About Shoulder to Shoulder and Hombro a Hombro

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Hombro a Hombro is a non-profit NGO legally registered in Honduras since 1998 but operating under the sister U.S. organization Shoulder to Shoulder since 1990. It originally represented a successful partnership between the University of Cincinnati College of Medicine, the City of Cincinnati, the Ministry of Health of Honduras and most importantly, the Community Health Board in Santa Lucia, Intibuca.  Presently Shoulder to Shoulder / Hombro a Hombro represents a collaboration with the previously mentioned groups and 12 other academic programs in the US.   Since 1994, the partnership has worked “shoulder to shoulder” resulting in the following services/facilities:

• Two  Hombro a Hombro Medical Centers in Santa Lucia and Concepcion: These state of the art medical clinic that operates 24 hours per day with  Honduran and US physicians, and a supporting staff providing care for acute and chronic illnesses including minor surgeries and obstetrics. We also have a laboratory, radiology services and a small inpatient facility for caring for patients overnight in each facility including  state of the art digital radiography and ultrasound capabilities. In addition, the Honduran doctors and visiting physicians frequently visit the elderly and the chronically ill in their homes. In addition, over 4000 Honduran and US volunteers have participated including medical students, residents, faculty physicians, nurses, dentists and various others- teachers, hydrologists, carpenters, lab technicians, engineers, electricians,  and nursing students, just to name a few. Participants volunteer their time and finance their own trips. The short term medical brigades are very active in promoting our Child Health Initiative. ( see home page, projects). The Hombro a Hombro Health Committee, who are all local community members, support and supervise all of the
• Additional Medical Facilities staffed and supplied by StoS/HaH.  These are staffed by Honduran health care providers and offer non emergency primary care in locations closer to where people live.  
• San Jose, Santa Lucia
• Santa Rita, Santa Lucia
• San Antonio, San Antonio
• San Juan, San Antonio
• Santa Teresa, San Antonio
• Magdalena
• Dormitory: A large housing facility adjacent to the clinic allows for up to 45 people to stay in Santa Lucia. The dormitory has beds, showers and a kitchen large enough to feed the group of 45. Not only does this allow us to house visiting medical brigades, it has been extensively used to host conferences and training seminars; e.g., in 2001 the Minister of Health held a conference for 60 regional and national health officers highlighting the value of community based health initiatives. Other conferences including numerous training sessions for village midwives and health promoters, conferences for schools and churches and other regional health seminars have been held in the clinic. Similar facilities exist in our new clinic in Concepcion
• Oral Health Program: Our clinic has two modern, well equiped dental facilities for acute, preventive and restorative dentistry. Hombro a Hombro employs two full time dentists and two full time dental assistants who provide the preventive dentistry services on a regular basis. Visiting teams of dentists and dental students from the U.S. volunteer their services many times throughout the year. In addition, Hombro a Hombro provides uses extensive fluoride varnish in its outreach program connected to the Child Initiative program. This project is coupled with the nutrition program described below.
• Nutrition Program: Hombro a Hombro has a rural school feeding program that feeds 1800 school children per day who are living in very isolated communities. Hombro a Hombro requires communities to form parent organizations that will build school kitchens, provide fuel for cooking and volunteers for preparing and serving the food. With the generous support of the Mathile Institute for the Advancement of Human Nutrition,  we are developing an extensive under 5 research based feeding program, the age where nutritian is most important.
• Water: Hombro a Hombro with the help of a hydrogeologist, has developed a program to help eliminate water bourn pathogens.   This is a two part project using slow sand filters in community buildings and clinics along with a home-based water filter that is based on the Potters for Peace filter. 
• Education: With the assistance from a grant from the US Department of State, a program to help improve the self-esteem of girls by supporting small entrepreneurial projects in their local communities has been established. In this program, called “Yo Puedo”. teachers were required to teach the girls a basic applied business math course and help the girls to form clubs. The clubs elected girls to lead the projects which included the production of basic embroidery items, growing gardens and even the opening of several small community stores. The girls not only gained valuable experience in running small businesses, they also gained confidence and a desire to continue their education.  This has been so popular, that the girls have allowed the boys to join in the project.
• Women’s Health:   Ongoing education and treatment of social and medical issues specific to women have been a priority for StoS since the beginning.  Examples include Yo Puedo, supporting and expanding the community based Madreguias program, extensive midwifery training for the community midwives, folic distribution, cervical cancer screening program using VIA with cryo treatment, just to name a few.
• Medical Information System:   We have developed and are implementing a medical database system.  We have completed an extensive house by house census of our service area and now track every “encounter” with people, whether it is in a home, clinic, child health brigade, nutritional intervention, or wherever.  With this system, we are able to not only provide research opertunities to better care for the poor, but give our medical staff intervential analysis of diseases related to time, nutrition, location and hundreds of other variables to give them guidance on where and how to provide community health interventions.
• Brigades:  There have been over 4000 volunteers from many countries travel to our sites in Honduras.  The purpose of these brigades is quite different from the usual intermittent, random medical brigade model so common in the developing countries.   Our mission is to provide education to students, education for our medical staff and community health providers, and run our Children’s Health Intiative.   Please see the published article that explains our model for brigades Shoulder to Shoulder Model.pdf

Shoulder to Shoulder Affiliate Projects

• Academic Affilicates.  Numerous affiliates bring brigade to our facilities and outlying clinics and villages to serve the people and provide education for their students.  Many have moved onto establishing themselves in villages and starting programs of their own, as discussed next.   (  link to affiliates.)
• Support of Affiliate programs: Shoulder to Shoulder uses it successful model of working with the community to provide other partners with the development and logistical support to expand their programs to further help the poor in Honduras, Equador, and Tanzenia.  With our support in their infancy, they are able to build and sustain programs with similar methods and objectives.  Examples of these include:
• San Jose del Negrito, Yoro, Honduras   The University of Pittsburgh has built a medical clinic and supporting structures and provide daily health care and community development based on the Shoulder to Shoulder model. See their project
• Santa Ana, Intibuca, Honduras.   Baylor University as provided medical and community development for more than 10 years at their site only a few miles but many hours travel from Santa Lucia.  See their site
• Pinares, Intibuca, Honduras  A partnership between Thundermist Health Center and Virginia Commonwealth University has produced a ongoing medical and community center in northern Intibuca.  This area works daily and directly with Hombro a Hombro in Intibuca.
• Guachicilimpito, Intibuca, Honduras.   Brown University has built a new clinic in a remote area of Intibuca that will serve as a satellite to the new Concepcion clinic.  Extensive community development is already advancing in this area which also serves an isolated area of Lempira, Honduras.
• San Jose, San Marcos de Sierra, Intibuca, Honduras.   The University of Rochester has been serving the absolutely poorest area of Intibuca for several years and is beginning construction of a community center here.   See their project
• Santo Domingo, Ecuador.   The University of Kentucky is working shoulder to shoulder in Ecuador using the original Shoulder to Shoulder model and assistance.  See their site
• Tanzania, Africa.   The Village Outreach Project is based on the StoS model and has again used the StoS resources and experience to jump start its service of the poor.  Their Site
• Support: Shoulder to Shoulder receives invaluable support from numerous partners. Please see our supporters page.  The Department of Family Medicine at the University of Cincinnati provided critical extensive medical, administrative, and educational services in the beginning of Shoulder to Shoulder and continues this support to the present. Many medial equipment companies, construction companies and logistical companies have made the impossible task of supporting a project in a very remote area possible.  In Honduras, the La Ceiba Bi-Lingual School, Sandra Payne, Principal, has been for many years providing translators to our medical/dental teams. These translators are students with high academic standing at the school who many times opt out of family vacation time (especially at Easter/Santa Semana in April) to travel to our sites to provide this much needed service. Most importantly, countless individuals contribute time, labor, expertise and money toward the success of Shoulder to Shoulder

Informacion sobre Hombro a Hombro

Hombro a Hombro es una Organización no Gubernamental legalmente registrada en Honduras desde el año 1998 pero ha operado bajo su organización hermana Shoulder to Shoulder desde 1990. Esto representa una asociación muy exitosa entre el Colegio de Medicina de la Universidad de Cincinnati, la Cuidad de Cincinnati, El Ministerio de Salud de Honduras y más importante, la Directiva de Salud Comunitaria de Santa Lucia, Intibucá. Shoulder to Shoulder en los Estados Unidos no tiene gastos administrativos, esto permite que todos los fondos donados sean utilizados para apoyar los esfuerzos de Hombro a Hombro en ayudar en las necesidades de la gente pobre de Intibucá. Como resultado, nuestra organización provee una amplia y eficiente variedad de servicios utilizando una cantidad mínima de fondos. Durante los últimos 13 años, la asociación ha trabajado “hombro a hombro” resultando en los siguientes servicios y facilidades:

• El Centro Medico “Hombro a Hombro”: cuenta con una moderna clínica medica la cual opera las 24 horas del día. Cuenta con dos médicos hondureños, y personal de apoyo que brindan tratamiento a enfermedades agudas y crónicas incluyendo pequeñas cirugías y obstreticia. También tenemos un laboratorio, servicios de radiología y pequeñas acomodaciones para internar durante la noche. Para poder mantener archivos adecuados, todos los pacientes y sus diagnosticos son registrados en una base de datos computarizada. Luego, estos expedientes medicos están disponibles para cada visita medica. Además, los doctores hondureños y médicos visitantes frecuentemente visitan a los ancianos y pacientes con enfermedades crónicas en sus hogares. También mas de 1000 voluntarios hondureños y estodunidenses incluyendo 172 estudiantes de medicina, 117 residentes, 134 médicos de la facultad, 30 enfermeras, 15 dentistas y varios otros maestros, hidrólogos, carpinteros, técnicos de laboratorio y estudiantes de enfermería han participado. Los participantes donan su tiempo y financian sus viajes con fondos propios. Las brigadas medicas de corto plazo colaboran con el ministerio de salud vacunando, colectando datos y estadísticas vitales; y una amplia variedad de proyectos educacionales / servicio que a continuación describimos.El Comité de Salud de Hombro a Hombro quienes son todos miembros locales de la comunidad, apoyan y supervisan todas las actividades conducidas por el equipo medico y equipo visitante.
• Dormitorio: Un amplio local adyacente a la clínica en Santa Lucia permite acomodar hasta 45 personas. El dormitorio tiene camas, baños y una cocina suficientemente grande como para dar de comer a todo el grupo. Este no solamente nos permite alojar brigadas medicas sino que también ha sido utilizado extensivamente para patrocinar conferencias y seminarios de capacitación. Ejemplo: En el 2001 el Ministro de Salud tuvo una conferencia con 60 funcionarios de salud regionales y nacionales resaltando el valor de las iniciativas de salud basadas en esfuerzos comunitarios. Se han sostenido en la clínica otras conferencias incluyendo numerosas reuniones de capacitación para parteras de las aldeas y promotores de salud, conferencias para escuelas e iglesias y otros seminarios de salud en el ámbito regional.
• Programa de Salud Bucal:Nuestra clínica tiene cinco sillas dentales funcionando y materiales para curar, prevenir y restaurar dentadura. Hombro a Hombro emplea un asistente de odontología a tiempo completo. Esta persona provee la mayoría de servicios de dentadura preventiva. Equipos de dentistas visitantes de Estados Unidos han donado sus servicios tres o cuatro veces por año. Además, Hombro a Hombro provee fluorización diaria a los niños de la escuela que viven en las comunidades mas aisladas. Este servicio esta acompañado con el programa de nutrición que a continuación describimos.
• Programa de Nutrición: Hombro a Hombro tiene un programa de alimentación en las escuelas rurales que da de comer a 1500 niños por día. Estos niños viven en 13 comunidades muy remotas. Hombro a Hombro requiere que los padres de familia de las comunidades formen comités de apoyo para construir cocinas en las escuelas, proveer la leña o gas para cocinar y voluntarios que preparen y sirvan la comida.
• Agua: Hombro a Hombro con la ayuda de un Ingeniero Hidrológico, Ha desarrollado un programa de fabricación de filtros caseros, estos pueden ser construidos por menos de L. 200.00 utilizando materiales que están disponibles en la localidad. Estudios Microbiológicos han confirmado que estos filtros rinden agua limpia y segura para tomar.
• Educación: Hombro a Hombro con la asistencia de una donación del Departamento de Estado del USA creo un programa para ayudar a mejorar el auto estima de las niñas mediante el apoyo de pequeños proyectos micro empresarial en sus comunidades locales. A los maestros se les pidió que enseñaran a las niñas cursos de matemática básica aplicable en negocios y ayudarlas a formar clubes. Estos clubes eligieron niñas para que dirigieran los proyectos los cuales incluyeron producción de artículos bordados, cultivo de hortalizas y aun la apertura de pequeñas tiendas en sus comunidades. Estas niñas no solamente adquirieron una experiencia valuable en como manejar un pequeño negocio, sino que ellas también adquirieron confidencia y el deseo de continuar sus estudios. Ocho niñas ahora están yendo al colegio local con becas otorgadas por Hombro a Hombro.

Cobertura

Hombro a Hombro ha estado trabajando con muchas otras comunidades para ayudar a mejorar los cuidados de la gente más pobre del área. Algunos ejemplos:

• Desarrollo comunitario, brigadas medicas y programas de capacitación a parteras en Santa Ana
• Brigada Medicas en Camasca
• Brigadas Medicas y programas de extensi ón rural (médicos, dental y nutrición) en Magdalena
• Brigada Medica en San Antonio y varios lugares con mucha necesidad
• Desarrollo comunitario, programa de nutrición y brigadas medicas en San Jose, Yoro desde 199