Blantyre Adventist Hospital is a Type 4 institution under SDA General Conference Policy. As such, it is intended to be completely self-supporting, receiving no church subsidies. So far BAH has been able to do quite well and has a positive acceptance by the community. However, operating in an economic environment characterized by high inflation and frequent, dramatic devaluations does give management a challenge. The key is to generate sufficient revenue by offering quality services and facilities at competitive price according to the hospital’s mission, all the while keeping expenses at a reasonable level without incurring debt. The hospital was founded by an American couple, Dr. Elton and Dr. Rheeta Stecker in 1974, as an offspring of Malamulo Hospital to help raise revenue for Malamulo Hospital operations.
In 1974, Dr. Elton and Dr. Rheeta Stecker purchased a three-bedroom house across the street from their home and renovated it into a six-bed “housepital”. They were mostly interested in maternity care and some general surgery.
From its inception, BAH’s growth has been tremendous. In 1983, the hospital expanded to twenty-eight beds. Five beds had to be added into the corridor because of pressure from patients not wanting to be moved elsewhere. In 1987, we negotiated to purchase a large piece of property adjacent to the hospital on which there was a large warehouse. Little did we realize that in five years we would need to expand to 40 beds. Our physician staff has increased from one physician to six with four specialists, internist, Ob/Gynecologist, Pediatrician and Surgeon.
Again in 1987 felt we needed to have a Health Education Centre to help our patients and the community learn about Preventive Medicine and a healthful life-style. We thank the Scandinavian ADRA for providing us with the funds for this building. It is a beautiful facility for audiences of up to 150. We are using it for ante-natal, breath-free, back pain, under-fives clinics and other classes.
The future of the hospital is one of continued growth with tremendous challenges and stress. The AIDS epidemic is putting such a strain on our facilities and staff that we will have to develop some kind of policy for home care. In 1992, 51% of our deaths were AIDS-related and the majority of the patients came from other Hospitals. The physicians, chaplain and nurses do the best to meet and counsel with the patients and relatives.
Philosophy of Operation
1. Goals of Blantyre Adventist Hospital:
a. To provide Dental, Medical and Optical care to all individuals requiring such care It is understood that not all services could not be available at Blantyre Adventist Hospital, like Mortuary, Intensive Care Unit and patients requiring this service could be referred to the Facility where the service is available.
b. To remain entirely self supporting , so that no church funds are required for the operation or subsidizing of this institution except for capital development and equipment purchases on donation basis.
c. To provide a framework in which committed Seventh-day Adventists, both national and expatriates, can have employment and earn their livelihood while at the same time carrying on the larger work of every lay minister that of spreading the gospel for the salvation of souls.
d. To be a demonstration of the healing ministry of Jesus Christ and, by the efficient and competent delivery of health care, act as a positive witness for the gospel and the Seventh-day Adventist Church.
2. These goals will be reached by the following means:
a. Provision of adequate buildings and equipment at Blantyre Adventist Hospital.
b. Provision of adequate expatriates and the national staff at Blantyre Adventist Hospital.
c. Provision of adequate supplies so that each professional will be able to carry out his/her work.
d. Competent and judicial management of the institution, so that funds are collected regularly and used wisely to meet the goals of the institution.
e. Provision of budges for continuing education for staff to meet the needs of the institution and personal goals of its employees.
f. Strong encouragement for each staff member to be actively involved in personal evangelism at his work place and in the church and community where he/she resides.
g. To assist with and coordinate better living programs for the community in which Blantyre Adventist Hospital is located.
3. Proposed Target Populations:
Any people living in or passing through the Blantyre areas requiring the services of offered who are in a position whereby to pay for such services or have an insurance scheme to care for their medical expenses.
4. Philosophy of Fees Structures and Charity:
a. The Blantyre Adventist Hospital is a fee-for-service institution which obtains the vast majority of its income by dispensing its services and selling its pharmaceuticals and medical lab work. The fees are based on a number of factors, including what local insurance, companies award for various services, what other institutions in Malawi charge for private services, and a consideration of the cost and time involved to render the services. Pharmaceuticals are purchased at the best possible price and mark up enough to cover the cost of the operation of the pharmacy and a margin of profit.
b. The charity fund is managed by a board of senior personnel at Blantyre Adventist Hospital. Since BAH is not the recipient of government or church funding, our philosophy is basically to take care of any emergencies but if the patient is unable to make financial arrangements, they should either be transferred to a charity or government institution for further treatment or arrangements to assist them with the charity fund should be made.
c. Blantyre Adventist Hospital does not carry personal accounts except when absolute necessity forces it. As a rule, all patients must either have an insurance scheme, pay cash, or be a part of a firm or organisation who have committed themselves to cover the account on their behalf.
5. Philosophy of Remuneration of Staff Members:
a. As part of the worldwide effort of the Seventh-day Adventist Church, Blantyre Adventist Hospital sees its work as a mission and not merely a job or employment in health care. This outlook along with the principle of sacrificing stewardship that includes the over-riding philosophy of remuneration of the staff of the Blantyre Adventist Hospital.
b. Having said this, there are very important principles that are taken into consideration in the remuneration of workers that provide balance to the concept of sacrifice. These principles are:
1. A worker should have sufficient income to support his family’s basic needs of food, clothing and housing.
2. A worker should be paid approximately on par with workers of his/her trade, profession or skills in the public sector.
3. Workers should be knowledgeable that BAH offers benefits to look after their welfare, and that the expenses on the benefits form part of charges to patients, hence the need for dedicated workers.
c. A fine balance has to be struck between the fee charged to patients and the remuneration made to staff members. Very low fees for patients lead to low remuneration of staff which produces frustration and hardship on the part of the worker. Too high fee charged to patients allow for better remuneration of staff, but bring hardship and suffering to the patients.
To find the balance is not easy, but keeping the principle of love for mankind, sacrifices for Christ and fairness and compensation to patients and staff makes it possible to set fees and wages with some basic of justice.
6. Service Development:
1. Current services offered at Blantyre Adventist Hospital:
Orthopaedic Surgery Internal Medicine
General Surgery General Practice
Opthamology OB/Gyn Ultrasound Scanning
General Ultrasound Scanning Pharmacy
Whole Body CT Scanner Physiotherapy
Non-medical: Pastoral and Credit facilities
1. Proposed Future Personnel Needs:
· Eye specialist
· Physicians to cover doctors when they leave for continuing education
· Radiography specialist
· Medical Lab Technologist specialist
2. Long-term Plan for Nationalization:
· Expatriate positions to be nationalized at intervals.
· To train national worker to take over Dental Lab Technician duties
· Train national worker to take over dentistry
· Train Enrolled Nurses to upgrade to State Registered Nurses
· Increase parking lot
· Expand hospital laundry drying shed
· Renovate hospital entrance
· Renovate old section of hospital
7. Major Equipment to be obtained:
1. Heavy duty drier
2. Heavy duty air conditioner for clinic
3. Medical Lab equipment
4. Second theatre
8. Committees at Blantyre Adventist Hospital:
1. BAH Board
2. Administrative Committee (ADCOM)
3. Departmental Heads Committee
4. Departmental Committees
5. Doctors Committee
6. Doctors/Nurse Supervisors Committee
7. Strategic Plan Committee
8. Social & Welfare Committee
9. Rectification Committee
10. Development Committee
11. Marketing Committee (a need)