The saving of a hospital

The Ethiopian government had given Gimbie Adventist Hospital (GAH) administrators a clear ultimatum: bring the facility and its services up to standard or close. Short of money and unsure of what to do, the Ethiopian Union and the Eastern Africa Division of Seventh-day Adventists turned to Loma Linda University for help.

"Too often, we have tended to send money or equipment to our mission pro- jects around the world and hope that will work," says Richard H. Hart, MD, DrPH, dean, School of Public Health. "Well, the 'quick fixes' aren't working--we need to develop long-term stability."

Over the past two years, LLU's efforts at Gimbie Adventist Hospital, in the highlands of western Ethiopia's Wollega Province, have involved students, alumni, and faculty who have served--and continue to serve--in a variety of roles. Students have completed internships up to a year in length, participated in short-term mission projects, or assisted with research.

In 1998, the School of Public Health coordinated a group of students and faculty from various Schools in the University to assist in a construction project on the hospital grounds. Serving this past year were five students or recent graduates--Owen Gardner, Paula Edgecombe, James Hagen, Jennifer Sprague, and Kevin Sayler.

Owen Gardner, who earned his MPH in health services research in the School of Public Health, and Paula Edgecombe, an occupational therapy graduate from the School of Allied Health Professions, served at Gimbie in the areas of administrative support and therapy on a volunteer basis.

James Hagen, who is working towards a master's degree in health administration from the School of Public Health, recently returned from a year-long internship at Gimbie Adventist Hospital.

Jennifer Sprague, who graduated as a nurse practitioner several years ago with her master's degree, has also volunteered for nearly a year at Gimbie.

Kevin Sayler, who is working toward a master's degree in environmental health, assisted David Dyjack, DrPH, chair and associate professor of environmental and occupational health, School of Public Health, with a study of air quality on the hospital grounds and in neighboring homes.

Husband and wife Seth and Beatrice Wiafe, who are currently studying at Loma Linda, spent six years at Gimbie, where he headed up the clinical lab and taught in the clinical laboratory training program, and she was matron (head of nursing). Both are currently working toward their BSPH degree, and he plans to finish an MPH degree before they return to Gimbie.

Three Loma Linda University alumni have joined the GAH staff on a permanent basis. Kenneth D. Rose, MD, a 1988 graduate of the School of Medicine, recently relocated from Penang Adventist Hospital in Malaysia to serve as medical director and surgeon at GAH. Nick A. Walters, MD, a family practice physician who graduated from the School of Medicine in 1989, came to GAH from Guam Adventist Clinic in February. Darla Lee, RN, MPH, a 1989 School of Public Health graduate, arrived in November, 1999, to serve as matron.

Loma Linda's answer to the request was the formation of Adventist Health International (AHI), an organization which now includes six corporate members--the General Conference, Loma Linda University and Medical Center, Adventist Development and Relief Agency, Adventist Health/West, Adventist Health/Sunbelt, and Adventist Healthcare, Inc.

The purpose of AHI is to provide consultation, training, management guidance, equipment, and support for struggling mission hospitals and rural health services in an effort to enable them to achieve stability, prosperity, and respect in the region.

AHI/Ethiopia, a collaboration between the U.S.-based Adventist Health International and the Ethiopian Union and Eastern African Division of Seventh-day Adventists, has taken on the responsibility of reorganizing the hospital's management infrastructure, as well as upgrading the physical plant to meet government standards.

AHI has also been working with Davis Memorial Hospital in Guyana and is in the process of setting up similar collaborative efforts in Rwanda, Zambia, and Haiti.

In March of this year, Dr. Hart and two other AHI/Ethiopia board members from Loma Linda--Dr. Dyjack and Donn P. Gaede, MPH, assistant professor of health administration, School of Public Health, traveled to the capital, Addis Ababa, for board meetings. While there, the board voted to take responsibility for seven more clinics, bringing the total to 14 clinics managed by AHI/Ethiopia.

In addition to conducting research on air quality, Dr. Dyjack worked with the National Onchocerciasis Task Force, a group charged with the task of distributing medicines to combat the disease. Dr. Dyjack is serving as project manager for this AHI/Ethiopia and World Bank-sponsored effort.

Mr. Gaede, Dr. Hart, and Dr. Dyjack have been assisting with the reorganization and development of a sound management structure for the hospital. Mr. Gaede and Dr. Hart also spent time teaching courses at the University of Eastern Africa Baraton, an Adventist educational institution in Eldoret, Kenya, as part of the Loma Linda-sponsored master of public health degree program there.

"AHI's strategy is to engage in capacity building in four areas," details Dr. Hart. "These include the development of a functional organization structure, the training of nationals in management, governance strengthening for board members of participating institutions, and resource mobilization--funding, equipment, physical structure improvements, personnel development, and communication."