Within two hours of drinking contaminated water in the Marshall Islands, Curtis Adams was holding onto the wall of his house so he wouldn't fall over.
People in the Marshall Islands often gather water from their rooftops, and one family had mixed some of that water with Kool-Aid and offered it to Adams, who was serving a mission for The Church of Jesus Christ of Latter-day Saints. Adams served from 2001-2003 and said he knew not to drink the water and never had before, but had a lapse of judgment. After drinking it he felt the effects within an hour and because he could barely stand up, Adams lay down on his couch, then took a shower.
"It just made me freezing," he said. "I was violently shivering the entire night."
The next morning Adams woke up with diarrhea and began throwing up on a very precise schedule of every 14 minutes.
"I had 14-minute episodes and would go back to my bed and fall asleep in a half second," Adams said. "I was more exhausted than I had ever felt in my life."
With an estimated 52,000 LDS missionaries serving worldwide at any given time, many in areas where food, water and environments are unfamiliar, it's inevitable that some will fall prey to sickness or injury. While most are able to continue serving, some go home for treatment and decide after healing whether they will return.
If a missionary is sick or injured badly enough, the mission president will usually contact the stake president of the missionary's family, who will then contact parents. In Adams' case, this did not happen because his mission president was 1,500 miles away in Guam and did not know the seriousness of his condition. Adams was referred to a doctor in New Zealand who prescribed worm pills, which did not help. Adams continued throwing up for two and a half days and then the diarrhea turned to blood.
"It wasn't 14 minutes anymore. It was five episodes of expelling blood," Adams said. "I tried to drink water and it was abrasive to my system and then my companion suggested I drink Gatorade and I was able to get good hydration in two or three days. Then I slept for 24 hours. I lost 30 pounds over the course of those days and it was a long recovery."
Adams was not diagnosed, but it was later concluded he had contracted cholera, a bacterial infection that draws all liquids from the body to the stomach, often killing the person by dehydration.
"I think I would have died out there if the right things didn't happen," Adams said. "My companion was scared. I think he handled everything really well. He really saved my life that way."
Because Adams' mission president did not know the severity of the situation until later, his parents did not find out until they received a letter from Adams at least three weeks after the episode. By then Adams was well into his recovery, but had lost a lot of muscle.
"I wasn't exactly functional for a good month or something," he said. "The days that it was really severe was just three or four days, but after that I tried to squeeze my bicep and it wasn't there. All my muscles were gone. I walked around like a zombie all day. I was completely screwed up."
Branson Smith's mission illness lasted long enough that he eventually came home. Smith was serving in Romania and had arrived there the first week of July this year. After a few days he began throwing up several times a day and traced the cause back to water or fruit he consumed. While his condition was not as immediately severe as Adams', he began losing weight and was prescribed some medications - which later turned out to be placebo pills - at a pharmacy. Two weeks went by and he wasn't getting better so he went to a clinic where he was prescribed more pills and referred to a specialist. It was determined Smith had gastritis and needed an endoscopy at a different hospital.
"So I made an appointment for a couple days," he said. "In the meantime I'm still throwing up two or three times a day. So I went to this other place and it was really, it was a sketchy place. It was almost like it had gone through an earthquake or something. Just walking down the halls people were sharing beds with blood stains or whatever stains on mattresses. There were nurses smoking in the hospital. People were walking around with like Band-Aids, like bloody Band-Aids all over their faces."
Smith ended up in a waiting room with five or six other patients awaiting the same procedure. One girl was crying and screaming that she didn't want to go in. After she came back from being examined, it was Smith's turn.
"So then I went in and the first thing I see when I walk in the door is this nurse and she's smoking in the exam room," he said. "And there's this nasty mattress and the doctor's like, ‘Alright get up on this.' He goes to this bucket and pulls out this 4-foot rod and I'm like, ‘Oh man, this is going to go inside me.' So I just opened up my mouth and he started putting it in my throat and I could taste Clorox."
The doctor wasn't wearing gloves or a mask and all Smith could think was that the only thing sanitizing the endoscopy rod from one patient to the next was the bucket of Clorox.
Smith was diagnosed with acute gastritis and was then sent to the church headquarters in Germany, where he stayed with other missionaries. He was able to go to a nicer hospital where he had an MRI, a Cat Scan, another endoscopy and an ultrasound. During this time his mother had been in contact with the mission president and was receiving regular emails from the mission president's wife. Smith was also able to call home and discuss what he should do next. After being in Germany for two more weeks and losing 42 pounds in a month, Smith decided to come home.
Since Adams didn't really know for sure what was going on with his sickness, nor did his mission president or parents, he didn't really consider coming home. He says although his recovery was long and difficult, it didn't change the good things he felt about serving. In retrospect however, he feels that the distance between him and the mission president, and the lack of knowledge of his condition from the doctor in New Zealand, is what caused the most problems in finding a cure.
"In my case I don't think they (his leaders) did a terrible job," Adams said. "They didn't do a good job either. It was the disconnectedness. I couldn't speak with anyone who knew anything."
When missionaries come home because of sickness or injury, they are released as they recover. Jason Cook, who preferred not to use his real name, came home from his mission in Mexico Aug. 26 to have back surgery. He is planning to return as soon as possible. He said he was injured playing volleyball in the MTC.
"An old sports injury started acting up about a month in and I thought it was my leg, but what really happened was I had a disc bulging in my back that was pushing on a nerve making my leg hurt," he said.
Cook had sprained his ankle about a month earlier in the MTC which reduced the amount of exercise he could participate in. That, along with sitting and studying most of the day, may have contributed to Cook's back injury because he was out of shape when he was playing volleyball, he said.
Cook's said the clinic at the MTC contacted his stake presidency, who then relayed the injuries to his parents in Logan. At the time he was barely able to walk and with the support of his parents he came home. He is now planning to return to the mission field.
Smith said missionaries spend a lot of time going over safety precautions in the MTC and added that mission presidents do all they can to be aware if something is going wrong. Smith has recovered from his illness and returned to his mission Nov. 8. He will now be serving in Knoxville, Tenn. Smith's advice for missionaries who come home would be to stay positive and keep their spirits up.
Cook said when he was leaving the MTC the district presidency told him that more than 50 percent of missionaries who leave because of sickness or injury do not return. For those who decide they do want to return, Cook's suggestion is to "stay in the right mindset."
"It's really hard when you're home because I think the hardest part is the transition of being a full-time missionary and then coming back to normal life," he said. "That's one thing my dad did really well was keeping me in the right mindset. If he hadn't done that I probably wouldn't have stayed too focused."
According to a January 2007 press release from the LDS church:
• Health and safety training is provided at the church’s 16 missionary training centers.
• Missionaries are required to stay with their companions.
• Careful instruction of automobile safety is given for missionaries using cars. There is also safety training is given to missionaries who ride bikes.
• There is a network of 80 physicians serving as full-time missionaries around the world. There are also 200 volunteer nurses and others with medical and health care backgrounds serving missionaries.
In April 2003 missionaries were not sent to Hong Kong temporarily because of the SARS Virus. According to a press release issued by the LDS church, missionaries were instructed to practice good hygiene during that time. The Asia Area Presidency and the area medical adviser in Hong Kong met daily to discuss precautionary measures for mission presidents and missionaries.
In April 2009 new missionaries assigned to serve in Mexico who were in missionary training centers in Utah and Mexico had to remain in the MTCs longer than originally planned because of the H1N1 outbreak.
In January 2006 three LDS missionaries were killed: one in a Virginia shooting and two in an automobile collision in New Zealand. In February 2007 four Nigerian missionaries were taken hostage. These are just a few recent examples of LDS missionaries being in danger since the church was established.
In a press release issued in February 2007 the church said that while these situations happen, “it is important to point out their infrequency.” According to Dallin H. Oaks of the Quorum of the Twelve Apostles, there are about three to six fatalities among missionaries per year, “but the official death rates for comparable-age young men and women in the United States are eight times higher than the death rates of our missionaries.”
In January 2006 M. Russell Ballard, also of the Quorum of the Twelve Apostles said the church does its best to protect the health and safety of missionaries. The church provides safety training to missionaries, oversight and evaluation of assignments and a network of doctors for emergency medical treatment.