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In Niger and Worldwide, a Legendary Surgeon and Humanitarian Is Mourned

Professeur Jean-Marie Servant, photo courtesy of Adel Laoufi via Facebook.

Professeur Jean-Marie Servant, photo courtesy of Adel Laoufi via Facebook.

Professor Jean-Marie Servant, a specialist in reconstructive plastic surgery, lost his long fight against leukemia on Dec. 29, 2016. Servant was regarded worldwide as an expert in his field, however his humanitarian work in Africa in collaboration with Doctors of the World was just as important, if less well known. A celebration of his life and commemoration of his work was held on Jan. 5 in Père-Lachaise's dome hall crematorium.

Niger Remembers the Professor Who Fixed Children

Reconstructive surgery makes up a large part of public health in Niger, where children often fall victim to complications caused by poor sanitary conditions and unsafe surroundings, sometimes requiring quite drastic plastic surgery:

  • Serious burns victims:  The use of firewood as cooking means in homes in Niger causes numerous accidents, usually to children. Sentinelles, an NGO dedicated to providing aid to the wounded in Third-World countries, explains this phenomenon:

Les enfants gravement brûlés sont malheureusement nombreux. Les «cuisines» des familles se composent généralement d’un simple feu de bois, où est posé le chaudron qui va servir de récipient pour préparer le repas familial. Souvent les enfants jouent autour du feu sans surveillance. Un coup de vent, un enfant trop près du feu, le pagne qui s'enflamme

The number of children who are seriously burned is unfortunately high. Family “kitchens” generally consist of a stack of firewood with a pot on top that is used to prepare and serve family meals. Children are often left near the fire unattended, meaning the slightest incident, a slight gust of wind for instance, can lead to the child's clothes catching on fire.

Servant came to the Niamey National Hospital not only to provide care to children suffering from serious burns, but also to train resident medical students in reconstructive surgery techniques. And his humanitarian work didn't stop there.

  • Treatment of Noma gangrene and other malformations: Servant went on to participate in the “Operation Smile” project, the focus of which was, and is to this day, to treat and repair the faces of children suffering from Noma, a form of gangrene that mainly affects malnourished children.
Pr. Servant au Niger via Issa Hamady sur Facebook avec sa permission

Servant with a patient in Niger. Photo courtesy of Issa Hamady via Facebook.

In an interview with the magazine Pharmaceutiques, a French language pharmaceuticals magazine, Servant explained his work in Niger in detail:

Nous essayons d’opérer essentiellement des enfants souffrant de malformations faciales (le Noma, notamment) pouvant être congénitales (bec de lièvre…) et laissant des séquelles esthétiques et fonctionnelles majeures. Les patients sont triés sur place, soit par des chirurgiens de Niamey. En général, nous recevons les photos via Internet, en France, une semaine avant le début de la mission. Si 80 % de nos interventions concernent des malformations faciales, nous opérons aussi les brûlés et les personnes atteintes de tumeurs. Par ailleurs, nous formons aussi des chirurgiens africains afin qu’ils puissent prendre le relais. Médecins du monde mène des actions au Niger, à Madagascar et au Vietnam. C’est elle qui finance, grâce aux donc, toutes les missions humanitaires de chirurgie réparatrice.  Nous nous rendons à l’hôpital national de Niamey de deux à quatre fois par an. Un chirurgien bien entraîné peut opérer une trentaine de personnes. Lorsque nous sommes deux sur place, nous pouvons en opérer une cinquantaine.

We essentially try to operate on children suffering from facial malformations (Noma gangrene, in particular) and congenital conditions, such as cleft palate. Our aim is to reconstruct the affected area and to reintroduce the mouth's major functions. The patients are usually diagnosed and categorised on location, normally by the surgeons at Niamey. We generally receive photos of the patients in France one week before we are scheduled to start work in Africa. While roughly 80 percent of our cases, we do also treat burn patients and patients with tumors. We also train the local surgeons, so that they are able to treat patients in these cases independently. Doctors of the World works in Niger, Madagascar, and Vietnam. It is thanks to funding from the organization that all of this humanitarian work is possible. We work at Niamey National Hospital between two and four times per year. A well trained surgeon can treat roughly 30 patients. Since there are always two of us on site, we can treat roughly fifty.

Servant took on a number of students as part of his work, one of whom was Nigerien surgeon Issa Hamady, who learned how to treat Noma gangrene effectively by working at Servant's side. Hamady recently reflected on what the late professor and his work means to him:

Un grand maître, un père aimant et attentionné pour moi, un homme au cœur énorme nous a quitté.
On ne pourra jamais dire assez les mérites, les prouesses de ce monsieur, son amour pour le travail bien fait.
Les centaines de patients atteints de Noma notamment, dont la vie a radicalement changé grâce à lui, tous ceux à qui il a transmis la fibre de la chirurgie réparatrice n'oublierons jamais.
Que son âme repose en paix

A great mentor, a loving and attentive father figure, and a man with an enormous heart has left us.
Enough could never be said about this great man's achievements, prowess, and passion for his work.
Neither his hundreds of Noma patients, whose lives have changed dramatically thanks to him, nor those he taught the essence and complexities of reconstructive surgery, will ever forget him.
May his soul Rest in Peace.

A Wonderful Homage From His Peers and Friends

Colleagues and close friends from around the world remember an exceptional surgeon and a brilliant man with integrity, whose generosity and kindness were unparalleled. Born in 1947, Jean-Marie Servant became the head of reconstructive plastic surgery at Saint Louis hospital in Paris in November 1995, where he worked for 15 years. In the early years of his career, he completed his internship at various hospitals around Paris, and then began his residency in Showa hospital in Tokyo, where he later became clinic director.

Dr. Adel Laoufi worked with Servant as clinic director during Servant's time at Saint Louis hospital. This is Laoufi's written homage to the late professor:

2016 a emporté beaucoup d'étoiles . Mais c'est ce 29 décembre que j'apprends ce qui est pour moi la plus triste disparition.  Difficile de décrire en quelques lignes ces heures passées ensemble au bloc opératoire. Je garde l'image de cette patiente de 80 ans , “inopérable” que nous avions opérés ensemble, en urgence , à cette même période de l'année , entre Noël et le jour de l'An d'une tumeur complexe et étendue de la face , avec reconstruction complète de la paupière . Des heures de travail complexe et minutieux où il m'a guidé et qui ont permis à cette patiente de profiter des années de plus de ses enfants et petits enfants. Jean Marie avait cette attitude paternelle qui faisait de lui un homme touchant et attachant , en même temps qu'il inspirait un immense respect par son génie chirurgical. J'ai eu la chance de le revoir il y a quelques mois avec mes amis et collègues Gregory Staub et Christelle Santini , autour d'un café , où il nous évoquait sa passion pour l'Art Africain.

2016 has taken many stars from us. However, for me Dec. 29 marks the saddest of these losses. It's difficult to describe in so few lines all those hours we spent together in the operating room. I will always remember the image of the supposedly “inoperable” 80-year-old patient, on whom we operated together for countless hours between Christmas and the New Year to remove a complex facial tumor, and subsequently to reconstruct the patient's entire eyelid. The hours and hours of complex and meticulous work were what allowed the patient to spend a few more years with their children and grandchildren. Jean Marie had a very nurturing personality, which made him a personable and caring man. You also had to respect his surgical genius immensely. I was lucky enough to be able to see him again a few months ago with my friends and colleagues Gregory Staub and Christelle Santini in a café, where he told us of his passion for African art.

Dr. Bachir Athmani also shared his thoughts and feelings

Jean Marie

tu étais un homme de bien
• Un homme droit et juste, mais non raide et inflexible ; tu savais te plier mais pas te courber.
• Tu aimais les hommes et tu savais les connaître.
• grâce à la mémoire de tes élèves tu es rentré dans la longévité

Jean Marie You were a good man;
• An honorable and fair man, but not inflexible. You knew how to bend but not break;
• You loved people;
• and you will always be remembered by your loving students.

In an open letter, Malagasy doctor M. Rakotomalala offered a final farewell to his old friend:

Je pense que tu n'aurais pas aimé ce que je m'apprête à faire. Parler de toi, te rendre hommage, dire que je suis déraisonnablement triste, après l'annonce de ta mort que tu m'avais pourtant maintes fois prédite.

Mais je vais le faire quand même  parce que tout au long de nos 20 d'amitié, je n'ai pas toujours fait selon tes  indications.

Comme ce jour où après m'avoir ôté une tumeur qui s'annonçait maligne, tu me vois quitter ton service pour un voyage outre atlantique pour assister à la remise de diplômes de mes enfants.Le projet était fou, mais j'étais libre, de prendre ce risque inconsidéré , libre de vivre, libre de mourir.  “Tu fais comme tu veux” m'avais-tu dit. Il n'y avait déjà plus de colère dans ta voix.

En fait, tu respectais dans mon geste, ce qui a dirigé ta vie: le libre arbitre, l'oubli de soi, la passion des autres. Et la force monstrueuse d'en supporter les conséquences.

Les longues missions de chirurgie réparatrice au Niger après avoir survécu à un pontage coronarien. Participer au baptême de ma petite fille aidé d'une cane, fragilisé par une convalescence incertaine, dans le vacarme et l'euphorie de nos reunions familiales. Venir nous rendre visite après son accident une semaine après, alors que tu pouvais à peine parler ni marcher.

Il y avait aussi ce coq au vin du bistrot Mazarine, après l'annonce de ta leucémie. Ces cigarettes fumées et ces cafés très serrés, contre toute indication. Je te disais d'arrêter et tu me répondais avec un petit sourire, qui en disait long sur le souci que tu te faisais de ta propre personne.

Lorsque nous nous sommes rencontrés au Niger en 91, tu te disais sursitaire depuis 6 ans. Et d'accident grave en opération miraculeuse, tu nous as donné 20 ans d'une amitié solide comme un roc, réparé avec tes mains d'orfèvre nos corps accidentées et baladé ton cœur immense dans nos vies piteuses et héroïques.

Surdoué, désintéressé, libre. Un géant.

Adieu, mon ami.

Au revoir, Jean-Marie.

I know you wouldn't have wanted me to write this letter: to speak of you, to pay you homage, to say that I am inconsolably sad after the announcement of your death that you predicted countless times. But I'm going to do so anyway because, throughout our 20 years of friendship, I haven't always done what you told me to.

Just like the day when, right after you'd removed my malign tumor, you watched me travel across the Atlantic to attend my students’ graduation ceremony. The idea was crazy, but I was free. Free to take such an inconsiderate risk, free of life, free of death. “Do what you want.” These were the words you said to me, but there was no hint of anger in your voice. In fact, you actually respected my choice.

This was the driving force of your life: not to judge others, forgetting your own wants and needs, and the passion of others. More importantly, you always knew that it was important to accept the consequences of your actions. The long reconstructive surgery missions in Niger after you'd undergone a coronary bypass. Attending my daughter's baptism, supported only by a cane and facing an uncertain recovery, amidst the row and euphoria of our family gathering. Coming to visit us after her accident a week later, even though you could hardly walk or speak.

There was also Bistrot Mazarine's coq au vin, after you'd just found out that you had leukaemia. All those cigarettes and coffees your drank, against all advice. I told you to stop and you replied with a little smile, which told of how little consideration you had for your own well being.

When we first met in Niger in 1991, you'd already been working there for six years. And by either accident or a miracle, you gave us 20 years of beautiful friendship, fixed our broken bodies with your hands of a master craftsman, and brought your immense heart into our pitiable and heroic lives.

Gifted, selfless, free. You were a giant among men. Farewell, my friend. Goodbye, Jean-Marie.

Writing on Facebook in fewer but no less poignant words, Borhane Belkhiria summarized the memory that will remain with Jean-Marie Servant's family and loved ones: “Geniuses are comets, destined to burn in order to make our generation a little brighter.”

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