Imagining ourselves out of a job

Clean new surgical theatre; inset: Steve and Catriona Bennett

Steve and Catriona Bennet (inset) helped renew the surgery facilities at Gahini hospital. New equipment like this operating table helped in being allocated new surgeons


When taking on a new role, many of us look for job security – yet when mission partners Catriona and Steve Bennett (an anaesthetist and surgeon respectively) moved to Rwanda, they hoped to be out of a job a few years later. Here Steve shares their journey.

“Don’t overestimate what you can do in a year…” is a quote attributed to Bill Gates, former head of Microsoft. Fair enough, but Catriona and I had both spent a year working in East Africa previously so we had some idea of what might be possible. We looked forward to seeing what we could accomplish in five years as mission partners at Gahini Hospital in Rwanda.

We anticipated that I would work caring for patients who might need surgery, while Catriona would work alongside the hospital’s non-medical anaesthetists developing their skills as well as delivering some more complicated anaesthetics. In addition, we hoped that we might improve the hospital’s surgical facilities, as the equipment there was not particularly appropriate or reliable.

Both of us have a passion for teaching and training, and we expected this might be a legacy for us among the Rwandan nonmedical anaesthetists and doctors training to become surgeons.

Through all this we hoped to share God’s love with patients and staff, and thought it might be possible that within the expected five years of our placement we would have developed facilities and trained enough staff that there would be Rwandans to carry on our work. We thought that we would have essentially worked ourselves out of a job.

Inauspicious beginnings

In the first few months after we arrived in Gahini, we found the reality was rather different from what we had expected. There was practically no functioning anaesthetic equipment, so we were limited in the operating we could provide. The hospital functioned like a government (district) hospital. Rwandan district hospitals were not supposed to have specialists, so even when we got anaesthetic equipment, we struggled to get the anaesthetic drugs we needed because the district pharmacy didn’t have them.

Sparkling new ward room with fresh paint and clean floors
Gahini’s general surgery ward was refurbished in 2019
Empty room filled with rubble
And in 2020 work started on refurbishing the orthopaedic ward

There was another hospital in the province that the government were already developing into a referral and teaching hospital. Links with the Kigali teaching hospitals were non-existent and trainees weren’t interested in moving to a rural hospital. In addition, a national audit had discovered that the hospital was £800,000 in debt leading to the hospital director and administrator being sacked soon after we started. Meanwhile, the priorities of the new director and of the diocese weren’t always what we anticipated.

We resigned ourselves to the thought that God knew why he had sent us here, and if we managed to merely serve the local patients by providing surgical care, we would at least be showing his love to the poorest in the rural community.

The situation didn’t really change during our first 30 months at Gahini. However, rather unexpectedly a number of welcome developments occurred at about the same time.

Surprising developments

The university needed placements for recently graduated medical students, and we received several new doctors to work in surgery under my supervision. To my surprise I then became an associate dean of the University of Rwanda.

Influenced by Catriona’s presence as a specialist anaesthesiologist, a German charity built a fully equipped orthopaedic theatre suite for a visiting orthopaedic surgeon to provide surgery for children with disabilities.

Shortly after, the government sent an orthopaedic surgeon to our provincial referral hospital, but he found there neither equipment nor facilities. As Gahini had the facilities needed, our hospital was able to acquire two orthopaedic surgeons and became the orthopaedic referral hospital for the whole province.

We received some very generous grants and donations, which allowed us to refurbish the surgical and orthopaedic wards and equip a highdependency patient area to look after some of our sicker patients more safely.

God’s miracles through our weakness

In the last six months, the hospital has been recognised enough for its work to be sent intern doctors, so there are now eight new doctors working throughout the hospital.

Catriona’s anaesthetic work has resulted in her receiving a number of non-physician anaesthetic students for their clinical placements, and she has been invited to be the university’s external examiner for their exams. And at the beginning of this year, the government sent Gahini an anaesthesiologist. We hope that they will also send a Rwandan general surgeon to replace Steve by the time we leave.

The end of the Bill Gates quote is, “… but don’t underestimate what you can do in 10 years!” We would suggest that even more important is to bring God what you have to offer, and let him work miracles through your weaknesses. Despite the inauspicious beginnings of our time in Rwanda, we have seen Gahini develop its facilities and improve its Rwandan staffing to the stage where we have indeed almost worked ourselves out of a job. Hallelujah!

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Published 21 June 2021
Region
Africa

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