance of documentation in nursing practice Writing of shift report 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.

15

the next three years.

Challenges Faced Lack of sensitization materials

The Blood Bank Need some basic Equipment.

There is still insufficient Staff.

Insufficient sensitization finances.

Proposed way forward The need to purchase sensitization materials like T-shirts, mufflers, caps,

Bangles, pens, chain etc

To own tube strippers

The need to purchase a biochemistry Machine to support the Haemogas Ma-

chine in the ICU--―Co bass‖

The need to purchase a separator to separate blood into components so that it can be preserved for longer duration.

Sterile connector and tube sealers are seriously needed.

The need to purchase a stand-By Virology Machine in case of Vidas Virology Machine breaks down i.e. the Architect.

4. ULTRASOUND Activities continued normally in the Unit through the year 2016 with no major

challenges registered. A total of 3375 ultrasound exams were done in 2016 as

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 intern from various Higher Professional Learning Institutions as well as Third

year students of the Catholic School of Health Sciences Shisong carried out

their training at the Unit at various intervals.

Departmental Needs

The departments needs an Ultrasound machine with current and required performance/installations.

An additional toilet to the existing one to serve female and male patients separately.

Refresher courses for the staff of the department would help them be updated

on recent and advanced procedures for examinations.

Ultrasound Statistics 2016

16

X-RAY (In-charge: Shey Pius Verla)

Work continued normally in the department as x-rays were conducted for the

outpatients and inpatients. A total number of 3375 radiological examinations

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-ences Shisong and other Higher institutions of training in Cameroon.

The Internal quality assessment team visited the department and made apprais-

als about the activities.

One of the unit‘s biggest challenge has been the manageable machine, installed

in 1974, and has been declared out-dated by the Quality Control Team from the

Ministry of Scientific Research and Innovation in 2014.

Our desire is for a new X-ray machine to be purchased to ease work and im-

prove on the quality of images. X-ray discussions between doctors , ward

charges and X-ray technicians were held. It is hoped that the Administration

will try to reinforce this discussion classes every Tuesday for the interest of our

patients and knowledge upgrading. Departmental meetings were regularly con-ducted.

Abdomen Abdomen-pelvic

Pelvis Obstetrics Thyroid Testes & Scrotum

Breast Others Monthly Total

Jan 13 113 86 69 3 6 - 9 229

Feb 20 139 148 94 2 10 1 5 419

Mar 16 132 78 81 1 7 1 6 322

Apr 20 155 103 54 3 4 - 10 349

May 18 169 91 73 4 6 2 6 369

Jun 41 98 102 80 - 13 1 6 341

Jul 28 108 127 61 1 14 - 11 350

Aug 39 112 178 85 2 4 - 19 439

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

Skull Spine Chest Pelvis Arm Leg ABD HSG IVP BAS04

meal/enema

Fistu-

lography

Hydro-

tubation Ure-

thrography

Month-

ly Total

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

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

May 11 47 147 11 14 31 12 17 2 1 - 2 1 296

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

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

Oct 8 91 81 29 10 25 5 12 4 1 - 9 7 282

Nov - 96 83 23 11 35 7 9 2 - - 8 5 279

Dec 4 44 82 16 5 23 8 19 3 2 - 4 4 214

Annual Total 3375

29

2016 Statistics of ANC and IWC

Vaccine Type Total

BCG 568

Polio

I II III

908 300 303 305

Penta

I II III

908 300 303 305

Pneumo

I II III

908 300 303 305

ROTA

I II

603 300 303

IPT I II III

948 442 303 203

Measles 282

Yellow fever 282

IPV 305

Number tested 488

Hepatitis Number positive 10

VIT A

6-11 mths 12-59 mths

3114 529 2585

Tetanus Toxoid

I, II III, IV, V

1093 442, 280 226, 92, 53

I.W.C

New 300

2461 Old 2110

ANC

New 486

3023 Old 2537

28

16. PRIMARY HEALTH CARE

Primary health care takes care of women in pregnancy and gestation as well as

babies from 0 to 12 months through health education, vaccination for immun-

ization, etc within the Hospital and in six Health Centers under our supervision.

The outreach posts are mostly found in the Kumbo East District except for

Banten, Kouram and Sabongida.

Scope of Shisong Health Area 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

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

zone designates the date for its PHC activities. Activities carried out within the year were as follows:

IWC for vaccinations and education of mothers every Thursday and Saturday

ANC booking clinic every Friday

ANC subsequent visit every Monday and Wednesday

Training of community workers for all the field programmes

Outreach visits continued to Sabongida, Wvem, Kingomen, Banten

Wainamah and Kouram health centers and other outreach areas for vaccination

Antenatal Clinic (ANC) and Infant Welfare Clinic (IWC)

Trainings

More trainings were organized for community workers, vaccinators and other

health programs carried out in the field. Community workers were also trained

in the course of the year on the distribution of mosquito nets

Training of community workers on NIDs of which polio vaccines were ad-

ministered to many children aged 0—59 months

Mother and Child Health Nutrition Action Week (MCHNAW), during which

Vit A was given to children, Mebendazole to children aged 0—59 months.

The PHC statistics are as follows:

PMTCT

Women counselled = 488 as opposed to 893 in 2015

Women tested = 476 as opposed to 873 in 2015

Women tested HIV + = 3, placed on Treatment as opposed to 24 in 2015

Refusals = 0 as opposed to 4 in 2015

17

6. DENTISTAL CLINIC Incharge: Sr. Mark Verjai

The Dental Unit continued to render routine dental services to the clients who

came for outpatient consultation as well as the hospitalized cases. Students on

internship from St. Louis Higher Institute and those from the CSHS were re-

ceived in the unit for more practical experience. The staff strength remained 3

persons who have worked so hard to realize the following statistics.

Statistics

7. OPERATING THEATRE (Njoaka Cyprian M –HOD)

The Surgical team continued to perform different procedures within the unit in

course of the year 2016. The Gynecologist, Urologist was joined by a General

Surgeon in June 2016 as they each continued with the operations in their re-

spective specialties. Surgeries witnessed an increase in the number of cases justified by the recruitment of a General Surgeon. The staffing situation im-

proved from 8 trained staff to 10 while the 3 auxiliary workers were there to

take care of environmental sanitation. A surgical team (Surg For All ) from

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

ever endoscopic surgeries were done in the hospital at a subsidized rate.

In the quest to improve on the equipment, the unit received an Anesthetic ma-chine, incubator and some other items donated by Leuven—Belgium in March

2016 to ease surgery procedures. Some electric irons were also purchased to

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.

Procedure No. Procedure No.

Caries 489 Scaling 82

Filling 264 Partial dentures 119

Repaired dentures 22 Traumas 7

Complete dentures 3 RCT 18

Abscesses 122 Periodontitis 26

Sensitive teeth 25 Tumors 4

Extractions 281 Others 596

18

Statistics of Surgical Operations

Challenges Absence of an intensive care unit and staff to monitor patients Delayed sterilization programs because of very old and poor function-

ing machines

Intermittent shortage of Anaesthetic drugs and surgical materials

Needs Construction and staffing of an ICU

Construction of more operation rooms (an in-built system) with pro-vision for different surgical specialties

Proper renovation of theatre II floors and walls

8. GYNAECO-OBSTETRIC The Gynaecologist and staff members of this unit continued working relent-

lessly to ensure that clients were given the needed medical attention to old, new

and referral cases. In line with the Thursday classes schedule, staff members

continued to upgrade their knowledge and skills by attending these classes

weekly. Dr. Faustin Onivogui left the unit during the second half of the year

and Dr. Bernard came in for a few weeks, then went back to complete his pro-

gram and resume work fully in 2017.

Challenges

Clients unable to pay their bills especially deliveries through C/Section

Despite the improved health care, there are still un-booked cases registered

who come at last minute for delivery.

Some pregnant women still use of traditional medicines with the belief that

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.

OPERATIONS IN 2016

Major Minor Hernia C/S POP Suturing I/D

1360 464 135 316 3 100 73

27

lack of material.

Statistics of clients seen in 2016

No pregnant diabetic woman seen within the year.

Recommendations

Provide an office for the Diabetes program in the institution to solve the

problem of meeting patients under the tree or in lawns.

We need more nurse educators to continue the education of diabetes melli-

tus in the Hospital.

We need an emergency department with resuscitation kits for complicated

cases.

Mobilise for the celebration of World Diabetes Day by providing a kit con-

taining glucometers and strips.

15. PERFORMANCE-BASED FINANCING (PBF)

The Performance Based Financing program in its firth year of collaboration

with the Shisong Hospital, continued with routine evaluation visits to make

appraisals of the quality of services rendered to the public. For administrative

reasons, the implementation of the program in the institution was halted by the

hospital Administration in the second half of the year

Rubric M F Total

Patients admitted 82 67 149

Outpatients 148 125 273

Patients seen at Diabetic clinic 83 83 166

New patients 21 24 45

Old patients 62 56 118

Patients with complications 42 124 166

Clients with type I diabetes 17 18 35

Clients with type II diabetes 66 65 131

New clients with type I 4

26

HIV still remains the leading cause of tuberculosis in TB patients as observed

that out of the 101 patients diagnosed, 57 of them were HIV positive.

Treatment Outcome

The success rate of patients diagnosed in 2016 will be measured in 2017 but for 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

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-

straints.

Challenges encountered

The program encountered so many challenges within the year that could ac-

count for the poor performance and mentioned. Some of these problems are:-

Poor follow-up of patients in the hospital and homes

High defaulting and death rates

Shortage of diagnostic material

Poor sensitization of staff and community

Lack of motivation for the staff

Difficulty to track and bring back defaulters

Way Forward

Addition of staff in the progam to facilitate work and the use of the bike

meant for the program by the additional staff to track defaulters

Motivation of staff of the TB program

Increase sensitization within the hospital on TB prevention

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

14. DIABETES MELLITUS PROGRAM

By Dr. Nchare Chouibou, MD, Diabetes Program Coordinator and Mr. Tachea

Roger, Nurse Diabetes Educator

Activities continued to be centred on educative talks on diabetes to all the pa-

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

19

Way Forward

Continuous health education at the Infant Welfare Clinic (IWC)

Increase collaboration and organize seminars with health center staff

Encourage the health centers to ensure that referrals are done promptly

Statistical analysis

PARAMETER Definition Sub total

2015

Total

2015

Sub total

2016

Total

2016

Deliveries Male 662 1214 587 1218

Female 552 631

C/section 316 316 316 316

Referrals Received

108 108 93 93

Premature Male 29 59 22

65 Female 30 43

Twin Male 51 98 42

88 Female 47 46

Triplets Male 0 1

3 0

Female 0 2

Still birth 40 40 31 31

Episiotomy 215 215 206 206

Mother Mortality 1 1 1 1

Babies Mortality Before 24hrs 6 6 12 12

After 24 hrs 7 7 9 9

Malaria Positive 0 0 0 0

20

9. CHAPLAINCY SERVICES

By Sr. Mary Charles, Fr. Tobias Ngah and Fr. Nestor Nyamnjo

The Chaplaincy continued to promote the mission of the Hospital by catering

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

to the sick during daily rounds in the wards to assist them in their spiritual

needs. Many patients participated in some of the sacraments according to their

needs for spiritual healing. The chaplains listened, advised, counseled, taught catechesis, and administered

the Sacraments (for Catholics). They worked in collaboration with the Coun-

seling team and staff members, especially the departmental heads. Gifts col-

lected at the end-of-year Masses were given to the poor.

Drawing inspiration from James 5:13-15, the following Sacraments were ad-

ministered this year, anointing of the sick people, Holy Communion, sacra-

ment of Reconciliation administered to patients, guardians and staff during the

Lent and Advent season.

Some spiritual activities of 2016 Holy Mass at 6:30 am……...Wednesday and Friday by Fr. Tobias & Nestor

Holy Mass at 5:30 am……………...Saturday by the Capuchins

Morning Prayers at 6:45 am………..Monday, Tuesday, Thursday, Saturday

Adoration of the Blessed Sacrament .............Every First Friday monthly

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

which the sacrament of anointing was administered. The Chaplains were ac-tively involved in preparations for the celebration of the Feast of St. Elizabeth

of Hungary on the 18th November, Recollection and organized Retreats in or-

der to uplift the spiritual life of the staff, administered ashes on Ash Wednes-

day. The doors of the Chaplaincy remains widely open to receive especially

spiritual material and financial support to boost the ministry.

10. EYE CLINIC With the permanent recruitment of Dr. Siben Litila as the Ophthalmologist of

the institution, the Eye Clinic witnessed an increase in the number cases re-

ceived within the year. Activities were intensified on the field during outreach

screening and diagnosed cases operated upon in the hospital theatre. Many cli-

ents in need of ophthalmological problems came for the various services. The

following are some statistics of services offered in 2017:

25

13. 1. TUBERCULOSIS PROGRAM Dr.Wandji Kounougo René, (TB Coordinator assited by Mrs. Mary Electa Lybarfe)

The tuberculosis (TB) program continued its activities of diagnosing, treating

and following up of TB patients hospitalized and those discharged to ensure

they complete their treatment. The activities of the TB program were not at its

best in 2016 as it did not meet its target despite ever effort put in place.

TB Diagnosis (case finding)

Comparatively, the number of TB patients diagnosed in 2016 witnessed a drop from those in diagnosed and referred 2015; i.e 101 patients in 2016 as opposed

to 188 patients in 2015. Below are the statistics for 2016

Smear Positive Pulmonary Tuberculosis (SPPTB) 59

Smear Negative Pulmonary Tuberculosis (SNPTB) 13

Extra Pulmonary Tuberculosis (EPTB) 25

Retreatment cases 4

TOTAL 101

ZEIHL

NELSON

XPERT

MTB/RIF FOLOWUPS Fluid Aspirates

Mont

h

No

done Pos

No

done Pos

No

done Pos

No

done Pos

Jan 22 1 99 7 10 0 0 0

Feb 48 1 128 15 20 0 1 0

Mar 101 1 90 4 14 1 0 0

Apr 133 9 101 7 11 4 8 3

May 105 10 82 6 11 4 5 2

Jun 124 11 116 12 12 0 7 1

Jul 44 5 83 10 12 0 15 1

Aug 77 3 56 6 23 3 12 2

Sep 99 8 - - 7 1 11 1

Oct 127 8 - - 10 0 12 4

Nov 50 0 71 6 10 1 6 0

Dec 38 2 60 3 6 1 4 1

Total 968 59 886 76 146 15 81 15

24

13. TUBERCULOSIS REACH LABORATORY

(By Wirnkar Sequinta)

Tuberculosis Reach Laboratory is one of the newly created laboratories that has

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

tuberculosis among immunosuppressed individuals, children and also exposed

individuals by early diagnosis, continues follow up and to ensure proper treat-

ment and management. These individuals‘ fall under two groups; HIGH

RISK, LOW RISK

High risk individuals fall under the following interventions ;

Intervention one : Any HIV patient newly eligible for antiretroviral therapy

regardless of symptoms,

Intervention two : Any hospitalized HIV positive patient regardless of symp-

toms and any hospitalized patient with TB symptoms regardless of HIV sta-

tus,

Intervention three : Any HIV positive outpatient presenting at a health facili-

ty with one or more symptoms,

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.

These groups of person's benefited from more modern ways of diagnosing TB

using the molecular technique ( GeneXpert)

Low risk individuals benefited from microscopy technique.

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

relapsed, defaulters and Xpert positive patients, their samples were collected

before the start of treatment and sent to Bamenda for culture for fear of drug

resistance and confirmation. Rifampicin resistance cases were immediately

referred to Bamenda for proper management with MDR-regimens

Challenges Lack of space in the lab leading to congestion

Temperature fluctuations

No intercom to communicate with the other units of the hospital

21

11. PHYSIOTHERAPY

Statistics analysis for 2016

Comparatively, the unit witnessed a drop in the number of clients attended to

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-

Ailment 2016

Back pain, joint pain, shoulder pain, neck pain etc. 330

Weakness hemiplegia 24

Paraplegia 12

Cerebral palsy 5

Bell‘s palsy 4

TOTAL 370

Description Number

VERNAL CONJUNCTIVTIS 17

ALLERGIC CONJUNCTIVITIS 37

BLEPHARITIS 190

DACROCYSTITIS 0

CORNEA SCAR 10

CATARACT 138

GLAUCOMA 101

REFRACTIVE ERROR 225

PRESBYOPIA 88

RETINAL DETACHMENT 6

DIABETIC RETINOPATHY 3

OPTICATROPHY 9

22

gram.

Lack of cooperation between the Doctors and Physiotherapist for comple-

mentary client management.

Inadequate space in the unit to accommodate the increasing number of cli-

ents amidst other needs. There is an urgent need for enough space to ease

work

12. INTEGRATED DAY CARE CENTER

Routine activities continued normally in the Integrated Day Care Center rang-ing from the management of HIV/AIDS to Primary Prevention, Treatment Care

and Support of persons affected by HIV/AIDS.in collaboration with

―BIWON‖Children‘s Brighter Future and Project Hope. Out-reach and educa-

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.

Care, support and ARV monthly refill was done as work was done in close col-

laboration with the Clinic Pharmacy, Histopathology/Cytopatology and the

Tuberculosis reach Laboratory.

Routine Weekly/Monthly Activities were as follows Talks to the pregnant women at ANC on HIV/AIDS prevention and PMTCT

activities.

Every Saturdays therapeutic committee meetings

Follow up of defaulters by community rely agents on daily bases.

Health education to clients every day.

Children‘s consultation and refill of their ARV‘s is done following their age

groups i.e. First Saturday (0 -11years), second Saturday (12 -15years), third

Saturday(13-19 years)

Children‘s meetings every three months. Departmental meetings were held on the last Saturday of the month. Below are

some statistics

HIV Statistics and Antenatal Clinic Inclusive for 2016

23

Antenatal Clinic Statistics

CD4 Statistics

Polymerase Chain Reaction (PCR) Statistics

Achievements Many clients on ARVs were properly followed up with TB test thanks to

the two units within the IDCC.

The support from the Regional Technical Group (RTG) Bamenda, in form

of testing kits, lancets etc have helped in the testing of many people for

HIV.

Less children defaulting treatment as an outcome of regular meetings at the

child play centre that was created.

CD4 collection carried out in various outreach stations with the use of PI-

MA machine improving patients‘ attendance and less defaulters.

Continues visits to secondary school students for free HIV testing in the

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.

Total

HIV

Test

Total

Pos.

Female Male Pre. VDRL HB B/G TPHA M

P

HBV

Neg Pos. Neg Pos. Neg Pos. N P

Total 1036 28 968 24 56 4 2.7 980 20 4032 1008 7 2 44 44

Total

Tested

Therapeutic Pre-Therapeutic Initiated on ARVs Total Clients on ARVs

2182 1891 301 301 2345

Total Collected Total Results Total Negative Total Positive

87 87 82 5