Mission work in Sierra Leone from John Green's "Everything is Tuberculosis"

Written by Sara Swenson with quotes taken from Amazon.com, the World Health Organization and the book Everything is Tuberculosis

In 2025, I read the book Everything is Tuberculosis by John Green. This book is a departure from Green's YA fiction books. Green is the "award-winning, #1 bestselling author of Looking for Alaska, An Abundance of Katherines, Paper Towns, Will Grayson, Will Grayson (with David Levithan), and The Fault in Our Stars." He writes mostly fiction novels but wrote his new book Everything is Tuberculosis after visiting Sierra Leone, Africa.

In 2019, John Green and his wife Sarah Urist Green met Henry Reider, a young tuberculosis (TB) patient at Lakka Government Hospital in Sierra Leone. John and Henry became fast friends. Green has since become a "vocal advocate for increased access to treatment and wider awareness of the healthcare inequi­ties that allow this curable, preventable infec­tious disease to also be the deadliest, killing over a million people every year." Everything is Tuberculosis tells Henry's story, along with the history of TB and society's relationship with infectious diseases, disability and poverty.

I was drawn to read this book as a John Green fan (I believe I have read all of his solo novels). However, I was a little intimidated by the subject matter, as I am typically not a non-fiction reader.

I greatly enjoyed this book. I think Everything is Tuberculosis will be a favorite non-fiction book of mine, for a long time. The book explores this science and health topic in an approachable way; you don't need to be a doctor or nurse to read this book. The book is well researched, but it doesn't try to teach you microbiology.

The first question I asked myself when starting this book was, "Is tuberculosis even still a thing?" It is not something a person in the west, especially in the USA, spends much time being worried about. TB doesn't really affect us here. I have learned that globally, TB is the "world’s leading cause of death from a single infectious agent and among the top 10 causes of death" (WHO). I quickly learned that TB the world's deadliest infectious disease, and it is treatable, but 1.2 million people still die each year from TB. So, if TB it is treatable, why is it so deadly?

Green writes “And so we have entered a strange era of human history: A preventable, curable infectious disease remains our deadliest. That's the world we are currently choosing.” He also writes “Where are the drugs? The drugs are where the disease is not, and where is the disease? The disease is where the drugs are not.”

The issue (in a simplistic way as described by me, as someone who is not an expert) is that the lifesaving drugs (which have existed for almost 100 years, the cure is not new) and up-to- date hospitals with trained staff and high-tech equipment are not in place at the places, including Sierra Leone, where these medicines and doctors are most needed. TB significantly impacts people in poorer classes. Another issue facing people in underdeveloped countries is that the medication for TB (when you can afford it) needs to be taken at specific times and people do not have access to clocks or wrist watches, so it is difficult to take the medications on a specific schedule. People with TB are also isolated and treated similar to people who are lepers. So, patients are often left alone, and children are separated from their families, sometimes for years at a time.

Green writes "One sanatorium told parents, “Remember your child is sent to the Sanatorium because it is ill and needs treatment; and if the best results are to be gotten and the child is to recover in the shortest period, it must be left to our care with little or no interruption from parents, relatives, and friends.”

Green writes "I would submit that TB in the twenty-first century is not really caused by a bacterium that we know how to kill. TB in the twenty-first century is really caused by those social determinants of health, which at their core are about human-built systems for extracting and allocating resources. The real cause of contemporary tuberculosis is, for lack of a better term, us." The resources to kill TB need to be allocated to the places that need it.

So, what do we do? What is the takeaway here? If you, like me, are thinking "I am just one person who lives on the other side of the world, what could I possibly do?" One thing I would recommend is to educate yourself, maybe reading this book is a good place to start. You can also reach out to your church or members of your synod to see if they are doing any mission work you can support. I also encourage you to look into John Green's work with TB.

Learn more about TB

Purchase "Everything is Tuberculosis"