The Luke Commission 
The information on this page was last updated 2/25/2026. If you see errors or omissions, please email: [email protected]
Summary
The Luke Commission (TLC) serves the most isolated and underserved people of Eswatini with comprehensive, and compassionate healthcare. At The Luke Commission Miracle Campus, TLC provides outpatient, inpatient, emergency, surgical, and specialized care, including eye and orthopedic surgeries, mental health support, disability services, and rehabilitation.
Beyond the campus, TLC deploys mobile health outreaches-bringing doctors, diagnostics, treatment, and life-saving interventions directly to remote communities. Through innovative programs like the nation's leading snakebite treatment program, Africa's largest PSA oxygen plant, and the groundbreaking Luvelo digital ecosystem, TLC is pioneering equitable healthcare solutions and transforming lives across Eswatini.
Contact information
Mailing address:
The Luke Commission
PO Box 1335
Sagle, ID 83860
Website: lukecommission.org
Phone: 866-351-1254
Email: [email protected]
Organization details
EIN: 208635797
CEO/President: Echo VanderWal
Chairman: Frans Johannes Pienaar (Eswatini)/Jim McKee (US)
Board size: 12
Founder: Harry and Echo VanderWal
Ruling year: 2007
Tax deductible: Yes
Fiscal year end: 12/31
Member of ECFA: No
Member of ECFA since:
Purpose
To end the isolation of underserved communities to quality healthcare.
The Luke Commission (TLC) exists to break barriers to healthcare and serve those most often left behind. Many Emaswati face overwhelming obstacles to accessing medical care-distance, cost, lack of transport, stigma, and limited availability of specialized services. TLC overcomes these barriers by combining on-campus care, daily mobile medical outreaches, specialized surgical programs, emergency response, and digital innovation to ensure that every patient receives high-quality, dignified care.
TLC's services include:
-Mobile medical outreaches-bringing doctors, diagnostics, and treatment directly to rural and peri-urban communities.
-Comprehensive hospital care at The Luke Commission Miracle Campus, which provides inpatient care, critical care, general and specialty surgical care, outpatient services, mental health support, disability care, and rehabilitation.
-Emergency and life-saving interventions, including trauma response, oxygen therapy, and Eswatini's leading snakebite treatment program. In 2023, for the first time in the nation's history, no deaths occurred from snakebites due to TLC's rapid response and antivenom availability.
-Oxygen independence-TLC built Africa's largest PSA oxygen plant, ensuring medical-grade oxygen production and nationwide distribution to hospitals and clinics. -Digital transformation through Luvelo, a groundbreaking enterprise solution piloted by TLC to ensure supply chain accountability, data-driven decision-making, and operational efficiency.
Through partnerships with local and international organizations, TLC continues to innovate and expand its services-ensuring that every person, regardless of background or location, has access to compassionate, life-changing healthcare.
Mission statement
To deliver compassionate, comprehensive healthcare to the most isolated and underserved populations of southern Africa in collaboration with local communities, government, corporate, and non-profit partners.
Statement of faith
Articles
Donor confidence score
Show donor confidence score details
To understand our donor confidence score, click here.
Transparency grade
D
To understand our transparency grade, click here.
Financial efficiency ratings
Sector: Foreign Missions
| Category | Rating | Overall rank | Sector rank |
| Overall efficiency rating | | 453 of 1420 | 38 of 126 |
| Fund acquisition rating | | 279 of 1420 | 32 of 126 |
| Resource allocation rating | | 274 of 1420 | 25 of 126 |
| Asset utilization rating | | 1170 of 1421 | 95 of 126 |
According to the organization's Form 990, it received $6,602,844 in government grants in 2024.
To understand our financial efficiency ratings, click here.
Financial ratios
| Funding ratios | Sector median | 2024 | 2023 | 2022 | 2021 | 2020 |
Return on fundraising efforts Return on fundraising efforts = Fundraising expense / Total contributions | 5% | 1% | 1% | 1% | 1% | 2% |
Fundraising cost ratio Fundraising cost ratio = Fundraising expense / Total revenue | 5% | 1% | 1% | 1% | 1% | 2% |
Contributions reliance Contributions reliance = Total contributions / Total revenue | 98% | 88% | 99% | 99% | 100% | 98% |
Fundraising expense ratio Fundraising expense ratio = Fundraising expense / Total expenses | 5% | 1% | 1% | 2% | 2% | 2% |
Other revenue reliance Other revenue reliance = Total other revenue / Total revenue | 2% | 12% | 1% | 1% | 0% | 2% |
| Operating ratios | Sector median | 2024 | 2023 | 2022 | 2021 | 2020 |
Program expense ratio Program expense ratio = Program services / Total expenses | 85% | 92% | 94% | 93% | 94% | 92% |
Spending ratio Spending ratio = Total expenses / Total revenue | 99% | 90% | 101% | 77% | 78% | 93% |
Program output ratio Program output ratio = Program services / Total revenue | 83% | 83% | 95% | 72% | 73% | 85% |
Savings ratio Savings ratio = Surplus (deficit) / Total revenue | 1% | 10% | -1% | 23% | 22% | 7% |
Reserve accumulation rate Reserve accumulation rate = Surplus (deficit) / Net assets | 3% | 12% | -1% | 25% | 36% | 7% |
General and admin ratio General and admin ratio = Management and general expense / Total expenses | 9% | 7% | 4% | 5% | 4% | 6% |
| Investing ratios | Sector median | 2024 | 2023 | 2022 | 2021 | 2020 |
Total asset turnover Total asset turnover = Total expenses / Total assets | 1.52 | 1.07 | 1.04 | 0.73 | 1.01 | 0.73 |
Degree of long-term investment Degree of long-term investment = Total assets / Total current assets | 1.14 | 1.78 | 2.40 | 2.24 | 2.37 | 2.71 |
Current asset turnover Current asset turnover = Total expenses / Total current assets | 2.30 | 1.90 | 2.51 | 1.63 | 2.40 | 1.98 |
| Liquidity ratios | Sector median | 2024 | 2023 | 2022 | 2021 | 2020 |
Current ratio Current ratio = Total current assets / Total current liabilities | 23.45 | 47.59 | 4.65 | 5.30 | 4.16 | 1.61 |
Current liabilities ratio Current liabilities ratio = Total current liabilities / Total current assets | 0.03 | 0.02 | 0.21 | 0.19 | 0.24 | 0.62 |
Liquid reserve level Liquid reserve level = (Total current assets - Total current liabilities) / (Total expenses / 12) | 5.02 | 6.18 | 3.76 | 5.99 | 3.79 | 2.31 |
| Solvency ratios | Sector median | 2024 | 2023 | 2022 | 2021 | 2020 |
Liabilities ratio Liabilities ratio = Total liabilities / Total assets | 4% | 4% | 12% | 13% | 19% | 25% |
Debt ratio Debt ratio = Debt / Total assets | 0% | 3% | 3% | 5% | 9% | 2% |
Reserve coverage ratio Reserve coverage ratio = Net assets / Total expenses | 60% | 90% | 84% | 120% | 80% | 102% |
Financials
| Balance sheet | |||||
| Assets | 2024 | 2023 | 2022 | 2021 | 2020 |
| Cash | $273,640 | $326,995 | $115,689 | $361,636 | $168,836 |
| Receivables, inventories, prepaids | $11,512,554 | $8,077,481 | $9,020,655 | $6,352,713 | $3,847,529 |
| Short-term investments | $0 | $0 | $0 | $0 | $0 |
| Other current assets | $0 | $0 | $0 | $0 | $0 |
| Total current assets | $11,786,194 | $8,404,476 | $9,136,344 | $6,714,349 | $4,016,365 |
| Long-term investments | $0 | $0 | $0 | $0 | $0 |
| Fixed assets | $8,990,782 | $11,683,823 | $11,201,723 | $9,099,798 | $6,820,687 |
| Other long-term assets | $152,684 | $105,398 | $93,538 | $112,424 | $56,139 |
| Total long-term assets | $9,143,466 | $11,789,221 | $11,295,261 | $9,212,222 | $6,876,826 |
| Total assets | $20,929,660 | $20,193,697 | $20,431,605 | $15,926,571 | $10,893,191 |
| Liabilities | 2024 | 2023 | 2022 | 2021 | 2020 |
| Payables and accrued expenses | $247,683 | $1,806,395 | $1,725,240 | $1,604,747 | $2,403,902 |
| Other current liabilities | $0 | $0 | $0 | $10,406 | $83,342 |
| Total current liabilities | $247,683 | $1,806,395 | $1,725,240 | $1,615,153 | $2,487,244 |
| Debt | $527,751 | $689,329 | $959,270 | $1,380,164 | $262,684 |
| Due to (from) affiliates | $0 | $0 | $0 | $0 | $0 |
| Other long-term liabilities | $0 | $0 | $0 | $0 | $0 |
| Total long-term liabilities | $527,751 | $689,329 | $959,270 | $1,380,164 | $262,684 |
| Total liabilities | $775,434 | $2,495,724 | $2,684,510 | $2,995,317 | $2,749,928 |
| Net assets | 2024 | 2023 | 2022 | 2021 | 2020 |
| Without donor restrictions | $20,154,226 | $17,556,386 | $17,357,848 | $12,570,728 | $8,143,263 |
| With donor restrictions | $0 | $141,587 | $389,247 | $360,526 | $0 |
| Net assets | $20,154,226 | $17,697,973 | $17,747,095 | $12,931,254 | $8,143,263 |
| Revenues and expenses | |||||
| Revenue | 2024 | 2023 | 2022 | 2021 | 2020 |
| Total contributions | $21,869,167 | $20,787,127 | $19,203,350 | $20,643,916 | $8,370,068 |
| Program service revenue | $0 | $0 | $0 | $0 | $0 |
| Membership dues | $0 | $0 | $0 | $0 | $0 |
| Investment income | $2,907,736 | $2,122 | $2,113 | ($7,001) | $27,066 |
| Other revenue | $126,057 | $116,720 | $148,755 | $108,451 | $131,228 |
| Total other revenue | $3,033,793 | $118,842 | $150,868 | $101,450 | $158,294 |
| Total revenue | $24,902,960 | $20,905,969 | $19,354,218 | $20,745,366 | $8,528,362 |
| Expenses | 2024 | 2023 | 2022 | 2021 | 2020 |
| Program services | $20,649,585 | $19,845,373 | $13,882,703 | $15,243,486 | $7,286,393 |
| Management and general | $1,480,824 | $900,927 | $701,177 | $661,245 | $503,102 |
| Fundraising | $291,675 | $308,908 | $266,943 | $242,826 | $167,741 |
| Total expenses | $22,422,084 | $21,055,208 | $14,850,823 | $16,147,557 | $7,957,236 |
| Change in net assets | 2024 | 2023 | 2022 | 2021 | 2020 |
| Surplus (deficit) | $2,480,876 | ($149,239) | $4,503,395 | $4,597,809 | $571,126 |
| Other changes in net assets | $0 | $0 | $0 | $0 | $0 |
| Total change in net assets | $2,480,876 | ($149,239) | $4,503,395 | $4,597,809 | $571,126 |
Compensation
| Name | Title | Compensation |
| Echo VanderWal PC | Executive Director | $84,000 |
| Brian Schmelzenbach | Board Member/Dir of Staff Develop. | $48,000 |
| Lawrence DeBoer | Chief Financial Officer | $25,563 |
Compensation data as of: 12/31/2024
Response from ministry
No response has been provided by this ministry.
The information below was provided to MinistryWatch by the ministry itself. It was last updated 2/25/2026. To update the information below, please email: [email protected]
History
TLC was founded in 2005 at the height of the HIV/AIDS pandemic in Eswatini. In 2005, no treatment for HIV/AIDS existed. Harry & Echo VanderWal moved to Eswatini with their three-year-old triplets and one-year-old baby with the goal of providing compassionate, comprehensive healthcare to as many people as possible-especially those suffering complications of HIV/AIDS.
Staff for the first outreaches included Harry, Echo, their children, and a translator. Based in a rented house near Manzini, Eswatini, the TLC staff soon grew to 15. Leaving before dark and arriving home after dark, the staff conducted more and more outreaches every year, reaching increasing numbers of people.
In 2013, TLC acquired the land that is now the Miracle Campus. In the years following, the TLC team constructed over a dozen buildings on campus, turning the Miracle Campus into a self-contained hub for serving the Kingdom of Eswatini.
Today, with over 500 staff, the TLC staff is 98% Emaswati. Between on-campus and outreach efforts, hundreds of patients from across Eswatini are welcomed each day for compassionate, comprehensive care.
Program accomplishments
https://www.lukecommission.org/wp-content/uploads/2022/03/TLC_ImpactReport_2021.pdf