I´ve seen some sad things so far. 6year old boy with Lyell´s syndrome probably due to Lumefantrin therapy (part of malaria treatment) showing exfoliation of about 36% of the body surface.Saddest of all HIV patients and AIDS/SIDA in all its variations. E.g. 23year old boy with Kaposi-Sarcoma and liver dysfunction who was absolutely unaware of his disease. Pneumocystis carinii pneumonia and cerebral toxoplasmosis are probably not uncommon but rarely diagnosed due to the lack of financial possibilities. At HDCV around 70 HIV test are performed each week of which about 10 are positive. The majority is female. As mentioned the government is supporting the medical treatment of HIV patients as well as it´s promotion. Anyway there´s still the idea of being HIV positive as a synonym for death sentence and people fear to do the test. The lack of information and the ignorance are major problems in the fight against this disease.
The biggest health problem and daily business in each medical centre is Malaria. Out of 70 Goute epaisse / thick smear done each day about 35 are positive for malaria /“palu/ paludisme”. Most common in this region is P.falciparum – the worst of all 4 – causing Malaria Tropicana. Again the lack of information and missing sensibility for prevention make the management of this disease nearly impossible. Mosquito nets are rarely used, each fever is treated with any kind of malaria medication, seldom in its correct dose and protocol and low financial status keep the patients away from medical aid and diagnostic features. 
My first experience in Dr. Martin Ndeutchoua´s hospital was an urgency operation of an extra uterine pregnancy which ruptured in a patient whose Hb was anyway just around 9mg/dl. Anesthesia was maintained by Diazepam, painkillers where only applied postoperatively. Another disease rarely seen in our regions but quite common in Africa is the “Drepanocytose” / Sichelzellanemie (anemia due to malformation of the erythrocytes in homo- or heterocygote genetics whose English term I don´t know). 8y old boy with hepatosplenomegalia and recurrent pulmonary infections who has to be hospitalised regularly for the treatment of all this complications. 
Last hospital I am working in on my journey to Cameroon is again a small private one, run by a very nice and calm doctor, supported by her husband and opened a month ago. Unfortunately the first delivery performed in her clinic yesterday ended in a dead born baby. Labor was unremarkable but the child must have been in distress because the amniotic fluid was contaminated with meconium apparently already for a couple of hours prenatal. The cause is unknown so far. 
All over the Cameroonian health system is suffering from non-existence, patients from poverty and lack of information and doctors from non-compliance and lacking facilities – and unpaid salaries for months. Specialists are rare in the country, e.g. there are 2 rheumatologists as well as 2 orthopaedics in whole Cameroon (17Mio people). One needs to be generalist to meet the demand and I pay my respect to all the doctors fighting idealistically against these problems under this unimaginable circumstances day by day.
