About

PAACS Part 1 Good morning and welcome to the first PAACS episode. PAACS stands for the Pan-African Academy of Christian Surgeons and on the next two episodes I’ll be sharing conversations with graduates and faculty in the PAACS training programs at mission hospitals in Kijabe and around Africa. Nothing done at Kijabe Hospital is in isolation. Surgeons have been training under the PAACS program at Kijabe for more than a decade, and I think the PAACS program develops some of the best Christian leaders on the planet – not just surgeons, but Christian leaders. Friends of Kijabe is a support organization – we support the work of Kijabe Hospital in general and we support the work of PAACS at Kijabe through infrastructure projects like the Operating Theatre Expansion or through needy patient funding. I’m excited to share these conversations because they paint a vision of what is possible. Dr. Jacques in Malawi describes the blessing PAACS is in African Healthcare The second interviewee is anonymous because of a sensitive location, but he articulates the intersection of mission, medicine and the gospel perhaps better than anyone I’ve ever interviewed. Dr. Beryl Akinyi, associate director of PAACS at Kijabe, talks about paying it forward – giving young surgeons the time and effort that was given her, to help them succeed. Please enjoy! David – You’ve been these multiple different places, you’ve seen PAACS working all over the continent, what is your impression on the work? Jacques – The work of PAACS? This is incredible, incredible work. As an African I can say clearly, without doubt, PAACS has been, and it is, and it will be a blessing for Africa. A real blessing for Africa. My real joy is, I come from nowhere, God allowed me to be a general surgeon, then on top of that, God allowed to become an educator with PAACS. I’m so happy to train others, just as Paul trained Timothy. This is my real joy, to train others. PAACS is a real blessing for us. David – Where is nowhere? Jacques – DRC is a huge country, blessed by several resources. But when you go to DRC, you will say what I am saying. People live in poverty, people die of simple health issues, people are not really educated. With all the conflicts that are happening in DRC, I really pray for my country. David – Where do you see yourself 5 or 10 years from now? The ways of God are sometimes difficult to understand. I don’t know why God didn’t allow me to find a suitable hospital in DRC to work and serve my people. He sent me instead to Cameroon to Mbingo hospital. I don’t know know why God has allowed the instability in Cameroon and sent me way down to Malawi. I don’t really understand, but I know as long as I’m on the path of our Lord Jesus Christ, I’m content with His plan for my life. But one day, if He allowed me to return to DRC, I would only say, “Thank You!” Y Interview David: One of the unique benefits of PAACS, you’re training not only surgeons, you are training Christian leaders. When you look at these wide-ranging systemic problems, that’s what you are teaching them to address. What does that look like in how you work with your students and how you are teaching them? Y: It’s really interesting to see how our residents are growing academically, but also spiritually. We recruit residents that are believers, they love the Lord, they want to share what the Lord has given to them. Some of them, they want to be missionaries, to go to remote places to help the needy people. But when they come to the training environment, they get more. We are trying to fit into the curriculum Bible studies, discussions that are related to what they are doing. How can you show the love of Christ to a sick patient? You might heal somebody with medication, but the way you touch the patient, the way you speak to the patient, the way you care for his well-being and the well-being of his family. This in our context, is very important. These are some of the things we try to emphasize, not just to look at the patient as a sick person, but as a person who has spiritual needs. Those spiritual needs need to come up so you will have the opportunity to talk to them. There are various ways we help our residents by demonstrating. As a teacher, I do all I can to help my resident understand why I am so compassionate to my patients. Why should I come and greet my patient? Why should I come and sit at his side and talk to him in a gentle way? Most of our patients are Muslims. It’s so amazing that when you offer prayers to them, they will always say “Yes, pray for me, pray for me so that I will get well.” And if we pray, we pray in the name of Jesus. We will tell them we are praying in the name of Jesus. And if they are healed, Jesus healed, not us. So, we integrate that into the system. We also help our residents to be residents that are telling the truth. That sheds light not only on the patients but on other workers. Did this thing happen? Did you do this test? No teacher, I did not. It helps to know we are not there only for the surgery, for the pathology, but we are saying to our resident, “Be honest in your deeds.” “Did you examine this patient?” No teacher, I did not. When we grow and understand honesty is part of the thing that reflects Christ’s life, it changes things. David: What’s interesting about that, is it shows the trust they have in you as a teacher. Y: One of the things I see in residents or workers, if they see the teacher saying, “I’m sorry, I think I should have done this thing differently.” That changes a lot in the life of the resident, the nurses, the team. For the teacher to say, “I think I made the wrong choice here. It was my fault.” It makes a lot of difference. This type of training I like so much because it carries me, because of who I am, and I should show respect and be honest to myself. If I am wrong, and I know that I am wrong, and I refuse to confess that, my resident will not do that. We know as a teacher, we do things, not intentionally, but if we make mistakes we must come back and confess them. And if we do that, the resident will train in the perspective that, if you are wrong, you have to say that you are wrong. It doesn’t have to be a hidden thing. It is a be a normal thing to say that you are wrong. “I’m sorry for doing that. I will not do this next time.” David: That’s so profound. Sometimes the hardest things to do are the ones that even a little child should know. This is an issue for every medical provider everywhere in the world. Am I willing to own the truth and speak the truth? Y: Really, we have a lot of opportunities. (Our country) is 99% Muslim. Most people who come to our hospital come for their health problems and this gives us opportunities to share Christ with them. It’s sometimes very easy to engage into a discussion with somebody. A few weeks ago, we got a gunshot injury. Somebody went to another country, bought a car, thieves pursued him to his house, and in his sleep, they shot him. The bullet went through the left side of his abdomen toward the right side. It passed in between two vertebrae, did not go into the spinal cord, just passing near. We took him into surgery, repaired about 4 bowel perforations, his ureter was cut, some of the vertebral vessels were so destroyed. But his function was not affected. Looking at the x-ray, “Is he really moving his legs, this man?” Looking at the entry, he narrowly escaped being paralyzed for his life, but it didn’t happen. That really gave us the opportunity to open the discussion, how God was merciful on him. We took the x-ray, showed him what could have happened to him. We opened that discussion, shared the love of Christ with. We are engaging in communication to lead him to Christ. So, trauma, getting into training, if I didn’t know how to repair these things, I wouldn’t have the opportunity to do that, to share Christ with someone. We see such scenarios in our hospitals most of the time. I’m really happy with the vision that PAACS has. We are going to change the way we do medical mission, because the Lord is in the process of changing the way we do medical mission. Why am I saying this? I used to be the only doctor in my hospital. When I came back I spent about 9 months being the only surgeon. I would be on call almost every night. That was the situation of each mission hospital about 20 years ago. Missionaries would come from overseas, they would go to the place where the need is overwhelming, and they would be the only doctor or surgeon in that place until they burned out. Do they have time with the patients, to share? If you look at the workload, you say “No, they probably do not have.” I’m proud to say, today we have 8 residents and we are planning to go up to 10. So, we will train and we will send. We are multiplying ourselves, instead of the past idea of just doing it. And we are multiplying with the local people, who understand the language, the politics, the places they need to go to. Medical mission is changing, it’s spreading, and I think now we are getting it right. Jesus started with 12 disciples, he concentrated on those 12, and taught them, and after that, they went all over. That’s how Christianity came to us, Christianity came to Africa. If they did not teach and also send, it would never happen. I think that PAACS is taking that hope. We are teaching, we are training, we are making disciples, and we are sending them to go spread the word. That is the positive thing to me in this situation. David – What motivates you as a surgeon, what gets you out of bed at three in the morning? Beryl – I’d say in Kenya there is a big surgical need, the fact that I can meet that and later they come back and they’re smiling, that motivates me. The other thing that gets me out of bed, is I’m heavily involved in training of residents. When I see someone comes in so green, and they graduate as a surgeon, to me that’s a very big motivation - we’ve added someone to the workforce, meeting the need within the country and Africa in general. How do you think about, and how do you talk about the surgical need in Kenya? Is there an easy way to describe it? Beryl – That’s one burden of having poor patients coming in late. The other problem comes in terms of workforce, when people are not properly trained to offer the service that is needed. Those who are trained or skilled, especially in subspecialties are very, very few. That means we have increased waiting time for anyone to get their treatment, and that just makes the burden heavier and heavier. That’s what I’d say currently. David – You were talking about how there is very limited sub-specialization, but a lot of you as general surgeons choose an area of expertise a little bit, even if it’s not on a diploma. What is that for you, what do you love doing? Beryl – Two things, I like doing breast surgery and surgical education. Breast surgery is a little bit individualized, direct to one patient. Surgical education, you are multiplying yourself, I’m not just one person doing this, I’m teaching many people at different levels. David – I have watched you in theatre, and you are a very good surgical teacher. You are very patient, very gentle, you are willing to take longer on a procedure so the person you are working with can learn to do it right. How, practically, do you think about surgical education? What are the things you do on a daily basis in your teaching role? Beryl – Currently, because Kijabe is a training site, we have general surgery, orthopaedic surgery, and pediatric surgery fellowship. I am the assistant program director for the general surgery program, but I coordinate the learning for all basic sciences for all these specialties. That has made me read more, but has also made me focus more on the bigger picture, what’s the need for all these individual students? I’m trying to organize, so that in the five-year-time that all these trainees are here, they get what they need to get to make them a better surgeon. As an individual, I’ve had people who invested time in me, so I could be a better surgeon. That drives me, because if they didn’t invest this time and energy in me, I don’t think I’d be what I am today. So, as an individual, I try to use those good qualities, to make me a better teacher for my residents. David – How does faith play into what you do with your teaching and even with patients? Beryl – God has called us to be good stewards with whatever talent he has given us. To me, being a surgeon is what God has given me, and that is what drives me. God has called me to be a good steward with this talent or this gift. Each time I go to the hospital to work, to teach, I do it for God, not necessarily for the patient or for somebody else to see me. If I do it for my own glory, or for the patients or everyone else to see me, at some point in time I will be tired if I don’t get any good feedback. Knowing I’m doing this for God, drives me to be better and better each day, because that’s what He requires of me. I’d say I’m very grateful to Kijabe and over all to the PAACS program for offering an opportunity for me to learn as a surgeon, to do what I love most, and for all the people who invested their time and energy to help me grow. I’m grateful to Kijabe as a hospital and to PAACS as an organization.