Growing up in the coastal city of Singkawang in Indonesia’s West Kalimantan province, Samuel Junaedi remembers that whenever he got sick, his parents would drive him to Bethesda Health Ministries, a missionary hospital in the remote village of Serukam. The 30-mile journey could take more than two hours due to the rough and bumpy road.

“But when we met with Dr. [Wendell] Geary and his team … we felt as if half of our illnesses were already cured,” the 61-year-old recalls. In a region on the island of Borneo where witch doctors have long required payments in animal sacrifices to heal the sick, the practice of Western medicine was similarly seen as transactional. Those with money, connections, and prestige would get help, while the poor and lowly were out of luck.

Yet Bethesda was different. No matter a patient’s class, ethnicity, or ability to pay, the doctors would see them. “They serve us not only with their expertise but also with their hearts. This has differentiated Bethesda from other health centers,” Junaedi said.

Today, although he has much closer options, Junaedi still drives more than an hour to get to Bethesda when he or his family members suffer from serious illnesses. “I prefer to come to Bethesda because of the professionalism, good communication, and loving care offered by the staff here,” he said.

Despite support from locals like Junaedi, the hospital may need a miracle to continue operating. Founded by the Conservative Baptist Foreign Mission Society (CBFMS) about six decades ago, Bethesda was once a lifeline for members of the indigenous Dayak people as well as residents of major cities in West Kalimantan seeking high-quality care.

Yet things have since changed. The last missionaries left in 2016, and with them much of the donations. Bethesda has also struggled to transition from foreign to completely local management, especially as its remote location has made it difficult to recruit qualified administrators. The construction of new hospitals and government-funded clinics in the region has also led to fewer patients coming through Bethesda’s doors. Today, the hospital’s funds are running out.

Like mission hospitals in many parts of the world, Bethesda is at a crossroads as the world around it changes. The board, staff, and the local community believe there is a continued need for Bethesda in West Kalimantan: A hospital run on Christian principles that treats patients equally and shines as a light in a profession often associated with greed, said Geary’s son Paul, now a doctor and organizational consultant for Bethesda.

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“Whether we’re going to survive, I don’t know,” he said. “We might have to close or wind down into something really small. Or the crucible of pressure and debate … might squeeze us out of this fire into something better.”

A legacy in the rainforests of Borneo

In 1964, American missionaries Wendell Geary, his wife Marjorie, and their two young sons (including Paul) first arrived in the remote hamlet of Sungai Betung, home to a few hundred animist Dayaks living in simple wooden homes surrounded by the lush rainforest. Their job: revive a wooden makeshift clinic without electricity that was built in the late ’50s by missionary John Bremen.

CBFMS, now known as WorldVenture, took over the ministry when Bremen left and assigned two American nurses to work there in 1962. Geary’s arrival allowed the clinic to treat patients suffering from more serious illnesses, including those needing surgery. Most of the patients were Dayaks living in scattered hamlets and villages in the Kalimantan hinterlands and nearby towns. Malays and Chinese Indonesians in the area also started to come to the clinic.

Wendell and Margie Geary with their sons, Wendell Jr. and Paul.
Image: Courtesy of Paul Geary

Wendell and Margie Geary with their sons, Wendell Jr. and Paul.

With no other medical clinic in a 25-mile radius, patients quickly flooded to the clinic. Some suffered mild illnesses such as skin irritations or fevers, while others came for treatment of more serious problems: malaria, pneumonia, TB, or injuries like those caused by animal attacks. About 50 to 100 patients arrived each day.

To meet the rising demand, the clinic expanded and CBFMS sent more foreign doctors and nurses to help, including American doctors Bert and Beth Ferrell. Marjorie, a nurse, recruited 15 local young adults and taught them the basics of nursing, including how to use medical equipment, care for patients, keep the 20 beds clean, and ensure the kerosene lamps were lit in the evenings.

This training in nursing later grew into a nursing academy at Bethesda, which provided skilled nurses and medical professionals for the clinic and for other health centers in Indonesia.

In the late ’60s, the Gearys and the hospital staff protected 300 Chinese Indonesians in their hospital and nearby church during a Communist guerrilla uprising and a spurt of attacks between the Dayaks and the Chinese, according to Geary’s letters.

In 1974, Bethesda moved to Serukam, a neighboring village not much larger than Sungai Betung. CBFMS built a full hospital with 100 beds and its own electricity and water supply. The facilities included several simple houses for doctors and staff and dormitories for paramedics. They also built an airstrip next to the hospital where light planes operated by Mission Aviation Fellowship could transport patients for emergency treatment.

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‘Not even mentioned on the map’

Since the 1980s, Indonesian doctors have joined the mission and have gradually replaced foreign doctors who have been increasingly barred from working in the health sector by the Indonesian government. At the same time, Bethesda started to handover ownership from foreigners to a board made up of Christian Indonesians.

Sri Sjamsudewi, from Sumatra, was the first Indonesian doctor to join the hospital in 1982. “My friends scolded me as crazy when I decided to join Bethesda,” she recalled. “They could not understand why I wanted to work in a place that was not even mentioned on the map.”

Sjamsudewi ended up working at Bethesda for 31 years until she moved to Singkawang in 2013. During her time at Bethesda, her faith in Christ grew as she saw God miraculously provide for both her big and small needs. There was the time Geary was unavailable and she had to operate on a man whose liver and lung tissue had been punctured by a buck’s antler, a procedure she had never done before. With a prayer on her lips, she swiftly cleaned and treated the injuries and the man recovered.

Another time, while assisting Geary in an extremely high-risk emergency operation, they miraculously found a tube that exactly matched the severely damaged abdominal aorta they needed to replace.

Yet God also answered much smaller prayers. She remembers how, shortly after joining Bethesda, she prayed to God for some practical needs: a thermos and an alarm clock. A few days later, the wife of one of her patients dropped off a gift. Inside was a thermos and an alarm clock.

Many Indonesian doctors have since followed Sjamsudewi’s path, joining Bethesda and working under the mentorship of Geary. They have gone on to specialize in fields such as surgery, obstetrics and gynecology, radiology, and oncology, and now serve in hospitals across the country. Geary also inspired Willy Ken from the Dayak Iban subtribe to pursue medicine. He became the first doctor from his community and served as Bethesda’s director in the ’90s.

Beyond medical care, Geary also shared the gospel with patients and preached at the hospital’s church. In 2012, Geary and Marjorie moved back to the United States after nearly five decades in West Kalimantan. Geary passed away in 2019 and Marjorie earlier this year.

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Bethesda’s financial woes

Due to the hospital’s remote location, Paul thought that the most difficult part of the transition would be finding doctors and nurses. But instead, they found it even harder to staff the hospital’s administrators, accountants, managers, and IT department. The lack of good governance at Bethesda meant that it was unprepared to handle the government health policy changes, the steep drop in donations, and the dwindling of patients.

When the Gearys left, foreign donations to the hospital left with them, Paul said. Today it makes up less than 10 percent of Bethesda’s revenue. About three-quarters of the revenue comes from patients with Indonesian health insurance, but the number of patients coming to Bethesda has also decreased. This is because of the wider implementation of the country’s health insurance system that requires patients to get a referral from community-level clinics before they can see specialists at Bethesda. At the same time, some of the bigger cities have opened their own new hospitals.

Dewi Citra Puspita, the director of Bethesda, noted that Bethesda has faced serious financial problems for years and the COVID-19 pandemic has exacerbated the problem.

Paul and his family visiting local friends
Image: Courtesy of Paul Geary

Paul and his family visiting local friends

“When COVID-19 hit this province, we decided to open isolation wards to treat patients suffering from the virus,” said Puspita. “The 20-bed ward was almost always full during the peak of the pandemic as there were no other isolation centers near here.”

The virus spread to the hospital’s doctors and paramedics, nearly paralyzing the hospital’s services. Yet even with limited staff, “we were able to substantially contribute to the treatment and curing of the COVID patients,” she noted.

Because the hospital received very few non-COVID-19 patients during the pandemic, their revenue dropped even further. Yet the hospital was able to keep its doors open thanks to special funding allocated by the government for health centers treating COVID-19 patients. Paul estimated that the funding would only last until the end of this year.

In addition, Bethesda has struggled to find a full-time internal medicine physician. Currently Bethesda only has a part-time internist practicing only once or twice a week. This limits its service and decreases the number of patients it can see. The average bed occupancy at Bethesda hovers at less than 20 percent.

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Bethesda’s Uncertain Future

Today, Bethesda is at a crossroads. Paul took an extended leave from his practice in Minnesota to spend more time in Serukam during this transitional period. He held discussions and informal surveys with members of Bethesda’s board, doctors, paramedics, managers, and local community representatives to figure out what to do next. He also reached out to a consulting firm in West Java with experience in hospital development and management.

Nearly everyone believes Bethesda should continue serving the community, Paul said. Yet they acknowledge that it would require significant reforms, including a shift to a missional hospital model that serves a mix of middle-class and poor patients so that it can increase salary levels and stay sustainable. Bethesda board member Francisca Badudu, an oncologist in Bandung, West Java, noted that the hospital may need to relocate to a more populated city.

“But the hospital should firmly continue upholding its vision and mission to witness the love of Christ,” said Badudu, who served in Serukam in the 1980s and held the position of chairperson of its board until recently.

To resolve some of Bethesda’s governance issues, Paul is hoping that Bethesda can open an office in a larger city to recruit highly skilled people to manage the hospital remotely. He’s also looking to find more qualified people to join the hospital’s board—initially, the board was made up of rural farmers or pastors with no experience running a large hospital. Today about half of the board has the professional qualifications for their position.

The hospital has also found potential financial supporters in the people it has served. One businessman in Jakarta, who was born in West Kalimantan, told Paul that he was keen to support the hospital if it has any major plans in the future. The man had often heard his parents speak fondly about Bethesda’s ministry.

Junaedi and his family are deeply grateful that God brought Geary and Marjorie to the jungles of West Kalimantan.

“I just could not fathom why they agreed to come to such a remote place like this,” he said. “The only answer behind it must be their genuine and unreserved love for God.”

“And the fruits of their obedience are just amazing,” he said. “The Lord has marvelously blessed their ministries through Bethesda.”

Additional reporting by Angela Lu Fulton.