Thank You, Katie!

We have a bittersweet announcement here at PMI- our Director of Volunteers, Katie McKenzie, is moving on to bigger and better opportunities.  Katie has been with PMI for almost three years.  Her passion for serving those in need, engaging with volunteers, and her creative inspiration will be sorely missed.

Katie is a tireless advocate for the voiceless and has spent her life devoted to service and standing up against injustice. Prior to her service at PMI, Katie worked with Invisible Children and brought her knowledge of grassroots engagement to our growing team.  While at PMI, Katie was instrumental in creating a lasting image, recruiting and training the hundreds of volunteers that serve with us each year, and leading our supporters on countless trips to East Africa and Central America.

One of Katie’s many gifts is an eye for design.  And she used that gift to really paint a picture of what we are doing here at PMI. We will miss her smile and enthusiasm for the developing world and we can’t wait to see what the future holds during this transition.

Katie, we love you, we will miss you, and we wish you all the best!

thank you!-2

Photo: Joshua Drake Photography

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PMI Nicaragua :: The New Kids in Town

TJ, Holly, Ian and Isla on the way to church

So, these last few months, I’ve kinda been the new kid in town.

As PMI’s new Regional Director here in Managua, Nicaragua, I arrived in January with my wife, Holly, and our ever-so-cute 3-year old twins in tow. We walked off the plane, holding hands down the escalator and into our exciting new future in Nicaragua. Later that night at our new home, surrounded by twenty or so yet-unpacked duffel bags, and sitting cross-legged on the floor of our living room provisioned with pizza, popsicles and headlamps (the electricity was out for a few hours), Holly and I made a plan on how to settle into our new life.

That week, we started to check off all the things on the “set-up” list. House? Check. Vehicle? Check. Grocery store? Check. Church? Check. Pre-school for the kids? Check. Everything went very smoothly and before we knew it, we had the kids suited up in cute little school uniforms, bouncing off to make some new amiguitos.

But, as many of you know, schools, in general, are germ factories. The first week of classes, no matter where you are located, is a time of meeting new friends (and their germs) and building new knowledge (and immune responses). Our kids were no exception. They woke up a few days later with a fever, and it quickly became apparent that it wasn’t just a 24-hour bug.

Alas, the one thing that we didn’t have checked off our list was a doctor. Irony alert: my job is to set up health clinics in Nicaragua (In my defense, PMI doesn’t yet have any clinics here in Managua, where the central office is located).

After polling some of our new friends from church, we settled on a pediatrician whose office was located at the nicest, well-equipped hospital around. We wiped the kids’ noses, strapped ‘em into car seats and braved Managua’s grueling traffic, arriving on-time for our appointment.

The hospital was NICE. New construction, lots of glass, marble and steel. Our doctor’s offices looked copied and pasted right out of any major US hospital or medical park. Nice waiting room, chairs, magazines, flat-screen TVs on the walls, and completely empty, save for us.

We waited almost an hour past our appointment time in that empty waiting room. When he was ready for us, we entered his office, and he took all the patient intake and vitals himself- no nurses or techs. Our case was pretty open and shut; most anyone could deduce from the various colors oozing from four little nostrils that the kids had ear/sinus infections. Two bottles of  (apparently yucky-tasting) antibiotic suspension and a prescription fever reducer later, we good to go.

All in all, we paid around $100, or $50 per child for the visit, which is at the top end of what you would pay for a pediatric visit here in Managua, and also completely inaccessible to more than 90% of the Nicaraguan public (hence, the empty waiting room).

Driving away, I reflected back on the experience. For the most part, I liked the pediatrician and would take the kids back to him, if needed. I also know that his big, nice hospital we visited has many other excellent doctors and facilities, and it’s absolutely the place I would take my children in an emergency. But, as someone who knows something (yet still learning a lot) about primary care in Central America, the quality of the care and experience still left me feeling like I had mostly just paid for marble and glass.

For primary health care, I realized, (and as a part of the PMI team I was pretty proud to say) I would have much rather taken my kids to a PMI clinic to see one of our doctors, who would have absolutely handled our case as well or better than this more expensive doctor did. The two clinic visits are even comparable; PMI’s clinics aren’t over-the-top fancy, but they are attractive spaces, nicely appointed with clean tile floors, comfy chairs (not to mention a flat screen in the waiting room!). But then again, you’d never get to watch it, because when a patient shows up at one of our clinics, they are immediately attended to by our full staff of nurses, doctors, pharmacists and admins. We’ve got the full suite of laboratory testing and exam technology that most primary/urgent care patients need. And the current cost for a general patient consult at PMI’s Nicaraguan clinics? About $4.00 or less.

Imagine the picture; a rich Gringo electing to take his sick children to the same clinic and doctor that a Nicaraguan mother who makes less than $5 a day can afford to bring her kids to.

Palmetto Medical Initiative exists to make high-quality health care (and specifically, primary care) accessible, affordable, and sustainable for the majority of the people in the world who can’t take their sick kids to a shiny marble and glass hospital on the rich side of town. We do it by finding donors who make initial investments to establish an excellent facility, and then we are as efficient as possible in running those clinics, finding talented, well-qualified medical professionals who are more passionate about public health than their own bottom line.

There will always be expensive, highly trained doctors and private, amazingly equipped hospitals for those who are able to pay top dollar. I am glad for that, and I count myself lucky to be one of the people who could access such a place. But make no mistake; quality CAN be affordable. Palmetto Medical Initiative’s success in treating thousands and thousands of patients in Uganda, Burundi, and Nicaragua over the last five years demonstrates that it is possible to provide high-quality, compassionate, affordable (and yet financially sustainable!) care to people who have very few resources; the very people who never could have accessed quality health care before, and who often need it most.

The best part is that while we’ve got multiple locations where our clinic model is already breaking down barriers to health care access, we’ve got lots more clinics we plan to open in the very near future.

Hi, We’re Palmetto Medical Initiative.

We’re the new kids in town, and we’re just getting started.

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Team Uganda :: Clinic Day Five

Today we took our always adventurous and bumpy van ride back to Garasoya. It was in a beautiful church with carved out brick above the windows and faded turquoise painted walls. We were greeted with over 150 waves and smiling faces and got right to work. Our first patient of the day was a facial burn victim. Five days ago she had a seizure and fell into a fire which left her with burns on her forehead and the right side of her face causing her eyes to swell shut. Even as a pop up clinic in a church we were able to successfully treat her. We cleaned her wounds, ensured her vision was still intact and provided the medications and counseling on how to care for both her burns and her seizures on her own. It’s hard to believe our last day of clinic was today. It seems like we just got here but looking back its truly amazing how many people we were able to help in such a short amount of time. We treated nearly 1,000 patients through great teamwork and a shared love to serve others.

For the last time we unloaded the vans at the hotel and took inventory. Then cleaned up and headed to a feast for our final dinner. People throughout the Masindi community who were a huge part of our success this week joined us for dinner as we celebrated and recognized our hard work and accomplishments. As we thought the night was over, we were surprised by an entertaining performance by a traditional Ugandan dance group. They performed several dances native to the country and by the end we were all wearing hula like tutus dancing in circles doing our best to move as well as they do. I couldn’t have asked for a better way to end our week in Masindi. We have all thoroughly enjoyed our time and will not forget the many faces we have seen throughout all of our clinics. Next up: off to the Paraa Safari Lodge tomorrow morning!


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Team Uganda :: Clinic Day Four

Clinic day four began with another early start, breakfast at 6:15 and roll call at 7…5 days in and we have yet to master it without missing someone but there’s still 2 days left. We then headed for our first of two clinic days to Garasoya. After a 90-minute dirt filled ride filling our nostrils with the sweet smells of the Ugandan countryside we finally made it to our destination. There we found what seemed like our longest line yet of Ugandan’s patiently waiting for treatment.   This clinic day was a little different than the days before as we were unable to set up clinic in a school but utilized a church and a grass hut. Our team is flexible and was up for the challenge and quickly set up shop and began seeing patients.

Throughout the day our triage and provider teams exemplified excellence in evaluating, diagnosing, and treating people with a plethora of medical ailments. We in therapy have seen numerous patients with low back pain and generalized joint pain given the extent of manual labor they perform on a daily basis, including digging, washing, and balancing heavy loads on their heads. We believe they enjoy our stretching routines and ergonomic education… or at least they laugh and smile at us while doing them. We saw one lady today who has had a BKA for over 40 years. She came in wearing no shoes and utilizing a handmade pair of crutches to ambulate. You probably could have seen her smile from America when we fixed her up with a new walker and a new shoe. It’s humbling to see what a difference one can make with a smile and some new sneakers.   Shout out also to the runners, registration team, and pharmacy team continue to amaze us with their efficiency and wonderful attitudes.

We closed up shop at clinic at 6:45 pm…a little later than anticipated but it was well worth it to see those last few patients. We made it home in record timing. No pedestrians, bike riders, chickens, and/or goats were injured in the process. One of the drivers said it was no easy feat! We end the day tired, sleep deprived, spray tanned in red clay, but thankful for this opportunity to serve the Ugandan people and our Lord and eager to finish strong with one more clinic day.

Lots of love from Uganda,

Scott & Jamie

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Team Uganda :: Clinic Day Three

Today we were blessed with 15 more minutes of sleep starting our day with breakfast at 6:15. Around 7 we made the journey back to Kasongoire to serve this community again. Even though were had been at the same site the day before, there was still a huge turnout for the clinic. The great thing about being at the same site two days in a row was that we were able to be extremely efficient since we knew the lay of the land. We were able to set up quickly and start seeing patients shortly after our arrival.

Very early in the day our team was faced with a very difficult patient. An 18-month year old girl presented with a skin infection that caused her skin to erode and invaded her entire chest wall. Her condition was so severe that through the erosion in her skin we were able to see the musculature and bones of her rib cage. This wound was so extensive that with the resources we had we were unable to give her the care she needed. She was told she would have to go the Masindi-Kitara Medical Clinic (MKMC) in order to receive appropriate care. Even though this clinic started by PMI allows many Ugandans to receive care that they otherwise would not be able to receive, the clinic does have a small fee for treatment. Her condition was so extensive that our providers believed she would require IV antibiotics and surgery, which would cost around 40 dollars in US dollars. It was humbling that even though the mom said she would be unable to afford it, she was confident that her extended family would each give what they could in order to get the proper treatment for her daughter to survive. She was taken by our ambulance to MKMC where she received the surgery and is now doing much better. She will need to stay at the clinic for about a month but we are so thankful she was able to get the treatment she deserved. Our team’s efficiency allowed this child’s critical condition to be identified early so that she could be brought to the provider room immediately when we began the day. We feel very lucky that our team works so well together.


Today was extra special because we saw around 275 patients, which is almost 100 more than we saw yesterday in the same amount of time. Although we saw many more patients today, we maintained the same level of care throughout the day. Other groups may have been sad that this adventure is halfway over, but we are excited for what is to come in these last few days in order to make the biggest impact we can and growing closer as team! #glasshalffull

Emily and Lauren

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Team Uganda :: Clinic Day Two



We started day 2 off with an early morning: 6 A.M. breakfast and by 7 A.M. we were loaded up on buses and headed to Kasongoire for the first of two clinics that we will hold at that site this week. The drive took about an hour and was so, so beautiful. We drove along bright red dirt roads over hills and through lush green fields of sugar cane. The dust doesn’t look quite as beautiful when coming out of your nose onto a Kleenex, but the roads were pretty nonetheless.

When we pulled up to the clinic there was already a line 200 people long wrapping around the buildings and nestled under trees. The best part: they clapped when we got off of the buses! Our crew was tired from the day before and the early start, but the warm welcome energized us and got us pumped for clinic. Many of the people were dressed in their “Sunday best,” women in colorful dresses and shawls and many men wore jackets (despite the 95 degree heat). We immediately got to work assessing the site, setting up shop, and registering all of our patients for the day. At 9 AM, we saw our first of 180 patients.

One of the many awesome things today was the number of stellar volunteer interpreters from the community who showed up to help translate and provide a communication channel between doctors and patients. We rely on a corps of volunteers to enable our team to serve patients at the clinic, and the interpreters we worked with today are amazing people. They worked tirelessly to help bring quality health care to their community and their smiles, work ethic, and upbeat personalities motivated us to work hard throughout the day.

Another highlight of the day was seeing the altruistic love of parents who bring their children to be seen by our providers. Many give up their own place in line to ensure that as many children as possible can be seen. Many mothers and grandmothers arrived with several babies in tow and waited in line for hours to be seen. When they finally had the chance to sit down with a health care provider and the provider asked “what can I help you with today,” the parent would immediately respond with what worry they have for their child. They would also list the treatments they had been trying for their children for many months while waiting to see a doctor. It was clear how invested every parent was in their child’s health and how desperately they hoped for a solution to ailments. They knew every spot, bump, and scratch on their child’s body. Though there are many cultural differences between our Ugandan friends and our team, it is so sweet to witness the universality of a parent’s love.

Our team really started to jive today – as we continue to bond as a team, we learn our strengths and weaknesses and work together to provide our patients with the very best care. Today, our efficiency and overall quality as a clinic improved. We left Kasongoire around 6 P.M. feeling exhausted, humbled, and fulfilled. We shared another great meal at Masindi Hotel, gave shout outs (there were lots!) and 5 more members of our team shared their life stories. We’re challenged, we’re happy, we’re feeling so humbled and loved, and we’re having the time of our lives in Uganda. Now we’re off to scrub the rest of the red dirt off of our limbs. See you in 6 days never, America!

Kristen, Susan and Erica

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Team Uganda :: Clinic Day One

We started the day with a team breakfast before heading out to our first day of clinic, which was in Walyoba. We traveled down a dusty road for about 30 minutes before arriving to the clinic site. When we arrived, we were greeted by a long line of Ugandans seeking medical attention. Some of the locals even stayed overnight to be seen. With some quick organization by the team, we were able to set up multiple stations in various rooms within the elementary school. There was a triage station, a provider station, a PT/optometry station, and a pharmacy.

Soon after this, the patients started rolling in. We saw patients with a variety of complaints, ranging from lower back pain, to difficulty swallowing, to impacted earwax. The first patient that we saw was not able to walk—someone had carried him all the way to the clinic to get care. Luckily, we were able to get him a ride back home in the ambulance! Another patient was having a hard time hearing and we soon found out that there was a beetle in her ear. One of the Ugandans that waited overnight to be seen was found to have an elevated blood sugar, even after going 18 hours without eating. She was then referred to the local clinic for management of new diagnosis of diabetes. An interesting home remedy that a patient had was eating dirt from the anthills on the side of the road to cure her nausea. Everyone was so grateful that we were there and one lady even said that she was going to bake something and send it to us. After seeing about 200 patients, our first day at the clinic came to an end.

Many of the children were playing outside of the school after we finished caring for the patients and they laughed hysterically when we tried to say hello in their local language. We said “Orairota” which was clearly incorrect because they all laughed and one girl politely reminded us that you “only say Orairota in the morning.” They loved singing and taking selfies with us and we even danced to a little Taylor Swift for them.

After a long but fulfilling day, we got to the hotel and wiped pounds of dust off of our face and hands before dinner. We were all very pleased with the beef tips, rice, potatoes, corn soup, veggies, pineapple, and thankfully, dessert. We got to know a little bit more about our group with some after dinner bonding activities. First we did “shout outs”, where we can call out team members for great thing they had done throughout the day (one included excitement about large amounts of beef jerky snacks in the pharmacy) Then, we heard some life stories from different members of our group which were very moving. We are planning to hear a story from everyone on our team throughout the week. We wrapped up the night going through lessons learned during the day to improve the clinic for tomorrow. It was a great first day in clinic and although they may say this every year, I think we have the best group ever!

Rachel Hanna

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Team Uganda :: Sunday Funday

After a very long but entertaining plane ride, we finally made it to Entebbe. Amsterdam’s airport was quite cold, but we all managed to catch short naps and some Danish breakfast before the 8 hour ride to Uganda. After successfully navigating customs we made our way to the Central Inn in Entebbe to catch some much needed sleep before the bus ride over to Masindi.

Our morning started early with a quick breakfast before loading up the buses for a 5 hour trek. This was probably the most interesting leg of the journey just for the traffic alone. The streets are so busy, and lane dividers do not exist. Between foot traffic – ie, pedestrians who cross the street at random, without any warning -and a rollerblader who hitched a ride on the back of our bus, there was no shortage of entertainment! Amidst all of this we got our first glimpses of this beautiful yet very different country.

We were greeted warmly at the Masindi Hotel by Janine, the district health coordinator, then grabbed a quick lunch before taking a tour of the Masindi-Kitara Medical Centre where we learned a little more about the people we’ll be serving this week. Amidst a slow and hot breeze our new guides talked to us about the healthcare system in Uganda and how different things are from the hospitals and clinics we have back home. A quick tour of the buildings would easily show how much they have accomplished here with almost none of the luxuries we typically take for granted in Charleston.

Once back at the hotel, it was time to divide up our supplies for our first clinic day tomorrow then a hearty meal before bedtime. And at last we met the last few members of our team, our pharmacy and medical students who had been here for a few days before our arrival.

It was a long journey over, but all of the waiting, sleeping, eating, sleeping some more, and wandering about plane cabins was well worth what will be in store tomorrow. For tonight we’ll spend some time winding down and chatting before greeting all the new people at the clinic. We can’t wait to start serving the people of Uganda and to see everything this week will bring!

Amanda Schnee and Molly McVey

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Team Nicaragua :: Celebrating 1 Year by Paving the Way for The Future

Day6Pics-5With such a great turnout at the clinic, we had to make seats in the street.

PMI cares deeply about providing sustainable health care in the communities in which it is involved. Today we were able to take part in celebrating the 1-year anniversary of PMI’s medical clinic in El Viejo by hosting a health fair out of the clinic itself. We even shut down the street to make room for our patient waiting area! This was the first time a PMI team offered its outreach services one of their permanent clinic sites. It currently serves under the leadership of Dr. Chico, and is equipped with several exam rooms, its own pharmacy and even a laboratory.

Day6Pics-9We loved getting to serve the people of El Viejo today.Day6Pics-8PMI Nicaragua’s local staff worked right alongside our team to bring quality care to the community.

We were able to see 267 patients, making today one of the busiest days of the week. Although the hallways and rooms were a little crowded, our patients were able to receive one on one care in a more private setting. They also became more familiar with the location, people, and services where they will receive regular treatment. A few patients were return visits from previous clinic days this week, and our doctors provided follow-up care.


Day6Pics-6Dr. Brett Bentley and fourth year medical student, Grace Twitty, review a patient’s complaints and plan the best course of action.

It is with mixed emotions that our last patient was seen today. Truthfully, there are many of us on the team who are the feeling the strain of 5 straight days in almost 100 degree weather treating over 1200 patients… but grateful. There is still a lot to pray over and process. The people we served were not the only ones blessed. Each of us appreciates the opportunity we’ve had to be a part of this team, to serve and care for the Nicaraguan people.

Day6Pics-22Our full team at the end of a full day (minus our amazing pharmacist, Jose Puentes – you were missed!)

Jim Johnson and Kristina Keilson

Photos by Joshua Drake Photography