Liberia Notes: A Secret History

4 min readApr 26, 2018

“The missionaries were out there early and stayed late.” So begins Berkeley historian David Hollinger’s Protestants Abroad,* a tale of hardy, focused individuals who set out to change the world and instead had an outsized influence back at home, transforming America’s own culture and its relationship with other civilizations.

Hollinger’s observation came back to me while visiting Dr. Rick Sacra last month at ELWA Hospital in Liberia. ELWA was ground zero for the Ebola epidemic. Several missionaries, including Dr. Sacra, became infected with Ebola, and the story has been well told elsewhere.

What struck me about Rick’s journey, and what made me recall Hollinger’s comment, was the decision he and his wife Debbie had made two decades prior during the brutal Liberian civil war. Fighting closed the hospital for six months. Instead of returning to America or some other place of safety and comfort, the Sacras instead moved to rural Ivory Coast to minister to Liberian refugees. Later, when relative calm returned to Liberia, so did the Sacras.

The West Point shanty town on a spit of land in Monrovia, Liberia

“What most makes missionaries worth understanding is their sustained, intimate engagement with the peoples of the globe beyond the North Atlantic West,” Hollinger writes. Sustained, intimate engagement describes the Sacras fixed purpose, which others might regard as a patently irrational throwing of caution to the wind. After getting out of Dodge, perhaps it’s best to get way out.

The Sacras are not alone in their headlong abandonment of the rational rules of living which modern, well-educated Western professionals are meant to follow. I know of a missionary doctor in South Sudan who trailed refugees to northern Uganda after fighting closed the hospital. Call it quits? Would be an understandable choice, but it’s not the route he and his family took. And this doggedness came after his daughter experienced a frightening febrile illness and he himself suffered visual impairment from retinal detachment, there being no ophthalmologist or eye laser in rural South Sudan. His decision was to return to the work “with or without vision in my right eye.”

L’Chaim Prize laureate Dr. Russ White of Tenwek Hospital in Kenya nearly died of septic shock following a stomach bug a decade and half ago. In those days, in those parts, evacuation was not an easily available option, nor was dialysis for his failing kidneys. He said a premature goodbye to his family — premature because he recovered. Years later, lightning struck twice, and he suffered a severe brain infection, of unknown cause and origin, and for a second time called his family to the bedside for possible last words. Again, by God’s grace, he survived. He not only recovered, he has gone on to train African interns and surgeons and now to tackle the enormous problem of structural heart disease in East Africa.

“You came back, not just you, but you brought your children back.”

A former missionary kid recalled to the BBC hearing these words in the Congo after his family returned to live with the poor of the forests following the Simba rebellion, during which several adults from their agency were killed. (Hollinger examines in depth the lives of missionary children and their often unique ability to influence others.) Or as Rob Foster said of contracting polio while his father served as a doctor in Angola, “For a while, I blamed my dad and his high-risk dedication to others. Today, I no longer feel like that; I am no longer bitter or resentful. If me getting polio meant that thousands of lives were either saved or immeasurably improved by my father’s work, then so be it.”

Traditional Kipsigis culture, in western Kenya, requires that a son carry his deceased father’s body up into the hills for burial. Dr. Ernie Steury was the first missionary doctor at Tenwek Hospital in the 1950s. Poor or absent roads and few automobiles meant that, after being brought by animal-drawn cart to the hospital, many ill Kipsigis would die far from home. The families wouldn’t even know their loved one had passed, much less be able to collect their relative and return home to the village for burial in anything approaching an acceptable time frame.

So, after a long day in surgery and an evening spent attending to patients in the clinic, Dr. Steury would sometimes take a deceased Kipsigis patient and climb the lonely, unlit hills around the hospital to bury the body, honoring the tradition of those whom he came to serve.** For what else could be done, without a morgue, without a family, without another humane resting place for the departed?

“Am I my brother’s keeper?” asks Cain impudently, and rhetorically, of God, after murdering his own brother. In assessing an earlier generation of American missionaries, both their successes and failures, Hollinger concludes his fascinating account: “At least they knew Cain’s answer was not theirs.”


Jon Fielder, MD

Chief Executive and Co-Founder

* Hollinger, D. Protestants Abroad: How Missionaries Tried to Change the World but Changed America. Princeton University Press, 2017.

** This story is told in Lewis, G. Miracle at Tenwek: The Life of Dr. Ernie Steury. Discovery House Publishers, 2007.




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