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Year in Review — 2018


In memory of Paul Manship


We ended 2018 on a solid financial basis.  All Programs were fully funded by donations.  Program budgets have been submitted for 2019.  We will need to continue a rigorous fundraising program in 2019, to full fund all of the programs.

Donations by Category:
2015 2016 2017 2018
Dental 33,539 19188 17,370 18,980
Scholarships 36,813 36,215 66,995 25,013
Nutrition 0 0 38,409 50,130
Bilingual School 15,067 26,871 17,135 19,425
Bilingual School Construction 0 21,039 21,250 4,775
Virtual Fiesta 21,142 9675 0 0
CREE (Tech & Robotics) 0 0 20,171 19,525
Undesignated Funds 43,512 52692 70,649 31,055
150,073 165,680 251,979 168,903


In 2018, we hosted 13 Brigade groups, for a total of 137 travelers.  Groups were affiliated with the following organizations:

Brown University

Wingate University

Mountain Area Health Education Center (MAHEC)

University of Maine

Virginia Commonwealth University

Ohio State University

Duke University

University of Chicago

Genessee Valley Presybyterian

Unidad Hospitaleria Movil Latino America (UMHLA)


We finished the 2018 school year on Nov 30th.  It was a very successful year.  We had 135 students enrolled – from Kindergarten to 5th grade.  In the next school year (2019), we will have 155 students, in grades Kindergarten to 6th grade.  We have finally, after 7 years, arrived at full capacity at the school.  That is really exciting!

Thanks to the generous $10,000 donation from Catholic Relief Services, and the addition of $10,000 from StS generous donors, we built our last building on the campus – a combined kitchen, dining hall, and meeting space.  It is beautiful!


Thanks to the donation of Alan Ostrow’s time, the Hondurans robotics team competed in in Mexico City.  The team was coached again by Daniel Marquez (high school math teacher) and Henglyns Lemus (High School Informatics teacher).   We came in 16th place, and received a Silver medal for design.  StS invested $15,000 to support this team, and send them to Mexico City.  It is expected that the 2019 competition will be in Canada.  We have not yet decided if we will have the funds available to send a team to the international competition.

However, the excitement from the International Robotics competition has led to the creation of local Legos Robotics teams.    We are supporting the startup of robotics clubs in Santa Lucia and Concepcion.  There are Legos teams in Honduras that compete in-country, and we are hoping that some of the teams from the Frontera will be able to participate in those competitions.  In late November, we held a local robotics competition, in which 6 teams participated.


The overall program (CREE) to provide technology based curriculum support is currently reaching 2300 children, used by 31 teachers in 12 schools.  By end of the 2019 school year, the plan is to cover 3750 children, and 68 teachers in 23 schools.  We utilize the Khan Academy in a local delivery vehicle called KA lite by  We won a $15,000 grant from Learning Equality.  This, coupled with a donation of 25 laptop computers, will support our expansion into seven middle schools and seven elementary schools.

In addition to our work directly in the schools, we supported the Math Olympics with tablets loaded with Khan Math lessons.  This year’s national finals were in La Esperanza.  The students from Intibucá did very well.

NUTRITION (Mani)                                                                                                        

We are providing micronutrient supplements to 2800 children in 3 municipalities.  The annual budget for this program is $100,000.  In June, the Mathile Foundation awarded us a grant of $50,000 to continue the program from September 2018 through August 2019.  We need to raise the remaining funds.  With  the recent donation of $12,000 from Tim Gunderman, our goal is to expand the end date of the program to the end of 2019.  We are currently about $20,000 short of that goal.

 SCHOLARSHIPS —for High School Students (and a few University students)

Fidelina Gehner  has created a very stable and self-sustaining program (successful due to her hard work on continually fund-raising for this program!).  The annual budget for this program is $50,000.

In 2018, the scholarships were distributed as follows:

  • San Antonio: $3,500 (20 students)
  • Camasca: $4,500 (50 students)
  • Concepcion: $4,200 (23 students)
  • Santa Lucia: $3,500 (20 students)
  • Magdalena: $3,500 (20 students)
  • University students: $23,500 (donor designated funds for 8 students)


Drs. Larry and Jan Tepe have completed the transition of the StS Dental practices into two private practice dental centers.   Both dentists are seeing more patients that ever, making more money than their previous salaries. Idalia Ramos has private dental practice, drawing patients from La Esperanza.   Dr. Floricia (Flor) Amaya attends the University in Tegucigalpa during the week; she sees patients from Friday through Monday, and is fully scheduled.

The Tepes  have continued to raise funds, to support StS’s dental services in the Frontera.


  • Paul Manship: Executive Director.  Passed away in March 2018.
  • Laura Manship: Executive Director.  Working from MA, with trips to Honduras 3 times/year.
  • Mariela Rodriguez: Assistant Director.  Living in Honduras.  Contract July 2018 –  June 2020.
  • Edel Andino: Technology Coordinator.  Contract June 2018 through May 2020.
  • Damaris Quintero: Scholarship Coordinator.  Full time employee since June 2015.
  • Gisela Ramos and Sandra Diaz: MANI Coordinators.  Full time employees since June 2016.
  • Gustavo Meza: Brigade Coordinator.  Full time employee since August 2017.
  • Iris Giron: Community Development Coordinator (funded by VCU and Brown Universities).  Full time employee since September 2017.
  • Nely Vasquez: Recent graduate from the Leadership Center, working as a teacher’s aide in the Bilingual School.  Full time employee, started September 2018.
  • Iris Villanueva: Position is “Promotion and Community Relations” for the Bilingual School.  She is charged with finding students to enroll, especially from other municipalities, and providing mentoring to the Director and Teachers at the school.
  • Volunteers for 2019: Grace Twohig, Maddie McKenna; Asa Kaylor; Henry Lathrop; Antonio Peraza; Elizabeth Morris.


Report prepared by:  Laura Failla Manship, LICSW, MBA,

Executive Director



Honduras Spends 80% Less Than the Rest of the World on Health Care

Status of Healthcare in Honduras  

The Archivos de Medicina published an article on the situation of health care in Honduras.  The article was published in Spanish in 2016.  In 2017, it was translated into English, and published in Archives of Medicine.  (links to the articles are below)

Some stricking facts from the study are:

Per Person Spending on Health Care

Honduras spends $101 per person per year on health care. ***

The average in Latin American and the Caribbean is $392 per person.

World average is $628 per person.

Organization for Economic Cooperation and Development (OECD) nations spend $2,880 per



*** Shoulder to Shoulder, under its contract with the Honduran government, receives $19 per person per year to provide medical care.


Availability of Medical Providers

The capital city (Tegucigalpa) had 23.8 doctors per 10,000 inhabitants.

The Department of Intibuca (where Shoulder to Shoulder provides services) has 2 doctors per 10,000 inhabitants.

None of the 18 departments in Honduras meet the minimum indicator of 25 physicians per 10,000 inhabitants as indicated by the regional human resources target.

The unemployment rate among registered doctors is 46%.



Ø  Honduras suffers from a nondefined public health policy;

Ø  Epidemiological surveillance systems are almost non-existent;

Ø  State payments to decentralized entities are not timely

(there are delays of up to one or two years);

Ø  Medical fees have been frozen for more than ten years;

Ø  There is corruption by government and private managers; and

Ø  The economic deficit of the public network of Hospitals exceeded 600 million Euros (33,000 medical centers, laboratories and hospitals run the risk of disappearing).

Links to the articles:

Situación del Sistema de Salud en Honduras y el Nuevo Modelo de Salud Propuesto

Situation of the Health System in Honduras and the New Proposed Health Model (English version)



Every month, the Shoulder to Shoulder Coordinator of Healthcare Services — Dr. Gloria Castro — sends a report to the Ministry of Health which details the Health Services provided in the previous month.

StS provides healthcare to over 70,000 people, in seven (7) municipalities.  The amount we receive from the government is not sufficient.  Receiving only $19 per person leaves us with a huge deficit each year.  


These reports are now posted on the StS website.


Click HERE to read them.  








Every donation matters  –  no matter how small.  


Little by Little, with your help, we’ll make a difference in the world.




Shoulder to Shoulder, Inc.

3445 South Dixie Drive, Ste 200

Dayton, OH  45439

or contact us at:


The “Marriage” between Brown, VCU, and Wingate Universities

Whoever said “you can’t teach an old dog new tricks”, had never met the travelers from Brown, VCU, and Wingate Universities.  Two weeks ago, Shoulder to Shoulder did something that we had never done before – we merged travelers from THREE universities in order to create ONE brigade group.

The Supervising MDs from VCU (Tommy Ball and Lauren Gorden) and their 2 Residents (Daniel Mendez and Sumni Yang) needed more travelers.

A Resident, Psychiatrist, and volunteer from Brown (Angelina Palombo, Horacio Hojman, and David Weign) needed a group to join.

A Pharmacist and pharmacy students from Wingate (Lisa Brennan, Kalyn Meosky, and Kelly Mansfield) needed to fill prescriptions for providers.

The group of 10 agreed to spend 3 days at Brown’s clinic site (Guachipilincito) and 3 days at VCU’s clinic site (Pinares).

What was the outcome?  A wonderful merging of personalities, abilities, and styles and the provision of medical, psychiatric, educational and pharmaceutical services to hundreds of patients!!


The communities of Guachipilincito, Concepcion, and Pinares all benefited by these 10 strangers coming together to provide services.  They saw patients in clinics, in elementary and high schools, and during home visits.  In Guachi, they attended 165 people; in Pinares, they attended 160 people.  The smiles on the travelers’ faces are proof that the strangers became friends.  How beautiful is that!

Matt and the MAHEC Brigade


by Backpack Matt

The first brigade I worked with as a Shoulder to Shoulder brigade coordinator was MAHEC. They arrived on February 10th and stayed until the 22nd. It was a group of ten people comprised of five doctors, a pharmacist, a pharmacy student, a medical student, a psychiatrist, and the son of one of the doctors. MAHEC stands for Mountain Area Health Education Center and is located in North Carolina. We had a filled itinerary for their stay here, and I spent a lot of time not only organizing and coordinating activities but also confirming and reconfirming them. I think my past experience organizing camps in Malaysia had prepared me well for these tasks. I was used to having people ignore phone calls, agree to something only to forget later, and read messages and not respond. It was challenging, but at the same rewarding to be able to overcome those obstacles and have what I thought was a great brigade.

After about five hours crammed into a bus from the airport, we arrived in La Esperanza where we spent the first night. The following morning I gave a short walking tour of the city and we visited La Gruta which is a religious site that overlooks the city, the public baths (which are a lot nicer than they sound), and the favorite gringo coffee shop La Fuente. Afterwards, we piled back into the bus and made our way to Camasca where they would spend the duration of their time. They were set up in the basement of the Evangelical church, where there were three rooms with bunk beds and a larger common area with tables. Working with us throughout the brigade were Eduardo, a translator, Alan who is Gustavo’s son (Gustavo is the other coordinator), Yeni (pronounced Jenny), and Nila. Yeni was our chef for the week and her experience cooking in restaurants in the U.S. paid off. We ate like kings. Nila assisted Yeni in the kitchen, which normally meant making the tortillas, as well as other general cleaning. They were a fantastic team with whom I spoke and listened to a lot of Spanish.

We followed the same schedule for all of the weekdays. Breakfast would be ready by seven, and by eight we were off to one of two locations. Every day two doctors would be assigned to stay in the health center in Camasca and assist the doctors there with seeing patients. I accompanied them most days as a translator, so that I could be in town for other meetings and because I didn’t trust myself to drive a manual truck. The rest of the brigade would head out into a different community each day to perform house visits. Camasca is an area that is made up of several aldeas (small villages) and the poor quality of roads, coupled with the lack of transportation, makes it difficult for some folks to come into the center of town to receive medical treatment. The psychiatrist, on the other hand, had a slightly different schedule. He wanted to try to reach out to people in town to come talk to him about their problems, something that has rarely, if ever, been offered to the people of Camasca. To get the word out Dr. Tom and I visited the local radio station. We announced his presence in the clinic and talked about a few of the stigmas about mental health. A great resource during this process was Profe Edwin, who spoke more bluntly on the radio. He acknowledged that there was abuse, alcoholism, and drug addiction within the community and here was someone who wanted to help. Although the talk we attempted to organize fell through when the power went out, Dr. Tom was still able to spend two days in the high school working with students in a one on one setting. He told me that there were some powerful stories and he felt inspired to return in August with the next MAHEC brigade with more psychiatrists and to try to set up a more lasting type of support system.

In addition to administering medical care, the brigade had a lot of fun in the community. There were afternoon soccer games on the smaller indoor court with kids in town. Many folks enjoyed walking up to the top of the mountain for the valley views below. Profe Iris had us up for juice and watermelon one evening. We visited the rocks of the sun for a stunning sunset. Dr. Tom and I were invited back on the radio later in the week where we assisted Profe Edwin with a raffle. Dr. Tom would draw the name, announce the number, and hand me the paper. My job was to decipher the name and hometown, and then give a short thanks for participating! Or good luck next time! A few people from home were able to find the link and listen to me obnoxiously rolling my R’s and getting very into the character of radio station host. The most entertaining activity of the week was our trip on Saturday to a waterfall about one hour away. We rented a minibus for the day, packed lunches that Yeni prepared for us, and drove to Colomancagua. The waterfall was part of the river that divides Honduras and El Salvador. Due to the small number of Hondurans that can swim, we had the place all to ourselves. It was a relaxing day off and one of the memorable places I’ve been to in Honduras.

The last day in Camasca was eventful, to say the least. After organizing a farewell dinner for the brigade with all of the Hondurans who had assisted us, I was informed by Dr. Rolyn, who works in the clinic, that it was not sufficient. He said there needed to be a ceremony at the bilingual school. Early the next morning, with the help of the teachers at the bilingual school, we scrambled to put together a small presentation. There was the national anthem, traditional dancing, and handmade thank you cards. We also gave the kids a short talk about washing hands, brushing teeth, and avoiding junk food. Although I’m not a fan of taking the kids away from their learning to appease foreigners, I do think everyone enjoyed themselves. The other big part of the last day in Camasca was a talk at the high school. I had spoken with Profe Edwin ahead of time and he gave me a list of topics to discuss that included values, motivation, drugs and alcohol, sexuality and hygiene. The brigade strategized the night before and came up with some superb ideas to get the kids involved and talking. They handed out statistics written in Spanish on small notecards to the kids, and as a class, we decided if they were true or false. Then we had them write anonymous questions that we answered. I was shocked at the lack of knowledge in some cases. I realized that there aren’t many resources available about these issues, but not having these discussions creates a dangerous gap of information that contributes to things like teenage pregnancy and alcohol and drug use. We made it clear that we were not there to tell kids what to do, but to provide them with as much information as possible so that they can make informed decisions, and know all of the risks associated with them. I do think the students benefited a lot from the talks, just as I know my cheeks were bright red the entire time as I did some of the more sensitive translations.

And just like that, it was time for the brigade to head home. I want to thank Dr. Amy, Dr. Brittney, Dr. Brian, Dr. Kyle, Dr. Rebecca, Irene, Kaitlyn, Caleb, Dr. Tom, and Braxton for their hard work and service to the people of Camasca. We anxiously await their return.



Change Comes with Relationships

Joanne Theobald, MSW, prepared this blog after the recent service trip of the University of Wyoming to Agua Salada, Concepcion, Intibuca. A lot of development work is two steps forward and one step back. But what keeps things going is the amazing synergy of relationships. Resources are always scarce, but the will of those who serve with integrity makes the difference.


Twenty-one members of the University of Wyoming Brigade (including four doctors, one family nurse practitioner, two registered nurses, one social worker, and thirteen students) spent a fun and rewarding third week of November in Agua Salada. As we moved through the week, seeing just shy of 300 patients in the clinic, hiking to approximately 15 homes to provide medical attention to those who cannot walk to consulta at the clinic, teaching water filtration and musculoskeletal care to community members, and awarding scholarships to area students, I was struck by how much has changed since my first trip in 2011, and certainly since 2007 when we first formed a partnership with this community.

Some things in Agua Salada don’t change: the warm sunshine, the amazing green vistas, the excitement of the children when we arrive, the warm welcome we receive, the cacophony of roosters crowing, dogs barking, and birds chirping, even the mild but now predictable conflict and posturing among the patriarchs during community meetings.

First, the obvious: the clinic. It’s difficult to ignore a tall concrete building here. Erected in 2012, it, along with the church and the school, forms the center of Agua Salada. It’s starting to show wear and tear, and it represents a constant reminder of our unfinished business: past attempts at employing local health providers in the clinic so residents could have access year-round to medicine fell by the wayside in 2014 following the disastrous downturn in the Wyoming oil, gas, and coal industries. Our project now barely gets approved from year to precarious year, struggling to hold on to the twice-annual brigade visits until conditions either improve in the state’s budget or we locate other funding.

Second, the changes brought by the march of technology across the frontera. Community meetings are now not only interrupted by a man herding his cows down the road by the clinic, or by an occasional deafening downpour on the tile roof, now it’s cellphones. Many families have a cell phone, having seemingly jumped from the appearance of electricity in the valley in 2010 quickly to the current technological age. Children are less fascinated with our cameras and computers than in years past. But they still laugh uproariously at pictures of themselves at the week’s end slide show. . Technology has transformed our community relationships positively between the Brigades: we share numbers and names, able now to communicate via text, WhatsApp, and Messenger. Finally, a conversation with Paul and Sandy during a visit to the bilingual school in Camasca brought hope that we can follow their lead and utilize the Kolibri/KA Lite and Khan Academy programs in the schools around Agua Salada. What a world changer that would be.

Finally, there’s now a bus that passes through Agua Salada, with a one way trip to Concepcion for adults costing 20 lempira, a hefty price. Hearing the bus pass each morning at 5:10 a.m., I think of Elvis, our first student who received a scholarship, a beca, to move into tenth grade last year, rising in the dark to board this 30 minute transport to colegio in Concepcion. Elvis lives just below the clinic, and his family usually becomes well-known to Brigade participants. He and his two younger brothers, Ariel and Sergio, have always engaged with us, playing cards and games, and his family supports us in so many ways; the septic system for the clinic actually runs through his grandparents’ property. Elvis is studying Informatics, one of three tracks at his colegio. He completes homework on his cellphone in the evenings, very difficult given the weak and inconsistent signal that exists in Agua Salada. He has aspirations of becoming an engineer, and even with the completion of his next two years, he will have greatly increased his chances of being employed at much higher wages than those that don’t attend. As he spoke to the other becados at the November scholarship reunion, he noted the benefits of increased study, admitting that at first meeting others at the school in Conce was daunting, but now he knows he belongs. Each year as we collect Cartas de Gracias from the thirty middle school becados, we see more evidence of change: improved writing skills, and their increasing recognition of the opportunities that  lie before them if they continue their education. Another change in this fourth year of the program? More girls than boys are now nominated by teachers for becas, and this year’s recipient for a tenth grade beca is a very intelligent young woman named Evely. Given all the research regarding the power of women’s education to decrease poverty rates, this is a welcome change indeed.

Elvis with Rolando, his father, at the school in Conce.

One condition that hasn’t changed, but perhaps will, is the lack of coliform-free drinking water in Agua Salada. Water tests conducted in 2013 confirmed the existence of E coli in the local water source. The community is excited to try out four new Sawyer International water filters, which will be placed at four central locations for all community members to use. Members of the local comite will train the community on the use of the long-lasting filters, which are reported to filter enough water for 100 people daily for over 5 years.

Community leaders Sabid and Samy teach water filtration to the community.

And the last change we noticed? The arrival of a beautiful, healthy, 9 pound girl in the community, just a brief two weeks before the November Brigade trip. Her parents have named her Erlinda Melissa, in honor of Linda Johnson, the University’s long-time Brigade director, and of Melissa, one of our most valued interpreters. Sometimes there is no way to express all we have meant to each other through the years, or how we have changed each other. But this comes close.

Erlinda Melissa, with her mother, Blanca.