Marvin Fanny, Seychelles’ first specialised paediatric surgeon |19 July 2021
Marvin Fanny is Seychelles’ first specialist paediatric surgeon, after having successfully completed a Fellowship from the College of Medicine of South Africa and a Master of Medicine in Paediatric Surgery with the University of Pretoria.
Dr Fanny, who returned after completing his studies in January 2020 and received his final results in June this year, is presently employed with the Ministry of Health, and is working at the Seychelles Hospital.
Seychelles NATION had a chat with the specialist surgeon on his journey towards such an accomplishment, and what his chosen professional field entails.
The road into the medical field
Dr Fannyrecounts that he has from the tender age of 10 dreamt of becoming a doctor, and has throughout his academic life worked hard to attain this.
Following his A-Level studies, the young hopeful was lucky enough to be the first Seychellois to attend the twinning programme between India and Malaysia, where he studied in both India and Malaysia, at the MalakaManipal Medical College.
Upon the completion of his internship in Malaysia, he returned to Seychelles towards the end of 2009and took up employment in the Surgical Department at Seychelles Hospital by January 2010.
“From my early studies as an undergraduate, I knew that I wanted to be a surgeon, so from that time, I started to apply for scholarships to study general surgery, so surgery in adults. As postgraduate training is always full, many of them were either full, or had placements to come in three or four years. So I tried to apply to South Africa and Cape Town told me they were full too. I then applied to Pretoria and they said they do not offer general surgery, but that they have paediatric surgery, and I took it. So, basically, paediatric surgery chose me,” said Dr Fanny.
“The whole process for me to get to South Africa was two years, in handing in the applications, and I also had to send all my documents to an institution in the United States America for them to be verified. They conducted a full background check from my undergraduate studies, internships, the hospitals at which I worked, every single council that I have been a part of, before the South African Medical Council could grant me admission,” Dr Fanny explained.
After two years of preparation, he made his way to Pretoria in 2013, where he worked in two major hospitals ‒ the Steve Biko Academic Hospital and the Kalafong Hospital ‒ both of which fall under Pretoria University. Towards 2019, he also worked in the Chris Hani Baragwanath Academic Hospital in Johannesburg.
What is a specialist paediatric surgeon?
Paediatric surgery is a distinctive surgical specialty, provided by highly-skilled surgeons, who are formally trained in general surgery, and further trained in the intricacies of treating smaller patients with unique surgical needs.
Paediatric surgeons are trained to treat the unique needs of children, and have expertise in treating birth defects and abnormalities that require surgical intervention, in addition to being skilled in newborn surgery, cancer surgery and trauma surgery. Becoming a paediatric surgeon requires completing one of the longest training pathways in the medical field.
“The duty involves running a specialist clinic, where patients are referred to you to identify their problems. Once the problem has been identified, some conditions need to be operated on and others do not, so we classify that. For those requiring surgical intervention, we book them, make the necessary arrangements and they get the surgery. And then there is the emergency component. I am on call so if there are any emergencies, I get called in and of course with emergencies, the same applies, some need surgical intervention and others do not,” explained Dr Fanny.
“We deal a lot with congenital anomalies, meaning children both with certain defects that we then have to fix, as compared to adults whereby we deal mainly with diseases of lifestyle that we more or less induce on ourselves. In children it is mainly birth defects, and we also deal with cancers, and childhood cancers. In other words, it is concentrated on general paediatric surgery, and we do paediatric urology, dealing with urinary bladders, kidneys and such,” Dr Fanny explained.
Surgery in the context of Seychelles
Considering the size of the population in Seychelles, it is highly unlikely that Dr Fanny will ever be as busy as when he was working in hospitals abroad, where the population is in millions.
“The fact that the population is small, the cases I receive are not as many as in South Africa where I was training, where the population is in millions, and it is very busy. And in relation to the conditions that children experience, like anomalies and birth defects, or a condition which happens once in every 5,000 live births, but in Seychelles our lives births are not even up to 2,000 a year, so the chances of me getting a case are once in three or five years. I want to help my population, my people, so being around is helpful already,” said Dr Fanny.
“At the same time, having someone specialised in the domain saves the government and economy a lot of money. To send a baby or child for treatment overseas, especially with babies, they need intensive care unit (ICU) care, they have to be accompanied by their parents, and the surgery itself, the specialised surgery costs a lot more than if treating an adult, so in terms of the economics of things, it is an advantage to the country,” he added.
In addition to providing treatment, specialist paediatric surgeons need to understand the emotional needs of children and families, to deliver child and family-centred care. Dr Fanny notes that having a Seychellois as the surgeon also serves to make parents feel more comfortable, as they can communicate clearly, without cultural barriers.
However, surgery is a skill that takes continuous and rigorous practicing practically, and for one to keep abreast with the latest research and sometimes fast-changing paradigm in the field.
“A surgical training is a skill you need to develop. Initially, you need to be able to identify the problem, and that’s where you have to read a lot. But the correction of the problem is the skill, and the skill you learn on the job. And it is a long process; it doesn’t stop as things keep evolving. Ideally, if there was a possibility of spending maybe three months in a country to keep up my practice and be back for the next nine months. Of course in the event of emergencies or things that require my expertise I would be flexible in returning,” said Dr Fanny.
Dr Fanny remains in contact with both medical institutions at which he worked in South Africa, and takes part in virtual meetings and sessions with other candidates sitting the same exam, seizing every opportunity for passive learning.
Personal experiences on the job
“There are a lot of beautiful moments in paediatric surgeries as it is often not common things. Surgery is rewarding as you see the problem and you fix it. It is rewarding and a lot of time, you never get to see the patient again. Whereas in other fields you keep seeing a patient repeatedly, and you keep treating them over a period of time,” Dr Fanny said beaming with excitement.
Over his career, Dr Fanny has had plenty of success stories, but his most difficult case, he recalls, was in South African, whereby he needed to connect the intestine to the liver in a small child and, successfully managed to get a partial flow of bile. The intervention was particularly difficult on account that the child presented late, and the success rate of treatment usually decreases the later they present.
“I’ve had kidney tumours as well, that occupied the whole abdomen, and that was also something difficult. But my most traumatic moment until today, was an 11-year-old girl, very late presentation with appendicitis. She had gone to the clinic a few times and was receiving treatment for something else, and she was the only child of an aged parent, and we operated on her and lost her. It took me a few days to recover from that,” concluded Dr Fanny.
Seychelles NATION wishes to congratulate Dr Fanny on his major accomplishment and wishes him all the best going forward.