Something More

Finding Hope in a Lassa fever outbreak
By Kelly Faber, MD

“This God–his way is perfect; the word of the Lord proves true;
he is a shield for all those who take refuge in him.” Psalms 18:30

Merely ten days ago I wrote a blog about the grieving of a friend where I said, “the Lord had other plans.” Little did I understand the extent of that statement and that we were actually in the middle, and not the end, of a story that continues to unfold today.

As many of you know already, Todd Dekryger was the Medical Director for this hospital, as well as a talented surgical physician assistant who ran our surgery department here at the Hospital of Hope. He was the visionary, the motivator, and main recruiter for the team. But in the middle of February, he became ill with symptoms consistent with malaria and rested at home over several days. He continued to struggle despite the treatment and was admitted to the hospital one week after he became ill. His testing for malaria was still significantly positive, which spoke to us about the severity of the illness. His labs were also suspicious for Typhoid fever, which we began to treat as well. Todd continued to worsen and the decision was made to medevac him out-of-country to seek further supportive care and recovery. And although Todd was extremely ill when he boarded that small plane headed for Germany, I had no doubt in my mind that I would see him soon on Togo soil.

But this was not to be. Less than 24 hours after landing in Germany, Todd went to be with the Lord.

The story was over.  Complications from severe malaria had not been overcome, but none of us were doubting that the Lord would somehow use Todd’s death to bring a message of Hope to the Togolese people—the message of how Christ had overcome death to save the world, to save the Togolese people.

But one week after boarding Todd onto that plane, Andrés*, a volunteer nurse with Samaritan’s Purse who had cared for Todd, developed a fever. As common diseases are common, Andrés treated his illness with malaria medications and tried to rest. But his fever never went away and three days later, by God’s miraculous plan, Andrés came into the hospital to get some IV fluids. The doctor who had cared for Todd was passing off patient care to another doctor for the day, but happened to look up at the computer screen and see Andrés’ lab results. Nothing short of dread came over her as the lab results that stared back at her were mirror images of those Todd had presented with.

What if Todd had something more?

That something more came to be diagnosed as Lassa fever—a viral hemorrhagic fever normally not found in Togo but instead endemic to Sierra Leone and Nigeria—countries that don’t even touch Togo!  By the time the suspicion for Lassa fever was confirmed, Andrés had already been isolated and infection prevention measures had been taken. Samaritan’s Purse was able to evacuate Andrés to the United States where he remains hospitalized in order to recover. As it turns out, Nigeria was and is experiencing a large outbreak of Lassa fever that was able to reach our town, likely through a patient who wanted to seek care at the Hospital of Hope.

Many of you may be thinking, This is still a horrible, tragic story. And in many ways it is.  No one can deny the pain and void we feel every day because Todd is not here with us leading the charge towards compassionate healthcare in the name of Christ.

But there may be something more.

If the initial infected patient, whom we’ll never be able to identify, had come into Togo and even our hospital, and just died here, we would’ve never known his true diagnosis. Since sophisticated testing, such as Lassa testing, doesn’t exist here, the death probably would have been attributed to liver failure, yellow fever, or just a severe bacterial infection. We would have continued to see patients without associating that death with any other illness that may have developed in our healthcare workers here or in the community. We try to do as few labs as possible here in order to keep things affordable for the Togolese, so we wouldn’t have seen daily labs each morning as we did with Todd. We would have never linked any labs results with each other.

What if the doctor who took care of Todd wasn’t seated at that computer at that moment to see Andrés’ test results? Andrés may have continued to get sicker and may not have had enough time to start treatment or get evacuated to the U.S.

Todd’s illness and subsequent death made it possible for us, for Togo, and for the world to be notified of a potential outbreak of a viral hemorrhagic fever in a country that was not felt to be at risk. Although many of us are on surveillance and verifying that we are not at risk, the story as it is unfolding, saved lives… many lives. Lives that this hospital was built to reach with the message of Christ.

The story seems like it should end there. But three days after Andrés left for the United States, and when we had already put an alert system in place due to Todd’s diagnosis, a woman showed up at the hospital with a fever. Because she told us that she had come from Nigeria three days before, we put her in isolation immediately under surveillance for Lassa fever. Two days later, two of her children, whom we had been following daily, became symptomatic with fevers and were placed in isolation.

As I stood in that mother’s room trying to explain the significance of Lassa fever while the tears fell silently from her face, I said, “Did you know that the fact that you are here at he Hospital of Hope in Mango is a miracle? I am so happy you are here with us!”

I explained that it was only by God’s hand of mercy that, after Todd’s illness and death, Andrés’ visits to clinic and evacuation, as well as her travel from Nigeria to our small town of Mango, we were able to identify her as having a likely case of Lassa. If we had never tested Todd’s blood in Germany and if Andrés had not gotten ill, we would not have investigated further. Had this woman gone to any other clinic or hospital in Togo, they wouldn’t have placed her in isolation and she could have continued to spread the virus unknowingly to others. Because of each step and in God’s perfect timing, this woman and her two children are at the only hospital in Togo that currently has the potentially life-saving medicine to work against Lassa fever. What are the chances that this family would leave Nigeria to come to Togo and end up here…at this time?

Zero. That is, zero without a God whose hand of mercy stretches to the skies! I am confident that no other death could have sparked the response and timeline for discovering that Lassa fever was here in Togo. I am confident, in no uncertain terms, that Todd’s death did make it possible for many others to keep theirs; others who have not yet heard the message of the Gospel; others who were either prevented from getting Lassa because of measures taken, or others who will now get a chance to be identified, cared for and treated.

No one who knew Todd has any doubt that he is face-to-face with the Savior Jesus Christ, the Son of Man who “did not come to be served, but to serve, and to give his life as a ransom for many.” (Matthew 20:28)

And what further testimony can one give to show the love of Christ? “By this we may know that we are in him; whoever says he abides in Him must walk in the same way in which he walked.” (1 John 2:5-6)

But the final word cannot be about Todd or Andres. Nor can it be about Togo or the Hospital of Hope.

“For by grace you have been saved, through faith. And this is not your own doing, it is the gift of God, not a result of works so that no one may boast.” (Ephesians 2:8-9, emphasis added)

The story is the Story of Hope. And it continues. It is the reason we are all here and we can’t wait to see how Christ will use our weak, broken, mourning selves to carry on His message of joy, strength, and peace as we press forward.

Please continue to pray for Togo and that Lassa fever will not spread any further. Please continue to pray for hope and healing our HOH team and Todd’s family and for Andrés and his family as they continue their journey of healing in the U.S.

–  Kelly Faber, MD, is a MedSend pediatrician and Chief of Staff at a Christian hospital in Togo. “Something More” is republished, with permission, from her blog “Go to Togo.”

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