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        <BOYAmt>153994</BOYAmt>
        <EOYAmt>180867</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>26632</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A">
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      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>3068577</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3029892</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3257161</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4581718</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4572574</CurrentTaxYearAmt>
        <TotalAmt>18509922</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>3068577</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3029892</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3257161</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4581718</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4572574</CurrentTaxYearAmt>
        <TotalAmt>18509922</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>18509922</PublicSupportTotal509Amt>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>3068577</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3029892</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3257161</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4581718</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4572574</CurrentTaxYearAmt>
        <TotalAmt>18509922</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>1.00000</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>1.00000</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleF documentId="990F">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>EAST ASIA AND THE PACIFIC</RegionTxt>
        <TypeOfActivitiesConductedTxt>PROGRAM SERVICES</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>MEDICAL SUPPLIES</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>2700148</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>SUB-SAHARAN AFRICA</RegionTxt>
        <TypeOfActivitiesConductedTxt>PROGRAM SERVICES</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>MEDICAL SUPPLIES</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>1397405</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>EUROPE INCLUDING ICELAND AND GREENLAND</RegionTxt>
        <TypeOfActivitiesConductedTxt>PROGRAM SERVICES</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>MEDICAL SUPPLIES</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>169142</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>MIDDLE EAST AND NORTH AFRICA</RegionTxt>
        <TypeOfActivitiesConductedTxt>GRANT MAKING</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>MEDICAL SERVICES</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>63301</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalSpentAmt>4329996</SubtotalSpentAmt>
      <TotalSpentAmt>4329996</TotalSpentAmt>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>EAST ASIA AND THE PACIFIC</RegionTxt>
        <PurposeOfGrantTxt>MEDICAL</PurposeOfGrantTxt>
        <NonCashAssistanceAmt>2700148</NonCashAssistanceAmt>
        <DescriptionOfNonCashAsstTxt>MED SUPPLIES AND EQUIPMENT</DescriptionOfNonCashAsstTxt>
        <ValuationMethodUsedDesc>ESTIMATED VALUE</ValuationMethodUsedDesc>
      </GrantsToOrgOutsideUSGrp>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>SUB-SAHARAN AFRICA</RegionTxt>
        <PurposeOfGrantTxt>MEDICAL</PurposeOfGrantTxt>
        <NonCashAssistanceAmt>1397405</NonCashAssistanceAmt>
        <DescriptionOfNonCashAsstTxt>MED SUPPLIES AND EQUIPMENT</DescriptionOfNonCashAsstTxt>
        <ValuationMethodUsedDesc>ESTIMATED VALUE</ValuationMethodUsedDesc>
      </GrantsToOrgOutsideUSGrp>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>EUROPE INCLUDING ICELAND AND GREENLAND</RegionTxt>
        <PurposeOfGrantTxt>MEDICAL</PurposeOfGrantTxt>
        <NonCashAssistanceAmt>169142</NonCashAssistanceAmt>
        <DescriptionOfNonCashAsstTxt>MED SUPPLIES AND EQUIPMENT</DescriptionOfNonCashAsstTxt>
        <ValuationMethodUsedDesc>ESTIMATED VALUE</ValuationMethodUsedDesc>
      </GrantsToOrgOutsideUSGrp>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>MIDDLE EAST AND NORTH AFRICA</RegionTxt>
        <PurposeOfGrantTxt>MEDICAL SERVICES</PurposeOfGrantTxt>
        <CashGrantAmt>63301</CashGrantAmt>
        <MannerOfCashDisbursementTxt>WIRE TRANSFERS</MannerOfCashDisbursementTxt>
      </GrantsToOrgOutsideUSGrp>
      <TransferToForeignCorpInd>false</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>false</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>false</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>false</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>false</ForeignPartnershipInd>
      <BoycottCountriesInd>false</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Use of grant monitoring procedures (Part I, line 2)</FormAndLineReferenceDesc>
        <ExplanationTxt>GRANT RECIPIENTS ARE REQUIRED TO KEEP RECORDS OF EXPENDITURES MADE WITH GRANT FUNDS, AND ARE REQUIRED TO PROVIDE A QUARTERLY ACCOUNTING OF THOSE EXPENDITURES TO GATEWAY MEDICAL ALLIANCE, INCLUDING COPIES OF RECEIPTS.IN REGARDS TO NON-CASH MEDICAL SUPPLIES AND EQUIPMENT, DISCHARGES OF BOXES OR SUPPLIES AND/OR PIECES OF EQUIPMENT ARE SUBMITTED BY VOLUNTEERS DISTRIBUTING THE SUPPLIES. VISITS TO OBSERVE RECIPIENTS USE OF SUPPLIES AND EQUIPMENT ARE MADE WHEN AND WHERE POSSIBLE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleG documentId="990G">
      <FundraisingEventInformationGrp>
        <Event1Nm>INFO BANQUET</Event1Nm>
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        <GrossRevenueEvent1Amt>19345</GrossRevenueEvent1Amt>
        <GrossReceiptsTotalAmt>19345</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>19345</GrossRevenueTotalEventsAmt>
        <NetIncomeSummaryAmt>19345</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleM documentId="990M">
      <SecuritiesPubliclyTradedGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>6118</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>MARKET VALUE</MethodOfDeterminingRevenuesTxt>
      </SecuritiesPubliclyTradedGrp>
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>9482</ContributionCnt>
        <NoncashContributionsRptF990Amt>4266695</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>WEIGHT BASED FORMULA</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="990O">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Officer directors etc family relationship Part VI line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHAEL SPIGER AND ANNE SPIGER ARE MARRIED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 governing body review Part VI line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED BY THE ADMINISTRATIVE STAFF, THEN BY AT LEAST 3 BOARD MEMBERS. THE FORM IS AVAILABLE TO THE FULL BOARD, BUT IS FILED WHEN APPROVED BY AT LEAST 3 MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Governing documents etc available to public Part VI line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THESE DOCUMENTS ARE MADE AVAILABLE IN OUR OFFICE, OR BY ELECTRONIC MEANS, UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>