June 21, 2005
by Toya Richards Hill

BLANTYRE, Malawi – It's one thing for a well-intentioned Presbyterian congregation in the United States to send money to Malawi to add a new wing to an overcrowded rural hospital.

For such a congregation to give its money with no strings attached – "undesignated" – is something else entirely.

The hospital might use that "undesignated" money to repair or improve existing space, or to pay the phone bill, or to buy such essentials as clean mattresses and sheets.

Undesignated money is particularly helpful because recipients can use it to address their most urgent needs, Presbyterian mission workers in Malawi say.

Most donor money is earmarked for specific purposes, according to Dr. Roland van de Ven, the medical director at Mulanje Mission Hospital, a facility under the auspices of the Church of Central Africa Presbyterian (CCAP), a partner of the Presbyterian Church (U.S.A.).

Donors tend not to think about mundane expenses like utility bills, paint, building maintenance and patient transportation, said van de Ven, a Dutch physician under contract to the Interchurch Organization for Development Cooperation (ICCO).

"People want to build things and make something new," said Dr. Sue Makin, an obstetrician-gynecologist working at Mulanje Mission Hospital as a PC(USA) mission worker.

"We don't always need something new," Makin said. "We just need to maintain what we have. ...

"We need new screens ... or we need new gutters. That's not always exciting."

Van de Ven's message to Presbyterians who want to help: "Please, don't earmark your money."

Van de Ven's plea is personal – 47 percent of the money he depends on to keep a huge (18-building) hospital complex in operation comes from donations.

But the need for undesignated money is widespread throughout the CCAP.

Donor money is usually earmarked for "programming and projects," said the Rev. Dan Merry, an executive of the Pittsburgh Presbytery who has been on loan to the CCAP's Blantyre Synod for the past year.

Money for what Merry calls "the sexy things."

What is often desperately needed is decidedly un-sexy: Gasoline to keep an essential vehicle running, for example. Gas can cost the equivalent of $5 (U.S.) per gallon, Merry said, and it's hard to find money to pay for it – because "the donors do not let the synod take any money for that."

Merry, who serves the Pittsburgh Presbytery as associate pastor for medium-sized churches, has been in Malawi with his family since August 2004. His work there, which has included a stint as acting general secretary of the Blantyre Synod, ends in July.

"There's very little money that comes from partner churches for operations," said Merry, who said he has devoted a great deal of his time to helping the synod cut costs. "It's still a challenge every month to make payroll," he said, and "when you don't make payroll, people don't eat."

Merry said Pittsburgh Presbytery donates about $200,000 a year to the Blantyre Synod, and one of his goals after he comes home will be to see that more of that money is undesignated. He thinks it would be good to set aside maybe 10 or 15 percent of donations for "undesignated use."

That would please van de Ven, who has struggled in recent months to scrape up enough money to buy clean mattresses for patients' beds. In ward after ward, patients must lie on soiled and worn foam mattresses.

Van de Ven also struggles with the hospital's laundry service. Dirty linen is hand-washed by employees often working without protective gloves and gum boots – a serious risk in a part of the world where common infections can be deadly.

And he has lots of staffing issues – not enough nurses; inadequately trained x-ray technicians; dental equipment sitting idle because he has no one able to use it.

His to-do list, it seems, goes on and on.

"We have plans" to make things better, said van de Ven, who also has worked as a missionary in Zambia – "but we are dependent on donors."

To make things better, he said, "I've got to have that money in a different way."

Presbyterian News Service