Everyone is talking about health care financing these days.  In Congo we have similar issues.  How do you run a hospital when your patients only earn a dollar a day?  Missionaries have wrestled with this question for decades.  The best answer seems to be: if you have the will, are clever, and you have the right tools. Finally, a combination of these components is almost in hand.   

The dilemma of affordable care haunts the staff of our Baptist hospitals and health zones every day.  Most strive to embrace the values of sacrificial service and compassionate care modeled by Jesus but they have essentially no external source of funds, and are further challenged by the lack of infrastructure, unreliable communication, the whims of politicians, rampant corruption, and limited resources.  But, to provide any serviced at all, the budget must balance at the end of the month with salaries paid and medicines purchased.  

At Kikongo, medical director Dr. Luhonda, and hospital administrator, Mr. Kimona, know that 25% of patients pay only half their hospital bill, and 10% almost nothing at all.  Dr. Michee, at the Sala hospital, figures he spends one third of his hospital’s monthly income on energy: kerosene to refrigerate vaccines, diesel fuel for midnight emergency surgery, spare parts for the solar light system, and gasoline for the 90 km motorcycle ride to Kikwit, every time they need to purchase medicines.  At the Vanga hospital, with a reputation for competent surgical and medical care, complicated and chronically ill patients come from hundreds of miles, and accumulate extended hospital stays.  How much of the actual cost can you hope to recuperate from a patient for a 6 month hospital stay?  At Sona Bata, Dr.Kapenze experiences dwindling hospital receipts because increasing numbers of patients prefer to get their medical care from a regiment of itinerant doctors practicing mediocre, even dangerous medicine, but who are facilitated by vote-seeking politicians.  For years at Nsona Mpangu, the accounting has been done long hand, but the administrator gives up with any kind of analysis because synthesizing the information eludes him.

Mission hospitals in Congo (and around the world) have a strong desire to make the benefits of modern medicine available to poor people, but struggle with rapidly increasing costs in a context of poverty, and lack of health insurance.  Former medical missionary Daniel Fountain, who spent his career building a sustainable health care system in Congo, once asked, “Can you run a refrigerator on aspirin?”  He concluded it was possible by implementing simple cost-recovery mechanisms (aspirin sales) and using biblical management principals while stimulating dialog with health workers on money and management. Dr. Fountain was also plenty clever, but he lacked, and hospitals still lack, an affordable, simple, locally maintainable tool for tracking financial and patient data from which they can make accurate analysis and take proactive management decisions.

Running a hospital, or a health care system, particularly in these rapidly changing times, requires tools with the capacity to collect and analyze financial and patient information.  Our son Jonathan, and his cousin Steven, have taken an interest in this problem and decided to embrace the cause.  Computers are getting cheaper every day but hospital management software can cost millions of dollars.  In past years, Jonathan helped Wayne and others, try to adapt software, offered free on the internet, to Congo hospital needs.  Nothing fit.  Recently an organization offered modest funding to write such software, so Jonathan is taking a year off from college to lead a team of Congolese programmers in writing software for “Bush Hospital Management.”  When his cousin Steven, a computer programming major, found out, the challenge intrigued him as well.  The boys are now four months along, with Wayne and a seasoned Congolese hospital administrator advising them as they progress.  This software, so desperately needed, promises to be a practical tool for administrators and decision makers in the ongoing challenge of providing health care to poor people, and making the institution financially self sustainable as they struggle with the economic realities of their patient populations.

Thank you for your prayers for this cause!