An idea born 25 years ago from a few volunteers who wanted to try a different approach to managing international hospitals now operates in more than 30 countries throughout the world and partners with 45 hospitals and more than 100 clinics. Adventist Health International (AHI) reinvigorates health, wellness, and wholeness in the communities it serves.

This year AHI marks its twenty-fifth anniversary, and it all started with a request from Ethiopia.

The Road to Gimbie

When Claude Steen, Jr., arrived in western Ethiopia, he was exhausted. After three months of travel, including 80 miles in a U.S. Army Studebaker truck, he had finally reached the clinic. It was 1947, and, as it turned out, the treatment center was in an old cow barn. By 1948 Steen had established Gimbie Adventist Hospital (GAH) and begun seeing patients. Everywhere Steen turned he saw opportunities, both for growth of the hospital and for spiritual growth among the villagers. The needs for both were great. The hospital grew significantly, both in services and in patients served. When the Steens left 12 years later, GAH was established as a solid health-care community with an active Adventist church.

In the 1990s, however, the hospital began to deteriorate rapidly. It was not surprising when, in 1997, the local government gave the Adventist Church in Ethiopia 12 months to upgrade GAH or the hospital would be shut down.

A request soon came to Loma Linda University (LLU) from both the national and international Seventh-day Adventist Church. As the flagship health-care system and medical school in the Adventist Church, it wasn’t surprising the request came to LLU.

When Richard Hart, M.D., Dr.P.H., then serving as dean of the LLU School of Public Health, heard the request, he knew he had to respond. Having served overseas himself in Tanzania in the 1970s, Dr. Hart knew firsthand the hardships these hospitals and clinics faced. Already too many mission hospitals throughout the world had either closed or fallen into an irreversible state of disrepair.

A small group of volunteers started to meet regularly in the LLU School of Public Health to strategize and explore what could be done in response to this request from Gimbie and the many other requests that were coming in from hospitals around the world. The group felt that LLU could serve as a solid foundation from which to help these hospitals.

Exactly what would it take to save these hospitals? What kind of financial resources would be needed? Could LLU provide medical personnel? The logistics were overwhelming. It wasn’t just a lack of financial support or even lack of doctors and nurses—the real issues were developing leaders, solid accounting practices, and a steady stream of volunteers.

“None of us really knew in the beginning where this idea would end up,” Dr. Hart recalls. “We just felt that we could no longer stand by while some of our most storied mission hospitals began to fade from existence.” In 1997 AHI began operations in Loma Linda with Hart as its first president. The organization started with two hospitals, GAH and Davis Memorial Hospital in Guyana.

A Pressing Need

Ethiopia, however, was a pressing need. If AHI didn’t respond quickly, the Ethiopian government would take control of the hospital. After a preliminary visit, AHI agreed to take on the challenge of building a new hospital facility at Gimbie. A team of volunteers from Adventist Development and Relief Agency (ADRA) Netherlands began construction of the new hospital in March 1998, supplemented by a group of students and faculty from LLU.

The new hospital at Gimbie was completed in 2003. Work didn’t stop there, however. The construction team now set their sights on repairing and upgrading the rural health centers throughout Ethiopia. This upgrade to the hospital and surrounding clinics satisfied the requirements of the Ethiopian government, and patients were moved into the new facility.

From Hart’s perspective, building the new hospital became a symbol of AHI’s commitment and belief that donors and volunteers could be found who were willing to move beyond the status quo and work for something better. After building the hospital, however, an even more difficult task was revitalizing the staff and morale at Gimbie and the outlying clinics in Ethiopia.

Local staff were gradually assembled, and relationships with patients and the government were healed. Gimbie was now on the long road back to respect and service.

“The initial premise of AHI was that good governance and management could make a mission hospital both financially stable and able to provide Christian service in its community once again,” per Hart.

Both Gimbie and Davis Memorial were able to pay off all their old debts, and began operating with a small profit. It became clear to the small group of AHI volunteers that even in the poorest countries, good management can make a hospital self-sufficient for operating expenses. Solid governing boards and strong management can lead these hospitals to operational solvency and the ability to control their own destiny.

According to Lowell Cooper, retired general vice president of the General Conference of Seventh-day Adventists who served as AHI board chair for 15 years: “From its inception AHI sought to leverage the expertise of health-care professionals and administrators in a manner that could benefit health-care institutions, particularly those located in economically challenged environments. Services and skills provided largely by volunteers, along with resources from private and institutional donors, have been game changers for many health-care facilities.”

What started with two hospitals, Gimbie in Ethiopia and Davis Memorial in Guyana, soon expanded across Africa and into the Americas. Requests began pouring in from across the globe. AHI continued to grow, both in countries and hospitals served, but also in its donor base and skills.

What is AHI?

The story of AHI captures the heart of international mission work, from the small band of LLU employees who volunteered their time to get it started, to the rough and tumble Australian handyman, Kelvin Sawyer, who drove hundreds of thousands of miles back and forth across Africa breathing life into old equipment. After arriving at a rural hospital, Sawyer would spend weeks to even months repairing and installing equipment or providing consultation.

There are also people like Ben Siapco, a retired microbiologist from LLU, who travels to various locations setting up and upgrading LLU, who provides facility inspections and helps review plans for new hospital constructions. The volunteers who have worked tirelessly for 25 years on behalf of hospitals and communities halfway around the world are too many to list. Their dedication, however, is legendary.

Developing a steady stream of financial support proved to be a critical piece in assisting these hospitals with their turnaround plans. In its first year of operations, donors gave a little more than $7,000 to AHI; the next year, 1998, AHI brought in more than $230,000.

In 2022 AHI raised more than $3.6 million.

These funds support more than 40 hospitals and 70 clinics around world, building and renovating hospitals’ infrastructure, meeting emergency needs such as the cholera outbreak in Malawi, renovating operating rooms and water supply systems, strengthening accounting systems and relevant financial training of accounting staff, and strengthening governance systems that prompt integrated health-care operations. 

As the footprint of AHI continued to grow, so did the involvement of other Adventist health-care systems in North America. From providing leadership on governing boards and committees to providing financial resources and consultation, Adventist hospitals from across America have stepped up to ensure AHI’s success.

Another area that AHI has impacted is the return of the Deferred Mission Appointee (DMA) program at LLU. The DMA program is a partnership program with LLU and the Adventist Church that provides a pipeline of medical professionals with a desire for mission service to mission hospitals. Students throughout Loma Linda have become passionate about international mission service again.

In Hart’s view, “one of the most gratifying impacts of AHI has been its impact here at LLU. Young professionals hear about what is happening and want to be involved. This may include short-term mission trips, raising money for projects, finding equipment, and planning for long-term service. There is nothing like infectious enthusiasm for doing good.”

The Future of AHI

As with all other health-care systems in the world, AHI has faced challenges in recent years working through COVID, global recessions, inflation, and even natural disasters. The 7.0 earthquake in Haiti brought tremendous destruction and pain to the Adventist hospital in Port-au-Prince, but it also brought tremendous opportunity for health-care development in the country. Today Hôpital Adventiste d’Haïti has one of the top facilities in the nation, with an advanced orthopedic and orthotic team. 

In 2010 Hurricane Tomas hit Antillean Adventist Hospital in Curaçao, in the southern Caribbean Sea. An earthen dam broke near the hospital and suddenly flooded the entire facility with three to four feet of water. Both patients and staff were evacuated safely, but the electrical equipment, which is so critical in a modern hospital, was essentially all destroyed. AHI raised more than $1 million to replace what had been lost.

Though financial assistance is one way that AHI can help, often its real strength is the coordination, consultation, management, and technical assistance that is provided to these rural international hospitals. Dr. Albin Grohar, who has been part of AHI since its inception, notes, “We ensure that health-care professionals in the field have someone on this end to consult with and rely on and assure them that they are not alone as they face the day-to-day difficulties of operating health-care entities in some of the world’s most challenging places.”

AHI continues to pursue its objective of improving health services in Adventist hospitals around the world, working with 45 hospitals in approximately 30 different countries. Whether it is helping set up medical labs or nursing schools, upgrading electronic health records, or providing support during a global pandemic, AHI continues to answer the call from Adventist mission hospitals worldwide.

Many of the hospitals once facing very threatening circumstances have now been placed on sustainable footing. Some of these hospitals have reached financial sustainability and now make their way on their own. Others join AHI just to be part of something bigger than themselves.

In recent years AHI, in cooperation with the General Conference Health Ministries Department and the Loma Linda University Global Health Institute, has convened both regional and global health-care conferences attended by large numbers of mission hospital personnel.

LLU Health is now focusing on developing global campuses at AHI institutions in strategic locations throughout the world. The first campus was developed at Malamulo Hospital in Malawi, one of the oldest Adventist mission hospitals. New global campuses are being developed at Béré Adventist Hospital in the country of Chad, to serve French-speaking African countries; Hôpital
Adventiste d’Haïti as a teaching hospital serving the Americas; and Scheer Memorial Adventist Hospital in Nepal to serve Asia.

These campuses will serve as training sites for both locals and international students. It is the hope that these campuses will develop into major teaching hospitals, providing a variety of academic programs, research options, and modeling of improved clinical practices. AHI does not see itself as a donor agency, but as a development organization, seeking to create progress and sustainability in each of its affiliated hospitals, clinics, and training programs.

God has truly blessed the work that AHI started and has continued throughout the world for the past 25 years. What began as a single request from a struggling hospital in a far-off land is now changing communities across the globe. To learn more about AHI and how donations can help those in need, visit ahiglobal.org.