ACS Bulletin - May 2017

Due to its geographic position in southern Europe, with miles of coastline on virtually all sides of the peninsula, Italy has often represented a “first approach” for people emigrating from North Africa and the Middle East to Europe and North America. Italy’s role as an international gateway means health care professionals in the country must be trained in cultural awareness to meet the needs of individuals representing a spectrum of backgrounds and ethnici-ties. To this end, the department of surgery at Pietro Valdoni, Sapienza University of Rome, Italy, has long supported a small rural hospital in the pluvial forest of South Cameroon located in Central Africa. Saint-Luc, a not-for-profit hospital, is part of the Mission Catholique de Bimengue, and our surgical residents do voluntary rotations at this facility.

Surgical rotations in Central Africa

The training program, started in 1988 with leadership from then-chief of surgery and a co-author of this article, Prof. Sergio Stipa, MD, FACS, provides residents with a six-month experience in an African mission hospital. Soon after the first residents began their rotations, they indicated that they found it to be a positive experience. In fact, residents have played a significant role in promoting the benefits of this particular rotation, which has developed a strong reputation for preparing hospital staff to administer care to people from different cultural backgrounds.

Saint-Luc hospital

Saint-Luc hospital is situated in Bimengue, which is part of the Cameroon forest (see Figure 1, page 13). The facility is surrounded for 70 miles by wilderness, which provides some protection from the urban violence that is a common problem in many major cities in Central Africa. Saint-Luc hospital is an eight-hour trip from the nearest airport, and the road to the mission—built by German colonizers at the end of the 19th century—is unpaved and full of holes. With just 30 beds, Saint-Luc is a small facility that serves a population of about 20,000 people. No other medical facility is available to the people living in the small villages and tribal communities within the forest. The mission and the hospital were built more than 40 years ago by a Catholic priest of the Spiritan Congregation from Como, Italy. The priest manages all of the organizational and economic affairs of the mission, except for the hospital, which is managed by the not-for-profit organization Don’t Forget Africa (DFA).

Care is provided to patients presenting with a variety of medical issues. Abdominal, obstetric, and urological surgery are routinely performed on patients in need. Patients suffering from other medical problems, such as marsh fever and illness related to intestinal parasites, also receive care at Saint-Luc.

It is difficult to comprehend how the local population received medical care before Saint-Luc was built. Most likely, local midwives and nonmedical individuals functioned as primary caregivers.