San Jose Partners

We are a sustainable community development project out of the University of Rochester Department of Family Medicine and we are glad you have found us!  Our Department has partnered with a rural community in Southwest Honduras called San Jose San Marcos de la Sierra.  We started working with this community in 2005 and have made great strides improving the health of the local population through a collaborative approach to rural development.  Although we are physicians by training, much of our efforts in San Jose are non-medical in nature.  For the San Jose community members, lack of safe water and under-nutrition cause more ill health than does their limited access to curative health care.  We realize this and create solutions to address the problems, even when the solutions are outside our comfort zone.  We are constantly updating this web site as things change.  Check back often.

image01 image01 image01 image01 healthy girl from San Jose
As you peruse our site, if you are as excited by our work as we are, please consider supporting us financially. We encourage you to visit our Donate page.  Even if you cannot financially support our efforts in San Jose at this time, consider doing all your Amazon shopping through our link to Amazon.  By clicking on our Amazon link, 4% of your purchase price is donated by Amazon to San Jose Partners.  That 4% donation costs you nothing, Amazon pays it.

For those who want more details on philosophy and project-specific information, visit the following link.

 

 

Fall-Winter 2014 Update

The October brigade was a great success!  We accomplished so much in these very busy two weeks.  Probably the most exciting update is we have a University of Rochester 4th year medical student spending the next 10 months in San Jose.  Joshua Back will be performing home surveys as well as increasing the pace of implementation for our other projects.

While the trip report is not yet complete, we have posted  a few stories from the trip below.

A young child and intractable seizures
A year ago we shared the story of a four year old girl whose parents raced across the hillside paths carrying their seizing daughter in their arms.  We were able to quickly stop her seizure with an injectable medication, but it was clear that she had been suffering continuing brain damage with each subsequent seizure.  We faced the tough decision of what to do to control her seizures going forward, after the brigade returned to the states.  Although unconventional, we decided to teach her parents how to administer the injections in the case of a prolonged seizure, provided them with vials of the medication and carefully written instructions detailing how to prepare and administer the seizure medication. In contrast, this year the family arrives at clinic almost unnoticed, with a sense of poise and quiet confidence so absent last year.  In the exam room, her father carefully unwraps the laminated instructions that we had given him last year and that the family carries with them wherever they go.  They've used it twice he says. Both seizures occurred when she was sick, lasted 15-20 min, and responded quickly to medication.  She seems completely transformed from last year, a reeling ball of giggles when approached with a tickling finger and speaking in full sentences when the tickling finally stops.  Her father no longer worries if she will survive, but now he asks what can be done to catch her up and ready her for kindergarten. 

Slope of poo 
There's a romanticism I'm prone to surrendering to when I watch children run easily through these grassy mountainside foot paths. The winding ways and deep forest short cuts to their aunts, grandparents, and friends are worn deep into their minds – an integral part of their understanding of life. I walk their paths as a stranger attempting to not loose myself on the unfamiliar slopes, over come with the beauty of this countryside. Inevitably, glimpses of the harshness of this existence snap me back to a more grounded reality. Clothes lines filled with worn rags, children playing with broken pieces of a wooden chair, a quick glance of two mattress-less bed frames for a family of seven. At times the reality check comes as an olfactory assault – the strong unmistakable smell of urine and human feces stretch a 10' up-slope of path leading to a home. The do-to lists seem insurmountable in this world of pervasive need, but we caution our tendency towards pessimism with a generational approach to community development. This year's micro-finance loans, when placed in the right hands, will lead to sufficient beds, food, and school uniforms in 3-5 years. This year' scholarship recipients, if properly supported, will go on to find employment previously unattainable and bring new skills back to their communities. In the mean time, we continue to work with community members' more immediate needs - improved cook stoves, water projects, and latrines for schools and homes. A tour through the communities of Las Delicias lead me up a familiar fence-lined rocky slope to a home where Manuel showed us a recently constructed latrine, one of many in the past few months. As we left the home I looked back down the slope and realized both why it was familiar and why I hadn't initially placed it among my memories – its distinctive smell and accompanying disease potential had been moved, contained within a deep pit, returning odorlessly deep into the earth, replaced by fresh air.

Elderly home visit
“Would you mind, do you have time? There's a couple just up the road. He's broken his waist and she's dying of a fever that won't quit.”  We've just returned from a 10 hr hike and tour of recent projects, but she's right, we do have time. Their son-in-law greets us at the road and leads us back through a grove of mango and calabash trees. A scant frame of a man lays flat under mounds of blankets and a walker stands next the bed – altogether out of place and otherworldly in this bare world of concrete and rough hewn wood. He wants us to know he's been in this bed for an entire year. He had broken his hip after a fall and was lucky enough to get surgical correction, placing a metal plate. However, his family could not afford the weekly trips to the city for his physical therapy and, now a year later, his leg still doesn't bend well. He wants to sit but he can't and he is in pain all the time.  A quick physical assessment reveals a body atrophied at all points, barely more than a skeleton, but still trying so hard to be mobile. I think of what happens to a patient who fractures their hip in the States – 5 days in bed requires weeks of inpatient rehabilitation and painful physical therapy. How does one begin to rehabilitate after 12 months in bed and with no therapist to guide the process?  We review exercises that he can do to improve mobility and we prescribe medications for controlling pain.  His face livens, filled with a new sense of hope, but we know that without infrastructure for true rehabilitation, he will likely not walk on his own again.  We walk home in the darkness, our path clear in the moonlight, a new understanding of "resource poor" settling silently on our shoulders.

One small daily commute for scholars, one insurmountable hike for the gringo
It is 6am and I find myself climbing the ascending road alongside one of the best high school students in the scholarship program.  She is on her way school, a trip that started an hour before she encountered me and will continue for another hour more until she reaches the school in San Marcos.  I consider myself a pretty good hiker, having walked all over San Jose during this brigade, but I am fighting with every ounce of energy just to keep up.  At some point just before reaching the middle of the hill, I find myself actually matching her steps, momentarily restoring my ego her causal steps had just trampled.  And then I realize that she only slowed because she is studying from her English notebook at the same time as she is climbing this seemingly insurmountable hill.  The terrain here is so treacherous that I consider myself blessed every time I return to the volunteer house with all my limbs intact.  But she has to study on this walk because it is hard to find enough time to study in between her twice daily two hour commutes.  Any of us thinking back to our twenty minute bus rides to school can only admire the obstacles that these students overcome every day. Meeting these students over the past week has solidified for me how our scholarship program opens the door of possibility for these students and how their shared mix of hard work, perseverance, and optimism enables them to take hold of the opportunity.

 

Micro-loan receipients with receipt of repayment in full