Charleston-based physician, Dr. Edward O’Bryan is co-founder of the Palmetto Medical Initiative (PMI), a venture that encourages and supports sustainable medical practices in developing countries (palmettomedical.org). His efforts have raised the bar for accessible medicine in places where it’s most needed.

Briefly describe your professional route.
I spent my childhood in Florence, South Carolina, and moved to Charleston in 2000 to begin medical school at MUSC. I actually started off wanting to get into international business, but I later refocused on medicine as a career.

During your speech at TEDxCharleston in April, you said that if you were living in a third world country, you’d rather have HIV than a broken leg.
Yes, and that’s actually a quote from a patient in Uganda with a broken leg. I think it’s a powerful statement that serves to highlight the fact that people can suffer from things that are seemingly simple (such as a broken leg) just as much as from things that are complicated. This man saw the great medical care his friends with the HIV virus were getting from foreign HIV organizations and noticed that others with severe medical issues, but not infected with HIV, were being neglected. The truth is that someone without access to appropriate medical care can just as easily die from a simple lung infection as from HIV, and yet globally we do not seem as willing to devote attention to these more common issues.

What inspired you to start the Palmetto Medical Initiative?
The inspiration came from a simple invitation from a friend to join him on a medical mission trip 14 years ago. Like most people who travel abroad to serve, I came home overwhelmed by the need of the people we saw as well as inspired by their willingness to overcome huge obstacles to receive care. I was convinced that, if others had the same experience, their lives would be changed as well.

The missing link was making sure PMI’s short-term trips complemented a sustainable medical model that allowed the people in developing countries to care for their own patients. We don’t conduct any trips where we don’t have a long-term presence to maintain a high level of healthcare by local medical professionals that we help equip and train. The final link was making the project sustainable, for which I have to give full credit to Matt Alexander and Michael O’Neal, my partners in the journey.

Where does PMI operate today?
PMI currently operates in Uganda, Nicaragua and Burundi. We see about 28,000 patients a year cumulatively, but that number continues to climb as we expand to more locations.

Is there a patient that you think about on an ongoing basis?
There are hundreds. I don’t think I ever treat a patient in the United States anymore without considering how their counterpart in the developing world would fare in the same situation. On one of my first trips to Nicaragua, however, I remember we were driving through a rural town when we were stopped and asked to help. A man had been found in a field with severe machete wounds from an assault the night before. The local people had given up on the man whose face had been cut almost in half and who had a back wound that penetrated his lung. They were about to call in the priest to pronounce him as dead, but happened to see our team driving through. With quick work, our team was able to revive the man, stabilize his face and lung wound, start antibiotics and get him transported to a trauma center. He survived.

Have your experiences changed the way you practice emergency medicine here at home?
As strange as it sounds, I think it’s made practicing medicine here more challenging in ways I would not have expected. I have seen patients treated with almost no resources abroad and do very well. That perspective is difficult to balance against patients here who have had every test imaginable and still seem to be unwell. I’ve gained more respect for the will to improve over the means to improve, and I’m more cognizant of appropriate resource utilization in my practice here at home. Also, I want to work with underserved populations here in Charleston. I think that’s a universal feeling of those who do international missions … it leads to local service as well.

What are your future plans for PMI?
We have a unique opportunity in our situation to hear all potential opportunities, but only act on those where we feel particularly led to do so. As such, we could be anywhere in the world next!

Who inspires you?
Our staff in Uganda, Burundi and Nicaragua always inspires me. They are so incredibly hard working and expect nothing in return.

What do you like most about living in the Lowcountry?
Whether I’m surfing or just driving home over the bridge, I love being where the water is always on display. Also, Charleston attracts a variety of diverse people who make life here very dynamic.

What’s next for you?
I hope to establish a Fellowship in Global Emergency Medicine at MUSC within the next several years as well as refine the ways PMI continues to encourage investment in the local community.

Kira Perdue is a public relations professional and freelance writer based in Mount Pleasant, S.C.