The heat was inescapable, intense, dry. It was 42°C in the shade and had been every day for weeks. Even at night there was no respite as the temperature only dropped to 30°C - we resorted to putting the fan under the mosquito net and covering ourselves with wet towels to get to sleep. Maybe I should have expected this in a culture whose greeting is, "Comment va la chaleur?" ("How's the heat?") to which the response is, "La chaleur est la!" ("The heat is there!")

Background
Hopital de Meskine is a small mission hospital in the arid Far North province of Cameroon. The hospital is run by Medical Centres of West Africa, a non-profit Christian organisation based in Louisiana, USA. There are several languages used locally but the most widely spoken are Fulfuldi and French, especially amongst the better educated.

The Hospital
The hospital has about 40 beds, an operating theatre with facilities for endoscopy, X-ray, ultra-sound, and a small laboratory that can do basic haematology, microbiology and biochemistry.

The dispensaire is a clinic primarily run by specialist nurses or examinateurs. They follow protocols and know when to ask for help from a doctor. They see over 100 patients on a busy day.

Patients requiring surgery or endoscopy must first have an HIV test and if positive the patient receives counselling and if the condition is life threatening a volunteer scrub team is used. I was surprised by how few tests were positive, less than 10%.

Patients would often only come to the hospital after having tried the witchdoctor. The worse case that we saw was of an eight year old boy who had fractured his right radius and gone to a "bone-fixer." This man had tried to splint the wrist, but had tied pieces of cane on so tightly with twine that the hand had infarcted and mummified, and there were infected ulcers under each piece of cane. By the time he arrived at the hospital the hand was completely dead and he needed a below-elbow amputation.

We are not great linguists but our French certainly improved during our time at Meskine, as all the medical notes, ward rounds, and many consultations, were in French.

It was a great experience to live and work in a Christian environment. Each day started with a short chapel service, a prayer was said before each operation and all the patients are offered prayer in a prayer ward-round once a week. It was wonderful to see people coming to know Jesus Christ even while they or their relative was sick.

We would like to thank MMA HealthServe for the generous travel grant.