John Fankhauser is on the front lines of the deadly Ebola crisis in West Africa.
And, in a way, it's no surprise.
As a young man growing up in Richland, Fankhauser, now 52, would talk about one day becoming a doctor and working in a developing country. "He's always had a real heart for missions. I've always looked up to him for that," said his younger brother, Don, a teacher in Kennewick. "He didn't go into (medicine) to make a lot of money. He wanted to help people."
Fankhauser works with Serving in Mission, or SIM, an international Christian mission organization, at a hospital in Monrovia, Liberia.
The country, which is on the western coast of Africa, south of Guinea between Sierra Leone and the Ivory Coast, is among those hardest hit in the largest-ever outbreak of Ebola.
Fankhauser has helped care for Ebola patients, including some American colleagues who became sick. In phone conversations last week, he said he's taking every precaution he can.
"But, this is also my home now. It's a place I feel called to," Fankhauser told the Herald.
"I feel like it's the right place to be."
Aware of the risks
The Ebola outbreak has burned rapidly through West Africa since March, with most of the cases -- more than 7,400, according to the Centers for Disease Control and Prevention's latest numbers -- in Liberia, Sierra Leone and Guinea.
More than 3,400 people have died.
Last week, the CDC confirmed the first case diagnosed in the U.S -- a man who traveled from Liberia to Dallas, Texas, showing symptoms about five days after arriving in the states.
Fankhauser's hospital in Liberia saw its first Ebola patient in June. Fankhauser was in California at the time, attending his son's college graduation. He returned to Liberia soon after, helping care for patients in a small isolation unit.
The virus, which used to be called Ebola hemorrhagic fever, is often fatal, spread from person-to-person through direct contact with blood or bodily fluids. There's no cure, although Fankhauser said treating the illness early in its progression leads to improved chances. Treatment can involve everything from aggressive hydration through IVs to blood transfusions.
Many doctors, nurses and other health workers treating the sick have been swept up in the epidemic. In late August, the World Health Organization put the number of health workers infected in Liberia, Sierra Leone, Nigeria and Guinea at more than 240, and the death toll at 120-plus.
The workers who care for Ebola patients at the SIM site wear layers of protective gear, from rubber boots to special suits, double gloves and hoods, Fankhauser said.
But there are no guarantees.
Some of Fankhauser's colleagues have become infected, including a Liberian nurse and Americans Nancy Writebol, a missionary who supported the Ebola unit, and Drs. Kent Brantly and Rick Sacra.
Sacra didn't work directly with Ebola patients. Brantly did, although he's said he doesn't think he was infected while working in the isolation unit, because of the precautions.
"By the grace of God," Fank- hauser said, all four survived.
Fankhauser said he's keenly aware of the risks, noting his colleagues were "extraordinarily cautious" yet still became sick.
But, he said, Liberia already had a shortage of doctors, and "now is not a time for a health care provider who's already here to go elsewhere."
'Where he's supposed to be'
Fankhauser lives and works at the ELWA campus, started by SIM decades ago. It includes a school, radio station and homes. ELWA stands for Eternal Love Winning Africa.
The original ELWA Ebola unit was in a converted chapel, but more space was needed. Today, the Liberian Ministry of Health helps run a 60-bed Ebola unit on the campus, with 40-plus more beds to be added this week. Doctors Without Borders also has a 200-bed Ebola unit on site.
Fankhauser, who is deputy medical director of ELWA Hospital, has shifted away from the direct Ebola care, although he's still providing administrative support for the Ebola unit.
His focus is on restoring the hospital's other services -- a critical task as the epidemic has devastated the country's health care system.
The married father of three is able to stay in touch via phone and email with his wife and kids, as well as his mother and siblings.
Fankhauser's mom, Joanne, who lives in Richland, said she stays glued to the news about Ebola. She's proud of her oldest son's work, but that doesn't mean she doesn't worry.
Fankhauser's sister, Carole Cox, who lives in Idaho, said she goes back and forth between concern for him and excitement that he's fulfilling his calling. As Christians, "we do what God calls us to do and we don't ask questions," she told the Herald. "That's why I'm excited for John -- that's where he's supposed to be."
Fankhauser's wife, Beth, and daughters Bethany, 19, and Rebekah, 14, are at SIM's headquarters in North Carolina. Son Joshua, 23, recently started a doctorate program in engineering in California.
Fankhauser grew up in Richland, graduating from Richland High School in 1980. He went on to what's now George Fox University in Newberg, Ore., to study chemistry -- following in the footsteps of his father, longtime Richland High chemistry teacher Ed Fankhauser.
After two years at George Fox, John Fankhauser traveled to South Sudan, spending six months helping at a hospital and with other projects, supported on the trip by West Side Church in Richland.
The experience solidified a passion for missionary work, he said.
Fankhauser finished his undergraduate studies at the University of Washington and also attended medical school there. He worked in the U.S. for years, including stints in South Carolina and Pasco, and a long tenure in California. He and his family have participated in shorter mission trips.
But long-term overseas service beckoned.
Last fall, Fankhauser and his wife and daughters moved to Liberia, with Joshua staying behind for college. At that time, Ebola was far from their minds -- the epidemic still months away.
"We didn't even consider Ebola. We knew there was typhoid, malaria, other tropical illnesses," Fankhauser said. "I don't think we ever anticipated being in the midst of an Ebola outbreak."
'My brother is my hero'
Fankhauser's wife and daughters left Liberia in the summer as the outbreak worsened. Fankhauser will reunite with them for a few weeks every couple months until it's safe for them to come back or time for him to move on.
CDC officials have said the epidemic could swell to 1.4 million cases in Liberia and Sierra Leone by the end of January if conditions don't change.
Fankhauser said he doesn't think it will come to that. He's seen a shift in the response, with more resources and attention.
But even more of both are needed, he said.
Prayer is too, he added. "I believe that prayer has an effect. I think this is an important time for people to be in prayer for West Africa," he said.
Fankhauser's mother echoed that call for prayer. His brother said it's important for people in the U.S. to be aware and do what they can.
Don Fankhauser always looked up to his older brother -- for his go-getter attitude, his adventurous spirit, he said.
Now his brother is in Liberia, doing the kind of work he talked about as a young man.
"I was just telling someone today -- if it was me, I'm not sure I'd have the guts to go back (like he did) and surround myself with people who are infected with Ebola," Don said.
"To be honest, my brother is my hero."
HOW YOU CAN HELP:
Dr. John Fankhauser says more help is needed to stem the spread of the deadly virus. For people looking for an organization to support, he suggests Serving In Mission, or SIM. He works with the international Christian mission organization in Liberia.
He also recommends Samaritan’s Purse, led by Franklin Graham, the son of evangelist Billy Graham, as well as Doctors Without Borders.
Find the organizations online at:
— SIM: www.simusa.org
— Samaritan’s Purse: www.samaritans purse.org
— Doctor’s Without Borders: www.doctors withoutborders.org.