The focus here is on the Director Degsnate's desire to reformulate his organizations strategy following the financial stringency being experienced by the institution. A historical perspective of this missionary hospital has been provided, together with organizational, financial, cost, technological and activity data. The issues which arise are: 1) Has there been a change in CMC&Hs "mission" over the years? 2) How has this change been brought about? 4) What should be the strategy for implementing this mission?