DOWNTOWN — When Santa Monica pediatrician Dr. Edward Malphus disembarked in the Cameroonian airport of Douala, he didn’t — and couldn’t — know exactly what to expect.
He had been traveling without pause for over 20 hours, with flights from California to Paris, and then on to the West African country where he would spend the next month living and working beside another American couple — Jim and Terry Hake — in a rural hospital run by nuns of the Tertiary Order of St. Francis, a day’s drive from the main city.
In that month, he would treat diseases not often seen in children on the Westside of Los Angeles, like malaria, HIV and malnutrition, and have the opportunity to cut through the business of medicine to the practice of it.
The trip was 20 years in the making.
For the previous two decades, Malphus, who has treated kids in Santa Monica for 26 years, volunteered with an organization called the Mission Doctors Association, a group of Catholic physicians that travels to poverty-stricken countries across the globe to provide low-cost medical care.
In that time, although he’d served as the board president and won awards for his dedication and service, he’d never had the opportunity to leave his practice and take part in the central mission of Mission Doctors.
This was his chance.
“It’s something I’ve always wanted to do,” Malphus said.
Mission Doctors has been working in Cameroon for decades, said Elise Frederick, the executive director of the organization.
“It’s a stable country, but terribly under-served,” she said. “It’s off a lot of people’s radar, because it’s not in the news. Those are the kinds of places we serve.”
Volunteers must come equipped with a medical license and a desire to be either long-term residents, who stay in-country for three years, or as a support doctor, who backs up the permanent physician for a month or more.
Doctors who go short term pay all their own expenses, Frederick said, while those that go for multiple years are supplied airfare and a $155 per month stipend.
“Peanut butter money,” she said.
The relatively low cost of providing food, shelter and medical services means that doctors can tend to the sick for approximately $3 per patient.
“We’re a pretty cost-effective organization,” Frederick said.
That’s critical in a place like Njinikom, the small village 5,000 feet into the mountains of Cameroon where Malphus was stationed, a place where the average worker brings in $2 a day.
Malphus quickly learned that his skills as a pediatrician would be welcomed in Njinikom, where the birth rate is far higher than a comparably-sized town in the United States.
Each day had a kind of routine to it.
Malphus would wake up early in the morning in their Njinikom “Hilton,” a two-story house built specifically for Mission Doctor volunteers using a grant from a charitable foundation created by the Hilton chain of hotels.
The home was built on the St. Martin De Porres Hospital campus, and stood just a short walk from the facility, which was comprised of a two-story main building, a smaller pediatrics wing and a cook-shack, where families of patients lugged supplies to cook meals for their sick.
Patient-care is looked at very differently in Cameroon, Malphus said.
“Every patient has a caregiver,” he said, usually a family member or friend that cooks and provides for the basic needs of the patient, much as a nurse would do in the United States.
Bills are also handled in a unique fashion.
Discharged patients loiter on campus until somebody comes with payment, which often equates to about $2 per day of medical care.
“People are expected to be responsible for their medical care,” he said.
Facilities at the hospital were basic. X-rays, labs and some nursing care were available, but nothing compared to the high-tech diagnostics available at a modern hospital. It forced Malphus to practice medicine in a new way.
“It was certainly more challenging,” he said. “You learn to do what you could do, the best you could do it.”
The people appreciated any kind of effort, and didn’t harbor the high expectations of people accustomed to the first-world miracle medicine seen nightly on cable dramas.
Even when patients didn’t pull through, the family members that remained were “appreciative and strong.”
“It’s not that they aren’t emotional, or don’t care,” Malphus said. “They’re practical about these kinds of things.”
Before the end of Malphus’ month in Njinikom, he was determined to leave a lasting mark on the medical practices in the village.
When he arrived, he noticed that babies were born into the world without more than a cursory inspection, much less the full exam they would receive at an American hospital, and information on appropriate medications and dosages also seemed to be lacking.
Malphus created an outline and checklist of common signs to look for in newborns that might suggest an illness or problem with the birth, and a tailored list of treatments for those issues.
After he left, he received word from one of the nuns that, using his checklist, a nurse noticed that a baby appeared to be ill and called down Tim Cavanaugh, the other doctor who had remained behind.
The check-in caught the illness before it could claim the fragile child.
“I said if I could do one thing that would save one life, it will be worth it,” Malphus said. “It was one of the best things I’ve ever done.”