In Togo, Africa, Elizabeth Fernandez is called “Nbataam-Kandabri,” the protector of children.
It is the term for pediatrician in Anufo, just one of the many languages spoken in the West African town of Mango. Dr. Fernandez has lived there for one year, working with Samaritan’s Purse, a nondenominational evangelical Christian international relief organization.
She is one of only two pediatricians in a hospital that serves a town of 55,000 people, plus hundreds that come from surrounding towns and from four neighboring counties.
It hasn’t been easy. “Routine” cases include severe malaria, meningitis, typhoid, snakebites, sickle cell, cancerous liver tumors and cancer in the lymphatic system. The death rate among children under 5 is 96 per 1,000 live births—nearly 10 percent.
“I think the hardest part about what I do now is that we see a fair amount of death at the hospital, so that can be emotionally draining,” she said. “I also work long hours, more than I did in residency.” She is one of three full-time physicians, and they juggle overnight on-call hours every third day, seeing patients of all ages.
“As difficult as it may be at times, it is equally rewarding work,” she said.
When Dr. Fernandez was 15, she became involved in World Link Ministries, which works to spread Christianity and build churches throughout the world. It was her strong faith that eventually led her to the field of medicine.
“I prayed for a field with both physical and spiritual needs,” she said.
Before enrolling in medical school, she traveled to Guatemala to visit her dying grandmother and caught a glimpse of the medical needs in less prosperous areas of the world.
“I remember being struck by the contrast between the hospital where my grandmother was admitted and the hospitals where I worked at the time,” she said. “I was already interested in serving overseas one day.”
She prepared for the experience extensively. Throughout medical school, she traveled to medically underserved areas around the world. She spent weekends in Mexican border towns, serving patients in mobile medical and dental clinics. She traveled to Peru as part of a team to set up mobile medical clinics there, and helped build a church and medical clinic in the Huichol village of Cañaveral, in the Mexican Sierra Madre Mountains.
With the Center for Medical Ethics & Humanities, she helped form Project Haiti, now called Project Hispaniola, a group of medical students that partnered with nongovernment organizations in Haiti to help improve the health care for villages in the Central Plateau. Her first trip to the country was in 2008.
“These experiences can really shape your future and the direction you want to go, whether you do global health or not,” said Ruth Berggren, M.D., director of the Center for Medical Humanities & Ethics and professor in the School of Medicine. “These experiences can profoundly effect the way you see yourself as a doctor while on planet Earth. Elizabeth is a great example of that.”
In February 2011, just before graduation, she worked for a month at Karolyn Kempton Memorial Christian Hospital in Togo.
“Before I left for Togo, I worried I wouldn’t be able to give back to the people of Togo as much as I would gain from the experience,” she said. “Even though I was soon to be a doctor, I feared my skills were too fresh and I was too inexperienced to be able to make significant contributions for the patients.”
That was before she saw the level of need.
There are 6.5 million people in Togo, where the life expectancy for men is 56 years and 61 for women.
Skilled medical professionals are rare. In Togo, there is only one physician for every 20,000 people. In contrast, according to the Association of American Medical Colleges, there was an average of one physician for every 383 people in the U.S. in 2013.
“I had never seen that level of medical resource-poverty before,” she said. “I was amazed at how much can be done to save lives with so little.”
After graduation, Dr. Fernandez was matched to the Medical College of Georgia for a residency in pediatrics.
During her residency, she remained undecided about where she would serve internationally. The path, she was sure, would show itself when it was time.
Then came the call she was waiting for: A new mission hospital and clinic called The Hospital of Hope was opening in northern Togo. She was asked to be among the first team of doctors.
She’s been there ever since, taking infrequent and brief breaks to travel to the U.S. to visit family and friends, and to mend emotionally.
She has no plans to ever practice medicine again in the States.
“When I started medical school in San Antonio, I had a number of people ask me why I would be interested in going overseas to practice,” she said. “Texas is a medically underserved state. I should stay right here in South Texas because there are plenty of medical needs here, they told me.
“When we talk about medically underserved, we’re talking about places like Togo.”
She plans to work there indefinitely, though the hours are long, the resources few and the struggles seem ever-present.
She gets through the hard times with prayer, she said.
“Some patients’ deaths hit harder than others,” she said. “I pray that I may never stop feeling something when a patient passes, but I also pray that God will allow me the strength to persevere when there is still work to be done.”
With the patients she treats, she often thinks back to her grandmother in the intensive care unit of that Guatemalan hospital with so few resources.
“It helps me to see my patients as if they are my family,” she said, “and I want to give them the very best care that I can.”