This case is useful for introducing the dynamics of not-for-profit marketing and organizational structuring. It reinforces the view of marketing as the range of activities involved in continuing to meet customer needs while generating value in return irrespective of the context?consumer, business-to-business, or nonprofit. It also demonstrates how charitable organizations could be funded as nonprofits but grow into revenue-generating organizations. St. Kizito Clinic in Nigeria had grown in the number of patient visits, number of services provided, and number of staff members since its inception 15 years earlier. The scope and quality of services were comparable to those provided by a number of competing secondary institutions. The clinic's location had evolved from a slum in a rural area to a slum in an urban area, leading to an increasing number of visits from the more affluent members of the surrounding communities. Medical Director Chiara Mezzalira, MD, faced the challenge of balancing the clinic's mission, which had as its primary audience the poor, the needy, and the underprivileged members of the society with environmental pressures wealthier clients presented. She was also mindful of the pressures from the clinic's Italian founder, the Association of Volunteers in International Services, to institutionalize proper management and accounting systems and reduce its financial dependence on the organization.