Adventist HealthI N T E R N AT I O N A L

2004 ANNUAL REPORT

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Adventist Health International deliberately slowed its growth in 2004, putting somecountry requests for joining on hold while we strengthened our existing processes and insti-tutions. So you will not see any new member institutions in this report, but you will see thecontinued blessing of God as AHI fills an increasingly vital role in the health work of theAdventist church.

Let me encourage you first to look in the middle of this report at the map and donationsummary. This is truly amazing, with AHI’s continued growth in donations reaching$841,000 this year. This is a combination of grants, organizational and church donations,and many gifts from individual people who believe in what is happening. Both God and you,our individual donors, seem to be urging us on to higher goals and commitments. Thank youfor your trust and confidence.

The initial premise of AHI was that good governance and management could make amission hospital both financially stable and able to provide Christian service in its commu-nity once again. We have concentrated primarily on reestablishing those institutions thatwere on the verge of dying, though now we are being encouraged to consider the develop-ment of new clinics and hospitals. In Ethiopia, we are also being asked to resume control ofthree Adventist hospitals that were confiscated by the socialist government back in the1970s: Debra Tabra, Dessie, and Empress Zewditu.

We have also come to the point where running all of AHI on the backs of volunteers, allof whom have other full-time jobs, is becoming more and more difficult. Some of our corpo-rate members are offering to provide budget support for employing limited staff to keep upthe traveling, board meetings, and correspondence that is a daily part of AHI. We are alsoconsidering a new organizational structure that can protect our Adventist system from thecontinued threat of malpractice litigation, now a part of most countries. You will be hearingmore of these developments in the future.

Thank you once again for being part of this incredible journey over the past six years.Holding the hands of so many dedicated staff in the 50 clinics and 26 hospitals in 10 coun-tries that call AHI their organization has been truly awesome. What hath God wrought!

Richard H. Hart, MD, DrPH, president Adventist Health International

Front cover: An adolescent patient in Nuzvid, India. Photo by Loren Seery.

PRESIDENT’S REPORT

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TABLE OF CONTENTS

PRESIDENT’S REPORT 2FEATURE—IMPRESSIONS OF A FIRST-TIMER 5FEATURE—SOMETHING IN THE WATER 7AHI MAP 12AHI LEADERSHIP 19FINANCIAL REPORT 20AHI SUPPORTING PARTNERS 21AHI SUPPORTING OPPORTUNITIES 23

COUNTRY REPORTS

CAMEROON 4ETHIOPIA 6GUYANA 8HAITI 9INDIA 10NIGERIA 14RWANDA 15TCHAD 16TRINIDAD 17ZAMBIA 18

Adventist Health International (AHI) is a multinational, nonprofit corporation with head-quarters in Loma Linda, California. AHI has been established to provide coordination, consulta-tion, management, and technical assistance to hospitals and health-care services operated by theSeventh-day Adventist Church, primarily in developing countries. AHI is not a funding agencyand depends on various organizations, foundations, governments, and individuals to providefinancial assistance when needed.

AHI believes that every health-care institution must be firmly rooted in its community withconcern for all aspects of development, and will pursue policies and programs which accomplishthis aim. AHI is committed to the education of local health-care professionals and will encouragethe establishment and/or retention of professional training programs whenever appropriate.

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bsorbing change is alwaysa difficult experience, evenwhen those changes areperceived as positive.

All four major institutions inCameroon underwent a year ofchange in 2004, including theCentral African Union leadershipitself. Monita Burtch, MS, AHIexecutive director, has been con-stantly on the move, managing aseries of crises and change.

Andre Nda’a, MD, the medicaldirector at Batouri Hospital, willspend the first four months of2005 earning his diploma in trop-ical medicine and hygiene at theUniversity of London. This oppor-tunity is richly deserved by Andre, who hasworked under difficult conditions for thechurch for many years.

Buea Hospital in the western part of thecountry has begun a long-awaited buildingproject. Using funds from previous dona-tions and more recent support from theEllsworth Foundation and Ingathering: Hopefor Humanity, they are converting a smallclinic into a two-story hospital and outpa-tient complex. This will effectively serve thematernal and child health needs of this por-tion of the country. David Hendrick, an AHIvolunteer from Michigan, is overseeing thismajor building project, which should becompleted in 2005.

Koza Hospital in the north has probablyhad the most difficult year, with the departureof Drs. Elfred and Marialita Solis resulting inintermittent physician coverage for somemonths. Located in a picturesque and popu-lated area, Koza has great potential. Drs. Greg

and Audrey Shank will arrive there when theycomplete their French language training inmid–2005. Greg is a surgeon and Audrey is infamily medicine. Both are deferred missionappointees from Loma Linda and will bringmuch-needed clinical and management skillsto Koza. The future is finally bright for thesededicated staff who have worked under diffi-cult circumstances for some years.

Finally, at the dental clinic in Yaounde,Perry Burtch, DDS, continues to provideclinical leadership to this busy practice withfour dentists. A new clinic is needed, astheir current area has become very crowdedand inefficient. The clinic is starting to loseits professional dominance in Yaounde, soplans are being developed to either pur-chase or build a new clinic building that canhouse both the clinic and AHI headquarters.

It truly feels like Cameroon has turnedsome major corners and is ready for a sea-son of peace and prosperity.

AMEROONC

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2004 Board of Director’s meeting in Douala

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aving been asked to write this briefpiece, I am a reluctant author. Thereluctance has to do with respect—respect for the many readers who

have considerable experience with mis-sion service on the African continent andother places. I’m afraid that as a first-time visitor to Africa, a tourist in essence,my impressions and views are bound tobe naive and not reflective of the realreligio-cultural issues that long-term missionaries face.

Yet, I feel compelled to share mynotions a bit. It was a privilege to be inCameroon and Tchad, to participate inAHI Board meetings in these countries, towitness the energizing roles played bylocal leadership and volunteers, and tovisit health-care facilities in Yaounde,Koza, and Bere this past January. I aminspired by the absolute dedication ofthose who work in these AHI health-caresettings.

I saw a steadiness of commitment inthose who serve in Koza and Bere.Conditions at Bere Hospital are as primi-tive for a health-care setting as they canget. There are no modern facilities ortechnological devices. Remoteness pre-cludes communication with friends, fami-lies, advisors, and consultants.

It is only the consistency of commit-ment to service, and service to JesusChrist, that impels individuals such asJames and Sarah Appel and others to dowhat they do so consistently. It is alsowhat compelled the physicians, lawyers,and other volunteers who are Boardmembers of AHI–Cameroon to meet for12 and a half hours without interruption,

striving to find solutions to the facilities,personnel, and other challenges they facein their settings. It is what drives health-care providers at Koza Adventist Hospitalto commit to make that facility the bestin the region for health-care delivery.

Whether at Koza, Bere, in formal AHImeetings, or just in casual conversationwith everyday men and women in thecountries we visited, the presence of tal-ent and dedication to humanitarian con-cerns was formidably evident. Yes, inways that we do not have to in FirstWorld societies, men and women on theAfrican continent often struggle and com-pete to survive. But with all the lack,there is great intelligence, wisdom, anddignity.

The leadership, health care, and sup-port staffs in AHI hospitals display aunique spirit of service and are unified intheir dedication to do “God’s work” asthey seek practical and ingenious solu-tions to patients’ physical and spiritualneeds in their own settings. The problemsthey face—lack of modern medicine andfacilities, remoteness, lives that may beunnecessarily lost, bureaucratic strug-gles—are real, to be sure. But their spiritin the Father’s service is what makesAHI’s and its supporters’ efforts and phi-lanthropy the more fruitful and worth-while.

Clearly, I was impressed with thework that African and expatriate health-care workers perform. How our Father isblessing AHI’s work is tremendous! I’mleft to thank the many individual andorganizational donors that consistentlysupport its mission of service.

HIMPRESSIONS OF A FIRST-TIMER

BY ALBIN GROHAR, PHD

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he success of Gimbie AdventistHospital (GAH), the first AHI institu-tion, continues to both amaze anddelight us all. GAH has now completed

its second year of full operational solvency,covering all local operational expenses frompatient revenue. AHI–Ethiopia continues tosolicit donations for capital development proj-ects, but all other expenses are covered locally.This is rather amazing in a rural area of one ofthe poorest countries in Africa. It provides amodel that is gradually being replicated else-where and is the result of careful managementby Chandra and Charlie Baier, Amy and JesseTabaranza, MD, the hard work of the localstaff, and the support of many volunteers whohave made Gimbie a common destination.

The design of the new building to include aprivate wing with eight private and semi-privaterooms has provided a financial edge for thehospital. A variety of services has been devel-oped which has reestablished the reputation ofthe hospital and led to higher occupancy. The

significant assistance of Maternity Worldwidehas brought volunteers and support forexpanded maternity care. The continued part-nership with Susie and Maty, the local Catholicnuns, has provided a model to the communityof teamwork and commitment. A major affilia-tion with the Fistula Hospital in Addis Ababahas led to GAH becoming a western base forthis important surgical service for women.

Donations from Ralph and CarolynThompson and Alan and Jane Sines haveenabled Gimbie to start construction on anurses dormitory as the hospital prepares tobegin its first academic program. This willgreatly enhance its ability to serve the westernpart of Ethiopia with qualified professionals.The continued development of the NutritionEducation and Rehabilitation Village will domuch to improve the nutritional status of chil-dren and decrease high maternal mortality byallowing high-risk mothers to remain close tothe hospital before delivery.

The success of GAH has not gone unno-ticed nationally, and during 2004,AHI–Ethiopia received requests toonce again manage the threeAdventist hospitals confiscated bythe government during the socialistrevolution of the 1970s. Serious dis-cussion about establishing a man-agement relationship with EmpressZewditu Hospital in Addis Ababahas been facilitated by FekedeGemechu, MD. A final decisionabout this request is expected inearly 2005. While these discussionsmature, additional rural clinics arebeing upgraded, staffing enhanced,and services provided throughoutthe country. Praise the Lord!

THIOPIAE

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A volunteer plays the guitar for a leg fracture patient

ith three marriages in one year,it is easy to suggest that theremight be something in thewater. One thing is for certain,

our AHI family is growing!Kelvin Sawyer met Sue in 1999. Their

relationship didn’t take off until 2004,and they began to write each other asKelvin drove around Africa. They weremarried on December 5 at Stanborough

Park Adventist Church in England. “Sue is really taking a leap of faith to

join me working for AHI and living out ofa Landcruiser,” says Kelvin. “To go fromthe leafy rural village of Slapton inBedfordshire to roughing it in Africa takesreal courage, but she says I’m worth it!”

James Appel was introduced to Sarahthrough e-mail correspondence in early2003. It wasn’t until she came toCalifornia in September to take nursingboards that James met her.

Sarah traveled first to Bere looking fora challenge. James followed severalmonths later and the result was inevitable.They were married in December of 2004in Copenhagen.

“First of all, if Dick Hart claims anycredit for getting Sarah and I hooked up, Irefute it all!” says James.

Danjuma Daniel met Tomi at BabcockUniversity in Nigeria in 1995. Tomi fin-ished her law degree and started work asan administrative assistant at Ile-Ife hospi-

tal, whereDanjuma workedas a financial offi-cer. The couplegot married April7, 2004, and therest, as they say,is history.

“Eight monthsof marriage hasstrengthened ourlove and we thankGod for the gift ofeach other,” saysDanjuma.

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SOMETHING IN THE WATER

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Sue and Kelvin Sawyer

Sarah and James AppelDanjuma and Tomi Daniel

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atching an institution inchits way back into financialsolvency and serviceexcellence is a fascinating

thing to behold. Davis MemorialHospital (DMH) has been on that roadfor the last few years. In looking back,there are many events and individu-als that contributed to this improve-ment. Dominant among those wasthe “right-sizing” of the staff severalyears ago, when the hospital reducedstaff by nearly a third. Though painfulat the time, this single event con-tributed significantly to the productiv-ity of those remaining and thecohesive spirit among them. TheFoundation Healthcare Worker training pro-gram was also seminal in creating a positivecan-do attitude among the staff and in build-ing DMH’s reputation as a “teaching” hospital.

One of the challenges at DMH through theyears has been retaining quality professionalstaff. While there are always community doc-tors who enjoy using our facility, keeping acore of committed Christians at the center iscritical for providing the kind of care thatmodels Christ’s methods. Lorna Mandalupa,MD, an Ob/Gyn specialist from thePhilippines, began this development processseveral years ago. Then Karla Guerra, DDS,from Mexico, began the new dental services in2004. Finally, John Wilson, MD, a deferredmission appointee graduate from Loma Linda,completed his family medicine residency andjoined in October. With the support of BertieHenry in administration, Carol Coffey in thebusiness office, and Mandy Le Fleur in nurs-ing leadership, our team is strong and workingtoward the future.

DMH is enjoying the status of once againbeing the “preferred” hospital in the entirecountry. To keep pace with this develop-ment, the time has come to engage in amajor development project. The most acuteneed is for a new outpatient facility thatincorporates a modern clinical laboratory,up-to-date radiology and imaging tech-niques, and a commercial pharmacy. Moreoutpatient space is also needed for the grow-ing number of patients.

To accomplish this, the Board has devel-oped plans and voted to start fundraising for anew health and diagnostic center to be builtnext to the hospital. This major two-story facil-ity will provide 24 exam rooms, a five opera-tory dental clinic, pharmacy, radiology andlaboratory services on the ground floor, and asuite of classrooms, computer lab, library, andnutrition laboratory on the second floor. Theseeducational areas will let DMH continue toexpand its community education services anddevelop additional professional programs.

UYANAG

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First-floor schematics of the new health center

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olitical and social unrest continuesto plague Haiti, despite many effortsto stabilize the country and institutedevelopmental reforms. Hopital

Adventiste d’Haiti, in the Diquini suburbof Port-au-Prince, gets caught in thesevarious issues as it tries to improve itslevel of service and remain financiallysolvent.

For much of this year, the city’s elec-trical power was on for only three to fourhours in any 24-hour period, making anyelectrical appliances difficult to use.

The hospital has worn out two smallgenerators during this time, in an effortto maintain its basic services. Finally,AHI, with the help of the ADRA emer-gency fund in the Interamerica Divisionand Ingathering: Hope for Humanity, pur-chased two large, nearly new generatorsin Florida. Reg King of Haiti Mission

Outreach took responsibility for gettingthem to the hospital, building a pad andshed for their use, and eventually con-necting them to the system.

A large diesel tank was also installedto enable the purchase of fuel on a moreefficient basis. This single act of provid-ing stable power will distinguish our hos-pital from others in the country and willgreatly improve health-care services.The total project will cost nearly$100,000 for all of its components, butshould last for years and provide enoughpower for the hospital, as well as for thenearby university, Universite Adventisted’Haiti.

A number of other remodeling proj-ects are moving ahead slowly. DorisDupruy, DDS, a young dentist trained inHaiti, has benefitted from six months inthe International Dentistry Program at

Loma Linda Universityand is ready to begin adental clinic at thehospital as soon as thechairs arrive and areinstalled.

Physical therapyservices have alsobeen started and arewaiting to expand withadditional equipment.The new patient wingis waiting for windowsand will be ready toopen. Each of thesesteps seem small, yetprogress remainssteady in this islandnation.

AITIH

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Generator units purchased for use in Haiti

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t was with some reluctance that theAHI Board accepted all of India’s 11Adventist hospitals into AHI member-ship at one time in 2003. These institu-

tions are scattered across this hugecountry, soon to be the most populouscountry in the world. With many differentcultures and economic issues, it was clearthat each institution would need its ownplans and support system. Some weredoing very well, while others were sufferingimmensely, months behind in payroll obli-gations, deep in debt, and having lost theirprevious reputations for quality.

Our strategy was to look for “low-hang-ing fruit,” those relatively simple interven-tions that could have a significant impact.We also decided to concentrate extra atten-tion on Giffard Memorial Hospital inNuzvid, one of our premier institutions inthe past, but in danger of immediate bank-ruptcy and closure. Its nursingschool, in particular, has con-tributed many talented staff toAdventist hospitals throughoutIndia and the world. With thelarge Indian community in theeastern part of the United States,there has been special interestand support for Nuzvid from theColumbia Union Mission Fund.

This fund donated $90,000to build a new dormitory and torefurbish the hospital. This newdorm will be named after AnnaKnight, the first African-American missionary to India.Nuzvid has also been blessedwith the volunteer work of aphysician couple from New

Mexico, Betty Whatley and Gregg Manoff.Their time at Nuzvid has started to bringtighter organization to the health servicesand begin the long turn-around process.

Ranchi Hospital in eastern India hasalso received special attention. Ranchi isin a tribal area that has not seen as muchdevelopment as other parts of India.Elwin and Jaya Vedamony, inorthopaedics and Ob/Gyn respectively,are giving leadership to the institution. Itseems clear that with a little nudge,Ranchi could become financially self-suf-ficient. It has a growing nursing schoolcrowded into a small dormitory thatneeds expansion. Ranchi has also beenasked to start a medical technologyschool to serve the area. Ingathering:Hope for Humanity has provided $60,000to remodel the ICU and surgical areas atthe hospital, which will allow them to

NDIAI

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Giffard Memorial Hospital in Nuzvid

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provide expanded contractualservices to local businesses.

Mattison Memorial Hospital inThanjavur has been another insti-tution of concern. The Mattisonfamily has given much to India,and their relatives and descen-dants are helping to build a newdoctor’s house on the hospitalcompound to protect some openland from being confiscated andallow the institution to expand. Asenior staff house can be con-structed for $25,000, and this isnow moving forward.

There are many other needsthroughout India that are beingaddressed. The hospital at Puneneeds to be rebuilt. There is considerable sup-port from businessmen in the local commu-nity to help with this project. Negotiations willshow the potential for constructing a new

facility and how it can witness in this growingcity of India.

The coordination of the entire countryhas been accomplished by a trio of individuals

that deserve credit for many hoursof travel, time away from home,and endless committees. AshleyIsaiah is our executive director ofAHI–India, and Don Bankheadfrom the division. Rod Applegate, aretired hospital administrator fromWalla Walla, Washington, serves asAHI regional vice president forIndia, and has given much of hisretirement years to India, provid-ing consultation, leadership, anddirection. While the issues seemalmost overwhelming at times, thisgroup continues to have confi-dence as they move cautiously for-ward. AHI is indebted to theircommitment and energy.

Rod Applegate visits with a patient

The girls hostel at Giffard Memorial Hospital under construction

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Trinidad

Guyana

Haiti Nigeria

Cameroon

AHI INSTITUTIONS

Contributions to AHI*January 1 to December 31, 2003

AHI–“Global” Fund $181,280AHI–Ethiopia 95,315AHI–Guyana 22,000AHI–Zambia 25,350AHI–Rwanda 39,498AHI–Cameroon 35,650AHI–Haiti 98,150AHI–Tchad 129,288AHI–Nigeria 97,850AHI–Trinidad –AHI–India 117,208

Total $841,589*only includes funds transferredthrough AHI–Global

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Tchad

India

Ethiopia

Zambia

Rwanda

ACROSS THE GLOBE

AHI–Global projects $181,280AHI–African continent projects 422,951AHI–Caribbean and West Indies areas 120,150AHI–India projects 117,208

Total contributions to AHI projects: $841,589

AHI PROJECTS

ow does one begin todescribe the rough andtumble world of Nigerianpolitics and health care?

It can be both troubling and gratifying, frustrating and fulfill-ing. Anchored by Ile-Ife Hospitaland its associated PostgraduateMedical Education (PME) programand the School of Nursing,AHI–Nigeria is transitioning into amore mature system with thedevelopment of management andaccounting systems.

Danjuma Daniel has worked forAHI since his return from obtaininghis MBA at Southwestern AdventistUniversity in Texas several years ago.Covering both the business functions ofAHI for the country and, more recently,becoming the business manager for Ile-IfeHospital itself, he still had time to find histrue love and marry Tomi, our invaluableassistant in the PME program. Tomi hasnow finished her law degree, and we areexpecting strong leadership from this cou-ple into the future.

This year has also seen our first AHIexecutive director for Nigeria, TayoOdeyemi, move on to another assignmentin Malawi. Tayo’s broad understanding ofdevelopment has been invaluable in estab-lishing AHI in Nigeria, and we wish he andhis family all the best in their new pursuits.Drs. Randy and Melinda Skau returnedhome after 10 years in Nigeria, clearly leav-ing part of their hearts in this marvelouscountry. AHI will continue to benefit fromtheir commitment and consultation as pro-grams develop. Akin Obisanya, MD, has

stepped into the leadership position forAHI in the country.

The School of Nursing is undergoing amajor change as it responds to the govern-ment mandate to upgrade to a baccalaure-ate level. This will require improvement offaculty, classrooms, and laboratories, andadditional dormitory space. A new affiliationwith Babcock University is being developedand is expected to facilitate this transition.Our graduates continue to score well ontheir national exams, and we expect thisschool to maintain its strong reputation.

Jengre and Aba Hospitals are alsoundergoing some transitions. It is easy tooverlook these smaller institutions in thenorth and east, yet they provide valuableservices in their local communities. BothJengre and Ile-Ife underwent some Board-mandated “right-sizing” of their staff dur-ing 2004, which has done much tostrengthen their financial stability. Theyear 2005 is expected to show the resultsof these needed changes.

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H

IGERIAN

Ile-Ife nurses complete a continuing education course

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hat a year of change andgrowth it has been in Rwanda.The arrival in mid 2004 ofMarvin and Beth Gottschall

has caused a major strengthening of thedental clinic in Kigali. Clinic profits inthe past enabled a major upgrade of thedental chairs and equipment. With theinvaluable installation help of KelvinSawyer, this equipment has once againpositioned Clinique Dentale Kigali as thepremier clinic in the capital city.

Mugonero Hospital has also seenmajor transitions. The hospital absor-bed a major increase in staff costs as the church increased salary scales. Theaddition of several external-service con-tracts has assisted in achieving financialstability.

Donn Gaede, MPH, secretary of AHI,has also secured an HIV/AIDS grant thatis based at the hospital and has supple-

mented operating costs of the institution.The Drs. Mark (Ranzinger and Edison)continue to provide medical leadershipwhile the hospital administrator, KamaliKamisa, works on his MPH degree inUganda. One can gradually feel the hospi-tal maturing into a broader based andmore stable institution.

A major new challenge is the govern-ment’s decision to phase out all A-2 nurs-ing schools in the country. This is theprogram that currently has more than400 students enrolled at Mugonero,requiring rethinking of what to do next.In consultation with the Ministry ofHealth, Loma Linda University School ofNursing has agreed to assist the nationalgovernment in strengthening its nursingplans for the entire country in exchangefor Mugonero being allowed to upgrade tothe new A-1 level. This will require anadvanced level of training for the faculty,

better educational facilities, and asmaller student body. But theexpanding role of nurses in healthcare, especially in the growingAHI system, requires us to makethis transition expeditiously.

Finally, funds have beendonated to start upgrading the sixrural health centers in the coun-try. These provide invaluable serv-ice in various locations, and theydesperately need upgraded facili-ties, better equipment, and con-tinuing education for their staff.With adequate supervision theycan each become financially self-sufficient units that contributemuch to health and development.

WANDAR

Marvin and Beth Gottschall strengthen the Kigali Dental Clinic

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ew stories have capturedthe intrigue, interest, andcommitment of AHI sup-porters like Bere Adventist

Hospital in Tchad. It really beganin 2003 when James Appel, MD,a LLU deferred missionappointee, was finishing up hisfamily medicine residency andlooking for a place to serve.Tchad had recently joined theAHI list of member countries,and a commitment was made toupgrade the small Bere hospital.Largely overlooked by the churchfor many years, this 30-bed insti-tution in southern Tchad was truly brokenin spirit and substance.

With encouragement from AHI leader-ship and a brief visit to the institution,James declared he was ready to take it on.Coming from a long line of missionaries,James admitted wanting a place where noone else would go, searching for the mostdifficult and destitute of situations. Bereoffered him that choice with its broken-down buildings, demoralized staff, non-exis-tent equipment, limited housing, hot desertclimate, confusing languages, and weakeconomy.

Before James could even arrive, anotherunique individual contacted AHI and saidshe wanted to go someplace with greatneeds, difficult circumstances, and unusuallanguages. Bere offered all that with its mix-ture of Arabic, French, and local dialectsand working conditions that had driven outmany before her. Sarah Andersen was anurse from Denmark and had alreadyproven herself in other mission conditions,

including short-term assignments in Brazil,Peru, Israel, and Ethiopia. She met Jamesin California briefly in September, 2003,arranged her finances, and headed out toBere on a two-year volunteer posting.

When James arrived in early January,2004, Sarah was already working to changethings at Bere. James’s colorful storiesthrough the year told of the tragedies andtriumphs, challenges, and choices that theyfaced each day. James’s frequent e-mailshome also revealed the even stronger pullof love as these two young professionals,drawn together by a common commitmentto service, gradually fell in love with eachother. After getting married on December30, 2004, James and Sarah returned toBere to continue the long road of develop-ing the hospital. As the year ends, the hos-pital compound has improved significantly.Two containers of equipment are on theirway, morale is vastly improved, and Bere’sservices and reputation are growing as fastas its infrastructure.

Staff worship at Bere Hospital

CHADT

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ommunity Hospital in Port-of-Spainhad already been sold once and wasthen caught up in a struggle betweenthe union and local conference over

control of its destiny. Many thought that join-ing AHI was a case of “too little, too late,” asthe external debt on the institution hadgrown to nearly US$2 million. When Trinidadjoined AHI in 2003, it was not clear where orhow to begin to stabilize this once-thrivinginstitution.

The small core of “true believers” whowere committed to saving CommunityHospital was led by Richard Spann, MD.Originally from Trinidad, Dr. Spann and hiswife had emigrated to England, where he hadtrained in neurosurgery and she in Ob/Gyn.When the call came to help save CommunityHospital, Richard immediately responded andhas carried a major clinical load as well asserving as president of the institution. Thevoid created by the retirement of CuthbertArthur, MD, a long-time leader atCommunity Hospital, has been filledby a growing number of communitydoctors and hospital staff who areproud to be part of the family.

Two significant new services atCommunity Hospital this year havebeen the establishment of a four-bedICU, that is arguably the best in thecountry, and a five-chair dialysisunit. Both of these programs havehelped reestablish the hospital’s rep-utation as a cutting-edge institution.Richard has personally providedmuch of the supervision in the ICU,caring for his growing neurosurgicalpractice and the many patients nowbrought to the hospital. Bob

Soderblom, MD, from Loma Linda, a semi-retired nephrologist with a deep interest inservice, agreed to travel to Trinidad for along weekend each month and help trainthe staff, establish protocols, and seepatients during the development of the dial-ysis unit. This unit has brought hope andtreatment to many and is now consideredthe best in Trinidad.

Through these efforts, CommunityHospital is on its way back, though there isstill much to do. A new outpatient facility isneeded, and the MRI scanner needs to befully operational. Health professional trainingprograms in conjunction with CaribbeanUnion College need to be started. Hospitalexpansion is already being discussed as daysof full occupancy occur more and more fre-quently. Perhaps more importantly, the debtload is being reduced, and there is hope inthe future once again in the halls and com-mittees of Community Hospital.

RINIDADT

A patient on one of the new dialysis machines

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tarting new clinical services is nevereasy, in any country or culture. This hascertainly been the case with the newdental clinic in Lusaka. It has taken

more than a year to obtain all the licensesand clearances to officially start in the remod-eled building near the Eye Hospital. Thisclinic is the first phase of a long-term strategicplan to develop a full multispecialty clinic inthis area where a number of local physicianscould practice in an Adventist institution.With the Eye Hospital and dental clinic nowestablished, other parts of this long-term plancan be considered.

Early in 2004, Michael Stafford, DDS,arrived with his wife, Andrea, and their twoboys. Mike grew up in Rwanda while his par-ents were missionaries there, so he feelscomfortable returning to Africa. He is acti-vating the new dental clinic and will providewestern dental care with modern equipment.

The Eye Hospital has enjoyed a fullcomplement of ophthalmologists for the firsttime this year, including Bo Wiafe, MD, asmedical director, Tom Beggins, MD. Morerecently, Eustace Penniecook, MD, and hiswife, Cessiah, came from Universidad deMontemorelos, where Eustace took both hismedical school and ophthalmology training.Cessiah has her MBA and is working in thehospital in business management. Theyhave been a welcome addition to ourLusaka-based team.

Phillip Mubanga, MD, has been workingin the clinic in Lusaka town on the Unionheadquarters compound. This has beengrowing nicely and is the third leg now ofAdventist medical services in Lusaka. Thiscomplements the 12 rural health centers thatare becoming part of AHI, in addition to ourtwo rural hospitals—Mwami in the northeast,and Yuka in the far west. Mwami has

received several grants to con-struct more staff housing, whileYuka has received help to estab-lish a clean-water system andbuild a new “banana” boat forcrossing the flood plain. Fam SiowLeong, MD, has been workingalone at Yuka, carrying heavyresponsibility while an adminis-trative team is being recruited.

A young volunteer from LomaLinda, Edward Martin, is volun-teering his administrative skills toAHI–Zambia in 2005. With theassistance of all the new and oldstaff, the strategic plans for Zambiaare coming together and will makethe new year truly impressive.Zambia’s time has come.

AMBIAZ

Drs. Hart, Fam, and Llaguno and Mr. Gaede discuss Yuka

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Rodney Applegate, MASouthern Asia Division

Alexis Llaguno, MDSouthern Africa-Indian Ocean Division

Elie Honore, MD, MPH, MHAInter-American Division

George Sanz, MDCentral Africa Division

Fesaha Tsegaye, MD, MPHCentral Africa Division

EGIONAL VICE PRESIDENTSR

PresidentRichard H. Hart, MD, DRPH

Chief financial officerLlewellyn L. Mowery Jr., CPA

SecretaryDonn P. Gaede, MPH

Dental servicesJames M. Crawford, DDS, MPHQuint P. Nicola, DDS

Disaster and humanitarian servicesEmmanuel M. Rudatsikira, MD, MPH

Equipment procurement and maintenanceJerry E. Daly, MA, MSLS

Facility/construction and maintenanceKenneth J. Breyer, ME

Financial managementDaniel E. Fontoura, MPPM

Legal servicesKent A. Hansen, JD

Nursing servicesJan Zumwalt, RN, MS, MBADolores J. Wright, DNSC, RN

Philanthropic servicesAlbin H. Grohar, PHDEric Rajah

Tropical medicine electivesLarry Thomas, MD, DTM&H

Environmental servicesDavid T. Dyjack, DrPH

AHI LEADERSHIP

OARD MEMBERSB ANAGEMENT TEAMM

hose interested in keeping up to date on AHI activities throughout the year are encour-aged to visit our webpage at <www.adventisthealthinternational.org>.T

Lowell C. Cooper, MDIV, MPH, chairMatthew A. Bediako, MA, MSPHB. Lyn Behrens, MBBSMardian Blair, MA, MSHAMaitland DiPinto, MPHLarry Dodds, MBAAllan R. Handysides, MBCHBKevin J. Lang, MBAHarold L. Lee, DMIN

Juan R. Prestol, MBACharles C. Sandefur Jr., MDIV

HI HEADQUARTERSA

Loma Linda UniversityMagan Hall, Room 111Loma Linda, California 92350(909) 558-4540E-mail: ahi@llu.eduwww.adventisthealthinternational.org

20

FINANCIAL REPORT

Adventist Health International is a nonprofit corporation as described in Section 501(c) 3of the Internal Revenue Code. Donations are tax-deductible for income tax purposes.

Statements of financial position (unaudited)Assets: 12/31/04 12/31/03Cash and cash equivalents $ 510,019 $ 305,010Property and equipment, net 10,157 14,512

Total assets $ 520,176 $ 319,522

Liabilities and net assets:Due to affiliate $ 171,986 $ 100,975Accounts payable & accrued liabilities 350 1,739Total liabilities 172,336 102,714Net assets:

Unrestricted 139,536 26,876Temporarily restricted 208,304 189,932

Total net assets 347,840 216,808Total liabilities and net assets $ 520,176 $319,522

Statements of activities (unaudited)Temporarily

Unrestricted Restricted TotalYear ended December 31, 2004

Support and revenue:Contributions (including restricted grants of $343,000) $116,250 $ 725,339 $ 841,589Net assets released from restrictions for program services 708,760 (708,760) –Interest 19,663 1,793 21,456

Total support and revenue 844,673 18,372 863,045

Expenses:International programs 714,083 – 714,083General and administrative 11,148 – 11,148Fundraising 6,782 – 6,782

Total expenses 732,013 – 732,013

Change in net assets 112,660 18,372 131,032Net assets at January 1, 2004 26,876 189,932 216,808Net assets at December 31, 2004 $139,536 $ 208,304 $ 347,840

Year ended December 31, 2003Support and revenue:

Contributions (including restricted grants of $321,386) $ 88,241 $ 461,398 $ 549,639Net assets released from restrictions for program services 362,133 (362,133) –Interest 12,746 1,840 14,586

Total support and revenue 463,120 101,105 564,225

Expenses:International programs 476,977 – 476,977General and administrative 31,027 – 31,027Fundraising 175 – 175

Total expenses 508,179 – 508,179

Change in net assets (45,059) 101,105 56,046Net assets at January 1, 2003 71,935 88,827 160,762Net assets at December 31, 2003 $ 26,876 $ 189,932 $ 216,808

21

Abraham, Leah L.Alexenko, KittyAlfke, Bonnie LeeAllen, Nicole JeanneAngebranndt, MartinAnholm, J. MilfordAnonymousAppel, JamesBadzik, Douglas AllanBadzik, Marilynn GleeBaier, RudolphBancarz, Gloria PaulineBarber, ChrisBarrera, MarionBechthold, DonnaBeckner, JeanneBennett, CletaBennett, Jack LeonardBergmann, Vera M.Block, David J.Botting, Gordon E.Bouland, Heber D.Boyatt, C. EdwardBreyer, Jeseph W.

Our work is made possible only through the generous support of individuals, organizations, churches, and companies. We deeply appreciate and thank our partners for their continued support.

Briggs, Bernard DanielBruins, Eric R.Bruins, Kevin A.Bruins, Roger C.Brutinel, JohannaBryson, JulieBudd, Barry J.Burtch, DeanCallaway, JayneCastillo, FayeCastro, DanielCha, JoyCoffin, LarryCondon, Stanley CharlesCrane, Lee F.Crane, Marilyn C. TurnerCrawford, Denelda E.Crounse, James EdwardCutting, Jane E.Davis, ClaudiaDelong III, Scott H.Denham, CharlesDixon, BruceDixon, Linda HelenaDodds, LarryDriver, CissyDunlop, Robert F.

LOCAL CHURCH PARTNERS

AHI SUPPORTING PARTNERS

Cedar Lake Seventh-day Adventist Church

Fletcher Adventist ChurchMarkham Woods Adventist

ChurchPeakland Baptist ChurchRichmond Hill Adventist

ChurchSandstone Chapel Adventist

ChurchSimi Valley Adventist ChurchSt. Joseph the Worker Church

ORGANIZATIONAL PARTNERS

Adventist Health Corporate OfficeAngels Camp Community ServicesCastle Medical CenterColumbia Union ConferenceCommonweal Foundation, Inc.CompUSA, LPGeneral Conference Trust ServicesGeneral Conference of Seventh-

day Adventists, Inter-American Division

Hope for HumanityLodi Adventist Elementary

SchoolMaree Noble Elizabeth Stumpf

Memorial FundMcKee Foods CorporationMission Impact InternationalNational Association of Seventh-

day Adventist DentistsPUC Ethics 101 ClassLLU School of Medicine Alumni

AssociationSilverHawk Technology, Inc.The Charlson Foundation

A girl in Ethiopia waits as her hair is braided

INDIVIDUAL PARTNERS

22

AHI SUPPORTING PARTNERS, CONTINUED

Kunau, CarolLaack, Nadia Nicole IssaLamberton, Dale FrancisLanfear, CarolLawrence, KimLecourt, Nancy HoytLepore, MarkLewis, Susan Kay BorderLohr, Jason L.Loredo, Lilia NietoLouden, Wendi L.Luthas, Vernon ChinLuyster, CarrieMackett, M. C. TheodoreManwell, Alisa S.Martin, Joshua D.Martinson, Elmer JamesMattison, Eloise Mae and Weldon H.McGhee, Julie A.McGhee, William HaroldMcLean, Orlin R.Mellish, Herman EdwardMiller, Agnes E.Miller, Thomas PatrickMitchell, AnnMoon, Edward TobyMoore Jr., P. J.Moreno, Michael R.Morris, WilliamMullen, Thomas NobleNeall, Kerry LennardNieters, Doris P.Nixon, KathyNutt, William and DanaOdermatt, Aina G.Oliver, Jennifer LeighOrdelheide, Franklin ConradOsborn, KimberlyOsborne, JosephineOsborne, Michael J.Perrin, Ralph W.Piper, Edward L.Purdy, SuzanneRaethel, Kathryn R.Raettig, Vilma JaraRamsey, Fern J.Rasco, JayRatto, Jennifer A.Ratzlaff, MelanieRay, Evert StanleyRebok, Douglas E.Redfield, James W.Redmond, MaryReilly, Sydney L.Ricketts, IlseRidgy-Finkbiner, ArlineRigsby, DottyRoberts, Kevin A.Rodriguez, ElizabethRoeske, Reiner S.

Rose, Grover A.Rose, Kenneth D.Roth, Daniel A.Rudatsikira, Emmanuel M.Rue, Michael and CarolRunge, Joyce BeatriceSaunders, AileenSaunders, Eileen W.Saxby, Doyle B.Schnell, EricSehdev, Mohanlal K.Seplak, Arthur G.Shade, JoanSines Sr., John AllenSmith, Chauncey LewSprague, J. HowardStiles, PeterSundin, Peter W.Suriner, RuthTasker, NathanThiel, Francis AndrewsThiel, NormanThomas, HelenThomas, Larry LeeThomas, P. SamuelThompson, Gordon WallaceThompson Jr., Ralph JamesTorres, Bertha E.Viel, JenViel, Matthew D.Vyhmeister, NancyWalsh, Eric G.Walter, Steven H.Ward, Mary LouWasiczko, Wayne AllanWat, Karen ElaineWatley, ThelmaWatson, CharlesWehtje, AmandaWehtje, Myron F.Weismeyer, Richard W.West, Raymond OwenWical, Charles LeonardWical, JoyWiesseman, GeorgeWiles, Herbert B.Williams, Joseph HenryWinslow, Gerald R.Winter, DonWong, Annie LamWoods, William E.Wright, DoloresWright, Lester NilsWuerstlin, D. JimWurangian-Caan, NeliaYu, ElaineZambrano, Eusebio A.Zumwalt, Janice R.

Dunn, Michael E.Dyer, Don S.Dyke, RobertEdstrom, JamesEstelle, ElmerFigueroa, Heidi JoFisher, Deo FlaizFlaiz, Richard AllanFontoura, Daniel E.Foster, Ray LyonFuller, Forrest LaVerneGaede, Charles H.Gaines, Elvin CarlyleGammada, Ephraim B.Giese, Jonathan M.Gimbel, Twyla D.Grace, LoranneGrgas, Neven A.Guttschuss, Heather AnnHagen, Helen G.Hagen, James R.Haglund, AndrewHam, Lyle BruceHamer, John H.Hannah, Steven MichaelHansen, Kent AllenHansen, Leilani KathleenHart, Lewis HenryHart, Richard HenryHaus, DavidHeavner, BeckyHeavner, George R.Herberg, Richard W.Herzog, Kim M.Hetke, Eleanor J.Hinck, Walter A.Hirst, David BarryHixson, Gerald E.Hodges, Lance ThomasHoe, Adele S.Hoffmeister, Frederick C.Horsman, Pat J.Hostetler, RochelleHoumann, Paul ErikHuff, Wynelle J.Hunt, Genella M.Hustead, MaryIng, Jeffrey JohnJackson, Richard M.Jacobson, Barbara M.James, JanJenson, Charles V.Job, Jayakaran S.Jones, Christopher AlexanderJones, Dustin R.Jones, Robert M.Koch, MarkKollist, Hillar R.Krall, JackKrussow, David J.

23

2005 FUNDING NEEDS (US DOLLARS)First figure for each project is total estimated budget, followed by amount needed through March 2005

AmountAHI–General Total budget needed

• Needed: Project Fixit (provides support for traveling technician to repair equipment) $50,000 $30,000• Needed: Travel support for accountants to establish accounting systems $20,000 $20,000• Needed: Travel support for board meeting attendance $25,000 $10,000

AHI–Cameroon• In progress: Construction of Maternity Hospital at Buea $120,000 $10,000• Needed: Construction of medical/dental clinic to replace old dental clinic $500,000 $500,000• Needed: Repair wiring and upgrade Koza Adventist Hospital $45,000 $45,000• Needed: New patient wards at Batouri Adventist Hospital $50,000 $50,000

AHI–Guyana• Needed: New Health and Diagnostic Center at DMH $400,000 $270,000

AHI–Haiti• Completed: Two new generators with connections $75,000 funded• Needed: Upgrading of dental and physical therapy clinics, patient wards, and surgical theatres $60,000 $50,000

AHI–India• In progress: Giffard Memorial Hospital (Nuzvid)—Build new nurses dormitory $80,000 funded• In progress: Ranchi Hospital—Major remodel of ICU/OR suites $83,000 $17,000• In progress: Mattison Memorial Hospital (Thanjavur)—Build new senior staff house $25,000 funded• Needed: Ranchi Hospital—Expand dormitory space from 20 to 60 nursing students $193,000 $193,000• Needed: Pune Hospital—Finalize plans and launch fundraising for new hospital. Est. $2 million $2 million• Needed: Giffard Memorial Hospital (Nuzvid)—Remodel senior staff housing $25,000 $25,000

AHI–Ethiopia• In progress: Upgrade four satellite clinics $20,000 funded• In progress: Construction of new nurses dormitory plus furnishings $75,000 funded• In progress: Construction of Nutrition Rehabilitation Village $30,000 $6,000• Needed: Upgrade final five satellite clinics $25,000 $25,000• Needed: Complete staff duplex $30,000 $30,000

AHI–Nigeria• In progress: Building upgrades of Ile-Ife, Jengre, and Aba Hospitals $120,000 $90,000• In progress: Complete new nurses dormitory $35,000 funded• Needed: Repair and remodel old nurses dormitory $20,000 $20,000

AHI–Rwanda• In progress: Upgrade six rural health centers $24,000 $14,000• Needed: Upgrade Polyclinique Adventiste Kigali $120,000 $105,000

AHI–Tchad• Completed: Build perimeter fences, repair roofs, rewire compound $30,000 funded• Completed: Send two containers of medical equipment $35,000 funded• Needed: New church building $30,000 $25,000• Needed: Build new outpatient building $28,000 $13,000

AHI–Trinidad• In progress: Development of new services, including ICU, MRI, dialysis unit $200,000 $80,000

AHI–Zambia• Completed: Establish new dental clinic in remodeled house in Lusaka $65,000 funded• In progress: Purchase land for staff housing complex in Lusaka $30,000 $6,000• Needed: Construct two new senior staff houses $120,000 $120,000

Back cover: an Ethiopian man. Photo by Kim Osborne

AHI SUPPORTING OPPORTUNITIES

Magan Hall, Room 111, Loma Linda, California 92350(909) 558-4540; ahi@llu.edu

www.adventisthealthinternational.org

Adventist HealthI N T E R N AT I O N A L