The shoulder to shoulder model-channeling medical volunteerism toward sustainable health change.
BACKGROUND
Rapid growth in medical volunteerism in resource-poor countries presents an opportunity for improving global health. The challenge is to ensure that the good intentions of volunteers are channeled effectively into endeavors that generate locally acceptable, sustainable changes in health.


METHODS
Started in Honduras in 1990, Shoulder to Shoulder is a network of partnerships between family medicine training programs and communities in Honduras and other resource-poor countries. The program involves short-term volunteering by US health professionals collaborating with community health boards in the host countries. The program has been implemented in seven US family medicine training programs and is supported by a small international staff.


RESULTS
During the 16 years of program operation, more than 1,400 volunteers have made visits to host countries, which include Honduras, Ecuador, and Tanzania. Clinics have been established, school-based food programs and community-based water filtration programs developed, and cancer screening and pregnancy-care programs put in place. These and other programs have been implemented on a budget of less than $400,000, raised through donations and small grants.


CONCLUSIONS
The Shoulder to Shoulder model allows health care professionals to channel short-term medical volunteerism into sustainable health partnerships with resource-poor communities. The resulting network of partnerships offers a powerful resource available to governments and foundations, poised to provide innovative interventions and cost-effective services directly to poor communities.
Heck
Jeffrey E
JE
Mountain Area Health Education Center, University of North Carolina, Asheville 28804, USA. Jeff.Heck@MAHEC.net
Bazemore
Andrew
A
Diller
Phil
P
D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration*; D005194:Family Practice; D006721:Honduras; D006801:Humans; D017146:Models, Organizational; D019982:Organizational Case Studies; D014838:Volunteers