Ebola and the Normal Christian Life
by David Stevens, MD, MA (Ethics)
Today's Christian Doctor - Winter 2014
He knew the symptoms and signs all too well, and his were progressing. He was going to die.
Could he trust God enough for this?
“I just felt ‘off’ that Wednesday morning,” Kent said, “so I stayed home to isolate myself.” He sent word to his missionary colleagues, and they entered his room in full protective gear, just in case he had the deadly virus. Three days later, his Ebola test came back from the government lab. It was positive. By then his symptoms had progressed and he had muscle aches, fever, a sore throat, headache, diarrhea and nausea. He was worsening and now he was getting short of breath, an ominous sign that had preceded death in the patients he had cared for, one of whom had passed on their deadly pathogen to him. He called his wife Amber, who thankfully had already left Liberia with their two children to travel to the U.S. for a family wedding before his symptoms started. He was so weak he could barely talk and thought, “This is probably going to be the last time I talk to her.”
Nancy Writebol, his nurse colleague who had also contracted Ebola, wasn’t doing well either, and only one dose of the experimental drug ZMapp was available. He had decided earlier that she should have it.
“Greater love hath no man than this, that a man lay down his life for his friends” (John 15:13, KJV).
With his condition spiraling downward, missionary colleagues prayed for guidance and urged him take the dose of the drug. There were no other medical options left.
How had it come to this?
Dr. Kent Brantly felt a call toward missions at an early age and pursued it. He participated in multiple mission trips to Africa and Central America. He attended the Global Missions Health Conference in Louisville, Kentucky and prepared for a future in missions by reading beneficial books and other resources. When he was accepted to Indiana University’s School of Medicine, Kent immediately got involved in the CMDA group on campus. His classmates quickly identified him as a leader and he became part of the team guiding the ministry.
As other CMDA student leaders disappeared into the wards at the beginning of clinical rotations, Kent made time to be a mentor to the younger students. After graduation, he joined a family practice residency at John Peter Smith Hospital in Ft. Worth, Texas. CMDA field staff so respected Kent’s leadership that they asked him to submit his name to be the resident representative at CMDA’s House of Representatives, but as he was now married to Amber, who he had met on a mission trip, with two children, he felt he needed to prioritize his limited time outside the hospital with them.
I got to know Kent and Amber during the summer of 2013 when they came to CMDA’s headquarters in Bristol, Tennessee to attend Orientation to Medical Missions, a training weekend for new healthcare missionaries. They had been selected to receive a post-resident fellowship from Samaritan’s Purse and had been placed at ELWA Hospital in Liberia. The hospital was almost completely destroyed in the Liberian Civil War, but it was being rebuilt with help from Samaritan’s Purse. Little did Kent know what God had in store. Like all new missionaries, Kent and Amber were concerned about personal burnout for Kent and the safety of their children, but their deep faith in God’s providence was evident even before they traveled to Liberia.
When they first arrived in Liberia, it was hot and humid, but the family quickly adapted to the weather, as well as the culture and Kent’s workload. They were finally realizing their long-held dream of serving in career missions.
Word reached the hospital in spring 2014 that an Ebola epidemic had broken out, but it was many miles away. ELWA Hospital is located just outside Monrovia, the capital of Liberia, so the staff began preparing, knowing the likelihood of the epidemic spreading was high as people regularly crossed the international borders. They needed to prepare for the worst.
They sought advice, obtained manuals, purchased protective gear, stockpiled supplies and created an isolation ward for Ebola patients. The first makeshift isolation ward was in the hospital chapel, and a physician and a nurse were designated as the Ebola team’s clinical leaders. Mandatory training was given to all their staff members, including the cleaning staff, those doing registrations and the clinical professionals. Since Liberia has only one doctor for every 100,000 people, they communicated regularly with the Ministry of Health to coordinate their efforts with the country’s health leaders. They established triage protocols and areas in front of the emergency room and outpatient clinics with 20 feet of space between them and the normal waiting area. Suspected cases would not be allowed to enter any common treatment areas. Non-touch infrared thermometers, large quantities of chlorine powder and reusable rubber boots were among the many items that needed to be purchased. Chlorine hand wash buckets with spigots were placed in the ER, wards, registration areas, visitor areas and the isolation unit. A number of 40-gallon trash cans were filled with chlorine solution to soak aprons, scrubs and boots after use. The list of things to do went on and on.
Drill after drill followed until everyone was prepared, but a couple of months passed before the first Ebola victim arrived. It began with a trickle, but became a steady stream by July 2014.
While ELWA was ready to face Ebola, other hospitals inside the city limits of Monrovia didn’t have the resources to prepare for the epidemic. Because these hospitals didn’t have protective gear, medical personnel were soon infected and half of them died. Some hospitals closed their doors because staff members refused to report for work out of fear of catching the virus. As the situation began to deteriorate, Liberia’s Ministry of Health turned to ELWA and asked the hospital to serve as the city’s Ebola treatment center.
Kent was asked to head the Ebola unit, now a full-time job as patients poured into the hospital. A cup of coffee in the morning, skipping lunch, followed by rice and meat for supper while sweating profusely in protective gear for hours a day resulted in him losing 30 pounds in a few months.
As he lay in what could be his death-bed, the question pestering his mind was, “How did I get it?” Their barrier and decontamination techniques were excellent. They checked and double- checked each other like scuba diving buddies. He just couldn’t believe he had gotten the virus on the isolation ward. But there was that one patient he saw in the ER while he wasn’t wearing normal protective gear. She had waited quite a long time, and it was late in the day when they decided to triage her to an area away from other patients while awaiting her Ebola test results. It later came back positive.
Many tropical and non-tropical illnesses present with fever, body aches, nausea or other symptoms that can be confused with Ebola. The real danger to healthcare personnel is before Ebola is suspected and confirmed. He strongly suspected that his infection came from that ER patient.
As his condition continued to deteriorate, his missionary colleagues made the decision to give Kent the ZMapp, and they infused it into his vein. It is an experimental drug comprising of three monoclonal antibodies, but it was untested on humans for safety or effectiveness. Kent almost immediately began shaking with chills, but within an hour or two his breathing improved and he was able to get up and go to the bathroom with some assistance. The next morning he was able to take a shower.
Was it the ZMapp or the fervent prayers being lifted up around the world by tens of thousands of people on his behalf that made the difference? Kent credits the prayers and only God knows whether the ZMapp had a part, but his improvement nonetheless was miraculous.
While all this was happening in Liberia, Kent had no idea that his story was making headline news all over the world. Amber told him in an earlier phone call that he had been mentioned in a newscast, but he had no idea the lengths his story was traveling. However, he did know one thing; God had given him incredible peace throughout his ordeal. Kent knew he was in God’s hands and wanted Him to be glorified through it all.
Behind the scenes, Samaritan’s Purse and SIM were working hard to get Kent (and Nancy, of course) evacuated to the U.S. for two reasons. First, his colleagues were almost overwhelmed in responding to the epidemic and treating their dear friend was adding significantly to that workload. Secondly, Kent could get better supportive care in the U.S., while at the same time allowing infectious disease specialists to learn from him how to help others. At ELWA, they couldn’t even give him electrolytes for fear of contaminating the entire lab.
He had an inauspicious transport to the plane when it arrived in Liberia. They put mattresses in the back of a pickup truck, built a frame over its bed and covered it with tarps. He was helped into the makeshift containment unit and transported to an airstrip, while his quarantined house was sealed from further entry.
No European country would let the plane fly over, so they flew to the Canary Islands, landed at a U.S. military base to refuel and then took off on the long leg to Maine before continuing on to Atlanta. The world held its breath and then cheered as he walked from the ambulance to the doors of Emory University Hospital swathed in a protective suit. Kent had no idea we were even watching.
With the attention of the world on Kent and his recovery, news anchors called him a hero. In one sense, he and Amber are all that and more. All of us should admire and emulate their lives. They denied themselves, took up their crosses and followed Him (Matthew 16:24). And as a physician, Kent lived out his covenant to put the needs of those suffering above his own and willingly took a great personal risk on their behalf.
But Kent and Amber don’t consider themselves heroes. As far as they are concerned, they are just living the normal Christian life as Christians have for thousands of years.
At the height of an epidemic of smallpox that killed five million people around 260 AD, Bishop Dionysius of Alexandria wrote of “our brother Christians unbounded love…” and said:
Heedless of danger, they took charge of the sick, attending to their every need and ministering to them in Christ, and with them departed this life serenely happy; for they were infected by others with the disease, drawing on themselves the sickness of their neighbors and cheerfully accepting their pains. Many, in nursing and curing others, transferred their death to themselves and died in their stead…
He went on to say:
The heathen [pagans] behaved in the very opposite way. At the first onset of the disease, they pushed the sufferers away and fled from their dearest, throwing them into the roads before they were dead and treated unburied corpses as dirt, hoping thereby to avert the spread and contagion of the fatal disease; but do what they might, they found it difficult to escape.
The student volunteer movement that inspired more than 20,000 missionaries to travel to China and around the world during the first 30 years of the last century was significantly stimulated by the cry, “Who will replace Borden?” Young William Borden was the heir to the Borden dairy fortune who renounced his fame and fortune and set off as a missionary to western China. On the way, he stopped in Egypt to learn Arabic, came down with meningitis and died. The words written in his Bible inspired thousands to follow in his footsteps—“No Reserves, No Retreat, No Regrets.” He wrote the last phrase just hours before his death.
Do you wonder why there are estimated to be 100 million Christians in China? It started with Borden living the “Normal Christian Life” abnormally, and God turned his death into a clarion call ringing in the hearts of a generation that transformed the world. Kent and Amber also don’t consider themselves heroes because tens of thousands of un-heralded missionaries sacrificed as much or more than they did. These missionaries left their homelands knowing that there was little chance they would return. They packed their belongings in their caskets knowing they would likely use them, and many did even before they arrived at their destination.
Willis Hotchkiss arrived in Mombas in 1895 and headed by foot into the interior of Kenya with porters carrying his luggage. He later wrote:
Swimming the streams, wading the swamps, blistered by the tropical sun…, drenched by the rain…, in danger from savage men, and attacked by wild beasts, winding along the narrow, tortuous native paths, single file, until feet are like lead, heads drooping, tongues swollen, eyes painful-here the romance of missionary life loses its fine outline in the dead level of actual life.
He and his companions all fell ill with malaria, five died and two others, so sick with Black Water Fever they couldn’t walk, were carried back to the coast. Willis Hotchkiss traveled on alone. He faced starvation, repeated illnesses and shunning by local chiefs, but he ultimately won minds and hearts. His “industrial mission” introduced corn and inspired the first water power grist mill with millstones he imported from India. Through his faithful witness, many Kipsigis came to Christ.
In the early 1930s, Robert Smith, World Gospel Mission’s first missionary, arrived in Kenya and asked for help in finding a good location with a waterfall that someday might produce electricity for a mission station and dispensary. Willis Hotchkiss found a spot for them and a few years later turned the results of his many years of service over to the same young mission. Today, the 300-bed Tenwek Hospital stands on that same site and is powered by that same waterfall.
The question you and I need to be asking ourselves is, are we living a normal Christian life? Is our main focus on our career goals, our security and our “happiness?” It’s not that we don’t love the Lord. We read our Bibles, go to church and give generously. We work hard to be good Christians, but the bottom line is this: are we willing to risk it all for Christ’s sake?
“For whoever would save his life will lose it, but whoever loses his life for my sake will find it” (Matthew 16:25, ESV).
The more we try to “secure” our lives, the more insecure they become. It is when we put our security in Christ and follow Him that we find real joy. That type of living sacrifice is the best platform to share Christ to an individual, a tribe and a race. And, as Kent and Amber Brantly have found, to the entire world.
And if we are going to reach every people group, that is what it is going to take!