Conversation with Dr. Etienne Mastaki about his journey from DRC to Kijabe, Anesthesiology training, Faith in Medicine, and the benefits of building resident/fellow housing in Kijabe.
DAVID: Well good morning. My name is David Shirk, and maybe you could share your name and what you're what you're doing at Kijabe Hospital.
MASTAKI: Good morning. My name Etienne Mastaki Alemi, resident in anesthesia in Kijabe.
DAVID: Excellent. And where is home? Where do you come from?
MASTAKI: So, I'm from Republic Democratic of Congo. I've been here for one year and nine months for now.
DAVID: Excellent. And I guess in America, on a map we call it D.R.C. Tell me about your home, maybe the country and then also your part. It's a huge country, right?
MASTAKI: Yeah, D.R.C. is a huge country. It has around 56 counties. I’m from the eastern part, Ituri province, in Kenya we would say Ituri county, it's on the border of Uganda.
DAVID: So, you’re a neighbor to Kijabe, or to Kenya. Languages, did you know any Swahili before coming?
MASTAKI: Yeah, I know some Swahili but, not the best Swahili like in Kenya, but I can hear what people are saying in Kenya.
DAVID: Even Kenya is not the best Swahili. I think Tanzania is the good Swahili and then they give us a hard time for how we speak in Kenya.
MASTAKI: So, I can speak French, Swahili, my English is not the best but, I'm, trying English and some D.R.C. language like Lingala.
DAVID: Wow, that's awesome. Was that a big adjustment? Was your medical training in English or French?
MASTAKI: My medical training was in French. It was not easy in the beginning, . It was a huge adjustment the, the language, but with God’s help we are trying to do our best.
DAVID:: Absolutely. And for people watching this, you know people, literally around the world, it's a big challenge. When we think about being a training hub for all of Africa, how do we welcome people and then how do you adjust how does everybody succeed and do well?
How is training going? How is anesthesia?
Mastaki: Training is going well. I think it was the best choice of my life. We have the wonderful consultants is a Kijabe is a good place for learning.
David: Good. Maybe tell me about your medical background. Why did you want to come here and study anesthesiology?
MASTAKI: Okay, thank you very much. It's a very good question. I did my medical school in D.R.C. in Goma city. So, I graduated in 2015. After that I did one year of internship in Nyankunde hospital. This is in the area where I'm from in Ituri county.
DAVID: So you know Dr. Cooper?
MASTAKI: I worked with him like one year, I think. I met him there in Nyankunde.
So, after that I worked in a missionary hospital called Itendey hospital for like three years. So unfortunately, in 2021 my hospital was burned with the rebels. They, came they destroyed everything and I was jobless for like two years. Then I met a doctor, a surgeon from PAACS, he’s called Dr. Jaques Ebhele.
DAVID: He's now in Malawi?
MASTAKI: He's in D.R.C. now.
DAVID: Oh, he’s back in D.R.C. Good, good, okay.
MASTAKI: I worked with him for like one year. He’s the one who talked to me about PAACS. I had some options, anesthesia. I was trying to think about radiology, but he convinced me to do anesthesia.
DAVID: What were the capabilities at these hospitals you were at in D.R.C. at Nyankunde and then the other mission hospital? Did you. . .you had theatres you had some anesthesia machines. Were there were there anesthesiologists or nurse anesthetists?
MASTAKI: No, I had never met an anesthesiologist before.
DAVID: What??
MASTAKI: Yeah. So it's my first time doing an anesthesiologist in Kijabe. [Speaker changed] And so who would provide anesthesia? Would they be nurses who returned? Yeah.And had they done formal training or they just kind of learned MASTAKI
They have formal training. They have like three years of training. . . Nyankunde is the biggest hospital in my area. It has, I think, a capacity of two-fifty beds. We have four theatres.
DAVID: What is the difference between somebody doing nurse anesthesia and a trained anesthesiologist?
MASTAKI: So with two years that I’m in anesthesia, I think the difference is just some skills, like difficult airways, blocks, and a lot of physiology, pharmacology, so it's making the difference between nurse anesthetist and anesthesiologist. So, for the nurse anesthetist most of the time the practical things. But the anesthesiologists have to do critical care and they have to combine the skills.
DAVID: Tell me about faith. Your background is in mission hospitals. Tell me about faith in medicine. What does it mean to integrate Christian faith in medicine, what you are trying to learn and what you are trying to provide.
MASTAKI: I'm lucky to be born in a Christian family. My father is a nurse actually.
DAVID: Oh wow
MASTAKI: So, I was raised in an environment where we would go to the church, I was seeing my father going to the hospital so, all this environment. I think had a big impact on me to do the medical school. I think that health care is a great environment for spreading the gospel. Because when people are coming to us they are, anxious, they are weak and most of the people, when they are sick, they want to look for God. They want to look for the face of their God. Because in we are African Some people some people can come to the hospital, others are going to see that people in the village (traditional healers), there are those who are going to the church, they want people to pray for them to so that they can be healed. So, I think the healthcare environment is really a good opportunity.
I think it's two months ago we had the opportunity to learn about the Saline process. I think it has brought something for us to continue to talk about the gospel to our patients and to help them even physically, mentally and spiritually. DAVID And so Saline, can you explain a little bit I'm I know it's a course that our people are dealing with the saline MASTAKI So, some people have sat together and they thought that it's better to combine the spiritual care with the healthcare and they gave us some formula that can help us to talk to our patients when taking the medical history. We can easily talk to them about their their faith and to know how they are doing.
DAVID: Maybe you could paint a picture of how you might use that with a patient. Like, if you're if you're talking to a patient, like what what might you say?
MASTAKI: There is a small formula we call FICF.
F - Faith F is going for faith. Do you have faith? Do you believe in God?
I – Important You are asking them if they think it’s important for them to have faith. C – Community.
C - Community C is going for community. Are you going to a church? Is there a community where you are able to discuss about your faith?
A - Assess - Assess the environment, do they have the family? You can discuss about people who are coming to visit you in the hospital and all those things. That small formula is just one minute and you are done.
DAVID: Interesting. Is that something that goes on the chart now? I heard I heard talk about like incorporating this into H.M.I.S.
MASTAKI: For now, not really, but our program director Dr. Matt has initiated a spiritual rounds. So, each Tuesday we are meeting the morning, we are sharing about our patients if we have had some discussion about their faith. DAVIDThat’s really cool. MASTAKII think next year we are going to do something with those who are coming first year, talk to them more about this Saline process. And we have a project maybe to try to incorporate it in our anesthesia charts so that you can facilitate it when we are doing pre-op to quickly review faith but with our patients.
DAVID: I should ask you about housing. Right now, we're prioritizing our residents and fellows coming from other countries. So, you're on campus right now. But then a lot of your colleagues live elsewhere out in the community, is that right?
MASTAKI: Even me. I was provided housing for one year. So now I'm living outside of the campus.
DAVID: So you're commuting in. Was that stressful?
MASTAKI: It's stressful. It's stressful because every morning you have to leave at five a.m. If it’s raining. . . Sometimes a case can take long and we are leaving, late like nine, ten p.m. it's stressful to leave the hospital to go back home. It’s really stressful.
DAVID: Anesthesia, you’re first in, last out, right? I don't know if you think about it that way? Before a patient comes into surgery like you have to do pre-op and make sure that they're safe to go into surgery. Once they're sutured up the surgeon can go, but then you have to make sure they're safe and PACU they can transfer out to the ward. You're the first and the last.
MASTAKI: Exactly
DAVID: We’re making progress on this project. God-willing maybe this time next year you could have a new home back in Kijabe. So that's what we're hoping and praying for. .
Well anything else we should talk about? Anything you would like to share with our friends of Kijabe, people who are might be watching this around the world?
MASTAKI: We want just to thank them and with their beautiful work, they are really doing a good thing. Through what they are doing I think they are saving Africa. Because we are coming from all over Africa to learn and to go - not only to save the life of the people through medical care - but also spiritually.
So, through PAACS (Pan African Academy of Christian Surgeons), you are doing a great job, and I can assure you that the fruit of you work is all over Africa. May God bless you.
DAVID: That’s awesome. Thank you so much, I appreciate.