Joseph Diangatebe is a Gabonese nurse from Mouila – the regional capital, about a 2 hour drive from Bongolo. He had been working there for the last 10 years when he heard about the creation of a nurse anesthesia training program at Bongolo. He moved to Bongolo to join the first class that began in September of 2019. The program, “Formation d’Anesthésie”, led by Dr. Jeff Lane, an American Anesthesiologist, is a 2 year intensive training course consisting of about 50-60 hours weekly. Each week contains classroom work, clinic/practical training in the operating room, a discipleship Bible study, case reviews and discussions. Throughout the week and on weekends the students take turns being on call with trained, senior anesthetic nurses or Dr. Jeff Lane. Dr. Kim Huang, another international worker, also helps to teach clinically and in the classroom a day or two a week. Short term visitors have also contributed to the training.
Dr. Jeff came to Bongolo for the first time in 2012 to volunteer and came back 4 more times over the years from 2012-2015 before responding to the call to come full time with his wife, Amy. After much prayer and preparation they moved to Bongolo in July of 2017. Dr. Jeff saw the profound need for qualified anesthesia providers in Africa. Data from the Global Surgery Movement states that, at this moment, 5 billion people do not have adequate access to surgery. They say it boils down to three factors: proximity to a hospital, and a lack of both medical equipment and qualified personnel. In short, people are dying that shouldn’t. In the West, complications relating to anesthesia result in 1 death per 200,000/300,000 cases – it is very rare. In some places in Africa the statistics are very different. Death resulting from unqualified personnel or poorly administered anesthesia are 1 out of 1,000 or even worse – 1 to 150 in some remote areas of the continent. The result is people are dying that should not.
Dr. Jeff started the program with a 3-pronged approach of training, discipling and sending. Nurse Joseph is being trained, discipled and will be sent back to Mouila when he graduates from the program. Joseph is joined in the program with two other Gabonese nurses, Peya Mimbondo and Mathieu Mondjo. Joseph arrived in Bongolo without any prior knowledge or experience in anesthesia.
Joseph began primarily by observing the work and loved it immediately. He then integrated into the team and started with the speciality of spinal anesthesia. He said that at the beginning of the training it was extremely difficult. He remembers working on a baby early on, “When the oxygen gets low it is very stressful! Respiration problems are extremely challenging!” He said he was so thankful for Dr. Jeff being right there to give steady courage with clear and calm instructions when those oxygen levels were dropping during that baby’s surgery. With a confident smile Joseph shared, “Now I can do this, no problem! Even without the aid of others.”
One of the things Joseph shared was how much he appreciates this program and its concentration on clinical training. In addition to the didactic teaching sessions, at Bongolo the training consists of lots of practical work, of actually providing anesthesia for surgeries. Joseph goes on to say, “You see all kinds of cases with all kinds of difficulties here. I have a lot of confidence because of all the practice we do.” He said the way the program works is each student is matched up with either Dr. Jeff, Dr. Kim or one of the trained nurse anesthetists, Ervais Iwangou or Christophe Mindonga. He feels this individual attention and practice are part of what makes this program so confidence-building as they develop their skill set.
Another aspect of the program that Joseph deeply appreciates is the Bible Study discipleship component. “We began the program with a study about being sons of God rather than orphans without a father. It’s given me confidence to walk with God, to have more love and care for the patients. Jesus had a compassionate heart for the sick, we want to be like Jesus. At Bongolo, God is in the center of everything. At other places we come to work without praying and singing. It’s a good thing to put God first. God gives us strength and intelligence, man is limited but God can give us what we need.” Joseph preceded to tell a story of an older Papa* that had surgery to amputate both his feet. The Papa was extremely sick and even after the surgery they knew he would not likely live much longer in this world. Joseph presented the gospel to this Papa and his eternal life was changed in that moment. The Papa passed away but not without knowing Jesus and His saving grace!
Joseph concluded in our interview, “It is a great adventure to learn anesthesia here!” He hopes the program continues and grows and will be recognized by the government and known all over Gabon. He said there isn’t a specialized nurse anesthesia training program in all of Gabon other than this one. “Dr. Jeff is a deep well of knowledge in anesthesia, we must profit from his knowledge!” He said what touches his heart the most about Dr. Jeff is his genuine faith and discipleship of this truth that “we are all first servants of God, not doctors or nurses.”
Training programs, like this, will help to greatly mitigate one of the 3 main reasons people needlessly die in this part of the world. Now, through the training program at Bongolo, these highly skilled anesthesia nurses will join the fight.
*Title of respect and endearment for an older man in this part of Africa.
Written by Alace Straw, Photography by Ulrich ILema