Communicating hope in Nigeria

In 1997, Herb Giebel, MD (a 1988 graduate of the School of Medicine), his wife, Gail, a nurse, and their two children, Melissa and Tami, accepted an assignment from the General Conference of Seventh-day Adventists to Ile-Ife, Nigeria, where Dr. Giebel would help establish a residency in general medical practice.

This idea was conceived by Samuel Daniyan, MD, a 1979-B graduate of the School of Medicine, who was instrumental in the Ile-Ife hospital being returned to the Church by the government. Gregory Saunders, MD, a 1985 graduate of the School of Medicine, along with others, helped provide the groundwork for the residency program. Adventist Health Services in Nigeria operates 3 hospitals, 15 clinics and health centers, and a nursing school.

The Giebel family arrived in Nigeria, Africa's most populous nation, on January 1, 1998. Five weeks after their arrival in Ile-Ife, a local feud between communities in the city disrupted traffic to the hospital enough that few patients were coming to be seen. "It was at that time," remembers Dr. Giebel, "that we were transferred to the Jengre Adventist Hospital in northern Nigeria until things in Ile-Ife improved."

The Jengre Seventh-day Adventist Hospital is a rural hospital located in what is called the "10-40 window"--the least evangelized part of the world.

Dr. Giebel says, "When we were there, we had no electricity or phone service and most of the time, no running water. The technical capability of the hospital was quite limited. For example, the lab tests we are able to do include white blood counts with differential, hematocrits, Widal tests, dextrostix for blood sugar, blood film for malaria and microfilaria, hepatitis B and HIV screens, blood typing, urinalysis, stool for ova and parasites, sputum for AFB, and skin snips for microfilaria. We are not yet able to do chemistries or cultures and sensitivities. Patients requiring x-rays, ultrasound, and ECG studies are sent to the nearest city, Jos, about an hour away.

"At first we wondered what we would be able to do in a place with such limitations. We soon found that it is true that 'God's strength is made perfect in our weakness' (2 Corinthians 12:9). Our lack of 'essential' medical equipment didn't keep very sick patients from coming for treatment, and didn't keep God from showing His strength by restoring health to many of these patients."

An interesting department in the Jengre Adventist Hospital is veterinary medicine. The population served by the hospital includes a large group of Fulanis, who are nomadic cattle herders. The veterinary branch helps the people keep their animals healthy and helps build bridges with the Fulanis, many of whom are Muslim.

One afternoon, two veterinarians who were completing their National Youth Service Corps year at Jengre returned from a day of vaccinating cattle. Dr. Giebel met Dr. Dawa, a Christian, and Dr. Ibrahim, a Muslim, as they were putting their equipment away. A one-week HIV/AIDS education seminar conducted in conjunction with the morning worship service at the hospital had just been completed, and the three men discussed the need to educate Nigerian young people regarding AIDS.

After the vets mentioned they had never knowingly seen someone with AIDS, a patient with AIDS who had been admitted the night before agreed to let them visit. What they saw as they entered his room was the figure of a person who looked like a mummy from the Egyptian pyramids--but was alive!

Just about anywhere the patient was touched, his skin would slough off. Not only was the patient HIV positive, but he had also been treated for tuberculosis and had developed a skin condition making it virtually impossible for him to see, eat, or drink. The two veterinarians found it difficult to spend more than a moment or two in the room with the patient.

"Why do you even admit a patient like this?" Dr. Ibrahim later asked.

Dr. Giebel considered this a very valid question. In the United States, the life of patients with AIDS can often be prolonged by using anti-retroviral drugs and high-tech medical care, but in Nigeria most of these drugs are not available or are too expensive. After consideration, he replied, "The reason we treat this kind of patient in our hospital is because we may be able to make them a little more comfortable during their last days, but more importantly, because we know that we can offer them hope for the future."

Moments later, Dr. Ibrahim asked Dr. Giebel if he could begin studying the Bible with him. Dr. Ibrahim didn't consider a study once a week to be adequate--he wanted to study daily, starting immediately!

A year after leaving Ile-Ife, the Giebels returned to again help start the residency training program. "We are continuing to pursue our goal of a strong residency training program for west Africa in spite of the obstacles that have sometimes blocked our progress," Dr. Giebel says. "We want to train Christian physicians to work in the needy areas of Africa who will not only be excellent clinicians, but also excellent communicators of the hope that all can have freely through Jesus."

One Adventist physician, Peter Opreh, MD, is in the fledgling general medical practice residency. "We are hoping," says Dr. Giebel, "to have more join us."

More than 50 Seventh-day Adventist young people are now enrolled in medical school in Nigeria. Some may choose to join the general medical practice residency program when they complete their degree, though it is not limited to Adventists. Anyone may apply who would like to serve God in medical ministry.

This spring, the Ile-Ife work has again been disrupted by feuding communities, which has left the hospital standing as an island in a sea of destroyed homes and businesses. If this feud continues, the residency program may need to be relocated.

Dr. Giebel says, "Even if the current feud stops immediately, we feel it is prudent to develop infrastructure in at least one other Adventist institution, and to broaden our training base so this kind of local unrest isn't able to completely disrupt the residency. Financial resources are our limiting factor for this."

Besides Dr. Giebel, School of Medicine alumni working with Adventist Health Services/Nigeria and the residency program include Dr. Saunders, general surgery; Mark Ranzinger, MD, general surgery/family medicine (1989); Randell Skau, MD, general surgery (1982); Melinda Skau, MD, family medicine (1982); and a one-year volunteer, Steven Scott, MD, family medicine/ obstetrics, (1984). Calls are open for a pediatrician, an obstetrician/gynecologist, and an internist to join the residency training staff.

Dr. Giebel comes from a family that has long been dedicated to service. His parents, Drs. Harald and Beverly (a 1956 graduate of the School of Medicine) Giebel are now working in Papua New Guinea, and have served overseas for 26 years.

His brother, Art Giebel, MD (a 1991 graduate of the School of Medicine), a full-time ophthalmologist at Jerry L. Pettis Memorial Veterans Medical Center in Loma Linda and a member of the School of Medicine faculty, fulfills his desire to serve by joining groups of physicians on short-term assignments. His sister Rita Giebel, JD, of Orange County, is a consultant for companies in the United States and Europe that create and sell medical devices. She serves as an anchor for the entire family, organizing and sending materials and goods to them when help is needed.