By: Rev. Lowell Gess

Rev. Lowell Gess, a 93-year-old retired ophthalmologist and Minnesota United Methodist pastor, headed to Sierra Leone in early January to bring medicine and moral support to the country he calls his second home. Gess established the Kissy UMC Eye Hospital in Freetown in 1984, and many local churches, individuals, and organizations provided donations that were put toward supplies and equipment for this trip. Although Gess didn’t play an active role in treating Ebola patients, he did work at Kissy and helped staff diagnose difficult cases of eye disease. Gess returned to Minnesota and his home city of Alexandria in early March. Here are his reflections from his two-month visit.

Why are you going to Sierra Leone? Why did you come to Sierra Leone?

I have been met with these questions hundreds of times.

In the summer of 2014, news broadcasts frightened the entire world with Ebola reports. West Africa (Guinea, Liberia, and Sierra Leone) was losing hundreds of patients each week. The doctor who was leading the response in Sierra Leone, Sheik Humarr Khan, and his nurse, Mbalu, each having survived Lassa Fever, died on July 23, 2014.

The infection was unwittingly carried to Nigeria and then to the United States of America, where the first two victims seen died in spite of highly flaunted modern medicine. These patients infected other Americans who mercifully survived.

The only fully trained ophthalmologist in Sierra Leone was Dr. Manfred Moerchen. Sponsored by Christian Blind Mission International (CBM), he practiced at the Kissy UMC Eye Hospital in Freetown. Doctors were at special risk. Of the first 12 doctors infected with Ebola, 11 died. With only 135 practicing doctors in a country of 6 million people, it was equivalent to 1,400 doctors dying in Minnesota, which has a population of 5 million. CBM removed Dr. Moerchen from harm’s way.

I had been part of the establishment of the Kissy UMC Eye hospital back in 1984. I had a sinking feeling as to the safety of the 29 members of the staff. While praying for their safety, I felt a call to go and help. There was little risk for someone 93 years of age who was expected to have a fatal heart attack or stroke in the immediate future anyway. I could be the ophthalmologist during this crisis, emergency, catastrophe…disaster!

Fortunately, Dr. John Mattia, a Sierra Leone physician with a diploma in ophthalmology who was under contract to Kissy from his primary practice at Lunsar Baptist Eye Hospital, and Dr. Matthew Vandy, at the government Connaught Hospital, stayed at their posts. However, Dr. Mattia could not come to Kissy because of the quarantine at Lunsar and travel restrictions.

In early September 2014, I bought a plane ticket. Only two airlines were making flights to Sierra Leone. British Airways still had not resumed air service as of March 18. Travel restrictions were in place by the U.S. State Department. The earliest booking allowed was January 3. Perhaps three months would give me pause to think about going into the lion’s den. Disturbing was the death of Dr. Martin Salia, the medical director of Kissy General UMC Hospital next door to the Kissy UMC Eye Hospital; he died despite having been flown to Omaha, Nebraska, to what was considered an ultimate treatment center.

I told no one of my ticket purchase, but my family learned in several weeks. While surprised, they were supportive. One granddaughter remarked: “It is crazy but cool.” Another added: “That’s grandpa’s calling.”

Baggage was limited to two suitcases and one 50-pound box at $400, but United Airlines allowed seven pieces of luggage at no charge. Medicines and supplies (valued at $60,000) poured in along with cash donations (another $60,000). On arrival in Freetown, Sierra Leone, the boxes easily passed through customs as they were accompanied luggage. Medicines and Ebola supplies shipped by other means involved delayed shipping and customs inspection and evaluation. Those I was bringing in were promptly available. I also had $12,000 cash in my pocket, $9,500 of which was donated through Central Global Vision Fund. One United Methodist Church in Watertown, South Dakota, raised $33,000 in its Christmas Eve service.

Besides the Ebola epidemic, hunger was rampant. The food available was out of reach for most people. A box of cereal cost over $9. Children especially were affected. I saw the gaunt faces of children who had not eaten for an entire day. Over 20 percent of the cash donations given were channeled, including two Christian ministries that also ministered to children of Muslim and traditional faiths.

In addition to eye care, a number of important projects were completed at the hospital, including the utilization of a 140-foot borehole for potable water. In the clinic, Ebola survivors were being referred to us, especially from Doctors Without Borders. In the early months of the plague, 80 to 90 percent of the victims died. With the coming of skilled treatment centers from Britain, the U.S., France, Norway, Switzerland, Cuba, and China, survival rates reached 40 to 60 percent. 

Now we were seeing survivors who were complaining of blurred vision. They all had the same signs and symptoms of uveitis. It is known that the deadly Ebola viruses are in the blood, flowing to vital organs of the body. Supportive treatment was being given to such organs as the kidneys and lungs, but no one thought about the eyes. The patient was too ill to inform the physician that his eyesight was blurred. Only when he recovered did he mention his compromised vision. As an ophthalmologist, I understand the anatomy and blood supply of the eye as being by way of the choroid, ciliary body, and iris. During the acute infection of the hemorrhagic fever, this eye tissue was being attacked.

How would it be possible to alert Ebola treatment centers that mydriatics and steroid drops were mandatory during the acute phase? I contacted my son, Tim, and granddaughter, Debby, also ophthalmologists, to contact the Center for Disease Control in Atlanta, the World Health Organization (WHO) in Geneva, and the Medicins sans Frontieres (MSF), or Doctors Without Borders, branch in Brussels. Even stepdaughter Carrie contacted a world health organization on the west coast. I was determined to visit treatment centers in Sierra Leone and spoke to doctors at the Swiss MSF center at the Prince of Wales compound in King Tom and Save the Children’s wonderfully equipped facility at Kerry Town…magically passing through impervious gates.

Time was running out. During the last week of my two-month stay, two distinguished visitors came to the Kissy UMC Eye Hospital. The first was the consultant from MSF Brussels, an eye surgeon. The second, two days later, was the infectious diseases specialist from WHO Geneva. They took my findings with the assurances that the suggested treatment would be made available to Sierra Leone, Guinea, Liberia, and beyond. The ophthalmologist graciously copied me his correspondence. The WHO doctor e-mailed Geneva and took 10 copies for the treatment centers in Sierra Leone that she was personally visiting.

I e-mailed the good news to Minnesota so that they could desist from more calls or letters. Miracles of miracles…the relief was fantastic. Those who would live through vicious Ebola now had a greater chance for normal vision.

Two weeks after my arrival, there was a dramatic fall in the number of new laboratory confirmed cases. The news was met with rejoicing. However, the last several weeks have seen a rise again to a weekly number of 100 or more. Vigilance is preached and practiced, but the dictum to not touch is still being ignored by some who continue unprotected care for the ill and washing of corpses, which culturally is so important. Dr. Mattia has been rigid in his protocol and has remained alive. We lived together in the Kissy apartment for half of each week during the two months. I said goodbye to him with our not having touched each other once during our entire time together.

Only a few emergencies braved coming to the eye clinic in January. The staff appreciated the teaching sessions at that time, but during the last weeks, we were flooded with patients. Many examiners were seeing 10 to 15 patients a day. The backlog of surgery was great. On one of the three days of surgery the week before I left, 27 cataract extractions with intraocular lens implantations were performed. Our operating microscopes were put to good use. Surgery ended when we ran out of drapes.

My calling has been in medical missions. I love God and my neighbor. I serve in the name of Jesus Christ who said in Matthew 25:40, “In as much as you have done it unto one of the least of these, my brethren, you have done it unto me.”

In summary: I have never lived for two months on such a high level of adrenaline. I settled into the plane seat and wended my way back to my primary home in Alexandria…crossing the ocean for the 186thtime. It was a spiritual experience. I have never been more dependent on God’s grace or experienced more highly the joy of ministering in the name of my Savior and Lord.

Why did I do it? Like Paul in I Corinthians 9:23, “I do all for the Gospel’s sake,” or as the popular Good News Bible in Africa says, “All this I do for the Gospel’s sake in order to share in its blessings.”

I am halfway through my three-week quarantine. Minnesota Public Health calls me each day for any symptoms and for temperature morning and night checks. Everything is fine.

Lowell Gess