Dr. Bijingni Pius- Director of TheLimbe Regional Hospital

Dr. Bijingni KUWOH Pius is at the head of one of the oldest and most strategic Regional Hospitals in Cameroon; the Limbe Regional Hospital. This self effacing personality was born of Kuwoh Philip Chungong and Mama Shifa Christina in Bambui. He is as such from the Chungong’s family, one of the biggest and the most popular families from Bambui.

 He attended the Saint Peter’s Catholic Practicing School in Bambui. This personality that has done much to improve upon the health of Cameroonians has very humble beginnings. Mr. Philip Chungong his dad was a Brick Layer working with the Catholic Mission. Dr. Bijingni Pius went to college at Providence Commercial College presently known as Saint Albert’s where he spent just one year. This choice of school was because his dad didn’t have enough money to send him to another school. 

It is during this stay at PCC that his uncle Vincent Nchami now of blessed memory who was working in Buea in the Prime Minister’s Office at the time decided that he should come down to Buea and continue his studies in a Secondary Comprehensive school. In Buea, an attempt to get him into Bishop Rogan College did not succeed. This came after an earlier attempt to get into Sacred Heart College Mankon didn’t also work. Dr. Bijingni in this press briefing declared that he had always wanted to become a medical doctor or a priest or both.

At the time however, the National Comprehensive Secondary School was being created and he succeeded in getting admission there in 1971 in the pioneer batch. In 1976 he made his GCE Ordinary Level and moved over to the Cameroon College of Arts Science and Technology CCAST Bambili. Dr. BijingniKwo Pius was the only science student from the National Comprehensive Secondary School Victoria who succeeded to gain admission into CCAST Bamibili that year. CCAST Bambili at the time was considered the destination of the best English speaking students from all over the country and only the best succeeded to gain admission there. 

After obtaining the GCE Advanced Levels in 1978, he applied for Medical School in Nigeria since his results qualified him for Direct Entry. Due to lack of appropriate communication he did not study in Nigeria but eventually studied at the University Center for Health Sciences CUSS Yaounde; the institution which trains almost all Cameroonian home trained medical doctors. However, before going to CUSS, he taught Biology and Physics at his former school; the National Comprehensive Secondary School Victoria. After this brief romance with the teaching profession, he went to the Faculty of Sciences at the University of Yaounde. It was while he was in the Second year that he passed the Competitive Entrance Examination into CUSS Yaounde. Dr. Bijingni’s story is most perfectly told in the following interview that was done by Francis Ekongang Nzante Lenjo in his cozy home at the Government Residential Area; GRA at Bota in Limbe.

Many believe that at the time, you needed a god father as well as an “envelope” to get into CUSS. How did you get into CUSS?

While studying at the Faculty, I was determined to get into CUSS no matter the number of times that I wrote the entrance exam. I just wanted to see if someone could pass the entrance exam without bribing. So I continued in the Faculty of Sciences while attempting to pass the CUSS entrance. While in the second year in the faculty I wrote the CUSS entrance again and my examination center this time was Providence Comprehensive College Bamenda. After the first day of the exam, we were told that the examination had been cancelled due to question leakages in other parts of the country. We how ever went for a re-sit of the exam a week later. I passed and had to go to CUSS. As a result I was forced to choose between continuing at the faculty and going to CUSS. This was like choosing between day and night since I had always wanted to be a medical doctor. I abandoned the faculty for CUSS. I studied at CUSS from 1982 to 1988, a period of six years and passed my exams in June every year and graduated in December 1988.

From 1988 till date you have been practicing. What do you think are the major highlights of your career?

My first posting was to the Regional Hospital in Ngoundere but because of prevailing circumstances at the time, I was shortly afterwards moved to Wum in Menchum Division. During my student years I saw the way medicine was practiced in the French speaking parts of the country and wished that I was never going to practice there so when they sent me to Wum I went happily. I can logically say that my career began in Wum. Shorty after I took over in Wum, Dr. TabotBenard, the one I replaced went to continue his specialized studies. This left me alone and I did almost everything on my own. My stay there permitted me to take a lot of decisions and take a lot of initiative. Nine months later I was joined by Dr. Chuwanga John who is now retired. I think our era in Wum will always be remembered by the population because we gave our best. We were bachelors and young with very little to disturb us. We were as such completely focused on our job. It was a Divisional Hospital taking care of the whole of Menchum Division. I was there as director from 1989 to 1993. In 1993 I was promoted to the post of Divisional Chief of Service for Public Health for Donga Mantung Division. Now, this post is referred to as the District Medical Officer after the change to the District Health System in 1992. I stayed in Donga Mantung from 1993 to 2001 but during this period I got a scholarship through GIZ; the German Development Cooperation and went to specialize in Public Health in Antwerp, Belgium. I came back in 1997-1998 with a Masters in Public Health and continued to work in Nkambe. While in Nkambe I introduced the District Health System which had just started. We had not yet well understood the notion of Integrated Health Centers. At the time they were talking of Developed Health Centers and then the PMI but later they changed to what is referred to as the Integrated Health Centers. The PMI took care of the mother and the child and the Developed Health Centers had a couple of activities that they were carrying out. They had a limited range of activities so we had to train people and fit them in the new orientation. Donga Mantung was too big to be managed as one Health District. I had to go to Nwa, Abongshe, and there were even areas under Fundong that were attached to Nkambe. A place like Fonfuka for health reasons is attached to Nkambe because if there is an outbreak, somebody will easily intervene from Nkambe. I proposed that they should carve out the Ndu Health District and at the time the Doctor Population ratio too was not very good. With the carving out of new districts we hoped more Doctors would come in. I also proposed the creation of many health centers.

The South West Regional  Hospital, Limbe

So where did you deposit your bags next after leaving Donga Mantung?

From there I was posted to the Bali Health District. I worked in Bali Nyonga from 2001 to 2009. During this period, I used to go out and work for the World Health Organization; WHO and the CDC; Center for Disease Control in the polio eradication initiative. In 2006 I was in Ethiopia and in 2008 I was in Chad, 2009 I was in Nigeria and then in 2013 I was in Pakistan working on the Polio Eradication Programme. Bali was a smaller district than Nkambe and I think there are many people that will remember my stay there. From 2009 I was moved to the Batibo Health District in the same capacity. At sometimes I was called up to the Region to reinforce the supervision team of the Region and sometimes I was also called up at the National Level as a Health Planner. In 2002 I attended an International Course in Bamenda on Action Research Organised by GIZ and the University of Sydney. We had participants from Nigeria, Cameroon and many other countries. 

What is your evaluation of the quality of Health Services in Cameroon over the years?

There has been a lot of positive change because you look at quality from the perspective of the infrastructure, the Health Personnel, the equipment and the users. For us to have good quality health care there must be improvements not only in the health sector but also in what we call related sectors. I think the few improvements that we’ve had are also due to an overall improvements in the country as a whole.In Wum in the eighties, there were days that vehicles only went up and other days in which vehicles only went down. At weekends you will sit in front of the Hospital and see an old Land Rover coming from the Esimbi area. When this happened, I knew that I was either going to have a strangulated hernia or a woman who had ruptured her uterus. Vehicles went only once a week ;that was on the market day and if you had a strangulated hernia and missed out on a vehicle you had to wait till the next market day. There have been improvements in health Services due to an increased in the number of health personnel and the much training on quality of Health care that has also taken place. This has made the Health Personnel to be more aware of quality even if it is difficult to practice. I think that we are still very far and we cannot only look at quality from the perspective of the Health Personnel. You also have to look at quality from the way the service users look at it; that is their own idea of quality. 

Many are those who think health personnel sometimes demand too much for services… 

I think the health personnel have been abandoned by Government for too long. Consultations for example in this country are normally 600 Frs CFA and this has been the rate since 1963. I don’t think that there is anything in this country that is selling at the rate at which it sold in 1963. The WHO says that at least 15% of the national budget should go into the health sector but in Cameroon we are at 5%. These are inadequacies that can explain some of the difficulties that we are going through at the moment. As long as the person who needs health care is negotiating with the person who is providing health care and paying out of pocket, it is always going to pose a problem. There has to be a third party between the two of them who purchases the health care for the person who is sick and imposes the quality and other requirements associated with it.

What kind of hospital did you meet and how far down the road have you taken that hospital?

Well with my experience as a Public Health Physician and Manager and given the years I spent at the District Level, close to a quarter of a century before coming to the Regional Hospital in Limbe, the first thing I did was a situational analyses. It is an old hospital constructed in 1946 and they started using it in 1948. It is a 200 bed capacity hospital. When I arrived I noticed that most of the services were not functioning. The X-Ray Machine was bad, there was no Echography Machine, the Dental Chair was not working and you had specialists in these places. These ones I call the software. The buildings are there but you need what I call the software in order to make the hardware function. We decided to buy some of these equipment and the Ministry provided some while others were provided by Senator Peter MafanyMusonge. Now we have an X-ray Machine. We have an ultra sound machine, we have an x-ray machine and we’ve at least got a dental chair. There is a lot which has to do with organization and like you talked about the quality of services, I put in place a Quality Improvement Task Force and also introduced the User Satisfaction Index Service which is consulted on monthly bases. We also paid more attention to our suggestion boxes and we visit them once a month and do what can be done as seen in the suggestion boxes. What we can’t do is forwarded to hierarchy.    

   There were also some Administrative lapses such as conflicts between workers that we went back to ministerial texts to straighten out issues. I think the atmosphere in the hospital is calm and the people are more relaxed. This is shown through some indicators. People spend shorter times in the hospital without seeing the doctor. The staff situation also improved and we have Doctors in most places in the hospital. The number of people using the hospital has also increased. From 26000 people in 2014 the number increased to 33000 in 2015. The number of deliveries also moved from 600 in 2013 to 800 in 2014 and in 2015 it moved to 950 deliveries. The imaging center that is under construction is going to house the scanner and the X-ray Machine and an MRI Machine as well as a Panoramic Dental X-ray Machine. Like I said, the hospital is an old one and the infrastructure needs a face lift. If not only for the African Nations Cup the institution needs to be taken care of generally. A stitch in time they say saves nine.