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A Volunteer's Courage

Just a few months before Sara Evans completed her two years of Peace Corps service, she contracted malaria and rheumatic fever. Then she was assaulted in her village and ended up leaving the Peace Corps and returning to the United States. But her ordeal was only beginning. Read this story written by her mother about one volunteer's courage and her struggle to get proper medical treatment after leaving the Peace Corps.

How common are problems like the one described in this story? We invite RPCVs to leave a message below and tell us if you have tried to get help with medical treatment after your completion of service for an illness or injury that occurred while you were a volunteer. Tell us your own experiences, both good and bad, and what should be done to improve the system.

The Peace Corps and the Returned Volunteer community need to know how frequently problems like this occur. Do improvements need to be made in the way this situation is handled and would these improvements require changes in Peace Corps policy or legislation to implement?

Director Vasquez in his many conversations and speeches before RPCVs has demonstrated that he takes issues involving the Safety and Security of Volunteers very seriously and welcomes hearing from Returned Volunteers. If you have a concern with this issue, then send Director Vasquez an email at GVasquez@Peacecorps.gov and ask him to find out how widespread this problem is and ask him to appoint a commission or working group to study the problem and issue recommendations for solving it. Read the story at:

A Volunteer's Courage*

* This link was active on the date it was posted. PCOL is not responsible for broken links which may have changed.

A Volunteer's Courage

Daughter Sara Evans returned home on Sept. 13th, 2002 after serving two years in Africa.

[Note: While "Sara Evans" was willing for her name to appear in this story, PCOL made an editorial decision to use a pseudonym in this story to protect her privacy. All other details in this story have remained unchanged.- Editor]

Daughter had a bout of malaria sometime in the March/April time frame of 2002. She went to the Peace Corps house in the Regional Capital, reported the illness and got pills.

In May, Sara became very ill and was in a lot of pain. She again went to the Peace Corps House and contacted the Peace Corps medical staff. The doctor suspected rheumatic fever and had her come to the capital city immediately. She was tested and it was indeed rheumatic fever. The doctor was considering sending Sara to South Africa to the medical center there just to be on the safe side but she knew we were in route and decided that since Sara was responding well to medication, it would be okay for her to wait for our arrival and travel with us as long as she got lots of rest. The doctor explained that Sara may have to take penicillin for up to five years as a precaution against a reoccurrence. She did not believe there was any heart damage, but another bout could be dangerous. Since she was responding well to medication, rest was the important thing.

Three months later, in August, we received a phone call from Sara that someone had broken into her hut, had got on top of her and held his hand over her mouth. This occurred in the pitch black, middle of the night. Sara bit his hand, proceeded to hit him about the head with a table. In the ensuing fight, Sara was bit in the face. The attacker got away and it was then that she discovered she was missing two of her teeth.

The villagers rallied around her, got her transport to the Peace Corps house where she contacted the medical staff who authorized her immediate transport to the capital city some 550 miles away.

Once in the Capital, Sara was given what was referred to as an HIV cocktail - apparently medicine given to anyone who may have contact with someone with HIV/AIDS. We still do not know if that was the case, and it is a worry to us. We have heard the attacker is in custody and we are pressuring the Embassy to push the local authorities into getting him tested. Anyway, Sara took medicine for one month and it made her very ill. She stayed on in the Capital, doing some office work for her boss. She was sick and not at all happy in the city and made the decision to come home.

The Peace Corps told her that it would take some time to make arrangements to come home. She could go ahead and make her own flight arrangements, pay for her own ticket and they would reimburse her. She called home to get her bank routing number so they could direct deposit the check into her checking account. She charged her airlines ticket to her VISA card and made arrangements to come home. I should tell you also, that she did visit a dentist in country who made her a plate to wear. It was very ill fitting, and caused her pain to wear so she mostly went around without it.

Sara went through her close out briefings, getting information about CorpsCare, etc. I believe that she was not feeling well and somewhat anxious to get home and probably did not digest the information as she should have. No fault there, just stating the facts. The medical staff gave her three authorization forms - one for a routine dental checkup, two to her family physician to check the treatment for rheumatic fever and to be tested for HIV at 3, 6 and 12 month intervals. (carbon copy forms, pink and yellow)

So Sara came home on Sept. 13. I immediately made an appointment for her to see the family dentist. He was a little appalled at the plate she had made in country and because he is such a caring dentist, told Sara he could and would make her a better one, which he did. I am grateful because it doesn't do a lot for one's self esteem to walk around with missing teeth.

The dentist referred us to another dentist who specializes in implants. We made an appointment to see him also. Both dentists worked together to come up with a treatment plan for implants and some bone graft. Unfortunately, the implant doctor's office mailed their estimates to the Peace Corps office in Indianapolis. I explained that they needed to wait until I got a claim number from the Department of Labor before submitting the estimates. The office tried calling Indianapolis to get the estimate returned and of course nobody there knows anything at all about it. So now both dentists are waiting for me to supply them with a U.S. Department of Labor claim number for injury before submitting the estimates together in a package for approval.

It took me over a month and repeated phone calls to the Peace Corps to obtain form CA-1 ----I'm hoping that's the correct one. It says it can take up to 10 weeks to process and I'm not happy about that. I was really upset when looking at my copy to discover the date of injury was left blank in error. I have no idea who to call about that or will I have to wait weeks to correct that mistake!!

Both dentists are ready to begin what we understand to be a procedure that could take up to one year. Sara did have a routine checkup, teeth cleaning and a filling. The dentist office had an authorization form for that work and I believe they submitted that for payment.

Next problem came about a week after Sara got home. She got very sick, chills, headache and fever. She thought she had malaria again. I called the family physician and got a run around because Sara hadn't been in for over two years so they no longer had her files in the office. The doctor was too busy to see her and didn't treat people with suspected malaria. The nurse told me to call Public Heath. I did and after many phone calls and lots of frustration, found a clinic with a doctor's assistant who treated people who did a lot of traveling and was familiar with some of the more exotic diseases.

He saw Sara, suspected malaria and sent her to the lab for tests and gave her two prescriptions, one for pain and one for malaria. We had no authorization form as we had no way to expect this illness. I am not sure where the billing stands on this visit. We gave them the Peace Corps phone number but with no authorization form I'm not sure.

Sara has made several calls to the medical office and has not got through to request the authorization form.

I purchased the prescriptions with my money and am hoping to be reimbursed but I'm not sure I have followed the correct procedure. The doctor called us later in the week to say that malaria did not show up on the slides, but he is still convinced that is what she had. He also said she was very anemic and needed an iron supplement. That may be why she was so tired. I guess taking a lot of medication can sometimes take the iron out of the blood and that would make sense as she was taking the medicine to prevent HIV. I bought the iron supplements and have no problem with covering that.

So the next step was finding a new family physician, which we did. Sara took her two authorization forms with her. The doctor was not comfortable with giving advice, immediately recommended she see an infectious disease doctor about the rheumatic fever and HIV. She looked at the bite mark on Sara's face and referred her to a dermatologist. I have made repeated calls to the Peace Corps to try and find out if we need authorization forms (PC-127C) to see the doctors we've been referred to. I am confused here about who pays as the HIV and bite mark were from an injury, the rheumatic fever was from sickness during her service dates. I think that let's CorpsCare out, but I'm just not clear on all this.

Sara decided she had enough of doctors. She went back east to visit her brother. Just before she left, she was coming down with a cold and I went into a panic. Told her she must start taking penicillin right away because I didn't want her getting another rheumatic fever attack. So we stopped to get her prescription filled (written out by the family physician). The pharmacist asked for her medical card - I told him I thought I would have to pay for it and get reimbursed. He said he didn't mind trying to find out whether or not she was covered. After several phone calls, he came back and said CorpsCare had no record of Sara Evans. So today I sent out e-mail asking for status. She remembers signing up for a year of medical coverage, and billing it to her VISA. I am currently checking the status of that.

So after all this, what are we looking for? We understand that Sara's travel reimbursement check was sent to the Peace Corps Office in her Host Country in error and that someone from the CDC is bringing it back to the states and will put it in the mail. I don't understand why a check was ever cut and why or how it ever got sent there. Major screw up there - poor business practice to us. Don't know if you are concerned about it or not, but we feel better just bringing it to your attention.

Sara suffered a very traumatic attack as a Peace Corps volunteer. We understand the whole red tape, paperwork thing but really expected some help in getting her treatment started immediately. Okay, its not life threatening, but is still a rather nasty injury. Rheumatic fever and exposure to HIV is not something to be taken lightly either, and here we find ourselves in a quandary as to how to get in to see doctors when we really aren't quite sure how they are going to be paid.

Yes, its our daughter and we can take her in and pay and worry about reimbursement later, but then the paperwork gets even more confusing. She is also trying to be independent and does not want us to pay for anything that she feels isn't absolutely essential.

I'm just feeling very frustrated. When I call the medical office, I get different answers and end up telling my story over and over again. It doesn't help that I work full time and end up making my calls from my work phone. The time difference doesn't help. Anyway, thanks for listening. If you have any suggestions, any comments and how this whole thing can be made smoother, I'm sure interested in hearing.

More ----- finally got a check in the mail. Sent to our address but with the name Kimberly Deni on it. Couldn't believe it. Called the Peace Corps Director's office and got his assistant. She advised me to tear the check up. I said no, that didn't sound right to me - was once again frustrated as she really only handled the appointments for the Director and didn't get involved in this type of thing. So I ended up talking to Allan Gall (sp?) in the General Counsel's office. Not really his department either but he did listen to all my whining. Connected me to Shari Fischer in Finance who told me to send the check to her attention. She assured me she would give this her personal attention. So guess what? About two weeks later we got another check in the mail for Kimberly Deni. I called Mr. Gall back again. He was really nice again, wanted me to call Miss Fischer again. I told him I had done that once, why would I do it again? Got the story about how unfortunately I was dealing with a government agency and I know how that is? Why is that always the standard answer? Talked to Shari Fischer again who apologized, etc. etc. Still have no idea what is going on. There is a reimbursement check and a close of service check floating around. One got routed back to Africa is coming back to the U.S. by way of a CDC employee. The travel reimbursement was to be deposited in Sara's checking account ---- what is going on?

Latest Update: No HIV test as of yet. I think every other Peace Corps volunteer had a test before leaving Africa. Can't say as I blame Sara for not wanting to go to the doctor. I mean we still don't know if we have authorization to see an infectious disease doctor or not?? Wonder if the Embassy ever had her attacker tested. They were to let us know.

The first two oral surgery procedures have been completed. The Bone graft is complete - Dr. Quinn did the surgery. Then in a second procedure, Dr. Quinn put in the titanium posts. A Catscan needed to be done so they don't hit any nerves. Who will pay for that? In six months the two teeth will be put on the posts. The total cost of the procedures will be about $10,000. The surgery has been authorized but so far the dentist has received nothing. We're just lucky that the dentist was willing to do the work and wait for his reimbursement.

New plate made - Dr. McKenzie did that. (Dr. McKenzie is family dentist for over 20 years.) I'm so embarrassed that he hasn't been paid. Dr. McKenzie will make the actual teeth to fit over the posts.

I have submitted $80 of prescriptions to be reimbursed. Drugs before surgery. No one has a record of that.

Wonder where that paperwork is? They sent it all back to me for a pharmacy number. I added it and sent it back. They probably put the wrong return address on the envelope just to confuse me.

Also, finally did receive the check for the plane ticket home.

...to be continued.

We invite RPCVs to leave a message below and tell us if you have tried to get help with medical treatment after your completion of service for an illness or injury that occurred while you were a volunteer. Tell us your own experiences, both good and bad, and what should be done to improve the system. In your message, be sure and include when your illness or injury occurred, how soon was your treatment completed to your satisfaction, and what was the final outcome?

Click on a link below for more stories on PCOL

7/5/03

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This Month's Issue

Protest at the Peace Corps

Do volunteers retain first amendment rights while serving overseas?

Read the story and leave your comments here.

This Month's Issue: Protest at the Peace Corps
Protest at the Peace Corps
Returned Volunteers honor Jack Vaughn
Alcohol Abuse a big issue for PCVs in Central Asia
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Op-ed: The Future of the Peace Corps
Marine Sergeant says PC is "truly hardcore"

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GAO Reports on PCV Safety and Security
The Digital Freedom Initiative
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PC Expansion: The Numbers Game?
Op-ed: Why Peace Corps needs Shriver's 4th Goal
When should PC return to Afghanistan?
RPCV Spy dies in Moscow
Op-ed: The Case for Peace Corps Independence
Preservation of an Independent Peace Corps
For the Peace Corps Fallen

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