As a family doctor and professor, William H. Markle, of Jefferson Hills, has seen his share of patients locally.

But Dr. Markle also has another set of patients in a mountaintop village in Honduras.

Since 2000, when parts of Honduras were still recovering from the devastation of Hurricane Mitch, which hit in the fall of 1998, Dr. Markle has been organizing medical brigades of nurses, dentists, physicians and medical students to travel to the village of San Jose in Honduras to provide basic medical care for its residents.

The groups travel to San Jose twice a year, usually in April and October, and take with them what they hope is enough medicine and medical supplies to last the village and its surrounding residents for the six months.

A local brigade left on Monday, and, along with its usual duties, this time hopes to hire staff for the medical clinic it has built in San Jose and to increase the number of people using filters for the stream water used by villagers.

There are about 1,500 people living in San Jose and about 6,500 more in the surrounding area who come to doctors for treatment.

Strictly volunteers

The members of the medical group donate their time and services and pay for their travel costs. They also raise money to purchase the medicine and medical supplies they take. Some take vacation time from their jobs to go.

The brigades fly into San Pedro, Honduras, the nearest large city. The group has formed a nonprofit fund-raising organization, Shoulder to Shoulder Pittsburgh-San Jose Inc., which is based at the University of Pittsburgh's department of family medicine. Dr. Markle is clinical assistant professor of family medicine at Pitt's School of Medicine and director of the family medicine residency program at UPMC McKeesport.

Shoulder to Shoulder was formed in conjunction with Cincinnati-based Shoulder-to-Shoulder Inc., which was started in 1996 to provide healthcare services in rural Honduras.

Currently, the San Jose clinic, built within the past 18 months with funding from the local group, is open only when the Pittsburgh-area medical groups travel there. But if a nurse or nurses can be hired to staff it, the clinic could be open year-round, Dr. Markle said.

Though Dr. Markle has been on eight trips, he isn't part of this brigade. It is headed by his partner in the venture, Dr. N. Randall Kolb, co-director of the family medicine residency program at UPMC Shadyside.

In January 2004, Dr. Kolb received a Jefferson Award for his volunteer work in treating the homeless of Allegheny County. Dr. Kolb originally spent time in Honduras helping to treat people in the wake of Hurricane Mitch. When he returned to the area, he discussed his experience with Dr. Markle, who had spent eight years in Honduras, before returning to the area.

Together the doctors met with the national Shoulder to Shoulder group to set up the program. At first, the doctors used a kindergarten building as their clinic and residents gave up their homes for brigade members to use while there during their two-week stints.

But the clinic now serves for treatment and sleeping quarters. Brigade members bunk in sleeping bags on the floor.

The medical team does not take appointments; people line up at the door. They do keep charts and information on patients and see many of the same people every six months. Among the conditions they've treated are injuries and burns, and chronic health conditions such as high blood pressure, heart disease and diabetes.

Daily meals

One of the first things the group established was a nutrition program providing children with a meal a day, since volunteers found that 50 to 60 percent of the children were malnourished. Food is purchased through an agency in Honduras and is prepared by mothers in the village. As funding allows, Dr. Markle said, more children from outlying areas will be added to the program.

Childhood immunizations are provided by the Honduran government, but villagers bring their children to the clinic for well-child checkups and other medical issues, Dr. Markle said.

The brigades also have conducted education programs on such topics as hygiene and dengue fever, a viral illness transmitted via mosquito bites. Dr. Markle said patients with conditions that are too advanced or too serious for the brigades to treat are referred to hospitals, which are about two hours away.

It's not uncommon for folks in the brigade to help pay for medical care that may be needed by a patient. Dr. Markle said during one trip to San Jose, the group met with a mother whose baby had hydrocephalus, an abnormal buildup of fluid in the brain.

The mother had taken the child to the hospital but couldn't afford the shunt that relieves fluid buildup and pressure on the brain. Without it, the child would die; with it, he'd lead a fairly normal life.

Members of the brigade took up a collection, then took the mother back down the mountain, bought the shunt and took it to the hospital, where it was put in.

"I saw that child the last time I was there and he looked quite well," Dr. Markle said. "I felt good about that."