In Pictures

The hospital in Cameroon trying to heal old wounds

A small hospital in western Cameroon is trying to make a change by healing untreated open wounds.

03/07/2018. Balaveng, Cameroon. — When it started in 2008, the hospital only had ten beds. Today, 42 of the 45 hospital places are occupied. About twenty patients from the area are treated externally — When the hospital started in 2008, it only had 10 beds. Today, 42 of the 45 hospital places are occupied. About 20 patients from the area are treated externally and some come to monitor their wounds and change dressings. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Balaveng, Cameroon – Perched in the foggy mountains of western Cameroon, the Balaveng Wound Hospital has a unique specialisation in Central Africa – it only treats wounds.

“Wounds are the ill-fated kid of medicine in Africa,” says Dr Romain Soumele, who founded the hospital in 2008.

It is estimated that more than 15 million people worldwide have a chronic wound. In Cameroon’s main hospitals, doctors reject patients with chronic or infected injuries, as their treatment with insufficient equipment is lengthy, complicated and non-lucrative. This is compounded by the fact that wounds are often seen as a result of witchcraft.

At Soumele’s hospital, 20-year-old ulcers, bedsores the size of a tennis ball, infected wounds coated with black necrosis and yellow fibrin are a common sight. As diabetes, HIV, sickle-cell or arterial problems complicate the healing process, the 42 in-house patients often stay there for months.

The small team of nurses at the hospital are specifically trained to apply the right bandage to each type of wound. Their wounds improve only to worsen again, as the skin sluggishly grows on burgeoning flesh, and they can spend up to 180,000 CFA ($330) a month.

Despite the hospital’s efforts, many of its patients leave before being fully treated due to the expense, and go back to traditional healing techniques or self-medication.

Ide Tsopbou, 35, head of the bandages section, says she often cries when patients leave without being fully healed. “You know you can do something for them but your hands are tied because they have no money left,” she says.

Sometimes, the hospital staff organises collections to help cash-stripped patients go back home. “The problem is that they always arrive here when it is already too late. Elsewhere, medical staff talks about amputation, but here, we manage to heal them,” Tsopbou says.

Every morning, internal patients line up to have their wounds cleaned and their dressings changed. — Patients line up to have their wounds cleaned and their dressings changed. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Marie, a French intern in Cameroon for 5 months, speaks to Dr.Geri-Trial on WhatsApp, during a video consultation. The Wound Hospital of Balaveng was founded by — The wound hospital of Balaveng was founded by Dr Soumele, a Cameroonian practicing in France. He has set up a collaboration between his hospital, the University Hospital of Montpellier in France, and the French and Francophone Society of Wounds and Cicatrisation, of which Dr Geri-Trial is a member. Once a month, hospital staff can consult specialists to get advice on complex cases, such as arterial ulcers. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Chantale is testing a newly arrived patient''s glycaemia. Diabetes and cardiovascular disease are the two leading causes of chronic wounds according to the — A lab technician tests a newly-arrived patient's glycaemia. Diabetes and cardiovascular disease are the two leading causes of chronic wounds according to the World Health Organization (WHO). In the Wound Hospital laboratory, only certain basic tests can be performed. Patients are sent to the nearby town of Dschang for vein and artery Ultrasound or analyses of the bacteria found in the wound [Adrienne Surprenant/Collectif Item/Al Jazeera]

Installation of a VAC, negative pressure apparatus, on Martin Tematio, 46 years old. This machine is used to vacuum exudants. Its application is very painful but helps to accelerate healing. Martin, i — Martin Tematio, 46, is undergoing negative-pressure wound therapy. The machine used forms a vacuum that helps with the removal of fluids such as wound exudate, irrigation fluids, bodily fluids or infectious materials. Its application is painful but helps to speed up the healing process. Martin, in hospital for the last two months, has an eight-month old wound. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Sylvestre Tchokosseu, 61, shows photos of the moment he was installed a VAC, a negative pressure device. He drove more than eight hours from southern Cameroon to the wound hospital to treat his ulcera — Sylvestre Tchokosseu, 61, shows photos of when he had undergone negative-pressure wound therapy. He drove more than eight hours from southern Cameroon to the wound hospital to treat his ulcerated feet. The wounds on both feet were more than 20 years old. 'At first, I thought the wound was a spell. I visited many charlatans before coming here,' he says. After eight months at the hospital, one of his legs healed. [Adrienne Surprenant/Collectif Item/Al Jazeera]

On André Lando''s 44-year-old bedside table, food and a box of Cinclamox, an antibiotic pill based on amoxicillin and clavulanic acid. Under his bed, this former quincaillier and informal drug seller h — Many leave before ending the treatment, cash-strapped and exhausted, to go back to traditional healing techniques or self-medication. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Maurice Takou, 50, leaves his room to wait for the daily dressing change. He''s been in the wound hospital for a month, but his wound is three years old. He describes the beginning of the ulcer: "A sma — Maurice Takou, 50, waits for the daily dressing change. He's been in the wound hospital for a month, but his wound is three years old. 'A small pimple appeared, which I scratched. Since then, it hasn't stopped growing,' said Maurice, describing the beginning of the ulcer. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Adele, who accompanies her mother to the Wound Hospital, raises her hand to ask a question during the first aid and hygiene training given to patients every Thursday. Discussions come alive when the s — At the Wound Hospital, first aid and hygiene training is given to patients every Thursday. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Marie-Jeanne Lemale, examines her wound and gives instructions to the nurse who redoes her dressing "you didn''t see the hole here" or "you forgot the oil there", she specifies. At the hospital for the — At the hospital for the past month and a half, Marie-Jeanne Lemale deplores the lack of improvement in her seven-month-old wound. At Dr Soumele’s hospital, 20-year-old ulcers, bedsores the size of a tennis ball, infected wounds coated with black necrosis, and yellow fibrin are a common sight. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Mireille and Chantale change the dressing of Désiré Noutinou, 62 years old, under the attentive eye of Vicky, intern at the Hospital for a month. — Nurses change a patient's wound dressing. The small team of nurses is specifically trained to apply the right bandage to each type of wound. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Julienne Nopoudem, 75, sitting next to her daughter Adèle, who prepares macabo. Julienne has a wound that''s been coming back since she was 10 years old. She has been successfully treated four times, b — Julienne Nopoudem, 75, has a wound since she was 10. She has been successfully treated four times, but the wound kept recurring and has not closed for the last 17 years. 'When we heard about this hospital, we thought if it was specialised, we might get something out of it. The medicines and dressings are very good. But they're rare, sometimes they're missing, and mostly expensive,' said Adele, after having spent two weeks in the hospital. [Adrienne Surprenant/Collectif Item/Al Jazeera]

Désiré Noutinou, 62 — Desire Noutinou, 62, rests on his bed in the hospital room he has shared with two other men for a month. The cost of hospitalisation varies between 80,000 and 180,000 west african francs ($143-323) per month, according to patients. Desire complains about difficulty in feeding and taking care of his 28 children while he is at the hospital. He says he may have to leave when school starts, even if his wound is not healed, in order to go back to work so he can pay for his children's schooling. [Adrienne Surprenant/Collectif Item/Al Jazeera]