I returned to my native Cameroon last year after more than a decade of sophisticated medical education in the United States. I returned looking for other challenges; challenges abound in Cameroon, but above all I am home.
There have been frustrations during the past year, but they are similar to those experienced by all Westerntrained physicians who return to the Third World. There are the familiar problems of shortages of economic resources, of reaching remote and inaccessible villages, of the lack of medical supplies and facilities... the list goes on and on. I was trained as an adult cardiologist, but the complexity and multiplicity of our national medical problems make the environment for specialized medical practice hopelessly impractical. Hypertension and valvular and congenital heart disease are rampant in Cameroon, and I have the undesired opportunity to see the natural history of untreated cardiovascular lesions.
I remember glowing with enthusiasm after