What God Has Arranged
Ten years ago, Earth Mission took ten Karen students and a fragile dream into the jungle of eastern Myanmar. This is what has been built since: by Karen hands, through a war, for their own people.
Ten Years of Earth Mission
Ten years ago, Dr. Mitch had a big dream: a solution to the lack of quality healthcare in eastern Myanmar. The solution was to train local young people to become primary care health providers in their own communities. Things started falling into place, and the first class began in January 2016. God brought great teachers. Our registration was approved. Karen leadership entrusted us with 10 students. The fragile dream was actually becoming something.
Thankfully, we could not foresee the difficult road ahead. The number of things that could, or perhaps should, have caused this mission to fail early on was not small. Looking back, we can see God arranging things, sometimes for the survival of the mission and sometimes to show us a better way forward.
"But when I look back over these ten years, one thing is clear: God has been faithful."
Dan Ryan, Executive Director
A decade in the jungle, forty years in the making
Founded in 1983 by LD and Sue Ryan, Earth Mission helped Christians use their technical skills to support missionaries in the field. In 1993, their son Dr. Mitch Ryan and his family began Earth Mission's medical missions to marginalized communities. After arriving in the jungles of Karen State, Myanmar in 2005, Earth Mission planted its roots for the long haul to help the Karen people achieve their vision for a high-quality healthcare system.
Earth Mission Asia Foundation
Registered as a nonprofit foundation in Chiang Mai, Thailand: the legal home that made it possible to bring students across the border.
First students & T-RAD Clinic
The first Physician Associate and Engineering Technology students arrived in Chiang Mai, and T-RAD Clinic opened in Kyaukkyi, Myanmar.
Rain Tree Clinic
Opened in the jungle of Karen State so students could train in the same remote setting they would one day serve.
First PA graduates
After five years of classroom and clinical training, the first Physician Associates stepped into service.
Military coup
A coup overthrew Myanmar's elected government. All programs were evacuated to Rain Tree Clinic before conflict reached T-RAD.
Accredited B.S. degrees
The first graduating classes received locally accredited Bachelor of Science degrees from Karen education authorities.
Surgical training & mobile surgical clinic
A postgraduate surgical program and the Mobile Karen Surgical Hospital launched to take essential operations closer to the front lines.
Natural Farming School
Began on campus to strengthen food supply, nutritional health, and long-term self-sufficiency.
What 10 Years Made Possible
In 2016, a year after the PA program began, T-RAD Clinic opened near one of the larger towns bordering Karen State. Within three years, patient visits grew from about 2,000 a year to more than 11,000. Then came the February 2021 coup. To keep staff and students safe, T-RAD closed and everyone moved to Rain Tree Clinic in the jungle. In some ways, that is where the training belonged all along: students now learn in the place they will serve, with the same diseases, terrain, and limits.
children die before age 5 (142 per 1,000), 24× more deaths than the U.S. More than 40% of those deaths are from pneumonia, malaria, and diarrhea, all treatable.
survival rate of children we treated for malaria, diarrhea, or pneumonia. If a child with these diseases can make it to RTC, their chances of surviving approach those in U.S. hospitals.
Each graduate commits to at least five years in a remote clinic and on average sees about 3,500 patients a year. Over ten years, 68,091 diagnoses have been recorded across all ICD-10 chapters, first by pen and paper and now moving to an electronic medical records system. The full data appears in the PDF report.
Trained where they will serve
A PA student can learn about malaria in the morning and treat a sick child that afternoon. An engineering student learns about power systems and then keeps the clinic running through a monsoon blackout.
Physician Associate Program
Five years, international standards, a Bachelor of Science degree, and a lifetime of service in remote Karen communities.
Advanced PA Fellowship
A two-year postgraduate fellowship in surgery, anesthesia, internal medicine, pediatrics, and obstetrics for PA graduates who have no one to refer to.
Engineering Technology
Four years of electricity, construction, equipment and vehicle repair, and project leadership to build and sustain healthcare in resource-limited jungles.
Faith in the Jungle
Rain Tree Clinic has grown into a local church. Staff and students pray together daily, serve patients of every background, and are learning to make disciples who make disciples.
Note on program data: figures for this report cover an 18-month period, January 1, 2025 through June 30, 2026, because Earth Mission changed its fiscal year-end. Next year's report returns to a 12-month period beginning July 1, 2026.
In their own words
Ten Years of Earth Mission
Dan Ryan on a fragile dream, a war, and ten years of watching God arrange things.
One of the hardest journeys I have ever walked
Saw Ray Kaw carried sand from the river to build Rain Tree Clinic. Now he runs it.
They watched how I cared for people
At 18 she knew nothing about medicine. At 27, Naw Zuzaenar Blu runs a clinic in southeastern Karen State.
No surgery is less important because it is small
Saw Sai Sai Poe went from a refugee camp to the operating table at Rain Tree Clinic.
The most creative people I know
There is no parts store in the jungle. Saw Eh Gay keeps a 65-building hospital campus running anyway.
Watchmen at 5 a.m.
A church grew up around a jungle hospital. Now its people are making disciples who make disciples.
What God Has Arranged
Somebody asked us to write down our theory of change. The phrase makes us a little itchy. Here goes.
What God Has Arranged
"We're not trying to end the war. That's way above our pay grade. What we're working toward is a healthcare system in Karen State that is Karen-run and doesn't need us."
Somebody asked us to write down our theory of change. The phrase makes us a little itchy. But if you're going to give money and prayer to something, you'd like to know what the people on the other end think they're doing, and why.
The Next 10 Years
By WHO standards, one doctor is needed per 1,000 people. Before the coup, Karen State had 0.07. By 2030, Earth Mission will have graduated over 100 PAs, doubling that ratio. The next challenge is to strengthen the systems around the Karen so they can use their skills even more effectively.
Karen Frontline Centers
Earth Mission will help transform key clinics into station hospitals, working alongside district and local leaders who will provide leadership, funding, and other support. Our PAs are highly skilled, but many work in clinics that lack the basics of administration, medical support, finance, and infrastructure. Strengthening these frontline centers is the next step: not simply training good healthcare providers but helping create places where they can provide good healthcare.
Electronic Medical Records
Earth Mission will implement electronic medical records in our hospital and mobile clinics to improve continuity of care, medical documentation, and the information available to healthcare providers. Once proven in our own facilities, the system could be expanded to other clinics and hospitals.
Where the money went
| Statement of Activities | 18 mo. ended Jun 30, 2026 | 12 mo. ended Dec 31, 2024 |
|---|---|---|
| Contributions of financial assets | $3,089,382 | $1,427,838 |
| Contributions of nonfinancial assets | $197,407 | $111,326 |
| Other income | $17,710 | $10,696 |
| Total support & revenue | $3,304,499 | $1,549,860 |
| Program services | $2,667,018 | $1,151,003 |
| General and administrative | $279,358 | $175,193 |
| Fundraising | $301,257 | $162,939 |
| Total expenses | $3,247,633 | $1,489,135 |
| Net assets, end of period | $550,021 | $493,155 |
| Statement of Financial Position | Jun 30, 2026 | Dec 31, 2024 |
|---|---|---|
| Total assets | $579,986 | $525,062 |
| Total liabilities | $29,965 | $31,907 |
| Net assets without donor restrictions | $372,956 | $413,800 |
| Net assets with donor restrictions | $177,065 | $79,355 |
| Total net assets | $550,021 | $493,155 |
Earth Mission, Inc. is a U.S.-registered 501(c)(3). The board meets quarterly, reviews financial statements quarterly, and holds the organization accountable in governance, legal requirements, and finance. Meet our leadership →
Rebuilding southeast Myanmar's healthcare system starts with you
"My aim is to become a good doctor. This is a big dream in my life. I am so happy to join the Earth Mission PA program. I want to improve my medical skills and protect my people."
Naw Victory Moo, PA Class of 2030
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