Who are they and what is their role within the community? Why are they a leader, and how long have they been a leader?

They are farmers, leaders, men, women, and community health workers from various villages. San Jose is both a town and a township, and the township includes seven other villages.

What are the four biggest issues within their community?

1. Limited access to water and poor water quality.
2. Limited education.
3. Limited or difficult access to health care.
4. Malnutrition.
5. Underlying all these problems is poverty. Without resources, residents see no way to improve their situation.

Describe the health of the community.

Since the feeder road from the main highway was built five years earlier, residents reported some improvements in health. Common health problems include diarrhea, grippe, tos, scabies, pregnancy, and malnutrition.

What is the available health care in the community?

San Marcos and La Esperanza are the two closest health care centers. Residents cannot go to La Esperanza without a referral from San Marcos.

How far away is it?

It is a two-hour walk.

Where do women go for births?

Mostly at home, although some hospital deliveries occur.

Are there midwives in the community?

Yes, there are five lay midwives.

Where do the children go to school, and how many continue into high school?

San Jose has a kindergarten-through-sixth-grade school with about 150 children attending. About 20 children from the area attend junior high school in San Marcos.

The source notes some uncertainty about the local school structure. La Esperanza may be the closest place with either high school or a college preparatory school, while universities are in Tegucigalpa or San Pedro Sula.

The mayor of San Marcos asked for fundraising help so children could attend university through a scholarship fund.

What about the food and water in the community? What are the sources? Is it adequate? Is there seasonal variation?

Water

Water is described as the biggest problem. Many people spend one to four hours each day hauling water uphill, and walking distances increase during the dry season when closer sources dry up.

San Jose town has two streams. No spring was mentioned. A few people have installed cisterns and gutters to collect rainwater, but cost is prohibitive for many households.

Some cisterns have developed cracks and leak. The average home can get through the dry season with three cisterns holding about 1,000 gallons each. An NGO called SANA has helped in the San Marcos area by supplying materials while residents dug the holes.

Food

Compared with other villages visited, the survey says the San Jose area appears behind in farming advances. Residents understand terracing and the need for fertilizer but say they do not have enough money to use them.

The survey also notes that neighbors seem to pay each other for labor rather than share labor, and it found no evidence of drip irrigation or graywater use.

What do they want to be sure that we know about their community?

They are poor, but they want to improve their quality of life.

How big is the community?

• Estimated population: about 2,000 people.
• Estimated houses: 801.
• Estimated area: unknown, though the author estimated the eight villages were spread over about five square miles.
• Future plan noted in the source: GPS mapping of each village and possibly each house.

What past projects has the community worked on together to improve health and welfare?

• Helped with road construction.
• Continual help with road maintenance.
• School construction, including labor, water, and stone; sand had to be trucked in.
• Created a neighborhood watch.
• Worked with CARE and its feeding program.

Were past projects successful?

Yes. The projects listed in question 9 were described as successful.

What projects have been done by the government or NGOs in their area and what were the outcomes?

Road, school, and feeding programs were carried out by NGOs and or government agencies. San Jose also approached the Honduran government multiple times to improve access to health care.

How does the community pay for projects?

Residents reported having no money to contribute, so projects rely on communal labor and locally available resources such as water.

Is communal labor acceptable and practiced?

Yes, but some community members said communal labor would need better organization to be equitable.

Where do community members get their money? Are there others who support them?

Income comes from migrant farm work and working for local farmers who have more resources. The largest cash influx comes from Hondurans working in the United States or in Honduran cities and sending money back to family members in the area.

Do many community members have to leave for weeks or months to work for cash?

Almost all able-bodied men and even some women leave for two to five months for migrant farm work, usually from November through March.

Do leaders understand that having foreigners in their town will change the town, not always for the better?

The survey says villagers did not fully appreciate the downsides of foreigners. The discussion explored several possible issues:

• Poor language skills may be insulting, such as calling a man by a female label.
• Foreigners may value women’s input more than is locally acceptable.
• The Revolving Drug Fund would require paying more than the government’s set fee for all medications.
• Access to medications could improve, but cost would also be greater.
• Cultural and behavioral differences were discussed.

How much land can the town provide for a clinic and living quarters?

The survey notes that land is a major problem. Families were given fixed amounts of land years ago, but parcels may be reduced through sale during financial hardship or through inheritance splits among children.

The document says this leads to land that is too small to support a family. It also suggests that people with more money, possibly through relatives in the United States, could buy larger amounts of land and then sharecrop to the original land owners.

The UR group does not want to create a hospital. It wants a small clinic for outpatient problems. Is this acceptable?

The source says this point was discussed, but the author was not sure community members fully understood the concept. The document explains that the available resources and population base do not support building a hospital.

The best near-term expectation described in the survey is a small clinic staffed by a Honduran nurse, with the University of Rochester group visiting two to four times a year to extend the nurse’s services.

How does the community feel about a Revolving Drug Fund?

Discussed.

What are the expectations around employment with the UR project?

The source records that the topic was discussed. It also notes that the University of Rochester would not be able to offer many jobs, may not offer year-round jobs, and would need to pay locally appropriate wages when jobs are available.

Will the town agree to create a health committee to work with the UR group?

Agreed. The survey notes discussion of the role of women in caring for children and families, and it says the group agreed that men often spent resources on things other than the family.