An Insider Glimpse Into the Ebola Crisis

Dr. Rick Sacra contracted the Ebola virus in September 2014, while working at ELWA Hospital in Liberia. Following several weeks of treatment at the Nebraska Medical Center, Dr. Sacra returned to Liberia. He shares his thoughts about ELWA’s response to the Ebola crisis, and the fulfilling nature of medical ministry.

By Dr. Rick Sacra

Monday morning, 9 February, was my last morning at ELWA Hospital – in just a few hours I would be heading for the airport. There was an appreciation program, with breakfast, for all of the hospital staff after our morning chapel gathering, recognizing those who had served so courageously during the worst of the Ebola crisis.

Dr. Rick Sacra with young baby Noah, a patient the hospital was able to treat because it stayed open.
Dr. Rick Sacra with young baby Noah, a patient the hospital was able to treat because it stayed open.

Along with Dr. Jerry Brown, our Medical Director, I was asked to say a few words. As I spoke, thanking our nurses, midwives, aides, and cleaners for coming to work during the toughest times (August-October 2014) my mind went back to a meeting with health care planners from an international NGO. They wanted to know: “What allowed ELWA to remain open when other hospitals closed?”

The health system collapse was one of the greatest unanticipated consequences of the Ebola epidemic. It led to many deaths, due to malaria or obstructed labor or pneumonia – illnesses that have nothing to do with Ebola that went untreated because hospitals and clinics were shut down. ELWA Hospital was one of the bright spots, remaining open and caring for the sick through the most difficult months of the crisis.

Also on that Monday morning we discharged little Noah from the hospital. Five-week-old Noah had come in about 12 days earlier with severe vomiting. He couldn’t keep anything down. He was hungry and was breastfeeding vigorously, but after every feeding he would vomit all of it up. He wasn’t making dirty diapers any more. He had lost weight and become dehydrated.

One of our doctors suggested he might have pyloric stenosis, a thickening of the muscle around the outlet of the stomach into the small intestine that leads to blockage of the flow of nutrients to the body. The best test for this is an ultrasound exam, and fortunately I had developed reasonable ultrasound skills over many years of scanning and learning on the job.

I went to the office and found our big two-volume ultrasound text, and read about pyloric stenosis. An ultrasound allows you to measure the thickness of the muscle in the pyloric canal (the outlet of the stomach) to confirm the diagnosis. As I scanned little Noah, one of my colleagues joked with me about “doing the scan with the ultrasound in one hand and my textbook in the other.” I told him this was not the first time I would be doing this, nor would it be the last! Some clear images confirmed that little Noah did indeed have pyloric stenosis, and would require surgery.

God has blessed ELWA with some truly gifted staff. Dr. Brown is one of the few residency trained surgeons in the country. We also have some highly qualified anesthetists, one of whom is especially skilled in handling infants. So after coordinating the schedules of all the staff who were needed, the child underwent a successful operation about four days after admission. As we monitored Noah through his recovery, I realized we were one of only a few institutions in Liberia that could pull together the resources to successfully diagnose and operate on this baby.

After the surgery baby Noah improved quickly. He nursed voraciously and started gaining weight – his parents were so relieved! Finally, on my last day in country, he would be going home!

This takes me back to the question that was asked by the visiting international health care coordinators: After the reopening of the hospital on 6 August 2014, how did ELWA manage to remain open when other facilities were repeatedly closing?

As I see it, there are two reasons. The first is that our staff are mission-oriented. We are motivated by the example of Jesus Christ and his call to care for our neighbors who are in need. Our belief in God is no mere intellectual assent or religious ritual, but real, “where the rubber meets the road” faith that has strengthened us to do this difficult and fearful work, and leave the results to God.

The second reason has to do with little Noah. When you put together all the pieces of the puzzle, you can accomplish so much more than any one person can accomplish on their own.

That synergy, the teamwork that results in the ability to give back to a couple their baby … alive, a baby who would have surely died otherwise, makes medical work so satisfying. It is a blessing to come to work knowing that what we have to offer might be a critical piece of the “puzzle” of saving lives.

SIM Canada has missionaries at the ELWA hospital, and is an affiliate of The Evangelical Fellowship of Canada, publisher of Faith Today. Watch the July/Aug issue of Faith Today for an update article on the Ebola crisis — and what Canadian organizations learned from their experiences.



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