In addition to offering educational experiences to medical students and residents from foreign institutions, the Department has developed an International Health focus for the curriculum of its Northwest Health Center residency program.

The Northwest Health Center track has been developed to serve the indigent and the medically underserved population of Houston and to prepare residents to deal with the multifaceted issues involved in serving urban populations of large metropolitan areas. In addition, the Department has targeted the track to eM.P.H.asize international health as a means to prepare our residents to develop a sense of global responsibility and to serve the needs of the increasing cosmopolitan population living in Houston as well as in other areas of the United States and the world.

The international health curriculum involves a regular conference series on international health topics and the offering of special rotations abroad to our residents.  Residents in each year of training may elect study abroad of one month’s duration.

The Baylor Department of Family & Community Medicine has recently established a cooperative effort with the Village of Santa Ana, Honduras.

Santa Ana, Honduras, is a small village of about 700 inhabitants, located in the mountains of Western Honduras, bordering El Salvador.  Located in an area formerly involved in a border dispute between Honduras and El Salvador, Santa Ana is geographically and perhaps politically isolated, and its resources have been few.  There is good water supply for the town but no electricity or telephone services.  Access to Santa Ana involves nine hours of travel via unpaved roads through the mountains.

Community activism in the past decade has resulted in the construction of a road for access from the larger town of Colomancagua, an hours’ drive away, and in some improvement in education and healthcare.  The Ministry of Health built a small health center that is staffed five days per week by a nurse.  However, the town and its large surrounding rural population have no physician, and medication supply is unreliable.  The nearest hospitals are 1-1/2 hours away in El Salvador and 5 hours in La Esperanza, Honduras.

Leaders of the Department of Family and Community Medicine of Baylor College of Medicine were invited by community leaders in Santa Ana to create a relationship, with the goal of improving health in this area.  This alliance would offer the people of Santa Ana a higher standard of healthcare and would afford an ongoing opportunity for Baylor residents, students, and faculty to be involved with international health in an underserved area. 

Teams of physicians and students from Baylor will periodically visit Santa Ana to conduct health clinics and to do community-oriented primary care.  The first health team from Baylor visited Santa Ana in February 2001; over one thousand patients were seen and excellent progress was made in community health assessment and plans to improve healthcare in the area.  Baylor will be continually involved with Santa Ana to provide more reliable medication supply and to ultimately help community leaders build an improved healthcare facility there and to procure local physicians for continuous healthcare. 

A similar alliance has been in progress for the past decade between the village of Santa Lucia and the Department of Family Medicine at the University of Cincinnati (UC).  Santa Lucia is approximately two hours’ drive from Santa Ana.  Dr. Jeff Heck, who leads the UC program known as Shoulder to Shoulder, ultimately brought community leaders from Santa Ana together with leaders at Baylor.  All involved have suggested that the Baylor program might also be known as Shoulder to Shoulder, and the two programs would informally work together to improve rural health in Honduras.

An endowment is being established at Baylor College of Medicine to provide ongoing financial support for the Shoulder to Shoulder-Houston program.  The endowment will fuel the effort to improve healthcare in this truly underserved area in Honduras and will help educate future leaders in medicine, in a personal way, about international health, public service, and the provision of healthcare services in isolated areas with scarce resources.