By Susan Schwartz, Montreal Gazette
For Montreal Children’s Hospital pediatric surgeon Sherif Emil, a recent teaching stint in the Nigerian city of Ilorin was a special homecoming — and an emotional one.
The only child of two doctors, Emil was raised in Egypt but lived in Ilorin between the ages of six and nine as his parents worked there.
Ilorin is the capital of Kwara State, which at the time was one of Nigeria’s poorest states, recalled Emil, now 60. “The roads were horrible. … It was such a primitive place to be — and that is where they chose to be.”
His parents were among fewer than 15 doctors for the entire state and, in some smaller towns, the only doctors altogether. His father, having just completed his training in general and orthopedic surgery, was the surgeon; his mother, a family doctor focused on children’s and women’s health care, took care of the non-surgical patients.
They were “typically the only barrier between the patient and a very poor outcome.” Fast-forward more than half a century and Emil is himself a doctor — a surgeon and professor of pediatric surgery and pediatrics in McGill University’s Faculty of Medicine and Health Sciences.
He was in Ilorin last September to lead a group of North American doctors in giving a two-day course called Trauma Resuscitation in Kids (TRIK) to a group of Nigerian pediatric surgeons: Drs. Karen Gripp, a pediatric emergency physician at University of Manitoba Children’s Hospital in Winnipeg; Natalie Yanchar, a pediatric surgeon at Alberta Children’s Hospital in Calgary, and Robert Finkelstein, a pediatric emergency medicine physician in New York and a native of Montreal.
The course, held in collaboration with the Association of Pediatric Surgeons of Nigeria and given just before its annual meeting in Ilorin, was made possible by an International Development, Aid and Collaboration grant from the Royal College of Physicians and Surgeons of Canada.
The TRIK course, initiated in 2012 by the Royal College of Physicians and Surgeons and now administered by the Canadian Association of Emergency Physicians, has been given to hundreds of health-care professionals in Canada and the United States who deal with pediatric trauma, including children’s surgeons and emergency-room doctors, respiratory technicians and nurses.
When Emil was last in Ilorin as a boy, there was no airport — “only primitive roads that would often flood and leave us trapped in the town.” On his way from the airport to the hotel in September, “I could see that the small town I had lived in had grown into a bustling urban centre.”
Ilorin now has a university, a medical school and a simulation centre, none of which were there in the 1970s. And yet, his parents “must have had a vision that something big would happen,” he said. Returning for the first time since childhood “was very emotional for me … a reminder of my parents,” he said. Thinking of them, both gone now, “I felt their spirit.” He never asked his parents what had prompted them to leave their comfort zone at home in Egypt and travel, with a young child, to somewhere so remote.
But during the year he spent planning the Nigerian course, “it suddenly became clear that I was here to continue the work they started: This was their legacy, more than 50 years after they made their fateful decision.” Riding a microbus from the hotel to the course site at the University of Ilorin and looking out at the city, “my tears were flowing — partly because I could see my parents’ legacy: It was so emotional to see the seed they once planted had blossomed.”
Emil recalled a Bible passage his mother liked: “From everyone who has been given much, much will be demanded (Luke 12:48).” “I really feel every day that I have been given so much, and the least I can do is give back,” he said. “I just never take my blessings for granted.”
Dr. Sherif Emil, centre, in light blue shirt, with the three other North American doctors who were with him in Ilorin, Nigera, to give a course in pediatric trauma care to Nigerian pediatric surgeons. The three are Dr. Robert Finkelstein (front row, beside Emil); Dr. Natalie Yanchar (standing between Emil and Finkelstein); and Dr. Karen Gripp (standing behind Emil), a pediatric emergency physician at University of Manitoba Children’s Hospital in Winnipeg. Dr. Sherif Emil, centre, in light blue shirt, with the three other North American doctors who were with him in Ilorin, Nigera, to give a course in pediatric trauma care to Nigerian pediatric surgeons. The three are Dr. Robert Finkelstein (front row, beside Emil); Dr. Natalie Yanchar (standing between Emil and Finkelstein); and Dr. Karen Gripp (standing behind Emil), a pediatric emergency physician at University of Manitoba Children’s Hospital in Winnipeg. Photo courtesy of Sherif Emil
Although this marked his first return to Ilorin since childhood, Emil has long had an abiding interest in Africa and been engaged in global surgery service and education. Since 2016, he has volunteered as a pediatric surgeon with the hospital ship Africa Mercy and, later, the Global Mercy, performing surgeries during field services in countries including Madagascar, Cameroon and Senegal. Recently he was appointed international chief medical officer of Mercy Ships, effective Jan. 1, 2025.
Emil left Egypt at 17 after high school for the University of Michigan to study chemical engineering and in 1987 started medical school at McGill; at that point, his parents emigrated to California. His father, who was 50 when they left, had to redo his exams and his residency; his mother, 57 at the time, went from being head of a health authority in Egypt to teaching in a school for medical assistants in California.
They had lived comfortably in Egypt and emigrating was “a massive sacrifice,” Emil said. But they saw no future for their son in Egypt, he said. “As a Christian minority in Egypt, we were always going to be second-class citizens.” After graduating from medical school at McGill, Emil began surgical training in California, where his parents were.
He returned to McGill to train in pediatric surgery and, following a fellowship, joined the department of surgery at the University of California Irvine; he remained in California until he was recruited in 2008 by the Montreal Children’s to lead the pediatric surgery division, a position he held until 2024. Pediatric trauma affects any child who is injured for any reason, whether by motor vehicle accidents, gun violence, burns or child abuse, Emil explained. “It is a diverse disease, but we think of it as a disease,” he said.
Trauma accounts for 35 per cent of pediatric health problems worldwide and is the leading cause of death in children over the age of one. Every year, it claims the lives of one million children worldwide, more than 90 per cent of them in low-income and middle-income countries like Nigeria.
“Every year, thousands of children who could be saved in our environment perish because they sustain trauma in nations that lack resources but also lack the systematic care protocols that have dramatically improved survival of these patients,” Emil said in a social media post from Nigeria last September. “It’s not just about resources. It is also about knowledge.”
Dr. Sherif Emil in 2014, explaining procedures to correct chest wall anomalies at the Shriners Hospitals for Children in Montreal. Dario Ayala The Gazette
Treating pediatric trauma doesn’t require fancy equipment, but what is required is basic infrastructure and knowledge: The goal of the TRIK course is for participants to learn the basic principles of recognizing pediatric trauma and treating these young patients systematically. It uses simulation, a teaching platform involving mannequins or actors to enact what would happen if a patient were there, to replicate clinical scenarios in which people must make decisions.
The TRIK course was given outside North America for the first time in October 2023, in Brazil, “and that is what instigated my wanting to go to Africa,” Emil said.
Of the 26 Nigerian pediatric surgeons who took the course in September, seven have committed to become future course instructors to teach their peers in Nigeria and West Africa, with continued support from their North American colleagues. The course is to be given in Kenya in June and in Burundi in November.
With the success of the course, “a seed was planted to improve pediatric trauma care in Africa,” Emil said. “This is a perfect example of how we can democratize surgical education and continue to learn and serve together for the benefit of some of the most vulnerable children in the world.”
There was “one last treat” for Emil in Nigeria: The primary school he attended, St. Joseph, is still there and he was able to arrange a visit and speak to the class on his last full day in Ilorin.
“The bright eyes of the children shone as I told them how much progress their country has made, that a bright future awaits them, and that they will be the hope of that future.”
This story was originally published January 3, 2025 in Montreal Gazette
