REPORT OF COMMUNITY HEALTH PRACTICE (CHP) AT MULANG HEALTH AREA BAMENDA HEALTH DISTRICT 03 - 04 JUNE 2015 By: SECOND YEAR MEDICAL STUDENTS 2015 Lecturers:

REPORT OF COMMUNITY HEALTH PRACTICE (CHP) AT MULANG HEALTH AREA

BAMENDA HEALTH DISTRICT 03 - 04 JUNE 2015

By: SECOND YEAR MEDICAL STUDENTS 2015 Lecturers: Dr Mfonfu Daniel and Mrs. Kiven Solange

Supervision by : Prof. Kuaban Christopher

REPUBLIC OF CAMEROONPEACE – WORK - FATHERLAND

MINISTRY OF HIGHER EDUCATIONUNIVERSITY OF BAMENDA

FACULTY OF HEALTH SCIENCESDEPARTMENT OF PUBLIC HEALTH

REPUBLIQUE DU CAMEROUNPAIX – TRAVAIL – PATRIE

MINISTERE DE L’ENSEIGNEMENT SUPERIEUR

UNIVERSITE DE BAMENDAFACULTE DES SCIENCES DE LA SANTE

DEPARTEMENT DE LA SANTE PUBLIQUE

The Dean requested and obtained authorization from the Divisional Officer of Bamenda II by the letter no 29/06/3100/5/445 of 27 of may 2015 to carry out the community health practice and diagnosis in Mulang health area .

The Dean requested and obtained a bus from the vice Chancellor of the University of Bamenda

The Dean wrote the invitation for the meeting for the presentation of the results of the CHP to Administrative & Community Representative; these invitations were distributed by Dr Mfonfu Daniel

PREPARATION OF CHP AT THE LEVEL OF THE DEAN OF FHS

GOAL OF COMMUNITY HEALTH PRACTICE :

The practical training course in Community Health Practice has as objective to familiarize the second year medical students with the exercise of establishing the diagnosis of the health situation of the community associated with the environment; and propose solutions.

OBJECTIVES: Collect data from households using questionnaires – on

environmental sanitation and on the evaluation of the vaccination status of children 0-23 months

Analyse data collected Identify health problems and risk factors that may

contribute to disease occurrence Make recommendations to solve the problems and risk

factors identified Educate the population on some identified factors that

could cause health problems while on the field

METHOD20 teams, 19 of 3 students and 1 of 2 students were constituted and assigned as shown under sketches of the three zones ensuring that all quarters were represented. The choice of household was based on the presence of children 0-23 months. The questionnaires were filled during two days, Wednesday 03 and Thursday 04 June 2015, in the morning hours by the Medical Students level 2 in the Mulang Health Area. Each team was assisted by a mobiliser. The synthesis of data collected was made in class in the afternoon, first by using the manual synthesis forms; and secondly entering them in the excel programs elaborated for the purpose, with the assistance of the lecturers

Description of Mulang Health Area, in Bamenda Health District; The population of Mulang Health Area for 2015 is

estimated at 29905 inhabitants

SOME LAND MARKS OF MULANG HEALTH AREA

Office of Government Delegate of Bamenda City Council

The lowest & plain valley in the West of Bamenda town lies in the Mulang Health Area

All streams from mile 4 stream to the stream behind the food market flow through Mulang valley forming one river at the western boundary of Mulang Health Area.

Longla Commercial College of Commerce Northern boundary starts after first bridge below Foncha

to Mulang

Rendezvous junction a few metres from Lachance bridge – the eastern boundary of Mulang HA

The Catholic Mission Ngomgham, The Baptist Church Musang The road from city chemist through Longla goes through

Mulang Health Area to former Council junction Cow boy junction Presbyterian Church Musang Primary and secondary school Ngomgham

SOME LAND MARKS OF MULANG HEALTH AREA (CONT)

Mulang Integrated Health Centre Building( Good building!, with Good dynamic Staff

and Community Mobilisers!)

SKETCH OF MULANG ZONE

6 teams worked in Mulang Zone

SKETCH OF MUSANG ZONE

7 teams worked in Musang Zone

7 teams worked in Ngomgham Zone

SKETCH OF NGOMGHAM ZONE

INFORMATION OF THE MANAGEMENT COMMITTEE AND MOBILISERS BEING TRAINED FOR YELLOW FEVER CAMPAIGN

DATA COLLECTION

SYNTHESIS OF DATA IN CLASS

PRESENTATION OF GROUP REPORTS UNDER THE SUPERVISION OF THE DEAN

PART I: RESULTS OF ENVIRONMENTAL SANITATION

SOME METHODS OF EXCRETA DISPOSAL OBSERVED

SOME METHODS OF EXCRETA DISPOSAL OBSERVED

SOME METHODS OF EXCRETA DISPOSAL OBSERVED (CONT)

SOME METHODS OF EXCRETA DISPOSAL OBSERVED (CONT)

Although 68.3% have pipe borne water we observed many households using non-potable water from wells & springs

OTHER SOURCES OF WATER APART FROM PIPE BORNE WATER SUPPLIED BY CAMWATER

Children , even adults, may often drink this well water without purification , let us help the population construct modest scientific & health prone wells

The population of Mulang HA seem to be ignorant of the importance, and even the various methods of water purification

Ankara is a method of farming whereby all the grass cleared in the farm is gathered into big ridges and burnt to produce better yield of crops according to the farmers. It produces food crops for the first year due to ammonia that is produced but the next the year the soil is red with no ingredients in it. Thus there is shifting of the ankara in the farm rendering the soil very infertile.This practice pushes the farmers to become fertilizers dependent. Organic farming is recommended .

IMPROPER SOLID WASTE DISPOSAL IN RESIDENTIAL AREAS, HAZARDS FOR FIRE DURING THE DRY SEASON

WITH A HEAVY AIR POLLUTION

Consequences of inappropriate disposal of solid waste/refuse

Breeding ground for rats Breeding ground for

cockroaches Contamination of streams,

rivers, oceans Blockage streams causing

floods Burning causes air pollution

with carbon dioxide, carbon monoxide that chemically reacts with sunlight to create harmful ozone layer on the surface of earth.

Feeding ground for dogs, other stray animals

Breeding ground for flies and ants

Contamination of ground water Production of offensive odour Sometimes they are feeding grounds for humans Burning also causes air pollution by Particulate matter,

this refers to the fine particles that produce visible smoke that reduce visibility and create haze, which is a major air pollution problem for many urban and rural communities. In addition to being unhealthy, particles soil our homes

Consequences of inappropriate disposal of solid waste/refuse (cont)

WATER PROMOTES THE BREEDING OF MOSQUITOES

FRESH WATER promotes the breeding of ANOPHELES mosquitoes that transmit malaria parasites that is why cases of severe malaria mostly occur in the population staying at the periphery of urban areas.DIRTY WATER like water flowing through urban areas is the breeding ground for CULEX mosquitoes that do not transmit malaria,

Standing water is breeding ground for Aedes mosquitoes that transmit yellow fever

METHOD FOR URBAN REFUSE DISPOSAL IS ‘SANITARY LANDFILL’

‘Sanitary landfill’ is an excavated area in an impermeable piece of land made of rocky or clay soil for the disposal of large amounts of solid waste . The refuse is spread out and compacted to a layer of about 60cm thick. At the end of the day, the compacted layer of refuse is covered with about 30cm of earth and compacted to stop flies and rats getting to the refuse and to stop any contamination reaching ground water. A bulldozer or a tractor is often used to compact sanitary landfill sites. Landfill sites must never be close to rivers, as materials from the site can contaminate water supplies. Surface runoff from adjacent areas should be diverted to reduce the amount of water draining through the sanitary landfill.

Only a survey with verification can establish the real usage of mosquito nets.

Mosquito net used as window curtainOnly studies with verification can be carried out in order to ascertain the real rate of utilisation of mosquito nets

The rate of utilization would be higher in a sample of farmers , as several farmers have been observed using it

Definition of Herbicide: There has been an increase in the use of spray of herbicides to kill grass or weeds in farms, gardens, and on the compounds and fields in North West Region. Pesticide is an umbrella term that encompasses herbicides , insecticides, fungicides, rodenticides, and various other substances used to control pests.

Herbicides are chemicals that neither decay nor decompose. Herbicides are absorbed through the skin, mouth, and the lungs. Herbicides are believed to present a bigger threat because they are highly concentrated

HEALTH IMPLICATIONS OF HERBICIDES (E.G. PARAQUAT, ROUNDUP)

Suicide; Homicide

Skin Irritation – skin rashes, contact dermatitis

Gastrointestinal system: nausea, vomiting, diarrhoea, sweating, restlessness and bleeding

Reproductive System: Spontaneous abortion; Premature birth in farmers; Declining sperm count and increased abnormal sperm have been associated with exposure to the herbicide

Birth defects when pregnant women are exposed to pesticides/herbicides: Enlarged head & liver, Cleft lip & cleft palate, Haemorrhage, abnormal or missing digits on hands or

feet and displaced or missing body parts or organs. The child of a mother exposed to

pesticides/herbicides during pregnancy can develop cancer such as leukaemia (blood cancer), Wilms' tumour (kidney tumour), and brain cancer.

Cancer: non-Hodgkin’s lymphoma, prostate cancer; cervical cancer, cancer of the pancreas, Cancer of the testes Blood cancers - acute lymphoblastic leukaemia,

thrombocytopenia . Manifested by: Weight loss, chills, fever, excessive

bleeding, skin growths and tumours. Certain childhood cancers are related to parental

exposure to pesticides/herbicides, such as increase in childhood brain tumours, leukaemia, and neuroblastoma.

Effects on Children: Children and infants are at a higher risk for illnesses from herbicides than adults because children are still developing, their immune systems are less able to protect them from damage from herbicides. Children are also more likely to play in areas that expose them to these chemicals, such as rolling on the floor, in the farm or lawn. Mild exposure can result in complaints of dizziness and nausea, but herbicides may also cause neurological and developmental damage to children. Children develop childhood cancers.

Foods: Many food crops, including fruits and vegetables, contain pesticide residues after being washed or peeled. These concerns are one reason for the organic food movement. A bunch of plantains containing pesticide/herbicide will get ripe and get rotten inside at the same time, cassava tubers and all tubers will decay.

Herbicides also kill friendly insects and fish - grasshoppers, honey bees, crickets, ants, fish - with severe consequences.

HEALTH EFFECTS OF HERBICIDES

(a) Clinical photo showing severe erosions over patient's lips on admission. (b) Extensive skin erosion over the scrotum found during the initial assessment. (c)Bedside urine dithionite test showing positive result with change of urine colour to pale green. (d) Healing of lips erosion on discharge. (e) Skin lesion over scrotum gradually improving and subsequent viral and bacterial cultures showing negative results.

Paraquat (Herbicide) poisoning

All the streams that flow through the Mulang H A as mentioned above can suddenly overflow the banks and cause heavy disaster to the population and buildings. Flooding occurs mostly in Mulang Zone. Contributing factors to flooding in

the river bed - building of houses and refuse disposal; land reclamation

Health Area: Mulang Number of households 400

66.0

83.0

32.0

2.50.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

· Private approvedPharmacy

· Pharmacy of thehealth facility

· Medicine store · Hawkers

Pe

rce

nta

ge

Place of purchase

Purchase of Medications

There is no approved private pharmacy in Mulang Health Area

Some patent medicine stores in Mulang Health Area

The owners declare they are serving the population because there are no pharmacies in the Mulang Health Area; a mechanism of control or suppression has to be established

Dr Mfonfu Daniel in a study in July/August 2007, showed that there is a causal relationship between palm kernel oil (manyanga) and skin rashes in children

He recommended the use of olive oil at birth as it is routinely done, and then Vaseline (petroleum jelly) as rubbing oil for the child; rubbing the Vaseline lightly on the body of the child, but not to prevent urine from touching the skin

All the cultures done were positive for candida albicans

All cultures were positive for candida albicans, and became mold after 24 hours

Bar with message against smoking

Five major Diseases /illnesses declared by Mulang Integrated Health Centre in May 2015

The staff declare that there is a serious problem of skin rashes in the community especially in children; they requested for the poster they saw at St Mary HC that Dr Mfonfu produced and the management of the skin rashes

For the treatment of the skin rashes epidemic in Mulang Health Area:Let us adopt the management proposed by Dr Mfonfu Daniel – Examine babies nakedStop the use of ManyangaTreat the rashes with an antifungal pomadeProvide IEC to the patients or parents of

children against the use of manyanga

Vectors promoted by wet Mulang HA, poor excreta disposal & solid waste disposal

Health Area: Mulang Number of households 400

2.0 1.55.0

2.0 0.00.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

HIV/AIDS Cancer Stroke due toHypertension

Mental health Other

Perc

enta

ge %

Diseases

Major incapacitated Chronic patients at home (disabling diseases)

Family were hesitant to provide information , such questions were considered personal and private

Table 18:CLEAN ENVIRONMENTNumber of Households visited 200Number of Households with clean environment 124Percentage of households with clean environment % 62.0

Some Criteria for clean environment: No litter around the house (papers, peeling of crops,

plastic bottles etc) No stagnant water. No bushes around the house. No faeces around the compound. No offensive odors.

PART II: EVALUATION OF VACCINATION COVERAGE RATES

-The target population 0-11 m used for May was that for June 2015-The coverage rate for BCG and Polio 0 are very low/most children are probably delivered out of the Mulang H C-The total of 0-11 months are used as denominator in the calculation of coverage rates whereas most children have not yet reached the target age for vaccination. -Negative DROP OUT RATE indicates many children start vaccination out of the HA.-Parents misplace vaccination cards.-Vaccines administered to some children are not well recorded in their vaccination cards.-Vaccination cards were locked by parents.

Factors contributing to low vaccination coverage rates in 0-11 months in routine EPI

UBa - FHS - CHP - 17 June 2015

VccicinesPolio 0 BCG

Polio 1, PENTA 1

Polio 2, PENTA 2

Polio 3, PENTA 3

Measles, Yellow Fever

Calendar Blrth 6 weeks 10 weeks 14 weeks 9 months 11 monthsNormal target Age used

0 11months

Target age group for Polio 0 & BCG

0 11months

Target age group for Polio1& PENTA1

6 weeks 11 months

Target age group for Polio2 & PENTA2

10 weeks 11 months

Target age group for Polio3 & PENTA3

14 weeks 11 months

Measles, Yellow fever

9 months 11 months

DETERMINATION OF IDEAL TARGET POPULATIONS TO BE USED AS DENOMINATORS FOR THE CALCULATION OF SPECIFIC VACCINATION COVERAGE RATES FOR CHILDREN 0 - 11 MONTHS

----------'

to (Denominator)

to (Denominator)

to (Denominator)

to (Denominator)

to (Denominator)

to (Denominator)

PROPOSED EPI TARGET POPULATIONS

VACCINATION C0VERAGE RATE % OF CHILDREN 12-23 MONTHSHealth Area: Mulang Health District: BamendaTotal number of children 12-23 months seen: Total number of children 12-23 months with cards: % with cards 92.1163

177

100.0 98.2 100.0 99.4 97.5 100.0 99.4 95.1 92.0 94.584.7

4.90.0

10.020.030.040.050.060.070.080.090.0

100.0

BC

G

PO

LIO

0

PO

LIO

1

PO

LIO

2

PO

LIO

3

PE

NT

A 1

PE

NT

A 2

PE

NT

A 3

Me

asl

es

Ye

llo

w f

ev

er

Co

mp

lete

ly v

acc

ina

ted

Dro

po

ut

rate

PE

NT

A1

&P

EN

TA

3Va

ccin

ati

on

co

ve

rag

e r

ate

%

Vaccines received

12-23 months is the conventional age group used for the evaluation of vaccination coverage in the community, by this age all children ought to be vaccinated; the vaccination coverage are very good; however more IEC has to be done

POSITIVE OBSERVATIONS

• Mobilizers facilitated the work• Mobilizers taught us how to interact with people of the

community• The questionnaires made things easier• The excel program for synthesis made the work easy• The lecturer was caring about the students on the field• The presence of the Dean reinforced the seriousness of

the exercise• The vaccination coverage rates amongst children 12-23

months were very good for the antigens evaluated

Most houses have pipe borne water supply which they say hardly stop flowing

There is a beautiful integrated health centre that coordinate health activities in the health area

Some people separate their waste into organic and inorganic.

Very few people buy drugs from hawkers. Many people declared that they sleep under a mosquito

net. The road bellow Foncha through Mulang is being

constructed

POSITIVE OBSERVATIONS (cont)

The Students educated the population on some identified factors that could cause health problems while on the field

No identification of any vaccine preventable disease according to the EPI program of Cameroon while on the field.

In some restaurants, hand-washing is done with water flowing from a container.

The school bus aided us in transportation The community collaborated and were welcoming

POSITIVE OBSERVATIONS (cont)

WEAKNESSES TO BE IMPROVED

Community health practice of the area coincided with the day of IWC on the first day of CHP making it difficult to find the number of children required

The road from La chance bridge through Musang zone including the Mulang Health Centre, to Ngomgham is very bad thus reducing accessibility to the Mulang HC

The target 0-11month used as denominators for the calculations vaccinations rates include children who are either above or below the recommended age groups

Some water closet toilets are directed to the stream; this practice can cause water borne diseases in people down stream - such as cholera, typhoid, hepatitis A, and etc

Very many people do not believe in protecting their body privacy because most simple pit latrines are poorly constructed with bad slabs, poor or no walls , without roofs & lids for squatting holes, providing a fertile ground for fly multiplication and consequently disease transmission.

Poorly constructed wells & springs with poor hygienic conditions are still being used in many households

Some people throw waste in streams. Some septic tanks are poorly constructed while some

are directed to the stream. In most restaurants, hand-washing is done with water

put in a single bowl.

WEAKNESSES TO BE IMPROVED (cont)

WEAKNESSES TO BE IMPROVED (cont)

Most piggeries and poultries are very dirty and have offensive odor.

Some people do not properly use their mosquito nets; some use it as window blinds.

Building in the Mulang river bed thus narrowing it,

One bus carrying students to the field bring the second batch very late in the field when most parents would have left the house

RECOMMENDATIONS In the spirit of multi sectorial development of health: The Regional Delegation of Public Health (Ministry of

Public Health) should stop the selling of manyanga (palm kernel oil) in health facilities.

The Ministry of Animal Husbandry should train farmers to keep clean and inoffensive piggeries and poultries.

The Ministry of Agriculture and Agricultural Schools should promote organic farming using the large amount of organic waste generated from our households and markets.

The Ministry of Public Health, WHO and UNICEF should establish the proportions for target populations to be used as denominators in EPI.

RECOMMENDATIONS (cont) Let the Ministry of Environment promote clean

environment by contributing to the stop the use of herbicides.

The Ministry of Public Health should carry out the surveillance of Birth Defects, spontaneous abortions and still births in all health facilities.

The Ministry of Industry and Commerce should promote the use of palm kernel oil for soap making only.

The regional Delegation of public Health should properly train of health workers on vaccination and recording of vaccination dates.

The City Council should grade the road from City Chemist Junction through Mulang Health Area.

• Let us separate household waste and waste from the markets into organic and inorganic;

• Let us take the organic waste to our farms and use it as organic fertilizer.

• Setting up an industry for producing organic fertilizer out of these organic waste, will serve as a source of employment.

• The Ministry of Agriculture should lead us

Let us promote organic agriculture

RECOMMENDATIONS (cont) The Council Should- Clean the water bed of Mulang River.- Prevent people from building in Mulang River Bed.- Provide more dustbins in the streets. - Recruit Sanitary inspectors to inspect the sanitary

conditions of bars , restaurants, the environment and toilets; and provide IEC for behaviour change.

The FHS should inform the community by mass media well before hand of the date of community health practice to be carried out by students.

The University should provide 2 buses to carry the students to the field; one bus could bring them back

CONCLUSION

1. We have tried as much as possible to present to you the results of the Community Health Practice in Mulang Health Area concerning the assessment of environmental sanitation and evaluation of vaccination coverage of children aged 0-23months.

2. We are grateful to the community for their cooperation and welcoming spirit.

3. We are also grateful to the mobilizers who facilitated our work by taking us exactly to houses with children of our required age range (0-23 months).

4. We plead the information that we have provided will help us improve the living conditions of our population in Mulang Health Area at our various posts of responsibilities.

5. We are very grateful to the school authorities for organizing this course.

CONCLUSION (cont)

References:• Course on community health practice , medicine 2

by Dr Daniel Mfonfu UNIVERSITY OF BAMENDA[UBa] , FACULTY OF HEALTH SCIENCES [F.H.S.] ,2015;

• Course on Environmental Sanitation , medicine 1 by Dr Daniel Mfonfu UNIVERSITY OF BAMENDA [UBa], FACULTY OF HEALTH SCIENCES, 2013/2014;

• Skin Rashes in children and PALM KERNEL OIL (Manyanga) in BAMENDA, CAMEROON, July – August 2007;by Dr Daniel Mfonfu.

THANKS

REPORT OF PRESENTATION OF RESULTS OF COMMUNITY HEALTH PRACTICE (CHP) AT

MULANG HEALTH AREA TO ADMINISTRATIVE AND COMMUNITY AUTHORITIES

01 JULY 2015

Lecturer: Dr Mfonfu Daniel Supervision: Prof Kuaban Christopher

UNIVERSITY OF BAMENDAFACULTY OF HEALTH

SCIENCESDEPARTMENT OF PUBLIC

HEALTH

UNIVERSITE DE BAMENDAFACULTE DES SCIENCES DE

LA SANTEDEPARTEMENT DE LA

SANTE PUBLIQUE

Goal of presentation of results of community health practice (CHP) at Mulang health area to administrative and community authorities:

Provide a feedback on CHP to authorities so that they could use it to give Information, Education and Communication (IEC) to the population of Mulang Health Area in order to enhance behaviour change for the improvement of healthy environmental sanitation and lifestyle

Welcoming of invitees and opening remarks by the Dean

Welcoming of invitees and opening remarks by the Dean

Welcoming of invitees and opening remarks by the Dean

Keen observation of presentations by all participants

Presentation of results of CHP

Profound observation of Power Point Presentation

All participants contributed positively to the efforts made by the students and thanked the Dean for choosing Mulang Health Area . They declared that the presentation had revealed to them what they did not know and stated that they were thus armed to educate their population.The participants requested for copies of the presentation so that they can use it to sensitize their population and carry out the recommendations proposed. They declared that they have found in the Faculty of Health Sciences a real partner. The meeting started at 10:00am and ended at 12:00noon

The Dean promised to progressively improve on the questionnaire to include other important recent activities carried out by the Ministry of Public Health.

Recent vaccines like pneumo and rotavirus will be included in the following years of CHP in other health areas

The Dean promised the participants the electronic copies very soon. The Dean sincerely thanked all invitees for their participation

MUCHING BERTRANG TEMBENG JATOR GODLOVE KONTIMVEFEMEH NTANGSI ARDINTON LOBE ESTHER CLAUDIA, FOMENA TENDA BLECK CARLOS, NONO TAGNIE STEVE LOICCHU NDZO DAVID ABONG CHE INNOCENT, MARTHE YAYA NGOWO ELIMBI ***

NING JEVIS ABAH

TICHA BRANDON TITA TEMBI DOUANLA LEONNELLEMOLI VICTORINE JEANNINE CHIA DIVINE AFUMBOMUGWES KAL OUM TAMBE EMILIA NDIP-

AGBOR, ELAD JUDE FOTABONG, ANAKA MANSFIELD ANAKA

Names of students of MULANG ZONE *** GROUP LEADER

GROUP MEMBERSENOW AWAH GEORGES STEVENS KOUMESSI HAPPY ARMAND

AURIOLENANA NANA VANESSA FAI NYUYFONI BALTENWANDJI KWADJIEP WILFRIED DIDEROT NGAMEN BANI STEVE NAEL

AGBOR FLAVINE AYUK YOUNGUETCHOUA TCHIENGANG SAMANTA ADIANIE

NJI ARMAND CHI FOMEKONG TIOKENG DREM'S TAILLOR

FONDJA JAURES ARNAUD NGUE NGAN DONFACK LORIANNEAMBE MARWEL ANCHO BEYOND TABIBATE CHRISTOPHERGWEHA BRIAN DENISOT KENFACK TATIENOU OREST LANDRYNJOYA NGAMIE YASSIR MASSOUD TOUKAM NGUEBMEGNE ARIELLE

CARELLEBESSOUN CHRISTINE SANTANA SAMBA OTAVISE ***

Names of students of MUSANG ZONE *** GROUP LEADER

ANAIS JESSIE-JUDITH NDOUMBE ETEKI,

OJONG DAVID ETENGENENG

HOSSIE KOMBO LIONNEL, MBOME MARPHA EBENYE THEODORA DEOVIE

NTUNTU SWENI TAMFU DIMELE SALI JOSIANE STEPHANIE, AYUVEA ANGELO TANGWA ***, MBAH WALTERS ACHUHKEYANPI AUBERLIN TOMNTEH AUGUSTINE NGORAN DJATCHA TCHATAT GRACE CARELLA

KUGHONG RIUBEN CHIA

EBAIEYONG SAMUEL EBAIEYONG SHU MFORBI MARIE, MOPPE MBOUTCHA MARCIA PINDI MOMISSE SERAPHINUJAMBENG VAIIE UJAMBENG, ATANGA YANKEU STELLAATANGANA PO’O DENIS CONSTANTIN,

KANYIMI REMIHIMBRU

NYOHMBOV CLINTON VERLA,

Names students of NGOMGHAM ZONE *** GROUP LEADER

Dr MFONFU DANIEL15 JULY 2015