Give man a fish and he'll eat for a day, right? But teach him how to fish ... well, that's the part that appeals to Matt Alexander, although he uses words like “long-term sustainability.”

How to help

The Palmetto Medical Initiative sends teams of 30-60 volunteers on quarterly mission trips to Uganda and Nicaragua. The trips take place in March, May, August and December so that local residents receive consistent care throughout the year while volunteers work to complete the medical centers.Many volunteers are medical, pharmaceutical, nursing and other students at the Medical University of South Carolina, although medical experience is not a must. Most pay their own way.Groups of long-term volunteers stay for four- to six-week intervals. One nursing volunteer stayed in Uganda for a year.To learn more or to apply to volunteer, call 696-2223 or go to www.palmetto

Alexander was working with nonprofits when he realized: It's one thing to provide short-term medical missions to the world's impoverished people. It's another to fill their needs for the long haul.

Christian rockers lend benefit aid

Popular rock band Needtobreathe, a longtime supporter of the Palmetto Medical Initiative, is lending its musical muscle to raise funds for the local nonprofit.The band is partnering with the Commonwealth Cares Foundation to host the Needtobreathe Classic, a March 19 golf tournament at Daniel Island Club's Ralston Creek and Beresford courses. Proceeds will go to the initiative.A rock band with Christian music success, Needtobreathe recorded its fourth album, “The Reckoning,” in Charleston. Band members Bear and Bo Rinehart, brothers from Seneca, formed the band with drummer Joe Stillwell and bass player Seth Bolt. In 2011, they opened for Taylor Swift's North American tour.Popular bands Collective Soul and MercyMe, along with singer John Mark McMillan, also will participate in the golf tournament. The musicians will play at an after-party for sponsors, select guests and the first 30 foursomes to register for the tournament.Golfers will have a chance to pair with celebrity guests from the sports and music industries.“Having Needtobreathe's support in our golf tournament takes this event to an entirely new level,” said Britt Gilbert, founder of Commonwealth Cares Foundation. “Our goal is simple: to raise as much money as possible for Palmetto Medical Initiative and its work around the globe. The more people who can get behind our cause, the better.”Gilbert has gone on two medical missions trips with Palmetto Medical Initiative, one to Uganda and one to Nicaragua. The foundation is the charitable arm of Commonwealth Financial Group, a Daniel Island-based financial services firm.The Commonwealth Cares Foundation has hosted a charity golf tournament for five years. This is the third year proceeds go to the group.The cost is $300 for individual player registration and $1,200 for a team of four. Celebrity foursome packages cost $5,000. Register at www.common or call 884-4545.

But what could a few Charleston guys — a doctor, a businessman and a property developer, all barely pushing 30 — do that entire local populations in say, Uganda, couldn't do?

For starters, they could raise money. They also could help local workers build medical centers. They could hire and train native medical and business professionals. And then they could charge something reasonable for the care provided — all to make the deal self-sustaining.

That's the teaching a man to fish part.

And it is the concept behind Palmetto Medical Initiative, a Charleston-based nonprofit that just built a regional referral medical center in Uganda that treats 1,600 patients a month.

Next up: The leaders are taking this model to other corners of the globe where treatable and preventable illnesses still impose death sentences. Nicaragua comes next.

In the beginning

It all started one day in 2008, when Alexander went surfing with his buddy, Ed O'Bryan, a young ER doctor passionate about mission work.

They stopped, sandy and sun blown, for a bite.

With deep faith, career ambitions and long lives ahead, they got to talking. Alexander was 27; O'Bryan was 30.

Alexander worked with the nonprofit Prison Fellowship. Several years earlier, his parents had adopted six children from Liberia. He traveled with them to the tense, ravaged nation.

Meanwhile, O'Bryan had been on many mission trips. He knew folks from St. Andrew's Church in Mount Pleasant who had good contacts in Uganda.

But how could they tap the benefits of short-term mission trips yet sustain a long-term investment?

“We can do all of this evangelism and discipleship, but who's going to pick up when we leave?” Alexander asked.

Three months later, the friends went on a scouting trip with photographer Joshua Drake. They flew over Uganda's blue lakes and rolling green hills toward the town of Masindi.

“We found a unique combination of beauty and a very welcoming people,” recalls Alexander, the group's executive director.

Yet the people suffered. It was normal for a woman to lose a child. Or for a child to lose a mother or father at an early age.

“There was this lack of hope,” Alexander says. “Everyone there had lost someone to a preventable disease.”

Alexander and O'Bryan left with a goal: launch a pilot project to help local people. Palmetto Medical Initiative was born.

A few months later, they took 35 volunteers, many of them Medical University of South Carolina students, to provide care and research needs.

As they landed, Alexander began to worry: What if nobody showed up to their clinics?

The local bishop called.

“There's a bit of a line forming,” he cautioned.

When they arrived, about 1,200 people waited in line. Some had walked 20 or 30 hours to get medical care.

Beyond radar

Michael O'Neal had just returned to Charleston after spending two years in Costa Rica with Young Life.

He'd taken a job overseeing a local construction company's operations. Yet he longed to use his skills in other countries. The Spanish major felt drawn to Central America.

“I've always had a heart for different cultures and a desire to see the world through a different lens,” O'Neal says. “The more lenses I see the world through, the clearer it becomes.”

Then he had a dream. In it, he worked in an African hospital.

It made no sense. His career was in construction, not medicine. And he'd never been to Africa.

“It was a shock to me. It just wasn't on my radar,” he recalls.

Meanwhile, his college friend Alexander had returned from Uganda with this pilot project idea. They had lunch.

“Would you consider moving to Uganda for a couple of years?” Alexander asked.

O'Neal went to his wife, Amanda, who shares his passion for mission work.

“The idea of seeing an entire community transformed was too hard to resist,” he recalls.

They would stay in Uganda for more than two years.

A stark need

O'Neal oversaw construction of a whole new medical center that serves as a regional referral hub.

He hired local builders and used local materials and building practices. Then he taught workers techniques for improving quality and efficiency.

The Masindi-Kitara Medical Centre's outpatient clinic opened in December 2010. The need was stark.

Uganda has one of the world's highest birth rates. Yet maternal and infant death rates are among the world's worst. Life expectancy is about 53 years, according to the CIA World Factbook.

The public health system doesn't come close to meeting the need. And private medical centers are too expensive for most Ugandans, Alexander says.

“The reality of poverty hits you when it has a face and a name, and you see it day in and day out. It hits close to your heart,” O'Neal says.

Take 4-year-old Eddie. He had walked into a pit where people burned trash and suffered severe burns on both legs.

In a desperate attempt to save him, Eddie's parents had rubbed dirt and ash on his legs to protect the open wounds. Infection set in.

The local public health staff advised Eddie's parents to take him home and keep him comfortable while he died.

Instead, the staff quickly administered antibiotics and cleaned and wrapped his burns. They did so every day for months.

Today, Eddie is 6. He plays soccer and visits the medical staff each month.

“He's become part of our family, our story,” O'Neal says. “He represents that next generation we are trying to reach and transform through health care.”

In 2011, the medical center added a 20-bed inpatient ward. In 2012, it added two surgical theaters and a 15-bed labor, delivery and maternity center, where about 100 babies will be delivered each month. The entire center treats 1,500 to 1,600 patients each month.

The next goal: Make it self-sustaining.

First, the center has employed 50 Ugandans including medical and business professionals — not a team of Americans.

“At its root, sustainability is a commitment by the local staff to the community and to see (the medical center) as their own,” says O'Neal, who now directs international projects.

Second, patients pay for care even though they are impoverished.

The initiative established fees based on what 98 percent of local residents can afford. That money goes back into the center. An indigent care fund helps those who cannot pay at all.

“We are there to serve them, not to make money,” Alexander says.

The entire Masindi-Kitara Medical Centre cost about $400,000 to create. Yet for the first seven months of 2012, the facility supported itself with patient fees.

Alexander expects it to be self-funded year-round by May once capital costs for the new maternity ward are paid for.

“That's what we get excited about,” he says. “The goal is for Ugandans to completely control the project.”

No drive-by

It's not every day when a guy grabs coffee with a buddy and winds up with a $50,000 check in hand and a camera crew recording the moment.

But when that buddy is Jason Surratt, missions pastor at Seacoast Church and Seacoast happens to be in the midst of a major gift campaign, these things happen. And so it went Dec. 18.

Seacoast has sent missions to Nicaragua for a decade, but the trips can have a drive-by feel, Surratt says. The $50,000 donation will help fund a new medical center.

“It is an investment,” Surratt says. “This is not just going to meet an immediate need today. It will be built to last.”

In Nicaragua, they found a huge shortage of treatment for chronic illnesses such as diabetes that can escalate into life-threatening complications if left untreated.

They also discovered a hotel in Viejo that had been mostly built, then abandoned for lack of money. It will become a large outpatient center. Palmetto Medical Initiative just sent the first payment.

Next up: Raise $50,000 more to complete renovations. Then teach a whole new community to fish for a lifetime of accessible health care.

Reach Jennifer Hawes at 937-5563 or follow her at