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BY: DAVID J. SAUER
Mr. Sauer is director of development, Medicines for Humanity, Rockland, MA.

Over the past eight years, three U.S.-based Catholic communities of Franciscan women religious have developed a companion relationship with the Tertiary Sisters of St. Francis, a congregation based in Shisong, Northwest Province, Republic of Cameroon, Africa.

But this story really begins 157 years ago, in March 1849, with the founding of the Sisters of St. Francis of Assisi, Milwaukee. Later, at different times, the Franciscan Sisters of Perpetual Adoration, LaCrosse, WI, and the Franciscan Sisters of the Eucharist, Meriden, CT, split from the St. Francis of Assisi mother house. Although the two new congregations were created in different eras, both, it is safe to say, came about as the result of new interpretations of organizational philosophy, changes in the church, or differences with the local bishop. More importantly, the leaders of each congregation made decisions concerning what they believed to be the most effective way of carrying out their ministerial roles and responsibilities.

Founding new congregations, especially ones related to an original congregation is surely not unheard of in the history of the church. However, as these three congregations approached March 1999, the 150th anniversary of their common founding, they began discussing what they could do to celebrate it. They decided to embark on a venture that would address systemic change in their respective congregations and engage in activities that would in a public way help fulfill their collective desire to seek a mutual reconciliation of past issues. The project that resulted is known as their "Common Venture."

Looking toward Africa
Anticipating changes in our evolving world, the three U.S. Franciscan communities decided early on that they wanted to make their refounded relationship international in scope.

In June 1997, they began a long-distance dialogue with the Tertiary Sisters of St. Francis in Cameroon. The Tertiary Franciscans were interested, even eager, to collaborate in the Common Venture. All four groups decided to promote a discernment process calling them to refound their respective communities to meet the needs that would confront them in the 21st century.

Beginning in March 1998, a year before the 150th anniversary of the U.S. Franciscans's common founding, the Common Venture participants committed themselves to:

• Mutually determine what it means to be a 21st-century Franciscan community in the United States and a 21st-century community of African women religious, while also discovering a deeper meaning of the Franciscan vocation in the global church.
• Seek resources with which to assist the Tertiary Franciscans in developing the skills necessary for more effective ministry in their rapidly evolving culture and to support the training and education of Cameroonian Franciscans by bringing students to the United States for training and undergraduate degrees. The U.S. Franciscans also agreed to dispatch educators to Cameroon to teach various skills and help Tertiary Franciscans achieve needed educational certifications.
• Identify other organizations that have an interest in supporting the Common Venture's goals and, specifically, in assisting the Tertiary Franciscans.

The Tertiary Franciscans
The Tertiary Sisters of St. Francis of Cameroon were founded in 1935 by the Tertiary Sisters of St. Francis of Brixen, Italy. Over the years, the Cameroonian congregation has developed ministries in education, child care, parish service, and medicine. Today the community numbers about 250 sisters, a third of whom work in its health care ministry.

The congregation sponsors two hospitals, a small nursing school and midwife training program, a school for laboratory technology, a residential facility for disabled children and adults, orphanages for children whose mothers have died in childbirth or from HIV/AIDS, 16 village-based health centers, some 60 bush-country outpost clinics, and a maternal and child center.

The two hospitals, which serve as inpatient and outpatient primary care referral facilities, receive many of their patients from the village-based health centers and the bush-country outpost clinics, which are from one to six hours away.

Cameroon
Cameroon, a nation of about 16 million people, is located immediately north of the equator on the Atlantic coast of Africa. Nigeria is to its immediate north, Chad and the Central African Republic are to the east, and Gabon is to the south.

Composed of former French and British colonies, Cameroon gained its independence in 1961. Its economy is primarily subsistence, with limited export trade. Annual per capita income is about $600. About 40 percent of Cameroonians are believers in traditional faiths, about 40 percent are Christian, and about 20 percent are Muslim.

Life expectancy is 51 years for men and 54 years for women. The nation has an infant mortality rate of 94 deaths per 1,000 live births. It ranks 164th among the 190 nations evaluated by the World Health Organization for quality of health care and overall investment in health. Cameroon has more than a million cases of HIV/AIDS.

The Catholic Consortium
The Common Venture's leaders, realizing that the Tertiary Franciscans needed significant medical resources, approached the Catholic Consortium for International Health Services (CCIHS), an alliance of U.S.-based Catholic health systems and other organizations. CCIHS members exchange "best practices," conduct immersion experiences, and either sponsor international projects or have an interest in the work of international health care. Some members collect pharmaceuticals and other medical supplies for shipment to international missions.

In November 2000, CCIHS representatives traveled to Cameroon to conduct a medical needs assessment. The assessment revealed that the Tertiary Franciscans wanted to improve their health education programs and increase the number of medical volunteers from other countries. The Tertiary Franciscans said they especially needed an infusion of medical supplies and equipment.

Initial supplies and equipment were provided from an international aid warehouse operated by the Sisters of Providence in Lacey, WA. Money was contributed by various CCIHS members, including Catholic Health Initiatives, Denver; the Seton Institute, Daly City, CA (sponsored by Ascension Health, St. Louis, and the Daughters of Charity Foundation, Los Angeles); Exempla Healthcare, Denver (sponsored by the Lutheran Medical Center Community Foundation, Arvada, CO, and the Sisters of Charity of Leavenworth Health System, Lenexa, KS); PeaceHealth Oregon Region, Eugene, OR; the Sisters of Mercy Regional Community of Detroit; and Mercy Health Partners Northern Region, Toledo, OH.

As a result of the fund drive, the Tertiary Franciscans were able to establish a facility in the city of Njinikom, Cameroon, to manufacture some 35 different pharmaceutical products and intravenous (IV) fluids. The CCIHS established scholarships enabling two Cameroonian students to attend medical school in Europe. The CCIHS also helped recruit medical volunteers to serve in Cameroon.

The U.S. Franciscans
Through the Common Venture, the three U.S. Franciscan communities have set in motion a minor revolution in the annals of international development in concert with religious communities in Africa.

Under the auspices of Franciscan-sponsored Viterbo University, LaCrosse, WI; and Cardinal Stritch University, Milwaukee, and their affiliated educational institutions, Cameroonian women have been granted degrees as nurses, dental assistants, anesthetists, and office managers. The U.S. Franciscans have also sponsored course work in Cameroon for people seeking to be nurses and teachers. They have, in addition, conducted seminars and consultations in theology, organizational development, general business, and physical therapy training.

Outcomes
As a result of the Common Venture, Cameroon's Northwest Province has seen improved health care access, increased effectiveness in the acquisition and/or local production of basic and essential medicines, the development of training programs for the indigenous medical staff, and an improved capacity to prevent HIV/AIDS and treat the pandemic's ravages.

The Tertiary Franciscans place a special emphasis on improving maternal and infant care. Their goal is to reduce infant and maternal death rates, provide prenatal and postnatal care, and treat many of the infectious diseases endemic to tropical Africa.

Despite having limited resources and staffs, the congregation's two hospitals provide necessary surgical interventions. They have developed new programs in cardiology and medical technology, at the same time striving to improve all aspects of health care education, especially nurse training. Many of these new programs are outgrowths of the Common Venture.

The Tertiary Franciscans have worked to integrate Western and African medicine, wherever possible continuing to support the use of natural medicines, the traditional birth attendant, and local medicine men.

An International Partnership
For the U.S. Franciscans, the overall goal of the Common Venture was to provide CCIHS members with meaningful and sustainable ways to collaborate with their counterparts in Africa. Among other things, the project has given CCIHS members an understanding of and respect for the operation of an African health care system. As a result of the Common Venture:

• There has been significant improvement in the training of Cameroonian medical personnel working in village-based health centers and bush-country outpost clinics.
• The Tertiary Franciscans have established a facility for producing pharmaceuticals and IV fluids.
• U.S. Catholic organizations have, through the CCIHS, shipped to Cameroon essential medicines and medical equipment and supplies.
• Medical volunteers have been recruited to provide Cameroonians with both essential medical care and education in general medicine, pharmacy, nursing, surgery, and the management of tropical diseases.

At present, three CCIHS members are working to help ensure long-term sustainability for the Tertiary Franciscans health care ministry. The Seton Institute recently sent the Tertiary Franciscans a shipment of needed pharmaceuticals. The Sisters of Providence have sponsored the acquisition and installation of communications equipment and set up an "Internet café." Medicines for Humanity, a Boston-based international health care organization, has begun what it calls "Project Lifeline," a five-year program designed to reduce Cameroon's high child mortality rate, with an emphasis on the prevention and treatment of HIV/AIDS, malaria, tuberculosis, and common childhood diseases.

A Spirit of Mutuality
The Common Venture offers U.S. Catholic organizations both an example and a unique opportunity to build on the work begun by Tertiary Franciscans with the aid of the CCIHS. Participants have gained great satisfaction from the human and material resources they have been able to provide to the Tertiary Franciscans's growing health care ministry in Cameroon.

Perhaps even more important, however, is the spirit of mutuality and cross-cultural understanding engendered by the project. The Common Venture is a pioneering example of what it means to be women religious in the 21st century. It deserves to be emulated.

For more information on the Common Venture, see www.commonventure.org. For more information about the Tertiary Sisters of St. Francis, Shisong, Cameroon, see www.tssfcameroon.org. David Sauer can be contacted at (262) 790-5228 or [email protected].

Help for the Tertiary Franciscans of Cameroon

There are a number of ways U.S. health care organizations can aid the health ministry of the Tertiary Sisters of St. Francis of Cameroon. One way involves establishing a "twinning" relationship with one of the congregation's hospitals, its school of nursing, or its school of laboratory technology. Another way is "adopting" one of the Tertiary Franciscans' orphanages.

Opportunities also exist for long-term (three months or longer) service with the Tertiary Franciscans's ministry. Visits can be arranged for groups to see at first hand the care delivered by the sisters — and to experience the beautiful Cameroonian countryside.

For more information, contact David Sauer, Medicines for Humanity, at ( 262) 790-5228 or [email protected].