SIEMENS

It isn’t easy to get to Kumbo, a city of around 100,000 residents in northwestern Cameroon. The only road between Kumbo and the district capital Bamenda 100 kilometers away is dusty and full of potholes. It takes five hours to make the trip in the dry season — and, at its worst, three to five days in the rainy season. Nonetheless, Kumbo is a busy place where you’ll find motor taxis speeding down red sandy streets and merchants displaying their wares on blankets or in wooden sheds.

Shisong Hospital, which was founded in 1935 by Franciscan nuns from South Tyrol, is located on the city’s outskirts. The hospital started out as a small maternity clinic to help combat the high rates of infant mortality and maternal death in the region at that time. Thanks to the nuns’ tremendous efforts over decades and donations from Europe, Shisong Hospital now has more than 350 beds and can accommodate about 100 additional outpatients in its various wards. Eleven years ago, a priest from Milan was looking for an African clinic to which he could donate a cardiac treatment center. He ultimately chose Shisong Hospital because of its solid reputation.

Sister Appolonia Budzee, the “heart and soul” of the hospital, believes this is the right approach. “We want decentralization; all the modern facilities don’t have to be in Yaoundé or Douala,” she says in reference to the political and economic centers of Cameroon. “Kumbo could soon become the capital for medical treatment in this country.” The new cardiac center, which was commissioned in 2009, is already something special in the region. “Shisong is the only facility of its kind in all of Central Africa,” says Sister Appolonia. “People come here for treatment of cardiovascular diseases from all over Cameroon, as well as from neighboring countries like Nigeria and Gabon — and sometimes even from Ethiopia, which is 5,000 kilometers away.”

With the ultramodern cardiac center, which includes two operating rooms and an intensive care unit, doctors in Kumbo could revolutionize medical care in Central Africa. For one thing, patients who previously had to travel to Europe for complicated heart surgery can now be treated and operated on in Cameroon. Because more than half of Cameroonian cardiac patients can’t afford to pay for their treatment, the cardiac center at Shisong Hospital runs a fund-raising Heart Foundation. The money helps to ensure that its medical services are available to everyone.

The flagship facility at the cardiac treatment center is a state-of-the-art catheterization lab — a high-tech facility that is used to detect and treat cardiovascular diseases. The core component of the lab is a new angiography device from Siemens, which has sharply reduced the need for open heart surgery. These days, a small incision is made in the patient’s groin in a minimally invasive procedure. A catheter, is then inserted into the incision and pushed up to the heart. Surgeons know where the catheter is at any given moment because they can use the angiography device to take digital X-rays of the patient’s body in real time from numerous angles during a procedure. They can then view the resulting images on three flatscreen monitors.

The images thus produced at Shisong Hospital are stored in a Siemens IT system. This makes it possible to compare them with images from other stages of an illness, which in turn allows physicians to determine whether an operation has been successful. “Microsurgery techniques help us operate more quickly and accurately, and patients also recover more rapidly after operations,” says Dr. Jean-Claude Ambassa, one of the resident cardiologists at Shisong Hospital. “We decided deliberately to go for the latest angiography model,” says Sister Appolonia. “Older equipment might seem cheaper in the beginning, but it gives you trouble later.”

From Forchheim to Kumbo. Bringing the high-tech unit to Kumbo proved to be a big challenge for Benjamin Wallon and Bruno Peynshaert, two service technicians from Siemens Healthcare. For example, the 9,000-kilo unit first had to be disassembled at its production facility in Forchheim, Germany.

To ensure the heavy equipment’s proper transport by ship and truck, it then had to be carefully and securely packaged to make it shockproof during the trip. Wallon and Peynshaert then spent three weeks in Kumbo with technicians from Shisong Hospital, putting the pieces of the high-tech puzzle back together. They worked from dawn to dusk until the unit was ready to operate. During that period, each individual component had to be bolted together and all the mechanical parts, cables, and electronic functions had to be properly calibrated. Wallon and Peynshaert also spent an entire week teaching technicians and physicians how to use the device in order to ensure that they would require as little assistance as possible from outside sources later on.

Peynshaert is confident that the new catheterization lab will be very useful. “In developed countries, such labs generally operate for about nine years before they become outdated. But if the doctors in Kumbo are careful, they can use their device for 12 years,” he says. Moreover, even if a software error should occur in the future, service technicians can access the device via the Internet and correct the problem. This function is made possible by the hospital’s relatively stable Internet connection and the Siemens Remote Service program, which alerts a service center in Germany before a device fails.

Despite Shisong Hospital’s impressive history of success, its officials still have to deal with major challenges. Well-educated Cameroonians prefer to go abroad to work. It is therefore difficult for the hospital to find qualified personnel. Only recently, for example, could a full-time heart surgeon be hired after a long search. And the hospital is still searching for an anesthetist. Ambassa is actually one of the few doctors in Kumbo who decided to return to Cameroon after studying medicine abroad. These days he is also preoccupied by a completely different issue, though. “Cardiovascular diseases could become the number one killer in Cameroon,” he explains.

Indeed, the World Health Organization estimates that cardiovascular disorders accounted for 14 percent of all deaths in Cameroon in 2010 and that this percentage is rising. Ambassa attributes this development to poverty and late-stage diagnoses on the one hand and his countrymen’s changing lifestyles on the other. “Many people opt for a European lifestyle. They eat more fat, don’t engage in sports, and work in offices — that creates a lot of heart problems.”

Over 10,000 people have come to Kumbo to be examined since the cardiac treatment center opened three years ago. “That shows how big the need really is,” Ambassa says. The hospital plans to acquire a blood bank at some point in the next few years in order to ensure that the cardiac center always has enough of the blood plasma it urgently needs. The Cameroon government also plans to improve the roads. Nonetheless, the people who work at Shisong Hospital know there’s still a long way to go before they reach their destination.