A 94-year-old Minnesota doctor who worked at a Sierra Leone clinic during the peak of the Ebola crisis last year has become an unlikely key player in West Africa’s response to a lingering symptom in patients seemingly cured of the deadly virus.
Lowell Gess, an ophthalmologist from Alexandria, found that patients at his Sierra Leone clinic who had been declared Ebola-free still had the virus lurking inside their eyes, causing vision loss.
“When I saw this, I knew I had to let every doctor know, that when they were treating Ebola patients, they also had to protect their eyes,” he said.
He swiftly spread the word, and in the process gained the attention of the international health community.
On Monday, Gess will meet with several Ebola researchers as they prepare to launch a research project on the problem.
Sharmistha Mishra, a University of Toronto researcher and World Health Organization consultant, will be among them. She was one of the doctors in Sierra Leone last year whom Gess asked to help him educate others about his surprise findings.
“Dr. Gess was among the first [doctors] to alert the wider clinical and health community about the lingering effects of Ebola virus disease on vision,” Mishra said. “He continues to be an inspirational and intellectual driver to understand how eye disease occurs after an Ebola infection.”
Gess, who is also an ordained United Methodist minister, has been on the front lines of vision care in Sierra Leone since opening an eye clinic there 50 years ago. He downplays his contributions, saying he’s just an ordinary man doing God’s work.
But last January, as the country was gripped in fear, with nearly 10,000 people diagnosed with Ebola, he flew into Sierra Leone. The hospital next to his eye clinic there had lost 11 of its 12 doctors. The ophthalmologist at his clinic returned to Germany.
“There was one eye doctor serving a nation of 6 million people,” said Gess.
At 93, he figured he had nothing to lose and braved exposure to the disease.
A vision pioneer
In the early 1950s Gess was a young medical missionary in Africa. By day, he cared for patients’ eye troubles. On weekends, he appealed to their hearts as a pastor.
By 1975, the government offered to help pay for a new ophthalmology clinic, but more funds were needed. Gess contacted 8,000 members of the American Academy of Ophthalmology, as well as Minnesota churches and church members, for financial help. The result was the Lowell and Ruth Gess Eye Hospital. It is also known as the Kissy UMC Eye Hospital.
The couple and their family made Sierra Leone a full-time home for about 20 years. Later they spent several months each year there and the rest in Alexandria.
Along the way, Gess became a respected surgeon and medical educator, training hundreds of staff and visiting doctors and introducing sophisticated medical equipment to the country.
“That hospital is the place to get eye surgery in West Africa,” said the Rev. Lyndy Zabel, who oversees mission work for Minnesota’s United Methodist Church and travels frequently to Sierra Leone.
“He’s held in high esteem by just about everyone — here in Minnesota and Sierra Leone,” said Zabel.
When the Ebola epidemic overtook the nation, Gess felt called to help. When he arrived last January, he arrived with $60,000 worth of medical supplies and a heart packed with hope.
The doctor was taken aback when he stepped off the plane.
“It was a ghost town,” he said. “During the 4-mile drive to the eye hospital through the heart of Freetown, a city of more than a million people, I encountered three visible people — watchmen.”
The clinic waiting room, typically packed, was empty. People were afraid.
Gess moved into an apartment upstairs. He sorted through his boxes of eye shields, chlorine tablets and medical equipment. He trained staff on new treatments. He repaired medical equipment.
By the end of January, patients were returning. On Feb. 11, three Ebola survivors appeared. The staff asked for Gess’ advice.
Examining the survivors’ eyes, he discovered the virus was still alive there.
All three had signs or symptoms of uveitis, a disease that leads to cataracts and other problems. The patients reported that the vision loss started when they were undergoing acute treatment for Ebola.
It was a eureka moment. Gess concluded that to preserve the vision of Ebola survivors — who had already endured so much misery — doctors treating Ebola in acute stages would need to provide eye protections such as steroid drops. Not a complicated fix, but critical.
With Internet and phone service irregular, Gess quickly called his son, Tim Gess, in Alexandria, also an ophthalmologist, and asked him to contact the Centers for Disease Control and Prevention in Atlanta and other international health organizations to share that information. He wrote letters and met with visiting international health officials.
Through hustle and coincidence, he got his recommendations into key hands. One of them was Mishra, who shared the findings at the Ebola treatment centers she was visiting.
‘Our brother’s keeper’
By the time Gess left for Minnesota on March 4, he had carved an unusual niche in the treatment of Ebola survivors.
Last month, Gess received a request from international researchers, asking if the Kissy UMC Eye Hospital would consider being the site for a project testing the persistence of Ebola virus in the eye and its treatment.
While the research could potentially save the vision of many Ebola survivors, Gess acknowledges it could face barriers. People in Sierra Leone remain fearful of Ebola because they’ve lost family and friends, he said.
There are four places in the body that Ebola persists, said Gess: the eyes, the brain, the placenta and the testicles. The project, he said, would contribute to understanding of the visual connection. He agreed to meet them.
On Friday, Gess packed his suitcases and six 50-pound boxes of medical supplies, and headed across the ocean for the 187th time.
The Ebola epidemic, he concluded, “makes us aware of our vulnerability.”
“In a true sense,’’ he added, “we are our brother’s keeper.”