"It was awesome to step back and watch people show up."
That's how Doylestown Health Urology surgeon Albert Ruenes, Jr., MD described the opening of the community health clinic in Yeumbeul, a town about 15 miles outside of Dakar, the capital of Senegal in Western Africa.
The Aristide Mensah Health Center is the culmination of years of work in Africa. In 2004, Dr. Ruenes began travelling each year to Senegal to teach African physicians how to surgically treat prostate cancer. Dr. Ruenes founded the nonprofit organization ASSISTS (American-Senegal Surgical Initiative, Surgeons Teaching Surgeons). The goal is to provide African surgeons training and support in order to treat medical conditions prevalent in West Africa.
Dr. Ruenes also developed a training tool in collaboration with Minnesota-based nonprofit volunteer organization, Children's Surgery International, to teach fistula repair to African surgeons, a result of his work in Tanzania and Ethiopia.
Construction on the Yeumbeul clinic began about two and a half years ago. It is named for Dr. Aristide Mensah, a professor and mentor of urologist Dr. Serigne Gueye, a close friend of Dr. Ruenes' who works at a hospital in Dakar and helps manage the clinic. A single-level concrete home was donated to ASSISTS. Telecommunications company Orange also provided seed funding.
The clinic officially opened in April 2017 to serve the village of 200,000 people. For most, it is difficult to travel to Dakar for health care because of lack of money, poor roads and a feeling of apprehension toward the city, says Dr. Ruenes. The Yeumbeul community is much more comfortable with traditional healers. The staff of the clinic comes from the village. The local mayor gave it his blessing.
"We were almost overrun those first two days," says Dr. Ruenes. "We knew there was a need." Making it more exciting was the fact the villagers showed up in their Friday clothes, the outfits they wear to mosque (the equivalent of 'Sunday best').
In its first year, 6,500 patients visited the clinic. With word of the clinic spreading in the community, that number has grown dramatically. Now, caregivers see between 40 and 50 patients a day (more than 14,600 per year).
Patients of all ages receive care at the health center for common ailments such as diarrhea and dehydration. Most of the homes in the village lack running water. Respiratory infections spread quickly through the village, making this another common reason to visit. Diabetes, cuts and injuries are also often treated. The clinic offers pre-natal care to women, hoping to head off fistula issues. Work is underway to put in an operating room with the hopes of offering delivery and Cesarean section services.
The goal is for the community to make the clinic its own and for villagers to provide feedback. Clinic staff offer health education to keep the villagers healthy – with help from the experts. Dr. Ruenes says the plan is to finish the third floor of the building to provide housing for physicians, nurses and medical students who volunteer their services there.
Dr. Ruenes calls his friend Dr. Gueye his "partner on the ground." Dr. Gueye lives in Dakar and helps oversee the health center, making sure equipment and supplies arrive and stay where they are needed. The clinic has a small pharmacy that Dr. Ruenes hopes to expand in the future. ASSISTS provides the salaries for the doctors and nurses and also for supplies. Dr. Ruenes continues fundraising to sustain the clinic.
"In part, what keeps me going is to see how a project somewhat limited in scope can have such a huge impact," says Dr. Ruenes. "And also the people's eagerness to learn and help improve the situation in their own country. There is such a need. They are grateful."
Dr. Ruenes calls Dakar his "de facto African home." He considers the physicians there his colleagues and says, "Working with them has been a joy." He plans to spend more time in Africa when he retires.
For now, he will continue the work started more than a decade ago when he travels to the West African College of Surgeons meeting in Dakar, Senegal in January 2019. Dr. Ruenes is hoping to bring two OR nurses from Doylestown Hospital to teach about instrument and sponge counts, with the goal of establishing these safety practices in the clinic's planned new OR.
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