You Gain Your Life When You Give it Away


Today’s guest blog is by Amanda O’Neal, who spent over two and a half years in Masindi, Uganda with her husband, Michael O’Neal. Amanda’s gracious heart and love for others is evident in her reflections on their time in Masindi.

By, Amanda O’Neal

Masindi, Uganda holds a very dear and precious place in my heart. I had the great honor of living there for two and a half years and I have been forever changed. In January of 2009, Michael and I packed up our lives, said goodbye to friends and family, got on a plane, and entered into a sacred wilderness.

When Matt Alexander and Dr. Ed O’Bryan created the brilliant idea of Palmetto Medical Initiative, they approached Michael to see if he would go to build the first medical center in Uganda. One interesting thing is that we were both Spanish majors with a heart for missions so naturally, we ended up in Africa. Doesn’t God have a funny sense of humor? So after careful consideration, prayer and counsel, we knew that it was something we were created to go and do.

Launching out into the unknown, we had no idea how this project would turn out. All we knew to be true was that this vision was innovative and was something worth taking a risk for. We stepped out in faith and found ourselves embraced by God’s provision. Stripped of friends, family and first world conveniences, I began to feel my outward identity of independence, efficiency and productivity fall away. I began to discover that living in deep connection to God and interdependence with the people around me was the more life-giving way. Masindi became a new home for us and the people became our new family. I learned how to hold space for the feeling of so much despair and yet so much hope. The transforming, redemptive work of God was at hand. Ashes became beauty. What started out as a field of sweet potatoes was transformed into a beautiful, life-giving medical center.

Palmetto Medical is a unique and beautiful model. What I love most about PMI is that the short-term medical mission teams serve as the building blocks for the greater goal of creating a self-sustaining medical facility. This is happening in Uganda and Nicaragua with great success. MKMC is self-sustaining. The vision is all about creating ownership and empowerment and that is something I will always stand for. I am so grateful that we got to be a part of building that vision into a reality. We poured our energy and our hearts into that vision. Some days that energy looked like sweat and tears and then other days it was laughter and love.

Despite many challenges and hardships, it was the most life-enriching journey for Michael and me. We went with the intention of helping the people of Masindi and yet they helped us so much. They taught us a new way of looking at life. They taught us that true joy can blossom in the soil of suffering. They taught us that we are brother and sisters, not “us” versus “others.” We learned in the most practical way that you gain your life when you give it away.

Thank you for taking the risk to move away from your friends and family, Amanda! Your spirit towards life and can-do attitude is inspiring and helped to shape PMI into what it is today.

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Building a Solid Foundation


We have had an exciting week at PMI with the opening of our third clinic site in Sebaco, Nicaragua. PMI’s Michael O’Neal takes a look back at the start of our very first clinic in Masindi and reflects on God’s provision and guidance to have it all come together.

By, Michael O’Neal, PMI’s Director of International Projects

As I reflect back on our first few months in Masindi, I can’t even begin to tell the story without first acknowledging a few people that Amanda and I started our journey with. We were warmly welcomed, by the only people we knew in Masindi at that time, Bishop Stanley, Janine LaGrand, and the church family of the Masindi Kitara Diocese. From the beginning of our partnership with the diocese of Masindi, Bishop Stanley had a vision of working together to provide healthcare to the people of the region. Over the course of our time in Uganda, we developed a great relationship with Bishop Stanley, Janine, and the members of the diocese. Bishop Stanley was instrumental in opening the doors to meet other partners and key leaders throughout the region.

I want to highlight and honor some of the other very important people that were instrumental in this project. One person whom I spent a lot of my time early on with was our contractor, Simon Mukati. Simon and I spent many days developing plans, budgets, and timelines around the development of PMI’s first facility. Simon’s willingness to work with me and to teach me the best building practices in the region was one of the richest blessings. Ultimately, we were able to literally lay a solid foundation for the clinic and we were able to do so through sourcing all of the materials and labor locally. I am grateful for his friendship and technical capacity as an engineer.

Joseph Aliguma was our first full time hire. Joseph had previous experience managing a healthcare center in Hoima, Uganda. Joseph and I spent countless hours working to develop, refine, and ultimately implement a business model that would allow MKMC to cover our operating costs, while remaining affordable to the least advantaged population of the region. Joseph helped shaped my understanding of the Ugandan culture and set a standard for leadership that was top notch.

When Amanda and I moved to Masindi in February 2010, we knew little other than we had been called to this place, at this time, for this reason. PMI had sent a few short-term teams to Uganda and now it was time to start building the permanent piece of the model. We had visited Masindi a few months before and knew only 2 or 3 people in the area. However, in terms of organizational infrastructure and professional networks, we were starting from ground zero. Over the first few months we worked tirelessly to connect with the right people, government institutions, and other non-profits to make the vision of sustainable, quality healthcare in Masindi a reality. What we found was that the people of Uganda are incredible! Over the first few months on the ground we developed deep relationships with passionate, faithful, brilliant people. Not only would these people shape the future success of MKMC and PMI, but also they would have a profound impact on our personal lives and how we view the world.

As we took on the task of developing organizational infrastructure in the country, we began to realize that the bureaucratic process was far from efficient. However, through diligent work and God’s provision, we were able to establish PMI as an official NGO (non profit) in Uganda within three months. This allowed us to finalize the land acquisition, partnerships, and to start doing business in the country officially.

Through our partnership with Mukati Construction Ltd. we walked through many grueling hot days in the Ugandan sun and the outpatient facility was completed and ready to open to the public within six months of starting construction.

The development of a business model that focused on sustainable, affordable healthcare was new to Uganda. As Marianne Carpenter continued to bring short-term teams to the region, Matt Alexander and I worked with Joseph Aliguma to refine our model and ensure that it was culturally relevant. As Joseph and I met with a variety of stakeholders’ day in and day out, one thing was clear, the people of Uganda placed high value on their health and the health of their families. The possibility of having access to quality and affordable healthcare was more than exciting to them!

In December 2010 we had a NGO license, a facility, a great staff, and a plan. Although we had made great strides over the past few months, this was still a scary time for us. We knew without a doubt that the Lord had a plan for this community and we were convinced that MKMC was a part of that plan. However, the moment that you put the plan on display and test the model is frightening. I remember thinking, will this really work? Will people really trust our staff to provide healthcare? Will they truly be willing to share in the costs of their care? As the US Ambassador to Uganda, Jerry Lanier, opened the clinic in December 2011, I was filled with pride in our staff, the community of Masindi, and the PMI family. The fear of our model not being successful still lingered in the back of my mind. However, that fear subsided when I witnessed the care of one of the first patients to use our facility, little Eddie. Many of you have heard his story. This little boy became the face of our vision. His story became the story of success and I knew the Lord was going to allow us to continue in His plan to serve the people of Uganda!

Thank you Michael for your servant’s heart and for you and Amanda taking the risk to move to Masindi and help build MKMC from the ground up. PMI would not be the same without you and your leadership.

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Our Third Clinic is Now Open in Sébaco, Nicaragua!


Today, PMI along with our partner Seacoast Church, officially opened our newest clinic site in Sébaco, Nicaragua. We are so blessed by the people who continue to give and give and make sustainable health care a reality throughout East Africa and Central America. We will share more updates with you on this important project later this week, but in the meantime we wanted to invite to you get to know a little more about Sébaco.

Did you know:

  • Agriculture is huge in the Sébaco region, with Sébaco Valley being one of the most fertile regions in all of Nicaragua.
  • Sébaco is strategically located on the Pan-American Highway and is a local transportation hub.
  • Sébaco is just over 100 kilometers from the capital city of Managua.
  • Sébaco is situated at a higher elevation and the temperatures are cooler when compared to our clinic located in El Viejo.
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The Roots of PMI – December 2008 – By Marianne Carpenter


Marianne, with her husband Cody, on a trip to Masindi in August 2011.

By, Marianne Carpenter, PMI’s first hire

December 2008 – I had just resigned from my job in Washington, DC in political fundraising, returned from a week long mission trip to Zambia and moved back in to my parents house in Cincinnati, OH, and had NO idea what I was going to do next. But I was praying to somehow continue to be able to serve the people of Africa and I was stepping out in faith and trusting the Lord to provide yet again.

A few weeks later I was in the car and received a call from my college friend, Claire, who told me that she had thought of me for a position for a nonprofit just getting started in Charleston founded by two young men. (I believe her exact message was: “Mar, I found your DREAM JOB! Call me!”) Their plan was to do medical mission work in developing countries – with the focus being on creating a sustainable model that would empower and improve healthcare in local communities for the long run. I couldn’t wait to learn more and see if I might be able to help in some small way.

Shortly thereafter, I was on a flight to Charleston to meet with the men behind the vision – Matt Alexander and Dr. Ed O’Bryan. Over breakfast at the Marina Variety Store on East Bay, I listened amazed as they explained more about their innovative vision and the steps that had already come together to start moving this idea into a reality. It was clear from the VERY beginning that God was already providentially providing relationships and opening doors to bring this dream into a reality in big ways. Thankfully Matt and Ed thought my combined skill set of fundraising, administration and international missions would be helpful as they continued to work to build the organization so they offered me a job, with a little risk involved, as at that time the organization was poised to either sink or soar.

Thankfully the Lord allowed the organization to soar. I moved to Charleston on Valentine’s Day in 2009 (and happened to meet my future husband that night, why thank you Lord!) It was one of the most amazing experiences of my life to be able to watch the pieces come together …sometimes in exciting, miraculous ways…sometimes in slow, trial and error seasons of perseverance. But overtime the organization continued to grow and grow. Matt and I were both working from our respective homes at the time to save overhead cost – so we both checked in regularly with one another and continued taking the necessary steps to get us to the next level. A brave first medical team of about 20 people set off for the first medical mission trip to Masindi in March of 2009…and from that point forward, volunteers continued to donate their time and talents to help make PMI’s vision a reality and serve the people of Uganda four times a year.

The first time I physically traveled to Masindi with a team, I was overwhelmed by both the poverty of the region and also the abundant joy of the people, despite their hard circumstances. One cannot possibly witness the incredible amount of suffering and pain people endure, and not be deeply impacted. Over the next few years, I would travel to Masindi over a dozen times with different, incredible teams – and God never ceased to amaze me by both the way he would work in the patients lives and the volunteers lives. It was beautiful to be in such a raw environment away from our phones, emails and daily comforts…and to really be forced to rely on the Lord’s strength to get us through the each day at the temporary clinic sites. Meanwhile, the sustainable medical center in Masindi began to take shape, and the organization continued to flourish in the US as more and more people became aware of the project and development opportunities continued to present themselves.

Now, over 6 years later, it’s wonderful to continue to watch PMI grow and thrive and continue to change lives all over the globe. I am reminded of the Malachi 3:10 verse, which reads:

“Bring the whole tithe into the storehouse, that there may be food in my house. Test me in this,” says the Lord Almighty, “and see if I will not throw open the floodgates of heaven and pour out so much blessing that there will not be room enough to store it.”

Surely the Lord has poured out his blessing upon PMI abundantly and all who continue to work and serve for His glory. Praise the Lord!

Thank you, Marianne for all that you have done to make the vision of PMI a reality. Your can-do attitude, love for others and leadership skills have made a tremendous impact on PMI. We are so grateful for your continued support and kind heart.

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The Roots of PMI: Passionate, Merciful, Inspired – Interview with Lauren Lyons


Lauren Lyons is a Pharmacist with Greenville Health Systems and is the Global Pharmacy Director at PMI. She originally hails from Columbia, South Carolina and has been a longtime volunteer on PMI trips.

How did you first hear about PMI?  I was a pharmacy student at MUSC. Marianne Carpenter had sent an email out through the MUSC student listserv introducing PMI and asking for volunteers for its first trip to Uganda the following March. I went to an informational meeting an heard Dr. Ed O’Bryan, Matt Alexander, and Dr. Cody Carpenter speak about their prior experiences with medical mission work and the vision of PMI. I was sold. I remember calling my mom as soon as I got in the car to tell her I was going to Africa in three months. I’m sure she probably freaked out, but I was so excited! All I could think was…I’m going to Africa! I never in a million years thought I would find myself in Africa….I was going to the land of The Lion King!

Approximately how long ago was that?  That was in November of 2008. I went on the very first trip in March of 2009. I then went to Nicaragua with PMI in December 2012, Burundi March 2014, Burundi August 2014, and Nicaragua in May 2015.

What makes PMI unique?  The planning and the thought that goes into the execution of mission trips is like no other. I have been on construction mission trips with a church and a medical mission trip with a church to Honduras after my trip to Uganda. PMI has a huge vision and desire to change the lives of the people we serve in the developing world, but PMI also provides a life-changing experience for its volunteers. The sustainability piece of PMI’s vision is also very unique. Other groups that I have worked with do not provide that aspect of providing long-term care. I definitely feel like I’m a part of something larger than myself and larger than the group of volunteers I’m working with for a week. I always hate to have to end a trip, but I feel better knowing that there is access to care after we leave and that another group will be back in three months.

You’ve been a supporter for a long time, can you articulate what it is that brings you back time and time again?  The people. I can honestly say that the most incredible people I know I’ve met through PMI…fellow volunteers, translators, and patients alike. I am reminded with each group that comes together that it’s a special group of people. How many people would take time off of work and pay a couple thousand dollars to travel across the world and provide medical care to people that likely don’t speak a language you can understand and may very well be terrified of you?? A special person with a huge heart. They may not even realize it until after the plane has landed and they’re in the middle of clinic day one.

You went on PMI’s first medical mission trip to Masindi, what is your greatest memory from that experience?  The line of patients waiting for us on Clinic Day One. I think the entire team was flabbergasted. I think we stood there and took pictures of the line for a good ten minutes before we could begin our work. We all knew there was a need because Ed and Matt had talked about it at all of our team meetings. We knew that healthcare was hard to find, let alone quality healthcare. I don’t think we realized until that moment how dire that need was and how great of an impact PMI would have in Masindi and beyond.

Did I miss anything?  Gosh I could go on and on about PMI and my experiences with PMI! I can’t say enough about all the great people employed by PMI.

This is an excerpt from a fundraising email I sent to co-workers recently…
Medical mission work has become my passion in life since taking my first trip with Palmetto Medical Initiative during my second year of pharmacy school. The true joy I feel as a pharmacist is handing a patient life-saving medication that they have never had access to and the gratefulness you can see in their eyes. I may not be able to understand the language they are using to thank me, but their smiles say it all. The reason I work with PMI is because I know another awesome team will be coming to this exact location in about 90 days for these patients to get refills to sustain treatment.

Lauren, thank you for your ongoing commitment and sacrifices to be a constant presence on PMI trips. Your enthusiasm and love for others shines through in all that you do!

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Combating Malaria with a Basic Intervention


By, Aaron Stroud-Romero, PMI’s Regional Director East Africa

Malaria is one of the deadliest diseases in the world. The WHO estimates that it is responsible for nearly 600,000 deaths annually. 1 With more than 14 million annual cases in Uganda there is significant disruption in work and school, while thousands, including many children, die of the disease. 2 A study just released by the American Journal of Tropical Medicine and Hygiene, suggests that interventions are not working. One of the best ways to prevent malaria is sleeping under insecticide treated nets, but for a variety of reasons, including the perceived benefit versus the cost; many people do not use them. In partnership with USAID and DIFD (the UK’s development program) the Uganda Ministry of Health managed to complete a universal net distribution program last year. But before any reports on the effectiveness of the program could be released, the New York Times posted an article demonstrating the negative repercussions to universal net distribution. While it is undoubtedly true that some (perhaps even many) nets are repurposed for livestock keeping and fishing (leading to the issues of over-fishing cited by the New York Times) many people must be using them for their intended purpose – keeping them and their family members safe from malaria.

I say this because of the massive decrease MKMC has seen in malaria cases starting immediately after nets were distributed in our region. There is clearly more evidence that needs to be gathered (the AJTMH study cited above was completed before the net distribution, but hopefully follow up studies will demonstrate the impact), and it remains to be seen how long the impact will last (the insecticide wears out and nets inevitably get holes), but evidence from MKMC suggest there has been a major decrease in the disease burden. In 2014 we saw a 33% reduction in the number of outpatient cases and a 25% decrease in inpatient cases -and the nets were not distributed until July!

MKMC Malaria Chart

Malaria is a seasonal disease, which sees major spikes during the rainy season, but even the rains have not brought the huge numbers of cases, which we had seen last year at this time. Since nets were distributed last summer, MKMC has averaged less than 100 outpatient cases per month (August 2013-May 2014 averaged 235 cases per month). Last month we saw a significant increase in the number of cases as the rains brought with them a surge in mosquitos.

Since opening, malaria had been by far the most common disease seen at MKMC, making up an incredible 45% of all outpatient cases in 2013. Last year that fell to 35% and in the first five months of this year malaria only accounts for 12% of cases. While it may be bad for business, we are celebrating the lack of malaria patients we are seeing.


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The Roots of PMI: Sustainable, Love, Responsible – Interview with Heather Johnston


Heather Johnston is a long-time PMI volunteer who lives in Charleston, South Carolina with her husband and two beautiful little girls.

How did you first hear about PMI? I was at the VA (my grandfather was having knee replacement surgery) and I saw Dr. Ed O’Bryan.  He told me that he and Matt were starting PMI, though I don’t believe they had named it yet.  It was just before they went on the initial scout trip with Matt, Ed and Josh to ensure that it was the right location to begin their work. He asked me to consider going on the first group trip.

Approximately how long ago was that? Sometime in 2008.

What makes PMI unique? It’s sustainable model that is truly impacting the lives of people who desperately need health care and would have no options for care if it wasn’t for the services the local staff are able to provide through PMI. Volunteers are able to aid the locals in fulfilling the big picture of care.

You’ve been a supporter for a long time, can you articulate what it is that brings you back time and time again? The very things that make PMI unique… and personally I love that it’s a tangible/hands-on way of fulfilling what Jesus says we should do. It seems like a tangible expression of a spiritual outpouring into others.

You went on PMI’s first medical mission trip to Masindi, what is your greatest memory from that experience? Fear and hope. I cannot begin to explain the the hope, then fear, then panic/anger, then hope that were on the faces of so many people!! I never took pictures because photographer Josh Drake was typically always there in those early days documenting the trips.  I know he has pictures of the mobs of people we saw, hundreds and hundreds that showed up our very first day.

Long story short, the locals tried to come up with methods to organize people, but their organization was different than our expectations of how things should be organized. It didn’t take long and the people realized there was no way everyone there would receive treatment. Panic seemed to set in, people spent a ton of money on transportation, took time off work, etc. and they were fearing it was all for nothing. (Not to mention their concerns of never having an opportunity to receive quality healthcare again.)

I was able to push into the middle of these mobs and with as simple language I could think of I acknowledged all they had given and sacrificed, expressed our gratitude for doing so, acknowledged their suffering, expressed our sorrow for not seeing everyone there, said we would work very hard all day, and then told them we would return. Somehow God let the people see and know the sincerity of my words, coupled with the reports of those who had received quality and even compassionate/loving treatment spread like wildfire among the people which allowed for calm and even hope to settle over everyone. I had people in these mobs who had angry, panicked tears in their eyes, then after hearing what I had to say they pulled me aside to thank me even though they knew they would not be receiving care that day.

Thank you Heather for ongoing commitment to PMI and for always showing love and hope in the face of adversity. Your presence on PMI trips is truly a blessing and we are so grateful for all the time you have given to us.

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The Roots of PMI: Progressive, Loving, Steadfast – Interview with Joshua Drake


Joshua Drake is a photographer based in Charleston, South Carolina who often volunteers his time to document PMI trips and shows the hope behind PMI’s long-term mission.

How did you first hear about PMI?  I heard about it from my brother, Luke Drake, who did his medical residency at MUSC with PMI Co-Founder, Ed O’Bryan.

Approximately how long ago was that?  About 7 years ago in 2008.

What makes PMI unique?  It’s unique, sustainable model in each of the countries they operate in.

You’ve been a supporter for a long time, can you articulate what it is that brings you back time and time again?  The opportunity to serve God and others.

You went on the first scout trip with PMI, what is your greatest memory from that experience?  Meeting up with Matt Alexander and Ed O’Bryan in Heathrow, (I flew from Houston where I was living at the time) and thinking this is real, we’re really doing this. It hit home, it went from a conversation to a reality I think for me at that time. We were not yet there, but the ship had sailed and there was no turning back.

From there, we traveled around Uganda for a week, seeing what would eventually become the long-term clinic, MKMC, and then visiting rural clinic sites for the first medical team’s visit. Also, the dinner conversations we’d have over there, processing the days and thinking about the future of what is now a very successful organization. It’s amazing to think back now and to see how it has all developed and grown from that first scout trip.

Thank you Josh for dedicating so much of your time and talent to PMI. Your images have brought our story to life and we are grateful for all that you do.

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PMI Staff Spotlight: Dr. Godson, Lead Physician at MKMC


Dr. Godson is one of PMI’s greatest assets. He is not only an amazing physician, but a kind and generous soul who blesses each of the patients and staff members he interacts with. He is also an incredible teacher as the numerous pharmacy and 4th year medical students who have completed a rotation with PMI Uganda can attest. We have been excited to support him in pursuing further education through his USMLE. He has completed his first two tests and heads to the Atlanta this coming week to take his third and final one.

Dr. Godson is excited for this opportunity and said, “I thank you and the whole of PMI for the efforts and support given to me to ensure that I travel to have my exams done. I have no other words to express my joy. And all I can say is thanks so much.”

Please pray for him this coming week, both for his test and his first experience in America!


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The Roots of PMI – Compassionate, Innovative, Fruitful – Bishop Steve Wood



Today, we are hearing from Bishop Steve Wood of St. Andrews Church in Mt. Pleasant, South Carolina, who led the development of PMI from concept to reality through prayer and discernment.

How did you first hear about PMI?  From Matt Alexander and Ed O’Bryan as they were thinking and praying about launching PMI.

Approximately how long ago was that?  Around 2008.

What makes PMI unique?  No one else is doing this – as far as I know.

You’ve been a supporter for a long time, can you articulate what it is that brings you back time and time again?  I believe in the mission.  I’ve seen the fruit.  And, I trust the leadership.

You connected PMI with the Diocese in Masindi, what is your greatest memory from that experience?  The most meaningful aspect of the work in Masindi was to hear from the Bishop and people of the Diocese of Masindi-Kitara about how overwhelmed the community was that PMI was building something permanent and ongoing in Masindi.  They had seen quite of bit of western aid over the years which was little more than a check and a handshake.  PMI’s clinic has given hope – in the form of medical care and jobs to the people.  The ongoing benefit is quite a legacy.

Thank you Bishop Wood for your ongoing spiritual leadership, support, advice and encouragement. You have been a blessing since day 1 and no doubt, by putting God first, PMI has been able to multiple and make more of an impact than we could have dreamed up over 7 years ago.

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