In Madagascar, PO worked in collaboration with the project director, Dr. Frank Kiel. The purpose of this project was to establish a laboratory in Madagascar capable of providing affordable histopathology services for Malagasy patients, and to train one or more Malagasy physician(s) in this medical specialty.  The ultimate goal was to establish a financially sustainable histopathology service administered and staffed by Malagasy physicians and personnel. 

The Madagascar volunteer project was made possible through generous support by USAID. The goals of the project were to (1) establish a functional and cost-effective histology laboratory, (2) immediate provision of diagnostic histopathology services, (3) build physician capacity in pathology by training two to four Malagasy physicians who would eventually take over the clinical services and laboratory operations, (4) build technologist capacity, by training histotechnologists.

At the conclusion of our formal involvement, the project had matured into a locally staffed and operated histopathology laboratory. In 2002, the service was turned over to Dr. Rakouth and Dr. Lalao. In 2003 the SALFA AnaPath Laboratory received official accreditation as a histopathology laboratory.