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00:00 Welcome again.
00:07 Patients first is their mantra and how Professor Luma succeeded to get this done can be credited
00:13 to his 32 year stay in the complex when he got in as consultant from London in 1991,
00:19 growing through the ranks as Chief of Service and Medical Director before taking over from
00:25 a 23 year long administration making him the second Director General following the departure
00:31 of the whites in 1996.
00:33 The internist by specialty takes our questions right after this.
00:45 The Director General of the Douala General Hospital, Professor Henry Nnameluma.
00:52 Welcome to the CRTV.
00:53 Thank you Mr. Mkwele.
00:55 It's a pleasure to have you in the Douala General Hospital.
00:59 It's a pleasure indeed to be here and I see the boss of this premise is still in white
01:05 jacket.
01:06 Every other medical doctor here is in white jacket.
01:10 Must you be in white jacket as the boss?
01:12 Yes, the boss must lead by example.
01:17 You come in, it could be in a formal way, but so long as I'm in the hospital carrying
01:23 out duties, going outside my hospital, I like to be in a white jacket.
01:28 A white jacket and my name tag so everybody knows that I'm a medical doctor.
01:34 I can go to the ward, I can do ward rounds, do consultations as I want even if my main
01:41 obligation at present is administration.
01:45 You are an internist and the details are there.
01:49 General Hospital Douala.
01:50 I'm taking interest in the word general.
01:53 What does it mean in the health infrastructure of Cameroon, general?
01:57 Before going into general, in Cameroon, hospitals are classified as first category hospitals,
02:03 second category, third, fourth, fifth and so on.
02:07 The first category hospitals are mainly referral hospitals for which we have five or six of
02:13 them of which there is the Douala General Hospital, the Yaounde General Hospital and
02:18 now there is the Garua General Hospital with others like the Gynecologist Obstetric Hospital.
02:24 So these are first category hospitals.
02:27 But the term general as for Douala General Hospital means that we have all the major
02:34 general specialties, all the major specialties like surgery and its specialties, internal
02:41 medicine specialties, so we have all of those obstetric, gynecology, pediatrics, so we have
02:46 the major medical specialties in this hospital.
02:50 Well, I would imagine it's in itself a reference because I think it's not only fitting Douala.
02:56 In this case, people will be coming from far and wide to meet any other specialist they
03:01 are looking for.
03:02 It is a referral hospital and serves the population of the littoral region and the neighboring
03:10 regions like the southwest, northwest, west and goes beyond that because we have patients
03:18 from the neighboring countries, from Equatorial Guinea, from Central African Republic, from
03:22 Chad, so we have all of those patients coming in.
03:24 And really, when we look at our statistics, more than 25% of our patients are those who
03:30 have been referred, who are coming because of a referrer from another center to our center.
03:36 What can we say are a few breakthrough cases that this hospital has handled ever since
03:43 you were here?
03:44 I mean, in terms of maybe a case that would have been flown out and they were handled
03:49 here, can you tell us?
03:53 Yes, we have done a number of things for which I would not be able to give you a specific
03:57 example.
03:58 But in terms of specialties, when we take, for example, radiotherapy, treatment of cancers,
04:06 this is the only hospital in our region which provides radiotherapy in our region, radiotherapy
04:16 that is for cancer patients.
04:18 We take the field of cardiology, we do interventional cardiology.
04:25 So if a patient had, for example, a heart attack or the arteries going into the heart
04:33 are blocked, here we can go in, dilate it and put a stent.
04:37 Those are innovations for which we are doing.
04:41 We carry out cardiac surgery.
04:44 Since cardiac surgery was being carried out mainly in Shisong and it is not possible now,
04:50 we carry out surgery.
04:52 We bring teams who help us to carry out surgery, for which in the last few years we have done
04:57 over 100 cases.
04:59 We also have specialties like the neonatal units which, you know, children, babies born
05:08 from at times younger than 28 weeks, we have had 26 weeks, are being maintained and they
05:16 are discharged from hospitals.
05:18 So those are some of the things that we are doing and we have major surgeries which are
05:23 being carried out.
05:24 So there are a number of things which we are doing for which patients should be evaluated.
05:29 What do you credit all of these successes?
05:32 Is it because we have the personnel, is it because we have the Professor Lumas who are
05:39 in tennis of very high repetitions or equipment?
05:46 It is multifactorial.
05:47 There are many factors why we have some of these successes.
05:52 The first one is the investment plan, the head of state emergency plan.
05:58 It renovated this hospital and it did it infrastructurally and also with equipment.
06:05 So we have a number of services which are up to date.
06:08 I will give you an example.
06:11 Our ophthalmology service, our intensive care service, when we go to the intensive care,
06:17 you feel as though you are in somewhere else but in this region when you go to that service.
06:24 We are able to provide diagnostic methods, MRIs, we have two CT scans which help in making
06:35 the diagnosis of certain ailments.
06:38 So we have a number of things which have come in place.
06:41 The second one is human resources.
06:43 It is difficult for us to be able to have good human resources in Cameroon but so far
06:52 the Ministry of Health, they make sure that some of our specialist hospitals have the
06:59 best doctors that we can have.
07:02 So that is why I say it is multifactorial, the equipment, the investment in human resources
07:08 and also communicating with people to know what we are doing in this environment.
07:14 I can attest to that Mr. Director General, Professor Luma.
07:17 But I see it is so clean here and it is so sophisticated like you rightly said.
07:22 Yet it seems to be too elitist.
07:27 Can we say this hospital is open to every other Cameroonian, average Cameroonian?
07:33 I will go with the words you have used.
07:36 You say it is clean, it looks elitist, it is sophisticated.
07:42 Before I answer the question, when we provide health, health should be provided in a clean
07:49 environment.
07:50 Sanitation is very important.
07:51 So the first thing we want is to have a clean environment and it is not easy to have a clean
07:57 environment.
07:58 We work hard for this environment to be clean and we are happy with the way it looks.
08:03 We would even like it to be cleaner.
08:05 It is clean on the outside and we are working as well so that everywhere in this hospital
08:09 should be clean.
08:10 The second, sophisticated.
08:11 In terms of equipment?
08:12 In terms of equipment, I agree it is sophisticated in terms of equipment because we have a lot
08:19 of equipment which we don't find in other hospitals and we have a good maintenance policy
08:27 for this equipment because you can also have that but the equipment is not functional.
08:33 We used to have those type of programs where the CT scan could have been bad for four,
08:39 five, six months and that is why we have two CT scans but now with the maintenance policy
08:46 that we have done for most of the heavy equipment, we do not have that problem.
08:52 Elitist is a word which is very controversial.
08:57 If you say elitist in terms of my human resources, the doctors who come, yes, we have some of
09:03 the best doctors in Cameroon here but elitist, not that we are only waiting to see a certain
09:09 type of patient coming to the Douala General Hospital, the Douala General Hospital receives
09:16 all categories of patients in all social groups.
09:21 In terms of accessibility?
09:23 In terms of accessibility, I will tell you that it is a matter of ignorance.
09:28 People do not know what happens in here.
09:32 We have an emergency service which runs 24 hours a day and in this emergency service,
09:39 when you have a severe trauma, severe disease, you are admitted and no monetary transactions
09:48 within the first 24 to 48 hours.
09:50 Nobody will even ask you.
09:53 The care, access to care is open for every category of Cameroonian.
10:00 You know it also has a negative part of it because some people who can pay may come but
10:08 once a doctor says that this is an emergency, we take you in and we treat you without asking
10:15 for payment.
10:16 So I think that is a form of accessibility.
10:18 The second order of form is that if you are referred from the periphery, you do not have
10:24 the means, you come in here, we have to look for ways to treat you.
10:31 Our mantra is patient first.
10:36 So we look at the patient.
10:38 We have social workers who go around and look at the background.
10:41 Then we can tell you at the end that okay, you will be able to pay a percentage of what
10:48 it costs you.
10:49 On the other hand, there are people who can pay for their health care but they may reach
10:54 a certain level where they cannot go further.
10:58 We will still reconsider that.
10:59 So this hospital, the access is open.
11:02 Director General, let me not cut you there.
11:05 Is it because it is Professor Luma, the respectable and reputed internist that we know in this
11:14 country talking?
11:15 Is it because it is the boss, the Director General talking that it sounds so easy said
11:21 than done?
11:22 I'm asking this because you need to tell us how you follow up this to the latter.
11:29 Do you go behind the medical doctors?
11:32 Firstly, it is not because I'm the one who is in charge of this hospital.
11:40 Not at all.
11:41 It's government policy.
11:42 The Minister of Health has given directives.
11:47 When we talk of humanization of care, those are some of the aspects which we see.
11:53 That means you cannot, because a patient cannot afford, you leave the patient and say go and
11:59 bring your deposits.
12:00 No.
12:01 It is government policy, humanization of care.
12:05 We have to do that.
12:06 And it is prescribed.
12:08 That is why we have social workers in the hospital.
12:10 We have a legal department because you may be able to explain that, OK, I will be able
12:17 to pay every month this amount of money.
12:20 OK, so you don't pay all of it up front.
12:23 We have all of those facilities and it's open.
12:25 So it is not because of the person talking to you.
12:27 It is part of government policy.
12:30 You're going to bear with me, the Director General of the Douala General Hospital.
12:34 This program is called Governance and Follow-up.
12:37 And that's why we're emphasizing.
12:38 Now let me now elaborate on that subject.
12:43 Big hospitals in Cameroon and maybe elsewhere are usually associated with scandals.
12:51 If it is not a baby that is stolen here, it is a body part that is alleged to have been
12:56 taken off, or it is a patient who is held hostage in the hospital for not being able
13:03 to pay their bills.
13:04 Now you're already talking about that.
13:05 But I don't think this big and good-looking hospital will be spared of some of these things.
13:13 Thanks Mr. Mukwele for that question because it is very important.
13:19 All our hospitals can get into problems at any time.
13:24 And with the advent of social media, it can be blown out of proportion.
13:29 But it happens.
13:30 And we have had our own fair share of it.
13:33 Can you cite some cases?
13:34 I'll give you an example.
13:37 About two months ago, somebody in the social media wrote that we had sequestrated, we had
13:47 imprisoned a lady who was referred from Mutengene Baptist Health Center and that we didn't take
13:57 care of her, we did not accept her baby, and we have imprisoned her.
14:03 Of course, I had to make sure firstly it was false because it never happened.
14:10 And we know that there are people who come from the areas where we have problems, where
14:15 we need to consider whether they can pay.
14:18 If somebody lives from a zone with problems and they come into this hospital, it is also
14:25 an obligation for us to understand that they don't have the means to pay.
14:30 And we go into an arrangement on how this can be paid or whether they will be let off.
14:35 So that was false information.
14:37 So we have that.
14:38 Some people...
14:39 And why do you think this kind of false information come up?
14:42 There are many reasons.
14:43 There are some people who will never accept good.
14:47 They always see evil where there is good.
14:51 Because in this case, my doctors were very embarrassed, my staff, because this lady was
14:56 well received.
14:58 She was transfused.
15:00 She felt well.
15:01 Her family accepted that she received good treatment.
15:06 What happened?
15:08 Her husband was in the media asking for money even after this patient had been discharged.
15:16 You can understand that there may have been an ulterior motive to it.
15:21 So there are many reasons why this happens.
15:24 It could be selfishness.
15:26 It could be also because they don't want to accept that things are going well in a certain
15:31 environment.
15:32 So it is again multifactorial.
15:35 So when was the last time a baby was alleged to have been stolen in this hospital or a
15:42 body part taken away from a corpse?
15:45 I don't know.
15:47 We are happy that we have not had this problem.
15:51 But everything is following the experiences of others.
15:56 We have to make sure that we put in place a system whereby this cannot happen.
16:06 What is the example?
16:07 I told you in our dressing we need to have a white coat.
16:10 We need to have a badge.
16:12 And everybody entering this hospital should be able to have put on a badge, even if you
16:17 are a visitor.
16:19 In the different services, we have put videos surveillance so we are able to see who is
16:26 coming in and in various sensitive areas.
16:31 We have been trying to talk with our different workers, our staff, to make sure that they
16:39 understand the repercussions of what their practice is.
16:45 Because even in terms of receiving patients, we have to make sure that the patients are
16:50 well received.
16:51 We talk with them.
16:52 It is not easy in this environment.
16:53 But we are striving towards that.
16:55 And we have to educate them on a number of issues which can bring problems.
17:01 I will take you to a place of affluence in this hospital to find out how patients in
17:06 dialysis are faring following renewed attention given them in this place.
17:12 I am Vyne Aitanga from Bamela.
17:16 But this thing started when I was in South Africa since 2017.
17:22 I decided to come back to Cameroon because I know my country can help me more than South
17:29 Africa.
17:30 So when I come back here, this is the way I started my dialysis.
17:37 Very expensive in South Africa.
17:38 When we started, the challenge was too much because to pay the dialysis up and that was
17:41 difficult.
17:42 But now, the way the government has organized everything for us, now it is very important
17:50 and it helps us because now we pay 50,000 a year and we can see that if it continues
17:56 like that, it will help us a lot.
17:58 Compared to that, we pay 10,000 a week.
18:02 You signed a notice in the hospital in September 2020 talking about people should be careful
18:10 about violence in the wards and all of that.
18:13 What happens?
18:14 Is it still continuing?
18:16 Violence on patients or violence on the staff?
18:18 Yes, violence is a problem.
18:23 Well I am happy that you saw such a note because our staff also have to be seen as though we
18:28 are protecting them.
18:29 Especially in the emergency department.
18:32 Some people come drunk and when they come, they must be received within minutes.
18:38 If they are not received, conscious flow or you can have a sudden death of a patient and
18:46 somebody will react abnormally.
18:48 It could be unintentional that they have acted.
18:51 You see, blows are thrown, windows are broken.
18:56 So we have that type of violence here, mainly in the emergency department.
19:00 And so we were warning people who are coming in that there is a law against that and we
19:06 are going to institute it if you don't behave well.
19:14 You're watching Governance and Follow-Up, hosting the Director General of the Douala
19:19 General Hospital, Professor Henry Luma, in a facility that could be considered a five
19:25 star if it were a hotel.
19:27 I'm sure I'm correct, Prof.
19:30 That is what the Cameroonian patients should benefit from.
19:33 They should benefit from good health care which is carried out in a clean environment.
19:41 Because it should also be in the environment where I would like to sleep on the bed, where
19:46 I would like to be seen.
19:48 So that is what we want to offer to our patients.
19:52 Director General, the State of Cameroon, like you mentioned earlier on, has been in a campaign
19:57 updating hospitals in the country with equipment and infrastructure.
20:04 Has your hospital benefited from that in the recent months?
20:08 Or it doesn't need that because from what we see, it doesn't really need that much.
20:13 Our hospital still needs a lot.
20:16 Our hospital needs a lot.
20:18 But we have benefited a lot.
20:19 As I mentioned earlier, there was the emergency plan of the Head of State for which we had
20:26 infrastructural improvements as well as our equipment.
20:34 We have that.
20:35 OK.
20:36 The hospital in itself has also invested in some aspects of it.
20:41 And recently, the government has invested because we have, for example, an oxygen production
20:47 unit and we have a functioning radiotherapy unit.
20:52 Then we still need more.
20:55 Today as we are talking, it will be said without fear or favor that the radiotherapy unit has
21:04 not functioned for one month because it is the only center in the region.
21:11 Patients, 80 to 100 patients receive treatment daily, five, six days a week.
21:18 It is only normal that such an equipment may come out with problems.
21:27 So we need to set a policy of maintenance.
21:30 That means that we have a project for which we should improve the care of cancer patients.
21:39 So this project will be forwarded so that in addition to what we have, we are going
21:45 to more, now I will use the word, sophisticated treatment, a linear accelerator to treat
21:51 these cancers.
21:52 And we have three main units.
21:54 We have a radiotherapy unit.
21:56 We have a medical oncology unit where they receive chemotherapy.
22:01 And we have a surgical unit because some of the cancers, the way of treatment initially
22:08 or eventually be through surgery.
22:11 And in this hospital, we practice the three methods.
22:15 But as regards radiotherapy, we are using the Cobalt source which we have been using
22:23 since the early 2000s.
22:26 We have been using that.
22:28 But we need to fine tune that treatment with more sophisticated equipment so that we all
22:34 still be radiotherapy.
22:38 In terms of diagnostics, when I talk about nuclear medicine and so on, we need to have
22:43 PET scans to help us to be able to pinpoint, you know, seek links of cancers in various
22:50 places.
22:51 We need to have that.
22:52 So as I said, as you say, this environment, you look at it and you think we have it all.
22:57 No.
22:58 We have a project so that cancer should be well taken care of from diagnosis to treatment.
23:05 And it should be done the same as it is done abroad.
23:08 So that is a place where we need to continue to ask the government for help to develop.
23:15 Apart from that, still in terms of equipment, we have the biggest hemodialysis center in
23:26 Cameroon.
23:27 That means that if there are a little bit over 1,000 patients on hemodialysis, 300 of
23:37 those patients receive hemodialysis in the Gwalior General Hospital.
23:43 That means that it is a big center where we dialyze 70 to 90 patients a day.
23:51 So we have to go forward throughout the day, we are dialyzing patients.
23:58 We need to go further than that.
24:01 We need to go to the definitive treatment, which is already being done in the Yaounde
24:08 General Hospital, which is renal transplantation.
24:10 These are openings of things which need to be done to complete what we are doing.
24:20 Let me take you back into the hemodialysis center of this hospital, where patients in
24:25 their comfort have got some declarations to make.
24:28 I would like to thank the head of state, the government, the healthcare personnel, the
24:35 director of the General Hospital, because for a while now we have been benefiting from
24:42 universal healthcare coverage.
24:43 For us, patients and hemodialysis, before this coverage was taken, it was very heavy
24:50 for us.
24:51 We had to pay for two sessions a week and it was really huge.
24:57 Already on this side, I say thank you very much.
25:01 It is a great relief.
25:03 It is as if Santa Claus visited us in the middle of the year.
25:08 Thank you very much.
25:10 I thank the director of the hospital, the nurses.
25:17 Before we go, can you drop a word to the public watching over this program vis-à-vis the
25:24 Douala General Hospital?
25:26 The Douala General Hospital, our mantra is patient first.
25:31 We want to take care of patients.
25:34 We are striving towards that, because there will always be problems, but we are striving
25:38 towards that.
25:39 The hospital is open.
25:41 People may say it is expensive.
25:43 I want them to compare the prices we are giving here compared to other centers.
25:48 The example I will give you is MRIs and CT scans.
25:53 In the last two years, we have many more patients than we used to have, because it is cheaper
25:58 here than most places in Douala.
26:00 There are 27 CT scans here in Douala, so you can imagine.
26:03 But yet, being a government hospital, we are proud to know that patients are coming in
26:07 to receive their treatment here.
26:09 Thank you for your time.
26:10 Mr. Mukwele, I am very grateful that you came here.
26:14 Thank you for your time.
26:16 Thank you for coming.
26:17 You are welcome.
26:18 Governance and follow-up, stop and end.
26:26 Thank you for watching this edition.
26:28 See you again.
26:29 Goodbye from Yaoundé.
26:31 [Music]