Missions accomplished

Throughout her career as a Maryknoll Lay Missioner in East Africa, SIU School of Medicine alumnus Susan Nagele, MD, (’81) provided care to the sick and worked with groups to administer vaccination programs that helped to eradicate measles, polio and other infectious diseases from towns and regions where she served.
She had to overcome language and cultural barriers, and bouts with malaria and dysentery. She learned to “make do” with inadequate supplies against a backdrop of extreme poverty, malnutrition and civil unrest. And she persevered to bring improved medical care to some of the most vulnerable populations on a continent of 1.2 billion inhabitants.
Raised in Urbana, she says she believes in the intrinsic – and altruistic – value of “thinking globally and acting globally.”
Nagele traces her urge to care for others to a childhood trip to Kentucky to visit her uncle, a priest. “It was the first time I’d seen a one-room schoolhouse,” she says. “It shocked me that these kids had so much less than I had.”
Summers spent working in her father’s dentist office and as a candy striper at the local hospital had her considering a nursing career. Her father dashed her nursing ambitions when he explained that nurses are not taught how to read x-rays.
“That made me mad,” Nagele says. “I wanted to learn everything, so I began to consider medicine.”
She matriculated at her hometown University of Illinois and then SIU School of Medicine. Short-term mission trips during college and medical school further stoked her passion for service work. Upon completing her family medicine residency training in Carbondale Memorial Hospital in southern Illinois, she pursued a contract with the Catholic Maryknoll Lay Mission organization “because they had the longest terms ─ 3½ years. I knew I wanted to do this for a while.”
And so she did, for 36 years.
Her first assignment was in Tanzania, a peaceful country in East Africa, developing primary care health services, including maternal and child health and immunization programs. She established an outpatient department and was instrumental in creating a 36-bed hospital for obstetrics and minor surgery.
In 1991 she moved to Sudan to begin a primary health care program for the Diocese of Torit, where she practiced for 12 years while a civil war raged, claiming 2 million lives. She established several dispensaries and health centers in various parishes. She also began a TB program that treated more than 500 people before it had to be closed because of the war. At one point she was the only doctor for more than 30,000 displaced persons in two camps.
In 2003 she moved to Kenya where she transformed a health center into a hospital in the Diocese of Kitale. In 2010 she moved again, to the Archdiocese of Mombasa to improve the services in the 16 health units and add five more, educating nurses and hospital administrators, and consulting on challenging patients, often in rural areas with little access to other resources.
Over the course of her career, she found difficulties to be mostly temporary. She says SIU deserves a lot of credit: “The training we got in problem solving really taught me to adapt and provide care in tight situations. Once I got past the fear of not being good enough, it was fine. I said, ‘you’re the best they’ve got, so just do your best.’”
Her love for her patients, the relationships they formed and the variety of the cases they presented also added to the enjoyment of her work. “I got to do more as a family doc overseas than many of the specialists have done back here,” she says.
In 2018 Nagele returned to Urbana to attend to her elderly mother and her own health needs. As 2020 drew to a close, she officially retired and watched as the first COVID-19 vaccines were deployed to curb the spread of the coronavirus. Amid the optimism, there was disappointment in how distribution in Africa lagged the rest of the world, and there was concern for her former colleagues.
“Global health care workers should have been one of the first groups vaccinated,” she says. “I know politically that wasn’t feasible. But we truly are all in this together. The virus can mutate and reproduce in one part of the world that’s neglected and then spread beyond its borders and cause new problems. We’re seeing it in the variants from Britain and South Africa now.”
Over the years, Nagele has been honored with numerous awards, including the School of Medicine’s Distinguished Alumni Award (’96), the American Academy of Family Physicians Humanitarian Award (2007) and the American Medical Association’s Medal of Valor in 2012, given to members who demonstrate courage under extraordinary circumstances in non-wartime situations.
But physicians value people more than medals.
Nagele got a precious gift last year when a young man contacted her through email. In 2000 she had treated him as a 9-year-old child. He and his mother had walked 120 miles to reach her clinic in the Sudan, an incredible feat considering he weighed only 20 pounds—the weight of a 1-year-old. He had contracted kala-azar, a potentially fatal disease transmitted by the bite of sandflies, and she expected him to die.
Instead he survived, thrived, attended the local schools and is now a community health worker in South Sudan, following in the footsteps of the woman who helped to save his life, Dr. Susan Nagele, whom he considers “my friend.”