Podcast appearances and mentions of christian surgeons

Welcome to the Personal Development Trailblazers Podcast! In today's episode, we'll break down the science of decision-making to help you escape burnout and design a career you loveMark Shrime is an internationally renowned speaker, surgeon, author, coach, and cat dad. He serves as the Editor-in-Chief of BMJ Global Health and a Lecturer in Global Health and Social Medicine at Harvard Medical School.Previously, he was the International Chief Medical Officer at Mercy Ships, the founding O'Brien Chair of Global Surgery at the Royal College of Surgeons in Ireland, and the Director of the Center for Global Surgery Evaluation at Massachusetts Eye and Ear Infirmary. He also served as Research Director for the Program in Global Surgery and Social Change at Harvard. Trained in otolaryngology, head and neck surgery, and microvascular reconstructive surgery, he earned an MPH in global health (2011) and a PhD in Health Policy focused on decision-making (2015).Clinically, he specializes in large head and neck tumors with Mercy Ships, working closely with residents from the Pan-African Academy of Christian Surgeons. He has worked and taught in multiple countries, including Liberia, Sierra Leone, Guinea, Benin, and Madagascar. His research explores the global burden of surgical disease, financial barriers to care, and surgical access worldwide. As a co-author of the Lancet Commission on Global Surgery, he focuses on optimizing surgical policies to improve health outcomes while reducing financial hardship for patients.Beyond surgery, his coaching, writing, and speaking help people navigate major life decisions. He merges personal experience with decision science to guide others in building a life of purpose and fulfillment. His book, Solving for Why, has sold nearly 15,000 copies. Outside of his professional endeavors, he is a photographer, rock climber, and ninja warrior. He competed on Seasons 8, 9, and 11 of American Ninja Warrior.Connect with Mark Here: Instagram / Threads: @markshrimeLinkedIn: https://www.linkedin.com/in/markshrime/Medium: @shrimePersonal website: markshrime.comWebsite: solvingforwhy.coGrab the freebie here: markshrime.com/anatomy-pdf===================================If you enjoyed this episode, remember to hit the like button and subscribe. Then share this episode with your friends.Thanks for watching the Personal Development Trailblazers Podcast. This podcast is part of the Digital Trailblazer family of podcasts. To learn more about Digital Trailblazer and what we do to help entrepreneurs, go to DigitalTrailblazer.com.Are you a coach, consultant, expert, or online course creator? Then we'd love to invite you to our FREE Facebook Group where you can learn the best strategies to land more high-ticket clients and customers. QUICK LINKS: APPLY TO BE FEATURED: https://app.digitaltrailblazer.com/podcast-guest-applicationDIGITAL TRAILBLAZER: https://digitaltrailblazer.com/

Recorded on 5 November 2020 for ICMDA Webinars. Dr Peter Saunders chairs a webinar with Dr Keir Thelander Hear the inspiring story of PAACS - an organisation that trains and disciples African surgeons to glorify God and provide excellent care to those most in need. Keir Thelander attended Indiana University School of Medicine and completed his general surgery residency at Fairview Hospital in Cleveland, OH, in 2004. After working as a General Surgeon in Cleveland, Keir was led to train and disciple African doctors to become surgeons. Keir's young family of 4 moved to Bongolo Hospital in Gabon. For 8 years Keir served as the Program Director of the Pan-African Academy of Christian Surgeons (PAACS) surgical residency program as well as the medical director of this 150 bed facility. Recently Dr Thelander has been Team Leader for the over 20 ex-patriots living in Bongolo, while he also worked as the West/Central Africa Director for PAACS. Presently, Keir is the Executive Vice President of PAACS. In this role he oversees their 15 training programs across Africa. Keir's passions are helping doctors and all people to thrive no matter the circumstances as well as surgical education in cross-cultural contexts. ⁠⁠⁠⁠To listen live to future ICMDA webinars visit⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://icmda.net/resources/webinars/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

In this episode of Conversations from Here I am honored and privileged to speak with John L. Tarpley, MD. He is Professor of Surgery, Emeritus at Vanderbilt University Medical Center and the former Program Director for General Surgery Residents there. He has also been the Associate Chief of General Surgery at the VA Hospital and is currently the Academic Dean of the Pan-African Academy of Christian Surgeons. He is a passionate advocate for patients and doctors alike. He has spent a huge portion of his professional life in Africa-- specifically Nigeria, Kenya, Rwanda and Botswana, training young surgeons and ministering to those most in need. "Tarp"-- as anyone in the hallowed halls of Vanderbilt will attest-- is a legendary character who is as humble as he is funny and as knowledgeable as he is wise. We talk about his life and work, discuss some of the challenges with getting medical care in places far from urban centers, his personal love story and an early obsession with college sports. It's a fascinating talk, indeed. Enjoy!   More on Dr. Tarpley: https://www.vumc.org/surgical-sciences/person/john-l-tarpley-md https://news.vumc.org/2016/07/26/tarpley-may-be-retiring-but-he-isnt-slowing-down/ https://paacs.net/   Books Mentioned: The Book of Joy: Lasting Happiness in a Changing World-- by the His Holiness the Dalai Lama, Archbishop Desmond Tutu & Douglas Abrams https://www.penguinrandomhouse.com/books/533718/the-book-of-joy-by-his-holiness-the-dalai-lama-and-archbishop-desmond-tutu-with-douglas-abrams/   Long Walk to Freedom-- by Nelson Mandela https://www.littlebrown.com/titles/nelson-mandela/long-walk-to-freedom/9780759521049/  

Dayalan: I'm Dayalan Clark. I'm a breast surgeon from the UK. I came out to Kijabe mainly to help because Beryl [Akinyi] has been on maternity leave. Beryl is the surgeon who does most of the breast work here, and Peter Bird, who we have known for many, many years, asked if we could if I could come and help. Peter grew up in India as a missionary child with his father being a surgeon and a missionary hospital, at a mission hospital in India in a place called Mysore. And it so happened that my wife's father was also a surgeon in the same hospital, and they grew up together across a wall as neighbors growing up in India. And that was my connection with Peter Bird. I think my wife and Peter lost connection, though our respective parents kept in touch. And then when we were visiting Nairobi for a safari in 2006, we heard that Peter was here. So we were going for a safari with my wife's parents. It was their 50th wedding anniversary and they loved wildlife. So that was our treat for them for their 50th wedding anniversary. And they said, “Oh, Peter is in Kijabe, let's try and meet up with Peter.” So we came and visited Kijabe had lunch with Peter.  In 2006 I took an early retirement from my work in the NHS in the UK with the express purpose to go and help mission hospitals in need. And then in 2019 I came out to Nairobi with a group of breast surgeons from the UK to train to do a training course and a teaching course in Nairobi, and who was on the local faculty to spread the word. So we met up again and I was telling Peter how I had taken an early retirement with the express view of going in and helping mission hospitals in need. And then he turned around said, Oh, would you be able to help in Kijabe if we needed us at all? I'd love to come to catch up if he needed me. And then of course, Peter was leaving last year and Beryl was going on maternity leave. So he contacted me and said, Can you come and help us while on maternity leave? And so I'm here. That's how I'm here.  David: That's amazing. Did you and your wife meet? How did you meet? Dayalan: I went to medical school in India, which is a Christian medical school called CMC Christian Medical College Vellore. And we were classmates in Vellore and we met there and got married after we finished our house jobs and then did some mission service, which is part of our obligation in India, then did our respective postgraduate training and in Vellore again, myself in general surgery and my wife in pediatrics. And then it worked again in mission hospitals in India and then went out to the UK in 1991, never intending to settle in the UK. But God, God's wills are strange and we never thought that's going to be the plan. But that's what happened. And I was very conscious that because we've trained in Vellore, I've always grown with the feeling that I consider myself very fortunate, coming from a very average background in India. My father was a minister in the church and retired as the Bishop of Madras. So very ordinary background, but consider ourselves very fortunate to have been able to have gone to the UK and to made a career there, to become consultants there and always felt as soon as my children were on their own feet, I'm going to stop working, retire and try to give back to people who been less fortunate than myself. Wow. David: Wow. That brings up so many interesting questions. I'm not super familiar with India, but one of my dreams is - this is why I was so excited to meet you is I heard from from Dr. Nthumba when we were starting Friends of Kijabe - he said, "you need to learn about Vellore, you need to learn about this place." And so, I'd love to hear about that. But then also I'm curious just what. . .you said your father is a minister and then became a bishop. Most people in America associate India with Hinduism, Jainism, Sikhism.  Is Christianity regional? Dayalan: Christianity is much more common in South India than in North India.  Where I come from, which is South India, but the population of India is huge. As you know, 1.3 billion people and 2% are Christians. So, 80% Hindus, about 10% are Muslims. And then, like you said, the other communities like Sikhs, Jains and such like from the rest of it with Christianity being 2%. So even Clark, which is my surname, is a very Indian name, but the background to that is one of my forefathers must have been converted. And when you convert it from Hinduism to Christianity, the way you denounced your previous religion was either you took on a biblical name or you took on a very western sounding name, often a missionary who converted you. I presume one of my forefathers was probably converted by someone called Clark or decided to take on a Western sounding name. And that's how Clark has come down the generations. David: Wow. So, there's a tradition that the Apostle Thomas went to India, right? Dayalan: It's historic. Legend is that he came down to this west coast of India, which is Kerala, and then traveled down and then actually came through Tamil Nadu where I'm from, near Chennai. It's called Saint Thomas Mount. And they say that that's where he probably last either left India or died there. We don't know. But I don't think there's enough factual evidence but that's what they think happened. Yeah. David: Interesting. It's not until really spending time in this part of the world that realize Christianity developed very differently than I perceived. Southeast Asia, Africa, a lot of the early church fathers were in those places. It was not a European thing until much later on, which I think is fascinating. Dayalan: Yes.  Considering Christianity arose, Christ lived in Jerusalem in the Middle East, I think proximity-wise you can see why it happened that way. Egypt is not far from where it was and you have flight to Egypt when Christ was born. But it doesn't surprise me. Definitely there was quite a lot of Christianity around this region and moving both east to us [in India]. David: Wow. I think my understanding of our previous conversation - tell me if this is accurate - that Vellore is probably a picture of what Kijabe could be like in, I don't know, what you would say, maybe 20 or 30 years? Dayalan: Quite possibly so. I mean, the first thing that struck me when I came to Kijabe, I saw the community spirit, the closeness, and how well people got on together. And the first thing that struck me, especially with a lot of missionaries here, the first thing that struck me was this is below in the fifties or sixties because Vellore was very similar. There's a Christ-centered Mission Hospital, which was largely supported by Americans and some British missionaries, both in terms of the day-to-day running of the hospital and in personnel, which I see exactly what is happening here. And Vellore has then gone on to become one of the leading institutions in India, both in teaching and in terms of health delivery. And my only prayer is that hopefully 30, 40 years Kijabe is going to get there. One of the things that Vellore has, which probably is an advantage for them, having developed so quickly and so well, is a medical school, which I think we don't have yet in Kijabe. But I think if we have Christ at the center, everything else will follow. And I can see great things happening in Kijabe, just in the services that I've seen, in breast cancer care itself, I can see there's huge scope because we've just had a mammogram machine installed. Oh, yes, which is fantastic. And then I've helped in helping the radiographers from here, going to Aga Khan and MP Shah to get some training and of course, we're going to have a breast radiologist coming from America, starting in August. So, with this mammogram machine, we have a state-of-the-art absolutely fantastic machine, and then if we have a breast radiologist to actually drive that forward. I can see Kijabe being a fantastic breast unit going forward.  David: That's amazing. So you went from Vellore, you went from a very faith-based medical system to the NHS, which I assume was not the same. No, no. What was that like? Dayalan: The NHS as a health provider is absolutely fantastic.  You have, which I think most developed countries should aspire for, a health delivery system that is free at the point of delivery irrespective of your social status, your economic status, or who you are. Absolutely fantastic health delivery system. But one of the issues with that is that it's very secular, even though the British consider themselves a Christian country. I think that's far from what's practically happening there. So, it wasn't an issue for me. I am still involved in my church. I sing in the church choir. I'm actively involved in church activities. They've been very supportive of me coming here and by their prayers. So that balanced it out. And yes, it was different. But I think the professional satisfaction that I got from treating my patients, knowing that irrespective of whatever treatment they needed, they got it, irrespective of their economic status. And I think that is something most countries should aspire for. Any developed country that doesn't do that I think is really failing their people. And so I think Britain and the NHS is a fantastic health delivery system. It's huge and any huge system like that will have flaws, will have deficiencies. But as a principle where they can deliver good quality care which is completely free at the point of delivery, I think the NHS is fantastic. David: What does India's delivery system look like? Because you're doing a lot of fundraising for the people who are not able to pay, correct? Dayalan: Yes. So now in the UK, we have a group very much like Friends of Kijabe called the Friends of Vellore UK. And because Vellore has been training medical students for about 80 years, they have people in various countries. We have friends of Vellore in the US and the UK and Australia and in different parts. And the original role of these organizations, are charities that were set up by mission. Those who went from the UK to the Vellore worked there, came back, and raised funds from their local churches. Equipment that was not being used by discarded by the NHS was being shipped back to Vellore. So, Vellore depended a lot on these Friends of Vellore in the different countries. But the law has now got grown so big and it's completely self-sufficient for their day-to-day running for their equipment. So they don't need the Friends of the Vellore UK anymore for that. So, we've turned our focus towards paying poor patients' bills. And one of the things that often used to worry me is that, yes, the law is a fantastic institution. They give brilliant care, tertiary care for people. But what about the poor man living on the street outside or just two miles away from the law? Where does he go? I mean, he doesn't have a chance of paying those bills. Vellore has now moved on in that 15% of their income, which is a large amount, is completely for charity. Dayalan: And they're moving towards no patient will ever be turned away from the law because of lack of funds. So that's where we come in and we have said no more capital investment from us. We are going to concentrate on paying for poor patients' bills and they have a very good system which was set up in the seventies called person to person. So, a person in the UK donates money for a person in the Vellore. So that money is then raised and sent to Vellore. Vellore administers that. Every penny that that person in the UK donates goes directly to paying that poor patient's bill. And the person who in Vellore UK who donates that money gets a report of the patient that they treated and whose bill they helped to pay. That was set up in the seventies and is a very popular way of helping poor patients because the donors love it. They know exactly what's happened, the social standard, how much the bill cost, and what either the patient or their parents earn. So that was that's a very popular program and Friends of Vellore the UK that is our main contribution. David: I just had to pause. In 1970. So that meant you had to send a letter for every single patient that was helped. Dayalan: That's right. It was snail mail in those days. I remember as interns and as house officers actually filling in the form for a PCP form. Whenever the consultant knew that this patient is is not going to affect, they'll turn round to the junior, which was us. Can you please fill in a PDP form? We would then go into the patient's history, the economic background, where they live, what they earn, how many meals they have, how big their house is, and then all that details are then put together. Then the money is sent from PCP and then a sort of report is compiled by the administrator and by Vellore, and then sent by mail to the people in the UK. David: I'm just absolutely floored because I associate this with organizations like Compassion International. This is normal now. This was not normal in 1970 by any stretch of the imagination. For somebody working in the charity space, it's just mind-bogglingly cutting edge. That's so cool. Dayalan: I think Vellore has been just miles ahead of everybody else in India and even abroad. One of the other things, just to give you an example was the medical admissions when we got into medical college. So, you did an entrance exam where you qualified and then you were called for an interview and the interview took three days and the interview was hardly anything on the subject material. But it's basically to understand what is the aptitude of this individual person. Does the CMC think that this person is someone who has the aptitude to go back and serve? That was the main crux of the interview. We had personal interviews, we had group tasks, we had individual tasks, we had psychometric tasks. This is going back 50 years when it wasn't even envisaged. In the UK we now started bringing this in for our medical admission. And I was saying, “Guys, we've been doing this for 50 years at Vellore.” I think Vellore was really miles ahead of everybody else in lots of their programs and lots of their thinking and a lot of their projects. David: Yeah, that's just amazing. Wow. Is there anything you see at KJB that reminds you of what that's like? Like what are common threads? Dayalan: Well, I think the common thread is the Christ-centered attitude of what you're doing for your patients. Nobody is interested in personal gain or personal glory.  All you are interested in is that God's name be praised and that patient getting well. And I think that's probably the first thing that struck me when I came here. That's it, I think the most important thing in health delivery system within a Christian ethos. So that was the first thing that struck me. The second thing that struck me is the training system is so similar. Vellore was started by an American missionary, Ida Scudder. The training system where residents do what they were doing here, like the PAACS (Pan African Academy of Christian Surgeons) training system, the residents take personal responsibility for the patient they're looking after. They present in rounds. They know everything about that patient. And the training system was very similar. And I think what I appreciate with PAACS, even more than what we had in Vellore is ours was mainly service-oriented. Here you've introduced some teaching into it. Also, you have, at least in surgery, regular teaching sessions which we didn't have in the Vellore. The onus was on the individual to go read up. And whereas here [in Kijabe] you have a structured training program with structured teaching from starting from the basic sciences, going right up to the operating skills, which is fantastic. David: How do how does the skill level of our [Kijabe] trainees match up to other places you've been? Dayalan: I think the training here, the skill level is fantastic, and I think it's what I like about the system is it's actually geared towards the African setting in that they have a general training which we don't have in the UK. We've moved away completely, but the UK can afford to do it because it's a developed country and they have the NHS which will look after everyone, whatever they need is, whereas here it's not the case. And so, I think the training is very broad here, very good here. And having seen the final-year residents, I know they're going to be doing the exams shortly and they will go out and I'm confident they would be able to manage most surgical conditions. And when I say surgical, not in the narrow sense of the UK, but in the broad sense of what Africa needs. So I think the skill levels are absolutely fantastic for this residency.  David: For some of the non-medical people listening. What are the biggest surgical needs for Africa? Dayalan: I think the surgical need for Africa is to be a generalist where you can actually have a basic understanding of surgical diseases, know what the pathology is, and be able to quite rightly identify the problem and treat it adequately. One of the things I've noticed here is I've seen lots of patients being referred from elsewhere who actually have no knowledge of how that disease should have been treated but are willing to have a go because of either bravado or there's a financial incentive because if they did something surgical, they're going to get paid for it. And I think that's where PAACS really stands out in that they've grown them quite well and by the end of their training they know exactly what to do. David: Do we know why breast cancer is so common? I know we're a referral center, so I have a skewed sense because that's so much of what we see in Kijabe. Why is it so prevalent? Why is it affecting young people? Do we have answers to those questions? Dayalan: Interestingly, the statistics we have shown that breast cancer is a disease of the developing country. When I was in India, working in rural India and Assam in the last few years, I didn't see very much breast cancer, rural India, villages, not so much. You go to the urban cities in India, it's more common. And similarly, Kijabe seems to get a track because of the reputation we have of having treated breast cancer for a long time. With Peters reputation, we are a referral center for lots of people around the area and so I think Kijabe and Kenya are also going in the direction of the other developing countries where breast cancer is getting more common. And I have a simplistic view to this and I've discussed this with you before in that the things that increase your risk for breast cancer, even though each of them is small, are much more common in the developed countries. Things like the oral contraceptive pill, and hormone replacement treatment, all of these are extraneous estrogens which your body is not used to and taking them increases your risk. Things related to childbirth. Not having children increases your risk.  Having children and the number of children you have is protective. If you have more children, you are more protected against breast cancer. The same way breastfeeding. In the West, there was a huge fad against breastfeeding and using artificial milk.  Breastfeeding is protective in developing countries like India and Kenya. It's a necessity. If you don't breastfeed, it's economically not possible to actually buy powdered milk. And so, it's because of necessity, you have to do it. Everyone breastfed. Each of these is a small risk, but if you add them cumulatively, they become a higher risk. And I think as more countries, the developing countries are getting more developed and getting more Westernized, all of them are following the same trend that we have in the West, and this is increasing the risk. And so, breast cancer is getting more common in developing countries, unlike it was 20 or 30 years ago. David: Wow. This just sounds both sad and scary. Dayalan: It is. Because statistics in the cities in India show that they're almost catching up with the West in terms of prevalence of breast cancer. And it's probably this whole modernization shaping the West and doing all the things that they think the West is doing, which is good. David: I was having a conversation with Rich Davis today about research. The thing that comes to mind is autism. How rare it is for for it to be seen here? Yet in Nairobi, it's much more common each year that goes by. I don't know if your wife has had this experience in anywhere else you travel. Each year that goes by, Arianna sees a few more children [with autism]. And it's I wonder if there are similar factors. I wonder what the correlations are and where it comes from? Dayalan: I think definitely you can. My wife's in the same field, she's a pediatrician also. And there's no doubt that that incidence is increasing. But also, I think we're more aware of conditions that we didn't know 20 years ago. So 20 years ago, autism was just about coming, making it very similar to screening for breast cancer, pre-invasive breast cancer like DCIS, we didn't know these conditions before, but slowly we're getting more. Research helps with that. We've got good screening programs both in the US and in the UK, fantastic breast screening programs, and so we're learning much more as we go along with each intervention that comes about like screening. So I think we're going to see more of it. And the more you see of it, the more you get to know of it and the more you get to know of it, the better it gets for patients and health benefits. David: What would have happened in Kijabe, if you did have breast cancer 20 years ago? There were probably very few chemotherapy options? I guess you could have done a mastectomy, but there was no reconstruction. I mean, was it a death sentence? Dayalan: Almost.  One of the problems we have in Kijabe and in Kenya and the whole I think is patients present much later, as a result of which the prognosis is not going to be as good as countries like yours and mine, where we have good screening programs, we pick it up early. If you take breast cancer in the UK now, two-thirds of the patients are going to be alive and well in 20 years' time. In Kijabe it's going to be a complete opposite statistic, roughly just off the top of my head, where two-thirds would be dead after 20 years. But that's because they present so late. So, yes. We've got much better in the treatment everywhere. And the problem we have is a lot of the new treatments in breast cancer, i.e., chemotherapy.  Monoclonal antibodies unfortunately are very expensive. So while in the UK where you have the NHS, where [cost] doesn't matter, in Kijabe and in Kenya, it's much more difficult to access all of these. But saying that, in the three months that I've been here, patients are being given the same chemotherapy regime that we use in the UK. Thanks to NHIF, thanks to patients' awareness, they're able to access monoclonal antibodies, not to the extent we would in the UK, but definitely, it's available and now we give our patients that treatment, and of course reconstructive surgery has moved on miles. Dayalan: In terms of the treatment options we have, it's increased phenomenally. When I started in the UK 30 years ago, we had one chemotherapy regime for breast cancer. Now we have 20, maybe 30 regimes that we can use - different chemotherapeutic agents and if one fails, you go on to the next and so on and so forth, which we didn't have 20 years ago. I think treatment for breast cancer is really looking up. And with the new mammogram machine, I think one of the big things that we should be looking at is setting up a screening program for the local people because the mammogram machine is not going to be busy with the amount of breast cancer work that we do. So really what we need to be doing is developing a screening program, going out into the community and telling them, come, let's have a look, get some mammograms. Let's pick this up early. If you have a cancer, we'll sort it out for you. 

Scott and Jordy are joined by Keir and Joanna Thelander to discuss Cross-Cultural Leadership. Keir and Joanna spent a decade in the jungle of Gabon, Africa as Keir served as a surgeon. Keir now serves as the Executive Vice President of the Pan-African Academy of Christian Surgeons, and Joanna as the Volunteer Coordinator at Grace Church.

Greg Sund David: [00:00:00] Good afternoon and good evening. We have no idea what time zone you guys will be in when you're watching this, but I am David Shirk. I'm director of Friends of Kijabe, and I'm sitting here with Greg Sund, our newest addition to the Kijabe team. Greg: [00:00:17] We moved here from a small village, rural hospital in Burundi, where we have been for about five years. David: [00:00:26] What was your training and background and specialty in the States before you started doing this Africa stuff? Greg: [00:00:34] So I'm a board-certified anesthesiologist. I did a fellowship in cardiothoracic anesthesia and I was in private practice for several years before we moved to Burundi about five years ago. And during my time in private practice, I was doing annual trips to various places in Africa and kind of prayerfully trying to discern with my wife where God might be calling us to. And we ended up at this hospital in Burundi, which was a teaching hospital, and it was a place where I could not just do anesthesia, but also teach anaesthesia to medical students and nonphysicians.  David: [00:01:22] What was the terminology for them?  Here we call them KRNA, Kenya Registered Nurse Anesthetist. Did you guys have a designation? Greg: [00:01:29] So that's one of the problems, is that the training for nonphysician anaesthetists is variable from country to country. In Africa, there's no continent wide standard. And so in Burundi, they were anesthesia technicians and so they had a bit less training than the Kenyan nurse anesthetists have here. And unfortunately, it's different in every country. And unfortunately, there's still a lot of hospitals in sub-Saharan Africa where the anesthesia is being provided by underqualified and sometimes not even trained providers who are just there to fill in the gaps. David: [00:02:13] And this was the case in Kijabe for a very long time. I want to get into Burundi, I want to hear more about that, because I actually don't know - I know you, and I know some of your colleagues, but I don't know much about the hospital and particularly the medical kind of situation that you guys were facing there before that. Why does somebody who's a private practice anesthesiologist in America walk away from that and move to Africa? Greg: [00:02:42] Yeah, well, ultimately, it was definitely a calling from the Lord that he laid on our hearts after doing frequent trips to Africa. I saw just the massive discrepancy in anesthesia care between what's going on in most of sub-Saharan Africa and what's going on and in the United States. And I was just really convicted that here I have the ability and the capacity to go to a place like Burundi or Kenya and teach anesthesia. And it was something that the Lord laid on my heart and thankfully on my wife's heart as well. David: [00:03:23] That's awesome.  And you guys came out...so you've been doing short travel trips and then you moved for a year in 2013? Greg: [00:03:31] Yeah, it was twenty fourteen. We moved to Burundi for a year and we joined a multi-specialist team that had just settled there a few months earlier that I had met on one of these short-term trips to Tenwek hospital in Kenya in 2010. We heard they were moving there [Burundi]. They had three surgical specialists and the anesthesia care at the time was provided by one non-physician anesthetist with coverage by some, actually, non-trained, providers. Their community health worker, who normally gives vaccines, was taught how to give Ketamine to get people through surgeries and caesarean sections on at nights and on the weekends. They asked me if we would come out for initially for a year to help work with this one non-physician anaesthetist to try to help increase her capacity for what she could do, and during our year there, we realized that there's actually, an anesthetist training program that sends students to this [Kibuye] hospital.  They're actually medical students who had a required anesthesia in critical care rotation and there was no anesthesiologist to teach them. And so we felt like this is where we were called to be for longer than just one year. So we went back to the States to support raise for a year, and then to France for a year for language training, because it's a Francophone country, and then in twenty-seventeen we moved there and we've been there up until just a few months ago. David: [00:05:12] We've had this KRNA program in Kijabe for about a decade [2007]. Officially. I think before that, unofficially. What what is the difference between anesthesiology training for a physician level anesthesiologist versus for nurse-level in Africa? Greg: [00:05:34] In general, nonphysician anaesthetists are there to put the patients to sleep, to monitor them during surgery, to wake them up. Physician anesthesiologists are there to be consultants for more complicated cases, when complications arise at any time during the perioperative period. They are also, typically in Africa, the ones that will be a lot more involved in intensive care medicine, in post-operative pain management, and also in leading and teaching medical students, anaesthetists, students and other other health care specialists that that need some training in anesthesia, critical care and or resuscitation. David: [00:06:31] What's what did ICU care look like in Burundi versus what it looks like somewhere like Kenya?  I know Kenya, we're behind America, but you still walk in to [Kijabe] ICU and we've got real ventilators and usually good oxygen supply, right? Greg: [00:06:49] Yeah, I think in the entire country of Burundi, there are about 12 ICU ventilators, unfortunately, none of them are at the hospital that I worked at. Those are all at the main university teaching hospital in the capital city. And when we arrived, there was no Intensive Care Unit. During my time there, we made a small step forward by designating four surgical beds that we were where we were able to do a little bit more intensive monitoring, nursing surveillance. But it was still a far cry from what you have at Kijabe, and what we're used to in the U.S. David: [00:07:35] What would what you want to see if you were to think five, 10, 15, 20 years out? What would you like to see happen in our region, in East Africa?  You could speak to Burundi or you can...I don't know how familiar you are with other countries?  So answer however you want. Greg: [00:07:57] I would say anesthesia care and critical care in general are very variable right now. And there are a lot of places where anesthesia is simply not safe. Mortality under surgery in sub-Saharan Africa, in general, is twice what it is in the US. And so there needs to be a great deal more invested in training nonphysician anaesthetists, which ultimately needs to be done by physician anesthetists. And that's kind of leading into why we decided to move to Kenya. David: [00:08:34] Awesome. David: [00:08:35] Mark Newton does some sessions here just on training. Training trainers, essentially. That's the that's the vision, right? Greg: [00:08:43] If you're teaching people who are qualified to teach others, that's the Biblical model from the 2 Timothy Chapter 2 - "teach others who will be able to teach others who will be able to teach others." Greg: [00:08:57] And so that's a big part of why we moved here. We saw that what we were doing, training nonphysician anesthesia providers in Burundi and medical students was good work and it was important, but it wasn't sustainable in the long term. And so in Burundi, for example, there are only seven physician anesthesiologists..  [00:09:20] I was the only one working outside the capital city. And so that leaves the vast majority of hospitals without any anesthesia consultants, without somebody who can manage critically-ill patients in an intensive care setting. And so ultimately, during our time in Burundi, I came to realize that Burundi was not alone. There are a lot of other East-African countries where this is the case. [00:09:47] If you look at the numbers, there is a recommendation by the World Federation of Anesthesiologists to have a minimum five physician anesthesiologists per one-hundred-thousand population. David: [00:10:06] How many people are in Burundi? Greg: [00:10:08] So the number in Burundi came out to. . .it was about zero point zero one eight [0.018/100,000], I believe.  It's better in Kenya [1.7/100,000], but it's still far from five per one-hundred-thousand. And so I came to realize over our time in Burundi that sub-Saharan Africa, while it does need more nonphysician anaesthetists, in order to to form and train more nonphysician anesthetists, we have to, at the same time, train physician anesthesiologists. David: [00:10:41] So what has the groundwork looked like for building up to this training program starting? Greg: [00:10:47] There started to be some discussions going on between a small group of us who are anaesthesiologists, who are missionaries in Africa in twenty-seventeen. Three years ago, and most of us had been exposed to or involved in helping to do some anesthesia training with surgeons under the PAACS, which is the Pan African Academy of Christian Surgeons. And so we already had some relational foundation with PAACS programs and the leadership of PAACS. We started talking together as a group about the need to start creating Anesthesiology Physician Anesthetist training program.  It seemed to us logical to try to partner with PAACS. And so, last year at the PAACS board meeting in Chicago, a group of us went and presented the idea of starting an initial, anesthesiology residency program under the umbrella of PAACS to their board. It was received favorably and they agreed to allow us to start this initial program in January twenty-twenty-one here in Kijabe. David: [00:12:06] Awesome. David: [00:12:07] And what has to what has to fall in place for things to kick off in January? I assume there's a few things. Greg: [00:12:16] Thankfully we have now three board certified physician anesthesiologists that will be serving here myself, Dr. Roger Barnette and Dr. Mark Newton. Both of them have been here already previously for several years. So that's the first piece. And we can check that one off. The second piece is we do need funding to support this program. To train each resident costs about twenty-five-thousand dollars a year per resident. Greg: [00:12:53] Our plan is to start with two residents and build up from there. And so we are currently in the support raising phase of this. David: [00:13:03] How long is the program? Is it three years? Greg: [00:13:05] Yes. So, all of our, anesthesiology residents will have done one a one year internship that might be done in Kijabe. It might be done elsewhere. But once they're once they've completed that, it will be three years of anesthesia and critical care training also. David: [00:13:26] That means total sort of three years. So seventy-five-thousand dollars per resident to get through the entire program. Greg: [00:13:36] The other thing you know, once that piece falls into place, the next thing we need to do is recruit our first two residents. The announcement that we would be starting this program was just sent out three weeks ago. Within a week we had over one hundred inquiries and within a week later, we had over 30 applications already submitted. We're currently, the the anesthesiology council under PAACS, is currently in the process of going through those applications,to find who will be our first two residents. David: [00:14:15] It's exciting. Yeah, it is really, really cool. It's been a dream long, long coming. David: [00:14:22] And then the other side of this, I assume that these guys will do have a bond service bond similar to how the surgeons do so, where the surgeons, if they come under PAACS, they're obligated to work the same number of years at a Christian Mission Hospital. Is that the same? Greg: [00:14:41] So that's our plan. And that's the model. Greg: [00:14:45] A big reason for that is because typically it is the rural areas that are that are underserved, both in terms of surgeons and anesthesiologists. And so, we're really looking to to recruit and train people who are going to go to those hard places and live in those rural areas where, you know, unfortunately, their salaries might not be as high as they would be in the city. And, their lifestyle is going to be very different. So, it's definitely a calling from the Lord, because they're going to have to give up a lot of the lifestyle that they might have in the bigger cities. Greg: [00:15:23] So that is our plan, to recruit residents who are who want to do that,  are willing to serve in rural mission hospitals after their training is done. David: [00:15:37] It might be worth explaining, because I'm sure some people will not be familiar with terms like missionary.  If somebody is not familiar with how the structure works, missionary might sound like an odd or archaic word. But but it's important to set up like what the need is because it gives a framework for what somebody like you or Roger Barnette or Mark Newton, how your life looks logistically, and why we need people to help with this training program. So what does it mean to be a missionary and how does that process work for you being here? Greg: [00:16:24] Wow, that's a that's a big question. David: [00:16:27] I mean, more practically than theologically, it's somebody who is sent by God. I felt a you talked a little about that in the beginning, as a spiritual call from God. This is your purpose. This is what you feel like you're being led toward in your life. But then what does that what does it look like practically after that? Greg: [00:16:49] I think those of us who are doing this feel called to to go to places where we can minister to the needs of people, both physically and spiritually. And so, you know, we're not just here to teach anesthesia. I'm not just here to teach anaesthesia, but also to to to disciple and to try and deepen my students, my residents, and hopefully my patients, to the understanding of who Jesus is, what he's done for me and and and the world, and point them to the hope that we have in him. Greg: [00:17:28] Logistically speaking, those of us who are missionaries working in medicine outside of the U.S., typically that means that we give up our salaries and we have to live off the support of others. So for all of us, we have a team of supporters in the U.S. Who give some give once a year, some give monthly, to meet all of our the expenses that that we have our living expenses and that allow us to be here and do this work. So for a lot of us that's going to be churches in the US or individual families. But that's really the only way that we can be here and continue to do this work. Greg: [00:18:17] Then that financial support goes through our mission agency. We are here under mission agencies who also care for us, who keep an eye on us, who help us logistically with all the particularities that come with living in rural Africa, which we can't be here doing what we're doing without them either. David: [00:18:42] I think this is helpful for people to understand the framework and complexity because we've talked about several organizations, and I don't want anybody's heads to get muddled over by this. But it's just important to know that it takes multiple organizations to make these things happen. So, they have their different roles. Your mission agency is Serge. But we've got PAACS, who's the overseeing body for the for these [training] programs. And we've got COSECSA, the College of Surgeons of East, Central, and Southern Africa, who's the accrediting body for the thing. And then we've got the little organization out of all of them, Friends of Kijabe, which is our nonprofit just dedicated to Kijabe Hospital.  David: [00:19:31] You have a great question of "Why, David, why are you doing this? What's your role in this process?  Why would funds come to Friends of Kijabe instead of PAACS?" David: [00:19:42] The short answer is ultimately funds are going to both. But Friends of Kijabe, we have connections with people who pass through here over time. And Kijabe Hospital has been around for 100 years. I think we're...2020...we just turned one-hundred and five [105] in May. So there's just a deep, deep network of people who care. And ultimately, this is why I think Kijabe is a cool place, is because we get to be part of these training programs that affect not just this one place, but affect the entire region. So for me personally, my role is just to help you guys amplify your message with the people we already have connected. And so that's our hope with Friends of Kijabe - essentially as money comes into Friends of Kijabe, a portion goes to PAACS for the education resources and a portion ends up at Kijabe Hospital. And we will just, really, follow the Anesthesia Council's instructions on where to write the check.  The biggest involvement of Friends of Kijabe, though, is the storytelling and connecting donors and just helping, hopefully, in that process. Greg: [00:21:03] Yeah, we're really grateful for friends of Kijabe. As I mentioned, the need to raise twenty-five thousand dollars a year per resident to us is a big part of this. And we are, as an Anesthesia Council, not really equipped to to do that. And so we were really grateful David and Friends of Kijabe agreed to help us with that with that arm of this program, as these guys are amazing. David: [00:21:34] You know, I spent a lot of time with Roger Barnette over the years, a lot of time with Mark Newton, and what they do for our countries, Kenya and Burundi, and for these parts of the region, and for our world, these guys are amazing.  For you [listening] as potential volunteers, once the world returns to normal, you will be really, really valuable. I know there's some people probably watching this. Joleen has been here. Usually, every summer she will come over for a month. I believe Liz Drum has been here before. Matt Kynes, we're hoping to get him here for a longer term basis, but he's been here, pretty regularly, teaching. And I know Roger Barnette has had some folks over from Temple and Mark Newton has brought folks from Vanderbilt.  Those connections are also really, really, really important.So if you're watching [or listening to] this, I know for some of you it may be possible on a regular schedule, and for some of you and may be less frequent, but it is a huge, huge, huge help for the people doing this [anesthesiology] on a daily basis, to either give them an extra hand, or give them a week or two off, where they can recover and get back into the fray. So definitely, as if you're watching this, keep that [a volunteer visit] in the back of your mind. David: [00:22:54] Also, how you can participate?  There's really three ways of really participating. You know, there's the financial component, there's the volunteer component, and then there's making connections with with colleagues that you may have around the States or around the world.Anything you would add to that? Greg: [00:23:19] No, I would second everything you just said. And yeah, I would encourage any anesthesiologist out there who's watching this, to come see for yourself. Kijabe is a really special place. A big part of the reason why we're able to start this program is because Kijabe is a place where we do get short-term volunteers who come and help and teach and give the long term folks a break. And it also is great because it gives the students a different perspective, because everybody who comes has something different to teach different areas of expertise, different experiences to share. And and all that, I think, is what's going to make this program so rich. David: [00:24:04] For me, this is really exciting because I've come in with my wife, Arianna, a pediatric emergency medicine doctor. We've been in Kijabe almost seven years now. When we came, we would hear legends, honestly, about these people who started these programs and how they came to be. So for me, just looking at this, this is just amazing. This is something that one hundred years from now, people are going to look back on and think, "Wow, this started there in this specific place with these people." Greg: [00:24:41] Thank you, David. Appreciate all that time and all your help. So it's exciting. David: [00:24:46] And so for all you guys out there who might be watching [or listening to] this, thank you in advance for however you are able to join us in making this making this dream of better quality, more accessible, more affordable health care a reality for people everywhere in the world. So thank you. Thank you.

Don't miss a single podcast of CMDA Matters. You can subscribe through iTunes or GooglePlay, download our free CMDA app and or listen on our website at www.cmda.org/cmdamatters. This weekly podcast hosted by Dr. Mike Chupp features one interview with brief news and announcements that matter to you. Today's interview is with Dr. Thomas Robey, the chair of the Pan-African Academy of Christian Surgeons. We hope you will find this interview inspiring as he discusses with Dr. Mike Chupp the history of PAACS, including the critical role CMDA played in its mission and growth to train and disciple African surgeons.

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.

The Pan-African Academy of Christian Surgeons is a five-year surgical residency program to train 100 Christian African doctors in mission hospitals by 2020. At the present, there are sixty-four residents being trained in nine countries. A great need exists for long and short term general surgeons and sub-specialists to participate. In addition, there is a spiritual curriculum to prepare each resident for spiritual growth and hospital leadership.

Medical doctor Bruce Steffes tells of his calling to help train doctors in Africa through the Pan African Academy of Christian Surgeons, a ministry which has been impacted by the Ebola epidemic.

Medical doctor Bruce Steffes tells of his calling to help train doctors in Africa through the Pan African Academy of Christian Surgeons, a ministry which has been impacted by the Ebola epidemic.

Harold Paul Adolph was born in China to an American medical missionary physician and wife servingwith China Inland Mission. Dr. Adolph received his M.D. in 1958 from the University Of PennsylvaniaCollege Of Medicine, completed a general surgery residency in the Canal Zone of Panama and thenserved one term in the Navy. In 1966 h and his wife Bonnie with their two children moved to Ethiopia asmissionaries with SIM, Int.He and his family have experienced just about everything you could imagine in their lives of servicein medical missions. Dr. Adolph has authored 5 books with the latest entitled “Today’s Decision –Tomorrow’s Destiny”. After retiring the Adolphs envisioned building a new hospital in SouthernEthiopia! Today this hospital is part of the Pan-African College of Christian Surgeons, an outstandingprogram for the training of Christian African doctors as surgeons for service in mission hospitals.Though his career, Dr. Adolph has become an amazing teller of the stories of medical missions. Thissession will be informal and will be moderated by Dr. Daniel Tolan, Associate Director of CMDA’s Centerfor Medical Missions.This will be an informal session in which questions may be asked and stories will give the answer.

The Pan-African Academy
of Christian Surgeons is a general surgery residency for African national physicians. Founded in 1997, it presently is training 35 residents and has graduated 20 fully trained surgeons. The lessons learned and applicability to similar programs in Africa will be discussed.

Bruce Steffes, MD shares about the Pan African Academy of Christian Surgeons

Is it possible to do true academic style residency training at mission hospitals in developing countries? Does the lack of resources and scarcity of mentors result in inferior training and therefore inadequately trained graduates? What governmental or regulatory bodies are involved in non-university based training programs in the developing world? Do short term visiting faculty really make a difference? How can spiritual discipleship be woven into medical and surgical residency training? During this breakout session, Dr. Carol Spears (missionary surgeon and Assistant Program Director at Tenwek Hospital in Kenya) and Dr. Agneta Odera (Kenyan physician in her third year of General Surgery Residency Training at Tenwek) will share their experiences in starting and developing a General Surgery Training Program in partnership with the Pan African Academy of Christian Surgeons. They will share their own stories of challenges, mistakes, areas of ongoing deficiency, as well as helpful hints, blessings, and personal stories. The goal of this session is to provide a minimal set of requirements needed for a successful residency training program and to provide information on resources available to assist new programs. The approach of training others to then go and train others models the example Jesus established in his ministry on earth.