an one organization staffed entirely by volunteers have an impact on the global healthcare system of the Seventh-day Adventist Church? If you ask Dr. Richard H. Hart, chancellor of Loma Linda University (LLU) and president of Adventist Health International, he will answer with an emphatic "yes!"

The Adventist church is known worldwide for its health and educational services. For years, overseas travellers were advised to seek out Adventist health-care institutions for the best available medical care. Through years of hard, creative work and sacrifice, alumni from Loma Linda University and others have been instrumental in establishing many of these hospitals.

Today the church operates 174 hospitals and sanitariums. Over half of these are located outside the borders of the United States. "We have a few hospitals in Europe and Australia, but more than 70 of these institutions are located in what we term the two-thirds world, the poorest countries, containing four billion people," Dr. Hart says.

"Over the past two decades, many of these health-care institutions have slipped badly," Hart explains. "The quality of care has dropped dramatically as weakening economies, shrinking overseas budgets, changing national and church politics, and other factors have taken their toll. Too many institutions have slipped from setting high standards to dragging the bottom, and national governments and our own church leaders wonder whether it is worth continuing some of them."

Understandably, morale suffered at many of these institutions. "Even the normal upbeat attitude evident when Christians gather together is lost and gloom often reigns supreme, making witnessing about God's love and care very difficult," Hart says. "It reached a point that some of these institutions are an embarrassment to the church. You might walk into the pharmacy and find it empty. Laboratory equipment is outdated, and often x-ray equipment is broken. In many places, the whole infrastructure of the facility is at risk."

In recent years, a growing number of individuals at Loma Linda University and the General Conference have become concerned about this rapidly deteriorating situation. Lengthy philosophical discussions ensued. Discussions centered questions such as: "Is health care a necessary part of the Adventist legacy?," "are we expecting too much from a 12-million member church?," and "Is the era of medical missions past and should other avenues of service be considered?"

"While opinions vary, the consensus was that the church's role in the medical area does serve a vital role in the global outreach of the Adventist Church," Dr. Hart says. "If these facilities were to close, LLU would be the biggest loser!

"We are not just helping them," Dr. Hart continues. "They are helping us to define who we are. If we lose these mission facilities, we have to fundamentally change the character, nature, and mission of LLU." A group of individuals accepted the challenge, and an organization with no regular source of funding or paid staff was formed--Adventist Health International (AHI). AHI has seven corporate members: Loma Linda Universty and Medical Center (LLUMC), the General Conference, Adventist Development and Relief Agency International, Adventist Health System West, Adventist Health System Sunbelt Healthcare Corporation, Adventist Health Care, Inc., and Kettering Medical Center.

The first institutions to become AHI members were Gimbie Adventist Hospital in Wollega, Ethiopia, and Davis Memorial Clinic and Hospital in Georgetown, Guyana. "These facilities were in desperate straits and in danger of being closed," Dr. Hart says. "We faced many challenges including establishing a governance and management system that makes the board and staff function together effectively."

The General Conference approved the new concept and said "let's try it out and see if it works." AHI initially began its work at Gimbie Adventist Hospital in Ethiopia. The church headquarters in Ethiopia had received a letter from the local government giving the hospital 12 months to put itself on a reliable footing or the government would be forced to close the hospital. "The hospital was already four months into the 12-month period," Hart says. With the assistance of ADRA/Netherlands and Students for International Mission Service, a LLU-based student mission organization, construction on a new hospital building began in 1998. After four years, and nearly $400,000 in donations, and many volunteers later, a new three-story hospital building was completed and dedicated last August. The new facility includes a surgery suite, labor and delivery room, patient wards, and an educational floor.

Another story is taking place at Davis Memorial Clinic and Hospital in Georgetown, Guyana, built in 1952. "Little had been done to the facility in the last 50 years." Hart says. Before AHI became involved, the once premiere hospital in Guyana had deteriorated. Church officials in the region voted to shut down the facility. That was before AHI was invited in to try to save the institution.

"AHI has made real progress in Guyana," says Donn P. Gaede, secretary for AHI and an assistant professor in the LLU School of Public Health. "Davis Memorial is now one of our bright spots."

"A complete turnaround has been accomplished by AHI," says Elie S. Honoré, director of the Inter-American Division Health Ministries Department. "AHI helped complete this turnaround though six steps that improved the board, management team, training processes, and other strategic areas."

"Various institutions from our division are now anxious to be part of AHI," Honoré says. "I wish things could move faster, but I understand the financial and personnel constraints on AHI and will be patient."

During a trip to Davis Memorial earlier this year, personnel from LLU Medical Center replaced the hospitals electrical system. Now hospital staffers can operate equipment without the worry of blackouts or brownouts affecting patient services. The Foundation Health-care Worker training program was also initiated in Guyana in early 2001. This program provides an introduction to health care through instruction and exposure to each department of the hospital. In its planning phase, the Ministry of Health of Guyana recognized the value of the program and designated it as a stepping stone to various health careers.

Alexander A. Isaacs, who now works in the Ministry of Health in Guyana, was named the course director. "One of the exciting things about the new life at Davis Memorial is the revitalization of the local church," Hart says. "When I visited Davis Memorial in previous years, the church members discouraged me from attending the church located at the hospital and would invite me to the larger churches located in Georgetown. The hospital church, where membership had dropped to approximately 50 regular attendees, now has more than 1,000 attending services each Sabbath at the facility. A new church had to be built to accommodate the growth."

An outgrowth of AHI has been the establishment of a four-year Master of Public Health program through Loma Linda University School of Public Health at the University of Eastern Africa Baraton in Kenya. This management training program currently has 65 students from 20 African nations and includes physicians, administrators, teachers, nurses, and church health secretaries. It is anticipated that graduates from this program will further help strengthen the work of the Adventist Church throughout Africa.

AHI has now grown to eight countries including Ethiopia, Guyana, Rwanda, Zambia, Cameroon, Nigeria, Chad, and Haiti, with a total of 14 hospitals and 40 clinics. The amount of energy and time required in each country means that no more than two or three new initiatives can be attempted at a time, at least until a larger resource base can be established.

"Requests are coming in from other mission hospitals, but it is important that a solid foundation with quality personnel and policies be developed in each area so improvements will be maintained," Hart says. "The core business of AHI is health, and we must maintain quality at an appropriate technology level. Each country must also move toward a certain level of financial self-sufficiency."

More information about AHI may be seen on the Internet at www.adventisthealthinternational.org.

_________________________
Richard Weismeyer is the director of university relations at Loma Linda University.