April 23, 2007

Dear Friends,

I’ve been in Cameroon over a year. Sometimes it feels like a long time but at other times it feels like I just arrived. There is still so much to learn and experience, and so much work to be done. Being an HIV/AIDS consultant for the Presbyterian Church in Cameroon (PCC) has taken on a new twist in 2007. It’s impossible to think about HIV/AIDS without also considering maternal and child health, malaria, TB, and other infectious diseases.

Primary healthcare is a crucial element in the fight against HIV/AIDS, so this year my work includes assessing how the PCC does primary healthcare. I’ve been touring all of their health facilities. Most of the church’s health units are in the “bush,” as we say, or rural areas.

Bafanji Health Center

Bafanji is about an eight-hour drive from my house in Buea. I visited with Miss Rita Abah, the church’s HIV/AIDS coordinator for the Northwest Province, and my driver Clement. I was ever grateful for my vehicle since we travel dirt roads that deteriorate into deep ruts whenever it rains.

I always enjoy driving through the countryside. Like traveling from state to state in the United States, the countryside changes as you move from province to province. The Southwest Province has a lot of dense, bushy areas with many banana, plantain, and palm plantations. As you travel through the Western Province and into the Northwest, the terrain is hillier and the brush thins out to wide spaces over looming hills and deep valleys. You travel for miles and miles passing small villages of huts with thatched or palm-branch roofs and concrete homes with corrugated zinc roofing. It’s not uncommon to share the road with a herd of long-horned cattle. There is an occasional town that may have a modest hotel and a gas station. In the “bush,” petrol is usually sold along the roadside in large glass bottles.

Bafanji Health Center was created in 1980 with the help of the Bafanji people. It is located in the Ndop Plain area at the top of a small hill with gentle slopes. The center is composed of two buildings: one is for patients and the other is a residential facility for staff. Resident staff housing is very important for people who work in the bush. These are remote areas where ready-made housing is non-existent. Transportation is also a problem, so the best solution is resident staff housing.

The people who use the health center are mostly subsistence farmers who grow crops like plantains, cocoyams, corn, peanuts, and tomatoes. In other words, they are good, down-home, country folk. The main cash crop is coffee but the difficult terrain and rainy season make it difficult to take the coffee to market, so most people in the area remain poor. Bush people work hard on their farms, especially during planting and harvest, so attendance at the health center is low during these times. This presents special challenges in providing healthcare, since they cannot leave the farms during planting and harvest even when they are sick. Crops must be in before the rainy season comes.

The rainy season brings needed water for crops and for drinking. During the rainy season, wells fill and everyone has water for activities of life. The center has a hand-drawn well for accessing water for patients, cleaning, and laundry. It is untreated so it must be boiled before drinking. Unfortunately, it has a leak, so precious water seeps away. They also have an above-ground storage tank to catch rainwater from the roof. Since it also leaks they lose much of the precious water that would sustain them during the dry season.

Getting water during the dry season is difficult. People walk a long distance to a spring that was once part of a pumping station for the whole community. The station was sabotaged in the 1990s during a tribal war, and since then there has been no community water source. The center uses about 200 liters of water a day, which means the yardman walks to the spring and back about five times a day carrying a 20-liter container in each hand. Since bringing water up to the health center is so difficult, employees wash linens in the spring. Afterward, women haul the wet linens in baskets balanced on their heads back to the center to dry in the sun.

We ended our day in the bush with a wonderful meal prepared by the staff of rice, plantains, greens, and beef in a red sauce. The journey home is often difficult and long. One never knows what could happen on the way or when the next meal may come, so no guest is ever sent away without a meal. Besides, friendships grow when we share a common meal.

Prayer requests

• That the health center find a permanent solution for its water problem.
• That God strengthen all health workers who are called to a ministry of healing in difficult settings.

Peace,

Shirley

Contributions from individuals may be sent to Presbyterian Church (U.S.A.) Individual Remittance Processing, PO Box 643700, Pittsburgh, PA 15264-3700. Contributions from churches should be sent to: Presbyterian Church (U.S.A.) Church Remittance Processing, PO Box 643678, Pittsburgh, PA 15264-3678. Write the title (Cameroon Health and HIV/AIDS Project) and the ECO number (E053502) on the subject line of the check and put it on your cover letter, too.