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29.10.2003 General News

"Full of malaria," Ohio woman dies

By Dayton Daily News
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NEGLEY, Ohio— After surviving on yams, rice, beans and mangoes for two years as a Peace Corps volunteer in Ghana, Susan Fagan looked forward to a Thanksgiving feast at home.

But Fagan was so weak and fatigued as she sat down for Thanksgiving dinner with her family she couldn't eat.

"She was ill when she stepped off the airplane and continued to go downhill," said Debra Moore, her older sister.

Within days of arriving home in the small eastern Ohio town of Negley on Nov. 15, 2001, the exhausted 39-year-old volunteer had thrown up and passed out.

Her family took her to St. Elizabeth's Hospital in Youngstown, where she was diagnosed with malaria, a mosquito-borne illness she had contracted in Ghana. She died two weeks later.

"I know how she died, but I don't know why," said Susan's 61-year-old father, Bud Wilson. "It's frustrating because there's no answers except the fact that she's dead. I am upset with the Peace Corps. I think the Peace Corps fell short of taking care of her."

In a written response, the agency says that Fagan's final medical examination in Africa "showed no evidence of malaria" and that Fagan spent almost two weeks in Ghana on her own after the exam on Nov. 2, 2001. The agency also pointed to a study by the Centers for Disease Control and Prevention on her death that mentions Fagan took a malaria preventative medication "inconsistently."

Wilson, who runs an antique store in Negley, said the Peace Corps failed to give him the exact date and details of the examination. He said he had not heard that his daughter had not taken her medication consistently, or about the CDC study until a Dayton Daily News reporter told him.

"Why wasn't I aware of this when this happened?" he asked. Wilson said the Peace Corps told him she must have been bitten the day she got on the airplane.

Fagan was the sixth Peace Corps volunteer to die of malaria, and the first since 1990, according to the Peace Corps' Death in Service database. All involved volunteers who served in Africa.

According to her death certificate, Fagan died of plasmodium falciparum malaria, the deadliest of the malaria strains, and adult respiratory distress syndrome, a condition brought on by the infection.

Tom Skinner, a spokesman for the CDC, said anti-malaria pills like chloroquine and Lariam (mefloquine), which Fagan was taking, are up to 90 percent effective in preventing and treating malaria.

Fagan's family assumed she was taking her medicine, Wilson said.

"Go to a travel doctor," she said in a Dec. 14, 1999, letter to her father in anticipation of her stepmother Linda Wilson visiting her in Ghana. "Don't forget the malaria pills — very important."

Free spirit chooses a different path

Fagan was 7 when her mother died in a car accident, and she was raised by her father on the family farm in Calcutta, Ohio.

"She never really had a mother figure," Bud Wilson said. "If I was doing mechanical work, she was there handing me a wrench. We had a relationship not just as a father and daughter, but as best friends. She was my buddy."

As a teen-ager, Fagan spent most of her time in boots, milking the 150 dairy cows or breaking horses on the farm.

"When she was in high school she worked in the barn every night," Wilson said.

In 1992 she married Wayne Fagan, a custom cabinetmaker. Susan became a regional manager in charge of several convenience stores in the southeastern United States, and she trained show horses on the side.

Wayne Fagan was diagnosed with esophagus cancer in 1997, and died a year later at age 33. In search of a new path, Susan signed up for the Peace Corps, and on Sept. 22, 1999, she became the agency's first volunteer in Akwida, a small fishing village in the western African country of Ghana.

Fagan tried to develop a tourism program in the area and help to save endangered sea turtles.

Former volunteer Christy Reich said Fagan wasn't the typical volunteer.

"She was definitely a big-hearted, neat lady who had gone through a tough time with her husband dying," said Reich of Santa Monica, Calif. "She wanted to have a new beginning. She had a lot of street smarts. She was way out in the bush. There were times when Peace Corps couldn't get to her because the roads were impassable."

A couple of times each month, Fagan would walk for four hours and then take a four-hour bus trip to get to the nearest phone to call her father.

"While in Africa, at first she'd call and she was all excited and she was bubbly," Bud Wilson said.

But after the first year, she grew more frustrated, family members said. The villagers seemed to have no desire to work, said Moore, one of her two sisters.

"She was there with no job," Moore said. "Why would you leave someone in a hellhole for one year with no project?"

Throughout her time in Ghana, Fagan was robbed several times and hospitalized three times — suffering from food poisoning and two bouts of malaria.

Still, she finished her two years on Nov. 2, 2001, and underwent a medical evaluation that included a slew of tests for diseases, including malaria.

After she got sick, Fagan tried to dispel her family's fears that she had malaria, saying she'd just spent two years in Ghana and knew how to take care of herself.

The morning after Thanksgiving Fagan threw up and then passed out in the hallway. Wilson said the doctor who treated her at St. Elizabeth's told him "she was full of malaria." Medicine was flown in from CDC headquarters in Atlanta to treat her.

"As soon as they gave her the medicine the heart went into cardiac arrest," Wilson said. "She went downhill fast."

Fagan’s family believes her death was preventable, if the Peace Corps had tested her for malaria closer to the date she planned to leave Ghana.

"Honestly, I feel she died due to Peace Corps neglect," said Susan's mother-in-law Dona Fagan.

Wilson still has trouble dealing with his daughter’s death.

"I'll never forget the last Father's Day card she got me — she was still in Ghana," he said. "She wrote, ‘I wonder where your wild daughter will go off to next.’ ”

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