Dear Friends of PAACS:

Transcription

1 Dear Friends of PAACS: Merry Christmas to you all and may God richly bless you in the New Year! December has been a busy month 10 new COSECSA fellows within the PAACS Family, 5 surgeons graduating from their programs of study (including the first diplomate in Egypt), all seasoned by reunions and transitions. Additionally, applications for the next pediatric surgery trainee are being taken. Please consider a year-end gift to PAACS in doing so, you are investing in young people within God s kingdom and the investment comes with eternal dividends! The Editors The Pan-African Academy of Christian Surgeons (PAACS) BULLETIN #150 December, 2016 Changing the spiritual and physical health of a continent Our vision: PAACS trained surgeons living the gospel and ministering to the sick. Our Mission: PAACS exists to train and disciple African surgeons to glorify God and to provide excellent, compassionate care to those most in need. Our goal: To train and disciple 100 African surgeons by Harpur Memorial Residents with Dr. Todd Lavery A Ministry of Christian Medical & Dental Associations 1

2 IN THIS NEWSLETTER From the Executive Director Pomp and Circumstance Comes to Egypt Four New Surgeons at Kijabe Hospital COSECSA Exam Results Pediatric Surgery Reunion Pediatric Surgery Training Position Taking Applications Some Closing Thoughts News Shorts Humanitarian Surgeon Course Offered Announcements Fellowship, Graduation and Married All in One Week Prayer Guide Available End of Year Donations New CMDA App for Your Smartphone and Tablet Prayer Requests FROM THE EXECUTIVE DIRECTOR Dear PAACS Family: As we end another year, I have been reflecting on God s faithfulness to PAACS in I put together a list of all that God has done for this organization and there is much for which we should be grateful. It is with a heart of gratitude that I say a thank you prayer to our Heavenly Father for His goodness, faithfulness and provision to PAACS over the past year and throughout the years. Thank you, Father, for establishing 12 PAACS surgical training programs in 8 African countries. Thank you for helping us to train 67 surgical residents in Thank you also for graduating 63 surgeons over the past 20 years who are now serving your precious children in 18 countries throughout the continent. Thank you for the PAACS long-term faculty that faithfully taught and mentored our residents and for the many short-term visiting faculty members that served freely at our PAACS training sites. Thank you, Father, for our surgical residents who have a heart to serve you and your people and for using these residents to pour out your love and care on their patients. Thank you also for bringing many of your people in Africa to the knowledge of Jesus Christ through the work and love of our PAACS faculty and residents. As he transitions to a new phase in life in 2017, thank you, Father, for the 11 years of service that Dr. Bruce Steffes devoted to PAACS and for all that you used him to accomplish for this organization. Thank you for each of the PAACS administration that faithfully served this organization in 2016 and for the many volunteers who led PAACS through their role on the Commission or on the Surgical or Advisory Councils. Thank you also for the PAACS family, who encouraged, financially supported and prayed for our organization. Thank you Heavenly Father for your many blessings upon PAACS. We are truly grateful to you for every kindness and love you poured out upon PAACS. As we celebrate the gift of another year, we are most grateful for the blessing of your Son Jesus Christ. With a heart of gratitude, Susan Koshy, Executive Director A Ministry of Christian Medical & Dental Associations 2

3 POMP AND CIRCUMSTANCE COMES TO EGYPT By Dave Thompson [Editor s Note: At his graduation, Shady Fayik Foad Ekladious became the 52 nd surgeon to receive a PAACS diploma but the first from the land of Egypt to do so. He will be joining the faculty at Harpur Memorial Hospital in preparation for the retirement of Thompson and Hanna in 2018.] Thelander, Steffes, Shady (with diploma), Hanna and Thompson pose for photos. After years of preparation, countless hours in operating rooms, conference rooms, wards, and surgery clinics and months of planning, the moment we had all had labored for at Harpur Memorial Hospital had finally come. A crowd of family and friends sat quietly on white, covered chairs or chatted in groups in the back of the decorated hall. Most of them watched a slide show on the screen in front about PAACS-Egypt and waited for the ceremony to begin. A procession of smartly dressed junior residents, gloriously robed faculty members, the graduate, and hospital and Anglican Church leaders quietly formed outside the open back door to the hall. A photographer and a videographer began filming. Some in the crowd noticed what was happening at the back door and came out to snap photos. Just then the MC asked everyone to stand, and the music of Pomp and Circumstance began to play. The residents, followed by the graduate and the faculty marched into the hall as the music swelled to a crescendo. When the graduate marched into view the crowd burst into happy applause. The first PAACS graduation ceremony in Egypt was finally underway, and I could barely keep from dancing! The ceremony was part of a celebration for our first graduate in Egypt, Dr. Shady Fayik. Dr. Shady (Shady rhymes with laddie) grew up in the city of Assyut in upper Egypt (southern Egypt). He studied medicine at Assyut University and then moved to Cairo and successfully completed a three-year residency in general surgery at Ain Shams University. When he began his training with PAACS in January, 2014, he was already a fully licensed surgeon. Dr. Shady joined PAACS because he did not feel he was ready to operate on live patients. Because of his previous training he was able to begin training with us at the 3 rd level. Now three years later, he was graduating. His wife Rania and the couple s 3-year-old daughter, parents, and 13 other family members were present to celebrate with him. So was his younger brother, John Fayik who, like his older brother, was fully licensed but knew he was unprepared. John has been accepted into the PAACS program at Harpur and will begin his training in January, Once the procession was over and we were seated on the stage, Bishop Mouneer Anis, the Anglican Archbishop of Egypt, North Africa, Jerusalem, and the Horn of Africa, stood up and gave the commencement address. Bishop Mouneer has a special attachment to Harpur Memorial Hospital because before becoming a priest he was a gastroenterologist and served as the Director of the hospital for more than 25 years. It was the Bishop who in A Ministry of Christian Medical & Dental Associations 3

4 2012 invited PAACS to establish a training program at Harpur so Egyptian doctors could be fully trained without leaving the country and could serve in Egypt s Christian hospitals. The bishop s commencement address is worth repeating. He retold Jesus s parable of the Master who gave talents to each of his three servants before going on a long trip. The bishop pointed out that the three servants did not earn their talents. The Master gave them the talents to invest for him. The bishop told how years ago he went to Pakistan on a mission trip and worked with an 80-year-old American doctor. The doctor s clinic was in a bamboo shack in the middle of a courtyard. The patient s he treated could only afford to pay 5 cents to see him, and whenever a patient needed an X-ray that cost more than he could pay the doctor would pay for it! Next to the courtyard there was a large and beautiful villa that looked like a castle. When he asked who lived there he was told it was owned by a wealthy and well-known Pakistani physician who spent most of his time abroad. Unlike the 80-year-old missionary who treated the poor and even paid for their X-rays, the wealthy physician was using his talents and abilities for himself. The bishop ended by challenging Dr. Shady to use the gifts given to him by PAACS to serve Jesus and others. The head of the City Council of Menouf spoke next, followed by Dr. Bruce Steffes, Dr. Keir Thelander, and Dr. Todd Lavery (a young surgeon who is planning to join the PAACS team at Harpur in 2017). Dr. Sherif Hanna, the Assistant PAACS Program Director at Harpur also spoke. He quoted Sir Richard Sydenham s four famous reminders to physicians and presented Dr. Shady with a framed copy of it, reproduced below: "It becomes every man who purposes to give himself to the care of others to seriously to consider the four following things: o o o o First, that he must one day give an account to the Supreme Judge of all the lives entrusted to his care. Secondly, in that all his skill, and knowledge, and energy have been given to him by God, so they should be exercised for his glory and the good of mankind, and not for mere gain or ambition. Thirdly, and not more beautifully than truly, let him reflect that he has undertaken the care of no mean creature, for in order that he may estimate the value and the greatness of the human race, the only begotten Son of God became himself a man and thus ennobled it with his divine dignity, and far more than this, died to redeem it. And fourthly, that the doctor being himself a mortal man, should be diligent and tender in relieving his suffering patients, inasmuch as he himself must one day be a like sufferer." After the presentation of the annual certificates to the junior residents and to Dr. Shady the Diploma for Competency in General Surgery from PAACS and Loma Linda University, it was Dr. Shady s turn to respond. He expressed his gratitude to God for his training, to his teachers for their devotion, to his parents for their love and support, and especially to his wife, Ranya, for encouraging him to apply. She supported his decision to join PAACS even though it meant she would have to give up her job as an engineer, move away from her family to Menouf, and be a fulltime wife and mother while he completed his training. Dr. Shady thanked her directly and with deep emotion. When she wiped tears from her eyes, many of who saw it started wiping tears from our eyes too! This was a moment I will always cherish, and it reminded me that there are many more wives of PAACS residents who are making similar sacrifices for their husbands and families. They do not receive diplomas when their husband s achievements, but they deserve equal congratulations Shady and Ranya A Ministry of Christian Medical & Dental Associations 4

5 and recognition from us. In his remarks to the overflowing crowd, Dr. Shady thanked his professors and PAACS for this opportunity: Actually, before joining PAACS, I had a long history of struggle in my career as a surgeon, as I was trained in a very disorganized way, and sometimes by unqualified surgeons, who were not keen to give all the knowledge and experience, as they consider knowledge as power, and they were not ready to lose their power. But, thanks to God, I heard about PAACS. I was dreaming of such a program which is well organized and under supervision of fully dedicated persons to teach the residents the American and Canadian standard of learning. I have to admit that this changed my life and my surgical practice, I've learned so much about so much. I have the privilege to be taught under such a great surgeons and teachers who gave all their knowledge, time, effort and skills to me. They taught us how to take care of the patient out of our love to God, and how to be faithful in dealing with the patients accepting all patients regardless of their differences. They taught us also how to be good and talented surgeons dealing with the difficult patients. They taught us how to read and search to enlarge our knowledge. I can't forget all these days and nights that we spent together working, operating, reading, examining, taking quizzes and praying. When it was my turn to speak, I explained why the footwashing ceremony has become an important part of many PAACS graduations. I recounted the story of how Jesus, knowing that he came from God and would return to God, took off his robe, wrapped himself in a towel, and washed the feet of his disciples. He then told them to follow his example and wash each other s feet. After explaining this, I took off my robes and cap and washed Dr. Shady s feet. For most of those attending this was a first; perhaps a quarter of the invited guests stepped into the aisles or went to the front to take pictures. I think it s safe to say that no one present missed the clear message that God is calling Shady, his wife Ranya, and the rest of us to a life of faith, service, and humility. As we marched triumphantly out of the hall to the music of Pomp and Circumstance, a bevy of lovely Egyptian women waiting at the back made it even better by ululating in celebration! There followed the usual frenzy of hugs, kisses on both cheeks, and photos. After a stroll to the main hospital Dave Thompson washes the feet of Egypt s new graduate, Shady Fayik, as Thelander, Steffes and Hanna look on in approval. building and an elevator ride to the fourth floor, guests were welcomed to a lovely reception on the roof of the main hospital building. A beautiful tent decorated with Egyptian motifs provided shade and more than 70 guests enjoyed a favorite Egyptian meal of barbecued chicken, stuffed zucchinis and green peppers, and flatbread dipped in tahini. Three kilograms of honeyed Egyptian sweets perfected the meal. Some might ask, Why go to all this trouble and expense for one graduate? Why spend good money on it every year? The total bill for our ceremony and reception came to $450 and was gladly shared by PAACS and the A Ministry of Christian Medical & Dental Associations 5

6 Harpur Memorial Hospital. I have attended many PAACS graduation ceremonies over the years, and these are my answers to these questions: 1. Graduation celebrations honor our graduates and our residents for their sacrifices and hard work and motivate other younger physicians to join their ranks. They also bring honor and meaning to the sacrifices their families have made and make public the role of the PAACS faculty in training and mentoring future surgeons. 2. Graduations give value to the contributions the hospital staff and employees make during the years of a graduate s training. For everyone who works in the hospital be it the lowliest yardman or the Director of the Hospital graduations are powerful reminders that it is our work together, relying on each other, that helps us achieve these lofty goals. They also prompt us to express our gratitude to the hospitals and their employees for making our training programs possible. 3. Graduations promote PAACS in the best possible way, showing off our professionalism, our love for Jesus, and our passion for humility and service. They are yearly opportunities for PAACS to grow in value in the eyes of our residents, our hospitals, our communities, and our city and state officials. 4. Finally, graduations are celebrations that give us the opportunity to openly and publicly thank God and worship Him for what He has done. Jesus said in John 15:5: I am the vine, you are the branches. If you remain in me and I in you, you will bear much fruit; apart from me you can do nothing. If this is true, then God is the reason for our success in training the skilled and compassionate surgeons that we graduate. These celebrations are our moment to publicly and joyously give God the glory and honor He deserves! FOUR NEW SURGEONS AT KIJABE HOSPITAL By Tim Berg, Wayne Koch & Erik Hansen For Beryl Akinyi Ooro and Mark Waithaka Mwangi, the years of hard work and dedication culminated in a celebration at Kijabe Hospital December 12, 2016 at 1:30 in the afternoon. Early afternoon sunlight brilliantly illuminated the gathering of family, friends and colleagues under tall Jacaranda trees on the campus of Moffat Bible College. As the guests arrived and joined together outside, the atmosphere became one filled with smiles and laughter as stories were shared and introductions made. The warmth and intimacy was made especially personal by the attendance of so L to R: Tim Berg, Beryl Akinyi Ooro, Rich Davis, Mark Waithaka Mwangi many close family members who had traveled a long distance to be present. Anticipation of the celebration heightened as the smell of hot food filled the air outside of the Library Hall. Dr. John Tarpley s heartfelt prayer blessed the feast and all the participants and set a momentous tone. A Ministry of Christian Medical & Dental Associations 6

7 The Library was transformed into banquet hall with fresh flowers adorning the tables and the large windows allowing a bright and festive occasion. Plates heaping with hot fare from Mama Chiku s kitchen indulged everyone s appetites as guests continued to stream in. As the meals were finishing, conversations hushed as the guests of honor were seated in the front and opening remarks were made by Dr. Rich Davis, Kijabe General Surgery Program Director. On this occasion, the first Guest of Honor was Dr. Chege Macharia, who had just finished the inaugural one-year PAACS Head and Neck Fellowship. Chege finished Kijabe General Surgery training the year before and the majority of his training was at Mbingo Baptist Hospital in Cameroon. This successful training provides sub Saharan Africa with only the 10th surgeon to have received subspecialty training for the management and care of individuals with tumors of the mouth, throat, salivary glands and neck. Dr. Macharia returned to Kijabe AIC to join the PAACS faculty there as the first full-time PAACS H&N surgeon. Dr. Wayne Koch presents the certificate to Dr. Chege Macharia Dr. Macharia worked under the tutelage of over 10 North American Head and Neck surgeons during his training. Under their direction he performed over 300 major cases including sufficient numbers of key indicator procedures such as total laryngectomy, neck dissection, maxillectomy, mandibulectomy, parotidectomy, and flap reconstruction. Already an excellent surgeon at the completion of his general surgery residency at Kijabe, the faculty of the H&N fellowship program judge that he is prepared to complete these and related procedures independently and to teach PAACS residents, raising the level of care and training at Kijabe. Head and neck surgery is a technically intensive specialty which cares for individuals with tumors and other conditions that have both life and vital function-threatening impact. PAACS looks forward to continuing the training of one fellow each year, continuing next with Dr. Mesele Bogale Mekuria of Ethiopia who will begin at Mbingo in mid-january. Dr. Wayne Koch, present Chair of the PAACS Commission and under whose leadership the Head and Neck Program was birthed, spoke to the crowd about Chege, Dr. Macharia was an ideal first H&N fellow for the PAACS program. His spiritual and clinical maturity combined with his well-established connection with PAACS helped him to "hit the ground running" last January upon arrival at Mbingo. He was able to benefit from expertise of each of the rotating faculty. After Dr. Koch was finished, Dr. Davis began by giving a brief history of the PAACS program at Kijabe. He then recalled the particular history of how the two new general surgeons were originally chosen. He stated how proud everyone was of the professional and personal development and maturity of both Beryl and Mark. Assistant Program Director Dr. Tim Berg then encouraged Beryl not only in her academic achievement but in her upcoming marriage later in this very week (to take place in Cameroon). The particular verse given her was from 2 Peter 1:3, His divine power has given us everything we need for a godly life through our knowledge of him who called us by his own glory and goodness. Concluding Beryl was presented with her diploma to a round of applause. Dr. Akinyi will return as a consultant surgeon at Kijabe Hospital next year and will be part of the newly formed Breast Unit. A Ministry of Christian Medical & Dental Associations 7

8 Regarding Mark, Dr. Davis recalled some special traits that he appreciated the most and then reminded everyone of Mark s achievement when he received the highest score on the FCS exam the week before. Dr. Berg encouraged Mark with a reminder of how God had provided for his exam preparation by having a difficult patient the week preceding which happened to be the subject of part of his examination. The particular verse given to encourage Mark was Mark 5:15, Neither do people light a lamp and put it under a bowl. Instead they put it on its stand, and it gives light to everyone in the house. Dr. Davis presented Mark s diploma to rounds of applause. Dr. Waithaka will join Dr. Bill Rhodes at Kapsowar Hospital next year. Beryl, Mark and Chege each then took turns to share their comments in response. Despite their usually measured demeanors, emotions poured forth and touching tributes were made especially to family and mentors. Beryl recalled how she had opportunities to study elsewhere but chose PAACS Kijabe because she wanted the mentorship offered there. She expressed how much that has meant to her and gave particular thanks to her consultants for how they had given themselves to her development. Mark also cited the examples of the surgeons he worked with that showed him how to be a good father and husband as well as a good surgeon. He emphasized the importance of his wife s support and recognized her. Mark gave all the glory he received for his recent award to God, stating how overwhelmed he was with how it had all turned out. Finally, Chege gave tribute to his mentor, Dr. Koch, his family and wife but closed with an emphasis on the achievements of Beryl and Mark with whom he had worked so closely these last several years. After Dr. Davis closed the meeting with prayer, everyone slowly filtered outside into the cooling afternoon air, savoring goodbyes, taking photographs, and enjoying the delicious cakes baked especially for the occasion by Dr. Davis s wife Stacy. At the same hospital a few days later, on Dec 16, they celebrated Dr. Edmond Ntaganda s graduation from the Pediatric Surgery training program at AIC-Kijabe Hospital/BethanyKids as well as his passing of COSECSA s FCS exams in the specialty. Dr. Ntaganda graduated as the 7 th Pediatric Surgery Fellow of the program and was joined during the graduation ceremony by his wife, Francine, as he received his PAACS/Loma Linda Certificate. Erik Hansen, his Program Director, writes, We are extremely proud of Edmond and look forward to being even a small part of the work that he will do in his home country of Rwanda as the only Rwandan pediatric surgeon in his country. Congratulations to Edmond, his wife, Francine, and his children Keren and Dan Gabriel. Dr. Edmond Ntaganda, his wife Francine and Program Director Erik Hansen A Ministry of Christian Medical & Dental Associations 8

9 COSECSA EXAM RESULTS Dr. Ntaganda (with certificate) surrounded by family, friends and attending staff. In the oldest city of Kenya, Mombasa, the surgeons and trainees of COSECSA met to give the Membership level exams on December 5 and the Fellowship level on December 6. A record number of trainees were scheduled to take the two exams. There were overall a total of 102 Examinees (both MCS and FCS). PAACS faculty participating in the exam included Bruce Steffes, Keir Thelander, Douglas Lundy, Adrian Park, Erik Hansen, Dan Poenaru, Dan Galat, Jim Brown, Tim Nunn and Rick Gardner. Dr. Russ White, in his role as Kenyan representative to COSECSA, helped run both portions of the exam and with Michael Mwachiro, organized the scientific portion of the conference to follow. In general surgery, there were 46 MCS candidates and 29 FCS candidates. Of the 46 MCS candidates, PAACS had furnished 14 of them for the MCS (30.4%) 11 first time and 3 redo candidates. Our successful candidates included Sam Fabiano, Dieudonne Lemfuka from Bongolo; Samy Nigo Lemery and Akanyun Sama from Mbingo; Chala Regassa Hunde from Soddo; Kenneth Shinga from Kijabe; Ian Orwa and Patricia Chesang from Tenwek; Juvenal Musavuli from Galmi; and Ben Harrison Lyimo and Mugisha Nkoronko from ALMC in Tanzania. Alliance Niyukuri (Bongolo), Ben Malikidogo (Graduate of Mbingo), and Yamikani Limbe (ALMC) also passed their retake of the MCS Oral exam. The next day at the Coast General Hospital in downtown Mombasa, there were seven (of eight candidates) who successfully passed the FCS oral exam. PAACS 87.5% was close to the overall passage rate for general surgery residents of 89.7%. Elizabeth Okemwa Mwachiro, Seno Ivan Saruni, John Kanyi Kabaiku were from Tenwek. Mark Waithaka Mwangi and Beryl Akinyi Ooro were from Kijabe Hospital. Anatole Nzanzu from Bongolo resat the exam. Ron Tubasiime from Rwanda also passed. Moges Molu, who had trained for part of his residence at Soddo, passed in General Surgery. Additionally, three PAACS faculty members (Zach and Jen O'Connor in general surgery and Dylan Nugent in orthopedics) were made fellows by examination. Two surgeons (Keir Thelander and Jim Brown) were made fellows by election. Mark Waithaka Mwangi from Kijabe Hospital received the top prize in general surgery. Previous top prizes in various categories have been won by PAACS trainees in 2009 and each year since The top FCS in general surgery has been won by PAACS trainees every year since A Ministry of Christian Medical & Dental Associations 9

10 Thelander, Okemwa, Ntaganda, Kabaiku, Tubasiime, Ooro, Nzanzu, Mwangi, Saruni and Brown celebrate their induction as fellows. The O Connors and Dylan Nugent were not available for the photo. Group photo of all new fellows in COSECSA 2016 A Ministry of Christian Medical & Dental Associations 10

11 Prof. Eric Borgstein, COSECSA President Milliard Derbew and COSECSA Vice-Present Pankaj Jani flank Mark Waithaka Mwangi with his award. Incoming PAACS CMO Keir Thelander, outgoing CMO Bruce Steffes and Mbingo Program Director Jim Brown mark the fellowship by election of Thelander and Brown. In the specialty arena, Edmond Ntaganda from Kijabe passed the FCS in Pediatric Surgery. A previous PAACS graduate, Ighohwo Etuh, also received his fellowship in plastic surgery after training at Mulago Hospital in Kampala, Uganda. Keeping up a tradition at each set of exams, all the PAACS faculty and residents attended a buffet dinner on Monday, December 5. It was time of rejoicing for the MCS who had finished and passed their exam but a time of some anxiety for the FCS candidates who would be examined on the morrow. Will Copeland, the new neurosurgeon at Tenwek Hospital, also attended the dinner. At the College committee meetings preceding the conference, COSECSA also accepted Sudan and Namibia as the latest additions to the countries of COSECSA which now total twelve in number. PAACS had requested a non-voting seat on the Governing Council of PAACS but were denied this. However, PAACS was pleased to be offered a seat on the Examination and Credentialing Committee. The following papers by PAACS personnel were presented during the scientific session. John Kanyi Kabaiku. Management of Chronic Subdural Hematoma by General Surgeons with Burr Hole Craniostomy in a Rural Hospital: Tenwek Experience. Elizabeth Okemwa. Institutional Review of Mechanically Ventilated Patients in a Rural Hospital Set-up in Kenya. A Ministry of Christian Medical & Dental Associations 11

12 Agneta Odera & Russ White. Open Heart Surgery at Tenwek Hospital: An Audit on the 10 year Experience in a Rural Based Hospital, Western Kenya Rick Garner. Management of Neglected Traumatic Hip Dislocation in Children Ian Orwa. Outcome of Surgical Management for Potts Disease in a Rural Kenyan Hospital: A Retrospective Case Series. Michael Mwachiro. Addressing Post-operative Pain Using Self-Reporting via the Jerry Can Pain Scale at Tenwek Hospital. Seno Saruni, Mark Oloo and L. Rere. Nifedipine Ointment Outcomes for Chronic Anal Fissure Treatment in a Rural Kenyan Hospital. Fridah Bosire. Ultrasound Guided Needle Aspirations in the Management of Breast Abscesses: A Retrospective Review in Tenwek Hospital. Erik Hansen. Sacrococcygeal Teratoma: A Single-Center Experience in East Africa. Agneta Odera. Case Report: Rare Case of Pericardial Hydatid with Cardiac Tamponade. COSECSA examiners from many African countries, the UK and N. America relax before the exam. A Ministry of Christian Medical & Dental Associations 12

13 PEDIATRIC SURGERY REUNION The inaugural PAACS BethanyKids Pediatric Surgical Retreat was held between Nov. 28 and Dec. 2, 2016 in Kijabe, Kenya. It brought together 4 pediatric surgical graduates of the Kijabe program from 4 countries (Drs. Heuric - Madagascar, Frehun - Ethiopia, Martin Uganda, and Lebbie Sierra Leone) and 3 current fellows (Edmond Ntaganda Rwanda, George Ngock Cameroon, and Sr. Masenga Tanzania), with their program Front (L to R): Byron Wheaton, Aiah Lebbie, Heuric Rakotomalala, Frehun Ayele, Sister Alicia director, a visiting Masenga, Malcolm Robinson. Back row: Justus Marete, Fred Rescorla, Martin Situma, Erik surgeon (Fred Rescorla Hansen, Mike Ganey, George Ngock, Edmund Ntaganda, Dan Poenaru US), the BethanyKids team, and the pediatric surgeon at Tenwek (Mike Ganey). Over 4 days, the group had a chance to learn / update on pediatric surgical topics (like congenital lung lesions and fetal surgery), discuss what discipleship looks like in surgical training and practice, and share ethical dilemmas, tough cases, and personal experiences in each country. There was also music worship, devotionals, and lots of time to chat, share, relax, and rejuvenate. Everyone seemed to really appreciate this get-together, and Dan Poenaru, initial Program Director of BKKH, stated, We re keen to see it repeated in the upcoming years! A Ministry of Christian Medical & Dental Associations 13

14 Attendees made these comments: "It was a wonderful thing to bring together graduates, teachers, staff of BethanyKids and the guest together. There was a lot of sharing and information that will help the different staff of various sites to streamline their activities". "Thank you for preparing this. It is wonderful to have a time of refreshment when involved in this kind of ministry and work". PEDIATRIC SURGERY TRAINING POSITION TAKING APPLICATIONS The Pediatric Surgery Fellowship Training Program at AIC-Kijabe Hospital ( in Kijabe, Kenya, is accepting applications for a training position with anticipated matriculation in July This 3-year Fellowship in the Pediatric Surgery training post is run in partnership with BethanyKids ( under the auspices of the Pan-African Academy of Christian Surgeons ( and is accredited by the College of Surgeons of East, Central and Southern Africa (COSECSA Qualified applicants will meet the following criteria: 1. He/she will be a citizen of an African country and be eligible to obtain a Kenyan medical license. 2. He/she will display evidence of an active Christian faith. 3. He/she will have completed, at minimum, formal training in a basic surgical training program (e.g. MCS or equivalent), though a M.Med., FCS or equivalent in General Surgery is desirable. 4. He/she will be fluent in English. 5. He/she will have completed the formal application (available at including strong letters of recommendation from a pastor/priest or lay leader at your local church and from a Christian physician who knows you well and has worked with you. Completed applications should be submitted to Dr. Erik Hansen (hanerik@gmail.com) with a copy to PAACS (admissions@paacs.net). More information about Kijabe Hospital is available at All qualified applicants will undergo a formal interview as part of the application process. Application Deadline: March 3, 2017 Please share this information with suitable candidates. A Ministry of Christian Medical & Dental Associations 14

15 SOME CLOSING THOUGHTS By Bruce Steffes The local PAACS office in Fayetteville, NC, is closed and dark, the keys have been turned in and December 31 is officially my last day as the Chief Medical Officer for PAACS. It is an appropriate time to reflect back and to look forward. After serving on the commission from November 2003 until March 2006, I was asked to take over as the unpaid Chief Executive Officer. Somewhat reluctantly and with great trepidation at the gargantuan task ahead, I answered God s leading and agreed. After 9 years serving as a volunteer in that role as Executive Director, I have spent the last two years as the Chief Medical officer, the last 8 months grooming Dr. Keir Thelander to take over in that position. As I close out my official role with the Pan-African Academy of Christian Surgeons, there is within my breast the inevitable sense of loss and uncertainty about the future but there is also excitement about what God will do coupled with a strong desire to finish well. I will raise my Ebenezer (1 Sam 7:12) and rejoice that Thus far has the Lord helped us December 2016 Number of PAACS training sites 2 9 (plus Bangladesh) Number of general surgery training programs 2 9 (plus Bangladesh) Number of specialty training programs 0 3 (2 more sites possible) General Surgery Sites wanting to join 2 2 (Togo 2019, Burundi?) Number of PAACS residents 9 76 (as of January) PAACS residents finishing their program 3 63 (as of January); 59 individuals Number of approved faculty 2 59 (as of November) Number of Commission members (including ex-officio) Specialty Councils 0 4 Council Members Task Forces 0 3 Short-term volunteer faculty ( ) Budget $37 K $1.77 M All throughout, despite the great odds and the lack of an example of a similar model for training physicians, God has directed the steps of PAACS and provided for all our needs. I would like to share some of my thoughts on the way forward for PAACS. While not claiming to be a prophet and realizing that at best "now we see through a glass, darkly (1 Cor 13:12), it is true that I have eaten, slept and breathed PAACS for well over a dozen years and have thought deeply about these matters. I once heard a preacher pray that if what he was about to say was from God, may it sink in deeply; if not from God, may it soon be forgotten. I breathe the same prayer as I offer these ideas and thoughts: 1. PAACS must maintain our core competency of education, cling to our vision and avoid mission drift! The avoidance of mission drift means PAACS must stay focused both spiritually and missionally. Christ Himself and the training of surgeons to serve the least of these must remain central in all that is said and done. PAACS cannot ever solve all of the infrastructure issues of this vast continent or even those of the hospitals with which we partner. A Ministry of Christian Medical & Dental Associations 15

16 2. Competency building and not necessarily patient service per se should remain the focus of PAACS. On the grander scale, we must always recognize the value and needs of the individual patient but we should remain strategic as Christ was strategic. We cannot let the urgency of manpower needs for patient care overwhelm and derail us from our main goal of training. PAACS legacy will be the surgeons we train and who will come after us. 3. Realizing the political uncertainties of Africa, training national surgeons to become the trainers of tomorrow is vital. Not all surgeons are educators by natural bent and it may take decades at a given place to make a transition that is timely and maximally efficient. Such succession must be intentional but not inappropriately hasty. It will be gradual but we must not insist on perfection. There must be deliberately-left room for failure by the new faculty member enduring the process of mentoring. 4. We should help train all of our senior level residents to become trainers of essential surgeons because the need is great, the individual load of a surgeon by a rural surgeon is often overwhelming and the possible solutions few in the foreseeable future. 5. Spiritual development and discipling of our trainees remains mission critical. PAACS should keep retention within Africa a major goal, avoiding brain drain, but people will seek to serve the least of these only as long as they know and feel God s call on their lives. Also, we must continue to emphasize that each soul a physician touches is eternal in its nature and the future of the soul should be as, or more, important than the future of the body all while practicing excellent medicine. 6. Even though general surgery in the foreseeable future will remain the workhorse of surgical care in Africa, specialty training is rapidly increasing. It would behoove PAACS to help develop those programs under the PAACS aegis as God leads. 7. We must choose our ministry, educational and government partners carefully and wisely asking God s guidance as we do so. The history of mission hospitals in Asia is a warning to us as it has clearly demonstrated the concept of a slippery slope and resultant mission drift. 8. Cost of our budget can never be allowed to be the factor that limits our ministry rather, the real challenge is to clearly determine God s call for our ministry. He will remain Jehovah-Jireh, the God Who Provides, and He can provide for His wishes to be accomplished and for the needs of His people. In my opinion, PAACS should stay focused on individual donors and annual donations; we should not chase endowments or large foundations if the price of doing so is too high or is too distracting from our mission. If it is God s desire, PAACS need not have undue concern about funding for He will provide. That said, we must never cease to try to increase awareness, increase prayer and increase recruitment as we inform others about what God is doing in PAACS and as we give them an opportunity to invest in such a way that there will be eternal dividends. 9. A healthy PAACS Commission is vital for continued growth. Youthful surgeons with an academic bent and a mind to serve Christ in this endeavor must be recruited for the commission and must be taught how to make missions and service to God a priority early in their career-building stage of life. Succession planning for the leadership of PAACS is vital. 10. Short-termers will continue to have a critical role for a long time to come and it is from there that most of the leadership, prayer and giving will arise. I personally believe that PAACS is only beginning to recognize its potential on the continent of Africa. The verse proclaiming the Savior in Isaiah 43:19 may well apply to PAACS as well: See, I am doing a new thing! Now it springs up; do you not perceive it? I am making a way in the wilderness and streams in the wasteland. A Ministry of Christian Medical & Dental Associations 16

17 It will be my pleasure to continue to work behind the scenes for PAACS and will look forward to returning to the mission hospitals to serve the missionary surgeons, the residents and the people of Africa. It is with deep appreciation that I thank all of you who have encouraged me and prayed for me over the years of service to PAACS. To God be the glory! NEWS SHORTS: Humanitarian Surgeon Course Offered: The 5th annual Stanford Global/Humanitarian Surgery Skills Course is being hosted by the Center for Global Health and Innovation at Stanford University School of Medicine, CA (SUSM), will host a one-and-a-half-day Continuing Medical Education (CME) course, February 25 26, 2017, on humanitarian surgery skills. The fifth annual international humanitarian aid skills course will review common conditions encountered in resource-limited environments. The course will provide instruction, case scenarios, simulation on common conditions and procedures performed in resource-limited environments. The course will offer the essential elements of tropical disease, low resource anesthetics, surgical safety, ethics, and cultural considerations in such settings. Specific skill areas that will be taught include orthopedic dislocations and fracture management, cesarean sections, post-partum hemorrhage, D/C, hand injuries, burns management, hand cut skin grafts, Z-plasty, blind burr holes, tubal pregnancy, and hysterectomy. Registry must be by January 30. Space is limited. SUSM designates this live activity for a maximum of AMA PRA Category 1 Credits. Find more information about the course online, look at cme.stanford.edu/humanitarian. For registration assistance, stanfordcme@stanford.edu. ANNOUNCEMENTS Fellowship, Graduation and Married All in One Week: Chief Resident Beryl Akinyi Ooro has had an eventful December thus far. She was inducted into COSECSA on December 7 after successfully passing her exams, had her graduation ceremony at Kijabe on December 12 and became the wife of Laison Royas Mawe on December 17. The ceremony was held at the Ndu Council Hall in Ndu town in Northwest Province of Cameroon. Both will be returning to Kijabe Hospital. Prayer Guide Available: The Fall 2016 edition of the PAACS Prayer Guide can be downloaded from the PAACS website ( by clicking here. This electronic document can reside on your smartphone, tablet or laptop and you can continue to be faithful in praying for PAACS each day! If you would prefer a printed copy, there are still a few copies A Ministry of Christian Medical & Dental Associations 17

18 left. If you want one, please and ask. End of Year Donations: After you have given to your church, please consider making an end-of-theyear donation to the Pan-African Academy of Christian Surgeons. To give via credit card, please go to Alternatively, make the check out to CMDA-PAACS and send to PO Box 1118, Bristol, TN If you are over 70½, then tax-free donations from your IRA (either Roth or non-roth) are a great way to support those organizations of which you approve. The Protecting Americans from Tax Hikes (PATH) Act of 2015, P.L , made it permanent almost a year ago. It is a powerful incentive to charitable giving. Also, naming PAACS as a beneficiary in your will is another great option to make an impact and leave a legacy. Monique Wherry (Monique.wherry@paacs.net) can help you with that. If you have the new CMDA app ( for your smart phone, you can also give that way (be sure to indicate that PAACS is the beneficiary). New CMDA App for Your Smartphone or Tablet: The Christian Medical & Dental Associations have announced the availability of an application for smartphones and tablets. It has many advantages besides the donation ability mentioned above. There are daily inspiratory quotes, the 365, and daily devotions designed for Christians in healthcare. The CMDA Resident and Fellowship Community is designed to help you keep those priorities and grow in your faith during your residency and fellowship years. The new app is a good way to stay connected with CMDA chapters and groups, the greater CMDA calendar, and opportunities for medical and dental missions and ministries. It is free for both I-phones and Android users. PRAYER REQUESTS: Praise God for the high pass rate on the COSECSA exams and for the new COSECSA fellows within the PAACS ranks! Praise God for five newly trained surgeons and for the first trained surgeon in Egypt! Pray for the expatriate surgical staff and residents who are away from their families during the upcoming holidays. Pray for the new trainees coming in January as they quit their jobs, plan a significant move and resettle their families. Pray that the new trainees will stay focused on the long-term goal and for their preparation of heart, mind and family. Pray that God will continue to call others to apply in the future and that they will listen and in particular for the right person for the next intake in pediatric surgery. Pray for the December graduates that God will clearly provide the next place of employment and ministry. Pray for the Tenwek trainees who will graduate in January as well. A Ministry of Christian Medical & Dental Associations 18

19 Pray to God that some of our trainees will be called to serve in underserved mission hospitals as a career. PAACS must maintain our core competency of education, cling to our vision and avoid mission drift! Pray for all our graduates as they serve in 17 countries of Africa as they serve their patients and their Lord. Pray that God will provide strength, resources and wisdom. Pray for those faculty members on home assignment (Carol Spears, Wendy Willmore, Zach & Jen O Connor, Heath & Angela Many are in N. America and Peter Bird in Australia) for rest, for the times of speaking and fund-raising and for the times of medical work. Pray for those programs which have faculty members absent that God will give them strength and rest to continue. Pray that God will call additional career surgeons to join the PAACS faculties: The manpower situations in Egypt, Ethiopia, Malawi, Gabon and Niger are particularly of concern over the next 6 36 months. Pray for God to call surgeons to join the training program in those areas and to guide and direct those who are already called and in preparation. Pray still that Mbingo Baptist, SIM-Galmi, Bongolo Hospital and Malamulo Hospitals will all receive government recognition for their PAACS training programs within the coming year. Pray for God s blessing and the favor of men in this. Praise God that the November 30 meeting entitled Working Group on Surgical Residency Training with the Kenya Medical and Dental Practitioners Board went well and did not threaten the standing of the Kenyan PAACS programs. Thank God for those short-term surgical faculty members serving at our hospitals, especially as they sacrifice their own family holidays to serve overseas. Pray for the Kenyan and Tanzanian programs who prepare for the January accreditation tour by Loma Linda University. Pray that we will have the wisdom, resources and manpower to properly implement the requirements from the report from the West African College of Surgeons. PAACS had requested a non-voting seat on the COSECSA Executive Council and this was again declined. However, PAACS may be granted a seat on the Examination and Credential Committee. Praise God for His wise working in this. Pray that God will provide the resources needed by the end of the year. Pray that God, Jehovah-Jireh, will continue to provide funds for PAACS as we expand with more residents and more training programs. Pray to God as the programmers develop the smartphone app for and improve the PAACS case log. Pray that they will meet their deadlines and for the roll-out of the beta version in February. Pray for God s hand on the new well-being index program that is being developed and for the beta version roll-out presently underway. Please pray for the ongoing work by the PAACS specialty councils. A Ministry of Christian Medical & Dental Associations 19

20 Pray for Keir Thelander as he shoulders the full load as the new Chief Medical Officer. Pray for the ongoing preparations for the PAACS Basic Science Conference to be held at Brackenhurst International Conference January 29 February 9, Pray for continued healing for two of the PAACS administrative team. Editors: Bruce Steffes, MD, MBA, MA (Bib. Min), FACS, FWACS, FCS(ECSA), FICS Dave Thompson, MD, FACS, FWACS A Ministry of Christian Medical & Dental Associations 20