Introduction
San Jose Partners was created by the Department of Family Medicine at the University of Rochester, in Rochester, NY. Given we are family physicians, medical care has always been a major pillar of our collaboration with the people of San Jose. Twice a year we run a medical clinic in San Jose. For many area people this is their best chance to be seen by clinicians who have received training from outside Honduras and therefore may have different skill sets. Additionally, we bring medicines that are often not available or not affordable in the region.
We do our best to provide essential medicines, and when needed, some specialty medicines that meet the needs of patients with chronic problems. We use a revolving drug fund approach. This means patients must pay for their medicines. The cost for medicines is very small because there is no profit involved and we do our best to procure medicines at low/no cost. A typical treatment for a common condition such as pneumonia or ear infection is usually less than $1. When compared to other facilities in the region our temporary pharmacy is well-stocked.
Common Medical Conditions
Given how hard the people of San Jose work most people are fairly healthy. The population is just now beginning the well known transition from diseases of poverty to diseases more commonly seen in affluent places. This means there is very little diabetes, hypertension, or obesity. We are just now seeing a small percentage of patients have enough resources to overeat and to reduce their daily hard physical labor resulting in the diseases of the affluent. When we first started seeing patients in San Jose we saw much more scabies, diarrhea, asthma, and occasionally tuberculosis. We like to think that improving access to potable water, building latrines, and reducing smoke exposure in the home from our interventions has helped reduce the incidence of these diseases.
| Common Conditions | Interventions | Unusual Conditions |
| Osteoarthritis Headaches Respiratory infections – upper and lower Urinary tract infections Sexually Transmitted diseases Rashes Vision and ear problems | Pregnancy Tests Urinalysis Microscopy Joint injections Ultrasound Cardiac rhythm strips OMT | Wolf Parkinson White Complete heart block Severe birth defects Seizure disorders |
Background/History
When we first partnered with San Jose we saw patients in existing adobe buildings with “exam rooms” being areas of a bigger room divided by plastic sheets. About 6-8 years ago the local government received a grant from Spain to build a clinic building. We now use that building when in San Jose and store our medicines and medical supplies in that building when not there. The clinic does not operate when we are not there, but not for lack of trying. Even before the new clinic was built we worked with the community to train a local person as a Community Health Worker (CHW). The community selected a person they felt would do well as a CHW. We paid for their two years of training with the understanding that person would need to work in the San Jose clinic at a reduced salary for two years. As the first CHW began work we repeated the process with another community member so that the clinic would always be staffed. What we found is that the CHW was only seeing 5-8 patients a week. Their main activity was to sell reduced cost medicines to patients who went to the government clinic in San Marcos, which is about 1-2.5 hour walk away (depending on where the patient lives in San Jose). After three years we decided to end the CHW program. A few years after we ended our intervention the government placed another CHW in the San Jose clinic. Their experience was the same as ours and they removed the CHW and posted her to the San Marcos clinic.
Home Visits
In addition to our work in the clinic we make multiple home visits to patients who cannot come to the clinic. Given the mountainous terrain a home visit can take all day and require more than two hours hike up and down mountains each way. Sometimes finding an isolated home can be a challenge, as can finding the way back to San Jose Centro.
Patient Education
In addition to curative medicine we educate the population on common health topics. Sometimes the educational sessions are impromptu to a crowded waiting room. Others are planned and scheduled educational interventions. Common talks include diarrhea and how to reduce risk; asthma; normal sexual maturation; sexually transmitted diseases; healthy eating, and many more.
