Pursuing a Calling That Leads to West Africa

http://www.nytimes.com/2014/10/17/world/africa/pursuing-a-calling-that-leads-to-west-africa.html

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Dr. Steven Hatch, an infectious disease specialist in Worcester, Mass., is volunteering at a new Ebola clinic in Suakoko, Liberia, run by the American charity International Medical Corps. Before going, he wrote this essay about his decision to travel there and administer care.

Why I Go

In nearly every medical school applicant interview, candidates are asked why they want to pursue medicine as a career. Invariably, the answer takes some form of a simple idea: I want to help other people. It is almost impossible to make this answer sound new or genuine or creative, and yet, for the most applicants it is an honest response.

I’ve been thinking about this of late because I’m now being asked a similar kind of question from colleagues and friends. You see, I am going to be headed to Liberia shortly to participate in the efforts to control the Ebola outbreak, and — in addition to being asked whether or not I am insane — people want to know why I would willingly seek out such an assignment.

It is a legitimate question. Although I think many Americans have magnified the danger that a person like me faces heading into the current chaos of West Africa, it is nonetheless a risky thing to do, and there is the real possibility that something terrible will befall me while I am deployed. Becoming infected with Ebola is only one of a laundry list of hazards I will face.

So why do such a rash thing?

For starters, I am an infectious disease physician. Many of those who join the ranks of infectious disease do so out of a passion for epidemics, and the awareness of the impact of human behavior and development on disease. In particular, many infectious disease doctors are driven toward international health, and in particular settings where resources are most limited. Even before Ebola came, West Africa was a place where infections were the leading cause of mortality. Global health groups often refer to the “big three” diseases that constitute the major causes of suffering: H.I.V., malaria and tuberculosis. But that is only the beginning in West Africa. There is yellow fever, pneumococcal disease, meningitis, rickettsial infection, streptococcus and a host of other maladies that can shorten lives and bring general misery to a place.

Trying to provide long-term solutions to such places is why I became passionate about infectious disease. I read Laurie Garrett’s book “The Coming Plague: Newly Emerging Diseases in a World Out of Balance” (an exhaustive and thoroughly well-researched account of the many infections that threaten our lives) prior to medical school almost 20 years ago, and it changed my life. I agreed with her premise that the rapid technological changes to our world may create a host of unintended consequences, that viruses and bacteria will be only too happy to exploit for their own purposes.

As someone who chose this particular profession for the reasons why I did, how could I not want to help out? Why do the police put their lives on the line on a daily basis? To preserve order. Why do firefighters run headlong to the fire? To put it out, of course. Ebola is not really different, and it is my fire; along with many other colleagues, I go to put it out. The vast majority of people who pursue these callings do not make the ultimate sacrifice, but they are willing to do so because they believe in something higher than their own lives.

I go also for more personal reasons. Last year, I traveled to Monrovia to help kick-start a residency program for the Liberian Ministry of Health. My host was the chief of internal medicine at John F. Kennedy Hospital, a man named Abraham Borbor. I liked him from the moment I met him. He was kind and intelligent and compassionate, and clearly had inspired fierce loyalty among his staff. But what drew me most to him was his sense of humor. After living through a bloody civil war and seeing death on a daily basis, he still was able to be amused at the world around him. He could joke about the fickleness of American and Liberian politicians as much as he found the idea of pouring some warm Coke into his glass of warm beer a source of great amusement — “Well, going the same place anyway,” he observed. He had a rich cackling laugh that had the effect of making you laugh along with him, a contagion of a different sort than what has befallen West Africa of late.

Now, because of Ebola, the world will not hear that laugh again.

Especially with Dr. Borbor gone, I go to honor the commitment that he made to his profession and to the next generation. He took me into his world and placed a small part of Liberia in me; how could I not go after the disease felled him?

We live in a cynical age, where a term like brotherhood can only be uttered sardonically, tossed out as part of a joke making fun of Victorian idealism. But Dr. Borbor became — at least in some meaningful although small way — my brother when I went over there. I go because I owe him something. I go because I do believe in the idea of brotherhood. I go because if I do not, after where I have been and the people I have met, that concept would mean very little. I would very much prefer to return whole, but if I do not, it will be because I could not see any other way forward.